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The American Civil War Experience: Lice, Disease and Quinine

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William Fletcher

Hood

The statistics of those who died during the Civil War, not from injury but from disease, are shocking. Of the 360,222 men known to have died on the Union side, a quarter of a million were lost due to disease rather than the enemy. While the Confederates didn’t keep records, it is estimated that seventy-five percent of the 258,000 Southern deaths could be attributed to disease.

For many, the cycle of illness started soon after joining up. Those from the less populated countryside found themselves in large groups after mustering in – perhaps for the first time in their lives – and were exposed to childhood maladies like the measles, mumps and smallpox. Confederate soldier William A. Fletcher’s experience appears to be not uncommon. A young man from Texas who first signed on in 1861 as a member of the 5th Texas Infantry of Hood’s brigade, he wrote in his memoirs that in the first large camp he was assigned to after signing up, he contracted the measles. While in the hospital recovering from an associated extremely high fever, he became infested with lice and before being released, he contracted the mumps.

Civil War soldiers encampedIn this camp we suffered a good deal with sickness—the most fatal I guess was measles. I had an attack of measles and was sent to the hospital in Richmond and remained there a few days and got tired of hospital life, so I tried to be a good boy and please the woman who had charge of the ward in which I was. I soon persuaded her to get me a discharge, and I returned to camp one cold, frosty morning; the next day I was hauled back a very sick man; was put in a small room that had a coal grate and was instructed to stay in bed and keep well covered up. I lay there a few days with a burning fever, taking such medicine as was prescribed. I had learned the “itch” [from lice] was getting to be a common complaint in the hospital, and after the fever had somewhat abated, I found I had it, so when the doctor made his next visit I drew my arms from under the covers and showed him the whelps or long red marks of itch, and he said he would send me some medicine that would cure it. [i]

FredericksburgWhile encamped near Fredericksburg, Fletcher suffered from a severe attack of jaundiceEmbattled Courage and was given a permit of sick leave. Rather than moving with his unit, he took a room in a Fredericksburg hotel where he received no medical care and almost died of food poisoning. [ii]  Cases like this – and worse – were common due to a lack of sanitary conditions, adequate food, clean water and trained medical care. Gerald Linderman confirms that “each army suffered two waves of disease,” the first being “acute infections of childhood.” [iii] Because those who survived the first wave developed immunities, the incidence abated over time. But it was followed by a second wave that decimated the ranks in ever increasing numbers. Considered “camp” diseases, dysentery, malaria, and diarrhea, took men in their tents and in hospitals by the thousands, reducing the effective fighting force of many units dramatically. [iv]

John D. Billings, in his memoir Hard Tack and Coffee, brought up two important points about health in army camps. The first was that many men Hard Tack and Coffee by John Billingscame to the army already ill. This was particularly true of the recruits in 1864 and 1865, “for those who have occasion to remember will agree that a sufficient number of men too old or diseased came to the front in those years – no, they did not all get as far as the front – to fairly stock all the hospitals in the country.” [v] Billings attributed this to both the incompetence of some of the doctors providing physical examinations for enlisting recruits and the desperation of the government willing to use marginal physicians and accept men clearly unfit for duty.

Billings also spoke of the presence in every company of men who feigned illness to escape duty. As might be expected, these men were seen as shirkers who burdened others in the company with the work they did not perform. These “beats on the government” showed up routinely at the sick tent to receive the care and, in some cases, medicine administered by the doctor. Quinine was the drug du jour “whether for stomach or bowels, headache or toothache, for a cough or for lameness, rheumatism or fever and ague.” [vi]  Some who feigned illness went so far as to refuse food and so created a real health crisis for themselves with varying consequences ranging from transfer to a hospital and eventual release from the service, to susceptibility to more severe and long term conditions. [vii]

The fact remains that many, many men died of very real and unwanted maladies. Diseases flourished in camp because of poor nutrition, inadequate sewage disposal, dirty water and infrequent bathing. Typhoid, measles, cholera and dysentery killed hundreds. Even General Lee contracted dysentery on his way to Gettysburg.  Billings spoke eloquently of his many friends who suffered and died of wasting illnesses, either in the field or in hospitals, away from the families who could have unquestionably cared for them better at home. [viii]

As James I. Robertson, Jr. pointed out in his book, Soldiers Blue and Gray, “more confederates died of illness during the seven week aftermath at Corinth than fell in the two days of intense fighting at Shiloh,” an aftermath not at all uncommon during the war and certainly after every battle. [ix]

Disease was – without question – the war’s biggest killer.

Copyright © 2010 Rene Tyree

i.  William A. Fletcher and Richard S. Wheeler, Rebel Private: Front and Rear: Memoirs of a Confederate Soldier, (Meridian: New York, 1995), 7.
ii. Ibid.
iii. Gerald Linderman, Embattled Courage: The Experience of Combat in the American Civil War,  (The Free Press: New York, 1987), 115.
iv. Ibid.
v. John D. Billings, Hard Tack and Coffee: The Unwritten Story of Army Life (originally published in 1887 by George M. Smith and Company, Boston.), 173.
vi. Ibid., 175-176.
vii. Ibid., 175.
viii. Ibid.
ix. James I. Robertson, Jr., Soldiers Blue and Gray, (University of South Carolina Press: Columbia, South Carolina ), 145.
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Death and Injury on the Battlefield – Part II

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Continuing from the post Death and Injury on the Battlefield Part I here, this post deals with battlefield injuries.

Confederate Wounded at Smith's Barn with Dr Anson Hurd 14th Indiana Volunteers in Attendance after the Battle of Antietam – Near Keedysville, MD, September 1862Those who were injured on the battlefield first had to either remove themselves or hope they would be helped to a field hospital, usually a tent, house, barn or shed marked by a red flag and located as close to the line of battle as possible.[i] There they might find a surgeon and one assistant surgeon, although there was only one of each per regiment. Getting the large number of wounded to the field hospital was challenging. “Three days after the second battle of Manassas, in August 1862, 3,000 men still lay where they had fallen. The first casualties were not moved until September 9th.”[ii] It wasn’t until after the battle of Antietam that the Union Army established an ambulance corps for removing the wounded from the field.[iii] Amputation

If shot by a Minie ball, a soft lead bullet fired from a rifle musket, a soldier’s wound was likely to be large because these .58 [caliber] bullets would deform and tunnel on impact.[iv] “Dr. E. I. Howard of the Army of Northern Virginia described the effects of Minie Ball on bone: ‘… wounds of bony structure inflicted by this missile are characterized by extensive fissuring and comminution such as was rarely, if ever, seen when the old smooth Bore musket was the weapon of the soldier.”[v] Amputation was the rule for gunshot or shrapnel wounds that involved major blood vessels or large bones. “Roughly 50,000 amputations were performed by both sides during the Civil War, compared to around 4,000 in the First World War.”[vi] Men shot or severely injured in the abdomen or chest wounds almost always died and so were rarely treated.

Erysipelas, pyaemia (clots in the veins) septicemia and hospital gangrene were the four major hospital diseases. Erysipelas, or St Anthony’s Fire, was a common problem. This was several years before Lister’s discovery of germ theory. Surgeons operated in unsanitary and unsterile conditions. The lower incidence of wound suppuration in destitute Confederate hospitals has been attributed to the fact that they closed wounds with horse-tail hair which was first boiled, whereas the Northern Army used surgical silk which, although a better product, was not sterile.[vii]

Those who worked in military hospitals did so at great personal risk. Many of them contracted diseases themselves and perished. Common in the literature is record of the absolute despair that existed there. This would, no doubt, make for a great story in and of itself at some point in the future.

Further reading:

  • For more on weapons carried during the American Civil War, see the previous post The Weapons they Carried here.
  • For good coverage of how amputations were performed during the Civil War, click here.

© 2007 L. Rene Tyree

[i] Penny Johnston, “A Healing History of North and South,” History Today, January 1997 [database on-line]; available from Questia, http://www.questia.com/PM.qst?a=o&d=5000399106; Internet; accessed 29 September 2007. [ii] Ibid., [iii] Ibid., [iv] Ibid., [v] Ibid., [vi] Ibid., [vii] Ibid.

Photo credits:

Confederate Wounded at Smith’s Barn with Dr Anson Hurd 14th Indiana Volunteers in Attendance after the Battle of Antietam – Near Keedysville, MD, September 1862

Cropped image of Amputation Being Performed in a Hospital Tent – Gettysburg, PA, July 1863. LOC.

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On Lice, Disease and Quinine

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The statistics of those who died during the Civil War, not from injury but from disease, are shocking. Of the 360,222 men known to have died on the Union side, a quarter of a million were lost due to disease rather than the enemy. While the Confederates didn’t keep records, it is estimated that seventy-five percent of the 258,000 Southern deaths could be attributed to disease.[i] General John B. Hood in Civilian Clothes

I found fascinating that for many, the cycle of illness started soon after joining up. Those from the less populated countryside found themselves in large groups after mustering in – perhaps for the first time in the lives – and were exposed to childhood maladies like the measles, mumps and smallpox. Confederate soldier William A. Fletcher’s experience appears to be not uncommon. A young man from Texas who first signed on in 1861 as a member of the 5th Texas Infantry of Hood’s (see Hood’s photo right) Brigade, he wrote in his memoirs that in the first large camp he was assigned to after signing up, he contracted the measles. While in the hospital recovering from an associated extremely high fever, he became infested with lice and before being released, he contracted the mumps.

Head LiceIn this camp we suffered a good deal with sickness—the most fatal I guess was measles. I had an attack of measles and was sent to the hospital in Richmond and remained there a few days and got tired of hospital life, so I tried to be a good boy and please the woman who had charge of the ward in which IWashington, D.C. Hospital tents in rear of Douglas Hospital was. I soon persuaded her to get me a discharge, and I returned to camp one cold, frosty morning; the next day I was hauled back a very sick man; was put in a small room that had a coal grate and was instructed to stay in bed and keep well covered up. I lay there a few days with a burning fever, taking such medicine as was prescribed. I had learned the “itch” [from lice] was getting to be a common complaint in the hospital, and after the fever had somewhat abated, I found I had it, so when the doctor made his next visit I drew my arms from under the covers and showed him the whelps or long red marks of itch, and he said he would send me some medicine that would cure it.[ii]

FredericksburgWhile encamped near Fredericksburg, Fletcher suffered from a severe attack of jaundice and was given a permit of sick leave. Rather than moving with his unit, he took a room in a Fredericksburg hotel where he received no medical care and almost died of food poisoning.[iii]

Cases like this – and worse – were common due to a lack of sanitary conditions, adequate food, clean water and trained medical care. Gerald Linderman confirms that “each army suffered two waves of disease,” the first being “acute infections of childhood.”[iv] Because those who survived the first wave developed immunities, the incidence abated over time. But it was followed by a second wave that decimated the ranks in ever increasing numbers. Considered “camp” diseases, dysentery, malaria, and diarrhea, took men in their tents and in hospitals by the thousands, reducing the effective fighting force of many units dramatically.[v]

John D. Billings, in his memoir Hard Tack and Coffee, brought up two important points about health in army camps. The first was that many men came to the army already ill. This was particularly true of the recruits in 1864 and 1865, “for those who have occasion to remember will agree that a sufficient number of men too old or diseased came to the front in those years – no, they did not all get as far as the front – to fairly stock all the hospitals in the country.”vi] Billings attributed this to both the incompetence of some of the doctors providing physical examinations for enlisting recruits and the desperation of the government willing to use marginal physicians and accept men clearly unfit for duty.

Billings also spoke of the presence in every company of men who feigned illness to escape duty. As might be expected, these men were seen as shirkers who burdened others in the company with the work they did not perform. These “beats on the government” showed up routinely at the sick tent to receive the care and, in some cases, medicine administered by the doctor. Quinine was the drug du jour “whether for stomach or bowels, headache or toothache, for a cough or for lameness, rheumatism or fever and ague.”[vii] Some who feigned illness went so far as to refuse food and so created a real health crisis for themselves with varying consequences ranging from transfer to a hospital and eventual release from the service, to susceptibility to more severe and long term conditions.[viii]

The fact remains that many, many men died of very real and unwanted maladies. Diseases flourished in camp because of poor nutrition, inadequate sewage disposal, dirty water and infrequent bathing. Typhoid, measles, cholera and dGeneral Robert E. Leedysentery killed hundreds. Even General Lee contracted dysentery on his way to Gettysburg.[ix] Billings spoke eloquently of his many friends who suffered and died of wasting illnesses, either in the field or in hospitals, away from the families who could have unquestionably cared for them better at home.[x]

As James I. Robertson, Jr. pointed out in his book, Soldiers Blue and Gray, “more confederates died of illness during the seven week aftermath at Corinth than fell in the two days of intense fighting at Shiloh, an aftermath not at all uncommon during the war and certainly after every battle.[xi] Disease was – without question – the war’s biggest killer.

Copyright © 2007 Rene Tyree