Compared to what is known about military aspects of the English Civil Wars, there is very little published information about the interaction of social factors, such as disease and diet, which clearly influenced the capacity of a soldier to fight a battle.
This situation has been brought about in the main by the paucity of published information available to the general reader. However, through the efforts of, for example, Caliver Books, Partizan Press and other similar specialist booksellers and publishers, some of the more readily accessible tests on medical matters are now available.
Given the primitive state of knowledge about the nature of disease, human anatomy and physiology that existed at the time, it would not be surprising if the effects of ill health had a greater influence upon the course of military history than has hitherto been recorded. Taking, for example, the Boer War at the turn of this century, and the Peninsula Wars at the time of Napoleon, campaigns for which there is a substantial residuary record, one can make some intelligent guesses about how the Civil War soldier would have fared in the face of epidemic disease, upon campaign or if wounded. One can make such projections because medical knowledge remained largely static from the time of Galen until the late Victorian era, with one or two important exceptions.
Perhaps the biggest toll of human life anywhere in mid-seventeenth century England was taken by infectious disease. The best known of these, and perhaps the most greatly feared at the time, was Bubonic Plague, known as "The Great Pestilence". In period literature one finds the terms "plague" and "pestilence" used for a variety of fevers, so that a careful scrutiny of the symptoms and circumstances is required to establish a precise diagnosis.
It is not normally realized that plague existed in England as an endemic disease for about 400 years, enlivened by periodic epidemics and occasional spectacular pandemic, the best known of which is, of course, the Great Plague of London in 1666. Plague is now known to be a disease of rats, which readily cross-infects to man via a carrier flea, when the death rate amongst rats reaches epidemic proportions. In contemporary accounts, rat deaths are seldom mentioned, suggesting that they were so commonplace that they were not worthy of comment.
During the years of the Civil War there were severe outbreaks of plague in a number of towns and cities in England and Wales, especially during 1644, and to a lesser extent 1645. Similar outbreaks occurred if rat fleas were transported in bales of woolen and other cloths from one town to another. This mode of transmission accounted for the characteristic sudden and sporadic outbreaks of plague in apparently unconnected locations.
The name "camp fever" is synonymous with typhus, and arose from the affinity of the disease for the crowded conditions typical of the primitive army encampments, where personal hygiene was non-existent. Unlike plague, this disease is readily transmitted from person to person via body lice, although the initial infection originates, again, from rats.
The largely open nature of the Civil War, with relatively few prolonged sieges, mitigated against plague as a major threat to troops who could, if they were aware of the presence of the disease in a town, avoid it. Person to person infection with the causative organism of typhus was a different matter entirely.
The pattern and symptoms of the fever that decimated the Earl of Essex's Army at Reading in 1643, suggests typhus. Likewise, Sir William Waller's successful siege of Chichester in early 1644, was also followed by an outbreak of typhus amongst the garrison, and which killed, among others, Sir William Springate of Kent. Other serious outbreaks in 1644 occurred in several west country towns, particularly Tiverton in Devon, which was occupied for periods of time by both Royalist and Parliamentarian armies in turn.
Other important "siege diseases" were smallpox and measles. The garrison of Basing House suffered from an outbreak of the former in 1644 at the height of the 19-week long siege (led by Colonel Richard Norton). However, it is not popularly appreciated that the species of smallpox prevalent in England at this time was in fact the mild European version known as Alastrim, and not the more virulent Asiatic form which replaced it. Otherwise, the siege of Basing House would have ended abruptly with the death of most of the besieged. Similar outbreaks of a disease which disfigured rather than dealt death, occurred in the Oxford garrisons during 1644, and no doubt amongst many other unrecorded towns and villages as well.
It is quite possible that within a few days of the beginning of a campaign march, many troops acquired sporadic or sometimes constant diarrhea (the "soldiers' disease" of the Napoleon Peninsula campaigns). This would have been caused by a variety of enteric organisms, including typhoid, paratyphoid and dysentery, arising from inadequate supplies of fresh water, and the problems of poor sanitation and hygiene.
Another contributory factor would have been the uncertain nature of the daily diet and the vagaries of the weather. Sergeant Nehemiah Wharton, who campaigned with Holles' Regiment of Foot (parliamentarian) in the late summer and early autumn of 1642, vividly describes how, for lack of other sustenance, the marching troops "drank stinking water", sometimes scooping it from the shallow indentations left by horses' hooves! While on a number of occasions he and his fellow soldiers wee soaked to the skin, and unable to dry their clothing adequately. Even officers were not immune to this hardship, as witness the tribulations endured by Lieutenant Archer of the London Trained Bands when serving with Sir William Waller's Army at the siege of Basing House in the autumn of 1643. It is hardly surprising that the soldiers welcomed supplies of ale and Perry as drink.
The privations endured during the winter months must have produced a considerable number of cases of sickness, due to conditions associated with extremes of cold, continual exposure to wet clothing and footwear, and the debilitating effects of an inadequate diet. Pneumonia and bronchitis must have been an ever-present hazard, while tuberculosis would have exacted an annual toll of deaths. Even the cool, wet summers (as ever a feature of the seventeenth century climate as they are of England today) would have produced a crop of similar illnesses.
Both Sir William Waller and Sir Richard Browne wrote to Parliament after the disastrous 1644 campaign in the midlands, graphically describing the parlous conditions, especially of the infantry. Again, even officers of foot regiments who shared the harsh campaigning rigors in common with the soldiers that they commanded were not immune (e.g., the deaths of Colonel James Houblon and Captain Grove of the Southwark Auxiliaries at Northampton during the last days of June 1644).
Another problem, peculiar to the marshy, waterlogged fens and of lowland areas of Somerset, Kent, Essex, etc., was that of malaria. Well-documented examples are difficult to come by, although frequent reference to "ague" or recurrent fever is highly suggestive of malaria. Certainly Oliver Cromwell, himself a "fenman", showed evidence of having this infection for most of his life. This disease remained endemic in England until early twentieth century.
The generally unsanitary nature of seventeenth century warfare meant that the clothes of campaigning soldiers rapidly became filthy, often lousy (witness Nehemiah Warton's soldiers stripping the corpse of a Royalist drummer and finding his shirt "very lowsey"), and as a result of this, wounds frequently became infected, often with fatal consequences.
The low resistance to infection engendered by the poor diet, incipient vitamin deficiencies (especially scurvy) and the climatic rigors to which troops were exposed compounded this problem. In a society in which the principal mode of transport was the horse, the risks of contracting tetanus, septicemia and gangrene were high. Such deaths were protracted and often agonizing.
Some examples include Lt.-Colonel Johnson of the Basing House garrison "shot in the shoulder whereby contracting a fever he died a fortnight after"; Lt.-Colonel Anthony Fane, a dragoon commander at the storming of Farnham Castle "shot through the cheek(s) whereof he died a few days later"; "One Lieutenant Vernon.....of a Kentish regiment.....was on the Monday before February the 10th (i.e. February 5th) shot in his left shoulder.....he died and was buried in the chancel.....February 12th". All the more remarkable was the fact that Lt.-Colonel John Birch was hit in the stomach by a musket ball at the storming of Arundel (Dec.1643) and survived it. He took almost three months to recover from the wound. The cause of the fatalities was the result of fragments of dirty cloth being driven deep into a wound, either beyond the reach of the surgeons' instruments, or more likely, being left there to fester!
Disease affected animals as well as man, indeed some rather fearsome infections can be cross-transmitted. For example, anthrax or "murrain", sometimes known as wool-sorters disease, recent research suggests was in fact the Black Death of the Middle Ages, and not the bubonic plague as is customarily believed. Cattle suffered particularly from a disease, the symptoms of which closely resemble rinderpest, and which was widespread, especially in 1648.
Above all the health and well being of horses would have been of paramount military importance. Chronic worm infestations were a major problem. Normal treatment was to force the horse to swallow a noxious draught of fluid designed to rid the animal of its burden of parasite, a procedure known as "drenching", and still sometimes practiced today. It cost £10 to shoe and drench the horses of Colonel Richard Norton's regiment in April 1645 (about 150 strong). Various recipes abounded, some worse than others, and none probably very effective, apart from a purgative action. Anyone who has seen or participated in this method of treating a horse will appreciate the traumatic effect it has on both horse and handler!
In summary, although one cannot be sure, it is likely that death and incapacity due to illness, whether infectious or caused by diet and/or climatic conditions, may well have played an important role in deciding some of the military outcomes of some Civil War engagements. It clearly affected the fighting capacity of many soldiers, particularly unacclimatized town-dwellers, like the London Trained Bands, who were quite unused to the rigors of the frequently unfriendly English climate. A great deal of research is still needed in this fascinating field of study.
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