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Charles Field Mason.

A complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia online

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iron pipe called the house drain, and finally the house drain beyond
the walls of the house terminates in the sewer. The arrangement
of the house drainage system is well shown in Fig. 229.

Traps are used on all fixtures, and these traps are usually vented
to prevent siphonage. The purpose of the traps is to supply a water
seal to prevent sewec gas from getting into the dwelling ; the three-
quarter S-trap is the type (Fig. 230). The flask trap used by the
Quartermaster's Department for lavatories and sinks is practically
the same as an S-trap in its interior arrangement. In yards and

(349)



350 HYGIENE. POST AND CAMP SANITATION

basements where the flow of water is intermittent a particular type
of trap known as the bell trap is generally employed (Fig. 231) ; the
objection to this trap is that in order to be efficient both the cover
and the water seal must be in place, while as a matter of fact the
one is often misplaced and the other soon lost by evaporation. A
much better type of trap is shown in Fig. 232.



F





FIG. 229. House Drainage. A, B, C, Plumbing fixtures; D, disconnecting trap; E,
branch sewer; F, ventilation opening; G, house drain; K, H, vent pipes connected by
dotted lines with each trap.

Sewage is disposed of by discharging into cess-pools, into run-
ning streams, upon sewage farms, and by the bacterial purification
methods.

The purpose of the bacterial purification systems, which are now
being used in the army to a considerable extent, is to liquefy and
purify the sewage so that it may not unduly pollute the streams into
which it is discharged. They consist essentially of two parts, a
closed tank in which the bacteria which work in the absence of air
liquify the organic solid matters, and a series of filter beds in which
the nitrifying or air-using bacteria continue the purification until
the sewage should emerge as a clear, colorless liquid like water.

Garbage is best disposed of by burning in a crematory which is
usually in operation in all the larger posts.

In the field the disposal of wastes, especially excreta, becomes a
matter of greatest importance and considerable difficulty.

Abundant experience has proven that whenever large bodies of
soldiers are collected together typhoid fever is sure to be introduced



THE DISPOSAL OF WASTES



351



by some one, and that, unless the command is vaccinated and proper
disposal made of excreta, the disease will spread through the agency
of infected water, food, bedding, clothing, soil, dust, or flies.



A





FIG. 230. Different Forms of Traps. A, Running trap; B, S-trap; C, | S-trap; D, \ S-trap.

Latrines for the men are always located on the opposite side of
the camp from the kitchens, generally one for each company unit

and one for the officers of a battalion or
squadron. They are so placed that the
drainage or overflow can not pollute the
water supply or camp grounds.

When the camp is for one night only,
straddle trenches suffice. In camps of
FIG. 231. Beii Trap. longer duration, and when it is not pos-
sible to provide latrine boxes, as for permanent camps, deeper
trenches should be dug. These may be used as straddle trenches
or a seat improvised. When open trenches are used the excrement
must be kept covered at all times with a layer of earth. In more
permanent camps the trenches are. not over 2 feet wide, 6 feet deep,
and 12 feet long, and suitably screened. Seats with lids are pro-
vided and covered to the ground to keep flies from reaching the
deposits; urinal troughs discharging
into the trenches are provided. Each
day the latrine boxes are thoroughly
cleaned, outside by scrubbing and in-
side by applying when necessary a coat
of oil or whitewash. The pit is burned
out daily with approximately one gal-
lon oil and fifteen pounds straw.
When filled to within two feet of the
surface, such latrines are discarded,
filled with earth, and their position
marked. All latrines and kitchen pits
are filled in before the march is re-
sumed. In permanent camps and can-
tonments, urine tubs may be placed in the company streets at night
and emptied after reveille.




FIG. 232. Improved Yard Trap.



352 HYGIENE. POST AND CAMP SANITATION

The proper disposal of garbage and stable refuse in camps is also
a matter of importance, otherwise they pollute the soil and become a
breeding place for swarms of flies ; everything which is combustible
must be burned ; what can not be burned must be buried.

The burning may be done in the kitchen fire, or the solid garbage
may be mixed with more combustible matter such as straw or
manure, saturated with petroleum and burned. Manure should be
burned in the same way as far as practicable.

In more permanent camps crematories should be provided. The
following crematory has proven very effective in practice.



Am CUORPNT MWK rrJr ***** *"* CURBENT




FIG. 233. Crematory Vertical Section. A A, Ground level.

At some convenient spot at the rear of the camp, a circular pit
is dug three feet deep and fifteen feet in diameter. The bottom is
covered with loose stones to the depth of fourteen to sixteen inches.
On this is built a circumferential wall to the height of one foot
above the original ground level, and the excavated earth is packed
against it, clear to the top so as to provide a sloping approach and
thereby prevent surface water gaining access to the pit. A pyra-
mid of large stones, four or five feet high, occupies the center. This
feature is essential to provide central draft and steady fire.

The bottom stones receive the liquid portions of the garbage
without affecting the fire, and the heated stones soon evaporate and
dissipate it. The solid portions are soon desiccated and become
fuel. Care should be exercised to empty the garbage into and not
around the crematory.

The following rules for the sanitation of camps sum up the whole
subject:

(a) When practicable, camps should be established on high and
well-drained ground not previously occupied.

(&) Men should not lie on damp ground. In temporary camps
and in bivouac they raise their beds if suitable material, such as
straw, leaves, or boughs, can be obtained, or use their ponchos or
slickers. In cold weather and when fuel is plentiful the ground may



THE DISPOSAL OF WASTES 353

be warmed by fires, the men making their beds after raking away
the ashes.

(c) Tent walls are raised and the bedding and clothing aired
daily, weather permitting.

(d\ In camps of permanence excreta should be disposed of by
sewers or incinerators.

(e) All kitchen refuse should be promptly burned or buried, and
perfect sanitary police maintained.

(/) The water supply is carefully guarded. When several com-
mands are encamped along the same stream this matter is regulated
by the senior officer.

If the stream is small, the water supply may be increased by
building dams. Small springs may be dug out and lined with stone,
brick, or empty barrels. Surface drainage is kept off by a curb of
clay.

When sterilized water is not provided, or when there is doubt as
to the purity of the water, it is boiled twenty minutes, then cooled
and aerated.

(g) The discharges of patients with typhoid fever, camp diar-
rhea, or cholera should always be disinfected at once with a solutio'n
of phenol (5 per cent) or of chloride of lime (six ounces to the
gallon of water), or with milk of lime, made from fresh quick-lime.

(h) The diseases just mentioned are frequently communicated to
soldiers in camp through the agency of flies, which swarm about
fecal matter and filth of all kinds, and directly convey infectious
material, attached to their feet or contained in their excreta, to the
food which is exposed while being prepared at the company kitchen
or while being served in the mess tent. The water supply may be
contaminated in the same way, or by surface drainage. Infection
is also often carried on the hands and shoes. It is for these rea-
sons soldiers are required to wash their hands before meals and after
visiting the latrines, and that all kitchens and mess shelters should
be screened to exclude flies.

(i) If it can be avoided, marches should not be made in the
hottest part of the day.

(/) When called upon for duty at night or early in the morning
a cup of hot coffee should be taken.

(fc) It is unsafe to eat heartily or drink freely when greatly
fatigued or overheated. If alcoholic drinks are used at all, such use
23



354 HYGIENE. POST AND CAMP SANITATION

should be postponed until after the day's march and preferable in
conjunction with the evening meal.

(/) Ripe fruit may be eaten in moderation, but green or over-ripe
fruit will give rise to bowel complaints. Food should be thoroughly
cooked and free from fermentation or putrefactive changes.

(m) In decidedly malarious localities from three to five grains of
quinine should be taken three times a day as a prophylactic, but the
taking of quinine as a routine practice should only be recommended
under exceptional circumstances.

The best safeguard against malaria is, however, the protection of
the body against the bites of infected mosquitoes. To this end mos-
quito nets should be used whenever available in malarial localities
or seasons, and if not available the skin should be as far as possible
covered during sleep.

(M) Light woolen underclothing should be worn, and when a
soldier's clothing or bedding becomes damp from exposure to rain
or heavy dews the first opportunity should be taken to dry it in the
sun or by fires.



CHAPTER IV

DISEASE PREVENTION

IN chapter XIII of the section on " Nursing" the infectious dis-
eases have already been discussed as far as the prevention of their
spread in posts is concerned.

While there are no diseases entirely peculiar to camp life, there
are certain diseases which are specially apt to become epidemic
under the more crowded conditions which necessarily prevail in
camps.

Among the more notable of these diseases are typhoid fever and
malarial fevers, diarrhea and dysentery, the eruptive fevers,
bronchial troubles and rheumatism, and in certain climates yellow
fever and cholera.

Typhoid fever. To prevent typhoid fever in the field all soldiers
should be vaccinated with the typhoid prophylactic; in addition all
urine and feces must be disinfected ; soil pollution must be prevented ;
flies must be destroyed ; drinking water must be boiled ; men must
not be allowed to bathe in polluted water lest they get it into their
mouths; in permanent camps the kitchens and messes must be
screened against flies and all food protected from both flies and dust.

Flies breed in decayed organic matter, especially in stable manure,
which should, therefore, never be allowed to accumulate in camp or
garrison. In their reproduction flies pass through the stages of
ovum or egg, larva or maggot, pupa, and adult. They carry not
only typhoid fever but also cholera, tuberculosis, and probably other
diseases. Besides the common fly which carries these diseases on its
feet and body there is a biting fly, known as tsetse, which transmits
sleeping sickness and other trypanosome diseases, by biting, in the
same manner as a mosquito transmits malaria.

Malarial fevers. We have seen that malaria is spread in one way
only, that is by the bites of the anophelina mosquitoes which have
previously bitten a human being who has malaria. As protection
against malaria involves mosquito destruction, it is necessary to
learn something about the life history of mosquitoes.

(355)



356 HYGIENE. POST AND CAMP SANITATION



Though all mosquitoes are annoying, only three kinds, as far
as we know, carry disease; these are the anophelince, which carry
malaria ; culex fatigans, which carries dengue and in certain localities
in the tropics a blood worm (filaria) which causes elephantiasis;
and cedes calopus, which carries yellow fever.

It is the female mosquito only that bites, and therefore the female
only which conveys disease. Ldes calopus (the yellow-fever
mosquito) is especially a day biter, and where mosquitoes are found
biting in the daytime they are apt to be of that variety. Then again
cedes calopus is the blackest mosquito, and is beautifully marked with
silver bands on the legs and body ; a lyre-shaped silver mark on the

back is characteristic and
identifies cedes calopus at
once. This mosquito is of
medium size (Figs. 234, 235).
The anophelince (the ma-
larial mosquito), Fig. 236,
differ from culex and ste-
gomyia in having palpi as long
as the proboscis in the female :
this mosquito differs also from
the other two in that the body
and proboscis of the anoph-
elince form one straight line,
while the other mosquitoes
are humpbacked. The resting
position of the anophelince is
nearly vertical to the surface,
while that of cedes calopus
and culex approaches the hori-
zontal (Fig. 237).
The males of all mosquitoes are distinguished from the females
by the fact that the former have feathered antennae (woolly heads),
while the latter have not (Fig. '247).

The yellow-fever mosquito is essentially a domestic or house
mosquito ; that is to say, she breeds in small collections of water such
as are found about a house, and does not stray far from home.
The malarial mosquito is a rural or country insect; breeds in large




FIG. 234. AJdes calopus, male.



DISEASE PREVENTION



357




pools, the still edges of running streams, irrigating ditches, etc.,
and is found far from human habitations.

When one of these mos-
quitoes bites a person afflicted
with the disease which she is
capable of carrying, she sucks
a little blood and with it the
germs of the disease. After
a week or two these germs re-
produce themselves in the
mosquito, migrate to her sali-
vary glands, and she then be-
comes capable of infecting
other persons. If she now
bites such a person, she in-
jects into his blood with her
saliva some of the germs, and

after a variable period, known Fic . 2K . jdes caiopus, female.

as the period of incubation, that person is usually taken down with
the disease.

The measures to be taken
to prevent such diseases are
destruction of mosquitoes,
protecting the mosquitoes
against infection by screening
infected persons and in the
case of malaria destroying the
germs in their blood by the
use of quinine ; protecting well
persons from infection by the
use of screens and nets, and in
the case of malaria, by the use
of quinine to render the blood
insusceptible to infection.

Mosquitoes breed only in
water, but very little water is
required for the purpose. The female deposits her eggs to the num-
ber of 40-400 upon the surface of the water, and after a period of




FIG. 236. Anopheles maculipennis (quad-
rimaculatus), female.



358 HYGIENE. POST AND CAMP SANITATION



twenty- four hours to two or three days they hatch, becoming larva or
wiggle-tails; the larval stage last one or two weeks until the pupa





FIG. 237. Resting posture of mosquitoes: i and 2, Anopheles; 3, Culex Pipiens.



form; after two to five days
imagos or adult insects emerge




FIG. 238. Culex pungens, male.

we prevent mosquito breeding.
This is accomplished by drain-
ing and filling, and by remov-
ing all small articles capable
of holding water. Collections
of water that can not be re-
moved should be closely cov-
ered and screened, or else
oiled with petroleum, about an
ounce to each fifteen square
feet of surface, the peiroliz-
ing being repeated about once
a week.



more the pupal shells split and the

(Figs. 240 to 246).

The entire transition from
egg to adult insect requires
from ten days to two or three
weeks.

Any collection of water,
provided it is moderately still,
answers the mosquito for
breeding purposes. They
breed in marshes, ponds,
ditches, rain barrels, cisterns,
gutters, watering troughs,
hoof-prints, old tin cans, in
fact anything capable of hold-
ing water. By allowing no
unprotected water collections




FIG. 239. Culex pungens, female.



DISEASE PREVENTION



359



FIG. 240. A raft of Culex ova.




FIG. 241. Patterns assumed by Ano-
pheles ova.





FIG. 242. Egg. Anopheles maculipennis FIG. 243. Larva of Anopheles mosquito.
(quadrimaculatu s) .





FIG. 244. Larva of Anopheles maculi-
pennis (quadrimaculatus).



FIG. 245. Larva of a Culex mosquito.



360 HYGIENE. POST AND CAMP SANITATION



Adult mosquitoes may be destroyed by fumigating with sulphur
or pyrethrum in the closed apartment, using about one pound to the
thousand cubic feet of air space ; if pyrethrum is used the mosqui-
toes are only stupefied and must be subsequently swept up and
burned.

Other measures for destroying mosquitoes are the clearing away
of all vines, brush, tall grass, and undergrowth ; such conditions do
not breed mosquitoes, but they give them shelter against the winds,
which would otherwise blow them away.

In the tropics the natives, especially the children, often carry
malarial parasites in the blood, even though they show no sjgn of
the disease, therefore camp should not be
made in native villages and natives should not
be allowed about the barracks.

In the field it is usually impracticable for
soldiers to sleep under mosquito nets, but
where malaria prevails a considerable degree
of protection may be secured by requiring each
soldier to wear gauntlets and a small head-net
while asleep or on guard.

Yellow fever resembles malarial fever in its
method of spread, and in the measures of pre-
vention except that quinine has no value in
prevention and is harmful in treatment. Yel-
low fever differs from malarial fever in that
its course is always acute, the fever seldom
lasting longer than five to seven days, and
especially in that an attack affords almost
complete protection against a second, while
in malaria one attack seems to predispose to
others, and the infection of malaria may re-




pheles; 3,



Calopus.



Diarrheas which are so prevalent among troops in the field are
due to a variety of causes. Infection of food by flies, faulty cook-
ing, overeating, improper food, particularly that purchased from
camp venders, exposure to chilling, especially at night, and impure
water are common causes. Many diarrheas are probably merely
symptomatic of graver disorders such as typhoid fever or dysentery.

The proper preventive measures are the supply of proper food



DISEASE PREVENTION



361




well cooked and protected from flies, the suppression of camp
venders, the furnishing of sterilized drinking water, and the general
use of woolen undershirts sufficiently long to cover the abdomen;
such a shirt is much better than an abdominal band.

The dysenteries are of three types, the catarrhal, due to exposure
and improper food ; the bacillary or epidemic form, and the amebic
or tropical form of dystentery ; the last two forms are infectious and
the measures of prevention are the same as in typhoid fever.

The eruptive fevers are especially apt to occur and become epi-
demic when large numbers of young men are brought into the inti-
mate contact of the camp ; the
general method of preventing
their spread has been dis-
cussed, but it is necessary to
describe here in detail the
special and most important
preventive measure against
smallpox, viz., vaccination.

Vaccination is the process
of inoculating a person with
vaccine virus, producing the
condition known as vaccinia.

Vaccinia is an eruptive dis-
ease of the cow, the virus of
which when inoculated in
man produces a' local pock
with constitutional disturb-
ance, and protects against
smallpox; vaccinia is proba-
bly smallpox of the cow, but
it has not been proven that
such is the case.





FIG. 247. Heads of mosquitoes: i and 2,

male and female Culex punpens; 3 and

4, male and female Anopheles; 5 and f,
male and female -'<des Calopus.



Bovine vaccine virus, that is, virus from the calf, is now used to
the exclusion o.f human virus on account of the danger with the
latter of transmitting human diseases.

Vaccine is usually provided either on bone points or in capillary
tubes ; in either case the virus is preserved by glycerin, but it gradu-
ally loses its power and becomes inert ; it should always be kept in
a dark, cool, dry place.



362 HYGIENE. POST AND CAMP SANITATION

In performing vaccination it should be borne in mind that it is a
surgical operation and that the same care must be taken to prevent
infection as in any other operation. The hands of the operator,
the surface operated upon, and everything coming in contact with
either should be as nearly sterile as possible; at the same time it
must be remembered that active antiseptics will destroy the vaccine.

" The skin at selected site must be clean; antiseptics are not nec-
essarily employed; should they be used they must be washed away
with sterile water that the activity of the virus be not destroyed.
Washing with warm water, followed by alcohol, is usually sufficient,
the alcohol being permitted to evaporate before proceeding. Scrub-
bing with soap and water is necessary for a dirty skin, but needless
irritation of the skin is to be avoided.

" Incision is the method of choice and it should be made with the
point of a sterile needle, producing a ' scratch.' A sterile scalpel may
be used, but is more likely to cause bleeding. The incision or
scratch should preferably not draw blood. There should be at least
two incisions, three-quarters of an inch long and one inch apart;
after exposure to small pox four incisions will be made. The virus
is then placed upon the abraded surface and gently rubbed in,
unnecessary irritation being avoided."

" The wound is allowed to dry thoroughly and can be left without
dressing, though several layers of gauze may be applied with
adhesive plaster. Any dressing that retains heat and moisture is
bad. Shields will not be used."

If a vaccination takes properly, about the third to the fifth day
after the operation a small papule or pimple will be noticed at the
spot scarified; by the seventh day the papule has become a vesicle
or blister depressed in the center; by the eighth or ninth day the
vesicle has become full size and an areola or red blush appears
around it ; at the same time the glands under the arm become a lit-
tle swollen and painful, and there may be some fever and general
discomfort ; on the eleventh or twelfth day the redness and soreness
begin to disappear, the contents of the blister become cloudy, and it
begins to dry up, forming a scab which drops' off about the twenty-
fourth day, leaving a characteristic pit or pits which is the sign of a
successful vaccination.

Vaccination does not always follow this typical course ; sometimes
the whole duration of the inflammation is much shorter, and the pit



DISEASE PREVENTION 363

or pock is not so marked; this is especially apt to be the case in
revaccination. Sometimes, especially when the operation has been
carelessly done or the vesicle is prematurely broken, violent inflam-
mation results, with sloughing and ulceration. Occasionally the
vaccinia is generalized, vesicles forming at other points on the arm,
or even over the entire body.

Cholera (Asiatica) runs its course very acutely in typical cases,
oftentimes terminating fatally in twenty-four hours. It is character-
ized by violent vomiting and purging the discharges soon becom-
ing like water by great prostration and muscular cramps. It
must not be forgotten, however, that the only symptom may be an
ordinary diarrhea, and that such cases are just as infectious as the
severe type. The preventive measures are described on page 254.



CHAPTER V

SANITATION IN THE FIELD

The selection of a camp site will often depend upon military con-
siderations ; the essential requirements are wood, water, and grass,
and from a sanitary standpoint dryness, elevation, and some pro-
tection from winds.

An old camp site should never be occupied because the soil is cer-
tain to be polluted and probably infected ; outbreaks of typhoid fever
and cholera have repeatedly followed the occupation of old sites.

Sites covered with rank vegetation should be avoided, as such
vegetation indicates excessive moisture. Open woods are not un-
favorable camp grounds, as they afford some protection from sun
in summer and winds in winter, but dense woods should never be
occupied on account of the dampness, stagnation of air, and decay-
ing vegetation. All underbrush should be removed from camp, but
sod should not be disturbed.

Tents, as soon as pitched, must be trenched; if the tent site is
covered with grass the grass should be cut or pulled up, because it



Online LibraryCharles Field MasonA complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia → online text (page 26 of 38)