Sunday, April 18, 2010

Review - "Mosquito Soldiers: Malaria, Yellow Fever, and the Course of the American Civil War" by Andrew Bell

[Mosquito Soldiers: Malaria, Yellow Fever, and the Course of the American Civil War by Andrew McIlwaine Bell (Louisiana State University Press, 2010). Cloth, illustrations, maps, notes, appendices, bibliography, index. Pages main/total:134/206. ISBN:978-0-8071-3561-7. $29.95]

Regular readers of Civil War books are continually reminded of the fact that disease killed far more soldiers than bullets, but the effects these maladies had on the actual direction of military operations has been a bit of a neglected subject. This situation changes with the release of Andrew McIlwaine Bell's Mosquito Soldiers. Bell narrows his own inquiry to the study of a pair of mosquito-borne tropical diseases, malaria (a single-celled parasite) and yellow fever (a virus)1.

In the early sections of his book, Bell does a fine job of concisely outlining for readers the essential background information for both disease processes, including cause, diagnosis, treatment, and prevention data. Palliative care was the best that could be offered at the time for yellow fever sufferers, but quinine was available to alleviate the symptoms of malaria. Unfortunately, while clouds of mosquitoes annoyed soldiers in the field to no end, it would not be conclusively known for many years that the insect served as the vector for both diseases.

Mostly from the Union perspective, Bell's study examines a wide scope of military operations from all three major theaters, all altered to one degree or another by the dangers imposed by the swarms of mosquitoes. Even so, while Bell writes convincingly that disease loomed large in the minds of generals and politicians, it remains unclear (and perhaps impossible to prove) whether sickness or the fear of its further spread ever really served as the primary factor in deciding the direction of any major military operation. As an example, while swamp fevers were cited by General Halleck as a reason to press for the evacuation of the Army of the Potomac's Harrison Landing position on the Virginia Peninsula in 1862, it would be difficult to determine at this distance the true motivation. Was it really an overriding health concern or was it a rationalization of a preferred military or political option? On the other hand, Bell seems to be on much steadier ground when he cites seasonal (specifically in terms of disease cycle) correlations in Confederate activities along the South Atlantic front.

Some of the study's findings were a bit surprising, including the status of Arkansas as the most 'malarial' (in terms of disease incidence) of all areas occupied by Union troops for extended periods of time. Helena is often singled out in participant accounts and in the literature as a particular pestilential post, but one still might have expected the lower Mississippi region to hold the dubious overall honor.

A popular view at the time was that black soldiers were somehow immune to the tropical diseases that felled so many whites, and thus they were best suited for serving in the Deep South. While Bell briefly mentions that there is some genetic basis for the argument2, he explains that the preponderance of evidence did not support it. This fact was recognized by U.S. army physicians at the time, but the idea remained alive among Union military and political leaders, as well as in the minds of the general population.

Mosquito Soldiers is a solidly researched manuscript, but, in my view, Bell's thesis that malaria and yellow fever often served as decisive factors in operational decision making remains largely unproven. While no one can deny their importance as contributors, too many impactful military, political, and environmental considerations were involved in directing Civil War campaigns to allow for that kind of reductionism. On the other hand, I don't wish to devalue the attempt, as useful information can be drawn from it and much remains from Bell's investigation into the rarely explored intersection of medicine and military strategy to appreciate.

1 - Soldiers frequently were subjected to concurrent illnesses, and, in this context, dysentery -- that greatest of all killers of Civil War soldiers -- and other diseases are discussed, too.
2 - Although it would have made for an interesting sidebar, sickle cell trait's role in providing limited protection from malaria among those soldiers of African descent (esp. those from West Africa) is absent from the discussion.

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