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War Surgery and Medicine

The Constitutional Factor

The Constitutional Factor

By no means every soldier, however, who had been subjected to the conditions already mentioned became afflicted with skin disorders. It was necessary for the victim to have some natural inborn susceptibility as well. This was a varying factor in every case, and the chief and only factor in a few people—those who are born with inferior skins and have them all their lives. In chronic cases admitted to 1 General Hospital a previous history of civilian skin infection was elicited in 30 per cent.

The recognition of this constitutional type could have eliminated some men who were sent overseas. Its main features were:


A long history of the above varieties of chronic skin infections in civilian life, particularly if they have been worse in the hot weather.


A similar poor resistance to general infective diseases and to infections of the mucous membranes of the nose, throat, ears, etc.


A number of associated non-infective disorders, of which the chief is hyperidrosis (especially of the hands and feet).


A family history of any of the above.

The Middle East environment owed its deleterious effects to a combination of heat, dry atmosphere, dust, sand, dirt, and lack of water, together with the cutaneous, internal, and psychological stresses of military service away from home in a trying part of the world. In the environment many skin conditions were slow to heal page 696 and prone to recur, entailing much hospitalisation. The more serious cases were evacuated to New Zealand, and it was felt at times that a more liberal policy of invaliding might well have been adopted so that men could have been returned to New Zealand where they would probably have given efficient service in a different climate.