2. The Crimean War (1854–6)
The Crimean War plays a very conspicuous rôle in the history of war-pestilences and of military sanitation; on the one hand, it showed how severe a penalty an army has to pay if, without measures of precaution, troops are sent to the scene of the war from infected localities; on the other hand, it showed that it is possible to prevent serious outbreaks of pestilence if energetic measures are adopted to provide good food and shelter for the troops. Whereas the English soldiers suffered a great deal more from pestilence in the first winter than the French soldiers, in the second winter, in consequence of great improvements introduced in the housing, clothing, and feeding of troops, the English suffered very little, while the French suffered severely.
In the year 1853 cholera made its appearance in several places in France, and in the following year it spread over the entire country; it raged most furiously in the southern districts. Since the French troops, who were embarked at Toulon and Marseilles, were consequently infected with cholera, those suffering from the disease had to be put ashore from the first transport ship at Malta, and others at the Peiraeus. When the troops disembarked at Gallipoli there were thirteen cholera-patients among them, and these were presently followed by other cases. Sporadic cases of cholera then began to occur wherever the French soldiers went, as in Nagara, Varna, Adrianople, &c. The fact that the disease was borne thither by French troops was frankly admitted by most of the French military physicians; only a few, for example, Cazalas, assumed that the disease was already prevalent in Dobrudja.[[196]]
During the expedition undertaken by the French soldiers to the unhealthy and deserted district of Dobrudja, cholera broke out in the army like an explosion, compelling it to return. The English soldiers during the siege of Varna, and also parts of the English fleet, were likewise attacked by cholera. Statements made by Scrive and Chenu regarding the number of French soldiers that succumbed to the pestilence diverge widely; according to Scrive, the French army, which numbered some 55,000 men, lost 5,183 men between July 3 and August 30, 1854, in consequence of cholera,[[197]] while Chenu gives us the following statistics:[[198]]
| No. patients. | No. deaths. | |
|---|---|---|
| July (1854) | 8,239 | 5,030 |
| August | 3,043 | 3,015 |
| September | 376 | 239 |
The English army, which numbered some 30,000 men, also suffered:[[199]]
| No. patients. | No. deaths. | |
|---|---|---|
| July (1854) | 449 | 285 |
| August | 938 | 611 |
| September | 1,232 | 575 |
| October | 445 | 273 |
In September the scene of the war was transferred to the Crimea, but there again cholera raged furiously in both armies; in the winter of 1854–5, to be sure, it carried away a relatively small number of men, but in the summer of 1855 it broke out anew with great severity. The total number of deaths in the French army during the entire campaign was 12,467, in the English army 4,513, and in the Piedmontese army 1,230. The size of the armies varied greatly; the French army was largest in the latter part of the year 1855, when it numbered 145,000 men; the total number of English soldiers was 97,864, and that of Piedmontese soldiers, 21,000.
According to Häsar,[[200]] cholera spread far and wide from the scene of the war—throughout Turkey, around the Black Sea, in Greece, in Smyrna, along the coast of the Dardanelles, in Constantinople, Odessa, Rumelia, and in the Danube principalities; the inhabitants of the district of Dobrudja also suffered severely from the pestilence, which after the war spread over a large part of Russia.
Scurvy also raged in the French army in the dry summer of the year 1855, as well as in the severe winter following. In August 1855 there were 2,581 scurvy patients in the army, which was the largest number in the summer months, and in February there were 4,341, the largest number in the winter months. The outbreak of scurvy among the English troops, who also suffered from the disease in the winter of 1854–5, was later checked by the consumption of better food.
Dysentery was also very common: 6,105 French soldiers suffering from that disease in the Crimea were taken to the field-lazarets; 2,061 died there, and 2,792 were removed to Constantinople. No less than 7,883 English soldiers contracted acute and chronic dysentery, and 2,143 succumbed to it.
As early as the winter of 1854–5 a small number of cases of typhus fever occurred among the French and English soldiers; but not until the winter of 1855–6, between the months of December and March, did the disease become very widespread in the French army in consequence of unfavourable living conditions; the English army, on the other hand, scarcely suffered at all during that winter. Scrive and Chenu publish the following statistics relating to the French army in the field-lazarets of the Crimea:
| Months. | Size of army. | Typhus fever patients. | Taken to Constantinople. | No. deaths. |
|---|---|---|---|---|
| December (1855) | 145,120 | 734 | 204 | 323 |
| January (1856) | 144,512 | 1,523 | 320 | 464 |
| February | 132,800 | 3,402 | 925 | 1,435 |
| March | 121,000 | 3,457 | 1,140 | 1,830 |
| April | 105,000 | 237 | 101 | |
| May | 67,000 | 38 | 17 |
According to Scrive, 11,124 typhus-fever patients, all told, were taken into the field-lazarets of the Crimea between September 1854 and July 1856; of these, 3,840 were removed to Constantinople, and 6,018 died in the field-lazarets.[[201]] But Scrive says that this number of typhus-fever patients is too small; it must have been increased by the number of persons who contracted the disease in the field-lazarets and hospitals, 4,502 of whom succumbed to it, and the number who contracted and succumbed to it in Constantinople and France, making 7,000 all told. According to Scrive, therefore, the total number of deaths due to typhus fever in the French army was no less than 17,515, from which he assumes that at least 35,000 men contracted the disease.[[202]]
In the English army typhus fever appeared only sporadically in the winter of 1855–6; according to Chenu, 167 men contracted the disease and 62 succumbed to it.[[203]]
Among the Russian troops typhus fever raged furiously,[[204]] and according to A. Hirsch it was also very widespread in southern Russia.[[205]]
In Constantinople, typhus fever, although it infected numerous persons in the military hospitals, apparently did not spread to the civil population. Baudens, who after the capture of Sebastopol came to the Orient, says expressly that the inhabitants of Constantinople were spared by the epidemic during its entire course.[[206]]
According to Murchison, typhus fever was borne by English troops to English soil, where in the years 1856–7 it caused epidemics in various parts of the country. The following table indicates the number of typhus-fever patients taken into the Fever Hospital in London:
| 1854 | 337 |
| 1855 | 342 |
| 1856 | 1,062 |
| 1857 | 274 |
| 1858 | 15 |
The increased number in London was not due to the fact that the disease was brought over from Ireland, since there were only fifty-three Irishmen among the patients, and only two of them had been in the city less than three months. On the other hand, the warlike events caused a famine, resulting in much misery among the poor, and this favoured the further dissemination of the disease.[[207]]
When the French troops were transported back to France, energetic and extensive measures of precaution were adopted; only those troops were allowed to embark who had for several weeks been entirely recovered from typhus fever; several stations for the discharge of men who contracted the disease on the way were located along the coast of the Mediterranean Sea, and sixty-two patients, all told, were left behind at them; suspected divisions of troops, before disembarking at Marseilles, were quarantined for a time on several islands along the coast, on St. Marguerite (Îles de Lérins), on the Îles d’Hyères, and on others, and before entering the city they were examined again, bathed, and reclothed. The result was successful. Laveran says:[[208]] ‘The further one went away from the seat of the infection, and the more the soldiers scattered, the more the miasm seemed to lose strength; in France the typhus-fever patients gave rise to only a few cases inside the hospitals where they were being cared for; the disease was never communicated to the civil population.’
Sporadic cases were observed in Marseilles, Toulon, Avignon, Chalon-sur-Saône, and in other places. A small lazaret-epidemic also occurred in Paris in the Val-de-Grâce; according to Godelier,[[209]] almost all the patients there belonged to the Fiftieth Regiment, which on November 30, 1855, embarked at Kamiesch. The condition of health in the regiment at that time was good, and, in particular, it was free of typhus fever. Of the two ships on which the soldiers were transported, the one took only thirty days to get from Kamiesch to Marseilles and had no cases of typhus fever, while the other, which had a harder voyage, took fifty days and had numerous cases of typhus fever on the way; fifteen patients were put into the hospital at Malta and twenty-five in that at Marseilles. No less than fifty-eight soldiers in this regiment contracted the disease in the Val-de-Grâce, and they infected five nurses; eight soldiers and one nurse fell victims to the disease.