Sunday, August 30, 2015

Disease Killed More Soldiers Than Combat

By Russ Hatter, 9-25-11

Editor’s Note: Information compiled here by Russ Hatter is sadly historically accurate. And while Hatter has done a marvelous job of “cleansing” it for you, the reader, there are nonetheless many sections that are of necessity very graphic in detailing Civil War medical knowledge and practices. You’ll learn a lot reading it; just be cautioned to the fact that it’s not pleasant.

More Civil War soldiers died from disease than died in actual combat. Statistics found in the Army Medical Department following the war confirm the deadliness of disease.

Bell I. Wiley tells us in his 1952 publication The Life of Billy Yank: “In the Federal forces four persons died of sickness for every one killed in battle, and deaths from disease were twice those resulting from all other known causes.”

Matthew Pacer provides a slightly different picture: “Three of every five Union soldiers who died did so from disease. For the Confederacy two of every three deaths resulted from disease. Roughly 224,000 Union officers and soldiers died of disease, while such ailments claimed about 164,000 Confederates.”

Author David Williams writes in A People’s History of the Civil War, “disease killed twice as many men as died from combat.” While each writer looks at Civil War fatalities in a different way, all three agree with our opening remark: “More Civil War soldiers died from disease than died from battle.”

Diminished Effectiveness
Disease could diminish the effectiveness of an army in the field, even devastating it, so medical depart­ments played a vital role by trying to keep soldiers healthy. Sanitation also became increasingly important, and promoting healthy living conditions was a material goal of both Confederate and Union medical services.

Medical knowledge about the connection between sani­tation and general health was sketchy however, so camps and even hospitals were often unclean and corre­spondingly unhealthy. Neither the germ theory nor the nature and necessity of antisepsis were yet understood.

Soldiers dreaded hospitals and sometimes went to great lengths to conceal sickness in order to avoid them. Medicine was in a relatively undeveloped state during the Civil War. Ignorance was a prime factor in the deplorable conditions, which prevailed in Union hospitals.

They operated in old bloodstained and often pus-stained coats and often used infected medical instruments. Physicians performed amputations with implements washed in water bloody from previous operations, thereby routinely spreading infection.

Gangrene was so commonplace that most military hospitals had special wards or tents for its victims. Both North and South ordered military hospitals to establish burial grounds. Each hospital of the Union army was charged to provide a “dead house,” for storage of corpses prior to burial.

Suffered Terribly
Soldiers on both sides suffered terribly from exposure to the elements. At night they slept in the rain, in the mud, in the snow, or on the frozen ground. The men often awakened to find themselves covered in snow or drenched with rain. Along with improper diet, such exposure made them susceptible to all sorts of deadly illnesses.

Men from isolated rural areas often lacked the exposure to sickness necessary to build up immunities. Consequently, many diseases achieved almost epidemic levels during the war's early years. Typhoid, measles, smallpox, diarrhea, dysentery, scurvy, gonorrhea, and syphilis afflicted both Union and Confederate forces.

As to venereal diseases, many physicians thought that they were moral afflictions rather than medical ones and hence did not afford them serious treatment. Nutrition and improper diet was also a problem and related maladies such as scurvy became widespread.

Drew Gilpin Faust commented in her book This Republic of Suffering – Death and the American Civil War that even the most privileged and famous could not protect themselves from the reach of war-borne disease.

William Tecumseh Sherman’s nine-year-old son died of typhoid fever contracted on a visit to his father in camp; Confederate general James Longstreet lost both his young children when they moved from Richmond to join him and came down with scarlet fever soon after they arrived. Eleven-year-old Willie Lincoln died in 1862 from typhoid fever, the consequence in all likelihood, of Washington’s water supply, contaminated by the army camps stationed along the banks of the Potomac River.

Crowded conditions contributed to a major outbreak of measles early in the war. So many died from a combination of measles and exposure that commanders frequently refused to accept men for active duty until they had been “put through the measles,” as Bell Wiley tells us. Still, the need for soldiers, especially among the Confederates, meant that sick men were often rushed to duty.

As the war progressed, the incidence of disease decreased in some areas. Contributing to this decline was the increased number of seasoned veterans who had never been vulnerable to disease or who had survived its onset to become immune to it.

Yet disease rates could vary markedly from region to region or from army to army. A region and its climate greatly influenced the occurrence of sickness. Union soldiers who campaigned in the South suffered an alarming increase in mortality rates because malaria and dysentery thrived in the hot and humid climate.

Impact Immeasurable
It is probably impossible to measure accurately the real impact of disease in the Civil War. Aside from affecting the performance of armies by striking down ordinary soldiers, it could debilitate officers, sometimes at the highest levels, to fog judgment and influence crucial decisions.

Even after the shooting had stopped, disease carried on its grim work when soldiers returned home with illnesses alien to different regions, thus to infect countless civilians. The medical profession would learn invaluable lessons from the war, but the cost of that education was exceedingly high.

Failure to eliminate unfit men at induction was one of the main factors contributing to the scourge of illness in the Federal army. Scores of weaklings entered the service and many of these men were already suffering with such diseases as varicose veins, hernia, syphilis and tuberculosis. Eventually these substandard men would break down and exacerbate the burden of an already overloaded hospital system.

Disposal of garbage in the camps was negligent and slovenly. One report said “camp streets and spaces between the tents were littered with refuse, food and other rubbish, sometimes in an offensive state of decomposition; slops were deposited in pits within the camp limits or just thrown out wherever and heaps of manure and offal were close to the camp.”

Neglect of personal cleanliness was rampant. Army regulations prescribed daily washing of hands and faces and complete baths once or twice a week. But few soldiers complied and neglect was common. Men would often go for weeks without bathing or washing their clothing.

Measles Came First
The disease that usually struck first in epidemic proportions was measles. Attacks would usually come within a few months of a unit’s organization and would often recur after large additional recruiting.

Eighteen-year-old Franklin S. Bristow of Frankfort enlisted Dec. 2, 1861 into the 22nd Kentucky Volunteer Infantry. Within a few weeks he contracted measles and died in the Ashland General Hospital on Jan. 7, 1862, after serving only 36 days as a soldier.

Measles seemed to prefer the winter months usually running its course in three to four weeks. Most of the time it was mild, but improper care and undo exposure could lead to pneumonia or other serious complications.

African American troops were more susceptible to measles and smallpox than white soldiers. Lewis Pitman, a former slave owned by Frankfort’s John R. Scott, joined the 119th United States Colored Infantry at Frankfort and died from measles less than five months later at Camp Nelson.

Former slaves of Frankfort’s John Macklin, Lewis and Turner Miller (brothers) enlisted at Frankfort into Company F, 119th United States Colored Infantry and both died of smallpox at Bowling Green.

Next was Malaria
Malaria, popularly known as ague or ‘the shakes, was common from the beginning to the end of the war and accounted for 20 percent of all reported illnesses on both sides.

The prevalence of the disease was mostly because of ignorance of its cause. Most medical men thought malaria was the result of breathing poisonous vapors emanating at night in swampy areas. Many diary accounts recorded units arriving in low Southern areas and encountering hordes of mosquitoes, followed shortly after by outbreaks of intermittent fever.

The later discovery of the link between mosquitoes and yellow fever and malaria would make possible the control of these killer diseases. But that was later and not during the war. The Union army reported one out of every four cases of illness was malarial in nature. Bell Wiley tells us that it was so common the standard greeting in many camps was, “Have you had the shakes?”

George Blades, a member of the 109th Regiment Company K, United States Colored Infantry, was honorably discharged in 1865 due to chills and fever, a result of chronic diarrhea caused from malaria, impure water, and improper diet. His unit participated in the fall of Petersburg, Va. and was at Appomattox Courthouse during the surrender of Robert E. Lee and the Confederate Army.

Following the war Blades settled in Frankfort, working on William Schofield’s farm in the southern part of Franklin County. His name appears on the Kentucky United States Colored Troop Monument in Green Hill Cemetery.

The standard treatment for malaria was whiskey and quinine. Other treatments included the use of iodide of potassium, sulphuric acid, and syrup of wild cherry, blue pills, morphine, ammonia, iron, cod-liver oil, soda, cream of tartar, cinnamon, and sweet spirits of niter.

Typhoid Most Deadly
The most deadly disease was typhoid, also referred to as “camp fever” or simply “the fever.” Typhoid caused one fourth of all deaths from disease during the war.

Alarm and depression were enhanced by the frequent carrying away of fever victims by burial details to the mournful cadence of muffled drums beating out the dead march.

Poor sanitation and lack of clean drinking water were a constant source of illness in the ranks that resulted in typhoid fever. Often latrines, or “sinks” as they were known during the war, were merely a straight trench, without pole or rail, the edges filthy and the stench exceedingly offensive, causing an infestation of flies and other vermin that transported bacteria from human waste to food stores.

Indiscriminate urination contaminated drinking water as well, producing diarrhea, dysentery, as well as typhoid. Clean drinking water was especially hard to come by when an army was on the march. Water from mud-holes was sometimes all that was available to drink. The bowel cramps that followed could be deadly. In treating typhoid army doctors relied heavily on stimulants and purges including calomel, quinine, and carbonate of ammonia, turpentine, and brandy.

Typhoid fever took the life of many soldiers from Frankfort. William Henry Harrison Hockensmith, a Union enlistee in the 9th Kentucky Volunteer Cavalry, was sent as a guard to Camp Dick Robinson where he contracted typhoid and died in 1863.

Ambrose White, a soldier with the 114th United States Colored Infantry, died of typhoid fever at Camp Burnside, Aug. 4, 1864.

James Francis Leonard, personal telegrapher of Confederate General P. T. Beauregard, died in 1862 of typhoid in Columbus, Mo.

Union soldier William T. McClure, a member of the 15th Kentucky Volunteer Infantry, died from typhoid in Huntsville, Ala. His residence was 318 Washington St., today’s Red Cross building.

Henry Oliver of the 117th United States Colored Infantry Frankfort died of typhoid fever at Covington, Sept. 10, 1864.

Venereal Diseases
Syphilis and gonorrhea took a horrible toll; neither disease could be treated effectively, and for those that were treated, they eventually proved fatal.

Thomas Lowry’s study on sexual activity during the war notes that one-third of the men who died in Union and Confederate veterans’ homes were killed by the later stages of venereal disease, during which the infection ate away at their brains, blood vessels, and vital organs.

And no one knows how many of the wives and widows went to their graves, ravaged by the pox that their men brought home, or how many veterans’ children were blinded by gonorrhea or stunted by syphilis. Doctors of the mid-19th century knew virtually nothing of what caused the disease, how it spread, or how to treat it.

Most Civil War army doctors simply tried to keep the bowels and kidneys regulated, and the patients quiet, using uncertain combinations of expectorants, purgatives, and narcotics.

The ‘Flux’
Diarrhea and dysentery, often called “flux,” made a complete run of the camps. From Bell Wiley we find “no other ailment was so frequently mentioned in soldier letters and diaries.”

Most soldiers referred to the malady as “the quickstep.”

Statistics compiled by the Medical Department show that from May 1861 to July 30, 1866, there were a total of 1,739,135 cases of diarrhea and dysentery with 57,265 deaths. These figures are low because soldiers, for obvious reasons, tended not to report bowel disorders.

Diarrhea and dysentery were more prevalent among African American troops than among whites, and decidedly more fatal. Diarrhea victims frequently had their bowels further irritated by heavy drafts of whiskey and repeated doses of salts or calomel.

Opium was widely used in combating dysentery and some cases were treated with strychnine. Other bowel disorder “remedies” were turpentine, castor oil, camphor, ipecacuanha, laudanum, and blue pills of mercury and chalk.

Frankfort-born Nelson Cheathan of Company B, 118th United States Colored Cavalry, died of chronic diarrhea at Portsmouth, Va., on Feb. 27, 1865.

And in conclusion …

As the country commemorates the 150th anniversary of the bloodiest war in United States history, it is important that we recognize and understand the suffering imposed on both sides mostly through ignorance, laziness and the scientific lag of the age.

Bell Wiley observed: “In both armies the greatest heroes were not those who died at the cannon’s mouth, but those who endured the lingering agonies of the sick and wounded.”



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