FROM THE AGE OF NAPOLEON TO THE FRANCO-GERMAN WAR
1. THE RUSSO-TURKISH WAR OF 1828–9
On April 28, 1828, Russia declared war against Turkey; the fighting took
place partly in the Balkan Peninsula, in Wallachia and Bulgaria, and
partly in Transcaucasia. In the western scene of the war, the Russians,
after the capture of Varna and the futile siege of Schumla in the
campaign of the year 1828, were obliged to retire to the left bank of
the Danube; in the second campaign (1829) Diebitsch defeated the Turks
at Kulevtchi, marched across the Balkan Peninsula, and appeared
unexpectedly at Adrianople, which the Turks surrendered to him without
resistance.
An unusually severe epidemic of bubonic plague accompanied this
campaign. In the year 1828 plague had spread from Asia Minor to European
Turkey and Wallachia; as early as 1825 and 1826 it appeared in
Bucharest, while sporadic cases of the disease occurred in Wallachia in
the summer of 1827 and in the winter of 1827–8.[185] On April 30, 1828,
the first Russian troops made their appearance in Bucharest; they were
quartered in the city itself and in the surrounding villages. On May 13
seven cases of plague appeared in a private house, but the Bucharest
physicians did not hold the disease to be plague. Orders to disinfect
the houses were issued, but intercourse with the surrounding villages
was not stopped. Some thirty inhabitants succumbed to the pestilence in
May, and at the end of that month three Russian soldiers were allowed to
enter the city. Since the number of cases in the city was increasing,
the troops stationed there were quartered in the village of Fundeni,
where, however, several more people soon contracted the disease. During
the month of May, plague broke out in other villages of Wallachia, and
in the course of the summer and autumn it spread throughout the entire
country. In regard to the origin of this epidemic of plague, Simon[186]
says: ‘All Wallachia was infected from the year 1826; but had it not
been for the war and the consequent afflictions of all kinds, the
disease would not have developed in the year 1828 into such a furious
and extensive epidemic. The arrival of the Russians was responsible for
this widespread outbreak, since they carried the infection contracted
from the inhabitants to a thousand different places.’
The removal of the troops to Fundeni temporarily checked the
dissemination of plague in Bucharest, but in the middle of August it
broke out again, presumably in consequence of the arrival of more troops
from the scene of the war; some thirty or forty villages were attacked
by this epidemic, which lasted until the middle of November. In January
1829, plague was conveyed by troops to Moldau and Jassy, which they were
to make their winter quarters; but the disease, notwithstanding the fact
that it was wrongly diagnosed and declared to be typhus fever, was soon
checked by energetic measures of precaution. Regarding the number of
plague patients in the Russian army, which was also attacked by several
other diseases, especially malaria, diarrhoea, dysentery, and fever, no
information is available; the Russian army numbered 150,000 men, and,
according to Seidlitz, 134,882 men were received into the lazarets and
75,226 men into the regimental sick-rooms up to the end of February
1829; thus 210,108 men contracted disease in a period of ten
months.[187]
In March 1829, plague broke out anew. Surgeon-General Witt, who had his
head-quarters in Jassy, declared that the disease was not plague, but an
endemic fever, and put an end to all measures of precaution in March.
‘After the patients were no longer quarantined,’ says Czetyrkin,[188]
‘the disease, bringing destruction in its train, in the spring and
summer began to make headway and spread over Moldavia, Wallachia, and
Bulgaria; it also accompanied the Russian army across the Balkan
Peninsula and appeared in Rumelia, where it completely wiped out several
hospitals. Those divisions of the army which were kept constantly on the
march and were thus exposed to the fresh air, rain, and dew, suffered
less severely; but the garrisons in the cities and strongholds were more
furiously attacked by the dreaded enemy. The overcrowded condition of
the lazarets, the lack of competent nurses and physicians (most of whom
were exterminated by plague), the uncertainty regarding the nature of
the disease—all this constituted the reason why the pestilence could not
be checked.’
The disease first appeared in March 1829 throughout Wallachia, but after
the middle of May it also revealed its presence south of the Danube;
Galatz, Babadag, Kustendji, Mangalia, Bazardschik, and Kavarna were
attacked in succession.
Varna suffered very severely; according to Petersenn, the first cases
occurred there in May 1829, in the infantry regiment Witepsk. The
patients were housed in tents on the sea-shore outside the city, and
since the number of people who contracted the disease continued to
increase, all the patients in the hospitals were soon taken there. The
city was finally completely evacuated and closed up, after the
inhabitants had been assigned to definite places to live in the open
fields and in a near-by forest. The plague reached its climax in the
latter part of June. ‘There was not a hospital,’ says Petersenn,[189]
‘not a quarter of the city, not a division of troops, not a family, not
a single place, which had escaped infection, and everywhere one came
across victims of the pestilence, some dying and some dead; for it
spared neither sex nor age nor class.’ And in another place the same
physician says:[190] ‘If the inside of the plague-camp afforded a
terrible sight, where sick men tossed about, gasping in the burning
summer heat, between the dead and dying, the conditions outside of the
plague-camp were no more pleasant to witness; for along the roads from
the city to the hospitals, on fields and meadows, behind every shrub, in
every ditch, dead and dying men were stretched out everywhere.’ And
Seidlitz, who visited Varna when the plague was at its height, asserts
that the corpses were piled up ‘like logs’ and carried away ‘by
cartloads’. According to Petersenn,[191] the number of patients that
died in the plague-hospital at Varna was:
From June 5 to 30 2,238
From July 1 to 31 1,484
From August 1 to 26 210
At the end of August there were only a few plague-patients in Varna. Of
forty-one physicians, twenty-eight contracted the disease and twenty
succumbed to it.
Conditions were as bad in many other places as they were in Varna;
Slobodzie, Kustendji, and Mangalia were likewise devastated. In Brailow
the first cases of plague occurred in March; in April 132 persons
succumbed to the disease, in May 150, in June 774, and in July the
pestilence abated.[192]
After the Russians crossed the Balkan Peninsula in the summer of 1829,
Adrianople, which was reached on August 12, 1829, was free from plague,
and it remained free until the end of the war. In the first part of
November, however, the plague broke out there in the large old barrack
which had been converted into a hospital and had become greatly
overcrowded. Patients, especially persons suffering from dysentery, had
been sent there from all sides, so that their number had increased on
August 17 to 1,616, on August 27 to 3,666, and on September 1 to 4,641.
On November 1, when the head-quarters were removed from there, 6,000
sick and healthy persons were left behind, the great majority of whom
fell victims to the plague. According to Rinck, in the latter part of
November ten or twenty soldiers suffering from plague were taken there
every day, and in the middle of December not one of the 300 sick-rooms
was spared; from fifty to sixty plague-patients were taken in every day
at this time.[193] In the middle of January 1830 the fury of the disease
abated a little among the Russians, but it raged more and more
destructively among the civil inhabitants, who numbered some 80,000. In
almost all the army-divisions stationed south of the Balkans, plague
broke out in the winter of 1829–30; the entire army, therefore, before
returning to Russia, had to be quarantined twice for a period of
twenty-one days.
Plague also revealed its presence in Transcaucasia, where fighting was
likewise going on. In Armenia it had broken out shortly before the
beginning of the Russo-Turkish War, as also in Erzerum. The
reinforcements coming from there had brought plague to Kars, where it
spread rapidly in the Turkish army.[194] In June 1828, when the
stronghold of Kars was stormed, the disease was borne by Turkish
prisoners back to the Russian army; but the strict measures of
Field-Marshal Count Paskewitsch prevented it from spreading further in
the army.[195] But the inhabitants of Kars resisted these orders, and
the result was that plague continued to rage there, partly in the
garrison, which in twenty days had 530 plague-patients, and partly among
the inhabitants, until September. The plague was conveyed by Turkish
prisoners to Eriwan, to the region of Tiflis, and to other places. In
the stronghold of Achalzich, situated midway between Batum and Tiflis,
plague broke out in the year 1829; in the latter part of February the
stronghold was besieged by the Turks, who were infected with plague. In
consequence of a sortie of the small garrison on March 6, which resulted
in the withdrawal of the Turks, since at the same time Russian
reinforcements were approaching, the plague was conveyed to Achalzich,
where the first cases occurred on March 10 in the garrison, and shortly
afterwards among the inhabitants. On May 23 that part of the garrison
which had been spared by the plague was marched out into the open
country, and the stronghold was thoroughly cleansed, after which no more
cases were reported. In the fall of 1829 plague completely disappeared
from among the Transcaucasian troops, and from the territory under their
control.
2. THE CRIMEAN WAR (1854–6)
The Crimean War plays a very conspicuous rôle in the history of
war-pestilences and of military sanitation; on the one hand, it showed
how severe a penalty an army has to pay if, without measures of
precaution, troops are sent to the scene of the war from infected
localities; on the other hand, it showed that it is possible to prevent
serious outbreaks of pestilence if energetic measures are adopted to
provide good food and shelter for the troops. Whereas the English
soldiers suffered a great deal more from pestilence in the first winter
than the French soldiers, in the second winter, in consequence of great
improvements introduced in the housing, clothing, and feeding of troops,
the English suffered very little, while the French suffered severely.
In the year 1853 cholera made its appearance in several places in
France, and in the following year it spread over the entire country; it
raged most furiously in the southern districts. Since the French troops,
who were embarked at Toulon and Marseilles, were consequently infected
with cholera, those suffering from the disease had to be put ashore from
the first transport ship at Malta, and others at the Peiraeus. When the
troops disembarked at Gallipoli there were thirteen cholera-patients
among them, and these were presently followed by other cases. Sporadic
cases of cholera then began to occur wherever the French soldiers went,
as in Nagara, Varna, Adrianople, &c. The fact that the disease was borne
thither by French troops was frankly admitted by most of the French
military physicians; only a few, for example, Cazalas, assumed that the
disease was already prevalent in Dobrudja.[196]
During the expedition undertaken by the French soldiers to the unhealthy
and deserted district of Dobrudja, cholera broke out in the army like an
explosion, compelling it to return. The English soldiers during the
siege of Varna, and also parts of the English fleet, were likewise
attacked by cholera. Statements made by Scrive and Chenu regarding the
number of French soldiers that succumbed to the pestilence diverge
widely; according to Scrive, the French army, which numbered some 55,000
men, lost 5,183 men between July 3 and August 30, 1854, in consequence
of cholera,[197] while Chenu gives us the following statistics:[198]
_No. patients._ _No. deaths._
July (1854) 8,239 5,030
August 3,043 3,015
September 376 239
The English army, which numbered some 30,000 men, also suffered:[199]
_No. patients._ _No. deaths._
July (1854) 449 285
August 938 611
September 1,232 575
October 445 273
In September the scene of the war was transferred to the Crimea, but
there again cholera raged furiously in both armies; in the winter of
1854–5, to be sure, it carried away a relatively small number of men,
but in the summer of 1855 it broke out anew with great severity. The
total number of deaths in the French army during the entire campaign was
12,467, in the English army 4,513, and in the Piedmontese army 1,230.
The size of the armies varied greatly; the French army was largest in
the latter part of the year 1855, when it numbered 145,000 men; the
total number of English soldiers was 97,864, and that of Piedmontese
soldiers, 21,000.
According to Häsar,[200] cholera spread far and wide from the scene of
the war—throughout Turkey, around the Black Sea, in Greece, in Smyrna,
along the coast of the Dardanelles, in Constantinople, Odessa, Rumelia,
and in the Danube principalities; the inhabitants of the district of
Dobrudja also suffered severely from the pestilence, which after the war
spread over a large part of Russia.
Scurvy also raged in the French army in the dry summer of the year 1855,
as well as in the severe winter following. In August 1855 there were
2,581 scurvy patients in the army, which was the largest number in the
summer months, and in February there were 4,341, the largest number in
the winter months. The outbreak of scurvy among the English troops, who
also suffered from the disease in the winter of 1854–5, was later
checked by the consumption of better food.
Dysentery was also very common: 6,105 French soldiers suffering from
that disease in the Crimea were taken to the field-lazarets; 2,061 died
there, and 2,792 were removed to Constantinople. No less than 7,883
English soldiers contracted acute and chronic dysentery, and 2,143
succumbed to it.
As early as the winter of 1854–5 a small number of cases of typhus fever
occurred among the French and English soldiers; but not until the winter
of 1855–6, between the months of December and March, did the disease
become very widespread in the French army in consequence of unfavourable
living conditions; the English army, on the other hand, scarcely
suffered at all during that winter. Scrive and Chenu publish the
following statistics relating to the French army in the field-lazarets
of the Crimea:
_Months._ _Size of _Typhus _Taken to _No.
army._ fever Constantinople._ deaths._
patients._
December (1855) 145,120 734 204 323
January (1856) 144,512 1,523 320 464
February 132,800 3,402 925 1,435
March 121,000 3,457 1,140 1,830
April 105,000 237 101
May 67,000 38 17
According to Scrive, 11,124 typhus-fever patients, all told, were taken
into the field-lazarets of the Crimea between September 1854 and July
1856; of these, 3,840 were removed to Constantinople, and 6,018 died in
the field-lazarets.[201] But Scrive says that this number of
typhus-fever patients is too small; it must have been increased by the
number of persons who contracted the disease in the field-lazarets and
hospitals, 4,502 of whom succumbed to it, and the number who contracted
and succumbed to it in Constantinople and France, making 7,000 all told.
According to Scrive, therefore, the total number of deaths due to typhus
fever in the French army was no less than 17,515, from which he assumes
that at least 35,000 men contracted the disease.[202]
In the English army typhus fever appeared only sporadically in the
winter of 1855–6; according to Chenu, 167 men contracted the disease and
62 succumbed to it.[203]
Among the Russian troops typhus fever raged furiously,[204] and
according to A. Hirsch it was also very widespread in southern
Russia.[205]
In Constantinople, typhus fever, although it infected numerous persons
in the military hospitals, apparently did not spread to the civil
population. Baudens, who after the capture of Sebastopol came to the
Orient, says expressly that the inhabitants of Constantinople were
spared by the epidemic during its entire course.[206]
According to Murchison, typhus fever was borne by English troops to
English soil, where in the years 1856–7 it caused epidemics in various
parts of the country. The following table indicates the number of
typhus-fever patients taken into the Fever Hospital in London:
1854 337
1855 342
1856 1,062
1857 274
1858 15
The increased number in London was not due to the fact that the disease
was brought over from Ireland, since there were only fifty-three
Irishmen among the patients, and only two of them had been in the city
less than three months. On the other hand, the warlike events caused a
famine, resulting in much misery among the poor, and this favoured the
further dissemination of the disease.[207]
When the French troops were transported back to France, energetic and
extensive measures of precaution were adopted; only those troops were
allowed to embark who had for several weeks been entirely recovered from
typhus fever; several stations for the discharge of men who contracted
the disease on the way were located along the coast of the Mediterranean
Sea, and sixty-two patients, all told, were left behind at them;
suspected divisions of troops, before disembarking at Marseilles, were
quarantined for a time on several islands along the coast, on St.
Marguerite (Îles de Lérins), on the Îles d’Hyères, and on others, and
before entering the city they were examined again, bathed, and
reclothed. The result was successful. Laveran says:[208] ‘The further
one went away from the seat of the infection, and the more the soldiers
scattered, the more the miasm seemed to lose strength; in France the
typhus-fever patients gave rise to only a few cases inside the hospitals
where they were being cared for; the disease was never communicated to
the civil population.’
Sporadic cases were observed in Marseilles, Toulon, Avignon,
Chalon-sur-Saône, and in other places. A small lazaret-epidemic also
occurred in Paris in the Val-de-Grâce; according to Godelier,[209]
almost all the patients there belonged to the Fiftieth Regiment, which
on November 30, 1855, embarked at Kamiesch. The condition of health in
the regiment at that time was good, and, in particular, it was free of
typhus fever. Of the two ships on which the soldiers were transported,
the one took only thirty days to get from Kamiesch to Marseilles and had
no cases of typhus fever, while the other, which had a harder voyage,
took fifty days and had numerous cases of typhus fever on the way;
fifteen patients were put into the hospital at Malta and twenty-five in
that at Marseilles. No less than fifty-eight soldiers in this regiment
contracted the disease in the Val-de-Grâce, and they infected five
nurses; eight soldiers and one nurse fell victims to the disease.
3. THE NORTH AMERICAN CIVIL WAR (1861–5)
At the outbreak of the Civil War almost nothing was done in the two
armies to prevent the outbreak and dissemination of diseases; the
assembling of so many troops rendered severe pestilences inevitable. The
successful activity of numerous voluntary societies did a great deal of
good in the way of improved methods of sanitation; the centre from which
this activity emanated was an officially recognized Sanitary Commission,
founded on June 15, 1861, which made the prevention of pestilences its
principal function. It was enabled to carry on its work by large
voluntary contributions of money. The means which the Commission
employed were: good equipment, food, and shelter for the men, isolation
of men suffering from infectious diseases, burning of the clothes, beds,
and tents used by these patients, erection of clean, well-ventilated
barrack-lazarets, and comprehensive plans for transferring invalid
soldiers from the field-hospitals.[210]
Since upwards of a million men, counting both sides, were gradually
brought face to face with one another, the loss of human life was
necessarily terrible. Regarding the losses sustained by the Northern
States, we are excellently informed by an exhaustive health-report in
six volumes, issued by the United States.[211] The report also contains
some statistics regarding the prevalence of disease among the
Confederates and regarding the prisoners, but no figures relating to the
losses sustained by the Southern States are available.
Regarding the total loss of troops sustained by the Northern States, we
find the following compilation:[212]
_Cause of death._ _White troops._ _Coloured troops._ _Total._
Killed in battle 42,724 1,514 44,238
Died from wounds, &c. 47,445 1,760 49,205
Suicide, murder, execution 469 57 526
Diseases 157,004 29,212 186,216
Unknown causes 23,347 837 24,184
——————— —————— ———————
Total 270,989 33,380 304,369
If we divide the deaths of unknown cause proportionally among the other
groups, the total number of deaths among the white troops due to
diseases was 171,806, and among the coloured troops 29,963.
In the statistical table in the first volume of the _Medical History_
the figures relating to the number of deaths are not complete; the total
numbers given there are:
_White troops._ _Coloured troops._
Wounds, &c. 36,688 1,427
Suicide, murder, execution 549 78
Diseases 128,937 27,499
Uncertain 449 ?
——————— ——————
Total 166,623 29,004
Typhoid fever demanded the largest number of victims; in the first two
years of the war it appeared in the form of murderous epidemics in the
Northern army, mostly in the Atlantic and central districts, and less
severely in the region of the great ocean. If the common continued
fevers, the typho-malarial fevers, and typhus fever, are combined with
the typhoid fevers and looked upon as typhoid fever, there died from
this cause in the Northern army during the entire war 32,112 white
troops and 3,689 coloured troops. In considering these figures, we must
remember that, as stated above, they are incomplete. On this basis, out
of every 1,000 men there succumbed to typhoid fever:[213]
_White troops._ _Coloured troops._
1861–2 20·75
1862–3 18·24
1863–4 8·52 28·50
1864–5 11·45 19·31
1865–6 8·98 11·60
————— —————
Average 13·58 19·8
As in the case of typhoid fever, so also in the case of other diseases,
the coloured troops suffered the heaviest losses, probably because the
food and shelter they received were not so good, and perhaps also
because they had less understanding of the sanitary measures that were
ordered. Among the Confederate prisoners that were brought north, about
40,875 in number, 18·4 out of every 1,000 succumbed to typhoid
fever.[214]
Regarding the appearance of typhus fever in the American Civil War,
views diverge. Since only a relatively small number of cases of that
disease are recorded, it is probable that those cases were wrongly
diagnosed, since typhus fever is so highly contagious. In the
health-reports of the Northern States, in which the word typhus, as in
England and France, means typhus fever, we find the following figures
relating to the disease:
_No. that contracted it._ _No. that succumbed to it._
White troops 2,501 850
Coloured troops 123 108
But there are very few case-histories and absolutely no post-mortem
reports available from which one can draw a positive conclusion. Laveran
doubts the occurrence of typhus fever.[215] According to Niedner, on the
other hand, typhus fever prevailed among the Northern prisoners in the
terribly neglected prisons of Salisbury, North Carolina, and probably,
too, in other places.[216] It is to be surmised that the increased
number of typhus fever patients in New York and Philadelphia, &c., which
Hirsch adduces in accordance with the statements of da Costa and Corse,
was connected with the epidemic among the prisoners.[217] According to
Corse, the number of deaths due to typhus fever in Philadelphia was 37
in the year 1862, 131 in 1863, and 335 in 1864.
Unusually prevalent were diarrhoea and dysentery, so that,
notwithstanding their relatively mild character, they caused a large
number of deaths. The cases of cholera reported were not Asiatic
cholera, but a local form of the disease. In the Northern army the
following figures indicate the number of deaths due to acute and chronic
dysentery and diarrhoea:
WHITE TROOPS. COLOURED TROOPS.
_Dysentery._ _Diarrhoea._ _Dysentery._ _Diarrhoea._
_A- _Chron- _A- _Chron- _A- _Chron- _A- _Chron-
cute._ ic._ cute._ ic._ cute._ ic._ cute._ ic._
June 1861 3 1
1861–2 338 136 230 501
1862–3 967 1,090 941 7,556
1863–4 1,242 931 620 7,868 496 220 503 784
1864–5 1,248 919 973 10,600 584 255 608 1,788
1865–6 286 152 159 1,033 412 151 257 706
————— ————— ————— —————— ————— ——— ————— —————
1861–6 4,084 3,229 2,923 27,558 1,492 626 1,368 3,278
Out of every 1,000 men there succumbed to dysentery and diarrhoea
together:[218]
_White troops._ _Coloured troops._
1861–2 4·17
1862–3 15·99
1863–4 15·78 43·54
1864–5 21·29 36·29
1865–6 16·00 26·97
Small-pox raged very extensively during the American Civil War; the
coloured troops manifested much more susceptibility to it than the
white. The dissemination of the disease was helped along by the fact
that vaccination, which had been neglected on account of the hasty
mobilization, could not be attended to as rapidly as was desirable.
Measles also broke out in both armies in the form of widespread
epidemics. All told, 67,763 white troops and 8,555 coloured troops
contracted the disease, while 4,246 of the former and 931 of the latter
succumbed to it. Out of every 1,000 men there succumbed:[219]
SMALL-POX. MEASLES.
_White troops._ _Coloured _White troops._ _Coloured
troops._ troops._
1861–2 1·36 1·97
1862–3 1·45 1·99
1863–4 3·21 16·52 1·88 12·35
1864–5 1·75 8·69 1·68 3·75
1865–6 0·69 14·24 0·11 0·51
Malaria became particularly widespread; on an average no less than 52
per cent of the white troops and 83 per cent of the coloured troops
contracted the disease per annum. It is absurd to say, then, that the
negroes are immune to the disease; on the contrary, they contracted it
much more frequently and suffered a great deal more severely from it
than the whites. The troops in the military districts of Carolina and
Arkansas, and also along the great rivers—the Mississippi, Ohio, and
Potomac—were attacked by it with particular severity. Out of every
thousand men the number that contracted the disease and the number that
succumbed to it is shown by the following table:[220]
WHITE TROOPS. COLOURED TROOPS.
_No. patients._ _No. deaths._ _No. patients._ _No. deaths._
1861–2 404·0 2·77
1862–3 460·1 3·76
1863–4 584·1 3·19 833·7 15·19
1864–5 558·4 3·34 750·0 8·77
1865–6 853·1 5·42 947·0 7·81
The total loss sustained by the Northern army in consequence of the most
important infectious diseases is indicated by the following table:[221]
WHITE TROOPS.
_No. _Ty- _Typhus _Dysen- _Chol- _Small- _Mea- _Ma-
troops._ phoid fever._ tery, era._ pox._ sles._ laria._
fever._ diar-
rhoea._
1861 41,556 17 3 4 1 3 1
May-
June
1861–2 288,919 5,795 201 1,205 34 393 568 800
1862–3 659,955 11,658 378 10,554 96 950 1,314 2,480
1863–4 675,413 5,632 123 10,661 56 2,171 1,268 2,152
1864–5 645,506 7,266 124 13,740 67 1,131 1,082 2,155
1865–6 101,897 894 21 1,630 22 71 11 552
——————— —————— ——— —————— ——— ————— ————— —————
Annual 468,275 Totals 850 37,794 275 4,717 4,246 8,140
Average 31,262
COLOURED TROOPS.
1863–4 45,174 1,251 60 2,003 7 760 568 699
1864–5 89,143 1,680 41 3,235 10 775 334 782
1865–6 56,617 650 7 1,526 13 806 29 442
——————— —————— ——— —————— ——— ————— ————— —————
Annual 63,645 Totals 108 6,764 30 2,341 931 1,923
Average 3,581
In the prisons the mortality on both sides was terrible. Regarding the
conditions among the Confederate prisoners that were interned in the
Northern States we are informed by the following table. The average
number of men in the prisons was 40,815, and of this number 19,060, all
told, died; taking the entire war into account, this gives a mortality
of 230.7 per 1,000 per annum.[222] The figures are divided among the
various diseases as follows:
_Deaths (all _Annual rate per
told)._ 1,000._
Typhoid Fever, Typhus Fever 1,109 13·6
Malaria 1,026 12·6
Small-pox, Measles, Scarlet Fever, 3,453 42·3
Erysipelas
Diarrhoea, Dysentery 5,965 73·0
Scurvy 351 4·3
Bronchitis 133 1·6
Inflammation of the Lungs and 5,042 61·7
Pleurisy
Other diseases 1,729 21·3
Wounds and uncertain maladies 252 0·3
—————— —————
Total 19,060 230·7
The conditions among the Northern prisoners confined in the Southern
prisons were still worse. In the Andersonville prison, where in the six
months between March 1 and August 31, 1864, an average of 19,453
prisoners were confined, 7,712 died; this means an annual rate of 792.8
per 1,000 men. The following table indicates the proportional mortality
of the individual diseases:[223]
_Cause of death._ _Deaths (all _Annual rate per
told)._ 1,000._
Typhoid Fever, Typhus Fever 199 20·5
Malaria 119 12·2
Small-pox, Measles, Scarlet Fever, 80 8·2
Erysipelas
Diarrhoea, Dysentery 4,529 465·6
Scurvy 999 102·8
Bronchitis 90 9·2
Inflammation of the Lungs and 266 27·4
Pleurisy
Other diseases 844 86·7
Wounds and uncertain maladies 586 60·2
—————— —————
Total 7,712 792·8
Since mortality statistics existed in only a few of the Northern States
at that time, and the deaths for the year in question were included
merely incidentally in the census taken every ten years, it is
impossible to adduce any figures relating to the spreading of infectious
diseases from the army to the civil population. But certain it is that
this happened to a great extent in the regions where the fighting took
place. In the case of two States, Massachusetts and Connecticut,
mortality statistics are available; in both we find an increased
death-rate during the Civil War. The figures, which do not include the
still-births, are as follows:
_Year._ _Connecticut._ _Massachusetts._
1860 16·3 18·7
1861 16·5 19·5
1862 18·0 18·5
1863 18·0 22·1
1864 19·0 22·8
1865 16·0 20·6
1866 15·0 18·1
1867 14·3 17·0
In the case of Massachusetts, moreover, we have statistics relating to
the cause of death; these statistics show a considerable increase in
deaths due to typhoid fever, small-pox, and dysentery; the mortality of
scarlet fever was also very high there during the war-years, but this
fact was in no way connected with the war. The number of people who
contracted the above-mentioned diseases in Massachusetts was:[224]
_Year._ _Typhoid Fever._ _Small-pox._ _Dysentery._
1860 937 334 441
1861 989 33 532
1862 1,135 40 479
1863 1,442 42 1,156
1864 1,344 242 1,186
1865 1,694 221 1,548
1866 1,091 141 949
1867 965 196 658
4. THE ITALIAN WAR OF 1859[225]
The Italian War of 1859, which the French and Piedmontese together waged
against Austria in Upper Italy, was not attended by any severe
pestilences, probably because it was terminated in a comparatively short
time, and the number of troops engaged was not very large. To be sure,
typhoid fever and dysentery carried away many men on both sides, while
an unusually large number of soldiers contracted malaria. Those fevers
which were called ‘Fièvres rémittentes épidémiques d’Italie’, and which,
notwithstanding their frequent occurrence, caused only a few deaths,
according to Niedner were for the most part malaria, and not relapsing
fever. The Austrian army seems to have lost more men in consequence of
pestilences than the French army. Regarding the spreading of the
pestilences on a large scale from the armies to the civil population we
have no information.
5. THE DANISH WAR OF 1864
In the war of 1864, which Austria and Prussia waged against Denmark, no
epidemics of wide extent occurred. ‘The small number of men engaged,’
says Knaak,[226] ‘the not particularly unfavourable external conditions,
the constant communication between the fighting armies and their
home-countries, and the non-appearance of large epidemics, all helped to
render the health-conditions of the war favourable.’ The total loss
sustained by the Prussian army, which reached a maximum size of 63,500
men, amounted to 1,048 men; of these 738 died in battle, in consequence
of wounds, &c., 310 succumbed to diseases, 193 of the latter to typhoid
fever. Statements regarding the number of deaths in the Austrian army,
which amounted to 25,000 men, are not available. The Danish army, which
numbered 54,000 men, lost 1,446 in consequence of wounds, &c., and 820
in consequence of diseases.[227]
6. THE GERMAN WAR OF 1866
As regards sanitation the German War of 1866 acquired importance through
the appearance of cholera on the scene of the fighting. None of the
other infectious diseases developed very extensively during this war; of
the Prussian army, which numbered some 280,000 men, only 379, all told,
succumbed to typhoid fever, and dysentery did not appear at all. A
rather mild epidemic of small-pox spread throughout a considerable part
of Germany in the year 1865, and lasted until the year 1866; whether or
not the war helped the disease to spread, which is not unlikely, we
cannot state with certainty owing to a lack of bases of comparison. The
German troops were well vaccinated, and the number who contracted the
disease was no larger during the war than in times of peace. It is
undoubtedly true, however, that the war exerted an unwholesome influence
upon the dissemination of cholera throughout Germany and Austria.[228]
Cholera had revealed its presence in Germany for the first time in the
year 1865; it broke out in Altenburg, during its fourth passage through
Europe, having been borne thither from Odessa. In the course of the year
it broke out, in a comparatively mild form, in many places in Saxony. In
the year 1866 it raged very extensively and furiously in the Rhine
province and in Westphalia, whither it was borne from Luxemburg; in May
cases of the disease occurred in several seaport towns of Pomerania
(Swinemünde, Stettin, Cammin, &c.), and in June it broke out in Hamburg,
Berlin, Posen, Silesia, East and West Prussia, and in the kingdom of
Saxony.[229] Thus it came about that some of the troops enlisted came
from infected parts of Silesia and Saxony, and the result was that
individual cases of cholera began to occur in the Prussian army.
The disease was conveyed by soldiers from Stettin to Leipzig, where it
spread to the civil population; from Leipzig it spread throughout Saxony
and Thuringia. When the Prussian army advanced into Bohemia the cases of
the disease began to increase, and after the battle of Königgrätz (July
3, 1866) the dissemination of the disease was helped along by the
crowding together of large numbers of sick and wounded soldiers. The
rapid advance of the Prussian army increased the disease’s rate of
dissemination; on all the army’s lines of march large numbers of sick
soldiers were left behind, for example, in Göritz, Gitschin, Königinhof,
Pardubitz, Czaslau, and Leitomischl. In Prague cases of cholera were
reported a few days after the city was occupied. The pestilence was
conveyed by Prussian soldiers to Moravia, where it appeared in Prerau,
Brünn, Iglau, Klosterbrück, Znaym, and Nikolsburg. The further advance
of the Prussians conveyed it to Lower Austria; in Vienna it did not
break out until August.
Some think that the pestilence was conveyed into Austria from Bukowina,
where it had broken out in May 1866. When the war broke out, it is
maintained, the disease was conveyed by troops to the western
crown-lands of Austria.[230] ‘The truth’, says Niedner, ‘probably lies
half way between; the epidemic in Bohemia was disseminated chiefly by
the Prussian troops, but in the other Austrian countries by Austrian
troops.’ Daimer,[231] one of the best authorities on the history of
pestilences in Austria, says: ‘In the year 1866 an epidemic of cholera
came to an end in Bukowina, where it was looked upon as the continuation
of one that had been prevailing in Turkey and Roumania; it spread
throughout the countries in which fighting was going on at that time,
and was borne by troops to remote regions.’ According to Presl,[232] the
number of deaths due to cholera in the several crown-lands in the year
1866 was:
_No. inhabitants _Deaths due to
(Dec. 31, 1869)._ cholera._
Lower Austria 1,983,149 15,114
Upper Austria 733,241 153
Salzburg 152,141 1
Styria 1,139,205 260
Carinthia 336,768 40
Carniola 465,463 930
Küstenland 585,467 1,067
Tirol and Vorarlberg 880,985 25
Bohemia 5,151,332 42,730
Moravia 2,016,186 55,527
Silesia 518,443 2,919
Galicia 5,491,675 34,857
Bukowina 522,481 11,656
Dalmatia 445,201 13
—————————— ———————
All Austria 20,421,737 165,292
In Prussia, too, cholera spread, in consequence of the war, more widely
than ever before; the total number of deaths caused by it in the year
1866 was no less than 114,776, and in the following year it was
6,086.[233] Of the Prussian troops 4,529 (16·2 per cent) succumbed to
cholera, and the total loss due to disease was 5,219; only 4,008 men
were killed on the field or died from wounds.
In the Grand Duchy of Hesse a few rather small epidemics occurred, and a
larger one in Mayence.
In the case of Baden the connexion between the appearance of cholera and
the war has been carefully investigated.[234] The disease broke out in
the region of the Main and Tauber and in the Odenwald, and in regions
which had never before been attacked by cholera. On July 24, 1866,
Wertheim received a Prussian garrison, which on the 26th was joined by
parts of the Hamburg contingent. As mentioned above, cholera had already
broken out in Hamburg in June, and a few days after the arrival of the
Hanseatic troops some of them contracted the disease and were taken,
despite the objections of the local authorities, to the town hospital.
On August 6, cases of the disease appeared in the city, and they
constituted the beginning of a small epidemic which lasted six weeks. On
September 22 the epidemic was over, after the population of 3,383 had
lost 28 persons by death; 64 persons contracted the disease. In near-by
Freudenberg, of 42 people that contracted the disease, 23 died. In
Schönfeld two soldiers of the Hamburg contingent contracted the disease
on July 29; the first case among the civil inhabitants, who numbered
524, was on August 2, and in a few days a small epidemic began; 166
people contracted the disease and 55 succumbed to it. At the same time
the Hanseatic troops conveyed the disease to Gerlachsheim, where 61
persons contracted it and 32 died of it, and also to Ilmspan, where 97
contracted it and 34 succumbed to it. On August 1 the Hamburg soldiers
came to Grünsfeld and brought four cholera patients with them, and the
result was that 177 of the inhabitants, who numbered 1,458 all told,
contracted the disease and 23 of them died. The disease was conveyed to
Dittigheim by cholera convalescents of the Hamburg contingent, and 225
persons contracted it there and 66 succumbed to it. In Gerlachsheim it
appeared after a Saxon ammunition-column, which was supposed to be
absolutely free from the disease, had passed through the city. In the
case of Walldurn, which had a very severe epidemic (the city had 3,339
inhabitants, and of these 827 contracted the disease and 113 succumbed
to it), it was impossible to prove that the disease broke out in
consequence of the arrival of the soldiers. Külsheim, which was infected
from Walldurn, had only a small number of cases. Throughout Baden 1,774
persons contracted cholera and 404 succumbed to it. From these
statements it is very evident that the danger of an extensive epidemic
of cholera in the regions south of the Main would have been very great,
if the war had been carried on there on a large scale, and had thus
prevented the authorities from taking measures to prevent the
dissemination of the disease.
The small epidemic in Uzmemmingen, a village of 700 inhabitants in the
north-east part of Württemberg, was brought about by a chamber-maid, who
on August 25 brought the disease from a Bohemian place through which a
Prussian detachment had passed; 60 persons, all told, contracted the
disease in Uzmemmingen, and 19 succumbed to it.[235]
In the Bavarian Governmental District of Lower Franconia cholera broke
out, as in Baden, in consequence of the operations of Prussian
troops.[236] In the last week of July there were skirmishes between the
Prussians and Bavarians near Hettstadt and Waldbrunn; after the
withdrawal of the Prussians, many of whom were seized with diarrhoea,
cholera broke out in both of those villages. The outbreak in Miltenberg
was also connected with the arrival there of Prussian soldiers.
Presently other places in Lower Franconia were attacked; for example,
Rothenfels, Birkenfeld, Karbach, Stadtprozelten, Tiefenthal,
Waldbüttelbrunn, &c. A Bavarian authority gives credit for the
non-appearance of the disease in Remlingen and among the civil
inhabitants of Uettingen, where Prussian soldiers suffering from cholera
lay, to the care and vigilance of the Prussian military physicians.
Cholera also appeared in the Governmental District of Swabia, breaking
out in the cities along the Danube, in Höchstädt, Dillingen,
Gundelfingen, and Neuburg. But it was impossible to prove that the
disease was conveyed thither from the scene of the war.[237]