TREATMENT OF TYPHUS

Among the old publications referring to the medical history of Napoleon's campaign in Russia I found one of a Prussian army physician, Dr. Krantz, published in the year 1817 with the following title: Bemerkungen ueber den Gang der Krankheiten welche in der koniglich preussischen Armee vom Ausbruch des Krieges im Jahre 1812 bis zu Ende des Waffenstillstandes (im Aug.) 1813 geherrscht haben. (Remarks on the course of the Diseases which have reigned in the Royal Prussian Army from the Beginning of the War in the Year 1812 until the End of the Armistice [in August] 1813). From this I shall give the following extract:

It is well known that the soldiers constituting the wreck of the Grand Army wherever they passed on their way from Russia through Germany spread ruin; their presence brought death to thousands of peaceful citizens. Even those who were apparently well carried the germs of disease with them, for we found whole families, says Krantz, in whose dwelling soldiers, showing no signs of disease, had stayed over night, stricken down with typhus. The Prussian soldiers of York's corps had not been with the Grand Army in Moscow, and there was no typhus among them until they followed the French on their road of retreat from Russia. From this moment on, however, the disease spread with the greatest rapidity in the whole Prussian army corps, and this spreading took place with a certain uniformity among the different divisions. On account of the overflowing of the rivers, the men had to march closely together on the road, at least until they passed the Vistula near Dirschau, Moeve, and Marienwerder. Of the rapid extent of the infection we can form an idea when we learn the following facts: In the first East Prussian regiment of infantry, when it came to the Vistula, there was not a single case of typhus, while after a march of 14 miles on the highway which the French had passed before them there were 15 to 20 men sick in every company, every tenth or even every seventh man. In those divisions which had been exposed to infection while in former cantonments, the cases were much more numerous, 20 to 30 in every company.

Simultaneously with typhus there appeared the first cases of an epidemic ophthalmy. Although the eye affection was not as general as the typhus - it occurred only in some of the divisions, and then at the outset not so severely as later on - both evils were evidently related to each other by a common causal nexus. They appeared simultaneously under similar circumstances, but never attacked simultaneously the same individual. Whoever had ophthalmy was immune against typhus and vice versa, and this immunity furnished by one against the other evil lasted a long period of time. Both diseases were very often cured on the march. We found confirmed, says Krantz, what had been asserted a long time before by experienced physicians, that cold air had the most beneficial effect during the inflammatory stage of contagious typhus. For this reason the soldiers who presented the first well-known symptoms of typhus infection: headache, nausea, vertigo, etc., were separated from their healthy comrades and entrusted to medical care, and this consisted, except in the case of extraordinarily grave symptoms, in dressing the patient with warm clothing and placing him for the march on a wagon where he was covered all over with straw. The wagon was driven fast, to follow the corps, but halted frequently on the way at houses where tea (Infusum Chamomillae, species aromaticarum, etc.) with or without wine or spiritus sulphuricus aetherius were prepared; of this drink the patient was given a few cupfuls to warm him. As a precaution against frost, which proved to be a very wise one, hands and feet were wrapped in rags soaked in spiritus vini camphoratus. For quarters at night isolated houses were selected for their reception - a precaution taught by sad experience - and surgeons or couriers who had come there in advance had made the best preparations possible. All the hospitals between the Vistula and Berlin, constantly overfilled, were thoroughly infected, and thus transformed into regular pest-houses exhaling perdition to every one who entered, the physicians and attendants included. On the other hand, most of the patients who were treated on the march recovered. Of 31 cases of typhus of the 2d. battalion of the infantry guards transported from Tilsit to Tuchel, only one died, while the remaining 30 regained their health completely, a statistical result as favorable as has hardly ever happened in the best regulated hospital and which is the more surprising on account of the severe form of the disease at that time. An equally favorable result was obtained in the first East Prussian regiment of infantry on the march from the Vistula to the Spree.

There was not a single death on the march; of 330 patients 300 recovered, 30 were sent into hospitals of Elbing, Maerkisch Friedland, Conitz, and Berlin, and the same excellent results were reported from other divisions of the corps where the same method had been followed.

A most remarkable observation among the immense number of patients was that they seldom presented a stage of convalescence. Three days after they had been free from fever for 24 hours they were fit, without baggage, for a half or even a whole day's march. If the recovery had not been such a speedy one, says Krantz, how could all the wagons have been secured in that part of the country devastated by war for the transportation of the many hundreds of sick.