Epidemics Resulting from Wars. Friedrich Prinzing
7. Scorbutus (scurvy) used to be a common disease on ships, in prisons, and in times of famine; it appeared with the greatest malignancy in besieged cities—Thorn, Nuremberg, Alexandria, Port Arthur, &c. The real cause of the disease is unknown, although too much food of one kind, particularly lack of fresh vegetables, together with long confinement in poorly ventilated and dark rooms, are important causative factors. Inasmuch as the disease almost always appears in the form of an epidemic, it is probable that there is a specific infective agent. It begins with a general feeling of weakness; the skin and mucous membranes become pale and sallow, the gums become inflamed and ulcerated, and small and large extravasations of blood take place in the skin and muscles, and at the joints and knuckles. In serious cases haemorrhages occur in the intestines, kidneys, bladder, and uterus. A change of diet and surroundings will quickly cure scurvy; otherwise progressive anaemia will result in death.
CHAPTER II
THE TIME BEFORE THE THIRTY YEARS’ WAR
Numerous as are the historical notices in former years regarding the destruction of armies by pestilence, correspondingly few are the detailed reports on the spread of pestilence among the non-belligerent population. The best-known example from antiquity is the Plague of Athens (430–425 B.C.), described by Thucydides. The plague began in the second year of the Peloponnesian War, a few days after the invasion of the Peloponnesians. That it is famous is due to the classical description of it by Thucydides, himself a sufferer from the disease. The Plague of Athens broke out in the Piraeus, a fact which has led to the inference that it was borne thither by mariners from Egypt. At the time of the invasion of the Peloponnesians, thousands of country people fled to the city of Athens, which on the advice of Pericles opened its gates to them; thus more than 400,000 people were crowded together within its walls. The first outbreak of the plague lasted two years, then there was an intermission of a year and a half, whereupon it commenced anew. The second outbreak, according to Diodorus, carried away 4,400 hoplites, 300 cavalrymen, a large (but uncertain) number of other soldiers, and 10,000 women and slaves. The plague also penetrated to other places, sparing, however, the Peloponnesus. The nature of the sickness described by Thucydides cannot be positively determined; it has been referred to as bubonic plague (Sprengel), as small-pox (Krause-Daremberg, Kobert), as typhus fever (Häser, Kanngiesser), as typhoid fever (Seitz), and even as anthrax. All we know for certain is that it was some highly infectious disease, recovery from which rendered a person immune. Krauss and Hecker believe that it was a special disease (‘antique plague’), which no longer occurs.[3]
The Plague of the Antonines, also called the ‘Plague of Galen’, which ravaged Italy in A.D. 166–8, has also been brought into connexion with warlike events. Avidius Cassius, who preceded Verus in command of the army, had been sent to Syria for the purpose of suppressing a rebellion, and there, after the capture of Seleucia, the plague broke out. It was borne by the troops back to Rome, where, after the triumphal procession of 166, it spread far and wide, so that it was necessary to load its victims on wagons and carry them off for burial. The plague spread from Italy to Gaul, to the very banks of the Rhine, and a large part of the province was literally depopulated—decayed and deserted villages were found everywhere. Häser inclines to the view that it was an epidemic of small-pox, while Laveran, Hecker, Krause, and Littré believe that it was neither small-pox nor typhus fever, but ‘antique plague’.[4]
The expeditions of the German emperors to Italy, as well as the Crusades, offer numerous examples of how large armies may be destroyed by disease. So, for instance, in 963 or 964 the army of the Emperor Otto I was attacked by a severe pestilence in Italy—a murderous disease which was usually fatal in twenty-four hours. The German army of Henry IV in 1081–2, but especially after the capture of Rome on June 3, 1083, suffered from plagues in Italy; but the same army fared even worse in 1084, when a plague broke out and carried away, for example, the entire German garrison in Rome. In 1137 Lothair’s army was likewise attacked by infectious diseases in Italy. But by far the most devastating of all was the pestilence which broke out in Rome in August, 1167, shortly after the capture of the city by Frederick Barbarossa, and paved the way to a catastrophe which culminated in the complete annihilation of the German army. At that time many eminent men succumbed to the disease, the army dwindled away in the hands of the leaders, and the soldiers fled in vast numbers in order to escape certain death. Even after the Emperor Barbarossa’s withdrawal from Rome the pestilence continued to rage in his army, and it was a long time before it disappeared from the city. It was the true (bubonic) plague, and usually resulted fatally on the first day. In the winter of 1190–1 a pestilence broke out in Lower Italy in the army of Henry VI; it appeared at the beginning of the siege of Naples and carried away many eminent men. The king himself contracted the disease, and had to be taken to Capua.[5]
The armies of the Crusades fared even worse; the mortality in the First Crusade, before and after the conquest of Antioch (1097–8), was terrible. The pestilence is said to have broken out first among the children and women who accompanied the armies, and its dissemination was favoured by a lack of sustenance and continual rainfall; from September to the 24th of November the pestilence carried away 100,000. The nature of the disease is not known, although it is known to have been very infectious. When a new army of 1,500 Germans arrived, it was quickly attacked by the disease and in a few days almost completely annihilated. Several hundred frequently died in a single day, and as the summer of 1099 was very hot and a number of bodies remained unburied, the pestilence lasted well into that year. In 1100 another pestilence raged among the crusaders. Again, during the Second Crusade a severe epidemic broke out in the army of the Emperor Louis VII at Attalia in Asia Minor; the pestilence spread rapidly among the inhabitants of the city, so that many houses, even entire streets, were depopulated.[6]
During the Third Crusade, shortly after the death of Frederick Barbarossa (June, 1190), a severe pestilence broke out in the army that was besieging Antioch; according to Michaux only 5,000 infantrymen and 700 cavalrymen survived out of the entire German army.[7] At the siege of Acre (Ptolemais), which lasted from August 1189, to July 1191, there broke out in the winter of 1191 a terrible pestilence which played havoc in the pilgrim army; it was caused by an inadequate supply of food, and its symptoms (enlargement of the limbs and falling out of the teeth) betoken scurvy. It also appeared in the army of Saladin, but was much worse in the Christian army, in which from 100 to 200 crusaders died every day. Duke Frederick of Swabia succumbed to this disease on January 20, 1191.[8]
At the time of the crusade against the heretics a serious pestilence broke out in Egypt in the army of the crusaders, which had already, on August 12, 1218, suffered from dysentery; it appeared in December during the siege of Damietta, after a heavy and continuous downfall of rain. ‘The patients’, says Wilken, ‘were suddenly seized with violent pains in the feet and ankles; their gums became swollen, their teeth loose and useless, while their hips and shin bones first turned black and then putrefied. Finally, an easy and peaceful death, like a gentle sleep, put an end to their sufferings. A sixth of the pilgrim army was carried away by this disease, which no medicine could cure.’[9] Only a few patients who survived the winter were helped to recovery by the warmth of spring. It was unquestionably a severe form of scurvy. The besieged, too, suffered from the destructive pestilence, and also from Egyptian ophthalmia. We read further in Wilken: ‘A horrible sight greeted the pilgrims when they took possession of Damietta. Not only the houses, but even the streets were filled with unburied corpses; in the beds dead bodies lay beside helpless and dying invalids, and the infection of the air was intolerable. Of 80,000 inhabitants which the city had had at the beginning of the siege only 3,000 were left, while only 100 of these were healthy.’[10] Other reports say that 10,000 inhabitants survived.
In 1270, during the Seventh and last Crusade, which strangely enough passed by way of Tunis, a pestilential disease broke out in Carthage, carrying away, in addition to many soldiers and men of rank, King Louis IX of France himself and his son, Jean Tristan. This pestilence was dysentery, and it spread even to Sicily, whither the king’s body was conveyed. After the king’s death conditions were even worse, since so many people died that it