The Illustrious Dead by Stephan Talty Page B

pains” arced across the body, especially the groin and back; the voice coarsened and dropped; the face grew darker and puffy; the eyes lost their affect and appeared corpselike. Some patients reported “sensations of gnawing or tearing” in their bodies, and the headache was constant. “It felt to me as if an immense weight were pressing down the bones of the head,” wrote one survivor of the disease, “and as if the brain were reacting against this pressure by violent and rapidly successive throbs.”
    As early as the second or third day, the mind began to be affected, with men muttering to people who weren’t there or singing nursery rhymes in ghastly voices. Complete exhaustion set in; if raising a cup of water to his lips could have saved his life, one sufferer recalled, he couldn’t have managed it. Others during the brief respites found it unbearable to stay in their beds and wandered constantly. The appetite disappeared and the men began to lose weight. Around the fifth day, tiny red spots usually appeared and spread from the chest and groin all over the body, except for the face and the palms of the hands.
    These are the classic, unmistakable signs of a disease known by many names: famine fever, the Hungarian disease, hospital fever, hauptkrankheit (“head disease”), and the most famous alias, “war fever.” But it is most commonly known as epidemic typhus.
    After ten to twelve days, the illness entered its crucial phase. Some of the severely affected saw their toes and fingers blacken with gangrene. Death came slowly. “Spotted typhus is beyond description, the patient wastes to nothing under your eyes,” wrote one woman watching her famous lover die in a Russian epidemic. “Of the illness I can scarcely write—there was so much pain.” Guessing who would die was a kind of hobby. One theory held that the number of tiny spots on the body could predict the end: the more there were, the deadlier the strain. Another school held that it was the color of the spots that gave the best clue: the closer the pea-size eruptions came to purple, the more certain it was that the patient wouldn’t survive. It was a long, often terrible death.
    Gathering the ill together and mixing them with men afflicted with other, milder ailments was the worst thing Napoleon’s doctors could have done. The mistake was compounded by the fact that the bodies of the dead (left unburied in heaps in the army’s haste) were often stripped by local peasants and the clothes sold or worn. Many recipients of the uniforms soon fell ill and died; entire families were found dead in their homes. In the clothes was the answer to the riddle that had eluded doctors and thinkers for centuries, the cause of the deadly illness that was incubating in the Grande Armée as it advanced toward Moscow.
    For centuries, typhus had excelled in attacking large armies. Now as Napoleon attempted to force Tsar Alexander to heed his singular rule, the signs of a new epidemic began to appear.
    And Napoleon’s doctors could do almost nothing to stop it.
    T O UNDERSTAND WHAT the Grande Armée’s doctors were thinking as they tried to save these dying men, one must understand the complex and often contradictory state of medical thought on disease in the early nineteenth century. The theory of the humors developed by Hippocrates in the fifth century B.C. was still the dominant mode of understanding health and sickness. According to it, black bile, yellow bile, phlegm, and blood were perfectly balanced in the healthy person. When diet or routines introduced an excess or a shortage of one of the humors, disease appeared.
    But competing theories, superstitions, and straight-out quackery were layered over this belief. Medicine was very much an intuitive art as opposed to a rigorous science, and what treatment one received could vary widely, depending on what school of thought one’s physician favored. There was no universal cure for certain diseases. Age,