Surgical Experiences in South Africa, 1899-1900 | Page 7

of the most troublesome of these was
diarrhoea, which gained the appellation of 'the Modders,' already a
classical name as far as South Africa is concerned. This most
frequently, I think, depended on errors of diet, combined with the
swallowing of a large amount of sand with the food as dust, and in the
water drunk. Cases of severe dysentery, however, were also not very
uncommon. Rheumatic pains were a common ailment, which,
considering the dryness of the atmosphere, would hardly have been
expected. Continued fever of a somewhat special type was not
uncommon, and was sometimes spoken of under the name of the
district, sometimes as veldt fever--of this I will say nothing, as others
better fitted to point out its peculiarities will no doubt deal with it.
Enteric fever, our chief scourge, I will pass over for the same reason. I
might, however, remark from the point of view of one not very
experienced in this disease, that in a large number of the fatal cases I
happened to see, the actual cause of death seemed to me to be
septicæmia from absorption from the mouth. The mouths were
unusually bad, even allowing for the often insufficient cleansing that
was able to be carried out, and I was inclined to attribute these in some
degree to the dryness of the atmosphere, which very quickly and

effectively dried up the mucous membrane of the mouth in patients not
breathing through the nose, and encouraged the formation of large
cracks. Pneumonia was rare, and this was rendered the more striking
from the comparatively large number of men who contracted the
disease on board ship on the voyage out from England.
As will be gathered from the above, medical disease seldom called for
the aid of the surgeon. Abdominal section was occasionally considered
in cases of perforation in enteric fever, and was, I believe, a few times
performed, but as far as I know without success. It was also proposed to
treat some of the severe dysentery cases by colotomy, but I never saw
the method tried. As far as I was concerned I never met with a case of
either disease I thought suitable for the treatment. I saw one case in
which an abscess of the liver had followed an attack of enteric, which
had been successfully treated by incision, and a few cases of tropical
abscess which probably came into the country were also subjected to
operation. Some cases of appendicitis, as would be expected, also
needed surgical treatment. In a few instances empyema followed
influenza, and a few cases of mastoid suppuration had to be dealt with.
Of surgical diseases the one most special to the campaign, although not
of great importance, was the veldt sore. This was a small localised
suppuration most common on the hands and neck, but sometimes
invading the whole trunk, more particularly the lower extremities
however, when the covered parts of the body were attacked. The sores
were no doubt the result of local infections; they reminded me most of
the sores seen on the hands of plasterers, and I think there is no doubt
the dust was responsible for them. I think piles were somewhat more
prevalent than they should have been among the men, but this was
probably dependent on the strain involved in defæcation in the
squatting position, since the soldiers were for the most part regularly
attentive to the calls of nature.
I saw a good many cases of lightning stroke, and some were fatal.
Sunstroke was not common, and, considering the heat, it was very
remarkable how little the men suffered from this condition. This was no
doubt in part attributable to the absence of the possibility of getting

alcoholic drinks, but it is not common for any one in South Africa to
suffer in this way, probably as a result of the continuous nature of the
sunshine.
In spite of the labours of hospital surgeons at home, it was rather
instructive to see the number of men who suffered with hernia,
varicocele, and varicose veins to a sufficient degree to necessitate going
to the base. The experience quite sufficed to explain the trouble which
is taken to prevent men with these complaints entering the service.
GENERAL CONSIDERATION OF THE NUMBER OF MEN
KILLED AND WOUNDED
I will now pass to the question of the proportionate frequency with
which the men were killed or wounded during the present campaign. I
propose to take only one series of battles, with which I was personally
acquainted throughout, to illustrate this point. This seems the more
satisfactory course to follow, since the number of casualties is still
undergoing continuous gradual increase, and besides this the warfare
has assumed a peculiar and irregular form, statistics from which
scarcely possess general application.
The battles