These events largely fulfilled the expectations of Confederate commanders, who were confident that southern diseases would stymie Union thrusts into the Carolina interior during the sickly season and planned accordingly. As Major General George B. McClellan’s army moved sluggishly toward Richmond in the late spring of 1862, Robert E. Lee sent a letter to commander of the Department of South Carolina and Georgia, John C. Pemberton, requesting reinforcements. “At this season I think it impossible for the enemy to make any expedition into the interior,” wrote Lee. “The troops that you retain there will suffer more from disease than the enemy.” Lee’s bleak assessment was not far from the truth, but when Hunter’s troops landed on James Island in June, Pemberton sent back a panicked plea for more guns. The reply came not from Lee but from Jefferson Davis, who also requested reinforcements from Pemberton to halt McClellan’s advance on Richmond. “Decisive operations are pending here in this section,” he wrote, “and the climate already restrains operations on the coast.” Two days later Davis wrote to Pemberton again, asking for at least three regiments: “It was hoped the season would secure you against operations inland, and that you could spare troops without weakening your strength for the defense of Charleston.” Davis, who knew the hazards of the southern disease environment as well as anyone and trusted Lee’s advice, explained his rationale more carefully in a letter to South Carolina governor Francis W. Pickens. Pickens was concerned that Charleston’s security might be compromised if Pemberton’s troops were transferred. Davis clarified that he only wanted soldiers “from positions where the season will prevent active operations,” which included the mosquito-infested areas along the Charleston & Savannah Railroad such as Coosawhatchie and Pocotaligo. Months earlier Lee, then commanding the department, had posted Confederate troops at these spots as part of his overall defense strategy for the region. Realizing that Southern cannon were no match for Union gunboats, the Virginia general had pulled Rebel regiments back from the coast in order to guard the railroad line that allowed him to move men and materiel rapidly from one threatened front to another. Pemberton eventually got the point. When he became convinced that Hunter was not an immediate threat, he sent four regiments to Virginia that helped check McClellan’s advance and save the Confederate capital from capture.21
A snapshot of the Union disease casualties among the men of the Department of the South—a command that included South Carolina, Georgia, and eastern Florida—in 1862 reveals why Davis and Lee were confident they could transfer troops from the Carolina theater to other parts of the Confederacy. Between April and November northern surgeons diagnosed 3,375 cases of intermittent fever in addition to 2,690 cases of remittent fever. Over 6,000 cases of diarrhea and dysentery— the chief medical ailments plaguing the department—were diagnosed during the same period. Catarrh, mumps, typhoid fever, and rheumatism added to the soldiers’ misery. But even these carefully compiled statistics probably offer a low estimate of the prevalence of malaria in the department. Soldiers who feared hospitals routinely avoided treatment and likely suffered through periodic bouts of “ague” without complaining. Quinine could not eliminate plasmodium parasites from the bloodstream, and they could become active again later. Because troops all along the southeastern seaboard noticed the staggering number of mosquitoes swarming in their midst, it is highly probable that many of those diagnosed with other maladies were suffering from malaria at the same time, a condition known as disease “synergism” in the modern medical vernacular.22
Confederates stationed in the Department of South Carolina, Georgia, and Florida also suffered extensively from malaria. Between January 1862 and July 1863 the department had a mean strength of 25,000 troops but recorded more than 41,000 cases of the disease. In Georgia mosquitoes hatched in the flooded rice fields lying along the Savannah River swarmed nearby Rebel garrisons, producing 3,313 cases of malaria among an average of 878 men in only fourteen months. The situation was similar for troops stationed across the border in South Carolina. Out of 5,735 diagnoses made at the Wayside Hospital in Charleston during one eight-month period, 1,535 were for malaria. Confederate surgeons’ experiments with quinine to determine whether or not it could be used as a prophylactic provide a good indication of how prevalent the disease was in South Carolina. Out of 506 soldiers administered quinine on a regular basis, 98 fell ill, while 134 of the 234 “who took no quinine” at all contracted a “fever.”23
While South Carolina’s malaria problem bolstered the confidence of Confederate planners in Richmond, it intimidated the Union commanders operating in the region. When Mitchel replaced Hunter as commander of the Department of the South in September 1862, he too allowed fear of southern diseases to affect his plans in the Palmetto State. In the weeks before he was killed by an Aedes aegypti mosquito, the general cut short a raid near Pocotaligo—an operation designed to sever the Charleston & Savannah Railroad—in part out of concern for the health of his troops in the interior. In a letter to a friend Mitchel shared the reasons for the abrupt departure, arguing that he could not “yet make a lodgment on the mainland, as the country fever would probably kill off all my troops.” He echoed this concern in an official report he subsequently sent to Washington at the end of October. The general’s uncharacteristic cautiousness confirmed the accuracy of Lee’s and Davis’s predictions and allowed the Charleston & Savannah Railroad to remain operational. By retaining control of this important line and others in the Carolinas for most of the war, the South was able to deploy forces rapidly to threatened points on the coast and keep its eastern armies supplied with goods smuggled in from Europe and the West Indies. In short, mosquitoes were helping the Confederacy retain control over its interior lines (a key component of the slaveholding nation’s defensive strategy) while simultaneously shielding its shorelines. In the fall of 1862 Mitchel found himself caught in this entomological pincer move; in the Carolina countryside malaria posed a grave threat to the health of his unacclimated soldiers, while yellow fever endangered his position along the coast at Hilton Head.24
The same was true for the Union military as a whole during the 1862 sickly season. Aedes aegypti mosquitoes swarmed the Yankee sailors and soldiers stationed along the coastline between South Carolina and Texas, while anopheles mosquitoes steadily eroded the health of their comrades who were ordered inland. Northern commanders, aware of the poor health of their men thanks to regular reports from their medical officers, were reluctant to launch operations during the unhealthiest months of the year. Halleck, for example, refused to pursue Beauregard into Mississippi in part because of concerns over what southern diseases might do to his men. It may be tempting to dismiss this cautiousness as little more than a convenient excuse for inaction until we reflect upon what happened to the Union forces that actually entered the bowels of the South during the fever months. The North’s plan to build a canal around Vicksburg during the summer of 1862—part of a bold first attempt to capture that city—collapsed when more than half of the “non-acclimated” soldiers succumbed to various diseases, mainly malaria. Halleck, who had proven himself a fighter, was not about to let a similar scenario destroy his army. He took these concerns with him to Washington in July 1862, when he was promoted to general-in-chief of all the United States’s armies and turned his attention to the operations of his new subordinate, Major General George B. McClellan. McClellan at the time was busy leading a colossal Union force through the swamps of eastern Virginia, another area of the South rife with mosquitoes and disease.
The South’s quinine shortage contributed to the poor health of Confederate soldiers. Recrudescent fevers often occurred months after an initial plasmodium infection, as this 1862 Harper’s Weekly cartoon shows. Source:Harper’s Weekly, 6, no. 262, January 14, 1862, 16. (Courtesy Collection of the New-York Historical Society, negative no. 81468d)
Although nineteenth-century physicians did not understand the link between mosquitoes and disease, the use of nets helped troops stay healthy. Here patients at Harewood Hospital
in Washington, D.C., pose for a photograph. (Library of Congress, LC-B815-1008)
Benjamin Butler’s rigid quarantine and sanitation measures helped prevent a yellow fever epidemic from occurring in New Orleans during the Union occupation. Here a cartoonist depicts President Lincoln graciously receiving his general after a job well done. Harper’s Weekly 7, no. 316, January 17, 1863, 48. (Library of Congress)
Major General Ormsby MacKnight Mitchel died of yellow fever while commanding the Union Department of the South. (Courtesy U.S. Army Military History Institute, folder RG100S–George L. Febiger Coll.31b)
General Thomas Williams’s attempt to dig a canal opposite Vicksburg during the summer of 1862 produced a severe outbreak of malaria among his men, which helped scuttle the North’s plan to gain quick control of the Mississippi River. Here contraband slaves, many of whom were likely carrying plasmodium parasites, assist with the project. Harper’s Weekly 6, no. 292, August 2, 1862, 481. (Courtesy HarpWeek, LLC)
Luke Pryor Blackburn, M.D. Dr. Blackburn’s attempt to start a yellow fever epidemic inside the nation’s capital was not enough to keep him from winning the 1879 Kentucky gubernatorial race. (Courtesy Kentucky Historical Society, accession no. 1904.4)
The effectiveness of the Union blockade increased the price and scarcity of quinine in the Confederacy, causing additional hardships for the southern civilian population. In this 1863 Harper’s Weekly cartoon an ill northern child wishes he lived in an area with less of the bitter-tasting medicine. Harper’s Weekly 7, no. 359, November 14, 1863, 736. (Courtesy HarpWeek, LLC)
By 1864 the North’s superior supplies of quinine helped Union troops stay healthier than their Confederate foes. Here federal soldiers at Petersburg receive a prophylactic dose of the drug, which was often mixed with whiskey to make it more appealing. Harper’s Weekly 9, no. 428, March 11, 1865, 145. (Courtesy HarpWeek, LLC)
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“THE PESTILENT MARSHES OF THE PENINSULA”
MALARIA WAS ONE of many problems that beset Major General George B. McClellan’s army as it trudged through the brackish swamps of Tidewater Virginia en route to Richmond. “Little Mac” was confident that his plan to capture the Confederate capital by pipelining 100,000 Federals up the long peninsula formed by the York and James rivers would end in a smashing victory for the North and a return to the antebellum status quo. Lincoln was less certain about the soundness of McClellan’s plan but, lacking a better option, gave his general the troops and transports he requested. McClellan’s target, coastal Virginia, had been known as a hotbed of malaria since colonial times, and the influx of huge numbers of men and animals during the Civil War provided a plethora of new prey for its large mosquito population. At Yorktown a year before Union troops showed up, Brigadier General John Bankhead Magruder’s Confederates suffered from “ague” much as Lord Cornwallis’s army had on the same spot eighty years earlier. When his supply of quinine ran low at one point, Magruder informed Richmond that the medicine was “absolutely necessary” to shrink the sick list, which had grown “frightful” without it. The Army of the Potomac would learn the same lesson when it arrived in the area, especially after heavy rains in late May and early June 1862 created innumerable breeding pools for anopheles mosquitoes, which thrived as a result of warm summer temperatures and a superabundance of food.1
These mosquitoes caused widespread suffering among the unacclimated Union regiments that took part in the Peninsular Campaign. Regis De Trobriand was a blue-blooded French immigrant who at the time had command of the Twelfth New York Light Artillery. During the march toward Richmond he and his men spent the night on President John Tyler’s plantation near Charles City, next to “a thicket which was interspersed with stagnant pools.” The next morning Trobriand experienced “aguish feelings,” which grew worse until he was forced to retire from the campaign. In later years he remembered the pestilential Virginia climate as being more dangerous to his men than the Confederate army. A surgeon attached to one of the Twelfth’s sister regiments, the Fifth New York Infantry, believed June was the sickliest month of the whole campaign. He noticed that the men assigned to picket duty at night were especially susceptible to disease, as they were “exposed to miasm in its most concentrated form.” Other regiments from northeastern states also suffered in the Virginia climate. The Massachusetts Thirty-second Infantry Regiment came straight “from the sea air of New England” and was quickly laid low by malaria. Men filtered in and out of the hospital for weeks, making the regiment unfit even for drill. Their comrades in the Fifth New Hampshire Infantry were camped in a swamp near the Chickahominy River which was full of mosquitoes, “moccasins and malaria,” reported the regiment’s historian, who also served as its surgeon for a time. He believed the “exhaustion, suffering, disease, and death” suffered by the men of the Fifth beggared description.2
Malaria plagued the Union army during the Peninsular Campaign for a number of reasons. First, the U.S. military’s medical department was still disorganized in 1862. The mismanagement of the ambulance service and the autonomy of regimental surgeons meant that many sick and wounded soldiers went without treatment for long periods of time. The Army of the Potomac’s medical director, Charles Tripler (who would soon be replaced by the more adroit Jonathan Letterman), insisted on keeping the sick with the army rather than evacuating them, which meant plasmodium parasites were more easily passed to noninfected troops in crowded hospitals. Compounding the problem was the army’s supply nightmare, which prevented adequate amounts of quinine from reaching regimental surgeons. Dr. William Smith was a surgeon serving with the Eighty-fifth New York Infantry who watched malaria and diarrhea sicken nearly half the men in his regiment. Unable to obtain quinine during the campaign, Smith suspected the scarcity of the medicine was to blame for the army’s high rate of sickness. His suspicions were confirmed weeks later when he obtained a supply of the drug and “quickly restored the fever cases” in his unit. Tripler was so exasperated by the lack of quinine that he pleaded for the medicine in a letter to the surgeon general on May 29, two days before the Battle of Seven Pines began. As a result of these shortages, quinine was used only sporadically as a prophylactic, and troops quickly fell ill. Also, many of the soldiers in McClellan’s army had spent a considerable amount of time training in the malarial flats around Washington, D.C., before the campaign began and were already carrying plasmodium parasites when they stepped off the transport boats at Fortress Monroe and were swarmed by hungry insects. Finally, McClellan chose to launch his offensive against Richmond through what Confederate secretary of war George Randolph called “the pestilent marshes of the Peninsula” at a time of year when anopheles mosquitoes were highly active. Had he moved more quickly or begun his campaign earlier in the year, it is unlikely that his army would have suffered as many disease casualties as it did.3
The biggest medical problems for the Army of the Potomac during the Peninsular Campaign were diarrhea and dysentery. In July alone, more than nineteen thousand Union troops were suffering from what they jokingly referred to as the “Virginia Quickstep.” But because nearly eight thousand cases of intermittent fever were diagnosed the same month, it is likely that at least some of the soldiers suffering with dysentery got it after drinking dirty water from the Virginia bogs in order to slake a malaria-induced thirst. Plasmodium vivax alone was rarely lethal, but together with the other maladies that were besetting Union troops at the same time (typhoid fever and scurvy were also problems), its presence could determine whether a soldier lived or died. Dr. Joseph J. Woodward was an assistant surgeon with the Army of the Potomac who recognized that many of his patients were suffering from more than one disease at the same time. With the surgeon general’s approval, he went on to create the category “typho-malarial fever,” which was the diagnosis for nearly fifty thousand patients before the war ended. How many of these cases were actually caused by plasmodium parasites remains a mystery because misdiagnoses were frequent and the symptoms of typhoid fever are sometimes similar
to those of malaria.4
As the exhausted Army of the Potomac retreated to Harrison’s Landing in July 1862 after a series of bloody engagements with Lee’s forces, malaria and mosquitoes followed. The sick list was initially between 20 and 40 percent, but Letterman, the army’s newly appointed medical director, thought the health of the troops was improving as the summer wore on. Brigadier General Erasmus D. Keyes, commander of McClellan’s Fourth Corps, disagreed. He sent a letter to Lincoln urging the president to withhold reinforcements and withdraw the army before the sickly season destroyed it. “To bring troops freshly raised at the North to the country in the months of July, August, and September would be to cast our resources into the sea,” he wrote. “The raw troops would melt away and be ruined forever.” Keyes knew firsthand about fresh Union troops melting away. One of his raw divisions occupied “the worst [position] on the Peninsula” during the siege of Yorktown and had been hit hard by “malarial and typhoid fevers.” Eleven days after he wrote to Lincoln, Keyes fired off another missive, this time to Montgomery Meigs, imploring the quartermaster general to use his influence with the administration to press for a withdrawal. His protests did not fall on deaf ears. Although McClellan wanted reinforcements for another crack at capturing the Confederate capital, Lincoln decided that the campaign had gone on long enough. The president was weary of Little Mac’s excuses, and his troops were needed in northern Virginia to fend off Thomas “Stonewall” Jackson’s forces, which had been spotted at Gordonsville. In August Halleck sent a letter to McClellan explaining another important reason for the Union pullout. “To keep your army in its present position until it could be so re-enforced,” the general-in-chief chided, “would almost destroy it in that climate. The months of August and September are almost fatal to whites who live on that part of James River.” Like many Americans of his time, Halleck feared the pernicious diseases of the South’s sickly season, which was in large part a result of mosquito activity. His concerns about the diseases at Harrison’s Landing echoed those of his subordinates, Davis, French, Hunter, Mitchel, Renshaw, and others who were equally worried about the unhealthiness of the areas in which they were operating. All along the South’s riverbanks and shorelines, anopheles and Aedes aegypti mosquitoes created biological hot zones that complicated the plans of Union commanders and damaged the health of their troops.5
Mosquito Soldiers Page 10
