Pox_ An American History - Michael Willrich [72]
On the eve of the war with Spain, the professionalization of the Army Medical Department was still a work in progress. As was the case with practitioners in many other disciplines at the turn of the century, including law and civilian medicine, the military surgeons’ claims to the rigor and status of a science outpaced the workaday reality. Under U.S. military law, neither their medical credentials nor their commissioned ranks entitled medical officers to command in the line. The surgeons could only make recommendations regarding camp sanitation to the line officers, who decided whether to implement them. In the past, many line officers had shown little patience with regimental surgeons, insisting that their intrusions interfered with military discipline. During the Civil War, one Union Army colonel had shrugged off his medical officer’s complaint that the camp smelled of excrement, insisting the stench was “inseparable from the army. . . . [I]t might properly be called the patriotic odor.” (No wonder Whitman recalled that war as “nine hundred and ninety-nine parts diarrhea to one part glory.”) By 1898, many line officers and soldiers had grown more respectful of the surgeons’ expertise, and the medical corps consequently wielded greater authority over camp conditions. But the national military school still did not offer a course in hygiene. And the advance of scientific medical knowledge since the Civil War had eliminated neither the patriotic odor nor the old tension between line officers and their medical men.24
Even within the medical corps, the new knowledge of the microbe did not overthrow older ideas about disease causation that centered on the relationship between bodily constitutions and their geographical environments. Major Reed and two other senior department surgeons, who toured many of the training camps in 1898, found that even “intelligent medical officers” instinctively looked for the sources of camp epidemics in “intangible local conditions inherent in the place.” It was as if the old miasmatic theory of disease remained unchallenged. “There is apparent in man a tendency,” noted Reed and his colleagues, “to believe in the evil genius of locality.” Military surgeons still relied more on their senses than their microscopes, reflexively associating filth and foreign surroundings with pathogens.25
When Congress declared war against the Kingdom of Spain, on April 21, 1898, the U.S. Army consisted of just 28,183 men, stationed at eighty posts across the nation. Apart from the late-century campaigns against the Indians, in which many men of the current officer corps had participated, the Army had not fought a war in thirty-three years. By the end of May, the Army mustered in 125,000 Volunteers, men from all walks of life whose military experience was limited to service with their state volunteer militias, units of the National Guard. The regiments bound for Cuba and Puerto Rico assembled throughout the spring and summer in camps in the southeastern states. After Commodore George Dewey’s victory in Manila Bay, the Army mobilized an expedition in the western states to steam across the Pacific and take possession of the Philippines. By mid-August, when the fighting with Spain ceased, the Regular Army and the Volunteers had a combined strength of over a quarter million men—the great majority of them inexperienced volunteers.26
The War Department and its medical branch were unprepared for this sudden buildup. Like the Army itself, Sternberg’s Medical Department was a stripped-down affair during peacetime. The department had no stockpile of supplies and no ready reserve of field-tested surgeons. Many of the older surgeons had been serving at desk jobs and were in no shape to take the field. To the small corps of properly trained field surgeons were hastily added more than one hundred commissioned officers and nearly four hundred medical officers from the state militias. During the summer, the Army would add