If any disease deserves its own military history, it ought to be malaria.  Indeed, British medical officer Col. C.H. Melville went further, declaring in 1910 that "the history of malaria in war might almost be taken to be the history of war itself." Malaria - and its cousin, yellow fever - had significant implications during the American Civil War and the debilitating consequences of the disease were already certain before the Civil War had started in earnest and well before its final history had been written, despite the considerable mystery that surrounded its actual cause.

Andrew M. Bell's new book, Mosquito Soldiers: Malaria, Yellow Fever, and the Course of the American Civil War, based on his 2006 doctoral dissertation, both removes the mystery and increases our understanding of these two diseases, which he declares "have [been] given short shrift" in most medical histories of the war.  While seemingly short, in fact Mosquito Soldiers covers much ground.  The title comes from Bell's apt conclusion that the insect served as a "mercenary force, a third army" during the war. 

The first chapter describes the science behind the diseases, their transmission by the Anopheles and Aedes mosquitoes, and their impact on ante bellum America.  Chapters 2-6 cover the history of the diseases during the war, for which Bell draws on the Official Records and other sources to make a good case that the insects and disease (and fear of disease) affected campaign and battle strategies.  A final chapter describes the role of "biological warfare," through acts of sabotage and terrorism (albeit based on misunderstandings of disease etiology) and the effect of the Union blockade on Confederate medical supplies, especially quinine.

Bell justly spends a good amount of time on quinine, "the most potent weapon Civil War surgeons had in their fight against malaria."  Derived from the bark of the South American cinchona tree, the alkaloid was an effective remedy for the fever and debilitating chills caused by malaria; indeed, it continued in use until the 1940s, when it was replaced by other drugs.  The Union enjoyed a ready supply of quinine and regimental surgeons dispensed many tons of the drug over the course of the war.  Bell also explains that the South suffered from a quinine shortage for most of the war.  The federal blockade limited the availability of quinine and other drugs and what little made it through the blockade or could be smuggled through Union lines was seized by Confederate quartermasters.

Civil War enthusiasts who are interested in the naval aspects of the war will be especially pleased with Mosquito Soldiers.  Noting that "Malaria [and yellow fever] . . . also sickened thousands of Union and Confederate sailors who patrolled the South's inland waterways and coastal harbors during the war," Bell describes how the diseases affected naval campaigns and life on specific vessels (the USS Delaware and the CSS Florida are only a few of several interesting cases).  As a resident of Houston, this reviewer was especially interested in Bell's lengthy discussions of outbreaks among soldiers and civilians on the Lone Star coast, especially in Galveston where an 1864 outbreak of "yellow jack" led to hundreds of deaths.

Mosquito Soldiers is supported by several interesting appendices, including one consisting of maps of malarial incidence among Union troops year-by-year as well as a map of yellow fever outbreaks.  The bibliography demonstrates Dr. Bell's use of an array of period newspapers, letters and diaries, and medical reports as well as relevant secondary sources, all supported by excellent explanatory endnotes.  The writing is clear and engaging.

Highly recommended.

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