Friedrich Prinzing

“ If we start from the time when more or less accurate descriptions enable us to determine the nature of the epidemics, we find that plague and typhus fever were the two diseases which, until a few decades ago, most commonly attacked the soldiers; the latter disease, which made its appearance in almost every war that was waged between the beginning of the sixteenth and the middle of the nineteenth century, consequently acquired the name ‘war-plague’. ”

“ 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. ”

“ Accordingly, I warn all military physicians not to congregate all their typhus fever patients in a single room by themselves; for few would come forth from such a room alive, while the poisoned atmosphere of the room would pervade the entire lazaret, infect the physicians and attendants, and finally spread throughout the immediate neighbourhood. People think that they can prevent the disease from spreading by congregating and isolating the patients, but as a matter of fact this has the opposite effect. ”

“ Since even in time of peace the close quarters in which soldiers live in barracks greatly favour the outbreak of epidemics, the military authorities constantly watched and profited by these advances in the field of disease-prevention; and with the success of efforts to decrease the prevalence of infectious diseases among the soldiers in time of peace, so also in war-times it became possible to check more thoroughly than ever before the dissemination of these diseases. Hence the number of men carried away by epidemics is much smaller in modern wars than used to be the case. ”

“ 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 the case of small-pox the infective agent is not yet known; infection is caused by contact with a patient, or with objects which he is using or has used. It is particularly dangerous to touch things on which the contents of the pustules have dried, for such articles remain infectious for a long time. Recovery from the disease usually renders a person immune for life. The mortality in different epidemics varies greatly; most dangerous of all is the so-called ‘black small-pox’ (haemorrhagic small-pox, with bleeding in the pustules and under the skin) . ”

“ For a successful battle against war-pestilences, it is a fortunate coincidence that the civil as well as the military authorities are equally interested in their prevention. Every military leader knows how important it is for the soldiers to keep healthy, since their efficiency is otherwise seriously impaired. It is not our task to describe the particular measures that are to be adopted; the manuals of military sanitation give us accurate information regarding these matters. ”

“ If a disease breaks out in a community in consequence of the fact that a military prison has been established there, in my opinion it is incumbent on the central government of the country to support the local authorities in their efforts to check the disease, and to give them financial help as well as scientific advice. Unfortunately, it is not to be denied that, in many small cities and in almost all rural communities, absolutely no provision is made for the isolation of persons suffering from infectious diseases ”

“ The hospitals were in a pitiable condition, and since the soldiers, after their previous experiences, had little hope of leaving the country alive, they gave themselves over to a most dissolute life, in consequence of which the country suffered terribly. Several contemporaries bear witness to the fact that a large part of the German troops never once faced the enemy, for the reason that they succumbed beforehand to ‘Hungarian disease’, which killed more of them than the swords of the Turks. Hence Hungary was called at that time the ‘Cemetery of the Germans’. ”

“ 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. ”

“ On the other hand, in those countries in which children are vaccinated in the first year of their lives, the infant mortality is low, although the same children lose their immunity to the disease when they grow older. To illuminate these facts let us adduce a few figures. In estimating the number of deaths, however, we cannot use the number of the living as a relative basis to work on, since the prevalence of small-pox varied greatly in the different countries; consequently we must take the total number of deaths and estimate the mortality on the basis of age from that alone. ”

“ Every aggregation of people, even in times of peace, at celebrations and annual fairs, in barracks, and 3so 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. ”

“ Typhus fever was conveyed to Warsaw by the Austrian auxiliary corps, and it quickly spread to the French hospitals, which were in a wretched condition. Later the Russian army also brought typhus fever to the city. A great many civilians in Warsaw contracted the disease; according to Wolf, the epidemic reached its climax in February, and lasted until the end of the year 1813. The lower classes suffered more than the upper classes from the disease, which, moreover, seems to have raged much more furiously in the vicinity of Warsaw than in the city itself. ”

“ One of the most potent causes of the infection at Verdun was the unpaved state of the town at the time of the siege. Every day refuse of all kinds was thrown from each house out into the street—the evacuations of men and animals, rubbish, and garbage—and there it mixed with the mud, liquefied and rotted through the action of the rain. The officials in charge of street sanitation were powerless. ”

“ To be sure, typhoid fever and dysentery carried away many men on both sides, while an unusually large number of soldiers contracted malaria. Those fevers which were called ‘Fièvres rémittentes épidémiques d’Italie’, and which, notwithstanding their frequent occurrence, caused only a few deaths, according to Niedner were for the most part malaria, and not relapsing fever. The Austrian army seems to have lost more men in consequence of pestilences than the French army. Regarding the spreading of the pestilences on a large scale from the armies to the civil population we have no information. ”

“ Many sick-attendants and sub-surgeons contracted typhus fever, which was prevalent in the hospitals, and several cases also occurred in the city, especially among people who quartered soldiers for money in their homes; many soldiers were thus crowded together in small rooms, and among them were a great many convalescents from Saxon hospitals. The infectious nature of the disease and its consequent dangerousness was shown by the fact that as a rule entire families gradually contracted it, although the epidemic was confined to individual houses. ”

“ Their pale faces and emaciated forms bore witness to hunger and sorrow, to a long deprivation of the usual necessaries of life and to lack of vital energy, to exhaustion caused by the long marches from Hanau to Leipzig, when in the ardent struggle to reach their fatherland they had used up their last ounce of strength. ”

“ How the quality of the bread becomes more and more unsatisfactory, and finally reaches the point where the product is scarcely worthy of the name bread; how people are obliged to eat the flesh of horses, dogs, and other animals; how the prices of the necessaries of life soar ad infinitum—all this is so well known that it needs no further exposition. ”

“ According to Lemazurier, the number of sick and wounded soldiers in Moscow was 15,000. The most common disease even in Moscow was typhus fever; according to Scheerer, when Napoleon’s army withdrew from the city it left behind several thousand typhus-fever patients, almost all of whom died—only the stronger patients were taken along on wagons.
The horrors of the return march are well known. Thousands froze to death in the extreme cold of November, horse-meat and melted snow were the sole means of nourishment, and any soldier who lay down was irretrievably lost. ”

“ The regiments of the Departments on their way to Paris were quartered in the homes of civilians, where they contracted small-pox. The disease spread easily among the young people who, owing to lack of time, had not been revaccinated, and many of whom had perhaps never been vaccinated at all. During the first part of the siege of Paris it was these regiments which suffered the most from small-pox, but later on the epidemic became more general and spread to all the corps. ”

“ Typhoid fever (called in England ‘enteric fever’, in France ‘fièvre typhoïde’, in Italy ‘febbre tifoidea’) in many wars has been very widespread among the armies; for example, in the American Civil War, in the Franco-German War (Metz) , and in the Russo-Turkish War of 1877–8. The progress of the disease is well known; between the time of infection and the outbreak of the sickness nine to eleven days usually intervene, sometimes even as much as three weeks. ”

“ In Mecklenburg typhus fever began to spread after the erection of a military lazaret in Malchow (October, 1813) , and after the erection of a second lazaret by the Swedes in Wittenburg (near Schwerin) .
In Kiel typhus fever did not appear until the beginning of the year 1814; Weber [158] attributed the outbreak there to the Swedish military lazaret, in which physicians and nurses frequently contracted the disease. At first the poorer people were attacked (probably because the sick-attendants were of that class) , and later the well-to-do. The pestilence, mild at first, soon became very severe. ”

“ During a war, the civil authorities must also do their part in preventing diseases from spreading to the civil population. The local administrations of a region in which fighting is going on are powerless. The generals care very little whether or not a city or village in the enemy’s country is infected by their troops, whom they quarter in whatever house or place best suits their purpose. ”

“ It is indeed very probable that the epidemic in London was due to the large arrivals of French refugees during the latter part of the previous autumn. That the epidemic may to a great extent be traced to our foreign communications is beyond doubt, and it is to be regretted that the steady decline of deaths from small-pox in the six years 1864–9 had induced a certain apathy in the matter of vaccination, and thus left a large portion of the population unprotected from the disease. ”

“ Everything the brutalized soldiers could not consume themselves or take with them, they destroyed or burned. There was an absolute dearth of farm-workers, and in addition to that, the year 1635 was dry and unproductive. Horrible are the descriptions of the hunger and misery which the people in all parts of Germany experienced at that time. Under such conditions pestilences could spread unhindered; to be sure, they relaxed a little after the year 1638, but by no means ceased entirely. Whenever real plague disappeared, typhus fever, which was prevalent in all parts of the army took its place ”