Napoleons Campaign in Russia Anno 1812 - Medico-Historical | Page 7

the land of the enemy. The forced marches were continued during the day, through sand and dust, until stormy weather set in with rain, followed by cold winds.
With the appearance of bad weather, dysentery, which had already been observed at the time of the crossing of the Niemen, showed itself with greater severity. The route the army had taken from camp to camp was marked by offensive evacuations. The number of the sick became so great that they could not all be attended to, and medical treatment became illusory when the supply of medicaments was exhausted.
The greater part of the army fought in vain, however courageously, against the extending evil. As everything was wanting of which the sick were in need, there was no barrier against the spread of the disease, while at the same time the privations and hardships which had caused it continued and reached their climax.
Some of these soldiers would march, equipped with knapsack and arms, apparently in good spirits, but suddenly would succumb and die. Others, especially those of strong constitution, would become melancholy and commit suicide. The number of deaths increased from day to day.
Marvelous was the effect of emotion on the disease. Surgeon-General von Kohlreuter, during and after the battle of Smolensk, witnessed this influence. Of four thousand Wuerttembergians who took part in that battle, there were few quite free from dysentery.
Tired and depressed, the army dragged along; but as soon as the soldiers heard the cannon in the distance, telling them the battle was beginning, they emerged at once from their lethargy; the expression of their faces, which had been one of sadness, changed to one of joy and hilarity. Joyfully and with great bravery they went into action. During the four days that the battle lasted, and for some days afterward, dysentery disappeared as if banished by magic. When the battle was over and the privations were the same again as they had been, the disease returned with the same severity as before--nay, even worse, and the soldiers fell into complete lethargy.
The necropsy of those who had died from dysentery revealed derangement of the digestive organs; the stomach, the large intestine, mostly the rectum, were inflamed; the intima of stomach and duodenum, sometime the whole intestine, were atonic. In some cases there were small ulcers, with jagged margins, in the stomach, especially in its fundus, and in the rectum; in other cases dysentery had proceeded to such an extent that pretty large ulcers had developed, extending from the stomach into the small and from there into the large intestine, into the rectum. These ulcers were of sizes varying from that of a lentil to the size of a walnut. Where the disease had been progressive the intima, the mucosa and submucosa--very seldom, however, the serosa--were perforated by ulcers; in many cases there were gangraenous patches in the fundus of the stomach and along the intestinal tract. The gastric juice smelled highly acid, frequently the liver was discolored and contained a bluish liquid, its lower part in most cases hardened and bluish; the gall bladder, as a rule, was empty or contained only a small amount of bile; the mesenteric glands were mostly inflamed, sometimes purulent; the mesenteric and visceral vessels appeared often as if studded with blood. Such patients had suffered sometimes from gastralgy, had had a great craving for food, especially vegetables, but were during that time entirely free from fever.
Remarkably sudden disaster followed the immoderate use of alcohol. Some Wuerttembergian soldiers, who during the first days of July had been sent on requisition, had discovered large quantities of brandy in a nobleman's mansion, and had indulged in its immoderate use and died, like all dysentery patients who took too much alcohol.
The number of Wuerttembergians afflicted with dysentery, while on the march from the Niemen to the Dwina, amounted to three thousand, at least this many were left behind in the hospitals of Malaty, Wilna, Disna, Strizzowan and Witepsk. The number of deaths in the hospitals increased as the disease proceeded, from day to day, and the number of those who died on the march was not small. Exact hospital statistics cannot be given except of Strizzowan, which was the only hospital from which lists had been preserved; and here von Scherer did duty during six weeks. Out of 902 patients 301 died during the first three weeks; during the other three weeks when the patients had better care only 36 died.
In the hospitals established on the march, in haste, in poor villages, medicaments were either wanting entirely or could be had only in insufficient quantity. All medical plants which grew on the soil in that climate were utilized by the surgeons, as, for instance in the hospital of Witepsk, huckleberries and the root of tormentilla. Establishing the hospital in Strizzowan