Epidemics Resulting from Wars. Friedrich Prinzing
The Siege of Port Arthur (1904)
GENERAL APPENDIX PUBLICATIONS OF THE DIVISION OF ECONOMICS AND HISTORY
Report of the First Commission THE ECONOMIC AND HISTORICAL CAUSES AND EFFECTS OF WAR
Report of the Third Commission THE UNIFYING INFLUENCES IN INTERNATIONAL LIFE
INTRODUCTION
In countries which have the misfortune to be the scene of protracted wars, the mortality regularly undergoes a considerable increase. This is caused chiefly by the infectious diseases which in war times so often appear in the form of epidemics. These diseases, moreover, not only afflict the country in which the war is waged, but are also carried by prisoners, returning soldiers, and in other ways, into the land of the victor, where it is possible for them to spread over a large territory. A report on the loss of human life among that part of a population which does not participate in a war has not yet been undertaken, writings on war pestilences usually confining themselves to the losses within the armies themselves.[1] It is the purpose of the present study to investigate the losses sustained by the non-belligerent part of the population in consequence of epidemics caused by wars.
In doing this it seems advisable to select a few war pestilences which on account of their enormous extent are particularly notable, and to subject them to an exhaustive discussion. This method has the advantage that it will enable us to show in individual cases how it is possible for these pestilences to extend over such a vast territory, under what circumstances they spread from place to place, and how they enter regions remote from the scene of war. For this exhaustive discussion the writer has chosen the pestilences that occurred during the Thirty Years’ War, the epidemic of typhus fever after Napoleon’s Russian Campaign, and the pandemic of small-pox after the Franco-German War of 1870–1. These epidemics afford very instructive examples of what horrible losses both friends and enemies may sustain in consequence of war pestilences.
While the outbreaks of ‘plague’ in the course of the Thirty Years’ War have already been made the subject of a comprehensive account, strange to say there are no such accounts of the other two epidemics; to give a clear picture of these pestilences the writer was therefore constrained to collect the necessary information from widely dispersed sources. In gathering his material a number of large German libraries assisted him most kindly—particularly, the Royal National Library at Stuttgart and the University libraries of Strassburg and Tübingen.
The other parts of the history of war pestilences are set forth in a more general way; for an exhaustive treatment of them would have necessitated several years of preliminary work, which the writer in the short time at his disposal was unable to undertake.
The writer has drawn as much as possible from original sources; this applies at least to the pestilences of the Napoleonic Period, and to the epidemic of small-pox after the Franco-German War. It would have been impossible to deal with the other wars in the same way without consuming considerable time. From the bibliographies it will appear what sources the author has consulted; rarely are quotations given from works which he has not seen, and in such cases it is indicated whence they were taken.
The causes of the origin and spread of pestilences during a war are clear. Every aggregation of people, even in times of peace, at celebrations and annual fairs, in barracks, and so forth, is necessarily exposed to the danger of pestilence; but this danger is ten times as great in large assemblages of troops during a war. The soldiers are then subjected to all possible kinds of hardship and suffering—lack of food, or food which is inferior and badly cooked, sleeping out in the cold and rain, fatiguing marches, constant excitement, and homesickness—and all these things greatly lessen their power of resistance. When large bodies of troops are obliged to remain in one and the same place for a considerable length of time, the additional difficulty presents itself of keeping the locality unpolluted by the excrement of men and animals, and by refuse of all kinds. If an infectious disease reveals its presence in such an aggregation of people, energetic and stringent measures must be adopted, even in times of peace, to prevent it from spreading. In war times it is often impossible to take the necessary precautions, since the attention of the commanders is directed toward very definite objects, to which all other considerations are subordinate. Whether the germ of the disease is already in the place, or whether the soldiers bring it with them, in either case there is danger that the fighting armies will cause the disease to spread over the entire scene of the war, and thus seriously endanger thousands of human lives.
Modern methods of sanitation have done much toward preventing the spread of army pestilences, not only in peace, but also in war. The last few decades have evinced that fact. Whatever attitude we may assume toward the question whether war can ever be wholly abolished, we must all agree that, if war has once broken out, all possible means must be employed to prevent the spreading of pestilence within the armies. Here the interests of the people and of the commanders coincide, since the efficiency of armies is often seriously interfered with by the outbreak of pestilence, and not infrequently the success or failure of a war depends, not upon the outcome of its battles, but upon the appearance or non-appearance of pestilence.
CHAPTER I
WAR PESTILENCES
All infectious diseases may spread in consequence of war and develop into epidemics of varying extent. In the next chapter we shall see how the wars at the end of the fifteenth century favoured the spread of an epidemic of syphilis. In the Union Army, during the American Civil War of 1861–5, both measles and typhoid fever were very widespread, and together they were the cause of 4,246 deaths, or about 1·75 per cent of the total enlistment. Scarlet fever, influenza, yellow fever, relapsing fever, and malaria (if the war is waged in countries where this disease is endemic—especially in the Lower Danube region, in the Netherlands, Spain, and Italy) have also played an important rôle in many wars. But we give the name ‘war pestilences’ only to those infectious diseases which in the course of centuries have usually followed at the heels of belligerent armies, such as typhus fever, bubonic plague, cholera, typhoid fever, dysentery, and small-pox; we may also include here scurvy, the etiology of which has not yet been definitely determined.
1. Typhus fever (spotted fever, exanthematic typhus—called in France and England simply typhus, in Spain tabardillo[2]—formerly called contagious typhus, hunger typhus, camp fever, and Hungarian fever) is an acute infectious disease of cyclic recurrence, which resembles typhoid fever only in name. From the eighth to the tenth day after infection, often somewhat sooner or later, it begins with a chill, accompanied by nausea, vomiting, violent headache, and psychic depression. In the first few days the patient’s temperature rises rapidly, and on the fourth or fifth day a rash in the form of dull-red spots, as large as a pea, breaks out over the entire body. These spots gradually grow larger, and after two or three days, through the appearance of very small haemorrhages, change into petechiae. The apathy of which the patient first gave evidence now gives way to wild delirium. At the end of the second week the temperature falls rapidly, and in one or two days becomes normal; often, however, the fall of temperature takes from six to eight days. The duration of the entire disease, accordingly,