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Trying to keep the troops healthy while they underwent their training at Camp MacArthur on the outskirts of Waco during World War I was a constant challenge for the doctors, nurses and assorted medical personnel assigned to the base hospital.

According to the Report of the Surgeon-General U.S. Army to the Secretary of War, that first fall and winter of 1917-18 in Waco was exceptionally cold and dry, and those close quarters may have contributed to several hundred cases of the measles and tuberculosis.

Other war-time medical annals note that the construction of the camp itself (at a cost of $5 million in July 1917) may have contributed to some of the illnesses that affected life on post.

For example, one inspector noted, although the city’s water system — which was sourced both by artesian wells and the Brazos River — “furnished excellent water at a temperature as high as 107 degrees” from the wells, the river water left much to be desired.

The Brazos River was frequently muddy and received the sewage of several small towns. Evidence of fecal contamination in December 1917 meant it required coagulation, filtration and chlorination.

The original water mains in the camp were fabricated of iron. Wooden mains were added to the camp water supply system in fall 1918. These lay on the ground for some time, were dragged along the ground scooping up dirt, and eventually lay in the trenches for some time before being connected to the existing system. Soon after the water was turned through these pipes, military doctors reported, typhoid fever appeared in the camp. After the pipes were cut off, the disease disappeared.

Prior to the sewage system installation at Camp MacArthur, waste water from the bathhouses was discharged into ditches which drained eventually into the Brazos River. Pit latrines also were used during this period, which were sometimes dug too shallow. Physicians were most unhappy with the sorry state of sanitation in the camp.

Manure from the camp was dumped into a ravine half a mile from the main part of the post. “This was satisfactory during the cool weather, but the system of disposal of manure proved to be very unsatisfactory with the advent of warm weather in 1918,” the inspector reported.

The dump was within 150 yards of the camp bakery, garbage scraps had been included with the manure, and fly breeding occurred on an extensive scale.

“As much of the great collection as possible was oiled and burned,” he added.

Measles appeared in Camp MacArthur in October 1917 and became an epidemic in the next month. There were 1,234 cases during November, December and January. A few cases arose each month throughout the remainder of that year, with a maximum of 132 in November.

The first case of the Spanish flu was reported on Sept. 23, 1918. The daily incidence thereafter slowly increased until Sept. 30, when there was a sudden rise to 262.

The epidemic continued for less than one month, with more than 2,500 cases admitted to the base hospital and 3,857 of the milder cases treated in improvised field hospitals. About one in three personnel was stricken with the disease, and one in 10 of those cases was complicated by pneumonia.

Although the camp surgeon recommended restricting the movements of personnel, and later the absolute quarantine of the camp, the post’s commander would have none of it.

Sources: Handbook of Texas Online, 32nd-division.org, Report of the Surgeon-General U.S. Army to the Secretary of War (1919); txgenweb3.org, usgwarchives.net.