THE QUESTION OF FATIGUE FROM THE ECONOMIC STANDPOINT. 253 



Gwynne Maitland, who during the war in Serbia has had special oppor- 

 tuiiities of observation; while the co-operation has been secured of 

 Professor T. Loveday, of Armstrong College, Newcastle-on-Tyne, and 

 of Dr. Major Greenwood (Statistician to the Lister Institute). They 

 submit their results rather as an indication of what the Committee hope 

 to achieve in the coming year than as claiming completeness in their 

 present form. 



Section I. 



Accumulated Fatigue in M^arfare. 

 Dr. Maitland. 



The present war supphes unlimited material for the study of fatigue, 

 but there is little opportunity afforded for experimental examination ; one 

 must for the most part be content with chnical observations. 



There is one outstanding advantage in these cases as compared with 

 civil cases; it is that they show much greater severity, and so enable 

 one to realise to what extent fatigue may be responsible not only for 

 functional disordei's, but ultimately for permanent constitutional lesions. 



There is, however, this great disadvantage, that there is no 

 opportunity for submitting these, as one can submit civil cases, to experi- 

 ment. It is obviously impracticable to be in the position and to select 

 the opportunity for measuring work before and after the strain of field 

 and trench work. 



By experience of work in the field and by the observation of cases, 

 useful conclusions can be reached, and some measure of reform has 

 already been forced upon the Army. 



The soldier has a limited capacity for work, but if he has been care- 

 fully trained that capacity may be increased ; on the other hand, if his 

 capacity is exceeded, and recuperation is not permitted to him, that 

 capacity may undergo so much diminution as to render him quite unfit 

 for military purposes. 



Military necessity, the impossibility of bringing up relays for replace- 

 ment, the inability to provide sufficient rest and uninterrupted sleep, 

 prevent the Army from getting the greatest possible value out of the unit. 



It was, indeed, found that long-continued trench strain resulted in 

 cases of breakdown which certainly recovered after a period of rest, but 

 such cases were left with a shorter period of utility on their return to 

 the trenches, and, breaking down again, frequently discharged as of no 

 further use. Not only was the period of activity shortened, but the 

 quality of their work deteriorated, as evinced by their inaccurate shoot- 

 ing, by their inability to time hand-grenade fuses, by hesitation in 

 matters which demanded quick and intelligent decision, and in various 

 other ways. 



In estimating the predisposing factors causing the acute cases of 

 fatigue it would have been of the greatest importance to classify the 

 various field operations in such a way as to obtain a common denomi- 

 nator, whereby forced marching, trench-digging, gun-moving, stretcher- 

 bearing, and so on, might be schematised, and an ideal number of hours 



