ABSTRACTA SICKLY LITTLE WAR:EPIDEMIC DISEASE, MILITARY CAMPAIGNS, AND THE SPANISH-AMERICAN WARByMark A. Youngren Before the twentieth century, disease killed more people during military operations than enemy action. This was particularly the case when soldiers from the temperate regions of Europe and North America were sent to fight in the tropical regions of the world, where they faced a disease environment filled with pathogens against which they possessed no natural defenses. The fear of epidemic disease was a constant companion for senior commanders down to the lowliest soldier, affecting when, where, and how the war was planned, fought, and supported; it affected who was recruited to fight and the willingness of individuals to go to war; and as epidemics began it greatly increased the burden on supply and transportation systems while requiring more and more recruits to simply maintain the numbers available to fight. Despite this, many histories of conflicts fought during this era have treated disease as merely an environmental factor that reduced the fighting strength of each side, less important than the strategies, tactics, and weapons which have been the focus of traditional histories of war. As medicine improved from the humoral theories of the ancient world to the bacteriological revolution that ushered in the germ theory of disease, military commanders and doctors began to understand the disease threats, but even at the end of the nineteenth century that knowledge was frustratingly incomplete. The Spanish-American War (1898) was one of the last conflicts of this disease era – more than seven men died from a disease for every one killed by enemy action. This research is the first scholarly effort to place as much emphasis on the medical weapons available to fight or avoid disease as on the military weapons used to fight the enemy, combining medical and epidemiological history with military history to evaluate the decisions made by the senior American leadership in light of the new discoveries on infectious disease and the lessons learned from previous conflicts fought in tropical regions. It shows that many of the deaths from that war were avoidable given the information available to the decision makers; furthermore, the country came close to losing the critical Cuban campaign of the war due to epidemic disease and the failure to prepare for the known disease environment on the island. Doctors were still torn between the older theories of miasma and contagion and the newer theories of bacteriology and insect vectors, puzzled by viral diseases that failed to show a disease bacterium visible under the microscope. To the thousands of men that died from typhoid, dysentery, malaria, and yellow fever, the Spanish-American War was not a “splendid little war” but rather a “sickly little war” that found the military and medical leadership woefully unprepared despite the medical and military knowledge available to them.
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