The column has since appeared in print, so it's my pleasure to now post the full text of the column on my blog. As I stated when I first started the blog a few months ago, one of the advantages of posting the column is that I can now provide hyperlinks to relevant information and illustrations in the column; in this case, readers will be able to access the text of Francis Porcher's Resources of the Southern Fields and Forests and a wartime article in the Richmond Daily Dispatch which Guy discusses in his paper and in the interview.
by Jim Schmidt
from the September 2007 issue of The Civil War News
Nurse: “And why do you wish you was in Dixie, you wicked boy?”
Sick Boy: “Because I read that quinine is worth $150 an ounce there; and if it was that here you wouldn't pitch it into me so!”
- “Advantage of Famine Prices” (Harper’s Weekly, November 14, 1863)
During the Civil War, the Confederacy – faced with an unreliable and expensive supply of quinine – was forced to use alternative treatments. Substitutes for quinine (derived from the bark of the South American cinchona tree and used to combat malaria) were mentioned in the medical literature of the era, but few of these alternatives were advocated by Confederate officials, and fewer still are described in surviving records.
The prevalence of malaria in the Confederate ranks was a burden, to be sure. “Beside its obvious effect on a unit's ability to march or fight, illness also consumed resources - transportation, manpower, and medical supplies - because the sick had to be cared for,” Guy said. “It's like the old wisdom that it's more damaging to debilitate enemy soldiers by wounding them than to kill them outright, because dead soldiers quickly stop consuming resources.” Even sick soldiers who stayed with their units instead of going to a hospital were a burden on comrades who had to look out for them.
Even when quinine was available in the Confederacy, its quality was often uneven or unknown. Guy mentions that ruses used in smuggling led to some labeling mix-ups - sometimes between quinine and morphine – which led to confusion in camps and hospitals. It’s possible that not all of the quality problems were accidental. “I recently found an article in the Richmond Daily Dispatch that claimed that smugglers had bought adulterated quinine from Yankees and sold it to Confederate medical purveyors,” Guy told me. “The stuff was supposedly cut with strychnine and morphine. The correspondent decried the villainy of the Yankees but not the motives of the smugglers or the gullibility of the purveyors,” he added. He admits that the Dispatch story may not be true; adulteration of drugs was common at that time with the motive generally no more sinister than to increase profits.
Guy also discusses the external use of oil of turpentine as a remedy for malaria. Although it was rarely mentioned as a remedy in the medical literature before the war, it had some strong proponents among Confederate medical officers. Surgeon Stiles Kennedy attributed the efficacy of turpentine to producing enough pain to demand "the whole attention of the mind,” acting on nerve centers, and producing a stimulating effect.
Surgeons – pointing to positive numbers in ersatz “clinical trials” in Confederate hospitals – were confident of turpentine as a remedy, but the influential Confederate States Medical and Surgical Journal (CSMSJ) was more conservative. “I was surprised that the CSMSJ seemed so insightful in its evaluation of the turpentine evidence,” Guy told me. “The journal's listing of confounding factors seemed almost modern, and the editors stopped just short of saying that a control group was needed,” he added. Given the anecdotal or subjective nature of most of the literature of the time, Guy is hard-pressed to explain the seemingly higher standard for medical evidence that the journal applied in this case.
The effects and treatment of malaria are important lines of scientific research even today, especially in the Third World, as witnessed by the extensive coverage given it in the most recent issue of National Geographic. As during the Civil War, the limited availability - and affordability - of drugs, means that the majority of the world's population still depends on traditional medical remedies. Recently, herbs such as Artemisia annua have been found to have antimalarial activity, and research continues this day to exploit natural products for the next generation of medicines.