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59 THE SERVICES. THE FOOD REQUIREMENTS OF THE BODY IN ACTIVE SERVICE. An important contribution to the study of practical dietetics has recently appeared in the shape of a report 1 on two experimental marches carried out for the purpose of deciding on a scale of field rations under strictly supervised conditions. These marches were performed in the autumns of 1909 and 1910. In 1909 the party consisted of 20 men of the Loyal North Lancashire Regiment, 3 men of the Army Service Corps, and 3 of the Royal Army Medical Corps, together with an officer of the regiment in command and three officers in medical charge and for the purpose of taking scientific observations. The marching took place on Salisbury Plain between Oct. 10th and 23rd, the weather conditions being unfortunately very unfavourable, rain falling every day almost, and generally heavily. Exact observations were made as to the amount of food consumed, the distances traversed, and the weights carried. The dietary supplied yielded protein averaging 186 grammes in the first six days and 141 grammes afterwards; the fat was about 50 grammes, and afterwards 110 grammes; and the carbohydrates 505 and 450 grammes in these two periods respectively; the total average Calorie value being 3465. It was found that in the first week 13 men gained and 7 lost weight; in the second week only 2 men gained and the remainder lost. The average gain in the first week was 0-32 kg. ; the average loss in the second week 1 kg. For the whole period 5 men gained and 15 lost weight, the balance of loss being 0-69 kg. per man; that is, the difference between the average weight at the beginning (64-15 kg.) and at the end of the march (63-46 kg.). The increase in weight during the first few days is considered to have been due mainly, if not entirely, to retention of water in some form, probably in muscular tissue. During the last five days of the experiment there was an average daily loss of 234 grammes (about lb.) in the case of the 20 men, and of 334 grammes (about lb.) in the case of the four officers. This was not due only, or chiefly, to diminution of fat, but to loss of muscle, and perhaps also of liver tissue. The loss was, as might be expected, proportionately greater in the heavier men. The results indicated a deficiencv in the ration supplied, especially in the amount of fat. The committee carefully considered the composition of the field ration and the relative proportions of the different food con- stituents, and recommended that the potatoes (weighing 19 lb.) be omitted, and that there should be substituted 2 oz. bacon, 2 oz. Cheshire or Cheddar cheese, 2 oz. dried peas, beans, or lentils (or 2 oz. oatmeal), 3 oz. coffee, milk, and sugar (in block form), and 4 oz. jam (additional to the existing issue). Also that pickles or other condiment should be supplied, either daily or two or three times a week. The second march was carried out from August 17th to 30th, 1910, the party consisting of 20 men of the Somersetshire Light Infantry, 4 men of the Army Service Corps, a serjeant- major and 3 men of the Royal Army Medical Corps, with a regimental officer, an Army Service Corps officer, and three officers of the Royal Army Medical Corps. On each occasion the men were volunteers, and received a consideration of Is. 6d. a day for their services. The procedure was similar to that of the previous year, and the weather conditions (if possible) worse. The area selected was Dartmoor, the camp being pitched at Willsworthy, near Lydford. Rain fell every day, and almost continuously for the last three days; the temperature was abnormally low, the wind high, the camp unsheltered, the site peaty. In spite of these depressing accompaniments the behaviour of the men was excellent and the conditions of the experiment loyally observed by all. The health of the entire party was very good, except for slight diarrhoea in some (probably due to chill) towards the end of the experiment. In addition to the amount of food previously supplied, 2 oz. of bacon, of cheese, and of oatmeal were issued daily, and the tea, sugar, and jam very slightly increased. In this dietary during the first week the protein averaged 207 grammes, the fat 142 grammes, and the carbohydrates 570 grammes, the whole having an energy value of 4508 Calories. During the second week the respective amounts of protein, &c., were 176, 175, and 529 grammes, with a total energy value of 4515 Calories. The average daily external work of the march (1419 Calories) was more than in 1909 (1034 Calories), the average length greater (14 miles, compared with 12 miles), the roads being also more hilly, though of better surface. As in the former march, an initial rise in weight was followed by a fall. On this occasion the increase in weight over the whole period was experienced by 10 of the men, 8 lost weight, and 2 made up in the second week for loss of. weight during the first. The increase in protein, fat, and carbo- hydrate provided during the second march is considerable 1 Wyman and Sons, Cd. 7182, price Is. ld. when compared with the corresponding amounts issued during the first march; and the total average Calorie value (4511) of the second is 30 per cent. higher than that of the first dietary (3465). The appearance of the men was strikingly different on the second occasion. No man showed any sign of wasting, no hollow cheeks, no sunken eyes. The first expedition was (unofficially) known amongst the troops as the " hunger march," which aptly expresses the view of the rank and file; but after the second march a considerable number of men expressed regret that it was not going to extend over another fortnight. The report must be con- sulted for details of weights, distances, food quantities, &c., all of which are set out in an admirably clear and complete manner. It is satisfactory to learn from the preface that the Army Council have approved of the field service ration (weighing 3lb. and yielding 4500 Calories) recommended by the committee, and have directed that experiments in lightening the equipment should be continued. ROYAL NAVY MEDICAL SERVICE. Fleet-Surgeon Cyril James Mansfield, M.V.O., has been promoted to the rank of Deputy Surgeon-General in his Majesty’s Fleet (dated Sept. 27th, 1913). The following appointments have been notified :-Fleet- Surgeon : H. B. Maryiott to the Bn.0. Staff-Surgeons: J. J. H. Rooney to the dlberucrle J. D. Keir to the Afme, and on recommissioning; and P. T. Sutcliffe to the Hindustan. Surgeons: C. M. R. Thatcher to the Victory, additional, for long course of physical training; and G. B. Cockran to the Mff)pM, for voyage out and home. ROYAL NAVAL VOLUNTEER RESERVE. The rank of Surgeon Probationer in the Royal Naval Volunteer Reserve has been approved, the relative rank being that of sub-lieutenant. While undergoing training afloat or a hospital course these officers will receive pay at the rate of 5s. a day, and in the latter case a hospital allowance at the rate prescribed for Surgeons, R.N. The pay and allowances on actual service will be the same as those payable while under training, with the addition of a special allowance of 2s. a day. ‘ ARMY MEDICAL SERVICE. Colonel Alexander F. Russell, C.M.G., is placed on retired pay (dated Dec. 21st, 1913). Lieutenant-Colonel Neville Manders, from the Royal Army Medical Corps, to be Colonel, vice A. F. Russell, C.M.G. (dated Dec. 21st, 1913). ROYAL ARMY MEDICAL CORPS. Major James C. Jameson to be Lieutenant-Colonel, vice N. Manders (dated Dec. 21st, 1913). Colonel F. H. Treherne has been selected for appointment as Honorary Surgeon to the Viceroy of the East Indies, vice Lieutenant-Colonel H. N. Thompson, appointed Deputy Director of Medical Services to the Scottish Command. Colonel N. Manders has embarked for Egypt. Lieutenant-Colonel J. M. F. Shine has been appointed to hold charge of the Military Hospital at Nowshera Canton- ment, vice Major J. Smith. Lieutenant-Colonel C. W. R. Healy has been appointed to hold charge of the Medical Division at the Royal Herbert Hospital, Woolwich, vice Lieutenant-Colonel A. R. Aldridge, C.S.I. Lieutenant- Colonel J. Fallon has been selected for the increased :rate of pay under Article 358 of the Royal Warrant. Lieutenant- Colonel J. Girvin has arrived home for duty from Ahmed- nagar Cantonment. Lieutenant-Colonel H. E. Winter and Lieutenant-Colonel G. A. T. Bray have exchanged positions on the roster; the latter officer will remain on the Home Establishment. Lieutenant-Colonel T. G. Lavie has arrived home on general leave of absence from Malta. Major G. St. C. Thom has arrived home for duty from India. Major W. S. Harrison has been placed under orders for a tour of duty in Jamaica. Major A. W. Sampey has been appointed to hold medical charge of the Enteric Fever Con- valescent Depôt at Wellington Cantonment, Madras Presi- dency. Major H. F. Shea has been selected for appointment as Specialist in Advanced Operative Surgery to the Lahore Division of the Northern Army in India. Major B. Watts has arrived home for duty from Meerut Cantonment. Major W. J. Waters has taken up duty at Tientsin. Major H. 0. B. Browne-Mason has assumed the permanent appointment of Deputy Assistant Director of Medical Services (Mobilisation) to the Poona Division. Major S. A. Archer has been appointed to the Belfast District. Major N. H. Ross has been placed in . charge of the Bacteriological Research Laboratory at Brigade Headquarters, Fyzabad Cantonment. Major St. J. B. Killery ’ has arrived home on general leave of absence from Bangalore ! Cantonment. Major J. S. Bostock has been appointed for . duty to the Aldershot Command. Major J. E. Hodgson has ’ been transferred from the London District to the Northern ’ Command. Major C. H. Hopkins has taken over medical charge at Devizes. Major B. F. Wingate has been appointed , to the London District for duty. Captain T. S. Dudding has embarked for India. Captain . A. W. Byrne has been selected for appointment as Deputy Assistant Director of Medical Services (Sanitary to the
