It was a great day for the Principal Medical Officer. In spite of the fact that there were nearer 1200 than 1100 men in his ship, the returns of "Sick" and "Hospital" cases had been recorded by successive "pairs of spectacles" for several days. Even a single twenty-four hours like that for a battleship on active service was worthy of remark, and three or four days of it undoubtedly constituted a record for the British or any other Navy. That the clean sheet would be spread over a whole week was almost too much to hope for, even after the sixth day of the double duck's eggs had gone by. But now the morning of the seventh day had come, the last of a week in which there had been no case of sickness in a ship which carried one of the largest, if not the largest, complement of men in the British Navy. It was no wonder that the P.M.O.'s eyes were beaming, and that he shook hands all round with his Staff Assistants, for it was an achievement which might well stand as a record for many a year.

"Since you do not appear likely to be troubled with anything worse than a rush of congratulations to-day, sir," I said, after extending my own felicitations, "perhaps you'll have time to tell me how you've done it. I've heard fine tributes paid the R.N.M.S. by French, American, and Italian doctors who know something of it, but I was hardly prepared to find you starting a sort of Ponce de Leon 'Fountain of Perpetual Youth,' in the British Fleet."

The P.M.O. laughed.

"Making a health resort of a battleship, with your dressing stations under casemates and your sick bay all but under a turret, does seem a bit like reversing the saying about 'in the midst of life we are in death,'" he replied. "But the fact remains that this ship—the whole of the Grand Fleet indeed—is one of the most remarkable 'health resorts' the world has ever known. Not since the dawn of history has there been a large body of men with so small a percentage of bodily ills and ailments as that which mans the ships of the Grand Fleet at this moment. This is due to the absolutely unique conditions which prevail here, and our success in maintaining and improving the standard of health is principally due to making the most of those conditions.

"The health of any community—of any body or collection of human beings—depends primarily upon the natural salubrity of the region in which it is located and the extent to which it is isolated from those living under less favourable conditions. A city may be very healthy naturally, but if its inhabitants are subject to a constant influx of more or less infected transients from less healthy places its own standard must inevitably be lowered. Under normal conditions, a modern warship—either in port or at sea—is one of the healthiest places in the world, and such sickness as prevails there is almost always contracted ashore and carried—and often spread—aboard.

"With a Fleet that has its base near a large city, so that the men are in more or less constant contact with those ashore, the health of the former will very largely depend upon the extent to which that contact can be controlled. Between dock-hands, etc., coming aboard and the sailors going ashore, it is difficult under such circumstances to keep the men afloat much healthier than those on the land. It is only when there is comparatively complete isolation from large cities that it is possible to take full advantage of the ideal conditions for maintaining physical healthfulness at sea, and such conditions exist at the Northern Base to a degree never before equalled in Naval history. Our success here is merely the consequence of making the most of those unique conditions.

"On the score of bodily healthfulness, life as lived in the Grand Fleet has more favouring conditions, and fewer unfavouring ones, than that possible at any other point at which a considerable fleet has ever had its base. Indeed, I could go farther than that, and say that never has a large number of men, either afloat or ashore, had such an opportunity to maintain so high a standard of physical health. In the first place, wet, cold, and stormy though it is for much of the year, the climate is a salubrious and invigorating one for the physically sound man that the sailor must be before he finds his way into the Navy at all. Even ashore the population is notably robust.

"In the next place, the anchorage is isolated, but not too isolated. It strikes almost the ideal mean on this score. In the ordinary routine, there is practically no contact whatever between those afloat and the people ashore. If the men land at all it will be for a game of football, a cross-country run, road work or something of the sort, in the course of which nothing whatever is seen of the resident population. It is not practicable to give the men a long enough shore leave to allow them to visit a neighbouring town, where one sees rather less navy blue as a rule than in many an inland town in England. The steward doing his marketing is about the only regular human link between a ship and the land, and his contact with those on shore is not of a character likely to be dangerous. This leaves the fresh drafts and the men returning from leave as almost the only possible carriers of new infection. How those are looked after I will explain presently.

"Much more complete isolation than this is, of course, effected when a cruiser or a fleet of cruisers goes on an extended voyage or patrol, but in such a case the freedom from contact with shore is offset by the more arduous conditions of life, especially in the matter of diet. The great thing about the situation of Scapa is that its unique position makes it possible to eliminate most of the rigors of sea life without being exposed to the health dangers of harbour life. A ship here can be just as well victualled as at Portsmouth, so far as the men are concerned, while letters and newspapers six times a week are ample service on that score. As I have said, the conditions for keeping mind and body at their best are ideal, and give us a unique opportunity for establishing new health records for the Navy.

"Of the two main channels by which disease could come to us from the outside—returning leave men and new drafts—the latter is the more dangerous, and therefore the one the more closely watched. Generally speaking, the men get leave about every nine months, this more or less roughly coinciding with a period in which the ship is in dock for repairs. If during a man's leave there is a case of any infectious or contagious disease in the house where he has stayed, or if he has reason to believe that he may have been exposed to infection or contagion elsewhere, he is ordered to report that fact immediately upon his return to the ship, when we take such precautions as the circumstances seem to warrant to prevent trouble. His clothes are disinfected, and he is ordered to report for examination over a period of days varying with the disease to which there was risk of his having been exposed. This enables us to isolate him (should it be necessary) before he is in a condition in which he could pass on the disease to others. A useful check which we have upon a man who might neglect to report his possible exposure to disease during his leave is the law which requires medical officers in all parts of Great Britain to ascertain if any soldier or sailor on leave is living in any house where there is a case of infectious disease, and to report this fact to the proper authorities. In this way it may be that we learn a man has been exposed even before he returns to the ship.

"New drafts are watched equally closely. Some time before a man's arrival a health sheet is sent to me on which is indicated any disease which he may have had during his period of service, together with information as to whether or not he may have been exposed to anything infectious in the interval immediately before he is sent to us. Any treatment for minor chronic ailments which may be in progress is continued in the ship. A general disinfection of kit and a daily reporting for twenty-one days for examination makes it practically impossible for a new rating to bring disease to the Ship's Company.

"The greatest obstacle to the preservation of perfect health in the men on a warship is the unavoidable necessity of having them sleep close together in comparatively confined spaces. This ship, from the fact that she was originally designed for a foreign Power, is worse off than most modern battleships on that score, and, everything else equal, would be more difficult to keep the men in health in than in any of the others. This is one of the reasons why I am so gratified by our showing of the past week. Sleeping in hammocks in itself is not unhealthy—quite the contrary, in fact—but the danger lies in the chance an infectious disease has to spread among so many men lying almost side by side and head to feet. Thorough ventilation is the best preventive of disease under the circumstances; this has been provided by fans.

"The one thing dreaded above all others on a warship is cerebro-spinal meningitis, both on account of its unavoidably high rate of mortality and the difficulty of preventing its spread under the limiting conditions. Luckily, we have had practically none of it up here. In the event of the appearance of a case of any infectious disease, the man is isolated, the men of his mess are put under observation, and all of their clothes are disinfected. As soon as possible the case is removed to one of the hospital ships which are always here. The restricted sleeping quarters occasionally are responsible for the quick spread of a bad cold, but the fresh air, free from germs, makes anything like an epidemic of influenza almost out of the question in the Grand Fleet. German measles has been rather a nuisance once or twice; in fact, we have seen rather more of it than we have of the German Fleet. If the latter is as easily disposed of as the former, however, we shall have little to complain of."

Of the progressiveness and general up-to-dateness of the Royal Navy Medical Service, I had already heard from a number of sources (I remember in particular how Madame Carrel had told me that the British Admiralty had adopted the remarkable "irrigation" treatment, discovered and perfected by her distinguished husband, long before any French military hospital would even consider it), so I was quite prepared to find every ship in the Grand Fleet amply provided to handle "action eventualities."

The problems of a hospital on a warship are quite different from those of even an advanced hospital at the Front. The latter has a fluctuating but more or less unbroken stream of casualties to handle, with sometimes weeks of warning when defensive or offensive action will make unusual demands. A battleship may easily be lying quietly at anchor in the morning and be joined in a death-grapple in the evening. Her surgeons may have spent a year with nothing more to keep their hands in than reducing sprains and stitching up cuts, and then a hundred casualties may drop out of the sky in the wake of a single enemy salvo. For them, it rarely rains but it pours, though it may be a long time between the storms.

The usual practice is for a warship to have a small permanent sick bay and hospital capable of coping with routine exigencies, and to supplement these during and after action by converting certain favourably located parts of the ship—always below the water-line if possible—into action dressing-stations. The equipment of these latter—operating tables, beds, lights, etc.—is all made on collapsible lines and kept stored close at hand. The battleship whose remarkable health record I am writing about, takes especial pride in the fact that it has two action dressing-stations, permanently equipped and ready for use at a moment's notice.

The men in the various turrets and casemates, as well as in all other parts of the ship where casualties are likely to occur in action, are trained to give first aid and carry their wounded to the nearest dressing-station. For the latter purpose a specially designed stretcher is used, so constructed that the wounded men, strapped in securely, can be carried at any angle with a minimum of discomfort. The stretcher at present in use in the British Navy is of Japanese manufacture. It is made almost entirely of canvas and strips of bamboo, the two materials which experience has shown are the best combination on the score of lightness and strength.

As soon as possible after an action the badly wounded are transferred to a base hospital ship, whence, as soon as they are able to stand the voyage, they are sent in a carrier ship to one of the big R.N.M.S. hospitals.

The superlative care which has been taken of the bodily health of the men of the Grand Fleet has been one of the main, if not the main factor in contributing to the healthiness of mind and the keenness of spirit which have made it possible for them to "stick out" their long vigil in the northern seas.