“Trench fever”: health, sickness, and the art of having a lousy war

sick bay
‘The Sick Bay’. Copyright- Imperial War Musueum. http://www.iwm.org.uk/collections/item/object/16862

‘The general health of the troops on war service’ is ‘actually better at this moment than it is at home’, the Scotsman announced in March 1915. ‘Modern Medical Science. Mitigating Disease in warfare’ appeared as the celebratory heading of a further article the following month. Even in July 1915, the same tone of congratulation was apparent; if some 6500 British soldiers had, by that point, been killed on Turkish soil alone, nevertheless, as readers were informed, ‘not even a microscopical portion of the fatalities is traceable to any weakness in the condition of our men’. ‘Our army’s extraordinary good health’ and ‘wondrous immunity from disease’ were soundly commended. ‘Never have soldiers entered upon a campaign in better physical fettle’, the Scotsman proclaimed.  In contrast to the Boer War, when typhoid had ‘killed a far greater number of our men than did the enemy’, here, too, the conditions of an eminently modern war had come to prevail:

it is safe to say that had a war of the magnitude of the present struggle, and conducted like it under siege conditions, entailing great hardships, prolonged exposure to the most inclement weather, and the billeting of large numbers of men in insanitary quarters for many months together, been undertaken by the British nation a few years ago, it would have been accompanied by an outbreak of disease which would have decimated our forces

By no means restricted to the Scotsman, articles of this kind appear across the spring and summer of 1915 in a wide-ranging and robust discourse of health.

For modern readers, this evocation of good fortune amidst the realities (and casualties) of WWI can appear somewhat anomalous.  It was resonant, too, of a certain proleptic irony.  Headlines in August 1915, for example, foreground another new locution – and a previously unknown condition in which ‘physical fettle’ was noticeably lacking while the ‘wondrous immunity from disease’ had apparently disappeared.  ‘Mysterious Disease like Influenza’, the Daily Express instead announced on 18th August, describing a rather different facet of life at the front. This was trench fever, an illness which, as its name confirmed, would come to be seen as yet another distinctive aspect of trench warfare.  Conventionally dated to the autumn of 1915 (see e.g. Dr M. G. Millar’s article Lice and Men***, as well as the relevant entry in the Oxford English Dictionary), it’s clear that trench fever was already well-known — as well as endemic — some months earlier. A missive sent from British Army Headquarters on August 16th was nevertheless carefully reassuring. If trench fever was widespread, innovation in terms of illness merely demonstrated the continuity of WW1 in terms of the other aspects by which a ‘great war’ might be identified and defined:

Nearly all great wars produce their own disease, which generally proves to be a variant of some other, locally modified. So far we have been exceptionally fortunate in being able to produce nothing more serious or more puzzling than trench fever.

As we might expect, the politics of naming can be revealing. If trench fever confirms location (and assumed point of origin) with a certain neutrality, the soldiers’ preferred term, as the Express also explained, was ‘Liquid German Fever’ – a name which was, in fact, grotesquely illustrative of what was known as the ‘melted German’ theory of origin. That the putrefaction of bodies within the trenches (and trench walls) was the source of infection was a staple part of the popular mythology of trench fever in the summer of 1915.  Meanwhile, on the other side of ‘No Man’s land’, the Germans endured what they variously called ‘Polish fever’, ‘Meuse fever’, ‘intermittent fever’ or ‘Five day’s fever’. If the terminology differed, the symptoms were the same.  Trench fever, as the Express elaborated, was characterised by a ‘rise in temperature for an average of four days’, together with ‘headache, nausea and great lassitude’.  By 1918, some 800,000 Allied soldiers had been infected. As the Clark Papers in the Bodleian Library in Oxford illustrate, trench fever was, in fact, to become so commonplace (and familiarised) that trench as defining element was often deemed redundant. ‘Harry Milton has fever, in France’, Clark’s War Diary records in November 1916, for example. Fever was, by definition, trench fever, in a specialised usage that lasted throughout the war.

From the point of view of Words in War-Time, such patterns of use confirm yet another shift in the language of WW1. It is equally clear, however, that trench fever did not suddenly emerge in the summer of 1915 without historical — or linguistic — antecedents. If trench fever as locution can seem remarkably stable by late 1915 (being adopted, as we have seen, in official communications by August of that year), we can also track earlier instances in which a new type of illness seems to be being indicated — even if these assume other manifestations in terms of language. One such example can, for instance, perhaps be located in January 1915:

Even the officers cling to the regulation garments selected on the outbreak of the war, not recognizing the wisdom of adapting themselves to the special circumstances. The result is that rheumatism, lung complaints, several varieties of influenza, and a kind of swamp-ague are all materially assisting the Allies in Flanders’

Here, what is termed swamp-ague is distinguished from the ‘several varieties of influenza’. Like trench fever, this is linked to the physical conditions of warfare and to the trenches as a literally unhealthy environment (not least given the excessive damp of the winter of 1914-15). Attributions of liquid German fever meanwhile, as we have seen, made such ‘unhealthiness’ even more explicit. That trench fever was also referred to as malarial fever in popular discourse makes plain another possible hypothesis in contemporary thinking whereby pathogens from dead bodies might, via mosquitoes, be transferred to those who fought at the front. ‘There is said to be a good deal of malarial fever among the troops in France’, as another entry in Clark’s War Diary (here in December 1916) usefully records. The real cause, however, remained unknown, while the clustering of cases meant that by July 1915 there was a widespread perception that a new and distinctive illness had come into being.

Seen in terms of language, however, we might note a parallel diction which also comes into prominence in 1914-15, whether in the early complaints of a soldier in mid-September 1914 that, within a few weeks of war beginning, he was not only foot-galled but vermin-ridden (‘I joined Lord Kitchener’s Army last Monday, a clean, fit young man. To-day I am a poor vermin-ridden, foot-galled, half-starved incompetent, like hundreds more’) or in the targeted advertising which began to appear in the summer of 1915 by which, say,  the ‘MAXEM ANTI-VERMIN BODY BELT’ promised ‘a sure protection against Vermin’. Similar was the “Ever-Clean” Body Belt, advertised in November 1915 complete with its own imagery of invasion and needful defense:

The “Ever-Clean” Body Belt for soldiers is a wonderful device of remarkable value to our men at the front. It is impregnated with certain chemicals deathly to all kinds of insects, vermin and parasites. Not only does it clear the person of all pests which are present, but repels further attacks.

That trench fever might be a product of not only of a metaphorically lousy war (here in another shift which derives from trench slang) – but instead a quite literal consequence of the lice which were the constant companions of the solders of the front, remained unsuspected.  Language in 1915 can therefore be used to reveal two parallel narratives – one in which the diction of fever, malarial fever, liquid German fever, and trench fever becomes increasingly widespread, and the other in which lice, body-vermin, and infestation prompt a range of remedies to be sent to the Front (and, in turn, an increasingly elaborate diction of their own). Lice, as another advertisement tellingly stressed already in June 1915, were a trench plague. In 1915 (and 1916), however, these narratives remain distinct — and the consonance of trench plague and trench fever unsuspected. Only in late 1917 would cause and effect finally be brought together through the researches of the Trench Fever Committee. As the Oxford English Dictionary explains (here in an entry revised in 2014), trench fever was, in reality, ‘a fever of infectious origin’ and, in terms of WW1, ‘a rickettsial disease epidemic in the trenches … transmitted by the human body louse, and typically characterized by fever’.  Relevant evidence is given from the Lancet in late September 1915, in an article which had, in fact, accompanied the first appearance of trench fever in the OED in 1933 (when it was defined simply as ‘an infectious disease incident to men engaged in trench warfare’). Language, lexicography, and popular diction can therefore usefully intersect in the process of definition, redefinition, and understanding in this respect. As the Words in War-Time archive confirms, however, trench fever was clearly well-established – as word and illness – in the previous summer, as well as being, at least linguistically, interestingly  diverse in its changing patterns of use.



See Millar’s comments that: “The first description of trench fever was made by Major J. Graham in September 1915. He wrote a short article called “A Note on a Relapsing Febrile Illness of Unknown Origin.” but the first publication, actually calling the disease “Trench Fever” was by Captain G. H. Hunt and Major A. C. Rankin in October 1915”


One thought on ““Trench fever”: health, sickness, and the art of having a lousy war

  1. Only just got to this one.

    The point about armies and disease is very relevant to the overall picture. The early war comments about the remarkable health of the soldiers was in comparative terms entirely true. Typhoid did indeed kill more men than bullets in South Africa – in fact a lot more. In nineteenth century wars you could typically expect 3 to 4 disease deaths to every one in combat. Typhoid, cholera, dysentery, malaria and typhus killed armies, not fighting.
    So the First World War was genuinely a surprise – the first conflict where armies did not die like flies from disease. Ironically it was improvements in public health that made trench warfare possible. Previous sieges had always ended when disease so weakened an army that it collapsed, for example in the Crimea in 1855 or in Virginia in 1865.
    The delousing rituals of the Western Front prevented any mass outbreak of typhus, which in 1915 was epidemic in Poland and Serbia. Chlorination of water controlled dysentery and cholera.
    By comparison the trench fevers of 1915-18 were relatively mild affairs. The armies suffered higher losses of personnel from VD. My understanding is that the acronym FUO was still often used as the diagnosis by regimental medical officers. I’m not sure to this day there is any clear idea what it was- although it sounds a lot like infections you can get from tick bites.
    I’d never heard the ‘melted German’ theory- yuck!


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