65 14 15 16 17 18 The GreatWar describe this important medical work as force protection, and it remains essential to ensure that soldiers are healthy and fit as can be for operations. In the trenches, the key role of the CAMC did not mean that soldiers were not sick. In fact, most were wretchedly ill much of the winter from the hard-living and difficult conditions, with “trench cough” nearly ubiquitous. But the threat of disease never affected combat effectiveness in the Canadian forces. Even the spectre of the Spanish flu of 1918 and 1919, a H1N1 virus similar to the coronavirus, which could not be cured by the doctors, did not affect the Canadian Corps ability to conduct operations at a high tempo and for a sustained period, although the German soldiers suffered more severely, and the flu contributed to a significant drop in morale in late 1918. Nonetheless, that terrible flu would kill over 55,000 Canadians, including at least 1,492 soldiers, although isolation of patients, the general better health of young men, and attentive medical care reduced losses among service personnel. A prewar 1911 Royal Army Medical Corps training manual had estimated that in a future war sick soldiers would outnumber the wounded by a factor of 25 to 1.5 On the Western Front, the figure was around 2.7 to 1, with a ratio of 1 disease death to every 10.4 from battle.6 Throughout the war, preventative medicine was considered a great success in keeping the soldiers in the line, ready for relentless battles of the trenches or the large-scale campaigns like the Somme, Vimy, or at Amiens. Disease deaths could not be entirely reduced, but they were far less than what they might have been, and they made up only a small percentage of the more than 66,000 Canadians who died during the war or in its immediate aftermath. Many of the lessons were also brought back to treat Canadian civilians in postwar Canada, aiding in better care of maternal health, tuberculosis, disabled soldiers, and engaging with renewed energy in preventing disease before it had to be treated. Colonel Alexander Primross, a wartime surgeon whose son was killed in action, noted in his 1919 presidential address to the Academy of Medicine in Toronto that “The men who have had the good fortune to have seen service at the Front have been profoundly influenced by their experiences.”7 While the CAMC played many essential roles during the war, CAMC Colonel George Adami claimed, “The great, outstanding feature of theWar has been the triumph of preventive medicine.”8
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