The Mosquito

by Timothy C. Winegard

  Over the course of the war, the Union dispensed 19 tons of refined quinine and 10 tons of unrefined cinchona bark to its soldiers as both a treatment and a prophylactic for malaria. For the Confederacy, however, “the effectiveness of the Union naval blockade meant that southern surgeons . . . suffered from quinine shortages for most of the war,” says Bell. “Given the prevalence of malaria in the South, it is astonishing that any Confederate troops were healthy enough to fight by the end of the war, when Richmond’s quinine supplies were extremely low.” This precious quinine certainly did not trickle down to the troops on the battlefield. Confederate politicians, including Jefferson Davis, had healthy stocks of quinine tucked away for themselves and their families. Ironically, while the naval blockade halted yellow fever, it allowed malaria to thrive.

  The astronomically increasing price of quinine in the Confederacy throughout the war attests to the cumulative effects of the Union blockade. It also signals that the smugglers knew just how crucial and sought-after the diminishing supply of the medicine was to a southern population suffering from unrelenting endemic malaria. In the opening year of the war, an ounce of quinine averaged $4, increasing to $23 by 1863. At the close of 1864, on the black market supplied by blockade runners, the price per ounce ranged from $400 to $600. By war’s end, quinine smugglers operating out of the Caribbean were making an incredible 2,500% return on their initial investment.

  “Advantage of ‘Famine Prices’”: An 1863 cartoon from Harper’s Weekly mocking the shortage and skyrocketing price of quinine in the Confederacy. “Sick Boy: ‘I know one thing—I wish I was in Dixie.’ Nurse: ‘And why do you wish you was in Dixie, you wicked boy?’ Sick Boy: ‘Because I read that quinine is worth one hundred and fifty dollars an ounce there; and if it was that here, you wouldn’t pitch it into me so!’” (Library of Congress)

  As the dealing in contraband quinine became increasingly profitable, it was smuggled into the Confederacy by any means possible, including many of the same creative methods used by drug mules or traffickers today. It was sewn into the bustles and skirts of women masquerading as traveling nuns or aid workers. It was stuffed and stitched inside children’s dolls, furniture, and upholstery. To clear Union customs and navigate checkpoints, carefully packaged cinchona powder was transported inside the anal canals and intestines of livestock. At the gates of Vicksburg, Grant’s sentries apprehended a trio of women carrying contraband quinine under false bottoms of their luggage. The lifesaving drug was confiscated and doled out to Union soldiers, although unlike their malaria-pricked Confederate counterparts, they had plenty of quinine in circulation already.

  Grant’s medical staff at Vicksburg had enough quinine on hand not only to treat malarial patients but also to distribute daily preventive doses to healthy soldiers. “The hospital arrangements and medical attendance were so perfect, that the loss of life was much less than might have been expected,” Grant said in praise. “I venture the assertion that no Army ever went into the field with better arranged preparations.” Quinine was so abundant that it was even administered to feverish “sallow-cheeked and sunken-eyed” Confederate prisoners and to local “haggard and care-worn” civilians. Malaria still incapacitated 15% of Grant’s force during the campaign as the drug—depending on the dosage, quality, and concentration of the active quinine ingredient—is not perfectly mosquito-proof, and many men refused to take the bitter medicine.

  The beleaguered Confederate forces and civilians trapped inside Vicksburg with dwindling provisions and no quinine were not so fortunate and faced a bleak, mosquito-bristling reality. “The dreary wastes of oozy swamp and fen,” wrote a British war correspondent, were deadlier “than sword or bullet.” Without quinine, “no man alive could have counteracted the effects of that climate,” he concluded. Rebel soldiers and hapless residents ensnared by Grant’s dazzling strategic designs and bloodthirsty mosquitoes, he confessed, were confronted with an abject existence of “malaria, salt pork, no vegetables, a blazing sun, and almost poisonous water.” Under the showering cloudbursts of Union shells, those holed up in Vicksburg were beset by malarious mosquitoes, described by a Confederate physician in a letter to his wife as “the largest, hungriest, and boldest of their kind. May you never know a mosquito!” The same mosquitoes that had served as Vicksburg’s guardian angels and driven off Union forces a year earlier now became Vicksburg’s own pixies of death. “The enemy’s shells annoyed us, but there was another foe we had to contend with,” wrote Confederate surgeon Dr. W. J. Worsham from inside Vicksburg, “more annoying than the enemy’s shells—the mosquitoes, or, as the boys called them, ‘gallinippers.’”

  Six weeks into the siege, the situation inside Vicksburg mirrored that of Jamestown’s Starving Time. A young Confederate soldier wrote home to his parents, pleading for provisions because abnormally large “Gallinippers” had pinned him “by the throat” and stolen his “Boots, hat, & 5,000 doll[ars] In Green Backs.” Ravenous civilians and soldiers ate dogs, rats, leather shoes and belts, and a few reports of cannibalism among the 3,000 huddled civilians surfaced after the war. To avoid the incessant shelling, soldiers and civilians took refuge in over 500 caves dug into the yellow clay hills and mockingly called “Prairie Dog Village” by Union soldiers. Malaria had also killed or sickened 50% of the initial 33,000 Confederate troops, who were depicted as “an army of scarecrows.” Union soldiers sympathized with what was described as “the woeful sight of a beaten, demoralized army—humanity in the last stage of endurance. Wan, hollow-eyed, ragged, sore-foot, bloody, the men limped along.”

  Amid the subdued celebrations of American independence, on July 4, the day after Lee’s Confederate Army was routed at Gettysburg, Grant accepted the unconditional surrender of Vicksburg. “The Father of the Waters,” announced Lincoln upon hearing the news of Grant’s victory, “again goes unvexed to the sea.” As Grant predicted, “the fall of the Confederacy was settled when Vicksburg fell.” With the crucial port city now under Union control, the Confederacy was split in half, precluding the lifeblood cattle, horses, corn, and other agrarian yields west of the Mississippi from reaching and sustaining Lee’s Army of Northern Virginia, while the snaking blockade tightened its grip on an already depleted and resource-starved South. More importantly, as malaria ripped through the veins of the gray-clad southern soldiers, this cordon also denied the Confederacy much-needed quinine. It was only a matter of time before the enslaved peoples “shall be then, thenceforward, and forever free.” The name the “Victor of Vicksburg” echoed through the corridors of power. Although most politicians, including Lincoln, had never met Grant in person, in the highbrow social circles and sycophantic cocktail conversations of Washington, he was rapidly becoming something of a celebrity.

  Grant’s unrivaled battlefield prowess, his lack of political ambition and bureaucratic scheming, and his personal opinions on emancipation and the military employment of African Americans quickly endeared him to the president. Having suffered and endured a succession of inept, maladroit, backstabbing, and politically plotting generals, Lincoln had been desperately scouring his senior ranks for his own Robert E. Lee since the drubbing at the First Battle of Bull Run. “Lincoln had heard that Grant claimed he could not have taken Vicksburg without the Emancipation Proclamation,” reports acclaimed author Ron Chernow in his superlative 2017 tour-de-force biography needing only the title Grant. “Once again, Grant’s sympathy with the broad political aims of the war formed no minor part of his attraction in Washington.” Chernow establishes that after Grant’s martial showmanship at Vicksburg, the unpretentious and self-effacing forty-one-year-old soldier was “a rising star in the Lincoln firmament, for he was fast becoming the president’s beau ideal of a general: one who regularly beat the enemy while endorsing the expanded war aims” of liberating and mobilizing southern slaves.

  Not only was Grant personally opposed to slavery, but he also fully supported the moral and military tenets of the Emancipation Procl
amation. “By arming the negro we have added a powerful ally,” he wrote Lincoln shortly after the fall of Vicksburg. “They will make good soldiers and taking them from the enemy weakens him in the same proportion they strengthen us. I am therefore most decidedly in favor of pushing this policy.” Grant’s strategic military assessments and personal views were harmonious with those of Lincoln. The two leaders immediately formed an unfailing bond and trustworthy union that would transform the fortunes of the war and the country itself.

  In March 1864, Lincoln promoted Grant to lieutenant general, a rank previously reserved exclusively for George Washington. “The President . . . eight inches taller”—measured by Grant’s aide-de-camp Horace Porter during the official ceremony—“looked down with beaming countenance upon his guest.” As commanding general of Union forces, Grant was now answerable only to the president, who was enraptured by his new military spearhead. “That man Grant has been of more comfort to me than any other man in my army,” Lincoln pledged. “Grant is my man, and I am his the rest of the war.” The cigar-puffing, alcoholic, tongue-tied, taciturn, short, and dowdy Grant, who stood in sharp contrast to the tobacco-abstaining, teetotaling, articulate, eloquent, loquacious, towering, and lanky Lincoln, summed up his commander in chief as “a great man, a very great man. The more I saw of him, the more this impressed me. He was incontestably the greatest man I ever knew.”* With their unwavering mutual respect, loyalty, and admiration, the like-minded military partnership and faithful personal friendship of Grant and Lincoln, who both had been lampooned and disparaged by detractors as bumpkin hayseeds from the western prairies, would win the war and forge the future of the nation.

  Grant’s campaign at Vicksburg was a microcosm of the wider war during its final two years. Larger and healthier Union forces were pitted against smaller and sicklier Confederate forces. For the first time in history, quinine helped decide the outcome of a war. The combination of sheer population and healthier soldiers prodded the Union to victory. According to John Keegan, “the Union triumphed in the end only because of larger numbers and greater wealth of resources.” Manpower was a serious problem for the Confederacy during the final two years of the war. To fully appreciate the influence of malaria and quinine in breaking the Confederacy, we must first do a bit of number crunching.

  Roughly 2.2 million soldiers served in the Union forces from a total available population of 22 million. Approximately 1 million Confederates fought from a total population of 4.5 million, excluding another 4.2 million slaves. By the close of 1864, of men between the ages of eighteen and sixty years, 90% of those in the Confederacy had served or were serving, compared with 44% in the North. But by 1865, desertion became a serious problem for Confederate commanders, with as many as 100,000 troops taking unauthorized convalescence at any given time. As the end of the war drew closer and desertion increased, the arms of Confederate conscription lengthened to embrace males between the ages of fourteen and sixty. Still, this sweeping measure could not shore up the compounding military shortcomings and deficiencies, reverse years of slaughter, offset the fading stocks of human fodder, or dam the bloodletting and the flow of deserters. By February 1865, with 16% of his army astray and unaccounted for, a disheartened General Lee confessed to Jefferson Davis that “hundreds of men are deserting nightly.” These numbers were compounded by rampant malarial infection and a severe lack of quinine. Abundantly supplied Union troops and allied malarious mosquitoes had tapped and bled dry the fighting strength and spirit of the Confederacy.

  It is worth keeping in mind, as US forces would realize later during the Pacific War and in Vietnam, that a sick soldier is just as useless to the war effort as a wounded soldier, and twice the burden of a dead soldier. A sick soldier needs to be replaced on the line while also continuing to consume resources. The dead do not drain supplies and manpower through medical attention and care. In the case of mosquito-borne disease, the sick also act as a conduit for the spread of infection to their fellow soldiers, continuing the cycle of contagion. This may seem harsh, but pragmatically, sick soldiers are deadweight and a taxing military handicap. “That the Confederacy suffered from a shortage of quinine in the war,” stresses Margaret Humphreys, physician and professor at Duke University’s School of Medicine, “made a significant difference in the number of men able to render military service. . . . The Union blockade then caused an acute shortage of quinine to the South, leveling the playing field further.” Unlike the Union, the Confederacy could not replace combat casualties, and recurrent malarial sickness drained the ranks of already dwindling Confederate field forces. “There can be no doubt,” Humphreys continues, “that the Confederacy did not have enough quinine to adequately treat malaria.”

  By 1864, the Anaconda Plan was 95% effective in strangling southern trade. In the spring of that year, Grant’s loyal and dependable friend and subordinate, General William Tecumseh Sherman, began his scorched-earth “March to the Sea” from Tennessee through Georgia and eventually up the Carolinas, cutting a 200-mile-wide swath of wanton destruction. Union soldiers burned crops and farms, impounded livestock, and destroyed railways, irrigation facilities, dams, and bridges. Sherman’s controversial tactics unintentionally broadened mosquito habitats and malarial infection across the South. Famine, disease, and deprivation gripped Confederate soldiers and civilians alike. The South was effectively being starved and sickened into submission by General Sherman, mosquitoes, and blockading ships.

  “Before Petersburg—Issuing Rations of Whisky and Quinine,” March 1965: This engraving for Harper’s Weekly depicts a Union “Quinine Parade.” Quinine was a war-winning weapon for the well-stocked Union. For the Confederacy, scant and inadequate supplies caused manpower shortages in the face of unremitting malaria. (U.S. National Library of Medicine)

  Meanwhile, confiscated consignments of quinine, food, weapons, and other vital supplies intended for Confederate troops ended up in the veins, stomachs, and hands of their Union enemies. “While the Union soldier’s ration was increased during the war,” explains Keegan, “the Confederate’s shrank,” reckoning that “the Union soldier was the best fed on record.” During the war, President Lincoln heeded Napoleon’s advice that “an Army marches on its stomach.” More importantly, as we’ve seen, the Union had ample supplies of quinine. Apart from this lifesaving cinchona powder, however, medical knowledge and practices during the Civil War were still rudimentary and antiquated.

  While experimentation with chloroform and ether anesthesia was a Civil War medical breakthrough, amputation was the preferred surgical practice, so mountainous piles of severed limbs littered field hospitals. Treatment for disease remained archaic. Revolutionary-era remedies such as mercury, bleeding, cupping glasses, and other superstitious cures were still common practice. As in the past, soldiers systematically avoided hospitals, viewing them as morgues rather than halls of healing. Hospitals served as the pivot transportation terminal for interchangeable infections, with soldiers swapping out one for another. Those suffering from illness generally sucked it up and soldiered on without seeking treatment. Union cavalryman John Kies, for example, was admitted after a Rebel round shattered his arm at Second Bull Run. He confessed to the doctor that he had been suffering from malaria for two months. Kies survived his battlefield wound. He even survived the amputation of his arm. He did not, however, survive his skirmish with malaria.

  As the war dragged on and scarce quinine supplies evaporated or became generally unaffordable, southerners medicated with all sorts of useless tree barks and other quinine substitutes. The Confederate surgeon general instructed doctors to use indigenous remedies “as may be found growing in proximity to every hospital and station.” A dense guidebook, Resources of the Southern Fields and Forests, was issued in 1863 to Confederate physicians and field commanders, itemizing a vast catalogue of worthless homeopathic replacements for quinine and other medicines. Across the South, ersatz substitutes for all manner of medicines and foods, includ
ing coffee, were consumed.

  A Union artillery officer later wrote, “Coffee was one of the most cherished items in the ration. If it cannot be said that coffee helped Billy Yank win the war, it at least made his participation in the conflict more tolerable.” In fact, the paper bag was invented in 1862 as a lightweight, cheap, and compact way for Union troops to carry their coffee. When Rebel and Yankee soldiers readily mingled and socialized, tops on the Confederate bartering list was coffee. “The Boys,” wrote Union sergeant Day Elmore from Atlanta in July 1864 at the onset of General Sherman’s March to the Sea, “have been to gather a number of times . . . traiding [sic] coffee for tobacco.” The most utilized Confederate coffee replacements were made from acorns, chicory, cotton seeds, and dandelion root. Coffee or not, by 1865, creative substitutes could not feed or cure the civilian population, let alone Lee’s shattered army, which was being badgered across Virginia by Grant’s robust Union columns. After a dogged nine-month stand around Richmond, on April 2, Lee abandoned the city to its fate.

  “Hard Times in Ole Varginny, an’ Worse a Cumin’! Scene—Rebel Pickets in Western Virginia,” Harper’s Weekly, January 1862: Two Confederate soldiers griping and grumbling about “gitting another Shake of that Ager [ague/malaria] and no quinine in the ‘Federacy! Worser still! Got them Blue Devils after me, an’ nary drop o’ Whisky!” As the Union naval blockade, dubbed the Anaconda Plan, put a stranglehold on Southern trade, endemic malaria and a dire shortage of quinine shackled Confederate soldiers and civilians throughout the war. (Library of Congress)