On Memorial Day, we take a single day out of the year to remember Americans (both by birth and adoption, both volunteers and draftees) who died for our country in war. The holiday conjures up iconic images of valor and dramatic death in battle: Minutemen at Bunker Hill, the motley defenders of New Orleans, bluecoats on Little Round Top, Rough Riders charging up on San Juan Hill, doughboys in the Argonne Forest, Navy torpedo bombers at Midway, G.I.s wading ashore at Normandy, Marines on the blasted hellscape of Iwo Jima and in the snowy passes below Chosin, soldiers besieged at Khe Sanh, firefights in the mountains near Kandahar, convoys on the road to Baghdad.

Death in wartime, however, has long had another face, especially in the nation’s first century and a half: disease. Bringing men from far-flung communities (often farms and small towns) and packing them together in close quarters, exhausted by marching and fighting and sometimes ill-clothed and fed, disease ran rampant. Indeed, in every American war before 1941, more soldiers died of disease than from battle. George Washington’s army was ravaged by smallpox, which he described as more dangerous than “the Sword of the Enemy”; the Continental Army lost ten men to disease for every one in battle. Two-third of the Civil War dead were from disease; in the Spanish-American War, that number rose to five-sixths. Half of military deaths in the First World War were from disease, mainly the Spanish Flu, and more died from contracting it just while signing up to serve. The Second World War saw heroic efforts to fight tuberculosis and malaria, but even with battle casualties rising to two-thirds of deaths, there were still 113,842 fatalities from disease or non-battle injuries (including the war’s many training accidents). For the wars between 1861 and 1918 in particular, the numbers and array of causes are grim:

During the Civil War in the United States, of 304,369 troops lost by the Union Armies from all causes, 186,216 died from disease. Dysentery and diarrhea accounted for more than 44,000 of these deaths; typhoid fever killed nearly 35,000, and malaria caused the death of about 8,000 soldiers.

When the Spanish-American War broke out…[a] call for volunteers quickly brought some 125,000 men into training…14,000 cases of typhoid fever had appeared among them. A government Typhoid Commission, headed by Dr. Walter Reed, reported that “more than 90 per cent of the volunteer regiments developed typhoid fever within eight weeks after they came into camp.” A force of about 17,000 men landed in Cuba at the end of June but [faced] outbreaks of typhoid fever, dysentery, malaria, and finally yellow fever…[in the First World War,] the [American Expeditionary Force] lost 50,510 men as a result of enemy action…disease killed 50,714 men..

These were, for the most part, miserable and pathetic ways to die, full of vomiting, diarrhea, sores, fevers, chills, and gasping for breath. The dead won no decorations for bravery. Their losses were not commemorated in movies, novels, statues, poems, or murals. Yet they, too, gave all for their country’s wars. In a year when most of us are spending Memorial Day in some form of quarantine, it is particularly appropriate to remember them as American heroes.

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