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Sunday, December 6, 2015

The Impact of Disease on the Civil War (Excerpt)

By Intisar K. Hamidullah


Background
In 1967 the Surgeon General of the United States announced that it was time to close the book on infectious diseases. Unfortunately, this statement was premature. Although our society may not experience epidemics as often as in the past, the epidemics of the present are still a menace to humankind. This unit will focus on four diseases: Measles, Small-pox, Tuberculosis, and Syphilis. These diseases caused a great deal of the deaths before, during, and after the Civil War. Additionally the lack of known treatments and lack of unawareness of prevention had detrimental effects on how these diseases spread throughout the world. Consequently with the advancement of medicine, treatment, prevention, and vaccinations the impacts of these diseases are not as harmful today as during the Civil War.

The invention of the microscope in 1660 enabled Robert Hooke and Antonie van Leeuwenhoek to study cells and other microorganisms that caused diseases. Robert Hooke looked at a cork taken from an oak tree and saw tiny cell-like compartments. The microscope helped him to see the layer of cork thirty times its original size, and thus details of a cell. Much of life is made up of cellular organisms: unicellular life or larger multi-cellular life. Cell Theory describes how living things are made of one or multiple cells, that cells carry out functions needed to support life and that cells come from other living cells.

There are two different kinds of cellular life: eukaryotes and prokaryotes. One major difference between the two types is that a eukaryote cells has a nucleus and a prokaryote cell does not. The nucleus is the largest organelle in a eukaryote cell and contains the DNA. In contrast, prokaryote cells simply contain DNA in their cytoplasm. Many other organelles are essential to the life and functioning of the eukaryote cell. These include ribosomes, endoplasmic reticulum, mitochondrion, and the Golgi apparatus.

In addition to inventing pasteurization to kill bacteria and keep foods such as milk fresh, Louis Pasteur is famous for having studied the causes of sickness in humans and animals. In 1856 he used the microscope to study microorganisms found in the blood of animals and people who were sick. These microorganisms are generally called germs, and Pasteur tried to better understand germs to help in prevention of disease. Studies like these led to the Germ Theory, which states that microorganisms too small to be seen without a microscope can invade the body and cause certain diseases. Prior to confirming the Germ Theory, most people believed that certain diseases had unnatural causes, such as a punishment for evil behavior, demonic possession, etc. Pasteur widely popularized the idea that many diseases were caused by bacteria, the most ancient type of cellular life on earth. Bacteria are found literally everywhere, except where humans have purposefully used chemicals or sterilization to prevent their growth. Thus, although many types of bacteria are useful, such as those living in the human gut which aid our digestion; we have developed antibiotics and other therapies to kill bacteria viewed as harmful.

But germs other than bacteria can cause infectious disease too. In particular viruses are extremely tiny (smaller than cells), but cause some of the most deadly diseases known. All viruses need to reproduce by attacking cells; they use the host cell's metabolism (life properties) to instruct the cell to make copies of viruses which then leave the cell to infect further cells. In this way, cells of human tissues and organs such as lungs can be infected and destroyed by bacteria and especially by viruses. Bacteria and viruses can be passed between humans in many different ways, including via sneezing, talking, coughing, singing, ingesting contaminated food and water and through sexual activity. The poor health conditions of war thus often make it easier for transmission of bacteria and viruses between humans.

One would naturally anticipate that the highest number of causalities during a war is from gunfire. However, this was not true during the Civil War; three out of five Union troops died of disease, whereas, two out of three Confederate troops similarly died. 1 More men died throughout this four year period than in any other war experienced by the United States. The cause for the disproportionate number of deaths was attributed to filthy living conditions in army camps, nonexistent surgical equipment, spoiled and poorly prepared foods, unwashed surgeon's hands, and other poor health conditions.

The Civil War was a breeding ground for diseases caused by bacteria and viruses. At the time little was known about what caused diseases. Surgical techniques ranged from barbaric to nonexistent. As a result a soldier had a 1 in 4 chance of surviving war because of poor medical care. During the early 1800's physicians had minimal training, in fact Harvard University did not own a stethoscope until after the war ended 2. At the beginning of the war the North had 98 doctors whereas the Confederate had 24 doctors. At the end of the war in 1865, the North had 13,000 medical doctors and the Confederates had 4,000 doctors. Since women were not allowed to fight, they often volunteered as nurses. Due to the efforts of Clara Barton, the Red Cross was established to improve medical conditions for soldiers and citizens. According to Walt Whitman, surgeons were butchers because limbs would be amputated in an effort to minimize pain and prevent further spread of infections to other soldiers, but these surgeons did little to minimize pain. At times death or infection set in because the two and four wheeled carts used as ambulances were unreliable and overcrowded. If events that preceded the Civil War had been resolved differently, then this dreadful chapter in US history might have been avoided.

Whether it was the Abolitionist movement in the 1820's and 1830's,the publishing of Uncle Tom's Cabin in 1852, the Dred Scott decision in 1857, the raid on Harper's Ferry in 1859, or William Lloyd Garrison's Anti-Slavery Society, the North was making it clear that they were not in favor of slavery. Then the decision of slave versus freed states was an issue during the Missouri Compromise of 1820, Compromise of 1850 and the Kansas-Nebraska Act of 1854. The aforementioned were all coupled with other differences between the North and the South. The North wanted federally sponsored improvements of roads, railways and canals and the South did not. The North wanted a high tariff for manufactured goods, whereas the South thought it would interfere with the established foreign trade for cotton. The North wanted a currency system, whereas the Confederates did not think the currency would benefit them. Of course, the largest issue was slavery with the North being against it and the Confederate being a proponent for it. Finally Abraham Lincoln who was against slavery was inaugurated President on March 4, 1861. The culmination of the aforementioned events was the start of the Civil War on April 12, 1861.

In addition to the Battle of Antietam, Battle of Bull Run, Battle of Gettysburg, Battle of Fort Sumter, etc. history was also taking place off the battlefield. On January 1, 1863 the Emancipation Proclamation was instated by President Lincoln. With this decree most African Americans hurried to enlist in the Northern Army. In spite of being free they still experienced discrimination, evidenced by substandard supplies, rations and payment inequities. They were given seven dollars per month plus a three dollar clothing allowance. Their white counterparts were given thirteen dollars plus a three dollar and fifty cent clothing allowance 3. The differences were enough for some to refuse to enlist; however, others were eager to be a part of all black regiments, like the Fifty Fourth Regiment of Massachusetts. Two years later, on April 18, 1865 the South surrendered and the Civil War was over. Along with the end of the Civil War, the 13 th Amendment was passed abolishing slavery.

Although the purpose of war can be to repair political conflicts, to obtain territory or to defend against invaders, war has always involved disease. During the Civil War not only did soldiers have to withstand bullets, shells, and bombs they also had to worry about infections. Additionally, not only was this war difficult to deal with physically, the ramifications emotionally were lifelong. The circumstances soldiers found themselves in were unimaginable and ranged from imprisonment, family separation, death, and watching fellow injured soldiers. Consequently, dealing with these circumstances one tends to develop anxiety, depression, post traumatic stress disorder, drug abuse, alcoholism and nightmares that do not fade. Although these emotional side effects of war are devastating, so are the diseases that can often be incurable. The seven most common diseases in army camps were typhoid fever, smallpox, measles, diarrhea, pneumonia, malaria, and tuberculosis. 4 For this unit we will focus on the history of measles, small pox, tuberculosis, diarrhea and syphilis. An English Professor stated that nothing could be more ridiculous than to contend that disease is always the primary cause of great historical change 5. But it is important to examine the episodes that influence disease.

From: teachers.yale.edu

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