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The Project Gutenberg eBook of Epidemics
Resulting from Wars
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*** START OF THE PROJECT GUTENBERG EBOOK EPIDEMICS

RESULTING FROM WARS ***
EPIDEMICS RESULTING
FROM WARS

PRINTED IN ENGLAND
AT THE OXFORD UNIVERSITY PRESS
Carnegie Endowment for International Peace
DIVISION OF ECONOMICS AND HISTORY

John Bates Clark, Director

 EPIDEMICS RESULTING FROM
WARS

By Dr. FRIEDRICH PRINZING

EDITED BY
HARALD WESTERGAARD
PROFESSOR OF POLITICAL SCIENCE IN THE UNIVERSITY OF COPENHAGEN

OXFORD: AT THE CLARENDON PRESS

London, Edinburgh, New York, Toronto, Melbourne and Bombay
HUMPHREY MILFORD
1916
 INTRODUCTORY NOTE BY THE DIRECTOR

The Division of Economics and History of the Carnegie

Endowment for International Peace is organized to ‘promote a
thorough and scientific investigation of the causes and results of
war.’ In accordance with this purpose a conference of eminent
statesmen, publicists, and economists was held in Berne,
Switzerland, in August 1911, at which a plan of investigation was
formed and an extensive list of topics was prepared. The programme
of that Conference is presented in detail in an Appendix. It will be
seen that an elaborate series of investigations has been undertaken,
and the resulting reports may in due time be expected in printed
form.
Of works so prepared some will aim to reveal direct and indirect
consequences of warfare, and thus to furnish a basis for a judgement
as to the reasonableness of the resort to it. If the evils are in reality
larger and the benefits smaller than in the common view they appear
to be, such studies should furnish convincing evidence of this fact
and afford a basis for an enlightened policy whenever there is danger
of international conflicts.
Studies of the causes of warfare will reveal, in particular, those
economic influences which in time of peace bring about clashing
interests and mutual suspicion and hostility. They will, it is believed,
show what policies, as adopted by different nations, will reduce the
conflicts of interest, inure to the common benefit, and afford a basis
for international confidence and good will. They will further reveal
the natural economic influences which of themselves bring about
more and more harmonious relations and tend to substitute general
benefits for the mutual injuries that follow unintelligent self-seeking.
Economic internationalism needs to be fortified by the mutual trust
that just dealing creates; but just conduct itself may be favoured by
economic conditions. These, in turn, may be created partly by a
natural evolution and partly by the conscious action of governments;
and both evolution and public action are among the important
subjects of investigation.
An appeal to reason is in order when excited feelings render armed
conflicts imminent; but it is quite as surely called for when no
excitement exists and when it may be forestalled and prevented from
developing by sound national policies. To furnish a scientific basis
for reasonable international policies is the purpose of some of the
studies already in progress and of more that will hereafter be
undertaken.
The publications of the Division of Economics and History are
under the direction of a Committee of Research, the membership of
which includes the statesmen, publicists, and economists who
participated in the Conference at Berne in 1911, and two who have
since been added. The list of members at present is as follows:
Eugène Borel, Professor of Public and International Law in the
University of Geneva.
Lujo Brentano, Professor of Economics in the University of
Munich; Member of the Royal Bavarian Academy of Sciences.
Charles Gide, Professor of Comparative Social Economics in the
University of Paris.
H. B. Greven, Professor of Political Economy and Statistics in the
University of Leiden.
Francis W. Hirst, Editor of The Economist, London.
David Kinley, Vice-President of the University of Illinois.
Henri La Fontaine, Senator of Belgium.
His Excellency Luigi Luzzatti, Professor of Constitutional Law in
the University of Rome; Secretary of the Treasury, 1891–3; Prime
Minister of Italy, 1908–11.
Gotaro Ogawa, Professor of Finance at the University of Kioto,
Japan.
Sir George Paish, Joint Editor of The Statist, London.
Maffeo Pantaleoni, Professor of Political Economy in the
University of Rome.
 Eugen Philippovich von Philippsberg, Professor of Political
Economy in the University of Vienna; Member of the Austrian
Herrenhaus, Hofrat.
Paul S. Reinsch, United States Minister to China.
His Excellency Baron Y. Sakatani, recently Minister of Finance;
Present Mayor of Tokio.
Theodor Schiemann, Professor of the History of Eastern Europe
in the University of Berlin.
Harald Westergaard, Professor of Political Science and
Statistics in the University of Copenhagen.
Friedrich, Freiherr von Wieser, Professor of Political Economy
at the University of Vienna.
The function of members of this Committee is to select
collaborators competent to conduct investigations and present
reports in the form of books or monographs; to consult with these
writers as to plans of study; to read the completed manuscripts, and
to inform the officers of the Endowment whether they merit
publication in its series. This editorial function does not commit the
members of the Committee to any opinions expressed by the writers.
Like other editors, they are asked to vouch for the usefulness of the
works, their scientific and literary merit, and the advisability of
issuing them. In like manner, the publication of the monographs
does not commit the Endowment as a body or any of its officers to
the opinions which may be expressed in them. The standing and
attainments of the writers selected afford a guarantee of
thoroughness of research and accuracy in the statement of facts, and
the character of many of the works will be such that facts, statistical,
historical, and descriptive, will constitute nearly the whole of their
content. In so far as the opinions of the writers are revealed, they are
neither approved nor condemned by the fact that the Endowment
causes them to be published. For example, the publication of a work
describing the attitude of various socialistic bodies on the subject of
peace and war implies nothing as to the views of the officers of the
Endowment on the subject of socialism; neither will the issuing of a
work, describing the attitude of business classes toward peace and
war, imply any agreement or disagreement on the part of the officers
of the Endowment with the views of men of these classes as to a
protective policy, the control of monopoly, or the regulation of
banking and currency. It is necessary to know how such men
generally think and feel on the great issue of war, and it is one of the
purposes of the Endowment to promote studies which will accurately
reveal their attitude. Neither it nor its Committee of Research
vouches for more than that the works issued by them contain such
facts; that their statements concerning them may generally be
trusted, and that the works are, in a scientific way, of a quality that
entitles them to a reading.
This monograph on epidemics resulting from wars is designed to
bring into light an aspect of international conflict that has never been
adequately appreciated. An examination of the facts here presented
will indicate that until comparatively recent times the most serious
human cost of war has been not losses in the field, nor even the
losses from disease in the armies, but the losses from epidemics
disseminated among the civil populations. It was the war epidemics
and their sequelae, rather than direct military losses, that accounted
for the deep prostration of Germany after the Thirty Years’ War.
Such epidemics were also the gravest consequence of the Napoleonic
Wars.
It may appear that a study of war epidemics can have only
historical interest, in view of the progress of modern medical science.
Plague, cholera, and typhus can be brought under control by modern
methods of sanitation. One can point to the fact that in the present
great war, the only serious epidemic that has been reported is the
typhus fever epidemic in Serbia. When the medical history of the war
comes to be written, however, it will be found that the aggregate
losses from sporadic outbreaks of war epidemics have been very
considerable. A war sufficiently protracted to lead to universal
impoverishment and a breakdown of medical organization would be
attended, as in earlier times, by the whole series of devastating war
epidemics. And even in the case of less exhausting wars, the chances
of widespread epidemics is far from negligible. There is much food
for reflection in the author’s account of the small-pox epidemic
following the Franco-German War. In 1870 the means of coping with
small-pox were as nearly perfect as they are in the greater part of the
world to-day. This fact did not save Europe from a widespread
epidemic, entailing human losses exceeding in gravity the losses in
the field. To-day, as in the past, the probabilities of increased
morbidity in the civil population, not only among the belligerents,
but among neutrals as well, must be entered as a highly important
debit item against war.
John Bates Clark,
Director.
 CONTENTS

PAGE

INTRODUCTION 1

CHAPTER I

War Pestilences 4

CHAPTER II

The Time before the Thirty Years’ War 11

CHAPTER III

The Thirty Years’ War 25

CHAPTER IV

The Period between the Peace of Westphalia and the French

Revolution 79

CHAPTER V

The Period between the French Revolution and Napoleon’s

Russian Campaign 92

CHAPTER VI
The Epidemics of Typhus Fever in Central Europe following upon
the Russian Campaign and during the Wars of Liberation (1812–
14) 106

CHAPTER VII

From the Age of Napoleon to the Franco-German War 165

1. The Russo-Turkish War of 1828–9 165

2. The Crimean War (1854–6) 170

3. The North American Civil War (1861–5) 175

4. The Italian War of 1859 183

5. The Danish War of 1864 183

6. The German War of 1866 184

CHAPTER VIII

The Franco-German War of 1870–1, and the Epidemic of Small-pox

caused by it 189

CHAPTER IX

From the Franco-German War to the Present Time 286

1. The Russo-Turkish War of 1877–8 286

2. The Boer War of 1899–1901 290

3. The War in South-west Africa (1904–7) 296

4. The Russo-Japanese War of 1904–5 296

5. The Occupation of Tripoli by the Italians (1911) 299

 6. The War between Turkey and the Balkan States (1912–13) 300

CHAPTER X

Epidemics in Besieged Strongholds 302

1. The Siege of Mantua (1796–7) 304

2. The Siege of Danzig (1813) 306

3. The Siege of Torgau (1813) 311

4. The Siege of Mayence (1813–14) 316

5. The Siege of Paris (1870–1) 320

6. The Siege of Port Arthur (1904) 324

CONCLUSION 328

INDEX 335
 INTRODUCTION

In countries which have the misfortune to be the scene of

protracted wars, the mortality regularly undergoes a considerable
increase. This is caused chiefly by the infectious diseases which in
war times so often appear in the form of epidemics. These diseases,
moreover, not only afflict the country in which the war is waged, but
are also carried by prisoners, returning soldiers, and in other ways,
into the land of the victor, where it is possible for them to spread
over a large territory. A report on the loss of human life among that
part of a population which does not participate in a war has not yet
been undertaken, writings on war pestilences usually confining
themselves to the losses within the armies themselves.[1] It is the
purpose of the present study to investigate the losses sustained by
the non-belligerent part of the population in consequence of
epidemics caused by wars.
In doing this it seems advisable to select a few war pestilences
which on account of their enormous extent are particularly notable,
and to subject them to an exhaustive discussion. This method has the
advantage that it will enable us to show in individual cases how it is
possible for these pestilences to extend over such a vast territory,
under what circumstances they spread from place to place, and how
they enter regions remote from the scene of war. For this exhaustive
discussion the writer has chosen the pestilences that occurred during
the Thirty Years’ War, the epidemic of typhus fever after Napoleon’s
Russian Campaign, and the pandemic of small-pox after the Franco-
German War of 1870–1. These epidemics afford very instructive
examples of what horrible losses both friends and enemies may
sustain in consequence of war pestilences.
While the outbreaks of ‘plague’ in the course of the Thirty Years’
War have already been made the subject of a comprehensive account,
strange to say there are no such accounts of the other two epidemics;
to give a clear picture of these pestilences the writer was therefore
constrained to collect the necessary information from widely
dispersed sources. In gathering his material a number of large
German libraries assisted him most kindly—particularly, the Royal
National Library at Stuttgart and the University libraries of
Strassburg and Tübingen.
The other parts of the history of war pestilences are set forth in a
more general way; for an exhaustive treatment of them would have
necessitated several years of preliminary work, which the writer in
the short time at his disposal was unable to undertake.
The writer has drawn as much as possible from original sources;
this applies at least to the pestilences of the Napoleonic Period, and
to the epidemic of small-pox after the Franco-German War. It would
have been impossible to deal with the other wars in the same way
without consuming considerable time. From the bibliographies it will
appear what sources the author has consulted; rarely are quotations
given from works which he has not seen, and in such cases it is
indicated whence they were taken.
The causes of the origin and spread of pestilences during a war are
clear. Every aggregation of people, even in times of peace, at
celebrations and annual fairs, in barracks, and so 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. 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 war times it is often
impossible to take the necessary precautions, since the attention of
the commanders is directed toward very definite objects, to which all
other considerations are subordinate. Whether the germ of the
disease is already in the place, or whether the soldiers bring it with
them, in either case there is danger that the fighting armies will
cause the disease to spread over the entire scene of the war, and thus
seriously endanger thousands of human lives.
Modern methods of sanitation have done much toward preventing
the spread of army pestilences, not only in peace, but also in war.
The last few decades have evinced that fact. 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.
 CHAPTER I
WAR PESTILENCES

All infectious diseases may spread in consequence of war and

develop into epidemics of varying extent. In the next chapter we shall
see how the wars at the end of the fifteenth century favoured the
spread of an epidemic of syphilis. In the Union Army, during the
American Civil War of 1861–5, both measles and typhoid fever were
very widespread, and together they were the cause of 4,246 deaths,
or about 1·75 per cent of the total enlistment. Scarlet fever, influenza,
yellow fever, relapsing fever, and malaria (if the war is waged in
countries where this disease is endemic—especially in the Lower
Danube region, in the Netherlands, Spain, and Italy) have also
played an important rôle in many wars. But we give the name ‘war
pestilences’ only to those infectious diseases which in the course of
centuries have usually followed at the heels of belligerent armies,
such as typhus fever, bubonic plague, cholera, typhoid fever,
dysentery, and small-pox; we may also include here scurvy, the
etiology of which has not yet been definitely determined.
1. Typhus fever (spotted fever, exanthematic typhus—called in
France and England simply typhus, in Spain tabardillo[2]—formerly
called contagious typhus, hunger typhus, camp fever, and Hungarian
fever) is an acute infectious disease of cyclic recurrence, which
resembles typhoid fever only in name. From the eighth to the tenth
day after infection, often somewhat sooner or later, it begins with a
chill, accompanied by nausea, vomiting, violent headache, and
psychic depression. In the first few days the patient’s temperature
rises rapidly, and on the fourth or fifth day a rash in the form of dull-
red spots, as large as a pea, breaks out over the entire body. These
spots gradually grow larger, and after two or three days, through the
appearance of very small haemorrhages, change into petechiae. The
apathy of which the patient first gave evidence now gives way to wild
delirium. At the end of the second week the temperature falls rapidly,
and in one or two days becomes normal; often, however, the fall of
temperature takes from six to eight days. The duration of the entire
disease, accordingly, is from two to two and a half weeks. Death
usually occurs at the crisis of the disease—from the tenth to the
twelfth day—rarely between the sixth and ninth days or after the
twelfth.
The danger of the disease varies greatly in different epidemics;
statements regarding this point diverge according as we refer to the
statistical records of hospitals or to the private practice of physicians.
With the latter the number of deaths is smaller, since persons
suffering from the disease in mild form less often go to the hospitals.
Epidemics in which a quarter of the patients, and even more, have
succumbed have frequently occurred, especially in war times, during
famines, &c. The cause (infective agent) of typhus fever is not known;
according to recent investigations it is spread by vermin; Ricketts
and others have fixed responsibility for it upon the body louse. The
infection is communicated from man to man, and very often it is
contracted from the clothes, linen, and other effects of typhus
patients. Recovery from the disease usually renders a person
immune against a second attack. Typhus fever frequently appears
nowadays in the eastern and south-eastern parts of Europe, in
Hungary and Galicia, and also in Spain, Italy, and Ireland.
2. Plague appears in two forms, depending upon the place where
the infective agent enters the body: the bubonic plague and the
pneumonic plague. In the case of the former the painful plague-sores
(buboes) develop, usually two or three days after infection, from the
lymphatic glands; these sores,—which appear most often in the
region of the groin, less often in the axilla, on the neck, lower jaw,
and in other places,—soon suppurate. There is either a development
of toxins, which are the cause of the severe general symptoms, or else
the bacilli pestis go from the glands into the circulatory system and
cause septicaemia, which is quickly fatal. Pneumonic plague takes
the form of a catarrhal inflammation of the lungs, causing a profuse
and bloody expectoration, which contains large quantities of bacilli.
This form of the disease almost always ends fatally in a few days. The
mortality of bubonic plague is somewhat lower; the disease has an
average duration of eight days, and carries away from fifty to seventy
per cent of its victims.
In the Middle Ages an epidemic of plague (black death) ravaged all
Europe. At the present time it is still endemic in India, in southern
China, in Egypt, in Uganda, and perhaps in other countries, whence
it frequently develops into general epidemics.
The infective agent in the case of plague is the bacillus pestis,
identified in 1894 by Kitasato, and subsequently, but independently,
by Yersin. Rats, which are very susceptible to the disease, play an
important rôle in spreading it; in India the outbreak of a plague
epidemic is always preceded by the dying of large numbers of rats.
Their excrement contains large quantities of bacilli, which may be
destructive to human beings. The rat-flea is also known to carry the
infection. The infection may be conveyed directly by plague patients,
when the buboes suppurate, or when the blood becomes generally
infected with the bacilli pestis, which are contained in abundance in
the sputum, urine, and excrement, or when the lungs are affected
and the patient charges the atmosphere by coughing. One who has
recovered from the disease is usually immune for life.
3. Cholera, after an incubation period of two to eight days, begins
with frequent (ten to twenty times a day) vomitings of a fluid like
rice-water, and incessant retching. The patient, owing to the great
loss of water, sinks rapidly; he acquires a corpse-like appearance,
loses consciousness, and death may result on the first or second day.
If the attack is survived, the patient frequently dies from sheer
exhaustion afterwards. The mortality of cholera is great—from forty
to fifty per cent of its victims die. In this calculation the numerous
cases of cholerine, that are always prevalent during cholera times,
are excluded. Recovery from the disease does not protect a person
against contracting it again. The infective germ in the case of cholera
is the ‘comma bacillus’, discovered by Robert Koch in 1883. The
spread of cholera is caused by the penetration of the comma bacillus
into the alimentary canal, resulting from contact with objects which
have been contaminated by the evacuations of cholera patients; less
frequently it is indirectly caused by the pollution, from evacuations,
of water used for drinking or washing purposes.
4. Dysentery has always played an important rôle in military
campaigns. To be sure, it is not very dangerous, so far as the patient’s
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