Posted in American Civil War, American Civil War Medicine, History of Medicine

American Civil War Medicine – Part 4 – Malaria

Medicines used in the American Civil War, from a Medical Exhibition owned by members of So.Sk.An.

Between 1861 and 1866 over 1 million Union soldiers  were diagnosed with malaria.  Malaria is a parasite transmitted by the Anopheles mosquitoes.   The mosquito breeds in stagnant, sunlit pools of fresh water and the adult female requires a blood meal in order to be able to ovulate and lays somewhere between 100-300 eggs at any one time.  Symptoms of the disease are chills, shakes, nausea, headache, an enlarged spleen and most notably, a fever that spikes every 1 to 3 days depending on the type of malaria and its parasitic cycle.  There are 4 species of malarial parasite that commonly infect humans:

  • Plasmodium falciparum –  Common type that was found in the United States during The American Civil War. Results in a congestive and malignant fever.  A pernicious malaria which left untreated is fatal;
  • Plasmodium Vivax – not often fatal and commonly referred to as an “intermittent fever”;
  • Plasmodium Malariae;
  • Plasmodium Ovale.

Malaria is categorised according to how often the fever spikes or paroxysms occur:

  • quotidian fever – every 24 hours;
  • tertian fever – every 48 hours;
  • quartan fever – every 72 hours.

The further south you travelled, the more prevalent malaria was.  The South’s “Sickly Season”, as it was referred to, took place during the months of summer and autumn.  The impact of malaria upon military campaigns in The American Civil War cannot be underestimated.  Examining the causal links between human health in general and developments in military history is extremely complex and lies outside the confines of this blog.  But there is no doubt that military operations are affected by epidemics and seasonal outbreaks.  For example, when the “Sickly Season” was in full swing, major offensives were less likely to be initiated by the Union army in certain areas of the Confederacy.

Pilulae Quinlae Sulphatis used for treating malaria.

The treatment options available in 1860s America were pretty good.  Quinine, which occurs naturally in the bark of the cinchona tree, was the most effective in controlling symptoms of the disease.  The cinchona bark was known for its febrifugal properties and continued to be used in anti-malarial drugs until the 1940s.   The Pilulae Quinlae Sulphatis treatment (pictured above) was standard issue in the Army Surgeon’s medicine chest.  The recommended dosage would be 3 grams of Sulphate of Quinia.  A fatal dose of quinine is 8 grams and many soldiers were given high doses of the drug.  Side effects of overdosing included ringing in the ears, headaches, nausea and blurred vision.  There were two large pharmaceutical companies whose headquarters were in Philadelphia,  Rosengarten & Sons and Powers & Weightman both of whom cornered the market in quinine based medications.

Union blockades meant stock piles of quinine in the South dwindled with each year of the war.  When quinine supplies did sometimes get through the blockade, Confederate soldiers hijacked it for themselves, leaving many civilians to suffer, untreated, the disease’s terrible side effects.  Quinine was also used to treat gout and dyspepsia.  Quinine substitutes were created by the Southerners to try to counter the shortages.  Constituents of these preparations included 30% dogwood bark, an equal portion of poplar bark, 40% willow bark all mixed with whiskey.  Alternative remedies were also tried by the desperate civilian.  Some believed that rubbing turpentine on the stomach prevented paroxysms and others tried putting red pepper in their tea.  All substitutes proved  ineffective.   Throughout the War, travel restrictions were in place in the South which meant that white Southerners, who would have normally fled their plantations during “Sickly Season”,  had to stay put and face the ravages of the disease.

Union Surgeons issued more than 19 tons of quinine throughout the War.  The daily ‘quinine call’ queues were a familiar sight in Union encampments.  Soldiers taking part in The Siege of Vicksburg (18th May – 4th July 1863) exploded powder cartridges in their tents to smoke-out the mosquitoes.  Many soldiers were most vulnerable from being attacked by Anopheles mosquitoes whilst performing picket duty.

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