Arrived in Russia the French were soon disappointed; gloomy forests and sterile soil met the eye, all was sad and silent. After the army had passed the Niemen and entered into Poland the misery, instead of diminishing, increased, the hour had struck for these unfortunates. The enemy destroyed everything on retreating, the cattle were taken to distant provinces; the French saw the destruction of the fields, the villages were deserted, the peasants fled upon the appearance of the French army, all inhabitants had left except the Jews. When the army came to Lithuania everything seemed to be in league against the French. It was a rainy season, the soldiers marched through vast and gloomy forests, and all was melancholy. One could have imagined himself to be in a desert if it had not been for the vehicles, the cursing of the drivers, discontented on account of hunger and fatigue, the imprecations of the soldiers on every occasion; bad humor, due to privations, prevailed everywhere. It would seem as if the furies of hell were marching at the heels of the army. The roads were in a terrible condition, almost unpassable on account of the rain which had been continuous since the crossing of the Niemen; the artillery wagons especially gave great trouble in passing marshes, and, on account of the extreme exhaustion of the horses, a great many of these vehicles had to be abandoned. The horses receiving no nourishment but green herbs could resist even less than the men and they fell by the hundred.

The improper feeding of the animals caused gastric disturbances, alternately diarrhoea and constipation, enormous tympanitis, peritonitis. It is touching to read of the devotion of German cavalrymen to their poor horses. They would introduce the whole arm into the bowel to relieve the suffering creatures of the accumulated fecal masses.

As the army advanced over these roads the extreme want of provisions was bitterly felt. The warriors already reduced to such an excess of misery were exposed to rain without being able to dry themselves; to nourish themselves they were forced to resort to the most horrible marauding, and sometimes they had nothing to eat for twenty-four hours or even longer. They ran through the land in all directions, disregarding all dangers, sometimes many miles away from the route, to find provisions. Wherever they came they went through the houses from the foundation to the roof, and when they found animals they took them away; no attention was paid to the feeling of the poor peasants and nothing was considered as being too harsh for them; in most instances the latter had run away for fear of maltreatment. Nothing is so afflicting as to see the rapacity of pillaging soldiers, stealing and destroying everything coming under their hands. They took to excess vodka found in the magazines which the enemy had not destroyed, or in the castles off the main route. In consequence of this abuse of alcohol while in their feeble condition many perished. The enemy retreated behind the Dwina and fortified himself in camp. It was thought that he would give battle, and all enjoyed this prospect.

On July 20, at a time when the conditions of the army were already terrible, the heat became excessive. The rains ceased; there were no rainy days, except an occasional storm, until September 17. The poor infantrymen were to be pitied; they had to carry their arms, their effects, their cartridges, harassed by continuous fatigue, overpowered by hunger and a thousand sorrows, and were obliged to march 10, 12, 15, and sometimes even 16 and 17 miles a day over dusty roads under a burning sun, all the time tormented by a cruel thirst. But all this has been fully described in an earlier chapter.

On July 23 the Prince of Eckmuehl (Davout) had a very hot engagement with the Russian army corps under Prince Bagratian before Mohilew; on July 25, a bloody battle was fought near Ostrowno. The houses and other buildings of Ostrowno were filled with wounded, the battlefield covered with corpses of men and horses, and the hot weather caused quick putrefaction. Kerckhove visited the battlefield on June 28 and says: "I have no words to describe the horror of seeing the unburied cadavers, infesting the air, and among the dead many helpless wounded without a drop of water, exposed to the hot sun, crying in rage and despair."

Napoleon made preparations to attack on July 28, but the enemy had retreated. At Witepsk, hospitals were established for the wounded from Ostrowno, among them 800 Russians. However, the designation "hospital" is hardly applicable, for everything was wanting; the patients in infected air, crowded, and surrounded by uncleanliness, without food or medicines. These hospitals were in reality death-houses. The physicians did what they could. On August 18, the French army entered Smolensk which had been destroyed by projectiles and by fire; ruins filled with the dead and dying; and in the midst of this desolation the terror-stricken inhabitants running everywhere, looking for members of their families - many of whom had been killed by bullets or by flames - or sitting before their still smoking homes, tearing their hair, a picture of distress truly heartrending. The soldiers who were the first to enter Smolensk found flour, brandy and wine, but these things were devoured in an instant. There were 10 thousand wounded in the so-called hospitals, and among these unfortunates typhus and hospital gangraene developed rapidly; the sick lying on the floor without even straw.

Holzhausen gives the following description:

After Smolensk had been evacuated by the Russians, most houses had been burnt out; the retreating Russians had destroyed everything that could be of any use. Corpses everywhere. Nobody had time to remove them, and the cannons, the freight wagons, the horses, and the infantry passed over them. On August 17th and 18th, was the battle of Polotsk in which the Bavarians distinguished themselves. There were no medicines for the wounded, not even drinking water, no bread, no salt. Of the many unhealthy places in Russia this is the worst, it swarms with insects. Nostalgia was prevailing. They had a so-called dying chamber in the hospital for which the soldiers were longing, to rest there on straw, never to rise again.

Awaiting their last the pious Bavarians repeated aloud their rosary, took refuge with the Jesuits, who had a convent at Polotsk, to receive the consolation of their religion.

Some thought Napoleon would rest here to establish the Polish kingdom. But this reasonable idea, if he had ever entertained it, he discarded. By giving his troops winter quarters, establishing magazines and hospitals he would have succeeded in subduing Russia by reinforcing his army; instead of all this he went on to Moscow without provisions, without magazines.

On August 30, the army reached Wiasma, a city of 8 thousand or 9 thousand inhabitants which had been set on fire upon the approach of the French. All the inhabitants had left. The soldiers fought the flames and saved some houses into which they brought those of their wounded and sick who could not drag themselves any farther. Cases of typhus were numerous. From Wiasma the army marched to Ghiat, a city of 6 thousand or 7 thousand inhabitants; at this place Napoleon gave a two days' rest in order that the army could rally, clean their arms and prepare for battle (the battle of Borodino on September 7. This battle is known under three names: the Russians have called it after the village of Borodino, of 200 inhabitants, near the battlefield and have now erected a monument there, a collonade crowned with a cross; some historians have called it the battle of Moshaisk, after a nearby town of 4 thousand inhabitants, and Napoleon has named it the battle of the Moskwa, after a river near the battlefield.) Napoleon had only 120 thousand to 130 thousand under arms, about as many as the Russians. It was 6:30 a.m., a beautiful sunrise. Napoleon called it the sun of Austerlitz. The Russian generals made their soldiers say their prayers. A French cannon gave the signal to attack, and at once the French batteries opened the battle with a discharge of more than 100 cannon. Writing this medical history of the Russian campaign I feel tempted to give a description of this most frightful, most cruel of all battles in the history of the world in which about 1,200 cannon without interruption dealt destruction and death; fracas and tumult of arms of all kinds, the harangue, the shouts of the commanders, the cries of rage, the lamentations of the wounded, all blended into one terrible din. Both armies charged with all the force that terror could develop. French and Russian soldiers not only fought like furious lions rivaling each other in ardor and courage, but they fought with wild joy, devoid of all human feeling, like maniacs; they threw themselves on the enemy where he was most numerous, in a manner which manifested the highest degree of despair. The French had to gain the victory or succumb to misery; victory or death was their only thought. The Russians felt themselves humiliated by the approach of the French to their capital, and unshaken as a rock they resisted, defending themselves with grim determination. The battle, Napoleon promised, would be followed by peace and good winter quarters, but he was not as good a prophet as he was a good general.

During the day the Westphalian corps was reduced to 1500 men. Napoleon ordered these to do guard-duty on the battlefield, transport the immense number of wounded to the hospitals, bury the dead and to remain while the army marched and stayed at Moscow. What the Westphalians could do for the wounded was very little, for everything was wanting. The hospital system was incomplete, miserable. It is true, the surgeons dressed, operated, amputated, during the battle and during the days following, a great many wounded, but their number and their assistance was inadequate for the enormous task; thousands remained without proper attendance and died.

About one thousand Wuerttembergians were wounded in the battle of Borodino, and on many of these surgical operations had to be performed. Strange to say, the greatest operations on enfeebled wounded were more successful, a great many more were saved, than was generally the case under more favorable circumstances. Thus Surgeon General von Kohlreuter observed that in the Russian campaign amputation of an arm, for instance, gave much better chances, more recoveries, than in the Saxon and French campaigns, during which latter the soldiers were still robust, well nourished and well, even in abundance, supplied with everything.

Means of transportation were lacking, for no wagons could be found in the deserted villages, and for this reason many whose wounds had been dressed had to be left to their fate - to die. Those but slightly wounded and those even who could crawl in some manner followed the troops, or went back at random to find their death in some miserable hut. Many sought refuge in nearby villages, sometimes miles away from the battle-field, there to fall into the hands of the Cossacks.

The Westphalians remained on the battle-field surrounded by corpses and dying men, and they were forced to change position from time to time on account of the stench. The scenes of suffering and distress which the battle-field presented everywhere surpassed all description; the groans of the mutilated and dying followed the men on guard even at a distance, and especially was this terrible during the night; it filled the heart with horror, von Borcke said that soldiers, at the request of some of the wounded in extreme agony, shot them dead and turned the face away while shooting. And soon they considered this an act of pity. The officers even induced them to look for those who could not be saved, in order to relieve them from their suffering. When von Borcke was riding on horseback over the battle-field on the 5th. day after the battle he saw wounded soldiers lying alongside the cadaver of a horse, gnawing at its flesh. During the night flames could be seen here and there on this field of death; these were fires built by wounded soldiers who had crawled together to protect themselves from the cold of the night and to roast a piece of horseflesh. On September 12th. the Westphalians moved to Moshaisk, which was deserted by all inhabitants, plundered, and half in ashes. While the battle raged several thousand wounded Russians had taken refuge there, who now, some alive and some dead, filled all the houses of the town. Burnt bodies were lying in the ruins of the houses which had been burnt, the entrance of these places being almost blockaded by cadavers. The only church, which stood on the public square in the middle of the town, contained several hundred wounded and as many corpses of men dead for a number of days. One glance into this infected church, a regular pest-house, made the blood curdle. Surgeons went inside and had the dead piled up on the square around the church; those still alive and suffering received the first aid, order was established and gradually a hospital arranged. Soldiers, Westphalians as well as Russian prisoners, were ordered to remove the corpses from the houses and the streets, and then a recleansing of the whole town was necessary before it could be occupied by the troops. Although there was only one stone building - and a hundred wooden ones - it gave quarters to the whole Westphalian corps. Two regiments, one of Hussars, the other of the light Horse Guards, both together numbering not more than 300 men, had taken possession of a monastery in the neighborhood. Two regiments of cuirassiers had marched with the French to Moscow.

In the quarters of Moshaisk the Westphalians enjoyed a time of rest, while the events in Moscow took place. The fate of those who had remained in Moshaisk was not enviable, but what had been left of the town offered at least shelter during the cold nights of the approaching winter. This was a good deal after the fearful hardships, and it contributed much toward the recuperation of the soldiers. Convalescents arrived daily, also such as had remained in the rear; a number of the slightly wounded were able for duty again, and in this manner the number of men increased to 4,500. Life in Moshaisk was a constant struggle for sustenance. There were no inhabitants, not even a single dog or any other living animal which the inhabitants had left behind. Some provisions found in houses or hidden somewhere benefitted only those who had discovered them. The place upon the whole was a desert for the hungry. Small detachments had to be sent out for supplies. At first this system proved satisfactory, and with what had been brought in from the vicinity regular rations could be distributed. But the instinct of self-preservation had become so predominating that every one thought only of himself. Officers would send men clandestinely for their own sake, and when this was discovered it ended in a fight and murder. Everyone was anxious to provide for himself individually, to be prepared for the coming winter. Sutlers and speculators went to Moscow to take advantage of the general pillage, to procure luxuries, like coffee, sugar, tea, wine, delicacies of all description. Notwithstanding the great conflagration at Moscow immense stores of all these things had come into the hands of the French, and this had an influence on Moshaisk, forty miles away from the metropolis, von Borke was fortunate enough to secure a supply of coffee, tea, and sugar, sufficient not only for himself, but also for some friends, and lasting even for some weeks on the retreat. But the supply of meat, and especially bread, was inadequate for the mass of soldiers. Ten days had elapsed when the situation of those in Moshaisk became grave again, namely, when communication with Moscow was cut off. Orderlies did not arrive, no more convalescents came, news could not be had, details of soldiers sent out for supplies were killed or taken prisoner by Cossacks. The retreat of the French army, the last act of the great drama, commenced.

While the Westphalians guarded the battle-field the army marched to Moscow, exhausted, starving, finding new sufferings every day. On the road from Moshaisk to Moscow they encountered frightful conditions in the villages which were filled with wounded Russians. These unfortunates, abandoned to cruel privations, dying as much from starvation as from their wounds, excited pity. The water even was scarce, and when a source was discovered it was generally polluted, soiled with all sorts of filth, infected by cadavers; but all this did not prevent the soldiers from drinking it with great avidity, and they fought among themselves to approach it. All these details have to be known before studying typhus in the grand army.

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The description of diseases given by the physicians who lived a century ago is for us unsatisfactory; we cannot understand what they meant by their vague designating of hepatitis, fibrous enteritis, diarrhoea and dysentery, peripneumonia, remittent and intermittent gastric fever, protracted nervous fever, typhus and synochus; there is no distinction made in any of the writings of that period between abdominal and exanthematic typhus.

However, before long physicians will discard much from our present medical onomatology that is ridiculous, absurd, incorrect, in short, unscientific, as, for instance, the designation typhoid fever.

Ebstein has pointed out all that is obscure to us in the reports of the physicians of the Russian campaign; for instance, that we cannot distinguish what is meant by the different forms of fever. According to the views of those times fever was itself a disease per se; when reaction was predominating it was called synocha, typhus when weakness was the feature, and in case of a combination of synocha and typhus it was called synochus, a form in which there was at first an inflammatory and later on a typhoid stage, but which form could not be distinguished exactly from typhus. From all the descriptions in the reports of the Russian campaign it can be deduced that many of the cases enumerated were of exanthematic typhus, notwithstanding that the symptomatology given is very incomplete, not to speak of the pathological anatomy. The only writer who has described necropsies is von Scherer. Some of the physicians speak only of the sick and the diseases, as Bourgeois, who says that on the march to Russia during the sultry weather the many cadavers of horses putrefied rapidly, filling the air with miasms, and that this caused much disease; further, in describing the retreat he only says that the army was daily reduced in consequence of the constant fighting, the privations and diseases, without enumerating which diseases were prevailing; only in a note attached to his booklet he mentions that the most frequent of the ravaging diseases of that time and during the Russian campaign in general was typhus, and there can be no doubt it was petechial or exanthematic typhus, for which the English literature has the vague name typhus fever.

Very interesting are the historical data given by Ebstein: "As is well known, the fourth and most severe typhus period of the eighteenth century began with the wars of the French revolution and ended only during the second decade of the nineteenth century with the downfall of the Napoleonic empire and the restoration of peace in Germany." During the Russian campaign the conditions for spreading the disease were certainly the most favorable imaginable.

Krantz, whom I shall quote later on, has described the ophthalmy prevailing in York's corps as being of a mild character.

Quite different forms reigned among the soldiers on their retreat from Moscow.

The description of the death from frost given by von Scherer is similar to that given by Bourgeois. The men staggered as if drunk, their faces were red and swollen, it looked as if all their blood had risen into their head. Powerless they dropped, as if paralyzed, the arms were hanging down, the musket fell out of their hands. The moment they lost their strength tears came to their eyes, repeatedly they arose, apparently deprived of their senses, and stared shy and terror-stricken at their surroundings. The physiognomy, the spasmodic contractions of the muscles of the face, manifested the cruel agony which they suffered. The eyes were very red, and drops of blood trickled from the conjunctiva. Without exaggeration it could be said of these unfortunates that they shed bloody tears. These severe forms of ophthalmy caused by extreme cold would have ended in gangraene of the affected parts if death had not relieved the misery of these unfortunates.

But Bourgeois describes another very severe form of ophthalmy among the soldiers which caused total blindness. It appeared when the army on its retreat was in the vicinity of Orscha, attacked many soldiers and resembled the ophthalmy which was prevailing in Egypt; there it was caused by the heated sand reflecting powerfully the rays of the sun; here, by the glaring white snow likewise reflecting the rays of the sun. Bourgeois considers as predisposing moments the smoke of the camp-fires, the want of sleep, the marching during the night, and describes the affection as follows: The conjunctiva became dark red, swelled together with the eyelids; there was a greatly exaggerated lachrymal secretion associated with severe pain; the eyes were constantly wet, the photophobia reached such a degree that the men became totally blind, suffered most excruciating pain and fell on the road.

Ebstein availed himself of the publications of J. L. R. de Kerckhove, Rene Bourgeois, J. Lemazurier, and Joh. von Scherer, and the manuscript of Harnier from which writings he collected all that refers to the diseases of the grand army. It may not be out of place to quote the interesting writings of de Kerckhove concerning the army physicians and Napoleon and his soldiers:

De Kerckhove left Mayence on March 6th., 1812, attached to the headquarters of the 3rd. corps, commanded by Ney; at Thorn he joined those braves with whom he entered Moscow on September 14th. and with whom he left on October 19th. When he returned to Berlin in the beginning of February, 1813, the 3rd. corps was discharged. He writes: The army was not only the most beautiful, but there was none which included so many brave warriors, more heroes. How many parents have cried over the loss of their children tenderly raised by them, how many sons, the only hope and support of their father and mother, have perished, how many bonds of friendship have been severed, how many couples have been separated forever, how many unfortunate ones drawn into misery? An army extinguished by hunger and cold!

Giving credit to the physicians and surgeons who took part in that unfortunate expedition he says: With what noble zeal they tried to do their duties. The horror of the privations, the severity of the climate and fatigues and the want of eatables and medicines which characterized the hospitals and ambulances in Russia, have not discouraged the physicians so far as to become indifferent to the terrible fate reserved for the sick. On the contrary, far from allowing themselves to relax, they have doubled their activity to ameliorate sufferings. We have seen physicians in the midst of the carnage and the terror of the battles extend their care and bring consolation; we have seen them sacrificing day and night in hospital service, succumbing to murderous epidemics; in one word, despising all danger when it was a question of relieving the sufferings of the warriors, immaterial whether Russian or French. We can speak of many sick or wounded left in ambulances or hospitals in want of food and medicines, many of such unfortunates deprived of everything, dragging themselves under the ruins of cities or villages, who found help from honest physicians.