'Mesopotamia Commission. Report of the Commission Appointed by Act of Parliament to Enquire into the Operations of War in Mesopotamia, together with a Special Report by Commander J Wedgwood, DSO, MP, and Appendices. London: HMSO, 1917.' [‎89r] (177/248)

171
*
37. It is necessary to emphasize that these figures are
in no sense a measure of the state of health of the garrison.
The accommodation in medical units was limited to about
1,450, the medical staff in them was small and many
patients were discharged in a convalescent state to be
looked after by the medical officers of corps units. We
were also compelled to have the less severe cases that
would ordinarily be sent to field ambulances or general
hospitals treated regimentally to equalize the work of the
available medical officers and subordinates.
38. A convalescent depot for British troops was estab-
Ushed in the Serai to relieve the pressure in the British
General Hospital and the field ambulances.
Principal Diseases.
39. Scurvy caused 1,050 admissions, all in Indians.
From an early stage in the siege I was apprehensive
regarding the disease in Indian troops and followers.
A few cases appeared in the middle of January, and the
incidence gradually rose ; in the middle of February we
had 140 cases, the daily accession being about five, and
at the end of March there were 579 cases, after which it
gradually declined. Excepting the effects of starvation
nothing undermined the health of the Indians more than
scurvy. It occurred in three forms—fully developed,
incipient and latent. The disease arose from long-
continued improper and insufficient food, especially the
absence of fresh vegetables and fresh meat from the
diet. It was greatly predisposed to by the prolonged
hardships, exposure, heavy duties, and the generally
depressing influence of the siege. We found we could not
prevent it, but if brought under treatment early we could
cure it. All our patients were better off in food supplies
than the troops at duty, as they included a limited
amount of milk, cream, eggs, rice, dhall, lime-juice,
pickles, canned fruit and tamarind. Indian units that
were quartered in the Fort, and North-East Section, and
at Wool-Press village, suffered inordinately from scurvy
due, it was considered to their not having free access to
the supplementary articles of food purchasable in bazaars.
Indians that ate horse-flesh from the time it was com
menced were decidedly less affected, and in those in whom
the incidence was high, it underwent reduction when this
meat was eaten, providing its consumption was not
postponed too long. Most Indians who did not eat horse
flesh before April 1st, could not digest nor assimilate it,
and in many it led to gastro-intestinal troubles ; neverthe
less I am quite confident that it kept many of them alive.
Nor did those who ate horsemeat early run down so
rapidly as those who did not. Green herbs collected
from the alluvial plain had a marvellous effect in keeping
down the incidence of the disease.
40. On February 23rd, 1916, I wrot':—“We cannot
prevent the occurrence of the disease (scurvy) in units
that will not eat horse-flesh, but we can cure the disease
rapidly in the medical units (if the men are sent in early),
as we have at least eight items that cannot be obtained
regimentaily—dhall, rice, fresh milk, eggs, pickles, imli,
(tamarind), chatni and chloride of calcium.” From
February 27th, we got in all incipient and suspicious cases.
41. The total number of admissions for dysentery was
684. It afflicted Indian troops and followers much more
than British soldiers. It was one of the most prevalent
and serious maladies dealt with. It was a particularly
fatal terminal complication in a number of scurvy cases.
42. There were 551 cases of malaria; it was relatively
more prevalent in British troops than Indians. These
were all relapses of old infections. It was observed that
in Indians previous malarial infection predisposed to
scurvy.
43. Gastro-enteritis and Diarrhoea gave rise to 528
admissions into hospitals. It was one of the most preva
lent disorders during the Defence; another 1,300 odd
cases were treated regimentally. Practically everyone
got it at one stage or another of the siege, and in many
it was chronic. It was attributable to many causes,
such as chills, night exposure, coarse and imperfectly
cooked food, etc.
44. During the last five weeks of the siege there were
165 deaths from conditions variously diagnosed as gastro
enteritis, enteritis, diarrhoea, etc. The essential cause
in these cases was undoubtedly starvation. The men
had got into such a state of debility and wasting from
shortage of food, that any added strain on the economy,
such as diarrhoea, was sufficient to lead to speedy dis
solution. In all these cases there was finally a marked
subnormal temperature. The condition was clinically
identical with cholera ; but neither I nor any of the Medical
Officers had any doubt about its not being cholera. This
disease continued epidemically after we got to the
Prisoner's Camp, Shamran ; during the month of May we
had over 1,500 cases, and about 180 deaths from it. I
got the malady myself ; after the first few hours it was
quite painless, and one passed into an apathetic condition.
45. Pneumonia (487 admissions) was one of the most
serious and fatal diseases, especially in Indian troops,
throughout the siege. It was largely predisposed to by
the intense cold at night in January and lebruary,
exposure in trenches, and in March and April breathing of
germ-laden dust, and the more or less lowered stamina.
46. We were fortunate in having no infectious disease.
In the early stage of the siege a recrudescence of beri-beri
amongst British troops gave rise to some apprehension,
but it then disappeared ; whilst in Indian troops and
followers during the latter half of the siege scurvy caused
anxiety.
47. The following table gives the numbers of deaths in
Kut from December 4th to April 28th, 1916 :—
Killed.
Died of
Died of
Totals.
Wounds. Disease.
British Officers
9
10
4
23
,, ranks
84
105
58
247
Indian Officers
8
7
5
20
,, ranks
... 369
278
531
1,178
Followers ...
67
88
123
278
537
488
721
1,746
48. On March 18th, an aeroplane H.E. bomb dropped
in the British General Hospital, killed 6, and wounded 26
British N.C.Os. and men ; 12 others of the 26 died from
their injuries.
Climatic Peculiarities During Defence.
49. During the siege the climate up to the end of March
may on the whole be classed as wintry and comparable
with that of the North-West Frontier Region of British India bordering Afghanistan. of India for the
corresponding period. In the months of December,
January and first part of February, it was very cold ;
from January 15th to February 8th it froze every night;
the troops in the trenches, especially Indians, found this
very trying. The effects were intensified by severe winds
and rain storms. On January 18th, 19th, and 20th, the
trenches were flooded with water at ice temperature. On
January 20th, several units in the first line trenches were up
to their waist in water, and about 30 Indians were brought
out of the trenches collapsed from .the cold ; in a few
cases the men could not be resuscitated. At this stage
frost-bite was common, which in some men led to gangrene
of the toes, and trench rheumatism was prevalent. The
lowest temperature reached was 24*8 J 1 ahr., on January
31st. After the middle of February the days were warmer,
and the night cold less severe. In March there was about
ten days cold weather associated with rain ; but the days
were mostly bright and pleasant. In Apiil the nights
were pleasant, and the days becoming hot, but not un
comfortably so.
50. About 4 inches of rain fell during the. siege--£ inch
in December, 1£ inches both in January and February
and | inch in March. The heaviest rainfall was from
January 18th to 21st, during which time the troops in
the trenches suffered considerable hardship. 1 he rains
occurred in torrential tropical downpours, usually, fol
lowed by a break lasting a week or two. During the
rainy periods the roads in the town were converted into
elongated puddles from 6 to 12 inches deep making traffic
difficult.
51. On January 18th I wrote in my diary:
“ Torrential rain fell for several hours during the night
January 17th and 18th. All the trenches were swamped
with water ; the troops endured a most miserable night in
the rain.
“ The streets of the town are one continuous puddle
several inches deep. The trenches in first, middle and
second lines have from 1 foot to 2 feet of water in them.
Pumping has had but little effect. Troops are making a
continuation trench to the river and lower ground to
drain them. Kit and bedding all soaked.
Medical Unite in Kut during the Siege.
52. (o) No. 3 a British General Hospital. 4 Section
(50 beds) ; (b) No. 9 Indian General Hospital. 1 Section