By André B. Sobocinski, historian, BUMED
“Dryness, coolness, fresh air, sunshine, cleanliness of body, clothes and bedding, good food, pure water, temperance, refreshing sleep, occupation exercise, cheerfulness, and contentment of mind…”
~A Recipe for Good Health by Medical Inspector Albert Gihon, USN, 1871
For much of the nineteenth century the United States was losing a war to an overlooked threat. Even as casualties by gunfire, cannon and sword mounted over the course of the century’s conflicts, the proboscis of a disease carrying insect would prove the deadliest weapon of them all.
In the Mexican War (1846-1848), an estimated 13 percent of U.S. forces (11,000) died of disease, chief among them Yellow Fever. At the U.S. Naval Hospital on Salmandina Island, naval surgeons were overwhelmed with Army, Navy and Marine Corps victims of the yellow scourge; many including the Navy’s senior physician in theater—Fleet Surgeon John A. Kearney—would die from the disease.
Disease would account for two-thirds of Union and Confederate deaths in the Civil War (1861-1865); 30,000 of these were the result of malaria alone.
Generations before the microbe hunters and long before mosquito control was a preventative measure, military surgeons treated mosquito-borne illnesses with the tried and well-meaning methods of their day. Typically, these were Mercury-based purgatives/emetics, venesection, and blistering/cupping—all based on ancient theories of bodily humors and temperaments; and all were designed to rid the underlying cause of disease.
In his 1854 textbook, Diseases and Injuries of Seamen, Navy Surgeon G.R.B Horner advised treating Yellow Fever by first evacuating the stomach and bowels with Ipecac, castor oil, blue mass (mercury, licorice, rose honey, althaea, and glycerol), rhubarb, or grains of calomel (mercuric chloride) and jalap (a poisonous root). More than sixty years earlier, Dr. Benjamin Rush had advocated the very same treatment of calomel and jalap (known as the “10-10 treatment”) to purge victims of the 1793 Yellow Fever Epidemic in Philadelphia.
Quite understandably, dehydration would prove a significant problem for patients being treated for the disease. Navy doctors typically counteracted the ensuing dehydration with everything from tamarind water and weakened Chamomile tea to lemonade and orange juice.
For fever, Dr. Horner recommended the application of cold water to the brow, but also the ingestion of ammonium acetate, potash (potassium carbonate) as well as tartar emetic (antimony potassium tartrate)—all of which had “fever reducing properties.”
A popular treatment for a host of other ailments, tartar emetic would be used for everything from parasitic diseases like shistosomiasis to alcoholism well into the twentieth century.
Venesection or blood-letting was a common practice used by many ship surgeons during the early stages of febrile diseases. This practice would fall into increasing disfavor throughout the century.
Even by the early nineteenth century, very few Navy doctors ascribed to Dr. Rush’s practice of bleeding fever victims 10 to 12 ounces during a sitting.
In his book Physician for Ships (1820), Surgeon Usher Parsons asserted that it was only “advisable to draw a small quantity of blood in the first twelve hours,” and the practice should be abstained from after this. In case of severe headache associated with the fever, Parsons advised application of leeches to the temples.
Narcotics like laudanum (alcoholic solution containing opium), black drop (opium, vinegar, and sugar) and Dover’s Powder (Ipecac and opium) were typically used as analgesics as well as for bouts of “irritable stomachs” and insomnia. To “quiet” the unsettled stomach, Parsons stood by his recipe for an “effervescing mixture” that contained lemon juice, water, potash, and laudanum.