Fever and Dysentery of Campaigns: War Typhus, 1742-63.

The war in Ireland after the accession of William III. produced two remarkable instances of war-sickness, which are fully given in another chapter. The campaigns of Marlborough against the armies of Louis XIV., from 1704 to the Treaty of Utrecht in 1713, appear to have found no historian from the medical side, nor does the duke refer to these matters in his dispatches or letters, beyond a remark in a letter to his wife from near Munich, 30 July, 1704, a fortnight before the battle of Blenheim: “There having been no war in this country for above sixty years, these towns and villages are so clean that you would be pleased with them[187].”

The war of 1742-48, in which George II. joined Austria against France, produced the first good accounts of war typhus, on land and on board ship, in the writings of Pringle[188]. After the battle of Dettingen, 27 June, 1743, the men were exposed all night in the wet fields; during the next eight days five hundred of them were attacked with dysentery, and in a few weeks near half the army were either ill of it or had recovered from it. The dysentery continued all July and part of August, while the army lay at Hanau. The village of Feckenheim, a league from the camp, was used as a hospital, some 1500 being quartered in it, most of them ill at first of dysentery. The latrines appear to have been ill designed and badly kept. “A malignant fever began among the men, from which few escaped: for however mild or bad soever the flux was for which the person was sent to hospital, this fever almost surely supervened. The petechial spots, blotches, parotids, frequent mortifications, and the great mortality, characterized a pestilential malignity: in this it was worse than the true plague.... Of 14 mates employed about the hospital five died; and, excepting one or two, all the rest had been ill and in danger. The hospital lost nearly half of the patients; but the inhabitants of the village of Feckenheim, where the sick were, having first received the bloody flux, and afterwards the fever by contagion, were almost utterly destroyed[189].” The survivors from the sick troops in Feckenheim were removed to Neuwied, where they were relieved; “but the rest, who were mixed with them, caught the infection.” The mixed troops were sent still down the Rhine in bilanders, during which voyage “the fever became so virulent that above half the number died in the boats, and many of the remnant soon after their arrival.” A parcel of tents sent in these bilanders to the Low Countries were given to a Ghent tradesman to refit; he employed twenty-three journeymen upon them, “but these unhappy men were quickly seized with this fever, whereof seventeen died.” They had no other communication with the infected but through the tents.

“These,” says Pringle, “are instances of high malignity. The common course of the infection is slow, and only catching to those constantly confined to the bad air. Sometimes one will have this fever about him for several days before it confines him to his bed; others I have known complain for weeks of the same symptoms without any regular fever at all; and some, after leaving the infectious place, have afterwards fallen ill of it[190].”

After the battle of Fontenoy on 11 May, 1745, the army was in good health: “the smallpox was the only new disease; it came with the recruits from England, but did not spread; and indeed we have never known it of any consequence in the field.”

On the Jacobite rebellion breaking out in Scotland later in the same year, some of the returning troops were ordered to disembark at Newcastle, Holy Island and Berwick. They had a long voyage, so that a kind of remitting fever which some of them had acquired in the autumn in the Low Countries was “by the crowds and the foul air of the hold soon converted into the jail distemper and became infectious.” At Newcastle most of the nurses and medical attendants of the extemporized hospital were seized with it, of whom three apothecaries, four apprentices and two journeymen died. But the most remarkable experience was on Holy Island. Of ninety-seven men taken out of the ships there, ill of the gaol-fever, forty died, “and the people of the place receiving the infection, in a few weeks buried fifty, the sixth part of the inhabitants of that island.” At Nairn and Inverness there was a singular experience in the spring of 1746. The ships which brought Houghton’s brigade to Nairn carried also thirty-six deserters to be tried by court-martial at the headquarters at Inverness: these men had deserted to the French in Flanders, had been found on board of a captured French transport carrying men to aid the Pretender, and had been thrown into gaol in England till an opportunity arose of sending them to their trial. Three days after the landing at Nairn of the force with which these deserters sailed, six of the officers were seized with fever and many of the men, of whom eighty were left sick at Nairn; in the ten days that the regiment remained at Inverness it sent one hundred and twenty more to hospital, ill of the same fever, which became frequent also among the inhabitants of the town. “Though the virulence of the distemper diminished afterwards in their march to Fort Augustus and Fort William, yet the corps continued sickly for some time.” From the middle of February, 1746, when the army crossed the Forth, to the end of the campaign, there were two thousand sick in hospital, including wounded, of which number near three hundred died, mostly of the contagious fever[191].

After the Peace of Aix-la-Chapelle in 1748, the English troops embarked at Willemstad for home; “but the wind being contrary, several of the ships lay above a month at anchor, and, after all, meeting with a tedious and stormy passage, during which the men kept mostly below deck, the air was corrupted and produced the jail or hospital fever.” The ships that came to Ipswich were in the worst state, about four hundred men having been landed sick there, most of them ill of this contagious fever. The infection was at first as active and the mortality as great on shore as on board; but the virulence of the fever was at length subdued by dispersing the sick and convalescents as much as possible[192].

Monro gives a similar account of the camp sickness among the British troops during the campaigns in North Germany in 1760-63. In the autumn of 1760, before he joined the forces, there had been much malignant fever and dysentery: the camp at Warburg was near the battlefield (31 July, 1760), where many of the dead were scarce covered with earth; there were also many dead horses, and in a time of heavy rains, the camp, with the neighbouring villages and fields, was filled with the excrements of a numerous army. Not only the soldiers, but the inhabitants of the country, who were reduced to the greatest misery and want, were infected, and whole villages almost laid waste. When Monro joined at Paderborn in January, 1761, he found the hospitals overcrowded, and the malignancy of the fever thereby much increased, so that a great many died. “The 1st and 3rd regiments suffered most, owing to all the sick of each regiment being put into a particular hospital by themselves, which kept up the infection, so that they lost one-third of those left ill of this fever, and many of the nurses and people who attended them were seized with it.” He distributed the sick men of the Coldstreams among the houses in the town, and lost few in comparison with the 1st and 3rd regiments. The contagion, under this bold policy, did not spread.

Two points in the symptoms are noteworthy: first the occurrence of suppurating buboes of the groins and armpits in several; and, secondly, the frequency of round worms.

“In this fever it was common for patients to vomit worms, or to pass them by stool, or, what was more frequent, to have them come up into the throat or mouth, and sometimes into their nostrils, while they were asleep in bed, and to pull them out with their fingers. The same thing happened to most of the British soldiers brought to the hospitals for other feverish disorders as well as this.”

He cannot explain the commonness of round worms in the sick, unless it was from the great quantity of crude vegetables and fruits eaten, and the bad water. Patients in convalescence often suffered from deafness, and from suppurating parotids. Some had frequent relapses into the fever, “which seemed to be owing to the irritation of these insects,” namely the worms. Most of those who fell into profuse, kindly, warm sweats recovered, the sweats lasting from twelve to forty-eight hours, and carrying off the fever. He never saw any miliary eruptions, and only sometimes petechiae, or small spots, or marbling as in measles[193].