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“Disease is war with the laws of our being, and all war, as a great general has said, is hell”

A much (over) used idiom about armies is that they march on their stomach. If you happen to be a snail army this may well be true, however, for the non gastropedal armies it is something of an exageration. Human needs though are a big consideration in war. Not only is your army of humans vulnerable to being shot and blown up, but they are also sensitive to a range of other maladies.

Though as a Derby resident I am thoroughly fed up with Florence Nightingale (come on there must be someone else you can make a statue of dear council), but I do have to concede that the attention she drew to the conditions in the Crimea were significant. More soldiers were dying from infectious diseases such as typhoid and dysentry than were dying from being shot, blown up or any other war based injury. And not just a few either, ten times as many. In simple terms that means that for every one man who died from being shot another ten died from essentially poo-ing or coughing themselves to death. Nightingale’s evidence helped to generally improve conditions, but it was no isolated incident.

Siege of Sevastapol

Many a child has been threatened with scurvy and ricketts when refusing their fruit and vegetables, and if you live in the Western world today its pretty unlikely. Heck even your cornflakes have been fortified with a billionty vitamins and minerals. You have to do some studious avoidance to not get a basic supply of vitamin D and C these days, and if you were doing that you’ll probably die of malnutrition first, but for soldiers and sailors long ago this was not the case. From the crusades to the nineteenth century an estimated two million sailors died from something that could be cured with some orange juice. Though the reason behind the curative properties of citrus fruit wasn’t established until the 1930s the benefits of daily limes were long known, just not tremendously practical on long voyages.The journeys that made time to stop off for some shopping, or found other sources of fresh food, such as the French forces at the Siege of Alexandria in 1801 making use of fresh horse meat.

Scurvy wasn’t a killer issue on the Centurion, but its a pretty picture…

During the American civil war one of the biggest threats to the well-being of the troops was not the being shot, but the being repaired. Low knowledge about infection control, and a need to keep the thousands of injured efficiently moving through the hospital system led to frequent reuse of equipment and insufficient bandaging. If the bullet didn’t do for you Streptococcus pyogenes probably would.

Giardia lamblia

Not only was being in hospital a dangerous thing for soldiers, but merely invading can be bad for your health. Most European nations went through a big period of colonial expansion (regular readers may note I have something of a big fat bee in my fine bonnet about this). Apart from the ambitions of twentieth century Germany (and its peverse obsession with increasingly colder countries) , most colonialising has, perhaps understandably, been of much warmer climes. Africa and South America are beautiful resource rich continents. If you wanted to expand your gold, diamond, oil and slave collections they were ideal places to go stealing. Unfortunately for our forebears they are also rich in a range of diseases. Some like giardia (a particularly nasty water borne disease) affected locals as much as the interlopers, but other diseases were a special gift just for visiting. Though malaria does affect residents of African countries, many people of African and southern mediterrannian heritage have a natural defence against it in the form of sickle cells (unfortunately for people with sickle cells it also happens to make you rather ill and unable to benefit from many of the normal qualities of blood). It has been suggested that diseases such as sickle cell anaemia and thalysseamia are evolutionary responses to living in places with a big bunch of blood sucking flies. For early colonialists malaria was a very real problem. During the Boer war lady mosquitos were responsible for sending as many, if not more men to hospital than wounds. Though quinine was used reasonably affectively, until replaced with other drugs during World war 2, it was hard to obtain and risks pulmonary oedema. Which is a particularly nice choice, die from malarial fever and convulsions, or suffocate to death on your own blood.

The female of the species really is deadlier than the male…

Trypanosome cruzi hasn’t made much noise on the war front but its a much more interesting parasite (/removes nerd hat)

One set of diseases which were still of concern to Generals even as late as the Vietnam war (and probably still now) were sexually transmitted ones. In 1494 French troops were busy sieging Naples when Treponema pallidum, the bacteria that causes syphillis, took to sieging them. Evidently an awful lot of people were committed to supporting the medieval troops, as from this initial outbreak the disease killed around five million Europeans. Whilst the round of applause that no-one wants, Gonorrhoea, has been found on the remains of the sunken Mary Rose and was enough of a concern that the English Parliament were making laws to help prevent it in 1611, whilst those much earlier adopters the French were doing banishing people for it in 1256. The venereal films that American troops complained of having to watch repeatedly in the 1960s may have been some shoddy plotting, but they were there for good reason. Though it might rank as one of the better ways of catching a disease they both can result in anything and everything, from blindness and madness to the rather ultimate death.

Gono is man’s best friend apparently, bonus mention for anyone who has named their dog that…

Health problems are not a thing of the past either. There are the problems of local cuisine (which many armies ban their soldiers from partaking in) bringing the delights of salmonella and their ilk. Water and air conditioning causing Leigionnaire’s, parasitic diseases of many and varied glorious types, and then of course those of our own making. Biological warfare is not a new phenomenon. Sixth century Assyrians poisoned water supplies, Mongol troops flung dead rotting animals into cities, and in 1710 the Russians took that one step further by throwing diseased dead people at Swedes. By the twentieth century increasing scientific knowledge gave governments the benefit of a whole new range of tiny killing machines, and bacterial warfare was born. During the Second World War Anthrax, Bruscellosis and Botulism were all weaponised. Not ever in their darkest fantasies could scientists have imagined that fifty years later vanity would drive people to paralyse their faces with Botulism…

This is one of the biggest risks as a modern soldier

Anthrax still plays a component part in modern biological warfare, along with crop pathogens (a starved enemy is a defeated one), and even insect warfare. Research facilities from world War 2 onwards sought more and more creative methods of beliguering the enemy. And if my mother’s tales of her childhood near one such reaserch facility are to be believed giant chickens too…

Is it this sort of thing that caused Gulf War Syndrome? Or the prevention?

The most recent example is the mysterious Gulf war Syndrome. Presenting with a range of problems those afflicted from the 1991 conflict could have enemy Uranium to blame or may well have their own army to thank as other potential causes include nerve gas antidote and organophosphate pesticides.

If you want a more realistic disease borne feel to your game…

Soviet Medical Personnel for your sickly people

Some sickly Prussian Landwehr chaps

or if you want to go all Mongol horde…how about some horses for flinging