THE SUMMER OF 1835 was a stressful time for Mrs. Zachary Taylor. In June she learned her daughter Sarah Knox had married a dashing young army lieutenant named Jefferson Davis and dutifully followed her new husband from Kentucky to his virgin estate on the Mississippi River below Vicksburg. Although Colonel Taylor expressed fatherly doubts about the wisdom of letting “Knoxie” become a soldier’s wife, Mrs. Taylor was less concerned with her daughter’s choice of a spouse than with the dangerous diseases she knew lurked in the shadowy, stagnant bogs that surrounded Davis’s “Brierfield” plantation. Fifteen years earlier she and her four children, including Sarah, had fallen ill while stationed with her husband’s regiment in the swamps of Louisiana. The two youngest girls did not survive, and Mrs. Taylor herself had nearly died. The thought of losing another child to the mysterious and unhealthy climate of the Deep South was more than she could bear.
Sarah tried to assuage her mother’s fears. “Do not make yourself uneasy about me,” she wrote in August. “The country is quite healthy.” The following month, however, both she and her husband were stricken by a severe illness while visiting relatives in West Feliciana, Louisiana. On the fifteenth of September, at the height of their agonizing ordeal, Davis staggered out of his sickbed to comfort his ailing wife, but Sarah, delirious with fever, failed to recognize him. Instead, in a fit of madness she sang a popular nineteenth-century song called “Fairy Bells” before closing her eyes forever. Davis never got a chance to say good-bye to his twenty-one-year-old bride and was forced to mourn her loss while still very ill. The future president of the Confederacy grieved in seclusion at Brierfield for the next eight years.1
Like most Americans of her era, Mrs. Taylor would have likely attributed her daughter’s tragic death to the poisonous air that was said to pervade unhealthy areas of the country such as the Mississippi Delta. Conventional wisdom since colonial times held that strange and virulent vapors continually wafted through the atmosphere of the warmer regions of North America and created health problems for anyone unfortunate enough to breathe them in, especially those born in healthier climates. What exactly caused the air to turn lethal, however, was still in dispute among physicians for most of the nineteenth century. Endless theories circulated in medical journals or were discussed at conventions at a time when medicine was more art than science. Some practitioners, perhaps a majority, believed decomposing animals and plants produced the noxious “miasmas” that sickened their patients. Others thought electrical charges in the ozone were the culprit. Still others rejected the “bad air” theory altogether and instead blamed excess hydrocarbons in the blood.2
In reality Sarah Taylor Davis had died of an insect bite. One night in late August or early September a female mosquito carrying a dangerous strain of malaria surreptitiously sliced through her skin, sucked up her red corpuscles through its straw-like proboscis, and unwittingly released into her bloodstream a dozen or so malarial sporozoites that it had picked up from a previous victim. Within minutes these sporozoites found their way into Sarah’s liver, where they transformed over the next two weeks into schizonts, each containing thousands of smaller organisms called merozoites. When the mature schizonts eventually burst, the merozoites poured out like tiny soldiers and invaded her red cells in order to reach the next stage of their development. As these parasites rapidly multiplied, dead and dying corpuscles clung to the walls of Sarah’s capillaries and healthy cells, creating a dam that blocked the flow of blood to her vital organs.3
Malaria is a parasite transmitted by Anopheles mosquitoes, a genus that prefers to breed in stagnant, sunlit pools of fresh water and can be found in most regions of the country. The adult female requires a blood meal to ovulate and can lay between one and three hundred eggs at a time. Symptoms of malaria include chills, shakes, nausea, headache, an enlarged spleen, and a fever that spikes every one to three days depending on the type of malaria and its parasitic cycle. In all likelihood Sarah Davis was killed by Plasmodium falciparum, one of four types of malaria that infect human beings. Of the other three— vivax, malariae, and ovale—only Plasmodium vivax was once common in the United States. Vivax alone rarely proved fatal to its victims, but Plasmodium falciparum was often deadly.4
Nineteenth-century physicians categorized malaria according to how often these fever spikes, or “paroxysms,” occurred. A “quotidian” fever appeared once every twenty-four hours, a “tertian” every forty-eight, and a “quartan” every seventy-two. Plasmodium vivax was commonly referred to as “intermittent fever,” “ague,” “dumb ague,” or “chill-fever,” while Plasmodium falciparum was known as “congestive fever,” “malignant fever,” or “pernicious malaria” because of its lethal effect.5
Patients diagnosed with “remittent fever” experienced febrile symptoms that, as the name suggests, periodically went into remission. But they did not disappear entirely (and temporarily) in the same way that so-called intermittent symptoms did. Like most nineteenth-century descriptions of disease, the term remittent was somewhat nebulous. Yet a handful of studies conducted in the 1830s and 1840s suggest that many of these fevers were the result of repeat plasmodial infections.6
Sarah Davis was one of countless Americans who contracted malaria during the nineteenth century. As settlers cleared virgin forests from Savannah to St. Louis to make way for the cotton and wheat farms that drove the antebellum economy, they inadvertently created a plethora of new breeding sites for anopheles. At a time when mosquito-control measures such as spraying the insecticide chlorophenothane (DDT) were still unknown, clouds of insects swarmed wagon trains and slave coffles, sparking complaints about “fever” and “ague” in the South and West, where crude housing, poor drainage, and regular flooding aided in the spread of the disease. Daniel Brush’s experience on the frontier was typical. In 1820 he and his family moved from Vermont to southern Illinois in search of better economic opportunities and wound up with a handful of other Yankee families in a small settlement called “Bluffdale,” four miles east of the Illinois River. When the entire community came down with malaria during the first harvest, Brush recorded his fellow settlers’ suffering: “Many had the real ‘shakes’ and when the fit was fully on shook so violently that they could not hold a glass of water with which to check the consuming thirst that constantly beset them while the rigor lasted, nearly freezing the victim.” He went on to describe the fevers that followed these fits as putting “the blood seemingly at boiling heat and the flesh roasting.”7
Other observers noticed the prevalence of the disease in the West. During a tour of the United States in the 1840s, the English author Charles Dickens encountered so many “hollow-cheeked and pale” malaria victims that he forever remembered the region where the Mississippi and Ohio rivers converge as “a breeding-place of fever, ague, and death.” St. Louis also seemed unhealthy to Dickens, despite its residents’ claims to the contrary. One Illinois physician’s frequent contact with malaria convinced him that he could accurately diagnose patients just by learning where they lived, while another practitioner thought the malaria victims he saw, even children, looked “prematurely old and wrinkled.” Country doctors from all over the Northwest published articles in medical journals on the best ways to identify and combat the mysterious disease that plagued their communities.8
But while malaria made life difficult for Westerners, it made life nearly intolerable for southerners at certain times of the year. Plasmodium falciparum occurred almost exclusively below the thirty-fifth parallel and was especially problematic in the states of the Deep South such as South Carolina and Georgia. Short, mild southern winters substantially lengthened the breeding season for anopheline mosquitoes and made Plasmodium vivax infections as common as colds in some areas. White southerners dreaded the annual arrival of the “fever season” (which lasted for a variable length of time between late spring and early autumn depending on the location), and those who could afford it escaped to seaside cottages or fled northward in search of healthier climates. During a visit to lowland South Carolina in the 1850s, landscape architect Frederick Law Olmstead noticed that the overseer on one plantation moved inland to higher ground during the “sickly season” (outside the flight range of anopheles) to escape the “swamps” and “rice-fields” that made life at night “dangerous for any but negroes.” The widespread belief among whites that blacks were immune to malaria, which served as a convenient justification for slavery, had some basis in scientific truth. West Africans inhabited malarial environments for thousands of years before being brought to America and developed a degree of genetic resistance which they passed on to their offspring. But by the mid-nineteenth century Africans from all over the subcontinent were intermixing with one another as well as with Indians and Europeans, which meant that many blacks were also susceptible to malaria.9
Although neither blacks nor whites understood what caused malaria, they both agreed that the farther south one traveled, the more prevalent the disease became. Slaves from states such as Virginia and Maryland feared being sold to planters in the lower South in part because of the malarial poison they knew plagued the area. John Green-leaf Whittier’s poem “The Farewell” captures the concern many black families must have felt for the health of their loved ones who were forced to move farther south:
Gone, gone, sold and gone
To the rice swamp dank and lone,
Where the slave-whip ceaseless swings,
Where the noisome insect stings,
Where the fever-demon strews
Poison with the falling dews,
Where the sickly sunbeams glare
Through the hot and misty air:—10
Whites also worried about the endemic malarial fevers of the South. Residents of lower Louisiana and Mississippi who lived in swamps near the Mississippi River routinely evacuated their homes to escape the strange sickness that mysteriously appeared whenever it flooded. Together with portions of western Tennessee, these areas were considered the most malarious in the Mississippi River Valley. Other locations infested with mosquitoes, such as the algae-covered bogs of south Alabama, coastal Carolina, and the Florida panhandle, were thought to be uninhabitable or exceedingly dangerous places for whites during the summer months. A physician practicing in tidewater North Carolina believed the prevalence of malaria in his neighborhood “would appear incredible to those whose experience has been confined to more healthy localities.” Indeed, military personnel stationed in the South for the first time were horrified by the unhealthiness of the climate. An army physician from St. Louis assigned to a fort on the Suwannee River in Florida saw so many cases of intermittent fever that he was convinced that even the pets in the place suffered from the disease. He and two-thirds of the soldiers under his care fell ill while on duty. Military doctors serving in Baton Rouge, Louisiana, considered one of the sickliest posts in the United States in the early 1800s, saw an average of 824 cases of malaria per 1,000 troops each year. Fort Gibson in Arkansas and Fort Scott in Georgia were also reputed to be malarial pestholes. From the burgeoning cotton estates of the Texas plains to the well-established tobacco and rice plantations of the East, anopheles mosquitoes fed on black and white bodies indiscriminately, transmitting plasmodium parasites and sickening their human prey in the process.11
The prevalence and severity of malaria in the South helped shape both northerners’ and southerners’ views of the region. For northerners this view was mostly negative. By the mid-nineteenth century long winters and infrastructure improvement projects spearheaded by industrious free laborers had all but eliminated malaria from New England and given rise to a generation of Northeasterners who had never been exposed to the disease. Like many Americans today, antebellum New Englanders viewed malaria as a “tropical” malady that was only a problem for people who lived in the unsanitary and underdeveloped regions of the world, which included the southern United States. Southerners’ repeated warnings about the health risks their local fevers posed to outsiders reinforced this negative image. So too did the stories shared by returning sailors about the intermittent fevers they had contracted while visiting cities such as Mobile and New Orleans. Malaria even helped convince northern insurance firms of the need to charge higher premiums to their southern clients and hindered the North-to-South flow of investment capital and people. In contrast, some southerners adopted a sort of perverse pride in the ailments they considered their own. Repeated infections with the same strains of malaria over a period of years meant southerners who stayed in one place became accustomed to the fevers in their neighborhood and developed a limited immunity against them. A number of southern physicians practicing during the antebellum period even went so far as to call for the creation of separate medical schools and publications to allow southern students the chance to learn more about the diseases that were indigenous to their region.12
Malaria, however, was not the only mosquito-borne illness that contributed to the image of the South as an unhealthy place to live. Yellow fever, a disease once found as far north as New York and Philadelphia, became a uniquely southern problem by the middle of the nineteenth century. The reasons why it became confined to the South remain unclear, although the North’s longer winters, quarantine and sanitation practices, and trade patterns may have played a role. Outbreaks in Charleston, Galveston, Mobile, New Orleans, Norfolk, Savannah, and other southern cities killed tens of thousands of people and created a level of physical and emotional suffering that can scarcely be imagined today. Victims in the advanced stages of the disease bled from the nose and mouth; suffered excruciating headaches, fever, and jaundice; and, worst of all, vomited a substance resembling coffee grounds (half-digested blood) caused by internal hemorrhaging, which was a telltale sign of the virus. Fatality rates during epidemics ranged from 15 to over 50 percent, but those who survived acquired lifetime immunity. Nineteenth-century Americans lived in fear of the disease they called the “scourge of the South,” and public panics often followed the first sign of an outbreak.13
Unbeknownst to antebellum physicians, yellow fever was being transmitted from person to person by the Aedes aegypti mosquito, a species that inhabits the southern United States and lays its eggs in hollow logs and artificial receptacles containing freshwater. Filthy southern cities offered nearly limitless incubation pools for Aedes eggs in the form of horse troughs, barrels, clogged gutters, and trash in the streets filled with rainwater. Winter frosts limited the activity of the mosquito and prevented yellow fever from ever becoming endemic in North America, but the virus was continually reintroduced by cargo ships arriving from the Caribbean, where it existed year-round. A single infected sailor or mosquito on board could spread yellow fever to the local Aedes aegypti population and cause widespread misery and death.14
Just such a scenario unfolded in New Orleans in the summer of 1853 in an outbreak that claimed over eight thousand lives in a matter of weeks. Panic-stricken residents closed their shops and businesses and fled in all directions to escape the poisonous atmosphere of the city, leaving behind unburied corpses that swelled and burst in the blistering Louisiana heat. One man was in such a hurry to escape that he decided, in the interest of saving time, not to press charges against a criminal who had stabbed him. New Orleans’s Charity Hospital was soon filled to capacity, and city officials burned tar on the street corners and fired cannons each morning and evening in an attempt to purify the supposedly unclean air. Priests and ministers were “called upon every hour of the day and night” to comfort the dying and their relatives, while evacuees spread the virus to other towns along the Gulf Coast and Mississippi River, killing thousands more. Four more major yellow fever epidemics over the next five years helped the Crescent City earn a reputation as a den of despondency and death.15
A year after yellow fever razed New Orleans, it appeared in Savannah, Georgia, and Charleston, South Carolina. Obituaries printed in the Savannah papers show a disproportionate number of the fatalities were German and Irish immigrants who had never been exposed to the disease and therefore had no immunity against it. Scores of men and women with last names like Hanns, Krauss, McDonald, and O’Donnell who had come to Georgia in search of opportunity found an early grave instead. The disease sickened Savannah’s bakers and kept farmers in the surrounding countryside from bringing their produce to market, resulting in food shortages, which compounded victims’ suffering. All one desperate resident could find to eat was “three or four spoiled hams.” Hungry, sick families were left vulnerable to looters, who took advantage of the chaos and began to plunder private homes.16
In Charleston the virus also targeted Irish and German immigrants in addition to nonimmune Americans from other parts of the United States whom native South Carolinians considered part of the “foreign population.” But by the end of September it “invaded all parts of the city” and afflicted residents of every “race” and “age,” including a number of wealthy locals who, ironically enough, had postponed their usual summer travel plans to avoid the cholera outbreaks that were said to be raging in the northern states at the same time. The Charleston papers printed the daily death toll (nineteen persons died in one twenty-four-hour period), and the city’s mayor enacted a strict quarantine on all incoming ships. People living in cities surrounding Charleston and Savannah panicked. When yellow fever appeared in Augusta, Georgia, in mid-September, a stampede of “four or five hundred persons” fled the city. Officials in Wilmington, North Carolina, were so unnerved by the reports coming out of Charleston and elsewhere that they imposed a one-hundred-dollar-a-day fine on anyone found inside their city who was known to have come in contact with the disease. By the time winter arrived and halted the epidemics in Charleston and Savannah, more than sixteen hundred people were dead.17
Yellow fever plagued the Gulf Coast of Texas as well. Epidemics hit Galveston and Houston throughout the 1830s, 1840s, and 1850s and periodically spread along the railroad lines to surrounding towns such as Cypress, Hempstead, and Montgomery. The suffering caused by these outbreaks was horrific. In 1839 Ashbel Smith was practicing medicine in Galveston when the city was struck with yellow fever. During one house call he encountered a twenty-five-year-old man he referred to as “L” whose “condition was truly awful.” Clad only in a shirt, L was delirious with fever, bleeding from his mouth, and “lying on the bed in every variety of position, sometimes on his face and knees.” Vomit and excrement were everywhere. Another of Smith’s patients, a baker named Mat, was “ejecting black vomit freely” and babbling incoherently when the doctor arrived. The unfortunate man died within a matter of hours. Such gruesome stories of misery and death reached outsiders and added to the South’s reputation as a bastion of insalubrity.18
An outbreak that struck Norfolk, Virginia, in 1855 provides a useful glance at how yellow fever could be introduced into a community. In June the steamship Ben Franklin arrived from St. Thomas, where yellow fever was known to be raging, and was immediately directed to the city’s quarantine station. After twelve days and with no reports of sickness from the ship’s captain, Norfolk’s health officer cleared the Franklin and allowed it to steam into the harbor for repairs. In early July a mechanic died of yellow fever after working in the ship’s engine room. In all likelihood he was bitten by an infected Aedes aegypti that had flown aboard the Franklin in St. Thomas, attracted by the sweaty bodies and pools of stagnant water in the vessel’s hull. Soon after the repairman’s death, the mosquitoes of Norfolk and nearby Portsmouth created the same ghastly scenes of human suffering which had horrified the citizens of Charleston, New Orleans, and Savannah in the previous two years. Coffins piled up in local graveyards, and terrified crowds flocked to the countryside to escape the disease. One Presbyterian minister in Norfolk remembered the swarms of flies that “collected about the doors and windows” outside the houses of the dying. Nearly two thousand Virginians perished during the epidemic.19
Northerners reacted to these macabre episodes with a mixture of compassion and loathing. Relief committees in northern cities raised money for victims, while nurses, doctors, and druggists headed south to give aid to the sick, occasionally contracting the disease and dying in the process. But other northerners were less sympathetic and interpreted the outbreaks as proof of the inferiority of the southern way of life. A Unitarian minister in Washington blamed Portsmouth’s “evil institutions” and “unwise laws” for the filthy conditions that allowed yellow fever to develop there. Another somewhat sanctimonious New York preacher told his congregation that one blast of cold northern air would mean more to the yellow fever sufferers in Norfolk than “a thousand physicians and surgeons convened there.” And a number of abolitionists believed the disease was divine punishment for the sin of slavery and argued (correctly, it turns out) that the malady was a consequence of the slave trade.20
At a time when “Bleeding Kansas” and the Fugitive Slave Law were fueling sectional tensions, southerners reacted defensively to these condemnations but were at a loss about how to control the disease that had grown to be identified with their section of the country. The medical community offered few answers and could not agree on the origin of yellow fever (either locally or outside the country) or even whether it was contagious or not. As a result, quarantines and sanitation measures, policies that in all likelihood helped eliminate yellow fever in northern cities in the early nineteenth century, were unevenly enforced in the South. City officials and newspaper editors often downplayed or denied the presence of the disease until the last minute in order to stave off public panics and the economic downturns that inevitably followed outbreaks. Businessmen who relied on maritime trade for a living exacerbated the problem by lobbying against lengthy quarantines that might cut into their profits.21
While Southern urbanites dreaded the return of yellow fever to their cities, they also knew that newcomers and visitors, people born in areas free from the disease, were especially vulnerable to its ravages. Locals who lived in endemic regions and contracted mild cases as children or adults enjoyed lifelong immunity. Many blacks seemed immune to the disease in the same way they did with malaria. Predictably, Southern whites observed these differences and cited them in proslavery screeds.22
In contrast, most of the New England farm boys and shopkeepers who volunteered to invade the South in 1861 had never been exposed to either yellow fever or malaria. And while their western comrades-in-arms had long been familiar with “ague,” they too were susceptible to the unique and potentially dangerous strains of the disease that flourished below the Mason-Dixon Line. In short the outbreak of the Civil War gave the arbovirus known to the Spanish as “negro vomito” and the multiple malarial parasites of the South, including Plasmodium falciparum, access to a legion of new, nonimmune hosts. An army of mosquitoes awaited the men in blue which was every bit as lethal as the gray-clad army they would face on the battlefield. And before the war ended, this army slew thousands of Union troops and influenced the strategic and operational thinking of their commanders.
The same concerns Mrs. Taylor had expressed to her daughter in the summer of 1835 were on the minds of the top brass in Washington in the spring of southern secession. Two months before the Battle of Bull Run, Commanding General Winfield Scott warned Major General George McClellan that the biggest threat to the success of Scott’s now-famous “Anaconda Plan” would be the impatience of a northern public oblivious to the South’s many dangers. “They will urge instant and vigorous action, regardless, I fear, of consequences,” wrote the septuagenarian general. “That is, unwilling to wait for the slow instruction of (say) twelve or fifteen camps, for the rise of rivers, and the return of frosts to kill the virus of malignant fevers below Memphis.”23
A veteran of two major wars, Scott knew the risks involved with sending unacclimated federal troops into a tropical environment during summertime. His concerns were echoed by another of Lincoln’s military advisors, Quartermaster General Montgomery C. Meigs. During a war cabinet meeting held in June 1861, Meigs, a native Georgian, was asked whether the military should first conquer the Mississippi River Valley or launch an attack against P.G.T. Beauregard’s army, which was then gathered near Manassas, Virginia. He told the group that he preferred to confront the rebels in northern Virginia rather than “go into an unhealthy country to fight them.”24
The northern public was more concerned about the South’s dangerous disease environment than Scott knew. Yankee physicians fretted about the consequences of sending U.S. soldiers “familiar with Northern climates and Northern diseases” into an area infested with dangerous “marsh miasm.” In Hints on the Preservation of Health in Armies, first published in 1861, John Ordronaux warned that “Northern troops, in passing now no farther south even than the lower Chesapeake,” would “enter a climate entirely foreign to their constitutions.” He thought that since Union troops from “Northern seaboard States” would be most affected by the South’s pernicious diseases, soldiers from “the great valleys of the Ohio and Mississippi” should garrison forts located in “lagoons,” “low, alluvial regions bordering on the sea,” and “the deltas of great rivers.” The pro-Union press seemed more worried about the threat posed by yellow fever. One New York Times editor advised the War Department to seize and hold inland southern cities such as Milledgeville, Georgia, and Montgomery, Alabama, arguing that these locales were less susceptible to the horrific “yellow jack” outbreaks that plagued port cities such as Savannah and Mobile. The British media hyped the threat as well by speculating that the “climate” and “terrible yellow fever” of the South might allow the Confederacy to “defy … all the levies that the North can bring against it.”
In nearly every area of the South Union troops would be forced to invade and occupy—the Gulf Coast, the tidewater region of the Southeast, the marshy lowlands along the Mississippi River—anopheline and Aedes aegypti mosquitoes thrived. Southerners were confident their “sickly season” would disrupt the operations of their unseasoned enemies but soon discovered that the diseases that they claimed as their own could work against southern armies as well. Richmond’s need for soldiers brought young men together from the Mississippi Delta and the Virginia hills who had never been exposed to each other’s plasmodium parasites, and during the first year of the war thousands of them fell ill with malaria. Yellow fever was also a threat to the Confederate army, a majority of whose members had grown up in rural areas and had never been exposed to the disease. As men from all over the country assembled to settle the issues of federalism and slavery on the battlefield, the mosquitoes of the South were galvanized by the large number of new prey that suddenly appeared in their midst. And before the guns fell silent, these tiny insects played a significant, and heretofore underappreciated, role in the events of the Civil War.25