Mosquito Soldiers

Malaria, Yellow Fever, and the Course of the American Civil War

Andrew McIlwaine Bell

• Publisher: LSU Press
• Year: 2010
• Print ISBN: 9780807137376
• eBook ISBN: 9780807146637
• Topic: History
• Subtopic: American Civil War History
• Index: History

Of the 620, 000 soldiers who perished during the American Civil War, the overwhelming majority died not from gunshot wounds or saber cuts, but from disease. And of the various maladies that plagued both armies, few were more pervasive than malaria -- a mosquito-borne illness that afflicted over 1.1 million soldiers serving in the Union army alone. Yellow fever, another disease transmitted by mosquitos, struck fear into the hearts of military planners who knew that "yellow jack" could wipe out an entire army in a matter of weeks. In this ground-breaking medical history, Andrew McIlwaine Bell explores the impact of these two terrifying mosquito-borne maladies on the major political and military events of the 1860s, revealing how deadly microorganisms carried by a tiny insect helped shape the course of the Civil War.
Soldiers on both sides frequently complained about the annoying pests that fed on their blood, buzzed in their ears, invaded their tents, and generally contributed to the misery of army life. Little did they suspect that the South's large mosquito population operated as a sort of mercenary force, a third army, one that could work for or against either side depending on the circumstances. Malaria and yellow fever not only sickened thousands of Union and Confederate soldiers but also affected the timing and success of certain key military operations. Some commanders took seriously the threat posed by the southern disease environment and planned accordingly; others reacted only after large numbers of their men had already fallen ill. African American soldiers were ordered into areas deemed unhealthy for whites, and Confederate quartermasters watched helplessly as yellow fever plagued important port cities, disrupting critical supply chains and creating public panics.
Bell also chronicles the effects of disease on the civilian population, describing how shortages of malarial medicine helped erode traditional gender roles by turning genteel southern women into smugglers. Southern urbanites learned the value of sanitation during the Union occupation only to endure the horror of new yellow fever outbreaks once it ended, and federal soldiers reintroduced malaria into non-immune northern areas after the war. Throughout his lively narrative, Bell reinterprets familiar Civil War battles and events from an epidemiological standpoint, providing a fascinating medical perspective on the war.
By focusing on two specific diseases rather than a broad array of Civil War medical topics, Bell offers a clear understanding of how environmental factors serve as agents of change in history. Indeed, with Mosquito Soldiers, he proves that the course of the Civil War would have been far different had mosquito-borne illness not been part of the South's landscape in the 1860s.

{1}
AEDES, ANOPHELES, AND THE SCOURGES OF THE SOUTH

THE SUMMER OF 1835 was a stressful time for Mrs. Zachary Taylor. In June she learned her daughter Sarah Knox had married a dashing young army lieutenant named Jefferson Davis and dutifully followed her new husband from Kentucky to his virgin estate on the Mississippi River below Vicksburg. Although Colonel Taylor expressed fatherly doubts about the wisdom of letting “Knoxie” become a soldier’s wife, Mrs. Taylor was less concerned with her daughter’s choice of a spouse than with the dangerous diseases she knew lurked in the shadowy, stagnant bogs that surrounded Davis’s “Brierfield” plantation. Fifteen years earlier she and her four children, including Sarah, had fallen ill while stationed with her husband’s regiment in the swamps of Louisiana. The two youngest girls did not survive, and Mrs. Taylor herself had nearly died. The thought of losing another child to the mysterious and unhealthy climate of the Deep South was more than she could bear.

Sarah tried to assuage her mother’s fears. “Do not make yourself uneasy about me,” she wrote in August. “The country is quite healthy.” The following month, however, both she and her husband were stricken by a severe illness while visiting relatives in West Feliciana, Louisiana. On the fifteenth of September, at the height of their agonizing ordeal, Davis staggered out of his sickbed to comfort his ailing wife, but Sarah, delirious with fever, failed to recognize him. Instead, in a fit of madness she sang a popular nineteenth-century song called “Fairy Bells” before closing her eyes forever. Davis never got a chance to say good-bye to his twenty-one-year-old bride and was forced to mourn her loss while still very ill. The future president of the Confederacy grieved in seclusion at Brierfield for the next eight years.¹

Like most Americans of her era, Mrs. Taylor would have likely attributed her daughter’s tragic death to the poisonous air that was said to pervade unhealthy areas of the country such as the Mississippi Delta. Conventional wisdom since colonial times held that strange and virulent vapors continually wafted through the atmosphere of the warmer regions of North America and created health problems for anyone unfortunate enough to breathe them in, especially those born in healthier climates. What exactly caused the air to turn lethal, however, was still in dispute among physicians for most of the nineteenth century. Endless theories circulated in medical journals or were discussed at conventions at a time when medicine was more art than science. Some practitioners, perhaps a majority, believed decomposing animals and plants produced the noxious “miasmas” that sickened their patients. Others thought electrical charges in the ozone were the culprit. Still others rejected the “bad air” theory altogether and instead blamed excess hydrocarbons in the blood.²

In reality Sarah Taylor Davis had died of an insect bite. One night in late August or early September a female mosquito carrying a dangerous strain of malaria surreptitiously sliced through her skin, sucked up her red corpuscles through its straw-like proboscis, and unwittingly released into her bloodstream a dozen or so malarial sporozoites that it had picked up from a previous victim. Within minutes these sporozoites found their way into Sarah’s liver, where they transformed over the next two weeks into schizonts, each containing thousands of smaller organisms called merozoites. When the mature schizonts eventually burst, the merozoites poured out like tiny soldiers and invaded her red cells in order to reach the next stage of their development. As these parasites rapidly multiplied, dead and dying corpuscles clung to the walls of Sarah’s capillaries and healthy cells, creating a dam that blocked the flow of blood to her vital organs.³

Malaria is a parasite transmitted by Anopheles mosquitoes, a genus that prefers to breed in stagnant, sunlit pools of fresh water and can be found in most regions of the country. The adult female requires a blood meal to ovulate and can lay between one and three hundred eggs at a time. Symptoms of malaria include chills, shakes, nausea, headache, an enlarged spleen, and a fever that spikes every one to three days depending on the type of malaria and its parasitic cycle. In all likelihood Sarah Davis was killed by Plasmodium falciparum, one of four types of malaria that infect human beings. Of the other three— vivax, malariae, and ovale—only Plasmodium vivax was once common in the United States. Vivax alone rarely proved fatal to its victims, but Plasmodium falciparum was often deadly.⁴

Nineteenth-century physicians categorized malaria according to how often these fever spikes, or “paroxysms,” occurred. A “quotidian” fever appeared once every twenty-four hours, a “tertian” every forty-eight, and a “quartan” every seventy-two. Plasmodium vivax was commonly referred to as “intermittent fever,” “ague,” “dumb ague,” or “chill-fever,” while Plasmodium falciparum was known as “congestive fever,” “malignant fever,” or “pernicious malaria” because of its lethal effect.⁵

Patients diagnosed with “remittent fever” experienced febrile symptoms that, as the name suggests, periodically went into remission. But they did not disappear entirely (and temporarily) in the same way that so-called intermittent symptoms did. Like most nineteenth-century descriptions of disease, the term remittent was somewhat nebulous. Yet a handful of studies conducted in the 1830s and 1840s suggest that many of these fevers were the result of repeat plasmodial infections.⁶

Sarah Davis was one of countless Americans who contracted malaria during the nineteenth century. As settlers cleared virgin forests from Savannah to St. Louis to make way for the cotton and wheat farms that drove the antebellum economy, they inadvertently created a plethora of new breeding sites for anopheles. At a time when mosquito-control measures such as spraying the insecticide chlorophenothane (DDT) were still unknown, clouds of insects swarmed wagon trains and slave coffles, sparking complaints about “fever” and “ague” in the South and West, where crude housing, poor drainage, and regular flooding aided in the spread of the disease. Daniel Brush’s experience on the frontier was typical. In 1820 he and his family moved from Vermont to southern Illinois in search of better economic opportunities and wound up with a handful of other Yankee families in a small settlement called “Bluffdale,” four miles east of the Illinois River. When the entire community came down with malaria during the first harvest, Brush recorded his fellow settlers’ suffering: “Many had the real ‘shakes’ and when the fit was fully on shook so violently that they could not hold a glass of water with which to check the consuming thirst that constantly beset them while the rigor lasted, nearly freezing the victim.” He went on to describe the fevers that followed these fits as putting “the blood seemingly at boiling heat and the flesh roasting.”⁷

Other observers noticed the prevalence of the disease in the West. During a tour of the United States in the 1840s, the English author Charles Dickens encountered so many “hollow-cheeked and pale” malaria victims that he forever remembered the region where the Mississippi and Ohio rivers converge as “a breeding-place of fever, ague, and death.” St. Louis also seemed unhealthy to Dickens, despite its residents’ claims to the contrary. One Illinois physician’s frequent contact with malaria convinced him that he could accurately diagnose patients just by learning where they lived, while another practitioner thought the malaria victims he saw, even children, looked “prematurely old and wrinkled.” Country doctors from all over the Northwest published articles in medical journals on the best ways to identify and combat the mysterious disease that plagued their communities.⁸

But while malaria made life difficult for Westerners, it made life nearly intolerable for southerners at certain times of the year. Plasmodium falciparum occurred almost exclusively below the thirty-fifth parallel and was especially problematic in the states of the Deep South such as South Carolina and Georgia. Short, mild southern winters substantially lengthened the breeding season for anopheline mosquitoes and made Plasmodium vivax infections as common as colds in some areas. White southerners dreaded the annual arrival of the “fever season” (which lasted for a variable length of time between late spring and early autumn depending on the location), and those who could afford it escaped to seaside cottages or fled northward in search of healthier climates. During a visit to lowland South Carolina in the 1850s, landscape architect Frederick Law Olmstead noticed that the overseer on one plantation moved inland to higher ground during the “sickly season” (outside the flight range of anopheles) to escape the “swamps” and “rice-fields” that made life at night “dangerous for any but negroes.” The widespread belief among whites that blacks were immune to malaria, which served as a convenient justification for slavery, had some basis in scientific truth. West Africans inhabited malarial environments for thousands of years before being brought to America and developed a degree of genetic resistance which they passed on to their offspring. But by the mid-nineteenth century Africans from all over the subcontinent were intermixing with one another as well as with Indians and Europeans, which meant that many blacks were also susceptible to malaria.⁹

Although neither blacks nor whites understood what caused malaria, they both agreed that the farther south one traveled, the more prevalent the disease became. Slaves from states such as Virginia and Maryland feared being sold to planters in the lower South in part because of the malarial poison they knew plagued the area. John Green-leaf Whittier’s poem “The Farewell” captures the concern many black families must have felt for the health of their loved ones who were forced to move farther south:

Gone, gone, sold and gone

To the rice swamp dank and lone,

Where the slave-whip ceaseless swings,

Where the noisome insect stings,

Where the fever-demon strews

Poison with the falling dews,

Where the sickly sunbeams glare

Through the hot and misty air:—¹⁰

Whites also worried about the endemic malarial fevers of the South. Residents of lower Louisiana and Mississippi who lived in swamps near the Mississippi River routinely evacuated their homes to escape the strange sickness that mysteriously appeared whenever it flooded. Together with portions of western Tennessee, these areas were considered the most malarious in the Mississippi River Valley. Other locations infested with mosquitoes, such as the algae-covered bogs of south Alabama, coastal Carolina, and the Florida panhandle, were thought to be uninhabitable or exceedingly dangerous places for whites during the summer months. A physician practicing in tidewater North Carolina believed the prevalence of malaria in his neighborhood “would appear incredible to those whose experience has been confined to more healthy localities.” Indeed, military personnel stationed in the South for the first time were horrified by the unhealthiness of the climate. An army physician from St. Louis assigned to a fort on the Suwannee River in Florida saw so many cases of intermittent fever that he was convinced that even the pets in the place suffered from the disease. He and two-thirds of the soldiers under his care fell ill while on duty. Military doctors serving in Baton Rouge, Louisiana, considered one of the sickliest posts in the United States in the early 1800s, saw an average of 824 cases of malaria per 1,000 troops each year. Fort Gibson in Arkansas and Fort Scott in Georgia were also reputed to be malarial pestholes. From the burgeoning cotton estates of the Texas plains to the well-established tobacco and rice plantations of the East, anopheles mosquitoes fed on black and white bodies indiscriminately, transmitting plasmodium parasites and sickening their human prey in the process.¹¹

The prevalence and severity of malaria in the South helped shape both northerners’ and southerners’ views of the region. For northerners this view was mostly negative. By the mid-nineteenth century long winters and infrastructure improvement projects spearheaded by industrious free laborers had all but eliminated malaria from New England and given rise to a generation of Northeasterners who had never been exposed to the disease. Like many Americans today, antebellum New Englanders viewed malaria as a “tropical” malady that was only a problem for people who lived in the unsanitary and underdeveloped regions of the world, which included the southern United States. Southerners’ repeated warnings about the health risks their local fevers posed to outsiders reinforced this negative image. So too did the stories shared by returning sailors about the intermittent fevers they had contracted while visiting cities such as Mobile and New Orleans. Malaria even helped convince northern insurance firms of the need to charge higher premiums to their southern clients and hindered the North-to-South flow of investment capital and people. In contrast, some southerners adopted a sort of perverse pride in the ailments they considered their own. Repeated infections with the same strains of malaria over a period of years meant southerners who stayed in one place became accustomed to the fevers in their neighborhood and developed a limited immunity against them. A number of southern physicians practicing during the antebellum period even went so far as to call for the creation of separate medical schools and publications to allow southern students the chance to learn more about the diseases that were indigenous to their region.¹²

Malaria, however, was not the only mosquito-borne illness that contributed to the image of the South as an unhealthy place to live. Yellow fever, a disease once found as far north as New York and Philadelphia, became a uniquely southern problem by the middle of the nineteenth century. The reasons why it became confined to the South remain unclear, although the North’s longer winters, quarantine and sanitation practices, and trade patterns may have played a role. Outbreaks in Charleston, Galveston, Mobile, New Orleans, Norfolk, Savannah, and other southern cities killed tens of thousands of people and created a level of physical and emotional suffering that can scarcely be imagined today. Victims in the advanced stages of the disease bled from the nose and mouth; suffered excruciating headaches, fever, and jaundice; and, worst of all, vomited a substance resembling coffee grounds (half-digested blood) caused by internal hemorrhaging, which was a telltale sign of the virus. Fatality rates during epidemics ranged from 15 to over 50 percent, but those who survived acquired lifetime immunity. Nineteenth-century Americans lived in fear of the disease they called the “scourge of the South,” and public panics often followed the first sign of an outbreak.¹³

Unbeknownst to antebellum physicians, yellow fever was being transmitted from person to person by the Aedes aegypti mosquito, a species that inhabits the southern United States and lays its eggs in hollow logs and artificial receptacles containing freshwater. Filthy southern cities offered nearly limitless incubation pools for Aedes eggs in the form of horse troughs, barrels, clogged gutters, and trash in the streets filled with rainwater. Winter frosts limited the activity of the mosquito and prevented yellow fever from ever becoming endemic in North America, but the virus was continually reintroduced by cargo ships arriving from the Caribbean, where it existed year-round. A single infected sailor or mosquito on board could spread yellow fever to the local Aedes aegypti population and cause widespread misery and death.¹⁴

Just such a scenario unfolded in New Orleans in the summer of 1853 in an outbreak that claimed over eight thousand lives in a matter of weeks. Panic-stricken residents closed their shops and businesses and fled in all directions to escape the poisonous atmosphere of the city, leaving behind unburied corpses that swelled and burst in the blistering Louisiana heat. One man was in such a hurry to escape that he decided, in the interest of saving time, not to press charges against a criminal who had stabbed him. New Orleans’s Charity Hospital was soon filled to capacity, and city officials burned tar on the street corners and fired cannons each morning and evening in an attempt to purify the supposedly unclean air. Priests and ministers were “called upon every hour of the day and night” to comfort the dying and their relatives, while evacuees spread the virus to other towns along the Gulf Coast and Mississippi River, killing thousands more. Four more major yellow fever epidemics over the next five years helped the Crescent City earn a reputation as a den of despondency and death.¹⁵

A year after yellow fever razed New Orleans, it appeared in Savannah, Georgia, and Charleston, South Carolina. Obituari...

Table of contents

• Cover Page
• Title Page
• Copyright
• Dedication
• Contents
• Preface
• Introduction
• {1}: Aedes, Anopheles, and the Scourges of the South
• {2}: The Glory of Gangrene and “Gallinippers”
• {3}: Mosquito Coasts
• {4}: “The Land of Flowers, Magnolias, and Chills”
• {5}: “The Pestilent Marshes of the Peninsula”
• {6}: “The Roughest Times Any Set of Soldiers Ever Encountered”
• {7}: Biological Warfare
• Epilogue
• Appendix 1
• Appendix 2
• Appendix 3
• Notes
• Selected Bibliography
• Index
• About the Author