From April, 1855, to June, 1856, comparatively few cases of dysentery appeared, showing how greatly the improved hygienic condition of the army influenced the development of this " camp pest." Very few, indeed, who served in the Crimea throughout the first winter escaped an attack of dysentery; and it is in keeping with my observation, that most of those who escaped entirely were officers who seldom ate the salt pork, but who subsisted on fresh food, which their private means enabled them to procure. The proportion of officers to men who suffered from either of the complaints specified, up to April, 1855, I have not been able to ascertain. The prevalence of ulceration of the intestines, especially towards the lower part, was perhaps the most taut of all the conditions found on postmortem examinations in the East, and was almost universal in cases of enteric disease.
The immense those who served during the early part of the war weresoati'eeted. the ulcvratimi being rather of recent than ancient date; and remark does not apply to those alone who died of abdominal affections, but also to those who succumbed from other diseases, or from wounds. It is also a fact, which I have had many opportunities of verifying, that men killed in action at a time when they were apparently in the possession of health, or rather, as it should be put, men dying shortly after receiving severe wounds when seemingly robust, were found to have ulcers in their intestines, sometimes of a very extensive character. To this it was not uncommon to find diseased kidneys and lungs added.
The disease, in these cases, might not be active at the period of death, but it was ready to break out whenever any injury or operation made an extra demand on the powers of life. It is of importance to note this extraordinary prevalence of undeveloped disease ptive character in the appearance ot' the men ig on their behaviour under accident. The pies afforded by post-mortem examinations of rinal ulcers in all stages of increase, and of cure, v and interestin.-r. The influence which the intestinal flux had, when ' with scurvy, to modify and restrain the oihcr tions of the blood disease, and the marked manner in which abdominal;;! to prevent th.- di-vrlopm.-nt ot' th<>iv M of a tubercular descr niplili.-d in the Crimea.
This derivation, as it may be termed, had more to do with the striking immunity from phthisis which prevailed, than any goodness in the climate, as, if it had not been for this counteracting agency, the other exciting causes to which the troops were exposed in such abundance, would have been more than sufficient to overbalance the advantages of any climate. Of phthisis, only 279 cases appear in the returns during the whole war, and 116 deaths in the East. I know, however, that many who there showed no symptoms of the disease, subsequently succumbed to it. Of fever (not typhus), 30,376 cases and 3,161 deaths therefrom appear in the returns; March, 1855, was the month when it most prevailed, and 21*0 per cent, the mortality during that month, and 10'4 the per-centage of mortality in the cases treated throughout the war.
In this " Crimean fever," there was nothing whatever peculiar, unless the absence of any great febrile action, the rapid prostration, slow convalescence, and proclivity to relapse be taken as specialities, which they were not, in my opinion, as in nothing did this fever differ from the typhoid fever seen in large cities, especially in Paris. It often followed dysentery, which, by reducing the patient's strength, prepared the way for this " fever," as it was termed, but which, in these cases, was the mere development of great vital prostration, with the complications that were to be looked for in such a sequence. The characteristic spots were not always present, relapses were frequent, and during convalescence, tuberculosis was not uncommon.