EPIDEMICS IN BESIEGED STRONGHOLDS
When fortified cities are subjected to a long siege the death-rate in
them increases considerably; if diseases break out during the siege,
they spread beyond expectation and carry away large numbers of people.
The greatest enemy of the people in a besieged city is hunger. Since the
approaching hostile army causes the inhabitants of the surrounding
country to take refuge in the cities, the latter suddenly become
overcrowded, moreover with people who are generally quite penniless and
have to be provided for by the rest. In former years, when warfare was
much more cruel than it is to-day, this was especially the case.
Furthermore, the size of the garrison must be rapidly increased, or
perhaps the whole of a retreating army, as was the case in Metz, must be
quartered in the stronghold. Accordingly, the first step taken by the
commander of a fortress must be to ascertain the quantity of provisions
on hand, and to work out an appropriate plan for the distribution of
them. How the quality of the bread becomes more and more unsatisfactory,
and finally reaches the point where the product is scarcely worthy of
the name bread; how people are obliged to eat the flesh of horses, dogs,
and other animals; how the prices of the necessaries of life soar _ad
infinitum_—all this is so well known that it needs no further
exposition. Besides the absence of these necessaries of life, the lack
of milk, fats, salt, and vegetables is accompanied by various
consequences; very frequently improper and badly prepared food gives
rise to a large number of severe cases of intestinal catarrh.
Insufficient nourishment is seldom the direct cause of death; on the
other hand, it frequently so weakens people that they are much more
subject to sickness, or, if they have already contracted some disease,
they are much more likely to die, or, if they recover, to convalesce
slowly. Thus Vacher[324] states that typhoid fever, which usually
results fatally in one out of four cases, during the siege of Paris
carried away no less than forty per cent of those who contracted it;
tuberculosis, he says, often acquired an acute form and caused death
within a few weeks. Little children present slight resistance to famine.
‘In regard to new-born and one-year-old infants I have observed in
certain cases that become more frequent every day, that the effects of
insufficient alimentation show themselves in the form of a progressive
emaciation, which includes all the tissues of the body and almost always
has fatal consequences; oedema of the teguments, anaemia, uncontrollable
diarrhoea, and continual plaintive crying on the part of the little
patients are the characteristic symptoms of that hunger-fever which
actually decimates our infant generation.’
Another result of insufficient nourishment, one which has frequently
been observed in besieged strongholds, is the appearance of scurvy.
During sieges, the hygienic measures of precaution, which are absolutely
essential to the maintenance of health in cities, can no longer be
carried out. If spring-water is secured outside the city for the
inhabitants, the besiegers cut off the source of supply; if the water of
rivers is used, then filtration plants have to be erected. But even
filtration does not prevent the appearance of those infectious diseases
the germs of which are carried in water, since for washing purposes the
river-water is used just as it is found. The removal of refuse
constitutes an extremely difficult problem; the cleaning out of privies
is often possible only to a very insufficient extent, especially when
the besiegers have advanced very close to the city, and the failure to
dispose of garbage necessarily causes large accumulations of dirt and
filth in the streets; this was especially the case in former times.
The burying of so many dead bodies, of both men and animals, especially
horses, has met in many sieges with serious obstacles;[325] if the
ditches intended for a large number of bodies are not dug deep enough,
the atmosphere becomes polluted; to burn them is impossible, owing to
lack of fuel; and if they are cast into the river, this jeopardizes the
health of those living further downstream. During certain sieges in the
past, hard conditions have made it necessary to leave corpses and
carcases lying in the open, with terrible consequences.
If the siege takes place in the winter, it is very difficult to procure
fuel for heating purposes, unless sufficient provision has been made
beforehand. In Paris, for example, the inhabitants suffered severely
from cold, and to meet the emergency artificial fuel was prepared by
mixing stable manure with tar and reducing the mass to solid form under
the hydraulic press.
In the following pages we discuss a few sieges which were characterized
by severe outbreaks of pestilence.
1. THE SIEGE OF MANTUA (1796–7)[326]
During the siege of Mantua, which the French carried on from May 30,
1796, to February 3, 1797, war-pestilences raged with fearful severity
among both besiegers and besieged. The city lay in an extremely
unhealthy region—malaria was ever prevalent and the drinking-water was
bad. The intentional flooding of the region and the great heat of the
summer of 1796 caused malaria to break out with great severity and to
acquire virulent forms that rendered the disease more dangerous than
usual. In the latter part of May 1796, the garrison consisted of 18,000
Austrian troops, whose power of resistance had been greatly reduced by
hard service from November on, and by exposure to rain and cold with
inadequate means of shelter. Besides intermittent fever, both intestinal
catarrh and typhus fever made their appearance in July; the latter, at
least, was probably the ‘nervous fever’ mentioned by Stegmeyer. Thus as
early as the latter part of July there were some 2,000 sick men in the
garrison. In August the investment was not yet complete, so that the
soldiers did not suffer from lack of food. Notwithstanding this fact,
however, the diseases increased in prevalence and caused many deaths;
the number of sick men was no less than 6,000. On September 12 the
Austrian general, Würmser, with about 12,000 men, succeeded in gaining
entrance into the city; he brought with him a large number of disabled
men who had been wounded in recent fighting, and many of whom succumbed
to tetanus and hospital fever. The number of patients now increased to
8,500; as there was no bedding or straw available, the patients were
compelled to lie on the bare ground, and the uncleanliness of the
hospitals grew worse. When the investment was finally rendered complete
in October, it caused a great scarcity of meat, fat, and wine; the
number of patients that month was 9,000 and the number of deaths 2,560.
These figures, however, are not complete, since they do not include the
patients in the houses set aside for troops overcome by exhaustion. Up
to this time the weather had been good, but in November rain set in; and
while intermittent fever then decreased in prevalence, dysentery raged
even more furiously, and typhus fever also broke out in a virulent,
quickly fatal form. The supply of food now ran very low, and although
there was sufficient bread on hand, horse-flesh was the only meat. To
add to the general misery, scurvy made its appearance in November, and
all those who contracted it died. The extreme cold compelled the
patients to keep their clothes on, and they lay without blankets on the
hard floors of the hospital corridors; their number had now increased to
9,500, and 2,400 died in November. In December the misery increased; the
cold became more and more intense, the supply of food was almost
exhausted, and the wine gave out altogether; scurvy raged in an even
more severe and virulent form, being frequently accompanied by copious
hemorrhages from various parts of the body. In the hospitals there were
7,354 patients, and 2,021 died in the month of December. In January the
acme of misery was reached; the scarcity of food was terrible, and the
ravages of scurvy were no less than frightful; 1,968 men in the garrison
were carried away in the course of that month. On February 3, 1797, the
stronghold was surrendered to the French. The number of patients taken
in by the hospitals between September and January exceeded 40,000, and
of the garrison, which numbered some 30,000 men, 10,249 (more than
one-third of the total) died. Fodéré estimates the total number of
deaths in the city of Mantua during the siege at 20,000;[327] regarding
the prevalence of diseases and the number of deaths among the civil
inhabitants Steegmeyer unfortunately gives us no information.
2. THE SIEGE OF DANZIG (1813)
Danzig, which in the spring of 1807 had passed through a siege of ten
weeks, was once more, in the year 1813, from January 11 to November 29,
subjected to the horrors of a siege, which for two reasons was even more
horrible than the previous one; in the first place, the garrison was
badly infected with disease, causing a severe epidemic to rage
throughout the city; and in the second place, the defenders of the
stronghold, which was most advantageously located to withstand a siege,
were national enemies of the inhabitants. Consequently the latter were
not only grossly disregarded in the distribution of supplies, but were
actually obliged to turn over all they had to the French and then buy it
back at exorbitant prices. And while the inhabitants, and toward the end
of the siege the soldiers, too, suffered severely from a lack of the
necessaries of life, the higher officers and the military officials
lived in luxury until the day of the surrender.
Napoleon had assigned the defence of the city to General Rapp, who
performed the task with great valour and ability. On the return march
from Russia, some 40,000 men of Macdonald’s corps had congregated in
Danzig, and 5,000 of them were sent away by Rapp; in the middle of
January the total number of men in the garrison, including the military
officials, was 35,934, consisting of Frenchmen, Poles, Bavarians,
Westphalians, Spaniards, Italians, and Dutchmen. While Macdonald’s corps
had fared pretty well, comparatively speaking, in the Russian campaign,
the men were all very much exhausted, and furthermore, typhus fever was
prevalent among them. As early as the latter part of January,
accordingly, the number of sick soldiers was very large; in fact, only
about 10,000 men were healthy and able to bear arms. ‘As there were no
hospitals, beds, or remedies,’ says Friccius,[328] ‘many died from lack
of care, and at the same time infectious diseases broke out and made
great havoc. A heap of dead men and horses was a common sight in the
streets, and in a short time many thousands of the troops, as well as of
the inhabitants, were carried away.’
In January the death-rate remained comparatively low; of the garrison
about 400 men died in the course of that month. But in February, which
was a very cold month, typhus fever spread abroad with great rapidity,
so that toward the end of the month some 130 soldiers died every day; no
less than 15,000 men lay sick, and the total number of deaths for the
entire month amounted to 2,000. When it began to thaw on February 24,
the number of patients and deaths increased still more, so that 4,000
men died in March and 3,000 in April. From April on, the condition of
health in the garrison improved, although the number of deaths in the
month of May was still no less than 2,000.[329]
As early as February typhus fever had spread to the civil population,
which before the siege had numbered some 40,000; a great many civilians,
however, had fled from the city before the investment was yet complete.
In the months of February and March, according to Blech,[330] some
200–300 persons died every week, ‘including representatives of all
classes—physicians, preachers, jurists, merchants, down to the humblest
people.’ The pestilence raged most furiously among the civil inhabitants
in the latter part of March. ‘Almost every family was in mourning, and
many families were wiped out entirely; the best and most estimable young
men were carried away in the prime of their lives. Whole families
perished, especially in certain streets which the pestilence seemed to
have selected for its chief dwelling-place.’[331] These were especially
the streets inhabited by the poorer classes.
It was not long before a lack of the necessaries of life began to make
itself felt in the city. As early as February 27 the Russians had cut
off the supply of water afforded by the Radaune, which fed the wells in
the city, and this necessitated dependence upon rain-water. For the
purpose of obtaining new supplies of food, a sortie along the Nehrung
was undertaken on April 27; and while the enterprise was successful, the
only persons who really derived any benefit from it were the higher
officers and military officials, who sold butter, milk, and corned beef
at exorbitant prices. Thus the well-to-do citizens, at least, were able
to secure food by paying an excessive price for it. In May the
conditions among the poor became a great deal worse; they were obliged
to eat things that were positively disgusting; horse-meat and waste from
the breweries were delicacies, while cats and dogs were also devoured.
The rations of the soldiers grew smaller and smaller, although there was
sufficient grain on hand to keep them supplied with bread. Says
Friccius,[332] in regard to a sortie undertaken on June 9, ‘How hungry
the troops in the garrison were is indicated by the fact that they cut
up every horse that was killed in battle and took the edible parts with
them.’
After the conclusion of the armistice, which became known in Danzig on
June 10, there was a pause in the siege lasting until August 18; during
this time the besiegers brought food to the garrison every five days,
but absolutely no provision was made for the civil inhabitants. During
the armistice many citizens left the city; indeed the French expelled
from the city all persons who were not sufficiently provided with the
necessaries of life. At first the Russians allowed the fugitives to pass
through their lines, but later on they raised objections, so that a
large number of the unfortunate inhabitants were obliged to live in the
open fields between the besiegers and the besieged, where many of them
died of starvation. In the latter part of September General Rapp allowed
some 300 of them, who had managed to keep alive, to return into the
city. Blech asserts that the emigration of beggars and others of the
poor reduced the population of the city by some 16,000.[333]
In October, lack of the necessaries of life reached a climax, so that
rats and mice were eaten. Since the scarcity of provender made it
necessary to slaughter almost all the horses, the soldiers were supplied
with large quantities of horse-meat. On November 1 the granaries, in
which were kept the provisions of the garrison, were destroyed by fire,
resulting in the loss of about two-thirds of the provisions. This made
it necessary to reduce the soldiers’ bread-rations, and the bread with
which they were supplied was made of half-burned flour and of rusks
fished out of the stinking Mottlau; ‘it was so disgusting that only
ravenous hunger could induce anybody to eat it.’[334]
In consequence of hunger and the unnatural food eaten, the mortality
among the civil inhabitants, the number of whom had dwindled down to
16,000, became very high; the number of deaths per week in the month of
October was no less than 50–80, to which, according to Blech, must be
added the deaths among the poor which were no longer reported. In the
first part of November there were some 80–90 deaths per week. On
November 29 General Rapp surrendered the city to the Russians and
Prussians; but since the conditions of capitulation could not be agreed
upon until January 1, 1814, there was an interval of about a month
during which the French garrison, but not the civil population, was
supplied with food; consequently the death-rate among the citizens
remained high. Furthermore, the besiegers, among whom a virulent typhus
had been raging since October, communicated the infection to the
inhabitants, 107 of whom succumbed to it in the last week of November,
133 in the first week of December, and 138 in the following week. On
December 1, permission was obtained to establish a market, and from that
time on, the citizens could once more provide themselves with food in a
regular way.
The loss of human life inside the besieged stronghold was terrible; of
the 35,900 troops in the garrison, 15,736 according to Friccius died in
the lazarets; at the time of the capitulation only 16,532 men were left,
and of these 1,482 were sick and had to be left in the city. According
to Blech, a total of 5,592 civilians died, 1,142 of them in the last
three months (October-December) of the year; the number of deaths in
December alone was 473. Toward the end of the siege some ninety persons
died of starvation.[335]
3. THE SIEGE OF TORGAU (1813)[336]
On May 10, 1813, when Napoleon had appeared in Saxony, and the King,
after considerable hesitation, had decided in his favour, the Saxon
garrison of Torgau, at that time a place of 5,000 inhabitants, was
replaced by a French army-corps. In the course of the summer large
transports of sick soldiers from various lazarets arrived at Torgau, and
on July 18 alone 3,000 sick men and 1,000 convalescents came from
Dresden. Consequently the number of sick in the stronghold was very
large even before the siege began; all public buildings had been
converted into lazarets. But even these were not numerous or large
enough to accommodate all the patients, who numbered some 6,000 in the
month of September, so that the occupants of houses along entire streets
were driven out of their homes, which were used for lazarets and
barracks. ‘A virulent, putrid fever’ raged in all the lazarets, and at
least one-third of the persons who contracted it died; the inhabitants
and the Frenchmen quartered in the homes of citizens were at first
spared by the disease.
After the battle of Dennewitz (September 6, 1813) the head-quarters of
the third and fourth French army-corps was transferred to Torgau, where
also numerous fugitives took refuge; at the same time the large French
head-quarters from Dresden arrived, so that the size of the garrison was
increased by 10,000 men and 5,000 horses. After the battle of Leipzig
the stronghold was besieged by the Prussians, and presently the supply
of food ran low and the uncleanliness in the streets and houses grew
incredibly worse. ‘Then the pestilence began to spread at an alarming
rate among the inhabitants and among the Frenchmen quartered in the
homes of citizens, so that the entire city of Torgau came to resemble a
large, overcrowded lazaret.’[337]
‘The regular lazarets now became veritable hot-beds of misery; they were
scarcely able to accommodate the large number of patients, who numbered
at least 12,000, and whom it was necessary to place so close together
that they almost touched one another. There was a lack of straw and of
other necessities, of sick-attendants and physicians, of effective
remedies, and especially of order and proper superintendence.’ The
patients suffered partly from severe, fetid diarrhoea, and partly from
typhus. In the courtyards there were enormous accumulations of dirt and
refuse, and the doors leading into many of the sick-rooms could scarcely
be opened owing to the collections of foul matter which covered the
floor ankle-deep; in order to reach the sick it was necessary to wade
through this and to climb over dead bodies. Absolutely no thought was
given to keeping the rooms warm. ‘Thus it is quite natural that among
these horrible surroundings the slightest wound, the most insignificant
indisposition, could easily have a fatal termination, and that it was
like sentencing a man to death to bring him to the lazaret.’ The number
of deaths exceeded 8,000 in the month of November alone.
Equally terrible were the conditions in the other parts of the city; all
the private houses were overcrowded with patients and filled with dirt.
A sickening odour permeated the atmosphere; in the ditches around the
fortress and in every corner of the city lay dead horses, rotting straw
sacks, ragged uniforms, and even human corpses. Refuse of the worst kind
was piled up in the streets, often as high as the second story. ‘At this
time’, says Lehmann, ‘Torgau looked more like a lazaret than a city
inhabited by healthy persons; for who would have been able to find a
house in which there were no persons suffering from nerve-fever?
Parlours, bedrooms, halls, stables, kitchens, and cellars—all were
filled with patients.’ The barracks and guard-rooms resembled hospitals.
In a few weeks more than 600 inhabitants died; entire families were
wiped out by the epidemic, and there was scarcely one which was not
mourning the loss of one of its members.
Up to the beginning of December the number of patients steadily
increased; in the lazarets alone, 300 soldiers died every day.
The terrors of the bombardment had a very disastrous effect upon the
inhabitants of the city, since it compelled them to live in damp,
unhealthy, infected cellars. Not until the latter part of December did
the epidemic begin to abate and to lose, at the same time, its virulent
character; the arrival of very cold weather, as well as the diminution
of the number of people, and the fact that the infection had practically
run its course among the inhabitants and the garrison, were at least
partly responsible for this abatement; furthermore, there was now less
crowding, and it became possible to establish better order.
The lack of system in the French lazarets is shown by the fact that the
authorities were never once able to give an account of the number of
persons that died in them. From grave-diggers’ records and church
registers Richter managed to compile the following table of statistics
indicating the number of deaths:[338]
_French _Saxon _Civil _Total._
soldiers._ soldiers._ inhabitants._
January-August (1813) 222
September 1,107 64 43 1,214
October 4,803 36 66 4,905
November 8,209 3 228 8,440
December 4,886 258 5,144
January 1–10 (1814) 649 83 732
January 11–31 314 91 405
February 400 79 479
March 100 52 152
According to this table there died, between September and January 10,
19,654 French soldiers, 103 Saxon soldiers, and 678 civilians. But
Richter says in regard to the above figures: ‘There is no doubt,
however, that the figures pertaining to the French soldiers are much too
small, since they include only those that were actually buried by the
grave-diggers in public burial-grounds. All those who died in private
houses, in the _tête-de-pont_, in the various forts, in the lunettes, or
in any of the outworks of the fortress are not included; their number
was by no means small, and many of them were buried unceremoniously by
citizens or by their comrades, while large numbers of bodies were left
lying in the open.’ In the month of May it was impossible to find a
grave-digger to bury the heaps of corpses, which were consequently
thrown in masses into the Elbe; this of course interfered with the
operation of the floating mills along the river. Nor are the bodies
disposed of in this way included in the above table. Accordingly,
Richter estimates the total number of deaths among the French soldiers
at between 29,000 and 30,000 men.
The pestilence continued to rage even after the surrender of the
stronghold, and did not begin to abate until the latter part of January.
Although the Prussian troops were not quartered in the city, and entered
it only in the day-time, the pestilence nevertheless spread to them and
carried away more than 300 men in the course of three months. Not until
the end of February did the pestilence among the civil inhabitants begin
to abate; the mortality was still high in March, but in April it sank to
normal again.
According to Richter, two-thirds of the patients in the military lazaret
were suffering from ‘colliquative, dysenteric diarrhoea’, and only
one-third from ‘true typhus’, whereas among the civil inhabitants the
latter was by far the more common. There were two forms of diarrhoea
observed; it appeared either as an acute attack of dysentery, which
rarely lasted longer than two weeks and then terminated in either death
or recovery, or else as a chronic, dysenteric diarrhoea, which caused
general weakness and finally death.
Typhus fever began always with a frequently recurring chill, and with a
violent headache and general indisposition; this was followed by a stage
of dry fever, accompanied by stupor, dizziness, and often wild delirium;
as a rule the first few days were characterized by obstinate
constipation, and bleeding at the nose was very common. Later on,
somnolence manifested itself, and the original constipation changed to a
copious, fetid diarrhoea. Petechiae appeared frequently, but not
invariably; at first small, bright-red spots showed themselves, and
later on they assumed a darker colour, grew larger, and finally turned
black. Their size varied considerably; sometimes they were the size of a
pin-head, while often they were from one to one-and-a-half centimetres
in diameter. Most of the patients died between the tenth and fifteenth
days; but if the disease progressed favourably, signs of improvement
usually showed themselves suddenly on the fourteenth or fifteenth day;
as a rule, convalescence was of short duration.
The two forms of ‘nerve-fever’ mentioned by Richter doubtless include
various other diseases. That many cases of typhus fever were among the
fever patients may be inferred from the fact that the disease was very
prevalent among the French troops, and also from Richter’s description;
he expressly mentions the sudden appearance of the disease, the initial
chill, the remission of the fever in the third week, and the rapid
convalescence—all of them characteristic signs of typhus fever.
Moreover, typhoid fever doubtless prevailed more or less extensively.
Richter describes ‘a pituitous modification of typhus’, with a lingering
development;[339] the crisis always came late, frequently not until the
sixth or seventh week, and was invariably uncertain, so that
convalescence was very slow and often interrupted by relapses.
Deuteropathic complications were of almost regular occurrence. There can
be no doubt that we have to do here with a good description of typhoid
fever, which revealed its presence chiefly among the newly-conscripted
young French soldiers.
Regarding the enormous loss of life caused by the epidemic in Torgau,
Richter, who was a Prussian military physician, says: ‘The devastation
that it caused among the Frenchmen, and unfortunately among the
inhabitants of the ill-fated city as well, was indeed terrible; in fact
there is happily scarcely a parallel to it in the history of the world.
One may safely say that the misery experienced by the French troops
throughout the entire course of that disastrous war reached its climax
inside the walls of Torgau. The French lazarets in the city represented
scenes of horror such as repel human nature, and such as one must
actually witness in order to appreciate fully their dreadfulness.’
4. THE SIEGE OF MAYENCE (1813–14)
The terrible devastation caused by typhus fever in the strongholds along
the Vistula, Elbe, and Rhine, which were so valorously defended by
French generals in the years 1813–14, excited general consternation.
Wittmann[340] furnishes a very accurate description of the misery
undergone in the besieged cities, especially the city of Mayence. First
he comments on the scarcity of supplies, observing that the vicissitudes
of war can never be foreseen; furthermore, he asserts that the
commanders of fortresses, when they anticipated a siege, purposely kept
the inhabitants in uncertainty about it. In the case of Mayence,
Napoleon ordered the city to be provisioned after the battle of Leipzig.
Some 2,000 oxen were collected, and most of them were kept in the
villages surrounding Mayence; but when the Allies crossed the Rhine the
oxen were all quickly driven into the city, where they grew lean owing
to lack of provender, and died of rinderpest in such large numbers that
it became necessary to slaughter them all and salt the meat. This was
done in such a careless way that a large part of the meat was spoiled;
even after the stronghold surrendered, some of this salted meat was
still on hand, and it was so rotten that it had to be destroyed. The
citizens had learned of the danger too late, and numerous unscrupulous
citizens bought up all the important necessaries of life and then took
advantage of the situation by raising the prices so high that only the
wealthy could procure food. Lack of good bread, which had been so scarce
during the previous siege of Mayence (1793), does not seem to have been
so severely felt in the siege of 1813. Particularly noticeable was the
want of fuel, so that many soldiers froze to death in the exposed
guard-rooms of the outworks. Legumes, especially peas, could not be
thoroughly cooked, so that it was frequently necessary to throw them
away. The supply of good fat, as well as of fresh vegetables, soon ran
out, while the great quantity of alcoholic beverages stored up in
Mayence had a very detrimental effect. Very inadequate provision was
made for the sheltering of the soldiers; inasmuch as the siege took
place in the winter, they could not camp in the open, and the barracks
were not large or numerous enough to accommodate them. Consequently the
officers were quartered in the homes of the wealthier citizens, one
officer in each house, while the troops were housed in large numbers in
the often insanitary homes of the poorer people. This of course greatly
favoured the dissemination of infectious diseases.
According to Wittmann, there was not a single trace of an infectious
disease in Mayence in September 1813. In October the field-lazarets of
the army were transferred from Leipzig to the West, and most of them
passed through Mayence; in the first part of November, moreover, the
field-army itself passed through the city on its return march; thus sick
and healthy soldiers conveyed typhus fever into the stronghold. ‘In the
vicinity of the hospitals and churches, where sick soldiers were
congregated, in the streets through which these doomed victims passed,
and in the houses in which they were quartered together with healthy
men, or into which they had crept from sheer inability to go further,
contagious typhus broke out first and with the greatest severity.’[341]
Dr. Petit, the commissary sent out by the government in Paris, did not
have the courage to oppose the will of Marshal Marmont, who was in chief
command, and so he sought to pacify the inhabitants by means of notices
in the papers to the effect that the prevailing disease was neither
epidemic nor infectious, and was only contagious typhus.
After the investment was complete, typhus fever caused terrible
devastation throughout the city. When the siege began, Mayence had a
garrison of some 30,000 men, while the civil inhabitants numbered about
24,500; to the latter, however, must be added a considerable number of
refugees from the surrounding country. The bad hospital arrangements, as
always happened at that time, greatly helped to spread the disease in
Mayence. According to a report made out by two French physicians and
reproduced by Wittmann, the air in the hospitals was terrible; every bed
was occupied by two patients, while the straw under them and the
blankets over them were never changed or washed, so that they must
necessarily have constituted a source of infection. A report by
Kerckhoffs[342] regarding the Mayence hospitals describes even worse
conditions:
I was appointed to serve in the hospital established in the
Municipal Octroi Building, and the first time that I went there I
found the living and the dead, the wounded and the sick, scattered
in confusion all over the place. The sick were stretched out on the
floor, without even straw under them, covered with ordure. I was
obliged to pick my way on tip-toe in order not to sink up to the
ankles in filth. I saw sick men lying beside the dead bodies of
their comrades. In effect, there were so many of them that they were
lying on top of one another. In some of the rooms the windows were
closed, so that no air could enter; in other rooms there was neither
glass nor boarding in the doors or windows, notwithstanding the
extreme cold. The sick men told me that they had been in that same
position for two, three, and even four days, without having had a
drop of water.
The soldiers under arrest, who were compelled to clean out the
hospitals, all died, no more sick-attendants were to be found, and a
large number of physicians perished in the performance of their duties;
all the persons employed in the hospital entirely neglected their
duties, and most of them were drunk all the time, since large quantities
of wine were on hand for the patients.
The result was that the epidemic gradually attained to enormous
dimensions. ‘The infection’, says Wittmann,[343] ‘carried away all the
grave-diggers one by one, and it was impossible to find anybody who was
willing to do that dangerous work. Thousands of dead bodies of citizens
and soldiers lay for weeks in front of the Münstertor, where they were
piled up like logs pending burial.’ In December and January the epidemic
reached its climax; after that it gradually abated, but did not come to
an end until May 3, 1814, when the siege terminated and the Allies
entered the city.
In the period between November 1, 1813, and May 3, 1814, 7,000 deaths
among the soldiers are recorded in the civil register of the city;
according to statements of the grave-diggers, some 10,000 or 11,000 more
soldiers were buried, whose names were not entered in the register for
the reason that they could not be ascertained; nor do the above figures
include the number of deaths in the stronghold of Kastel on the other
side of the Rhine. Of the civil inhabitants, 2,445 (about one-tenth of
the population) died; a large number of physicians contracted the
disease, and four physicians and five surgeons succumbed to it.
5. THE SIEGE OF PARIS (1870–1)[344]
After the battle of Sedan the Germans immediately began to march toward
Paris; on September 15, 1870, the first cavalrymen appeared before the
capital, and on September 19 the investment was complete.
An exhaustive account by H. Sueur and a large number of other reports
offer us very full information regarding the condition of health in
Paris during the siege, since the administrative apparatus never stopped
running. The approach of the German armies caused numerous well-to-do
citizens to leave the city; some went south, some to Switzerland, and
some to England. Sueur estimates their number from the reports of the
railroad companies at 300,000. On the other hand, a large number of the
inhabitants of the surrounding country sought refuge in the city; their
number is estimated at 180,000. Furthermore, the size of the garrison
was considerably increased; the number of men in the regular army on
November 4, 1870, is estimated at 236,941, and this does not include
8,000 men in the First Division of the First Corps. To the above,
moreover, must be added the number of soldiers who died between the
beginning and the end of the siege. Thus the number of men in the
regular army at the beginning of the siege was some 246,000; of these
some 56,000 were already in the city in the middle of the summer, while
the remaining 190,000 arrived later. Accordingly, the total number of
people in the city shortly before the siege began was increased by
70,000. Legoyt estimated the population of the city on July 1, 1870, at
1,890,000, so that on the opening day of the investment there were
1,960,000 (in round numbers, 2,000,000) people in Paris. The arrival of
the 190,000 soldiers altered the composition of the population, since
the increase augmented only the number of males between the ages of 20
and 40.
A severe epidemic of small-pox raged in Paris, as stated above, even
before the siege took place. In the first part of the siege, moreover,
the disease raged with even greater fury in the city, since most of the
young newly-enlisted mobile guards had never been vaccinated. The
maximum of deaths caused by it were reported between November 6 and
November 27. We have already described the course of the small-pox
epidemic in Paris.[345] It was influenced neither by hunger nor by cold,
but developed chiefly for the reason that it was impossible to
congregate and isolate the large number of unvaccinated and susceptible
persons.
Typhoid fever, dysentery, and diarrhoea, because of the unfavourable
conditions brought about by the siege, became very widespread and
virulent. Whereas in the year 1869 there were 630 deaths caused by
typhoid fever, during the siege of 1870 no less than 3,475 persons
succumbed to that disease. Dupinet[346] thinks that the above number is
too small, because the disease was often not recognized, and pneumonia,
a common complication, was entered as the cause of death. Inasmuch as
typhoid fever was endemic in Paris, and as the native inhabitants had
acquired immunity by recovery from an attack in the early part of their
lives, those who were most severely afflicted by the disease were
chiefly the soldiers in the army and the refugees from the surrounding
country. The largest number of deaths was reported in the twentieth week
of the siege, i.e. between January 14 and 20.[347] No less than 375
persons succumbed to typhoid fever in the course of that week, whereas
in the corresponding week of the previous year only sixteen deaths had
been reported. The largest number of deaths caused by dysentery and
diarrhoea in a single week was reported somewhat later; the limited
prevalence of these diseases during the siege is indicated by the fact
that in the half-year 1869–70 the number of deaths caused by them was
never more than twenty per week. From statistics compiled by Sueur we
have arranged the following table (p. 323), which also includes the
deaths caused by bronchitis and pneumonia, but not the victims buried on
the battle-fields, of whom there were some 3,000.
The table indicates the gradual diminution of the food-supply. In
December the quality of the bread grew worse and worse; white bread
could no longer be baked, and in its place an almost inedible form of
brown bread was made out of bran, wheat, rye, rice, barley, and oats.
Particularly noticeable was the lack of good fats, making it necessary
to prepare foods with a bad-tasting tallow that was sold under the name
of ‘Beurre de Paris’. Since the cattle had to be slaughtered (those that
were not killed died of various diseases), there was very soon a great
scarcity of milk, making it very difficult to feed infants.[348]
Several persons have maintained that the extreme cold exerted
considerable influence upon the death-rate; and a glance at the two
columns in the table indicating the number of deaths caused by pneumonia
and bronchitis would seem to justify this contention. How great the
difference was, as compared with normal years, will be obvious when we
call attention to the fact that, whereas in the twenty-second week of
the siege (January 28–February 3) 627 persons succumbed to bronchitis,
in the preceding year only seventy-six deaths were caused by that
disease between January 30 and February 5, and that, whereas from 465 to
468 persons succumbed to pneumonia between January 21 and February 18,
1871, the number of deaths caused by that disease in the corresponding
period of the previous year varied from 90 to 119 per week.
According to the unanimous verdict of the Paris physicians, typhus fever
did not make its appearance during the siege.
MORTALITY DURING THE SIEGE OF PARIS
──────┬───────────────┬───────────────────────────────┬────────┬───────
_No. │_First and last│ _Important ordinances and │_Average│_Total
of the│ day of the │ events._ │ no. │ no.
week._│ week._ │ │ deaths │deaths
│ │ │ in the │during
│ │ │ years │ the
│ │ │1867–9._│siege._
──────┼───────────────┼───────────────────────────────┼────────┼───────
〃 │ 〃 │ 〃 │ 〃 │ 〃
│ │ │ │
──────┼───────────────┼───────────────────────────────┼────────┼───────
1│Sept. 4–10 │ │ 889│ 981
2│Sept. 11–17 │ │ 852│ 1263
3│Sept. 18–24 │Sept. 19, investment completed │ 821│ 1272
4│Sept. 25–Oct. 1│ │ 766│ 1344
5│Oct. 2–8 │Oct. 8, meat ration fixed at │ │
│ │ 100 gr. for adults, 50 gr. │ │
│ │ for children │ 754│ 1483
6│Oct. 9–15 │ │ 737│ 1610
7│Oct. 16–22 │ │ 761│ 1746
8│Oct. 23–9 │ │ 754│ 1878
9│Oct. 30–Nov. 5 │Oct. 30, requisition of fuel │ 767│ 1762
10│Nov. 6–12 │ │ 781│ 1885
11│Nov. 13–19 │ │ 780│ 2064
12│Nov. 20–26 │Nov. 21, requisition of │ │
│ │ potatoes │ 793│ 1927
13│Nov. 27–Dec. 3 │ │ 833│ 2023
14│Dec. 4–10 │ │ 833│ 2455
15│Dec. 11–17 │Dec. 15, horse-meat ration │ │
│ │ fixed at 50 gr. per head │ 884│ 2728
16│Dec. 18–24 │Dec. 19, reduction of bread │ │
│ │ ration to 300 gr. for │ │
│ │ adults,150 gr. for children │ 854│ 2728
17│Dec. 25–31 │ │ 856│ 3280
18│Jan. 1–6 │Jan. 4, beginning of │ │
│ │ bombardment │ 838│ 3680
19│Jan. 7–13 │ │ 902│ 3982
20│Jan. 14–20 │ │ 903│ 4465
21│Jan. 21–7 │ │ 936│ 4376
22│Jan. 28–Feb. 3 │ │ 951│ 4671
23│Feb. 4–10 │Feb. 4, armistice. First │ │
│ │ supplies brought in │ 955│ 4451
24│Feb. 11–17 │ │ 974│ 4103
25│Feb. 18–24 │ │ 995│ 3941
26│Feb. 25–Mar. 3 │ │ 984│ 3500
27│Mar. 4–10 │ │ 1020│ 2993
28│Mar. 11–17 │ │ 975│ 2576
──────┼───────────────┼───────────────────────────────┼────────┼───────
│ │ │ 24148│ 75167
──────┴───────────────┴───────────────────────────────┴────────┴───────
──────┬─────────────────────────────────────────────────────────────────────
_No. │
of the│
week._│
│
│
│ _No. of deaths during the siege caused by_
──────┼───────┬────────┬────────────┬────────────┬────────────┬─────────────
〃 │_Small-│_Typhoid│ │ │ │
│ pox._ │Fever._ │_Dysentery._│_Diarrhoea._│_Pneumonia._│_Bronchitis._
──────┼───────┼────────┼────────────┼────────────┼────────────┼─────────────
1│ 116│ 39│ 8│ 25│ 54│ 45
2│ 168│ 45│ 10│ 65│ 66│ 55
3│ 158│ 45│ 9│ 43│ 62│ 61
4│ 210│ 56│ 23│ 46│ 46│ 36
5│ │ │ │ │ │
│ │ │ │ │ │
│ 212│ 54│ 18│ 69│ 50│ 56
6│ 311│ 54│ 26│ 72│ 64│ 55
7│ 360│ 55│ 23│ 76│ 66│ 70
8│ 378│ 62│ 49│ 99│ 71│ 77
9│ 380│ 61│ 32│ 87│ 69│ 72
10│ 419│ 62│ 39│ 91│ 79│ 82
11│ 431│ 94│ 25│ 91│ 73│ 92
12│ │ │ │ │ │
│ 386│ 103│ 25│ 92│ 81│ 89
13│ 412│ 140│ 25│ 76│ 92│ 99
14│ 398│ 137│ 33│ 83│ 108│ 107
15│ │ │ │ │ │
│ 391│ 173│ 38│ 103│ 131│ 190
16│ │ │ │ │ │
│ │ │ │ │ │
│ 388│ 221│ 30│ 73│ 147│ 172
17│ 454│ 250│ 51│ 98│ 201│ 258
18│ │ │ │ │ │
│ 329│ 251│ 52│ 151│ 262│ 343
19│ 339│ 301│ 46│ 143│ 390│ 457
20│ 380│ 375│ 42│ 137│ 426│ 598
21│ 327│ 313│ 48│ 134│ 478│ 548
22│ 258│ 324│ 63│ 150│ 465│ 627
23│ │ │ │ │ │
│ 225│ 260│ 57│ 144│ 468│ 593
24│ 174│ 298│ 59│ 158│ 471│ 539
25│ 134│ 301│ 52│ 181│ 410│ 557
26│ 147│ 260│ 50│ 190│ 338│ 424
27│ 85│ 258│ 60│ 142│ 267│ 379
28│ 98│ 229│ 49│ 104│ 188│ 301
──────┼───────┼────────┼────────────┼────────────┼────────────┼─────────────
│ 8068│ 4821│ 1042│ 2923│ 5623│ 6982
──────┴───────┴────────┴────────────┴────────────┴────────────┴─────────────
Scurvy broke out, but did not become at all widespread; sporadic cases
of the disease were observed among the civil inhabitants, while in the
prisons and hospitals it was somewhat more prevalent. Delpech[349]
attributes the appearance of the disease to the lack of fresh
vegetables, which were very expensive and could not be given out in the
public establishments. Among the soldiers the disease broke out only in
Fort Bicêtre, the garrison in which consisted of 800 marines, of whom
some seventy or seventy-five contracted it. None of them were given any
salted meat, and Grenet[350] contends that the outbreak was caused by
the lack of light and air in the small casemates, and by arduous
service, especially in the night. But here, too, the real cause was
probably to be found in the lack of fresh vegetables, which Grenet does
not mention.
The death-rate in Paris during the siege was about three times as high
as normal. Sueur has estimated that in the years 1867–9 the mortality in
the twenty-eight weeks corresponding with those in the above table was
13·1 per 1,000 inhabitants, whereas in the twenty-eight weeks of the
siege the mortality was 38·6 per 1,000.
6. THE SIEGE OF PORT ARTHUR (1904)
Port Arthur was besieged by the Japanese from July 30, 1904, to January
2, 1905—a period of 156 days. Whereas, as stated in the last chapter,
the condition of health in the Russian army was good, the sanitary
conditions in Port Arthur during the siege were very bad, since the
supply of provisions that had been laid in proved to be
insufficient.[351] The offer made on August 16 by General Nogi and
Admiral Togo, granting all the women, children (under 16 years),
ecclesiastics, members of the diplomatic corps and military and naval
attachés of foreign powers permission to leave the stronghold, was
refused by General Stössel. As early as August 5 horse-meat began to be
distributed;[352] from September 17 on the troops were supplied four
times a week with horse-meat, since there was no other fresh or canned
meat available. At this time almost everything in the city was consumed,
though the Chinese secretly brought rice, eggs, and other things, on
boats from Chufoo. After September 28 the soldiers were given meat only
twice a week (one-half of a pound of horse-meat or one-third of a can of
preserved meat). Regarding conditions up to October 20 we are informed
by the report of the Russian General Medical Staff:[353] ‘The supply of
food ran lower and lower; beef gave out very early, only a small
quantity of canned meat was left, and even the portions of horse-meat
had to be dealt out very sparingly, as we had very important use for
horses in transporting ammunition, water, food, &c., to the various
positions. In the city it became more and more difficult every day to
procure food; meat, if by any chance a small quantity was marketed, was
sold in the stores for one and one-half roubles per pound. A chicken
cost twelve roubles, a goose twenty roubles, an egg one rouble, a pound
of onions one rouble, a pound of horse-meat one half-rouble.’
In November all the soldiers were given was horse-meat; only the sick
received canned meat. The supply of food in the possession of private
individuals was exhausted, while garlic and vegetables had given out
altogether.
On September 19 the Japanese captured the redoubts controlling one of
the aqueducts that supplied Port Arthur with water; there was however
another aqueduct, and, furthermore, wells were bored and a plant for
distilling seawater was put into operation. The statement of the Russian
General Staff that there was at no time a serious scarcity of water is
not confirmed in Olga von Baumgarten’s diary, which frequently refers in
plaintive terms to the lack of drinking-water in the lazarets.[354]
During the summer the condition of health among the Russian troops was
comparatively good;[355] on August 26 there were 132 officers and 5,661
men in the lazarets. In the first part of October typhoid fever broke
out in Port Arthur, where it was endemic, and before long an epidemic of
such severity was raging in the city that it was difficult to find
places in which to shelter the patients. There were also a great many
cases of dysentery. Owing to the lack of preserved meat and vegetables,
scurvy also made its appearance; the first cases of the disease were
observed early in October. In the latter part of that month there were
in the lazarets 450 typhoid-fever patients, 855 dysentery patients, and
167 scurvy patients. In addition to these diseases, cases of
night-blindness (inability to see after dusk) were observed; the latter
disease is quite common among Russian country-people, being caused by
bad nourishment.
In December the garrison was completely exhausted. Scurvy had become
more and more widespread, and between the fourteenth and twenty-seventh
of that month 71 officers and 1,790 men had been committed to the
lazarets. On the day of the surrender (January 2, 1905) the number of
men in the Russian garrison was 32,400, and of these 6,458 were lying
sick or wounded in the lazarets.[356] Of the remaining 25,942 men,
13,207 were incapacitated; thus the number of healthy men (besides 2,193
marines) in the garrison at the time of the surrender was only 12,735.
Regarding the loss of life during the siege we find no information in
the report of the General Staff. The number of soldiers in the city
(excluding the officers and officials) was 41,780 at the beginning and
32,400 at the end of the siege. No further information regarding the
condition of health among the civil inhabitants of Port Arthur is
obtainable.
CONCLUSION
The history of war-pestilences has shown how severely belligerent armies
are attacked by infectious diseases, how seriously their operations are
hampered by them, and what loss of life such diseases cause by spreading
to non-combatants. If we start from the time when more or less accurate
descriptions enable us to determine the nature of the epidemics, we find
that plague and typhus fever were the two diseases which, until a few
decades ago, most commonly attacked the soldiers; the latter disease,
which made its appearance in almost every war that was waged between the
beginning of the sixteenth and the middle of the nineteenth century,
consequently acquired the name ‘war-plague’.
For a long time nobody knew just how to combat these pestilences, and
nowhere were rational measures adopted aiming to prevent them from
spreading. We have seen the bitter truth of this statement in connexion
with the endless Napoleonic wars. One reason for the neglect of
preventive measures was the belief that these pestilences broke out
spontaneously when large numbers were crowded together under miserable
living conditions. The physicians of that time, in their efforts to
explain the sudden appearance of these pestilences, arrived at the
conclusion that they were autochthonic. But modern medical science,
realizing its limitations, contents itself with the hypothesis that the
original cause of these diseases is not to be ascertained, and with the
knowledge that the infective agents in the case of almost all of them
have been discovered, and that an outbreak of any infectious disease in
any specific locality signifies that the germ of that disease must in
some way have been deposited there. It was precisely the belief in the
spontaneous origination of pestilences that led people to neglect
watching for and isolating, with all possible dispatch, the first
cases—a measure which is to-day looked upon as the most important means
of preventing the dissemination of a disease.
The belief in the autochthonic origin of diseases continued to prevail
until the first half of the nineteenth century. Hecker upheld it in a
discussion of the plague-epidemic that occurred during the Russo-Turkish
War of 1769–70; he believed that the intermittent fever prevalent in the
Danube countries passed over into putrid fever, with or without
petechiae, that carbuncles and buboes gradually developed, and that
putrid fever was thus converted into bubonic plague. ‘It is therefore in
all probability true’, says Hecker, ‘that the outbreak of plague in the
Russian army in the year 1770, as well as in the year 1828, was not
caused by direct infection from the Turkish troops, but was merely an
independent development from intermittent fever and spotted fever.’
Recent investigations in the field of medicine turn over to the other
sciences all questions regarding ultimate causes, and confine themselves
to what is actually observed. We know that the agents responsible for
infectious diseases are specific minute organisms which must be present
in the system to produce the disease in question, and that these
micro-organisms are conveyed from place to place by infected persons, by
intermediaries, on articles to which they have attached themselves, in
contaminated food, in drinking-water, and in many other ways.
Investigators have studied the conditions in which these infective
agents live and the manner in which they are disseminated, they have
discovered methods of determining the nature of the disease in a very
short time, and they have come to recognize the danger of coming in
contact with germ-bearers, that is, with persons, healthy or
convalescent, who have these micro-organisms in their systems without
being themselves sick. Medical science is now endeavouring, by means of
systematic procedure and splendid organization, to guard soldiers
against the danger of infection; good drinking-water is provided, the
men and the rooms in which they live are kept clean, persons suffering
from infectious diseases are isolated, all rooms and articles used by
patients are disinfected, infected divisions of troops are quartered by
themselves, germ-bearers are watched for and discovered, &c. The success
of such measures is well known. The knowledge gained and profited by in
times of peace is also applied in times of war, and to-day we are able
to confine pestilences within much narrower limits than was formerly
possible. In order to do this, however, we must have, in addition to an
efficient system of transporting and feeding troops, physicians who are
well informed in regard to hygiene and bacteriology.
As early as the eighteenth century, successful efforts were made to
prevent, by means of energetic measures, the reappearance of plague in
Europe; the Russo-Turkish War of 1828–9 was the last war in which it
broke out. On the other hand, typhus fever continued to be the Nemesis
of belligerent armies, while a new infectious disease, cholera, entered
upon the scene and played a very important rôle in the Crimean War, and
a by no means minor rôle in the war of 1866. Along with these diseases,
typhoid fever advanced into the foreground about the middle of the last
century, and it soon turned out to be one of the most dangerous diseases
that occur among soldiers. This appearance of typhoid fever has led some
to think that the disease has prevailed extensively only in
comparatively recent times. Hirsch, however, ably defends the opposite
view; he maintains that typhoid fever was in many instances confused
with the _febres pestilentes_, _malignae_, _putridae_, and _nervosae_,
with the mucous fevers, bilious fevers, putrid fevers, &c. In discussing
the typhus-fever epidemics that occurred in the course of the Napoleonic
wars, we have several times called attention to the fact that typhoid
fever probably broke out in the form of epidemics; but it could be
diagnosed with certainty only after post-mortem examinations began to be
more frequent. At all events, typhoid fever is to-day prevalent all over
the world, and there is always danger that field-armies will be infected
with it, either in their own land or in the land of the enemy. All the
wars of the last few decades have clearly demonstrated this fact.
For a successful battle against war-pestilences, it is a fortunate
coincidence that the civil as well as the military authorities are
equally interested in their prevention. Every military leader knows how
important it is for the soldiers to keep healthy, since their efficiency
is otherwise seriously impaired. It is not our task to describe the
particular measures that are to be adopted; the manuals of military
sanitation give us accurate information regarding these matters. We
merely mention the fact that it is of great value and importance to have
physicians, who are well acquainted with hygienic problems, make a
preliminary examination of sanitary conditions in the territory through
which the soldiers will be required to pass in order to reach the scene
of hostilities.
Very great difficulties, to be sure, confront the efforts made in war
times to prevent the outbreak of infectious diseases. If the struggle is
carried on in an infected region, the troops are often compelled to seek
shelter in infected houses; thus during the battles of Orléans and Le
Mans in the Franco-German War the troops, in order to protect themselves
against the severe winter cold, had to live in houses which small-pox
patients had shortly before occupied or were actually occupying at the
time. Circumstances frequently arise which render impossible the
adoption of the most effective measure calculated to prevent the
dissemination of a pestilence, that is, the isolation of infected
divisions of troops; one can readily imagine how difficult this would be
in the case of an army re-forming after a lost battle. Furthermore, even
if one of the belligerent armies is doing all it can to prevent diseases
from spreading, its efforts must be seriously handicapped if the enemy’s
army does not include an equally diligent sanitary corps and does not
devote the same amount of energy to the prevention of the outbreak and
dissemination of infectious diseases. For even if a sanitary corps is
successful in warding off a reaction upon its own troops, nevertheless
this reaction is sure to take place with respect to the civil
inhabitants of the country in which the war is waged.
During a war, the civil authorities must also do their part in
preventing diseases from spreading to the civil population. The local
administrations of a region in which fighting is going on are powerless.
The generals care very little whether or not a city or village in the
enemy’s country is infected by their troops, whom they quarter in
whatever house or place best suits their purpose. On the other hand, the
communities in which military prisons are located are confronted with a
very difficult problem, since these prisons, if infected men are
confined in them, easily develop into centres of infection; this fact
was observed a hundred times in the year 1870. If a disease breaks out
in a community in consequence of the fact that a military prison has
been established there, in my opinion it is incumbent on the central
government of the country to support the local authorities in their
efforts to check the disease, and to give them financial help as well as
scientific advice. Unfortunately, it is not to be denied that, in many
small cities and in almost all rural communities, absolutely no
provision is made for the isolation of persons suffering from infectious
diseases; the authorities justify themselves with the reflection that in
case of emergency barracks can quickly be erected for the purpose, but
at the same time they fail to remember that working-men are not always
available in the storm and stress of war times, that building materials
in the general scarcity of supplies cannot always be procured with
sufficient promptitude, and that pestilences, if the isolation of the
first cases is delayed, usually spread with great rapidity.
In future wars we must expect the military authorities to do all they
can, just as soon as the prisoners are taken, to segregate as carefully
as possible all known and suspected cases of infectious diseases. The
difficulties confronting the military authorities, when it is necessary
to remove large numbers of prisoners with all possible dispatch away
from the scene of the war, are, to be sure, very great.
Finally, we must also call attention to the danger to which the civil
inhabitants of a country are exposed, when the soldiers return home
after the termination of a campaign in an infected region. It must be
demanded under all circumstances that divisions of troops among whom
infectious diseases have made their appearance, before returning from
the enemy’s country, shall be subjected to a medical examination,
isolated, and disinfected, just as was done on such a large scale, for
example, by the Japanese after the wars with China and Russia. This also
applies to all other persons who have had anything to do with infected
divisions, particularly to teamsters.
All preparations designed to prevent the outbreak and dissemination of
infectious diseases must be made in times of peace; barracks and
lazarets must be erected, physicians who are well acquainted with
methods of hygienic investigation must be available, and an adequate
number of nurses and sick-attendants must be prepared for immediate
service at the very first appearance of an infectious disease. For the
military authorities, who can scarcely perform all the duties that the
beginning of a war imposes upon them, it will facilitate matters greatly
if in future campaigns the Red Cross devotes its attention, not only to
the care of the wounded, but also, on a larger scale than it has
heretofore, to the prevention of the outbreak and dissemination of
war-pestilences.
INDEX
Acre, pestilence, 14.
Adrianople, bubonic plague epidemic 1829, 168 f.
del Agua, 277.
Algiers, typhus epidemic 1868, 195 f.
Amoebic dysentery, 7 f.
Amsterdam, pestilence 1624, 72.
Andersonville prison, 181.
Anti-vaccinationists, 198, 251, 260, 269.
Armenia, plague epidemic 1828, 169 f.
Athens, plague, 11.
Augsburg, pestilence 1634, 58 f.;
pestilence 1703, 80;
small-pox epidemic 1871, 259.
Austria, small-pox epidemic 1872, 275 f.
Barbarossa, 12 f.
Basel, small-pox epidemic 1870, 271 f.
Baudens, 174.
Baumgarten, von, 326.
Bavaria, typhus epidemic 1813, 149 f.
Beitzke, 122, 129, 132.
Belgium, small-pox epidemic 1870, 273 f.
Beri-beri, 298.
Berlin, pestilence 1637, 69;
small-pox epidemic 1871, 230 f.;
typhus fever epidemic 1813, 124 f.
Berne, small-pox epidemic 1870, 271.
Bernstein, 140.
Black Death, 6.
Blech, 122, 308, 309, 310.
Boehnke, 195.
Boersch, 29, 78.
Boin, 103, 104.
le Borne, 95.
Bouchut, 322.
Bourchardet, 320.
Brandeis, 12.
Braun, 151.
Bremen, small-pox epidemic 1870, 242.
Breslau, pestilence 1758, 82;
plague 1633, 47;
small-pox epidemic 1871, 224 f.;
typhus epidemic 1813, 123.
Brunner, 272.
Bubonic plague, 5; 1707, 85;
Adrianople 1829, 168 f.;
Armenia 1829, 169 f.;
Bucharest 1828, 165 ff.;
France 1628, 73 f.;
Italy 1629, 74 f.;
Netherlands 1635, 72 f.;
Russo-Turkish War 1769, 86;
Russo-Turkish War 1828, 165 ff.;
Thirty Years’ War, 25 ff., 41 ff.;
Varna 1829, 168 f.
Bucharest, bubonic plague 1828, 165 ff.
Bukowina, small-pox epidemic 1871, 276.
Burckhardt, 78, 158, 272.
Bürger, 313.
Cannstatt, 112.
Canz, 94.
Cazalas, 183.
Charles VIII, expedition to Naples, 17.
Charles XII, 85.
Chauffard, 200.
Chemnitz, small-pox epidemic 1871, 255 f.
Chenu, 171, 173, 183.
Cholera, 6 f.;
Balkan War, 300 ff.;
Crimean War, 170 ff.;
France 1853, 170 ff.;
German War of 1866, 184 f.;
Tripolitan War, 299 f.
Civil War, American, 5;
dysentery, 178 f.;
malaria, 180;
measles, 179;
small-pox, 179;
typhoid fever, 177;
typhus fever, 178.
Cless, 260.
Colin, 203.
Cologne, small-pox epidemic 1870, 247 f.
Concentration camps, South Africa, 292 ff.
Constantinople, cholera epidemic 1912, 301.
Copenhagen, pestilence 1710, 85.
Crimean War, cholera, 170 ff.;
dysentery epidemic, 172;
scurvy epidemic, 172;
typhus epidemic, 172 ff.
Crusades, 12, 13 ff.
Czetyrkin, 165, 167, 169.
Daimer, 185, 275, 276.
Damietta, siege of, 14 f.
Danzig, pestilence 1709, 85;
siege of, 306 ff.;
small-pox epidemic 1870, 220 f.;
typhus fever 1813, 122.
Davoust, 141.
Delpech, 201, 202, 324.
Deneke, 141.
Denmark, small-pox epidemic 1871, 280 f.
Depopulation, Thirty Years’ War, 76 ff.
Diemerbroeck, 73.
Dietz, 78.
Dillenius, von, 151.
Diodorus, 11.
Diphtheria, Boer War, 294.
Dresden, pestilence 1757, 83;
plague 1632, 44;
small-pox epidemic 1871, 254 f.;
typhus epidemic 1813, 127 f.
Dupinet, 321.
Düsseldorf, small-pox epidemic 1871, 245 f.
Dysentery 7 f., 14;
American Civil War, 178 f.;
Crimean War, 172;
Franco-German War, 190 ff., 194 ff.;
Port Arthur, 326 f.;
Russian Campaign, 116 ff.;
siege of Paris, 321 ff.;
siege of Torgau, 314 f.;
Thirty Years’ War, 31 ff.
Elsässer, 150.
Ebstein, 12, 115, 137.
England, small-pox epidemic 1870, 278;
typhus fever 1808, 105;
typhus fever 1856, 174 f.
Enteric fever, 8.
Erfurt, small-pox epidemic 1871, 236 f.;
typhus epidemic 1813, 133.
Erisman, 287.
Feichtmayer, 98.
Ferenczy, 291.
Finland, small-pox epidemic 1871, 280 f.
Fischer, 127, 128.
Flexner, 7.
Flinzer, 130, 255.
Follenfant, 298.
Fonteret, 205.
Fracastorius, 20.
Franco-German War, small-pox epidemic, 197 ff.
Frankfurt-on-the-Main, pestilence 1633, 63.
Frankfurt, small-pox epidemic 1871, 250 f.;
typhus epidemic 1813, 135 ff.
Franque, von, 137, 138, 140.
Frederick the Great, 82, 83.
Friccius, 122, 307, 309, 310.
Friedländer, 157.
Fuchs, 17.
Gaffky, 8.
Gasc, 117.
Geissler, 256.
Genoa, typhus fever 1799, 67.
Gilbert, 100.
Giraud, 132.
Gmelin, 61.
Godelier, 175.
Göden, 121.
Gratiolo, 22.
Grätzer, 78, 82.
Gravelotte, 189.
Greiner, 132.
Grellois, 196.
Grenet, 324.
Grossi, 74.
Gurlt, 1, 99, 101, 115, 122, 125, 131, 132, 143, 153.
Gustavus Adolphus, 27 ff., 50.
Guttstadt, 186, 214, 219, 223, 230, 231, 233, 234, 242, 243, 248, 270,
283.
Györy, 20, 24.
Haga, 297.
Hain, 98, 161.
Hamburg, small-pox epidemic 1870, 239 f.;
typhus fever epidemic 1813, 141 f.
Hammer, 85.
Hanau, typhus fever epidemic 1813, 134 f.
Häser, 12, 17, 72, 74, 81, 85, 92, 97, 114, 123, 172, 306.
Haurowitz, 176.
Hecker, 17, 86, 87, 89, 329.
Heilbronn, small-pox epidemic 1870, 263 f.
Herero War, 296.
Hildenbrand, 106, 113.
Hirsch, 15, 18, 19, 173, 178, 184, 185, 330.
Holk, 44.
Höring, 263.
Horn, 52, 113, 124, 125, 133.
Hörnigk, 64.
Hufeland, 100, 103, 106, 107, 108, 112, 113, 124.
Hungarian disease, 20, 22 ff.
India, small-pox epidemic 1873, 282.
Ireland, small-pox epidemic 1871, 280.
Italy, small-pox epidemic 1872, 277 f.
Joerdens, 99.
Jörg, 112.
Kanngiesser, 12.
Kausch, 123.
Kerckhoffs, 115, 116, 120, 318.
Kiev, bubonic plague 1770, 89.
Knaak, 1, 183, 287.
Koch, 7, 286.
Königsberg, typhus epidemic 1806, 100;
typhus epidemic 1812, 121 f.
Kopp, 108, 122, 131, 134, 135.
Kosloff, 286, 289.
Kraft, 138.
Kraus, 301.
Kriesche, 204.
Kruse, 7.
Kübler, 184.
Ladysmith, typhoid epidemic, 291 f.
Lammert, 26, 50, 58, 64, 66, 72, 74, 77.
Larrey, 115.
Laveran, 1, 12, 73, 100, 118, 158, 175, 178, 197, 202.
Lehmann, 311, 312.
Leipzig, pestilence 1630, 41 f.;
small-pox epidemic 1871, 252 ff.;
typhus epidemic 1813, 128.
Lemazurier, 115, 117, 118.
Lentilius, 79.
Leprosy, 15 f.
Lersch, 13, 14, 18, 282.
Leyden, pestilence 1624, 72.
Liévin, 220, 221.
Linstow, 1, 101.
Littré, 12.
Löbenstein-Löbel, 132.
Lohnes, 150.
London, small-pox epidemic 1871, 279.
Loth, 194, 237.
Lotz, 274.
Louis IX, 15.
Louis XIV, 79.
Lübeck, small-pox epidemic 1871, 240 f.
Lyons, small-pox epidemic 1870, 205 f.
Magdeburg, small-pox epidemic 1871, 233 f.
Maier, 125.
Majer, 258.
Malaria, American Civil War, 180 f.;
Italian War of 1859, 183;
siege of Mantua, 304 f.
Mansfeld, 29 ff.
Mantua, pestilence 1630, 75;
siege of, 304 ff.
March, 182, 274.
Maréchal, 18, 21, 30, 92, 109, 155.
Maria Theresa, 80.
Martin, 188.
Martius, 258.
Massachusetts, small-pox epidemic 1872, 281.
Matignon, 299.
Maurin, 196.
Mayence, siege of, 316 ff.;
small-pox epidemic 1870, 266 f.
Mayr, 257.
Measles, American Civil War, 179;
Boer War, 294 f.
du Mesnil, 203, 321.
Metz, pestilence, 21;
pestilence 1636, 65 f.;
pestilence 1792, 93;
small-pox epidemic 1870, 203;
typhus epidemic 1813, 155 f.;
typhus epidemic 1870, 196 f.
Meyer, 32.
Michaux, 14, 196.
Michigan, small-pox epidemic 1872, 281.
Milan, pestilence 1630, 75.
Moore, Thomas, 18.
Moravia, typhus epidemic 1813, 161.
Mortality, Moscow pestilence 1771, 91;
Seven Years’ War, 84;
Thirty Years’ War, 78.
Moscow, bubonic plague 1771, 89;
typhus fever 1812, 116.
Munich, pestilence 1634, 55 f.;
small-pox epidemic 1871, 258 f.
Münster, small-pox epidemic 1871, 242 f.
Murchison, 73, 112, 174.
Myrdacz, 183, 287.
Nantes, pestilence 1793, 95.
Napoleon, 115 ff., 126.
Nassau, typhus epidemic 1813, 140.
Netherlands, small-pox epidemic 1871, 274 f.
Neuhof, 126.
Neumann, 110.
New York, small-pox epidemic 1871, 281.
Niedner, 173, 184.
Norway, small-pox epidemic 1871, 280 f.
Nuremberg, plague 1633, 53;
small-pox epidemic 1871, 258 f.
Oesterle, 304.
Oettingen, von, 298.
Okuniewski, 324.
Ophthalmia, 15.
Ozanam, 21, 73, 74, 75, 81, 84, 97, 101, 104.
Parenteau-Desgranges, 109.
Paris, siege of, 320 ff.;
small-pox epidemic 1869, 202;
typhus fever epidemic 1814, 156 f.
Parrot, 118.
Pastau, von, 225.
Pellerin, 157.
Peloponnesian War, 11.
Peninsular War, typhus fever, 101.
Perroud, 206.
Pettenkofer, 286.
Pfaff, 40.
Physicians, typhus mortality, 123, 129, 131, 135, 137, 142, 145, 151,
155, 319.
Plague, 5 ff.;
Athens, 11;
Rome, 12.
Pneumonia, siege of Paris, 322 f.
Pneumonic plague, 5 f.
Pont-à-Mousson, typhus fever epidemic 1813, 154.
Port Arthur, siege of, 324 ff.
Prague, pestilence 1742, 81;
small-pox epidemic 1872, 277.
Presl, 186.
Pringle, J., 1, 82, 308.
Prinzing, 199.
Prussia, small-pox mortality, 198.
Rabinowitsch, 272.
Rapp, 260.
Rasori, 97.
Reisseisen, 155.
Reissner and Neidhart, 265, 266.
Reuss, 260.
Rhumelius, 29.
Richter, 311–16.
Riecke, 313.
Roetenbeck, 52.
Roller, 99.
Roloff, 131.
Rösle, 78.
Roth, 297.
Russia, small-pox epidemic 1871, 280 f.
Russian Campaign, typhus epidemic, 115 ff.
Samoilowitz, 89.
Sanitary Commission, American Civil War, 176.
Schäfer, 148, 298.
Schafonsky, 89.
Scheerer, 115, 116.
Schinzinger, 152.
Schnurrer, 12, 21, 24, 52.
Schön, 60.
Schopper, 301.
Schwiening, H., 18.
Scorbutus, 9.
Scotland, small-pox epidemic 1871, 280.
Scrive, 171, 173.
Scurvy, 9, 14;
Crimean War, 172;
Metz 1552, 21–2;
Port Arthur, 326 f.;
siege of Mantua, 305 f.;
siege of Paris, 324;
Thirty Years’ War, 52 ff., 66.
Sedan, 189.
Seidlitz, 166, 167, 168, 169.
Seitz, 26, 55, 81, 95, 98, 99, 144, 147, 148, 149, 150, 257.
Sforza, 299.
Siegel, 253.
Sigel, 261.
Silesia, typhus epidemic 1805, 98.
Simon, 166.
Small-pox, 9, 17;
American Civil War, 179;
Franco-German War, 197 ff.;
Germany 1865, 184;
Germany 1870, 212 ff.;
siege of Paris, 321.
Small-pox mortality, in France, 199;
French prisoners 1870, 209 f.;
Germany 1871–2, 268;
Prussia, 198;
Prussia 1862–73, 214.
Stegmeyer, 305.
Steiner, 16, 299, 324.
Steinheim, 142.
Stemmler, 132.
Stettin, small-pox epidemic 1871, 226 f.
Stiga, 7.
Stockholm, pestilence 1710, 85.
Strassburg, small-pox epidemic 1870, 204.
Stricker, 115.
Stuttgart, small-pox epidemic 1870, 261 f.
Sueur, 203, 320, 322.
Süssmilch, 83.
Suttner, 55.
Sweating sickness, 18 ff.
Sweden, small-pox epidemic 1871, 280 f.
Switzerland, typhus fever epidemic 1813, 158 f.
Syphilis, 16, 17, 18.
Takaki, 298.
Teuffel, 188.
Thierer, 62.
Thilenius, 138.
Tholazan, 169.
Thouvenel, 154.
Thucydides, 11.
Tilly, 27, 50.
Torgau, siege of, 311 ff.
Typhoid fever, 8 f.;
American Civil War, 177 f.;
Boer War, 290 ff.;
Franco-German War, 190 ff.;
Herero War, 296;
Port Arthur, 326 f.;
Russo-Japanese War, 297 f.;
Russo-Turkish War 1877, 288 ff.;
siege of Paris, 321 ff.;
siege of Torgau, 315 f.;
Thirty Years’ War, 71.
Typhus fever, 4 ff., 19 ff., 106 ff., 149 f.;
1812, 114 ff.;
1813–14, 162 ff.;
Algiers 1868, 195 f.;
American Civil War, 178;
Balkan War, 301 ff.;
Berlin 1813, 124 f.;
Breslau 1813, 123;
Coalition War, 98;
Crimean War, 172 ff.;
Danzig 1813, 122;
Dresden 1813, 127 f.;
England 1622, 75 f.;
England 1808, 105;
England 1856, 174 f.;
Erfurt 1813, 133;
Frankfurt 1813, 135 ff.;
Genoa 1799, 97;
Hamburg 1813, 141 f.;
Hanau 1813, 134 f.;
Königsberg 1806, 100;
Königsberg 1812, 121 f.;
Leipzig 1813, 128 ff.;
Metz 1813, 155 f.;
Metz 1870, 196 f.;
Moravia 1813, 161;
mortality 1813–14, 163;
mortality among physicians, 108;
Moscow 1812, 116;
Nassau 1813, 140;
Paris 1814, 156 f.;
Peninsular War, 101 f.;
Pont-à-Mousson 1813, 154;
Russian Campaign, 115 ff.;
Russo-Turkish War of 1877, 287 ff.;
Seven Years’ War, 82 ff.;
siege of Danzig, 307 ff.;
siege of Mantua, 305 ff.;
siege of Mayence, 317 ff.;
siege of Torgau, 311 ff.;
Switzerland 1813, 158 f.;
Thirty Years’ War, 26 ff.;
Verdun 1792, 109;
Vilna 1812, 117;
Wars of French Revolution, 92 ff.;
War with Moors in Spain, 21;
War of Polish Succession, 80;
Warsaw 1812, 119;
Württemberg 1813, 150 f.
Uetterodt, L., 1.
Ulm, pestilence 1634, 62;
small-pox epidemic 1870, 262 f.
Vaccination, 200, 201, 202, 207,
211, 212, 217, 231, 240, 241, 251, 255 f., 260, 265, 269 f., 279, 282,
283, 284, 285;
effects of, 197 f.;
effect on mortality, 9.
Vacher, 199, 206, 207, 303, 320.
Varna, plague 1829, 168.
Venice, pestilence 1630, 75.
Verdun, pestilence 1793, 82 f.;
typhus epidemic 1792, 109.
Vernois, 200, 201.
Verona, pestilence 1630, 75.
Vienna, small-pox epidemic 1872, 277.
Vilna, typhus fever 1812, 117.
Virchow, 115.
Viry, 196.
Vogt, 271.
Volz, 186, 194, 262.
Wahl, 247.
Wallenstein, 27, 50.
War Pestilence, use of term, 4.
Warsaw, typhus epidemic 1812, 119.
Weber, 143.
Weichselbaum, 185.
Wendt, 123.
Westergaard, H., 1.
Wilbrandt, 94, 136.
Wilken, 14, 15.
Wittmann, 316–19.
Woillez, 207.
Wolf, 119.
Wunderlich, 251, 252, 270.
Württemberg, pestilence 1634, 63;
typhus epidemic 1813, 150 f.
Yellow fever, Spain 1810, 101.
Zenzen, 318.
Zurich, small-pox epidemic 1871, 272.
GENERAL APPENDIX
PUBLICATIONS OF THE DIVISION OF ECONOMICS AND HISTORY
The Conference which met at Berne in 1911, under the auspices of the
Division of Economics and History of the Carnegie Endowment for
International Peace, appointed three Commissions to draft the questions
and problems to be dealt with by competent authorities in all countries.
The first Commission was entrusted with _The Economic and Historical
Causes and Effects of War_; the second with _Armaments in Time of
Peace_; the third with _The Unifying Influences in International Life_.
Subsequently the suggestions of the three Commissions were considered
and approved by the entire Conference.
The questions are to be discussed scientifically, and as far as possible
without prejudice either for or against war; and their discussion may
have such important consequences that the questions are presented below
_in extenso_.
Report of the First Commission
THE ECONOMIC AND HISTORICAL CAUSES AND EFFECTS OF WAR
The Conference recommends the following researches:
1. Historical presentation of the causes of war in modern times, tracing
especially the influence exercised by the striving for greater political
power, by the growth of the national idea, by the political aspirations
of races and by economic interests.
2. Conflicts of economic interests in the present age:
(_a_) The influence of the growth of population and of the industrial
development upon the expansion of States.
(_b_) The protectionist policy; its origin and basis; its method
of application and its influence upon the relations between
countries; bounties (open and disguised, public and private);
most-favoured-nation treatment; the attitude towards foreign goods
and foreign capital; the boycott; discouragement of foreign
immigration.
(_c_) International loans; the policy of guarantees; the relations of
the creditor to the debtor States; the use of loans for gaining
influence over other States.
(_d_) Rivalry among States with respect to capitalist investments in
foreign countries:
1. The endeavour to obtain a privileged position in banking
enterprises, in the opening and development of mines, in the letting
of public contracts, in the execution of public works, in the
building of railways (Siberian, Manchurian, Persian Bagdad Railway,
Adriatic Railway, &c.); in short, the organization of larger
capitalistic enterprises in foreign countries.
2. The hindering of foreign countries by convention from executing
productive enterprises on their own soil, e.g. from building
railways in their own countries.
3. The anti-militarist movement, considered in its religious and
political manifestations. (Only opposition to all military organization
is here to be considered.)
4. The position of organized labour and the socialists in the various
States on the questions of war and armaments.
5. Is it possible to determine a special interest of individual classes
making for or against war, for or against standing armies?
6. The influence of women and woman suffrage upon war and armaments.
7. The extension of obligatory military service in the different States,
in times both of war and of peace.
(_a_) The conditions of military service; the system of enlistment and
of general obligatory service, the actual position of aliens.
(_b_) The ratio of the persons obliged to render military service to
the entire population.
(_c_) The influence of the present system of military obligation and
the organization of armies upon warfare and upon its duration.
8. The economic effects of the right of capture and its influence upon
the development of navies.
9. War loans provided by neutral countries; their extent and influence
on recent warfare.
10. The effects of war:
(_a_) Financial cost of war. The methods of meeting it: Taxation;
International Loans; External Loans.
(_b_) Losses and gains from the point of view of public and private
economic interests; checks to production and the destruction of
productive forces; reduction of opportunities for business
enterprises; interruption of foreign trade and of the imports of food;
the destruction of property; shrinkage of values of property,
including securities; financial burden caused by new taxes, debts, and
war indemnities; effects upon private credit and upon savings banks;
advantages to those industries which furnish military materials;
advantages and disadvantages to neutral countries.
(_c_) The effects of war upon the supply of the world with food and
raw materials, with special reference to those States which are in
large degree dependent upon other countries for such supplies, e.g.
Great Britain and Germany; by diversion of capital from those
countries which produce food and raw materials (especially the
stoppage of railway building and of new investments in agriculture and
other industries).
(_d_) The condition of the victorious State: manner of levy and use of
contributions and war indemnities; influence upon industry and social
life.
(_e_) The manner in which the energy of nations is stimulated or
depressed by war.
11. Loss of human life in war and as a result of war: influence upon
population (birth-rate, relation between the sexes, ratio of the various
ages, sanitary conditions).
12. The influence of war and of the possibility of war upon the
protective policy, upon banking conditions (especially upon banks of
issue), and upon monetary systems.
13. The influence of annexation upon the economic life of the annexing
States, and upon the State whose territory has been annexed.