In Napoleon’s war against Prussia (1806–7) typhus fever broke out in the provinces of East Prussia, where the second half of the war was waged. According to Hufeland,[[96]] the disease appeared wherever the soldiers went in the fall, winter, and following spring; he diagnosed it as putrid fever, nerve fever, and typhus fever. Hufeland, to be sure, often points to the fact that the disease of 1806–7 was in several respects different from that of 1803; in particular, the disease of 1806–7 was characterized by a long period of incubation, lasting diarrhoea, meteorism, blood in the evacuations of the bowels, and a long convalescence. But since Hufeland expressly says that the disease lasted twenty-one days, and at the same time mentions petechiae and the fact that the disease often broke out suddenly, there can be no doubt that it was typhus fever. The peculiar mixed character of his description can be explained only by the assumption that epidemics of typhus fever and typhoid fever appeared simultaneously, and that the two diseases were regarded as one and the same. Gilbert[[97]] expressly mentions ‘éruptions pétéchiales’ in his description of these epidemics in the military hospitals. In Königsberg typhus fever raged in the hospitals and among the inhabitants, 6,392 of whom died. In Thorn, Bromberg, and Culm, all of which had military lazarets, the disease spread from them to the civil population. In Danzig, which in the spring of 1807 passed through a siege of seventy-six days, the condition of health was good, whereas typhus fever raged among the French besiegers. In 1805–6 the disease was conveyed by Russian troops to Silesia, where it broke out in Trachenberg, Adelnau, Ostrowo, Wohlau, Neisse, and Leobschütz.[[98]] German prisoners brought typhus fever with them to France, where it broke out in the first part of January 1807, in the Departments of Aube and Yonne.[[99]]
Typhus fever raged less furiously during Napoleon’s war with Austria in 1809. After the battle of Wagram it appeared in the overcrowded hospitals of Vienna, and also in Tyrol. Since the war had first been waged in Bavaria, the disease had also broken out there (in Landshut and Augsburg), but had nowhere become very widespread.
Typhus fever broke out in the form of very severe epidemics during the long struggle of the French in Spain and Portugal in the years 1808–14, since here the French army suffered terribly in consequence of unremitting hardships, the scanty supply of food, and the poor hospital arrangements. While in the Spanish Peninsula the French army is said to have lost 300,000 men in consequence of disease, and 100,000 men in consequence of the enemy’s arms. A particularly severe epidemic raged in Saragossa when that city was besieged by the French in the months of June, July, and August 1808, and again in the months of December-February, 1808 and 1809; of 100,000 inhabitants 54,000 succumbed to typhus fever, and of 30,000 soldiers 18,000 fell victims to the same disease, so that the city was forced to capitulate.[[100]] In the year 1810 yellow fever caused great devastation in the southern part of Spain, attacking Cadiz, Cartagena, and Gibraltar; in 1811 it raged furiously in the provinces of Murcia and Valencia,[[101]] but the epidemic was confined to the coast.
From Spain typhus fever was frequently conveyed by transports of prisoners to France; the border districts through which the prisoners passed were the first to be attacked, as, for instance, the town of Dax (near Bayonne). Ozanam says:[[102]] ‘La France en ressentit les effets depuis les Pyrénées jusqu’aux environs de Paris, sur toutes les routes suivies par les prisonniers espagnols, et l’Angleterre en fut infestée au retour des débris de ses troupes du même pays. En France la ville de Dax, frontière de l’Espagne, fut une des premières à éprouver les ravages des maladies épidémiques, qui accompagnent toujours les armées. La situation basse et marécageuse, jointe à l’encombrement de son hôpital par des militaires atteints du typhus nosocomial, ne tarda pas à favoriser la propagation de la contagion, et elle fut bientôt transmise aux environs. Les prisonniers espagnols y contribuèrent encore, et le caractère contagieux de la maladie ne fut pas plus douteux, lorsqu’on vit les employés au service des hôpitaux et à celui du transport de ces militaires en être tous atteints.’ (France felt the effects (of the disease) all along the routes followed by the Spanish prisoners—from the Pyrenees to the environs of Paris, while England was infected by the remnants of its troops when they returned from France. The town of Dax, situated near the border between France and Spain, was one of the first places to experience the ravages of the epidemic diseases which always accompanied the armies. Its low, marshy situation, together with the fact that its hospital was overcrowded with soldiers infected with nosocomial typhus, greatly favoured the propagation of the contagion, which soon spread throughout the vicinity. The Spanish prisoners also helped to spread it, and the contagious character of the disease was no longer questionable when the attendants at the hospitals, as well as the men who had charge of transporting the sick, were seen to contract it.)
The Spanish prisoners were sent far into the interior, and caused outbreaks of pestilence wherever they went. In consequence of the strain and exertion involved in their transportation, and also of the inferior food, typhus fever soon became very widespread among them. Diseased and wounded men were always carried in the same wagons, while it was often necessary to remain for a considerable length of time in camps, where sick and healthy men lay side by side on straw; thus many died on the way. In order to prevent the disease from spreading to the civil population, it was arranged that the buildings designated for the prisoners should lie away from the town where the soldiers were quartered, or that the prisoners should be sheltered in barracks. All intercourse between the prisoners and the inhabitants was forbidden, and after their departure the straw used by them was burned, and the buildings they had occupied were fumigated.[[103]]
Since, however, it finally became necessary to house the sick in hospitals, it was absolutely impossible to prevent the disease from spreading. The result was that the following places in Central France were attacked: Limoges, Guéret, Châteauroux, Issoudun, Moulins, Nevers, La Charité, and Bourges.[[104]] As people everywhere were afraid of contracting the disease, the prisoners were transferred as soon as possible to near-by districts, and this merely helped to spread the disease. According to Boin, Bourges, in the year 1809, became the rendezvous of all Spanish prisoners, who were housed there in barracks and in public hospitals; of 653 prisoners of war received in the public hospitals, 103 died. In the city itself only a few cases of typhus fever were observed. The highly contagious nature of the disease was well known to Boin, who says:
‘Les dames religieuses de la Charité, chargées du service des salles, les élèves en chirurgie, les servans, les gardes de nuit, le casernier, les gendarmes qui escortaient les voitures remplies de prisonniers malades, le chapelain, le secrétaire du commissaire des guerres, les personnes que la charité évangélique a fait imprudemment entrer dans les salles, ont été frappés de la maladie. Tous ont couru des risques, quelques-uns ont succombé.’ (The nuns who had charge of the rooms (in the hospital) at La Charité, the medical students, the attendants, the night-watchmen, the porter, the gendarmes who escorted the carriages conveying sick prisoners, the chaplain, the secretary of the War Commissioner, and the persons who imprudently allowed a sense of duty and charity to induce them to enter the rooms—all contracted the disease. They all ran risks, and some of them died.) Nevertheless, Boin did not hold the disease in Bourges to be typhus fever, but a ‘fièvre maligne putride’; he also adds that he failed to observe petechiae in a single instance. The physicians sent by the Government, on the other hand, diagnosed the disease as ‘hospital fever’. Inasmuch as there is no doubt expressed anywhere else regarding the appearance of typhus fever among the Spanish prisoners (Ozanam speaks expressly of the appearance of petechiae on the second, third, or fourth day), it was undoubtedly that disease which broke out in Bourges.
Not only the French, but also the English troops were attacked by typhus fever in Spain and Portugal; they are said to have lost 24,930 men in consequence of diseases, and 8,889 men in consequence of battles and skirmishes. The disease was conveyed to England by returning soldiers, but was confined there to a few houses. After the battles of the year 1808, which went against the English, the badly infected English troops were transported on ships in stormy weather to Plymouth, where from January 24, 1808, to January 24, 1809, some 2,427 of them were received into the hospitals. Of that number 824 were suffering from typhus fever, and 1,503 from dysentery; all told, 405 died.[[105]]