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.
3. The North American Civil War (1861–5)
At the outbreak of the Civil War almost nothing was done in the two armies to prevent the outbreak and dissemination of diseases; the assembling of so many troops rendered severe pestilences inevitable. The successful activity of numerous voluntary societies did a great deal of good in the way of improved methods of sanitation; the centre from which this activity emanated was an officially recognized Sanitary Commission, founded on June 15, 1861, which made the prevention of pestilences its principal function. It was enabled to carry on its work by large voluntary contributions of money. The means which the Commission employed were: good equipment, food, and shelter for the men, isolation of men suffering from infectious diseases, burning of the clothes, beds, and tents used by these patients, erection of clean, well-ventilated barrack-lazarets, and comprehensive plans for transferring invalid soldiers from the field-hospitals.[[210]]
Since upwards of a million men, counting both sides, were gradually brought face to face with one another, the loss of human life was necessarily terrible. Regarding the losses sustained by the Northern States, we are excellently informed by an exhaustive health-report in six volumes, issued by the United States.[[211]] The report also contains some statistics regarding the prevalence of disease among the Confederates and regarding the prisoners, but no figures relating to the losses sustained by the Southern States are available.
Regarding the total loss of troops sustained by the Northern States, we find the following compilation:[[212]]
| Cause of death. | White troops. | Coloured troops. | Total. |
|---|---|---|---|
| Killed in battle | 42,724 | 1,514 | 44,238 |
| Died from wounds, &c. | 47,445 | 1,760 | 49,205 |
| Suicide, murder, execution | 469 | 57 | 526 |
| Diseases | 157,004 | 29,212 | 186,216 |
| Unknown causes | 23,347 | 837 | 24,184 |
| Total | 270,989 | 33,380 | 304,369 |
If we divide the deaths of unknown cause proportionally among the other groups, the total number of deaths among the white troops due to diseases was 171,806, and among the coloured troops 29,963.
In the statistical table in the first volume of the Medical History the figures relating to the number of deaths are not complete; the total numbers given there are:
| White troops. | Coloured troops. | |
|---|---|---|
| Wounds, &c. | 36,688 | 1,427 |
| Suicide, murder, execution | 549 | 78 |
| Diseases | 128,937 | 27,499 |
| Uncertain | 449 | ? |
| Total | 166,623 | 29,004 |
Typhoid fever demanded the largest number of victims; in the first two years of the war it appeared in the form of murderous epidemics in the Northern army, mostly in the Atlantic and central districts, and less severely in the region of the great ocean. If the common continued fevers, the typho-malarial fevers, and typhus fever, are combined with the typhoid fevers and looked upon as typhoid fever, there died from this cause in the Northern army during the entire war 32,112 white troops and 3,689 coloured troops. In considering these figures, we must remember that, as stated above, they are incomplete. On this basis, out of every 1,000 men there succumbed to typhoid fever:[[213]]