Military medicine, 175, 8: 118, 2010 118 military medicine

EMPIRICALLY BASED FITNESS 
The opinion of the military physician and military surgeon 
began to matter. Those opinions refl ected the scientifi c prog-
ress, numerous military ventures, and the medical experiences 
of European colonial expansion of the 17th century. Disease 
causation as proposed by Thomas Sydenham and John Locke 
was based upon the relative potencies of contagion, mias-
mas generated from the decomposition of organic matter, and 
Lessons Unlearned, Education Forfeited: 
Military Hygiene Enters the 21st Century 
COL Stephen C . Craig , MC USA (Ret .)
ABSTRACT  Obtaining and maintaining a military force hearty enough for the trials of campaign and combat is the 
concern of military hygiene. It has been a challenge for governments and commanders for centuries. Empirical prac-
tices in recruiting, training, and maintaining service members gave way to more scientifi c, evidenced-based practices of 
the 18th century, and the research-driven, laboratory-proven methods of the late 19th century. As science made military 
medicine predictable, it widened the intellectual and professional gap between commander and medical offi cer, weaken-
ing trust and hindering communication. It also distanced the medical offi cer from the more mundane health and fi tness 
concerns of service members by transforming military hygiene into military preventive medicine. Medical misadventures 
consequent to this state of affairs continue into the 21st century and will remain until a philosophical and educational shift 
in the value of military hygiene occurs.
Medical History, Uniformed Services University, 4301 Jones Bridge 
Road, Bethesda, MD 20814. 
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Military Hygiene Enters the 21st Century