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The American Civil War was four of the darkest years in American history. Family fought family, brother fought brother, and the American people fought each other over the right to own and sell slaves, an institution established long before the combatants were ever born. Yet, this war would change the way the United States saw itself and how it was seen worldwide. However, this new view would come at the cost of approximately 620,000 to 752,000 men, women and children. [1] That is a staggering number considering the population of the United States in 1860 was 31 million.
Despite the violence and brutality of the battles during the Civil War, the darkest specter of the soldiers and civilians on either side was unseen, that of disease. Dysentery, malaria, yellow fever, typhus, typhoid fever and pneumonia were constant companions and killers in cities, towns and military camps. My annotated sources discuss three questions/debates frequently: 1) Which disease killed the most people, soldiers and civilians, during the Civil War? 2) How did hospital sanitation and care contribute to Civil War deaths? and 3) Why did the care of Black soldiers and Black civilians differ from the care given to the White population?
Question number one is unique because every source has its own opinion on which disease was the deadliest. Andrew Bell, author of Mosquito Soldiers, chose Malaria and Yellow Fever. Dr. Drew Faust, author of This Republic of Suffering, discussed Typhoid Fever and Scarlet Fever primarily, but she also mentioned outbreaks of Smallpox, Malaria and Yellow Fever. Dr. Margaret Humphreys, author of Intensely Human, mentions Malaria and Pneumonia as primary killers; yet, she says Yellow Fever was not a primary agent of death. Robert Reilly MD in his article Medical and surgical care, mentions Dysentery, Malaria, Yellow Fever, and Typhoid Fever as the top killers, with Measles and Smallpox as secondary. Dr. Jim Downs author of article The Art of Medicine, says Dysentery, Typhus, and Pneumonia were the top killers, with Yellow Fever, Typhoid Fever and Smallpox coming in right behind. Dr. Helle Mathiasen author of the article Bugs and Battles, focuses his short article on Malaria and Yellow Fever and how they were spread by mosquitos in the South.
For question #2, Dr. Drew Faust, author of This Republic of Suffering, also covers hospital sanitation and care, and that doctors and nurses frequently contracted illnesses from the patients they were treating which included: Typhus, Typhoid Fever and Smallpox. Dr. Megan Nelson, author of Ruin Nation, wrote on death, hospitals and hospital care. She documented how easy it was kill, how there were so many ways to do it during the war, and how hospital staff, especially after large engagements, were overwhelmed by the wounds they saw and how to care for so many. Robert Reilly MD, in his article Medical and surgical care, spoke not only of the diseases that ravaged the armies, but on the medical advancements the war helped to create. He wrote extensively on the advancements in both the medical and surgical fields.
To answer question #3, Susan Grant, author of The War for a Nation, focused her book on the African-American plight in contraband camps, military hospitals, and the treatment of Black POWs. Dr. Margaret Humphreys, author of Intensely Human, focused her book on African-American care in hospitals which were separate from White facilities, Black doctors/surgeons, and the regions in the South where Black troops were known to become ill more frequently. Dr. Jim Downs, author of the article The Art of Medicine, wrote on how emancipated slaves and runaways in contraband camps became sick due to the proximity of these camps to Union army camps and the lack of food and clean water available to them.
[1] Reilly, Robert F, MD. “Medical and surgical care during the American Civil War, 1860-1865.” Baylor University Medical Center Proceedings 29, no. 2 (2016): 138.