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Report of Capt. Charles F. Kieffer, Surgeon in Charge, Artillery Brigade, Fifth Army Corps

Spanish - American War

228

REPORT OF CAPT. CHARLES F. KIEFFER, SURGEON IN CHARGE, ARTILLERY BRIGADE, FIFTH ARMY CORPS

Dated September 22, 1898

I have the honor to submit the following report of the health and sanitary condition of the Light Artillery Brigade during the operations about Santiago and the voyage to Montauk on transport. This command was made up of six batteries. Of these, four batteries left on the first expedition and landed June 23, and two batteries on the second expedition, landing on July 9. The batteries were all in widely-separated positions in the trenches and were massed near Caney, immediately after the formal surrender. This camp was maintained until the departure from Santiago in different transports, between August 19 and August 23. The average strength of the command was 550 enlisted, 25 officers. There were three medical officers with the command: Capt. Charles F. Kieffer, Lieut. William W. Quinton, and Lieut. William H. Wilson, assistant surgeons United States Army. There were also four acting hospital stewards and an average of 8 Hospital Corps privates.

Immediately after the surrender the organization of a brigade field hospital was begun, and in a few days I had excellent provision for 50 sick, including cots, blankets, supplies, and foods. This hospital held all our seriously sick men, and the others were made as comfortable as possible in their battery camps.

The daily sick report averaged 120, and this proportion of the troops was more or less constantly maintained during the month following the fall of the city. These figures do not represent the total unfit for duty, because many of the men were so enfeebled that if more work than the minimum to maintain a clean camp had been required, they would have been unable to do it. The great majority of


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the sickness was a thermic fever and various types of malarial infection. These fevers at different times attacked at least 95 per cent of the command-75 per cent had two attacks and about 40 per cent had three attacks to the time of leaving the island. Careful notes were made, and in a future report I hope to present some of the technical aspects of these cases. There were also 10 cases of either typhoid infection or severe remittents with typhoid symptoms. In the absence of microscopical evidence a differential diagnosis was impossible. I incline, however, to the belief that the cases were of malarial type. We had very few cases of dysentery, and the type was mild and easily controlled. Two cases of measles developed, necessitating a quarantine. Ten men were transferred to hospital ship by order of the chief surgeon of the corps, and when the command left camp 10 more were transferred to general hospital at Santiago.

During all this period there was but 1 death-a suicide. There was not one death from disease until after the dispersion of the brigade at Montauk. I understand, unofficially, that 2 men have died in hospital at Montauk and 1 officer at Washington. These men were in Southern camps a long time before going to Cuba, and made the whole campaign, being exposed to the weather and all attendant hardships as much as any troops on the island, and the sick showing is therefore a good one.

The camp was selected with great care by the brigade commander. The water was excellent, being a mountain stream fed by springs. Every effort was made and every precaution taken to keep it pure, and I think with success. Whenever possible contamination was feared, the men were counseled to drink boiled water. This is a difficult thing to get men to do. A thirsty man will drink anything, but nevertheless a great deal was accomplished along this line. The men were also forbidden to eat the various tropical fruits brought into camp, especially the mango. I think this precaution kept the average of intestinal troubles as low as it was. Tents were aired daily. The conical tents were dropped and the canvas lashed about the tripod and pole so that all the ground beneath was thoroughly aired and sunned. For a long time the command had no tents and the men slept under shelter of the gun paulins. The same precautions were adopted with them. The paulins were thrown back and the ground well aired. The men were also made to build bunks to raise themselves from the ground. This was generally accomplished with forked sticks, grain sacks, and split bamboo. The sinks were regularly inspected, filled in, and renewed. The men were forbidden to enter any of the old dwellings and buildings about. The use of old lumber stripped from these filthy huts, as flooring or for making bunks, was also forbidden. I think this was the most frequent and glaring sanitary misdemeanor committed in Cuba. Men were allowed to enter dwellings, strip boarding, shutters, and doors and use them in their tents.

The presence of the horses made an additional difficulty in camp sanitation, but the picket lines were frequently changed and kept very clean. In fact, a very rigid and effective police of the camp was maintained. So that, notwithstanding a great handicap, these men came out very well. They had horses to groom and the horses had to be herded. This necessitated a large proportion of the men being out in the fierce sun for quite a long time each day, and brought in that way many relapses.

The value of the precautions taken is proven, I think, by the exceedingly low proportion of cases and mortality from dysentery. But, above all else, there was at no time even a suspected case of yellow fever, and, as far as I can learn, very few organizations escaped this infection entirely. I wish also to state that every single sanitary recommendation received the hearty support of the brigade commander, and was immediately and effectively carried out.

This brigade had at all times as good a supply of medicines as could reasonably be expected under the circumstances. After the surrender of the city, we were very well supplied with not only comforts, but luxuries. Ice was furnished in quite generous amounts, and this 5 miles from the city. The prepared soups and milks were very grateful to the sick. No soldier of this command was at any time placed in jeopardy for lack of medicine.

The food supplied the men was of good quality and the ration was well handled. The beef was exceptionally good. There was a considerable lack of food during the siege, and only the most portable of the components of the ration could be brought up to the trenches. The suffering was not great from this cause, and I think, beyond lowering the resistance of the men somewhat, had no permanent ill effect. It was a hardship of the campaign borne cheerfully and alike by all, from the commanding general to the last recruit. From the fall of the city, as far as careful inspection could determine, these men messed about as well as they ever do in the field.


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I wish to commend to the surgeon-general the work of Assistant Surgeons Quinton and Wilson and their zeal in the execution of their duties. These officers performed their duties and did hard professional work when they were sometimes as sick as the men they were caring for. This report has been delayed by my own illness.

Captain Kieffer's report was forwarded by the brigade commander, Gen. W. F. Randolph, with the following remarks:

"In forwarding the inclosed report, it is a source of gratification to call the attention of the Department to the extremely able manner in which Dr. Kieffer has performed his duties. As its senior medical officer present, he was brigade surgeon from July 9 to August 24, when he was compelled to succumb to repeated attacks of malarial fever. Immediately after the surrender at Santiago, the camp of the Light Artillery Brigade was established near El Caney. The command was largely without tents, which had been carried off on the transports to Porto Rico. During this time the troops were exposed to daily rains, and the sick report assumed such alarming proportions as to necessitate the establishment of a hospital for its own immediate use. In this work Dr. Kieffer showed untiring effort, and I believe that his subsequent illness was largely due to his frequent exposure to the sun in visiting Santiago, to obtain tents, cots, and supplies. Not a single death from disease occurred while the brigade was in Cuba, and when the yellow fever expert, Dr. Gonzales, made the final examination, previous to its departure, he gave it one of the few clean bills of health granted to departing troops."