Disease, Death, and Despair

The American Civil War experienced greater casualties than any other American war thus far. Totals are estimated to be around 560,000 deaths with twice the number of deaths caused by disease than battle wounds, several thousands more were left with injuries that would impact their daily routines for the rest of their lives.[1]

As mentioned above the majority of fatalities were not accrued on the battle field, but in the camps where unsanitary conditions created breeding grounds for disease. The most common disease during the war was chronic diarrhea due to vitamin deficiencies.[2] In order to understand the significant toll of disease on the Union army here are some statistics to create a clear and distinct picture. A total of 6,000,000 illnesses were treated in the North alone however only 425,000 of those occurred on the battlefield. In addition, diarrhea/dysentery affected 711 per 1000 men and various camp fevers affected 584 per 1000 men. Some further enlightenment, in one Union regiment of the 937 soldiers only 79 were healthy enough to fight after disease had spread through the camp in only a few short weeks.[3] Clearly, disease was a seriously detrimental issue of the Civil War, no man was left unaffected by these ailments and as the statistics show it’s hard to believe that any were truly healthy.

Unsanitary conditions and lack of understanding about the importance of cleanliness also contributed to mortality rates. Author Richard H. Shryrock, of the article, “A Medical Perspective on the Civil War,” quoted Philadelphia surgeon W. W. Ken, “ ‘We operated in blood-stained and often pus-stained coats. . .with undisinfected (sic) hands. . .We used undisinfected (sic) instruments. . .and marine sponges which had been used in prior pus cases and only washed in tap water.’ ”[4] The main cause of death after an injury was hemorrhaging and infection. A chemical named Lister was used during the war but surgeons only used this once they realized the wound was infected. This method was reactive rather than proactive; if surgeons had sterilized wounds from the onset the casualties would have been greatly reduced.[5] Surgeons lack of knowledge regarding medicine practices certainly attributed to the number of deaths however as compared to previous wars the medicine practice had improved during the Civil War.[6]

At the time of the war and even today there is a negative stigma attached to Civil War surgeons. The inadequate supplies, tools, sanitary conditions, and medicine however was the leading cause of death during the war. True many surgeons had little schooling but many did the best they could under the circumstances. There was little in the way of numbing medicine (often whiskey or morphine, both in short demand) so many men felt very distinctly the pain or surgery.[7] The Civil War was a hard time to be a soldier, medicine and surgery notwithstanding

When I first started researching medicine of the Civil War I was hoping to find more information on amputations but the statistics are unclear. Many amputations were unsuccessful due to hemorrhaging and infection. If a soldier was shot in the abdomen region his chances of survival were slim. Often it was better to be shot in the leg or arm where hopefully the broken bone would be amputated, leaving a soldier with a missing limb but alive nonetheless. The minie balls were especially harmful to soldiers, the size and weight nearly always left the soldier with irreparable injuries.[8] The number of pictures of amputated limbs of the Civil War would make many believe that the majority of deaths were a result of battle injuries. Today modern medicine has found several treatments for disease virtually eliminating it as a source of death in combat, instead wounds and injuries are the leading cause of American military deaths today, a complete reversal of 150 years ago.

* An interesting side note from Swiss physician Edwin Klebs in the 1880s: “ ‘. . .the greatest and most admirable success has been attained by the North Americans in military medical work. This history of the war of the secession has to show a display of medical and scientific activities that leave anything that ever since has been achieved in Europe way in the background. . .’ ”[9]


[1] Harold Ellis, Review of Civil War Medicine: Challenges and Triumphs, by Alfred Jay Bollet, British Medical Journal 325, no 7356 (2002), 170 http://www.jstor.org.ezproxy.colostate-pueblo.edu/stable/25451894 (accessed July 4, 2012).

[2] Ellis, 170.

[3]  Michael A. Flannery, “Civil War Medicines: Approaches for Teaching,” OAH Magazine of History, 19 no. 5 (2005), 42 http://www.jstor.org.ezproxy.colostate-pueblo.edu/stable/25161979 (accessed July 4, 2012).

[4] Richard H. Shryock, “A Medical Perspective on the Civil War,” American Quarterly, 14 no. 2 (1962), 162 http://www.jstor.org.ezproxy.colostate-pueblo.edu/stable/2710639 (accessed July 4, 2012).

[5] Shryock, 163.

[6] Shryock, 164.

[7] Bollet, 170.

[8] Shryock, 162-163.

[9] Shryock, 169.

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4 comments
  1. charlesanselmo said:

    When viewing this thread I cannot help but envision the Civil War soldiers as being unwilling guinea pigs for crackpot surgeons. As disheartening as it it to view it like that, it seems that is how many medical professionals have viewed the Civil War. With the crude tools and poor understanding of diseases and the importance of cleanliness, the Civil War became a trial by fire for the practice of medicine.

  2. catymark said:

    This is actually not as depressing as I thought it would be upon reading the title. The medical advancements have come a long way in a relatively short time, saving many soldier’s lives. It is rather disheartening to know that “physicians” didn’t know anything about infection and the need to clean their instruments and hands. The soldiers’ lives were more or less in the hands of their ill trained doctors. The evidence presented here is interesting; I knew that more soldiers died during the war of disease than of battle wounds, but the actual numbers are shocking.

  3. The statistics of the amount of Union soldiers who died mostly from disease and infection because of unsanitary conditions and the lack of knowledge to infection is very sad. By today’s standards, it is difficult to believe how primitive medicine was during the Civil War period. This topic gives us an excellent glimpse into the “infancy” of the medical field during the mid-19 century and how horrible It had to be for Civil War soldiers who could have been saved from death had medicine been more advanced than it was. I reflect on our “Wounded Warriors” returning from the Middle East and although some have lost perhaps a limp or two, fortunately today they can still live productive lives, thanks to the advanced medical technology. Some disabled veterans have even ventured out to accomplish great physical challenges, like competing in marathons or mountaineering. There is no doubt that we have come a long way in caring for our wounded soldiers today.

  4. jadams08 said:

    It is shocking to think how many men could have been saved from sanitary medical equipment. It is also hard for me to imagine men dying from vitamin deffinciancies because that is something that just does not happen in our part of the world today. Doctors and surgeons during the Civil War had a tough role to play when you think about how many amputations they did in a day, I would go crazy too. Many worked long hours and saw horrific things during the war and you would think sooner rather than later that would take a tole on their physical and psychological well being.

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