Mortality and Morbidity in Modern Wars, II: Military Populations

Abstract

In the previous chapter, we looked at the main trends in morbidity and mortality in civil populations since 1850. In this chapter our focus shifts to the military. An invaluable recent source of information on this topic is Lancaster (1990: 314–40) who gives a disease-by-disease account of morbidity and mortality among soldiers from the seventeenth century. Until the twentieth century, soldiers were lucky to survive military medicine. Basic treatments included the cauterizing of wounds and the removal of limbs to prevent gangrene. The biggest early advances in military medicine came when doctors started to wash their hands. The role of Florence Nightingale in transforming the military hospitals during the Crimean War (1853–6), and her broader role in improving the welfare of the British Army, is legendary. Yet, notwithstanding the gigantic losses directly attributable to battle, up to World War I, most deaths in war among soldiers were caused by epidemic diseases like dysentery, enteric fever, cholera, typhus, plague, and simple infections like measles—the traditional killers encountered in civil populations. And, as with civil populations, the real advances in controlling these infections came with the development of antibiotics and vaccination after 1945. In this chapter, we begin by looking at mortality trends in a number of theatres of war between 1859 and 1914 using data from Curtin (1989). As a specific illustration of the role of one simple infectious disease, measles, as a cause of mortality in military camps during this period, we take the American Civil War (1861–5). By the end of World War I in 1918, the role of many infectious diseases as causes of military mortality and morbidity had changed from lethal to nuisance value. This shift is shown through an examination of the role of measles in World War I. After 1945, the use of antibiotics and the generalized availability of vaccination against most of the common infectious diseases ensured that the historic infectious diseases waned in their impact on military populations just as they did in civil populations. Again we use measles and the American army as examples to show these declining effects.