CHAPTER VI

THE EPIDEMICS OF TYPHUS FEVER IN CENTRAL EUROPE FOLLOWING UPON THE RUSSIAN CAMPAIGN AND DURING THE WARS OF LIBERATION (1812–14)

1. GENERAL OBSERVATIONS REGARDING TYPHUS FEVER

Typhus fever, as a specific disease, was well known to the military physicians during the age of Napoleon, since, as set forth in the previous chapter, it regularly appeared during the numerous Napoleonic wars in the form of widespread epidemics. In France the simple word ‘typhus’ was often used to denote the disease, and the custom still prevails there. In Germany the disease was called infectious nerve fever, war plague, lazaret fever, &c.

At the beginning of the nineteenth century it was generally believed that great hardships, colds, lack of the necessaries of life, and the consequent consumption of spoiled foodstuffs give rise to fevers, and that these fevers, in accordance with the epidemic character of the year and of the season, and also in accordance with the severity of the hardships undergone, might develop into dysentery and typhus fever. At all events, even the eminent physicians of the day, men like Hildenbrand of Vienna[106] and Hufeland of Berlin, who in the course of two decades had abundant opportunity to study the disease, assumed that it is possible for typhus fever to break out spontaneously. It was believed that this fever, originating spontaneously, gradually developed the power of infection. Hufeland’s position was self-contradictory, for he assumes that the disease can break out spontaneously and yet that it can be warded off by means of isolation.[107] He says: ‘A proof of the fact that this disease can spread only through infection is offered by the stronghold of Küstrin, which, being closed up tightly during the entire year of 1813, was free from disease, whereas all the surrounding country, even the army of the besiegers, suffered terribly.’ Whereupon Hufeland immediately adds: ‘The war carried on among us and by us with such unheard-of exertion and hardship caused the disease to break out several times anew throughout our country, and hence it could but become general.’ That it is possible for typhus fever to break out spontaneously and subsequently spread by infection was everywhere believed, even by French physicians. It is hardly necessary to say, however, that the theory of the spontaneous origination of the disease does not accord with modern views. The severe hardships undergone, the hunger and cold, the effluvium of gangrenous wounds, the moral depression, and the many other bad effects which characterized this war more than any other, necessarily decreased the soldiers’ power of resistance and increased their susceptibility to infection. Incidentally, all sorts of telluric and meteorological phenomena, volcanic eruptions, earthquakes, the great heat and dryness of the year 1811, the meteors of that year—all these things were at the time brought into causal connexion with the war pestilences of the years 1813–14.

‘Many people stated positively’, says Hufeland,[108] ‘that they contracted the disease almost immediately after they had occupied small, narrow rooms in company with infected French soldiers, or after they had washed their clothes or waited upon them. This frequently happened in small houses that undertook, for a small profit, to shelter invalid soldiers quartered upon the wealthier citizens. Many asserted that they contracted the disease by passing the night in small inns in the towns and villages around Berlin, and on the roads from Königsberg, Danzig, and Frankfurt, and by sleeping on beds or straw which had shortly before been used by infected Frenchmen or Russians. A certain number of men contracted typhus fever by serving as attendants, in order to earn a little money, in the local French military hospital. In this way many of the servants and attendants employed there, as well as numerous surgeons and apothecaries, contracted the disease and subsequently infected the members of their families who brought them home and took care of them, and who, in turn, infected the other inhabitants of the house and of the neighbouring houses.’ Further on, Hufeland adds that only those inmates of the hospital contracted the disease who, as servants and attendants, had been in close and constant contact with the patients.

In the years 1813–14 a large number of physicians were carried away by typhus fever; it was estimated at that time that some 500 of them throughout Germany (excluding the surgeons) fell victims to the disease—in Silesia alone 63 physicians died, in Leipzig 17, in Württemberg 17, and in Baden 35.[109]

Emphasis was always laid upon the fact that the clothes and other effects of people who had succumbed to typhus fever were highly infectious. The wide prevalence of the disease among the Jewish inhabitants of Vilna was attributed to ignorance or disregard of this fact; for when orders were issued to destroy such clothing, the Jews, out of sheer avarice, disobeyed them. The persons who acquired such effects in this cheap and illicit manner usually paid the penalty themselves; in addition, they did a great deal toward spreading the disease.

The military hospitals were also largely responsible for the dissemination of typhus fever; Parenteau-Desgranges[110] called them outright ‘centres de contagion’. The cities in which military hospitals were erected were always severely attacked by the disease. It was generally complained, even by the French physicians, that the French hospitals were poorly arranged and badly managed—even simple cleanliness and competent attendants were lacking. Patients suffering from infectious disease were placed together with others suffering from some mild form of sickness or from a wound, thus giving the infection the best conceivable chance to spread. Let us read how a French physician describes the conditions in Verdun during the severe epidemic of typhus fever that raged there in the years 1792–5:[111]

‘The disease spread with no less severity from other sources of infection, such as the temporary hospitals established in the Convent of Canons of Saint Nicholas, in the Monastery of Saint Vannes, and in the barracks. The unfortunate patients, thrown in heaps on the damp stone and earth floors, scarcely having under them a few mats, or perhaps some dirty straw, filthy with their excrement, three of them often sharing a single blanket of coarse wool, presented the most dismal picture one could possibly imagine. At least three-quarters of the patients died. They were buried in huge ditches dug in the vicinity of the ramparts, and in the gardens surrounding the abbeys of Saint Vannes and of Saint Nicholas.’

The German Central Hospital Management, which was founded in the latter part of November 1813, and from which Bavaria and Württemberg held aloof, sought to introduce certain improvements into the military lazaret system, but it was unable to accomplish a great deal, owing to the lack of hospitals, physicians, and all the means necessary for the treatment of sick and injured people.

Very dangerous for the dissemination of the disease was the belief that the placing of typhus fever patients together with other invalids did no harm, but rather that the congregating of numerous typhus fever patients by themselves caused the contagion to develop with especial severity. The Saxon staff surgeon Neumann, for example, writes in regard to this question:[112] ‘Anybody who lies in a bed to which the poison is still clinging will without fail contract the disease; on the other hand, I have often seen people suffering from other forms of sickness lie alongside of typhus-fever patients and escape infection, provided they had nothing in common, did not touch one another, or make use of one another’s linen. Hence I draw the conclusion that the poison of typhus fever, like the poison of bubonic plague and small-pox, cannot enter the system from a distance, not even from a very short distance, and can be communicated only by close and direct contact. This seems to contradict our experience that the intensity of the poison is greatly increased when several patients lie side by side. Accordingly, I warn all military physicians not to congregate all their typhus fever patients in a single room by themselves; for few would come forth from such a room alive, while the poisoned atmosphere of the room would pervade the entire lazaret, infect the physicians and attendants, and finally spread throughout the immediate neighbourhood. People think that they can prevent the disease from spreading by congregating and isolating the patients, but as a matter of fact this has the opposite effect. This is clear when we consider that the mere being together of unhealthy people causes the poison to develop, and that not only the people themselves, but also the very exhalations from their bodies, are sufficient to spread the infection. For example, if a considerable quantity of dirty clothes or linen is allowed to accumulate in a pile, and after a short time is picked up, the usual result is that the people who do the work experience a severe attack of typhus fever.’

Very often conditions made segregation impossible, even when it was desired, or else the French generals refused to permit it. Consequently, infection was so frequent in the hospitals that the disease at a very early date acquired the name ‘hôpital fever’ (fièvre d’hôpital).

The fact that the weather conditions exerted some influence was not to be overlooked; in the year 1813, when the warm weather began, the disease abated a little, whereas in the year 1814 it ceased altogether at the beginning of the warm weather. The reason for this was that the cold weather forced people to huddle together in houses, and that bathing and washing, particularly among the soldiers and poor people, was less frequently and profusely indulged in; another reason was that the heavier clothing worn in winter facilitated the breeding of vermin.

Failure to take measures of precaution, if the disease once broke out in a neighbouring place, also contributed greatly toward the dissemination of it. ‘If typhus fever was present in any military halting-place, frequently nothing was done to prevent it from infecting the next place, where it had not yet made its appearance; or, if anything was done, it was often merely to issue an order which was not complied with.’[113] At the same time, to be sure, one must take into account the fact that sheer ignorance rendered useful measures impossible. If this ignorance prevailed in the highest places, nothing better was to be expected of the small cities and towns.

That the ‘contagious typhus’ prevalent during the Napoleonic wars was the same disease which we call typhus fever is very certain. The physicians of the middle of the nineteenth century, when views of typhus and typhoid fever had cleared up somewhat, have confirmed this fact.[114] The descriptions of the disease are almost invariably reproductions of the same picture, the sole difference being that it was much more severe and fatal among the half-starved soldiers on their return from Russia, and among soldiers packed together in strongholds, than it was among people who were less afflicted by the war and who lived at a distance from the military routes.

As a rule, the disease broke out eight or nine days after infection. It began with a general indisposition, which lasted several days, or, if this indisposition failed to appear, with a chill, great languor, loss of appetite, and weakness in the limbs; frequently brain disorders also manifested themselves, at first in the form of a mild stupefaction, singing in the ears, violent headache, somnolence, or wild delirium. The exanthema usually appeared between the fourth and the seventh day. Hufeland describes it as ‘an outbreak of red spots, covering most of the body; they were mostly of a violet tinge, but were not sharply defined, and often gradually merged into the colour of the rest of the skin’. It was frequently asserted that the petechiae now and then failed to appear at all, even in severe cases. Jörg says expressly:[115] ‘Sometimes they broke out sparsely, one here and one there, and in such cases it was easy to overlook them.’ After the disease had progressed for two or three weeks the patient’s temperature went down, and there were few fatalities after the twenty-first day. Convalescence was of short duration, provided the outbreak had not been preceded by exhaustion due to hardships. In regard to abdominal and intestinal symptoms, great dissimilarity was observed; Hufeland states that when there were no complications, an autopsy revealed not the slightest change in the intestinal organs, and Horn says that ‘the colour of the intestines was often almost natural.’ The severity of the disease varied greatly; it was particularly fatal among the soldiers homeward-bound from Russia, more than half of whom died. It is frequently asserted that the majority of those who were thus directly infected succumbed to the disease, and that it carried away some ten per cent of the civil inhabitants who contracted it.

Of course it would be a mistake to say that all the epidemics of that time were epidemics of typhus fever; undoubtedly typhoid fever carried away large numbers of people, since it is to be assumed that the disease was endemic in many cities. But owing to the inaccuracy of the descriptions and the lack of autopsies, it is usually impossible to distinguish the diseases with certainty. Even when the results of autopsies were made known, the condition of the intestines was often described so inaccurately that we cannot even make out whether or not there were intestinal ulcers, which are the most important pathological-anatomical symptoms of typhoid fever. But the initial chill, the short duration of the disease (three weeks), the presence of petechiae, the rapid fall of temperature, and the shorter convalescence, all of which are ever-recurring symptoms, enable us to distinguish the epidemic of the years 1812–14 with certainty from typhoid fever.

Through the influence of the works of Hildenbrand and Hufeland the larger part of the medical world of that time came to look upon contagious typhus as a specific disease; other views, however, were vigorously supported, for example, by Markus of Bamberg, who held it to be an inflammation of the brain. The difference of opinion regarding the character of the disease was important, not only theoretically, but also practically, in view of the therapeutic practice of the time; for those who regarded the disease as an inflammation of the brain had naturally, in accordance with the methods then in vogue, to resort to bleeding. But all unprejudiced observers came to the conclusion that bleeding was harmful, and that it killed all the patients upon whom it was frequently practised. Very soon the beneficial influence of fresh air and cold came to be recognized, and the latter was often provided by means of cold-water baths and douches. ‘It was a universally confirmed principle, derived from experience, that the warmer the patients were kept, the more severe was the disease, and the colder they were kept, the milder the disease.’ How beneficial fresh air was for the patients was shown by the fact that those who were kept out in the open air withstood the disease much more easily than those who were kept shut up in houses and hospitals, and that it was much less dangerous to transport patients from place to place in the open air, than to keep them shut up in overcrowded hospitals. ‘Thousands of patients’, says H. Häser,[116] ‘survived even the most severe forms of the disease without human help of any kind. Many, especially physicians, attributed their recovery to the fact that for weeks at a time they were constantly being transported in the cold winter from one halting-place to another, and were not compelled to lie in overcrowded hospitals, where typhus fever and dysentery raged most terribly.’

In dealing with the epidemic of typhus fever of the years 1812–14 we have a double epidemic to consider. The one was disseminated directly by the returning remnants of the ‘Grand Army’, and after causing terrible devastation in East Prussia it spread, in a relatively milder form, to other parts of Germany. The other epidemic broke out during the great battles in Saxony, which lasted several months, and from there spread virulently over a large part of Germany. In order to avoid repetition, the following account will treat of the dissemination of the two epidemics jointly.

2. THE RUSSIAN CAMPAIGN AND TYPHUS FEVER IN RUSSIA[117]

Napoleon began to make preparations for his Russian campaign as early as the year 1811; troops were assembled in Westphalia, Hamburg, Saxony, Holland, on the Rhine, and near Verona, and several hospitals were founded, as in Danzig. An army of 550,000 men was organized to take part in the expedition into Russia; it consisted of Frenchmen, Germans, Italians, Spaniards, and Poles. How this army was destroyed on its march to and from Moscow, and in what a pitiable condition the remnants of it arrived in Germany, is well known. Since it is our purpose to point out here how that severe epidemic of typhus fever spread abroad from those remnants, we can deal but briefly with the prevalence of the disease in the army itself.

In consequence of the great heat, of the lack of drinking-water and good food, and of the continual bivouacking (the peasants burned and deserted all the villages along the way), the army suffered greatly even on the march to Moscow. After crossing the Polish border the soldiers were severely attacked by dysentery and diarrhoea; Kerckhoffs estimates that no less than 80,000 men were suffering from dysentery at the beginning of August 1812. Typhus fever broke out, very sparsely, to be sure, as early as the latter part of July, when the army arrived at Vilna; there were also cases in the hospitals at Minsk, Vilkomir, Globokie, and Mittau, but the disease was not yet so infectious as it proved to be later. After the battle of Smolensk (August 14–18) large numbers of wounded soldiers (between 6,000 and 10,000 according to various reports) were brought to that city, and from that time on, typhus fever and other diseases (hospital fever, diarrhoea, dysentery, gastric fever, &c.) continued to spread throughout the army. On September 14, Moscow was entered, and on September 15 the city was in flames. The army then had peace until October 19, when the return march began. During their sojourn in Moscow the soldiers were very improperly nourished, eating almost nothing but salted meat and fish, and drinking large quantities of wine and spirits. According to Lemazurier, the number of sick and wounded soldiers in Moscow was 15,000. The most common disease even in Moscow was typhus fever; according to Scheerer, when Napoleon’s army withdrew from the city it left behind several thousand typhus-fever patients, almost all of whom died—only the stronger patients were taken along on wagons.

The horrors of the return march are well known. Thousands froze to death in the extreme cold of November, horse-meat and melted snow were the sole means of nourishment, and any soldier who lay down was irretrievably lost. Between Moscow and Smolensk, which was reached on November 9, one-half of the soldiers who had started out from Moscow died; the number of sick soldiers was enormous, and typhus fever raged more and more extensively. On December 8 Vilna was reached, but there the army was not given a moment’s rest; two days later the Russians advanced and captured 30,000 of Napoleon’s soldiers who could go no further.

In pursuing the French army the Russians also suffered severely from diseases; according to Ebstein,[118] between October 20 and December 14, 1812, they lost 61,964 men, most of whom died of ‘nerve fever’ (typhus fever).

In Vilna, which was greatly overcrowded, typhus fever raged furiously. The large number of sick and exhausted soldiers that were left behind, owing to the extreme cold (the thermometer went down as low as –28° Réaumur) sought shelter, partly in private houses, and partly in hospitals. The latter, for the first few days after the arrival of the Russians, were in a terrible condition; sick men and dead men were packed together in the cold, unheated rooms, the former lying on rotten straw, completely deserted, and without care or nourishment. The corridors and courts were filled with dead bodies and with refuse of all kinds, while in the rooms themselves there was no less filth, since nobody removed the excrements. ‘The courts and corridors of the hospitals’, says Gasc, an eye-witness,[119] ‘were so covered with dead bodies that it was necessary to walk over heaps of them in order to enter the rooms.’

Not until after the Emperor of Russia arrived in Vilna was some semblance of order restored. But it was then too late; almost all the patients in the hospitals were infected with typhus fever, and according to Gasc and Lemazurier the great majority of the 30,000 French prisoners died. For owing to the long series of extreme hardships which the soldiers had undergone, the disease broke out in its most severe form, causing wild delirium, very large petechiae, abscesses, and gangrene. Many patients succumbed within twenty-four hours, and recovery was very slow for those who survived the attack.

In a short time the disease spread throughout the city, not so much because the soldiers were quartered in private houses, as because the Jews got possession of the clothes of the dead. Of some 30,000 Jewish inhabitants no less than 8,000 died. In February and March all classes of society, even the wealthiest people, were attacked. The disease also spread to the surrounding country; Lemazurier says that between the middle of 1812 and the beginning of 1813 some 55,000 bodies were buried in Vilna and vicinity, and that the estimates made in Wittepsk, Smolensk, and Moscow were in proportion. The pestilence spread southward and eastward, and according to Faure, in February 1813 thousands of French prisoners died in the overcrowded hospitals in Orel. The same writer says that all of the French soldiers who fell into the hands of the Russians succumbed to typhus fever.[120] We may safely assume that the civil inhabitants of all places in that part of the country were also attacked, even though we have no figures or statistics to confirm the assumption.

The pestilence also raged extensively in the region of the Baltic Sea; St. Petersburg was severely attacked by it. According to Parrot,[121] in the last months of the year 1812 there were a great many cases of ‘nerve fever’ in Dorpat; in Riga the military hospitals were overcrowded, and out of a population of 36,000 and a garrison of 20,000 there were 5,000 sick. The mortality in the hospitals was very high, since, on account of the extreme cold, two-thirds of the small windows were covered with boards and hay.

Regarding conditions in Warsaw we have more detailed information. According to Wolf,[122] two distinct epidemics raged there after the end of December 1812; the one was an epidemic of typhus fever (probably typhoid) and appeared only among the soldiers; the other was an epidemic of typhus fever, which did not attain to epidemic dimensions until January 1813, although a few isolated cases had been observed in Warsaw in the last months of the year 1812. ‘This disease was almost invariably accompanied by a spotted exanthema, which, if the disease was at first rather difficult to diagnose, often gave the first clue. In the case of many people the eruption was so severe and so general, appearing even on the face, that it resembled measles.’ The comparison with measles was also drawn by other observers. Typhus fever was conveyed to Warsaw by the Austrian auxiliary corps, and it quickly spread to the French hospitals, which were in a wretched condition. Later the Russian army also brought typhus fever to the city. A great many civilians in Warsaw contracted the disease; according to Wolf, the epidemic reached its climax in February, and lasted until the end of the year 1813. The lower classes suffered more than the upper classes from the disease, which, moreover, seems to have raged much more furiously in the vicinity of Warsaw than in the city itself.

3. THE APPEARANCE OF TYPHUS FEVER IN NORTH AND CENTRAL GERMANY

On the return march from Moscow to Vilna the remnants of the army had all taken the same route; for, though all bonds of discipline were loosened as far back as Smolensk, nevertheless the instinct of self-preservation kept all the soldiers from abandoning the common line of march. This was also the case during the march from Vilna to the Niemen, where the extreme cold caused untold suffering. After crossing the river, however, the few unfortunate soldiers who had survived the awful misery of the march, hungry, clothed in rags, with torn shoes, alive with vermin, with frozen and gangrenous limbs, scattered in all directions, some going home, and others to strongholds that were in the hands of the French. Thus typhus fever, with which all parts of the army were infected, was spread in a comparatively short time over a large part of Germany.

At first the eastern provinces of Prussia, through which these remnants of the army passed, were attacked by the pestilence; owing to the fact that so many were infected, measures of precaution were everywhere futile. ‘Adynamic fever’, says Kerckhoffs,[123] ‘spread also among the civilians, who were not only afflicted by the terrible scourge of our passing armies, but also became the victims of a murderous contagion. It was a fatal present which we gave them, and which caused such a high mortality among the inhabitants of the country through which we passed. Wherever we went, the inhabitants were filled with terror and refused to quarter the soldiers.’ In the more distant parts of Germany, in the western provinces of Prussia, in Bavaria, Baden, and Württemberg, where people had perceived the danger, it was easier, in the first months of 1813, to guard against the dissemination of typhus fever, since the number of returning soldiers was small and it was accordingly feasible to enforce orders regarding quarantine. With the approach of spring the disease began to abate a little even in the north and east; in the month of April it had almost entirely disappeared from the French troops there, while in May and June the condition of health among them, according to Kerckhoffs, was very good. But in July typhus fever broke out again, and since the Russian army was also infected with it, the disease became uncommonly widespread throughout Saxony and Silesia during the months of fighting that ensued. After the battle of Leipzig, when southern and western Germany were overrun by French fugitives and prisoners, typhus fever once more broke out in that part of the country with greater severity than ever before; even in the province of Brandenburg and in the adjacent regions the pestilence raged, having been borne thither by French prisoners.

In Lithuania, and East and West Prussia, typhus fever raged extensively in the winter of 1812–13. According to H. A. Göden,[124] who had charge of a large military lazaret in Gumbinnen, the epidemic spread continuously from the border of Russia to Berlin. ‘It appeared most virulently’, he says, ‘in the cities of Gumbinnen, Insterburg, Tilsit, Königsberg, Elbing, Marienwerder, Konitz, and Landsberg; it followed along the military roads, and broke out most severely in the halting-places and in those cities where French military lazarets were established.’ In Gumbinnen typhus fever broke out suddenly in the latter part of November, immediately after the arrival of the fugitives, and spread rapidly. At first it appeared in houses where officers and soldiers were quartered; as a rule, several members of a family contracted the disease simultaneously, and only rarely was one member spared. The pestilence raged most furiously in the months of January and February; the town had some 6,000 inhabitants, and frequently 20, 30, or 40 people, including entire families, died in a single day. In the military lazarets the mortality was considerably higher. In March the pestilence began to abate, and in May it disappeared altogether.

In Königsberg the pestilence began in the month of December 1812 and came to an end in May 1813; excluding the soldiers who died in the military lazarets, the following deaths were recorded there:

December (1812) 430 January (1813) 581 February 802 March 622 April 608 May 327 June 196 July 178 August 157 September 160 October 151

In the year 1812 there were 2,648 deaths in Königsberg, whereas in the following year there were 4,403. In the first part of January, when the city was evacuated by the French, 10,000 people, according to Stricker, were left behind. The entire province of East Prussia, according to Gurlt, lost 20,000 inhabitants by typhus fever.[125]

Danzig, which was besieged by the Russians from January 11 to November 29, 1813, suffered terribly. A French army of 35,900 men, under General Rapp, was in the city, and during the siege it was exposed to all sorts of privations as well as to extreme cold. As early as February typhus fever had become very widespread; from January to May, 11,400 soldiers died in the hospitals (4,000 in March alone), while 5,592 inhabitants succumbed to the disease in the course of the entire year.[126]

Silesia was hit extremely hard. The pestilence was conveyed there in the months of October, November, and December 1812 by transports of Russian prisoners, and it appeared in Trebnitz, Striegau, Krottkau, Friedenwalde, Trachenberg, Breslau, Parchwitz, Quaritz, &c. The officers on duty, the persons who lifted the patients from the wagons, the physicians, and the sick-attendants were always the first to be infected.[127] With the opening of spring the disease disappeared, but broke out anew after the battle on the Katzbach. In Breslau the disease appeared in a very virulent form, since the infected soldiers were housed there in overcrowded lazarets, which in the month of November took in some 6,300 patients daily; numerous physicians (statements vary between 16 and 22) also succumbed to typhus fever. Among the civil inhabitants, to be sure, the disease did not become very widespread; out of a population of 62,789, only 3,055 died in the year 1812, 3,095 in the year 1813, and 3,301 in the year 1814. From the middle of September 1813 to February 1814, 478 civilians and some 1,800 soldiers succumbed in Breslau to typhus fever; the total number of soldiers that died between the middle of September and the beginning of March was 3,400.[128] In the governmental district of Liegnitz, having a population of 600,000, according to Kausch[129] only 13 physicians (excluding the surgeons) died. The disease was borne by transports of infected soldiers into other parts of Silesia, and at the end of the year 1813 all the military lazarets in Silesia were infected. In Waldenburg and vicinity (Obersalzbrunn, &c.) typhus fever broke out after the soldiers had marched through on October 20 and November 25, 1813, and seventeen days later the disease was very widespread, all the members of many families having contracted it. In Bunzlau typhus fever raged with unusual fury; in the military lazaret 12,000 men are said to have died between June 1813 and March 1814.

Presently typhus fever appeared, with the arrival of the remnants of the Grand Army, in regions further away from the Russian border. Häser[130] describes the manner in which the disease spread, always along military roads, as follows:

‘French soldiers returning from Russia’, he says, ‘spread the contagion of various diseases over a large part of Central Europe. Almost naked, or clothed in torn and half-burned rags, without shoes, their feet covered with straw, and their frozen limbs covered with festering sores, they marched through Poland and Germany. Typhus fever and other diseases associated with it marked their course. The inhabitants of the country were forced to house the sick; but teamsters also conveyed the infection to villages which the soldiers did not visit. The disease raged most furiously in the hospitals, which scarcely anywhere were able to meet even the most modest demands made upon them.’

Regarding the appearance of typhus fever in Berlin we are informed by Hufeland and Horn.[131] First to occur there (in the months of February and March 1813) were numerous cases of ‘nervous fever’, which was doubtless typhoid fever. Still it is likely that cases of typhus fever also occurred at that time, for Horn, in writing about ‘nervous fevers’ in the Charité, describes the exanthema with the same words that Hufeland uses in reference to later cases. Among these patients there were already some who had returned from Russia.[132] At all events, in the first part of March 1813 there occurred cases of contagious typhus, which was brought to Berlin by French, and later by Russian soldiers; the observed ways of infection, regarding which Hufeland informs us, are mentioned above. In the middle of April there were 246 typhus-fever patients in the Charité. In order to prevent the disease from spreading in this hospital, Hufeland adopted strict measures of precaution. The patients were all carefully isolated on the second floor, which was shut off by means of a grating. The newly-arrived patients were supplied with clean, fresh linen, their clothing was disinfected for several days in hydrochloric acid, and then washed in boiling water containing lye, while objects of no value were burned. The sick-rooms were constantly ventilated by leaving the windows open, and were thoroughly cleaned every day. The physicians, surgeons, and attendants, before they entered the sick-rooms, had to put on black mantles of glazed linen, and on leaving the rooms they had to wash their hands and faces in cold water and rinse out their mouths. In this way the disease was prevented from spreading in the hospital itself.

After the battle of Leipzig typhus fever broke out anew in Berlin; according to Horn, 144 cases of ‘nerve fever’ were received into the Charité in January 1814, 92 in February, 54 in March, 14 in April, 8 in May, and none in June. Regarding the total mortality in the epidemic of typhus fever in Berlin, which in the year 1813 had about 155,000 inhabitants, the following table, compiled by Gurlt,[133] gives us information; there died in:

1812. 1813. 1814. _Total _Total _From _Total _From deaths._ deaths._ Typhus._ deaths._ Typhus._

January 422 500 31 680 170 February 457 544 57 596 118 March 444 740 233 781 85 April 476 719 227 653 55 May 584 752 184 443 28 June 396 518 85 434 19 July 417 460 29 541 14 August 338 551 20 454 5 September 370 467 22 577 16 October 425 621 34 430 13 November 356 555 105 412 11 December 571 585 157 565 11 ————— ————— ————— ————— ——— Total 5,256 7,012 1,184 6,566 545

Typhus fever appeared throughout the entire province of Brandenburg. Maier[134] gives us some information regarding the city of Brandenburg, where ‘infectious nerve-fever’ disappeared in the latter part of May 1813, and where, after the battle of Leipzig, it again broke out, but did not become very widespread. On October 27 prisoners from Baden and Hesse were quartered there; they remained until October 31 and then went on to Ruppin. Among them were some convalescents from a military lazaret in Saxony, who infected the occupants of all the houses in which the prisoners were quartered. Between November 5 and December 6 there were 38 ‘nerve-fever’ patients in the Altstadt and 7 in the Neustadt, a small number of whom died. Typhus fever raged very furiously in Jüterbog after the battle of Dennewitz, carrying away entire families.

After his defeat in Russia, Napoleon had quickly returned to France, and there, by means of new conscriptions, had in a short time assembled an army of very young men, who had never done military service and were therefore not accustomed to the hardships of war and, in particular, were much more susceptible to infectious diseases than the troops that had served under him before. In April, when the army of the Allies had arrived at the Elbe, Napoleon with his newly-gathered army left the Rhine and marched to Saxony, which from then until autumn was the main scene of the war. Since the Russian army was still infected with typhus fever, contracted in the winter campaign, and since, furthermore, isolated cases of the disease were still occurring among the remnants of the French troops that had returned from Russia, the inevitable result was that Saxony was not only completely impoverished by the protracted war, but was also terribly afflicted by war pestilences.

In Saxony typhus fever had already become very widespread in the first few months of 1813; all the places through which the military transports passed were attacked, as Sorau, Guben, Lübben, Görlitz, Leipzig, and Weissenberg; while places in which military hospitals were erected fared even worse, as Schneeberg, Zwickau, Chemnitz, Freiberg, and Augustusburg. The severe epidemic in Annaberg (in the Saxon Erzgebirge), lasting from March to May 1813, has been described by Neuhof.[135] In March a Saxon field-hospital was established there, and presently everybody who came in contact with the hospital contracted typhus fever. In neighbouring Thum, where the patients passed only one night, many citizens succumbed to the disease.

Dresden, in the first few months of the year 1813, was not attacked by the disease, notwithstanding the fact that soldiers and officers returning from Russia were taken sick and died there; only in rare instances were citizens, in whose homes officers had been quartered, attacked, and the disease did not rage at all extensively.[136] On the other hand, typhus fever raged furiously in Dresden after Napoleon’s successful battle at Bautzen (May 20 and 21, 1813), when large numbers of wounded soldiers were brought to Dresden and placed in lazarets, which soon became greatly overcrowded. The less-severely wounded were housed in the homes of citizens, who were compelled to receive them and suffered terribly in consequence of it. The result was that typhus fever spread from the soldiers to the civilians. After the battle of Dresden (August 26, 27), from which Napoleon again emerged victorious, but especially during the short siege of Dresden (from the middle of October to November 11), the epidemic increased in both extent and fury. The increased mortality is shown by the following table, which includes only the residents:

January 184 February 199 March 188 April 194 May 289 June 257 July 264 August 474 September 882 October 659 November 960 December 944

According to Fischer, one person out of every ten that contracted the disease died, while the mortality in the French military hospitals was incredibly high. In the course of the year 1813 no less than 21,090 soldiers died in Dresden, while in the same year 5,194 residents died; 3,273 civilians died in the year 1814, and 1,785 in the year 1815. The average number of deaths per annum among the civil inhabitants was 2,304.

Regarding the terrible conditions in Dresden at that time, a pastor informs us in a letter:[137]

It was a gruesome sight to see the wagons full of naked corpses, thrown together in the most horrible positions, drive away from the hospitals and set out for their destination. Many bodies are said to have been cast into the Elbe. The terrible days began about the middle of May, when many house-owners were obliged to quarter as many as two, three, and even four hundred men. Presently persons suffering from wounds, scurvy, and infectious disease began to arrive from Bautzen, some straggling along piteously on foot, others being rolled along in ghastly groups on pushcarts. This disease-spreading mass was now housed in the homes of citizens, since the twenty-five hospitals were no longer able to accommodate them. The houses, yards, streets, and public squares were full of dirt and refuse. Dearth of food, resulting from the breakdown of means of supply, added to the general misery. Entire families were wiped out, and many houses are still standing empty (1814). Wagons bearing the dead clattered on all the streets, and there were few inhabitants who did not wear some outward sign of mourning for lost relatives.

Leipzig suffered even greater hardships. The pestilence was conveyed thither by French soldiers in February 1813, and on the 27th of that month there were thirty-eight fever patients in the Jacobsspital. In the summer of 1813, when the war was going on in Saxony, the disease raged there furiously. After the battle of Dresden a large percentage of the wounded were brought to Leipzig, and more than 20,000 sick and wounded soldiers were kept there for several months. As usual, typhus fever broke out in the city in consequence of it, and carried away large numbers of soldiers and citizens. After the battle of Leipzig upwards of 30,000 wounded soldiers, mostly Frenchmen, were housed in the city. ‘Virulent nerve-fever,’ says Beitzke,[138] ‘which had been prevalent in the city for some time, now broke out with tenfold severity, not only in the city itself, but also in the surrounding country, and carried away large numbers of people. The arrival of the cold weather, which helped to check the disease, was under these circumstances a great blessing.’ In the year 1813 some 80,000 French soldiers, according to the hospital lists, succumbed to wounds, war-typhus, and other diseases, in Leipzig. From February 1813 to January 1814, seventeen young physicians died there of typhus fever. The number of civilians buried in Leipzig in the year 1813 was 3,499, in the year 1814 it was 2,022; the average number of interments in the years 1810–12 was 1,443, and in the years 1815–17 it was 1,187. The number buried (including the still-births, but not the soldiers) was, by months:[139]

1813. 1814. January 98 450 February 121 276 March 206 244 April 202 152 May 178 159 June 200 120 July 290 85 August 189 107 September 176 118 October 311 111 November 743 96 December 785 104

Most of those carried away were adults; the following table indicates the relation between the age of the victims and the mortality:

_Years of Age._ 1812. 1813. 1814. 1 356 517 456 1–10 161 310 305 10–20 29 174 76 20–30 91 362 157 30–40 87 492 173 40–50 104 559 207 50–60 126 409 208 60–70 124 358 234 Over 70 119 256 155

In reference to the year 1813, in which typhus fever caused the greatest devastation in Leipzig, we see how the mortality among persons between the ages of ten and sixty increased between fourfold and fivefold, while among very young children and very old men, it increased by at most one hundred per cent. In the year 1813 more men than women died (1,900 men and 1,599 women), whereas in the following year the reverse was the case (1,009 men and 1,013 women).

Typhus fever spread throughout all Saxony. In Plauen, which was at that time a city of 6,800 inhabitants, the following number of deaths, according to Flinzer,[140] were due to typhus fever: 4 in 1812, 32 in 1813, 59 in 1814, and 5 in 1815. These figures do not include the foreign soldiers that died. According to Flinzer, the specific disease before the year 1819 was usually typhus fever. In the year 1814 the total number of deaths in Plauen increased to 440.

Numerous sick, wounded, and captive soldiers were quartered in Zwickau after the battle of Leipzig. There and in the surrounding villages, in consequence of the erection of a hospital, typhus fever had already appeared in September, but in Zwickau itself, thanks to timely measures of precaution, it gained no headway. In the year 1812 only 183 civilians died there, 376 in the year 1813, and 260 in the year 1814; 380 soldiers died there in 1813, and 14 in the year 1814.[141]

The pestilences spread all over the country, even into the most remote corners of the Saxon Erzgebirge; Annaberg and the neighbouring towns of Marienberg, Weipert, and Geyer were again attacked, although less severely, according to Neuhof, than in the spring. In March the disease disappeared entirely.

The Saxon strongholds along the Elbe fared worst of all; regarding the terrible devastation caused by typhus fever in Torgau we shall have something to say in the tenth chapter. Magdeburg and Merseburg were also severely attacked; this is evident from the fact that one-half of the physicians in Magdeburg (nine in number) succumbed, according to Roloff, to hospital fever.[142] In Wittenberg, whither typhus fever was borne in February 1813 by infected French soldiers, and where it had subsequently disappeared, the mortality was very high during the siege, which lasted from October 28, 1813, to January 14, 1814; of 6,000 or 7,000 inhabitants, upwards of 4,000 had left the city before the siege began. In the course of seven months (July 1813 to January 1814) 590 people died there, whereas the average number of deaths had been only 300 per annum. When the city was captured by the Prussians the death-rate increased; no less than 331 persons died between January 14 and April 14, 1814.[143]

After the battle of Leipzig the defeated army marched back through Weissenfels, Naumburg, Weimar, and Erfurt to the Main. There was now no active effort made to supply food to the army, which still numbered some 100,000 men; the soldiers had to eat whatever they could pick up along the way. ‘Extreme misery and exhaustion’, says Beitzke,[144] ‘led to great excesses; the places along the route were made to suffer, and worst of all, the region through which the French army hurried back was generally infected with the germ of typhus fever.’ ‘The route of the army, clear to Mayence,’ says Giraud,[145] ‘was again strewn with corpses and débris.’

In Weissenfels some 3,000 soldiers are said to have died in the hospitals, and also 600 civilians, within a year. In Altenburg, which had suffered from typhus fever in the spring of 1813, 1,650 men and 55 officers died between October 2 and December 1 of that year. In Eisenberg (in Saxe-Altenburg), according to Greiner,[146] a lazaret was established in the fall of 1813, but there were but few cases of typhus fever transmitted to citizens owing to the adoption of all measures of precaution. On the other hand, the disease was conveyed to numerous near-by villages, in which large numbers of sick and convalescent soldiers were quartered. ‘The Cossacks did the most toward spreading the disease, for wherever any of them were quartered, one could count with certainty upon an early outbreak of nerve-fever.’ In November 1813, a severe epidemic of typhus fever broke out in Gera, and the mortality in four months was seven times as high as usual. In Zeulenroda (south of Gera) the pestilence was not very severe; it was brought there by sick and convalescent soldiers, who were quartered in the houses.[147] Jena, on the other hand, was very severely attacked: the epidemic began in November 1813, and lasted until March 1814.[148] According to Gurlt, the usual number of deaths in normal years in the districts of Weimar and Jena was from 1,750 to 1,850; but in the year 1813 no less than 3,948 people died there, and in 1814 there were 3,363 deaths.

After the battle of Lützen (May 2, 1813) some 8,000 wounded French and Prussian soldiers came to Erfurt, necessitating the immediate erection of lazarets. After the battles in August, when the scene of the war moved closer to Erfurt, the misery in the city was greatly increased, resulting in a rapid dissemination of typhus fever. In the latter part of August, when 9,000 sick and convalescent soldiers arrived in the city, the citizens were obliged to quarter them; the number of soldiers that succumbed to typhus fever was appalling, while as many as 17 civilians often died in a single day; in the week before the battle of Leipzig 504 soldiers died in the hospitals. On October 20–23 the French lazarets were cleaned out as thoroughly as possible. During the siege, which began on October 25 and lasted seventy-three days, the misery was extreme, and typhus fever raged more and more furiously. From November 1 to November 17 some 400 civilians died, while no less than 1,472 soldiers died in the military hospitals; 143 soldiers died on December 9 and 10. The houses of a few citizens were rendered absolutely tenantless. In the year 1813 Erfurt lost 1,585 citizens, as compared with an average of 554 for the years 1811–12; the number of deaths in the year 1814 was 1,121. Typhus fever also raged so furiously among the Prussian besiegers, that the lazarets were soon overcrowded, and it was necessary to house the troops in other places.[149]

In Fulda, which was forced to take in thousands of sick soldiers, typhus fever soon began to spread rapidly, as it also did in the country surrounding the city. In Giessen, where a Russian field-lazaret for 1,800–2,000 men was erected, the epidemic soon spread to the civil inhabitants.

At Hanau the French retreat was opposed by General Wrede with an army of 50,000 Bavarians and Austrians, a much smaller number than the French had. The two days of fighting that ensued (October 30 and 31, 1813) caused the pestilence to develop murderously. Kopp has given us a good description of this epidemic in Hanau.[150] Since the beginning of the war the city had always had a military hospital, which lay outside the city. During the battles in Saxony the number of sick and wounded increased, so that it was necessary to erect a second lazaret within the city. Many sick-attendants and sub-surgeons contracted typhus fever, which was prevalent in the hospitals, and several cases also occurred in the city, especially among people who quartered soldiers for money in their homes; many soldiers were thus crowded together in small rooms, and among them were a great many convalescents from Saxon hospitals. The infectious nature of the disease and its consequent dangerousness was shown by the fact that as a rule entire families gradually contracted it, although the epidemic was confined to individual houses. The engagement at Hanau, from which the French emerged victorious, resulted in the unfortunate city being stormed and plundered. ‘Even while the battle was going on,’ says Kopp, ‘a corps of the French army scattered throughout Hanau. This corps had brought with it from Saxony the germ of infection; for the region around Dresden could be looked upon as the great breeding-place where, in view of the enormous assemblage of people representing so many nations, and owing to the concurrence of so many unusual factors, the soil was uncommonly fertile for pestilential diseases.’ After the engagement a multitude of French prisoners, greatly weakened by hardships and hunger, came to the city. The dissemination of typhus fever was especially helped along by the fact that many poor inhabitants engaged in looting on the battlefield, and took home with them the knapsacks and other effects of the dead. The clothing of the dead came into the possession of those who were charged with burying them, and later got into the hands of the poorest families in the city and in the neighbouring villages. ‘I often entered the houses of poor people,’ Kopp goes on to say, ‘and found the entire family suffering from typhus fever, and on the walls of the low sick-room the uniforms, shirts, and other effects of the dead soldiers would still be hanging.’ The result was that the number of patients greatly increased after the battle, and in less than two weeks an epidemic began to develop; at first it was rather mild, but later on it carried away large numbers of people, and lasted until the end of February, having reached its climax in December. From December 1, 1813, to January 4, 1814, 248 people died, whereas the normal mortality for the month of December was but 30. The total number of deaths, including the soldiers, between October 26 and March 1 was 613, while in ordinary years only 125 people died, on the average. The middle class suffered worst of all, while of the upper classes three physicians and several clergymen died. Of the 192 typhus-fever patients that Kopp himself treated, 21 died (10·9 per cent), but these figures do not include a rather large number of very mild cases. People of all ages and both sexes were attacked; children suffered less than adults, while old people and heavy drinkers were the most liable to succumb. The disease lasted from two to three weeks; death usually occurred on the fourteenth to twentieth day, often somewhat sooner.

Frankfurt-on-the-Main suffered terribly in the year 1813 from enforced quartering. Even in the spring, after the newly-organized French armies had passed through the city, the Frankfurt lazarets were overcrowded with sick and wounded soldiers from Saxony, which was then the scene of the war. Accordingly it was decided in Frankfurt to build barracks adapted to the expected requirements; and in order to protect the city as much as possible from the infection of typhus fever, the barracks were erected outside the city limits, before the Allerheiligen Tor, and were situated in the Pfingstweide along the Main. The building of these barracks was a large and very expensive undertaking, but they undoubtedly served a very useful purpose by protecting the inhabitants for a considerable length of time against the infection of typhus fever.’[151] On September 21 and 22 large numbers of sick and wounded soldiers came to Frankfurt; they filled all the lazarets, and many of them had to be quartered in the homes of citizens. From that time on typhus fever began to spread throughout the city. Fortunately for Frankfurt, the retreat of the French army from Hanau to Mayence passed by the city, since the French generals were afraid that they would be unable to get their troops out of Frankfurt again. On October 29 all the sick and wounded French soldiers in the Frankfurt hospitals were taken out and conveyed by boat to Mayence. The hospital on the Pfingstweide, which had room for 1,480 patients, was immediately cleansed and made ready for the army of the Allies, who were marching into Frankfurt in large numbers. Typhus fever now reached its climax. The arrival of the German and Russian armies almost doubled the number of people in the city; the soldiers were quartered in the homes of citizens and immediately infected them with the pestilence. On January 14, 1814, there were more than 4,000 typhus-fever patients in the city alone, while in the district their number far exceeded 6,000. How the mortality among the civil inhabitants was thereby increased is shown by the following figures, which include only the deaths in the civil population:

July (1813) 86 August 83 September 93 October 103 November 328 December 289 January (1814) 264 February 248 March 212 April 132 May 135 June 76

Four physicians and seven surgeons succumbed to the epidemic in Frankfurt. Of 668 typhus-fever patients taken in by the Hospital zum Heiligen Geist, 100 died. Generally speaking, Frankfurt-on-the-Main fared pretty well, for the reason that most of the patients were housed outside the city; the lower classes, particularly servants and maids, suffered the most. In the city itself the disease was confined chiefly to the narrow streets of the Altstadt. In March and April the pestilence began gradually to abate, and in May it ceased altogether.

After leaving Hanau the retreating French army went on to Mayence and France. The great loss of human life due to typhus fever during the siege of Mayence will be discussed in the tenth chapter. Wiesbaden[152] was attacked very severely; 800 men are said to have died in the military lazaret there, while of the native inhabitants, who numbered 4,000 at that time, 466 contracted the disease and 141 succumbed to it.

From Mayence the pestilence spread and infected the Rheingau; the outbreak in Oestrich (below Hattenheim on the Rhine) is described by Thilenius.[153] In October sick and wounded French soldiers were taken down the Rhine, and in the latter part of that month 500 soldiers on three boats were held up by a severe storm at Oestrich, where the bad weather compelled them to remain for twenty-four hours. The patients, contrary to orders, left the ships and were taken in by the inhabitants of Oestrich. Before they went away fourteen of them died; a number had already died on the boats. On November 7 five or six citizens of Oestrich contracted the disease; before the 9th more than thirty had been taken sick, and on the 10th there were 93 typhus-fever patients in the city. All told, 330 people in Oestrich contracted the disease, and 103 succumbed to it. In the latter part of November neighbouring places were infected by dispersed French soldiers, by the small lazarets of the troops of the Allies, by visits to the sick, and by participation in funeral ceremonies. Particularly hard hit was the town of Kiedrich, where 336 people contracted the disease and 69 succumbed to it.

As in Oestrich, so in Winkel (near Rüdesheim), according to J. B. von Franque, the pestilence broke out on November 5, 1813, when a boat-load of infected French soldiers was driven ashore there; sixty or seventy of the patients entered the village of Winkel, where they were housed in a schoolroom. Presently a large number of the inhabitants (91 all told) contracted the disease, and 31 of them died. In the small neighbouring community of Espenschied the pestilence broke out in a Prussian military lazaret and spread to all the houses with the exception of one.

Kraft[154] gives us some interesting information regarding the appearance of typhus fever in Runkel-on-the-Lahn (above Limburg). This outbreak affords an example of how quickly the pestilence spread in small places. Shortly after the arrival of the Allies, traces of lazaret fever revealed themselves there, and in the latter part of November 1813, several sick soldiers were brought there and housed in the homes of citizens. Presently typhus fever broke out all over the town; in the first part of December the castle at Runkel was converted into a lazaret, and it was very soon filled with patients. The poor allowed themselves to be employed for short periods as sick-attendants, and the result was that they either contracted the disease themselves or else conveyed it to their homes; it was not long before the entire town, as well as the surrounding country, was infected. The convalescents from the military lazarets were not isolated in separate houses, but taken to the surrounding towns and villages (for example, Weyer, Villmar, Münster, and Erfurt), many of whose inhabitants were taken sick. The pestilence raged far and wide; at the climax of the epidemic (February to the middle of March) entire families lay sick, and a great many physicians and surgeons were attacked; the disease disappeared about the middle of May. In Runkel itself, which had 850 inhabitants, 214 contracted the disease and 70 died; the total number of deaths between December 1, 1813, and July 1, 1814, was 94, whereas the normal number of deaths for an entire year was but 17. In the village of Münster, which had 760 inhabitants, 86 were taken sick and 22 died; and in the village of Weyer, which had 727 inhabitants, 179 were attacked and 58 died; the average number of deaths per annum in both villages was 12. As in these small places, so in all the towns and cities the pestilence broke out wherever a sick soldier of either army passed.

From October 28 on, transports of half-dead typhus-fever patients for several days kept arriving at Limburg itself, where they were sheltered in a convent. In only eight days several inhabitants living near the lazaret, and also several sick-attendants and their families, contracted the disease. In consequence of the quartering of Russian and Prussian troops in the homes of citizens, and also in consequence of the erection of a permanent hospital in the city, into which hundreds of patients were received every day, typhus fever broke out with great severity among the inhabitants; the climax of the epidemic came in January. Of 600 civilians who contracted the disease 76 died.

In the Grand Duchy of Nassau, to which the last-named places (Wiesbaden, Oestrich, Rüdesheim, Runkel, and Limburg) belonged, and which had some 270,000 inhabitants, the number of people who contracted the disease and the number who died from it, according to the reports of the church and town authorities, was recorded for the period between October 1, 1813, and April 1, 1814. According to von Franque, the following figures were compiled in reference to the civil population in the Governmental Districts of that time:

_Governmental _Due to Typhus Fever._ _No. Deaths from District._ all causes._ 〃 _No. Patients._ _No. Deaths._ 〃 Ehrenbreitstein 11,522 2,409 3,680 Weilburg 2,173 419 680 Wiesbaden 29,349 6,179 8,099 —————— ————— —————— Total 43,044 9,007 12,459

Altogether, fourteen per cent of the population were attacked by typhus fever, and three per cent succumbed to it; scarcely a single community was spared.

Epidemics of typhus fever also occurred further down the Rhine; Coblenz, for instance, was severely attacked. According to Bernstein,[155] a small epidemic broke out in Neuwied in January 1814, having been borne thither by a Prussian corps under General Kleist, which left behind eighty-two sick soldiers, many of them suffering from ‘nerve-fever’. The disease spread in a rather mild form throughout the city, but lasted only four weeks.

Typhus fever likewise appeared in North Germany, which was not directly infected by French soldiers retreating from Leipzig. Hamburg was attacked with great severity. In March 1813, the Russian colonel, Tettenborn, by means of a bold _coup de main_ had captured Hamburg, but he was unable to hold it, and on May 30 the French returned. Marshal Davoust erected strong fortifications and drove out all the poorer inhabitants, most of whom had come from the neighbouring Altona, and thus made ready for a long siege, which did not begin until the end of the year, although the blockade was complete by the middle of January. Large quantities of filth accumulated in the streets, since all working-men were employed at the redoubts and hospitals. Food became more and more scarce. ‘On such a fertile soil’, says Th. Deneke,[156] ‘typhus fever flourished. The disease spread rapidly from the hospitals throughout the entire city, since not only were all arrangements wanting for the isolation of the patients, but half-recovered patients were actually discharged from the hospital and quartered in the homes of citizens. Of the garrison, which at the beginning of the siege numbered some 25,000 or 30,000 men, sixty or seventy, at one time as many as 100, died every day between the first part of February and the last part of March, and they were all buried outside the Steintor, close by the town-moat. No less than 10,700 bodies were interred there, 8,200 people having succumbed to typhus fever, and 2,500 to wounds; among those buried were numerous prisoners. Regarding the number of inhabitants that died we have no information. The condition in the hospitals must have been terrible; since there was not sufficient room or the proper facilities to take care of the patients, the physicians and attendants did their duty only under constraint, and the managing officials in many instances grossly abused their authority; one of them, the director of the Legert Military Hospital, for example, ended characteristically by becoming in 1824 the leader of a band of robbers in France.’ Seven physicians fell victims to the pestilence in Hamburg. The city did not surrender until May, after the capture of Paris, whereupon typhus fever appears to have disappeared quickly.

From Hamburg typhus fever was conveyed by fugitives in all directions; Altona was attacked with particular severity. As mentioned above, thousands of the poor driven from Hamburg had been received in Altona. ‘The people, driven from their homes by fear,’ says Steinheim,[157] ‘streamed through our gates and went about seeking shelter. At the same time the gates of Hamburg were closed, and swarms of unhappy people, the dregs of Hamburg’s population, straggled with the sad remnants of their property, bent over more by sorrow than by the weight of their burden, through our gates and found protection, nourishment, and shelter in our homes; it was a heart-rending sight.[106] They were housed, partly in barracks, stables, and barns, and partly in the houses of the lower-class citizens, whose homes were thereby ‘so crammed full that not a single corner was left unoccupied by some poor stranger’. More than 17,000 refugees were received in Altona, whose normal population at that time amounted to some 24,000. At the beginning of January, when the very cold weather came (the thermometer often went down as low as –20 degrees Réaumur), all the cracks and openings in the doors and windows were stopped up to prevent the entrance of the outside air. In the latter part of December 1813, typhus fever broke out in these overcrowded quarters and carried away large numbers of people. The exact number is unknown; according to Mutzenbecher 1,138 fugitives, all told, died in Altona. According to other reports sixty-eight per cent of the patients in the hospital succumbed. The epidemic reached its climax in March, and with the coming spring it began to abate, partly because it became feasible to house the fugitives in better quarters, and partly because the warmer weather rendered better ventilation possible.

The disease was also conveyed from Hamburg to Eppendorf, but no information regarding the number of deaths there is available.

In Lübeck typhus fever broke out in March 1814, among refugees from Hamburg, and carried away 613 people. According to Gurlt, typhus fever was conveyed to Bremen, partly by the army of the Crown Prince of Sweden, and partly by fugitives from Hamburg; the epidemic is said to have been rather mild.

In Mecklenburg typhus fever began to spread after the erection of a military lazaret in Malchow (October, 1813), and after the erection of a second lazaret by the Swedes in Wittenburg (near Schwerin).

In Kiel typhus fever did not appear until the beginning of the year 1814; Weber[158] attributed the outbreak there to the Swedish military lazaret, in which physicians and nurses frequently contracted the disease. At first the poorer people were attacked (probably because the sick-attendants were of that class), and later the well-to-do. The pestilence, mild at first, soon became very severe. The disease also broke out in other places in Holstein; Pinneberg was severely attacked, and the disease was also observed in Schleswig. It is remarkable that, according to Weber, no exanthema was observed in Kiel; it must, however, have been present in a scarcely noticeable form, since a rash appeared on the entire skin of convalescents. The disease always began with a chill, and was characterized now by obstinate constipation, now by diarrhoea; no patient who survived the thirteenth day died. And even if an exanthema was not observed, there can be no doubt that it was typhus fever which raged in Kiel. Weber himself calls the disease contagious typhus.

4. THE APPEARANCE OF TYPHUS FEVER IN SOUTH GERMANY

Typhus fever was conveyed to various places throughout South Germany by the few soldiers that returned from Russia. Nowhere did it become very widespread, since the authorities soon realized its dangers and prevented it from spreading by means of appropriate measures of precaution. A change took place, however, after the battle of Leipzig, when large numbers of fugitive and captive French soldiers came into the country, and when troops, particularly Russians, kept constantly marching back and forth across the country and spreading the infection. Another important cause of the appearance of the disease there was the fact that lazarets were erected in South Germany during the campaign in France, for the purpose of sheltering the sick and wounded soldiers that were transported back from France.

Regarding the dissemination of typhus fever in Bavaria we are very well informed in a dissertation by F. Seitz.[159] As among other divisions of troops, so also among the Bavarian division, typhus fever raged extensively. On the march from the Vistula to the Oder thirty or forty men contracted the disease every day, and some of them also suffered from diarrhoea, dysentery, and other diseases; so that when Crossen-on-the-Oder was reached only 113 officers and 2,253 men were left. During the sojourn in Crossen and during the march through Saxony in March, the number of the patients increased, and by the middle of March there were only 1,000 able-bodied men left. Thus they arrived at the Bavarian border. ‘The rumour of the wide prevalence of nerve-fever in North Germany,’ says Seitz, ‘and the apprehension that the disease might be conveyed into Bavaria by soldiers returning from the field of battle, had preceded the arrival of the first warriors. Nevertheless people did not wish to forgo the pleasure of sheltering in their homes the soldiers, who had been exposed to so many hardships and privations, and of helping them to forget their past troubles; and in performing this philanthropic duty they lost sight of the necessary caution which prudence demanded.’

The infection of an entire family in Regensburg by a soldier discharged from the hospital (in February 1813), and reports regarding infection in other places, resulted in the adoption of strict measures in the border-towns. All returning soldiers, if it was suspected that they were infected with disease, were examined by a commission, and if the suspicion was confirmed by this commission, they were not allowed to be quartered in the homes of citizens, but were obliged to find shelter in barracks and lazarets, or in suitable buildings outside the town. Patients were sent to the military hospitals of Bayreuth, Bamberg, and Plassenburg (near Kulmbach); as soon as these hospitals were filled up, a new one was erected in Altdorf. Strict isolation of the patients was enforced, and this prevented the further dissemination of the disease among the civil inhabitants. To be sure, a few people contracted the disease after coming in contact with soldiers; for example, in Amberg, Sulzbach, Burglengenfeld, Grafenau, Cham, Nuremberg, &c. On the other hand, there were a great many typhus-fever patients in the military hospitals, especially in Bamberg. There typhus fever caused a high mortality among the soldiers; but, thanks to strict measures of precaution, only a few civilians were taken sick (about 100 out of 20,000 inhabitants), while of several physicians that contracted the disease only two succumbed to it. About the middle of the year 1813 typhus fever disappeared in Bavaria, without having demanded many victims. The ‘nerve-fevers’, which were prevalent during the summer (for example, in Regensburg from July to September), are not regarded by Schäfer as contagious, and must be looked upon as cases of typhoid fever.

In November, on the other hand, after the battles near Leipzig and Hanau, typhus fever broke out suddenly in many places in Bavaria, and in December raged furiously. The orders, issued in the spring of 1813, prohibiting all persons suspected of carrying disease from crossing the borders could no longer be enforced. Says Seitz:[160] ‘When French prisoners began to march across the country on their way from Saxony and Würzburg to Bohemia, the pestilence spread among the inhabitants of the cities and of the flat lands. Typhus fever raged in its most terrible form among these poor prisoners of war; many succumbed to it in various places along the route, and thousands died in the hospitals. That the disease, which haunted all defeated armies like a ghost, would necessarily reap an abundant harvest among them, was clear to every physician who observed the physiognomies of these warriors as they were being led away in captivity from the vicinity of their fatherland into remote regions. Their pale faces and emaciated forms bore witness to hunger and sorrow, to a long deprivation of the usual necessaries of life and to lack of vital energy, to exhaustion caused by the long marches from Hanau to Leipzig, when in the ardent struggle to reach their fatherland they had used up their last ounce of strength. Whosoever was brought by profession, sentiment, or curiosity into contact with these unfortunate soldiers sooner or later contracted the disease. Physicians, police-officers, servants, national guards (who watched over the prisoners), country-people (who carried the patients), messengers (who brought food to the soldiers in their quarters), were as a rule the first to be attacked.’

The Grand Duchy of Würzburg was next attacked. In Würzburg itself, where there were 2,000 or 3,000 French patients in the hospitals, the pestilence broke out furiously wherever the soldiers went. In Miltenburg more than 100 persons contracted the disease in the latter part of December; in the district of Mellrichstadt the number of typhus-fever patients was 429 (121 deaths), and in the district of Bischofsheim there were 1,067 patients and 328 deaths. According to Seitz, the number of deaths throughout the entire Grand Duchy of Würzburg, which at that time had a population of 344,500, was 2,500, while no less than 16,000 people contracted the disease. In Nuremberg the pestilence did not become very widespread; it broke out in the first part of November and lasted until the middle of January; 150 persons, all told, contracted the disease. Dinkelsbühl was severely attacked; in the month of November a large number of French prisoners suffering from typhus fever and diarrhoea were housed there in the Carmelite Monastery, and in a short time some 200 of them died. Between the 25th and 30th of November typhus fever spread to the civil population, and, in a few days, more than 100 people contracted the disease and 10 died; the number of patients increased until December 12, and then decreased, until the pestilence disappeared in the latter part of January; 448 persons, all told, contracted the disease and 89 succumbed to it. In the middle of November it was conveyed by a transport of French prisoners to Bamberg, where it spread with such fearful rapidity in the military hospital there, that twenty persons died every day and all the sick-attendants and medical assistants contracted it. The disease soon spread throughout the city, even infecting people who had in no way come in contact with the sick prisoners. Epidemics of typhus fever were reported in twenty-one villages in the surrounding country.

All Upper Franconia, through which transports of prisoners were taken to the Bohemian border, suffered terribly from the pestilence. The disease was first observed in the towns and villages lying to the north of Bamberg, whither it had been conveyed by dispersed troops immediately after the battle of Leipzig (in Nordhalben, Hof, and other near-by villages). Later on it also appeared in the districts further south. The region between Bayreuth and Münchberg was, comparatively speaking, less severely attacked. On the other hand, typhus fever raged furiously in the military hospital on the Plassenburg, where at the end of December there were some 700 persons suffering from the disease. In Kulmbach, a town lying at the foot of the mountain, more than 100 persons contracted the disease.

While French prisoners were bringing typhus fever into the country from the west, Austrian and Russian troops were also bringing it from the east. To be sure, the authorities were enjoined to restrict the foreign troops to the use of ten military roads that passed through the country, but the Austrian and Russian leaders frequently ignored these instructions. Consequently the pestilence spread over the entire region, a fact which Seitz confirms with numerous specific instances; regarding the extent to which it raged in Munich, he gives us no information.

Typhus fever was conveyed to Regensburg by French prisoners. ‘Toward the end of the month [December],’ says Schäfer,[161] ‘typhus fever was conveyed to Regensburg by French prisoners, some of them sick and some of them well, but all of them scantily clad and half-starved. They were quartered in the dance-halls, and those that were sick were taken to a convent which had been hastily converted into a hospital. There the civil inhabitants, owing to the lack of appropriate arrangements, were obliged to distribute food among the sick, and the result was that the fever finally became general. Not until then was the advice which the physicians had given at the beginning heeded; they had urged, namely, that the patients should be cared for by the hospital-attendants themselves, that each one should have his own separate attendant, and that only those persons should be allowed to enter the hospital whose presence was absolutely necessary.’ By February, according to the official report, 308 persons, all told, contracted typhus fever in Regensburg, and 51 succumbed to it.

In Ingolstadt an unusually severe epidemic broke out after the arrival of the French prisoners. In the first part of December the number of prisoners that died every day was no less than ninety, but after the middle of the month the mortality was somewhat lower. On December 18 there were 845 typhus-fever patients in the hospitals, and the number of deaths on this day amounted to only twenty-seven. From then to the end of the month only fifteen or twenty persons died per diem. On December 10 several civilians contracted the disease; on December 18 the number of civilians suffering from the disease was thirty-six, and about an equal number on December 30. The total number of deaths among the prisoners of war amounted to 2,000. Typhus fever also appeared along the Danube on both sides of Ingolstadt.

In the course of the winter, typhus fever was also borne into southern Bavaria by Austrian troops; it broke out in the towns along the military road, e.g., in Vöcklabruck, Traunstein, Rosenheim, and Landsberg. Places which the soldiers did not visit were also attacked by the pestilence. In Weilheim (west of Lake Starnberg) the disease broke out repeatedly after soldiers had marched through the place; up to April 8 no less than 885 persons had contracted the disease there, and some 100 had succumbed to it.

According to Seitz, 18,427 cases of the disease and 3,084 deaths attributable to it were officially recorded in Bavaria between October 1813 and June 1814; the lists kept by the Governmental Districts were undoubtedly very incomplete, but on the other hand we must assume that the contagious and non-contagious ‘nerve-fevers’ (typhus and typhoid) were not always distinguished. For the several districts Seitz furnishes us with the following figures relating to the number of people who contracted and succumbed to typhus fever:

_The Region of the_ _No. Patients._ _No. Deaths._ Main 5,752 1,067 Rezat 2,135 32 Regen 1,627 290 Upper Danube 4,613 1,003 Lower Danube 1,338 270 Salzach 1,815 259 Isar 1,147 163

This does not include the number of deaths among the prisoners of war, nor among the native and foreign soldiers. For the Main region, Seitz also furnishes figures relating to the age of the patients; of the 5,752 persons who contracted the disease 453 were children, 1,345 were young men and women, 3,657 were of middle age, and 297 were old men and women.

As in Bavaria, so also in Württemberg, typhus fever broke out in two epidemics; the first, which was less extensive and less severe, was caused by soldiers returning from Russia, and the second broke out in consequence of the passing of troops through the country after the battle of Leipzig. According to Elsässer,[162] in the first part of the year 1813 there were 165 cases of typhus fever and twenty deaths due to it reported from fifteen different localities. In the month of July the disease disappeared from Württemberg. At the end of the year 1813, however, the disease was again borne into the country, partly by French prisoners, and partly by Russian soldiers. ‘Throughout Württemberg’, says Lohnes,[163] ‘this fever appeared wherever foreign troops had tarried. Consequently contagious typhus first appeared in the northern lowlands, while the region around Tübingen and the southern and eastern part of the country at the beginning did not suffer at all. But in December, when large bodies of troops marched through the highlands, the southern part of Württemberg, these fevers followed the soldiers’ lines of march. At first it was the French prisoners who carried lazaret-fever with them wherever they went, and a very severe form of the disease too; later on, these fevers always broke out wherever the Russian soldiers went, although very few of the soldiers themselves were infected with them. Frequently persons contracted the disease who had no sick soldiers in their homes. As a rule the disease in such cases was mild, but it was very dangerous wherever patients were left or congregated in large or small hospitals.’

As early as the month of February, the disease had reached its climax in Württemberg; in March it began to abate rapidly, so that in the first part of the summer only 150 patients could be counted in fifteen Governmental Districts. From then until the end of the year it broke out only sporadically. Braun,[164] who asserts that more than half of the physicians in Württemberg contracted typhus fever, mentions the names and residences of seventeen physicians who succumbed to it; we see from this list that the disease was prevalent throughout all Württemberg. The disease was also conveyed to the southern part of Upper Swabia. According to Dillenius, 1,300 sick soldiers were sent in the first part of the year 1814 from France (especially from Mülhausen in Alsace) to the military hospital at Tettnang; twenty-four of them died on the way, and in the course of the following four months five times as many succumbed to typhus fever in the hospital.[165]

Baden suffered severely from typhus fever; in Karlsruhe, for instance, typhus fever raged from October to December 1813. But Baden suffered particularly, for the reason that all the sick soldiers in the Bohemian army were sent back there from France. Their number far exceeded all expectations, since typhus fever was uncommonly prevalent in the field army in France, and the soldiers arriving from there infected the hospitals. Even when the Austrian and Russian troops marched through the country the number of ‘nerve-fever’ patients was very large. Freiburg im Breisgau, at that time a city of 9,000 inhabitants, suffered very severely in consequence of enforced quartering; some 210,000 soldiers were housed in the homes of its citizens. In the garrison lazaret and university hospital, which together had room for 500 patients, no less than 1,200 patients were crowded together in December 1813; almost all of them were suffering from diarrhoea and typhus, and owing to the lack of linen they were compelled to lie in their own dirty clothes on sacks of straw. Every morning two large wagonloads of dead bodies were driven away for burial. As usual, the pestilence spread to the civil population, carrying away entire families. On October 12, 1813, the former Abbey of Thennenbach was converted into a military lazaret, in which two weeks later some 1,200 patients were sheltered, although it had adequate room for only 700. Between December 27, 1813, and March 1814, 567 soldiers succumbed there, most of them to typhus and dysentery. The epidemic reached its climax about the middle of January, when as many as thirty persons died per diem. After the middle of January the number of deaths rapidly decreased.[166] Northern Baden was also attacked. In Mannheim the sick and wounded French soldiers who arrived after the battles of Lützen and Bautzen were led around the city and taken to Spires. Thus typhus fever did not appear in Mannheim itself, where the condition of health was subsequently also good. The statement of the _Rheinische Merkur_, that out of 13,000 patients in the military lazarets in Mannheim 3,347 died, according to Gurlt,[167] is incorrect; the number of deaths was no more than 346.

Regarding the total number of deaths due to typhus fever in Baden no information is available; at all events it was very large. This is shown by the fact that in the last part of 1813 and first part of 1814 no less than thirty-five physicians and thirty surgeons of the first class fell victims to the pestilence.[168]

In November 1813, thousands of scattered French prisoners came to Darmstadt; many of them were suffering from typhus fever, which soon spread throughout the city. Many places in that part of the present Grand Duchy of Hesse which lies south of the Main were severely attacked by the epidemic; as many as 2,000 or 3,000 inhabitants of many places contracted the disease. But by July 5, 1814, it had everywhere disappeared.[169]

5. TYPHUS FEVER ON THE LEFT BANK OF THE RHINE; FRANCE AND SWITZERLAND

The continued retreat of the French army passed from Mayence through Metz to Paris, and the route of the retreat was marked by patients left behind. In this way the epidemic of typhus fever was quickly transplanted to the north-eastern part of France. Alsace-Lorraine, the Palatinate, Champagne, and Burgundy were all attacked in succession. The epidemic raged from Kreuznach to Strassburg; the dispersion of the retreating army caused even the smallest villages to suffer, so that the pestilence appeared in Worms, Frankenthal, Spires, Oppenheim, Neustadt-on-the-Hardt, Dürkheim, Landau, Alzey, Trabach, Zweibrücken, Weissenburg, Hagenau, Zabern, and in other places. Mörs (near Frankenthal) was almost completely wiped out.[170] The following places in France are mentioned as having been attacked by the pestilence: Saint-Avold, Courcelles-Chaussy, Mars-la-Tour, Sierck, Cattenom, Pont-à-Mousson, Toul, Nancy, Étain, Verdun, Bar, Longwy, and Sedan. Thouvenel describes the epidemic of typhus fever in Pont-à-Mousson, which broke out in December 1813, when transports of sick soldiers arrived there, and spread to all the surrounding towns and villages; it increased in severity until the middle of March, and by June had almost disappeared. He describes in emotional language the endless succession of wagons that arrived every day:[171]

Who of us will not remember as long as he lives those harrowing scenes, which one cannot describe without shuddering? Who will ever forget those hundreds of wagons filled with unhappy wounded men who had had no medical care since leaving Leipzig; and packed in with them were sick men suffering from dysentery, typhus fever, &c., almost all of them dying of inanition, weakness, and filth, as well as of disease. Those unfortunate men piteously begged only for a place in a hospital already filled with dying men, only to receive in reply a forced refusal. And so they were under the cruel necessity of going further to die, with the result that they infected all the towns and villages along their route, wherever they were granted a generous hospitality.

Strassburg, comparatively speaking, suffered but little. As early as December 1, the prefect of Strassburg had issued orders that a special building should be set aside in every town for the reception of sick soldiers that arrived there, and that they should under no circumstances be housed in the homes of citizens. In October and November convalescents had been quartered in the residences of citizens, who had subsequently been infected. In November the number of typhus-fever patients, which averaged ten or fifteen per month, increased to thirty-six, and in December to 100. In accordance with the above-mentioned decree all newly-arrived soldiers were examined by a Board of Health; the sick were sent to the hospital, and the healthy were quartered with citizens. ‘Notwithstanding this,’ says Reisseisen,[172] ‘the healthy ones infected a large number of inhabitants through their old woollen overcoats, which were thoroughly saturated with the miasma of the hospitals. The clothes that were sold privately were particularly dangerous, so that in the latter part of December strict orders were issued to keep watch for the old clothes and burn them. In the first part of January, when the rather lax siege began, typhus fever spread irresistibly throughout the city; in that month the pestilence reached its climax with 175 deaths. On January 22 the prefects ordered general fumigations in all public buildings, and recommended that the citizens should also fumigate their homes. The result was very successful; in February 112 people died, in March 75, and in April 27, and then typhus fever disappeared. No foreign troops marched through the stronghold, and although all the French prisoners of war passed through the city, no more citizens were infected by them, for the reason that they were quartered in the fortifications.

The devastation caused by the pestilence in Metz was no less than frightful. Maréchal and Didion[173] give us a picture of this severe epidemic. On November 19, 1813, some 5,000 sick soldiers were assigned to that city; it was necessary to see that they were sheltered, and at the same time measures were adopted to prevent the disease from spreading. According to the report of the astute Mayor of Metz, Baron Marchant, the 5,000 soldiers, all of them suffering from an infectious disease, arrived, and sixty of them died every day. All the physicians in Metz contracted the disease, and several of them died. It was impossible to procure sick-attendants, since those who had performed this service had all contracted the disease, conveyed it home, and infected their families. Sick soldiers who were quartered privately, and particularly convalescents, also helped to spread the disease throughout the city; more than 150 houses were infected. In the latter part of December the number of patients greatly increased. On January 1, 1814, after Blücher had crossed the Rhine, the Germans marched against Metz, and then an enormous crowd of people from the surrounding country fled to that city for protection. This caused typhus fever to spread far and wide throughout the city. Furthermore, sick and exhausted soldiers were constantly being sent to Metz, and it is estimated that some 30,000 of them arrived there. The worst month was February, and 7,752 soldiers, all told, died in six months:

November 463 December 1,602 January 1,360 February 2,365 March 1,622 April 340

1,294 civilians also died, the largest number (371) likewise in February. In the entire Department of Moselle, which at that time had some 400,000 inhabitants, no less than 10,329 people succumbed to this epidemic, and this number does not include the soldiers.

Regarding the wide dissemination of typhus fever in the Departments east and south of Paris, which formed the scene of the war in the first part of the year 1814 (the Departments of Haute-Marne, Côte-d’Or, Aube, Yonne, Marne, Seine-et-Marne), no further information is available. Troyes, Besançon, Dijon, Avallon, and Auxerre are mentioned as places that were attacked by the pestilence.

In Paris, cases of typhus fever occurred in February, when the war moved closer to that city. The sick and wounded soldiers were consequently obliged to go to the hospitals in Paris; but since these were neither large nor numerous enough to accommodate so many patients, it became necessary to open several provisional hospitals in appropriate buildings. At first all the typhus-fever patients were taken to the Hôpital de la Pitié, but it soon became necessary to change this policy, since the disease had spread throughout all the wards of that building. In the latter part of February the first cases of typhus fever appeared in the city, in consequence of the return of many soldiers to their own families. In March more and more people contracted the disease, which toward the end of the month was raging furiously, though more in the hospitals than in the city. In the Hospice de la Salpêtrière, which had been converted into a military hospital and began to be used on February 9, 1814, a small number of persons contracted typhus fever in the latter part of March, and in the months of April and May the disease spread; after that, however, it began to abate. A great many nurses and attendants were taken sick.[174] In April a large number of people in the city were lying sick with typhus fever. In one boarding-school, from which several persons visited the hospitals and brought typhus fever home with them, thirty people contracted the disease and four succumbed to it. In May cases of typhus fever became more rare, and in August no more people contracted the disease. The mortality in Paris in the year 1814 was very high; whereas in the years 1812 and 1813 the number of deaths had been 20,133 and 18,676 respectively, in the year 1814 no less than 27,778 people died, which number includes 2,559 soldiers that died in the hospitals. In the year 1815 the number of deaths decreased again to 19,992. How large the number of deaths due to typhus fever was, it is impossible to state with certainty, since in the case of only a small number of the persons who actually died of typhus fever was that disease recorded as the cause of death. The rubric ‘fièvres putrides et adynamiques’ increased in the year 1813 from 1,337 deaths to 2,860 deaths, and the rubric ‘fièvres malignes ou ataxiques’ from 804 to 1,376.[175]

Owing to the overcrowded condition of the hospitals in Paris, soldiers were conveyed upon a number of boats on the Seine to Rouen. Since sick and wounded men were thus transported together, typhus fever was conveyed to Rouen, where it carried away large numbers of persons employed in the hospitals. In the same way, sick and wounded were transported to points on the Loire, causing typhus fever to spread to Tours, where 860 soldiers succumbed to it.[176]

The proximity of the scene of the war in January and February 1813 caused typhus fever to break out in the Swiss Cantons lying close to the French border; for example, in the cantons of Basel-Stadt, Basel-Land, Neuenburg, Solothurn, and Waadt. The number of deaths in these cantons was:[177]

_Year._ _Basel-Stadt._ _Basel-Land._ _Neuenburg._ _Solothurn._ _Waadt._ 1812 442 867 1,041 1,349 3,705 1813 425 748 1,014 1,072 3,186 1814 721 1,679 1,335 1,844 3,475 1815 479 812 1,220 1,240 3,267 1816 355 710 1,234 3,720

According to A. Burckhardt,[178] lazaret-fever broke out in Basel with extraordinary fury when the Allies passed through that city; it raged particularly among the foreign soldiers, but also attacked the attendants in the hospitals and the civil inhabitants. The number of deaths caused by it is unknown.

6. TYPHUS FEVER IN AUSTRIA IN THE YEARS 1813–14.[179]

The country in Austria which was most exposed to the ravages of the epidemic of typhus fever was Bohemia, along whose borders the war was for a long time carried on. As early as February 1813, ‘nerve-fever’, accompanied by petechiae, was borne by Bavarian and Prussian troops into the district of Königgrätz, but thanks to energetic and strict measures of precaution, it did not become very widespread. The principal outbreak of the epidemic in Bohemia took place in the autumn of the year 1813. The number of typhus-fever patients taken into the Prague hospital in September 1813 was 39, in October 77, in November 196, and in December 287.[180] The region along the Saxon border suffered the most: e.g. the districts of Leitmeritz, Saaz, Rakonitz, and Elbogen. In the Leitmeritz district typhus appeared in August, and became more severe in September and October; the places along the military road leading from Dresden to Prague were particularly hard hit. The epidemic lasted until April. In the near-by Kaurzim district sick and wounded soldiers of all nations arrived, after the battles of Pirna, Dresden, and Kulm, causing a virulent epidemic to break out everywhere; in many places all the inhabitants contracted it. In the latter part of the year, when the pestilence seemed to have abated a little, it broke out anew when the French garrison was being taken from Dresden to its place of detention; in fourteen days 2,422 persons in sixty places contracted the disease, which disappeared in May. Typhus fever had spread over 103 localities, all told, in that region, and of 8,066 people who contracted it, 751 succumbed. In the Saaz district typhus broke out in the last part of October 1813, and carried away large numbers of people; it raged all along the military road in the vicinity of the scene of the war. The highest mortality was in the month of December, and in May the pestilence disappeared. In the Rakonitz district entire communities lay sick in the first part of the year, but in April no new cases of the disease occurred. In the Elbogen district typhus fever broke out in September 1813 in the city of Eger, in consequence of the arrival of French prisoners and fugitives; the epidemic soon spread over the entire district, and lasted until March 1814.

The rest of Bohemia suffered less severely from typhus fever in the winter of 1813–14. In the Beraun district, lying to the south-west of Prague, it began in October 1813, when the homes of the citizens became crowded with convalescing soldiers; the epidemic came to an end in March 1814. The number of people who contracted the disease was 3,807, while the number who succumbed was 296. The adjacent districts of Pilsen and Kattau were likewise attacked; in the Pilsen district typhus fever broke out in October 1813, in consequence of the arrival of French prisoners; a number of places were infected by them, so that in November and December it developed into an epidemic, which lasted until April. Of 1,185 people who contracted the disease, 237 died. In the Kattau district 645 contracted the disease and 132 succumbed.

In the eastern part of the country the districts of Tabor and Czaslau were severely attacked. ‘In the Tabor district’, we read in the above-mentioned report,[181] ‘there appeared in the month of August at Neuhaus, where a field-hospital had been erected, several biliary-mucous nerve-fevers, which broke out in numerous places along the road to Prague, soon spread to the Tabor district, and became epidemic. They quickly revealed their presence in all places where sick soldiers passed the night, or where the natives took part in the transportation of sick soldiers.’ The climax of the epidemic was in January, and in the middle of May it disappeared; of 4,267 people who contracted the disease, 448 succumbed. In the Czaslau district, adjacent to the Tabor district on the north, the disease was disseminated in November 1813 by transports of prisoners and troops, by the quartering of convalescents in the homes of peasants, and by peasants who helped to transport sick soldiers. On December 16, 1813, no less than 4,313 civilians in thirteen places were suffering from typhus fever. The highest mortality prevailed in the vicinity of the hospitals; the epidemic disappeared with the arrival of spring.

Typhus fever was also conveyed into various parts of Moravia,[182] partly by Austrian troops, and partly by French prisoners; in the districts of Brünn, Iglau, Olmütz, and Teschen it broke out in numerous places. In twelve communities in these districts, having a combined population of 28,267, some 2,126 people contracted the disease between December 1813 and the summer of 1814, and 207 persons succumbed. In March the epidemic disappeared almost everywhere. According to the figures compiled by J. Hain,[183] the number of deaths in Moravia and Austrian-Silesia together was:

July (1813) 3,818 August 3,893 September 3,888 October 4,059 November 4,457 December 5,202 January (1814) 8,280 February 7,249 March 7,756 April 5,464 May 5,541 June 4,147

In Lower Austria typhus fever also broke out, particularly in Vienna; the number of deaths there was:

_Due to typhus fever._ _All deaths._ 1813 784 12,971 1814 1,529 15,309

In the rest of the country few diseases appeared, despite the fact that troops kept marching back and forth.

Typhus fever was conveyed by marching troops to Styria also; the source of the pestilence was the seven military hospitals in Graz. We read in the report:[184] ‘The pestilence, proceeding principally from the seven military hospitals lying within the city limits as from a focus, was spread abroad by convalescents, attendants, physicians, &c. The mortality in these hospitals was extremely high; the buildings set aside for the purpose could scarcely accommodate the number of sick. Everything was topsy-turvy; the corps of field-doctors on hand was not nearly large enough to take even the most necessary care of the large number of patients.’ The region around Graz, Marburg, and Bruck was most severely attacked by the disease, which also spread to Carinthia and broke out in Klagenfurt and vicinity.

7. SURVEY OF THE EPIDEMIC OF TYPHUS FEVER IN THE YEARS 1813–14

It is impossible to draw an accurate picture of the loss of human life which typhus fever caused in the years 1813–14. This is due, on the one hand, to the lack of reliable statistics, and, on the other hand, to the fact that the several regions suffered to a varying degree, depending upon the number of troops, prisoners, and refugees that they received. The number of persons that succumbed to typhus fever in Germany during the years 1813–14 must be estimated at least as high as 200,000 or 300,000. Assuming that 200,000 people succumbed to the disease, the number that contracted it would amount to some 2,000,000. Since Germany at that time had hardly more than 20,000,000 inhabitants, some ten per cent of them, on the basis of this assumption, contracted the disease. The size of this number is significant, when we consider that the stronger and older people manifested particular susceptibility to the disease.

One of the chief causes of the wide dissemination of typhus fever in the years 1813–14 was the imperfect development of the lazaret system. If at first a lazaret for infectious diseases was available, the number of patients it was called upon to accommodate in a few days became so large that new buildings always had to be opened for them, and it was impossible to keep them isolated. The efforts of the various municipal administrations to have the lazarets erected outside the city limits were powerless against the brutal obstinacy of the French, and, later, of the Russian generals. The severity of the penalty which they had to pay for unceremoniously housing infected French troops in strongholds together with healthy men, is evident from the fearful devastation caused by typhus fever in Danzig, Torgau, Mayence, &c. The little communities were absolutely helpless against the dominating power of the soldiers. One might reproach the municipal administrations of that time with failing to adopt measures of prevention against the menacing danger of pestilence, particularly in places which did not suffer in consequence of the marching back and forth of soldiers. But one must take into account the excitement which permeated the entire people at that time—the hopeful longing to be freed from the national enemy’s long oppression, toward which all thinking and planning was directed, the employment of all resources for this purpose, and in particular the fact that sheer ignorance rendered appropriate measures impossible. If this ignorance prevailed in the highest places, nothing better was to be expected of the administrations of the smaller cities and towns. The population was therefore everywhere defenceless against the intrusion of the pestilence, which was given an opportunity to become more and more widespread. This, however, had not been the case in Central Europe since the Thirty Years’ War.