Silent Death: Dysentery, Disease and Sickness

Emerging Civil War welcomes back guest author Michael Aubrecht

Walt Whitman, circa 1860
Walt Whitman, circa 1860

Future years will never know the seething hell and black infernal background and it is best they should not. —Poet Walt Whitman, on the misery he witnessed in hospitals and camps

It has been estimated that well over 600,000 men died during the four years of America’s Civil War. Surprisingly, approximately two-thirds of those deaths were due to rampant disease and dysentery. Therefore, the majority of the soldiers who did not come home from the battlefield were actually sick, not shot, when they passed away.

The state of medical advancements left much to be desired at the time, as the technology that was being developed to take lives far exceeded the technology to save them. Physicians did not understand the concept of infection and therefore made little effort to prevent it. Proper antiseptics and methods of implementation were not yet developed, and the poor conditions of camps and field hospitals made sterility impossible. No antibiotics were available either, and even the most minor of wounds could easily become a fatal infection. While the typical soldier was at very high risk of being shot and killed in combat, he faced an even greater risk of dying from disease.

Army camps were literally breeding grounds for all kinds of disease, and both young and old men died by the thousands from measles, smallpox, pneumonia and malaria. Poor hygiene, the lack of adequate sanitation facilities, infected drinking water, and the proximity of animals helped to rapidly spread germs. Exposure to the elements made simple illnesses deadly. At the time, a severe case of diarrhea and dehydration could even be fatal. In an effort to prevent these senseless casualties, the armies established sanitary commissions to educate soldiers on ways to maintain a safer living environment.

American poet Walt Whitman often volunteered at Union camps and hospitals, where he assisted medical personnel in nursing the sick and wounded. He later captured the atrocious conditions that soldiers experienced when he penned the words contained in the epigraph to this post. It has been said that a soldier would come under the threat of fire infrequently, but he would be in mortal peril every day from the invisible enemies that sprung from the filth of their camps and devoured their ranks from the inside out.

Despite the healthy appearance of the soldiers in this sketch, camps were filled with germs, resulting in sickness and death.

As thousands of soldiers gathered together in tent cities, many of them were exposed to different communicable diseases for the first time. Hundreds immediately fell prey to these viruses. Their city-dwelling compatriots, however, were more likely to be immune to these diseases. Measles was considered one of the worst diagnoses, and this illness quickly made its mark on the Confederate army. One officer, Surgeon L.J. Wilson of the 42nd Mississippi, recalled a major epidemic that broke out in his camp in 1861. He stated that the rampant disease was “something that astonished everyone, even the surgeons.” Within three months, 204 men from three different regiments died. Dr. Wilson was left with over 100 more patients who were crammed into an old tobacco warehouse. Within several weeks, a new regiment could lose half its numbers to the germs.

Perhaps the most common ailments to strike the camping soldier during the Civil War were bowel disorders. The affliction of both diarrhea and dysentery was so widespread that it came to be called “the runs,” as those suffering from it would often be seen rushing to find a latrine trench. It also became known as the “Virginia Quickstep” or the “Tennessee Trot.” That said, the most devastating sickness to hit the Southern forces was typhoid fever, which was commonly referred to as “Camp Fever.”

It has been estimated that up to one fourth of all non-combat deaths in the Confederate army were the results of typhoid. During the winter of 1862–63, troops stationed in the Fredericksburg area suffered in misery as the spread of respiratory sickness enveloped the army. One soldier wrote, “It is fearful to wake at night, and to hear the sounds made from men about you. All night long the sounds go up of men coughing, breathing heavy and hoarse with half choked throats, moaning and groaning with acute pain, a great deal of sickness and little help, near or in the future.”


Aubrecht, Michael, The Civil War in Spotsylvania: Confederate Campfires at the Crossroads (The History Press, 2009).

Robertson, James I., Jr. Tenting Tonight (New York: Time-Life Books, 1984).

Toalson, Jeff, No Soap, No Pay, Diarrhea, Dysentery & Desertion: A Composite Diary of the Last 16 Months of the Confederacy from 1864 to 1865 (iUniverse, Inc., August 18, 2006)

Welch, Spencer Glasgow, A Confederate Surgeon’s Letters to His Wife (Neale Publishing Company, 1911).

7 Responses to Silent Death: Dysentery, Disease and Sickness

  1. I am going to bring this up because I think it is something that needs to be remedied. My Masters thesis is on Civil War/military medicine, and the article above is an excellent example of the truth–many more men died of illness–mostly not pretty illnesses–than were victims of combat. Yet time and time again I speak at organizations whose members were–miraculously–all victims of combat. All those ancestors died on the battlefield. My, my!

    A soldier or sailor is no less a hero because he was marched to death, fell victim to unsanitary conditions, or could not fight off the ravages of infection. My husband’s Civil War ancestor did NOT make it up Lookout Mountain–he died in a wagon near the rear of the army with a pantload of poop and nothing else left to give to his country.

    So let’s have some honesty here, folks. We aren’t all related to royalty, and our ancestors were not all killed in combat. Let us honor men (and women) whose “last, full measure” may not sound as grand and glorious as some, but it is the truth, and not an alternative fact.

    1. I meant to say “Yet time and time again I speak at organizations whose members have ancestors who were–miraculously–all victims of combat.” I blame it on the cat . . .

  2. I think there is another facet of this that needs mention. In his recent books relative to General John Bell Hood – and in this instance especially germane to the wounds the General suffered – author Stephen Hood includes the detailed journal kept by the doctor who attended him. It’s interesting that much of the doctor’s recorded efforts reveals a deliberateness and constant attention in respect to attending to the general and frequently changing dressings and cleaning the wound. Did he know, or suspect, that there was in fact a connection between those efforts and reducing the risk of infection? There probably isn’t any means of being sure. But, it emphasizes that men of higher station on both sides seemed to get a level of care that was unavailable to the thousands of ordinary soldiers suffering from this deadly combination of diseases. It was this horrific loss that inspired many improvements in medical care that occurred after the war. If there’s a silver lining around this dark cloud that’s it!

    1. The idea of sanitation was brought to the forefront during the Crimean War, which immediately preceded our American Civil War. During that conflict, Florence Nightingale, “The Lady with the Lamp,” pioneered the idea of combining sanitation and sustenance in treating Britain’s wounded. Her experiences were not lost on the American medical community. Thanks to the greatly increased survival rate of the wounded British military brought to light from the Crimea, our own soldiers and sailors were much better off than they otherwise would have been. This is not to say, of course, that conditions for them were not typically abominable.

  3. Michael – interesting piece. One of my own ancestors, John M. Crutchfield, 60th Va Infantry, died at Chimborazo in Richmond (March 1865) after first being wounded at the Battle of Piedmont in June of 1864, then being transferred to the infamous Camp Morton (Indianapolis, Indiana). He was subsequently transferred to Chimborazo in a prisoner exchange. Records aren’t specific about what killed him, but I assume it could have been complications from his wound and the ill treatment at Camp Morton or, as you point out, dysentery. Though he did not “die in combat”, his death was certainly a direct result of wounds received in combat. He’s buried in a common grave with 2 other men at Oakwood Cemetery in Richmond. Thanks for writing this!


  4. Thanks Michael. It’s good you educate us about the “silent death” that was an equal opportunity killer on both sides in the Civil War, and much more effective at ending lives than all the Minié balls and artillery ordnance that the North and South could muster. And, as you pointed out, the medical science and understanding– as well as the sanitary practices– of the 1860s were not up to the challenges disease presented. Union Surgeon General William A. Hammond called it spot on when he recognized that the Civil War “had been fought at the end of the Medical Dark Ages.”

    I’ve been fascinated with these topics since I read one of my ancestor’s detailed accounts of his Army of the Potomac camp over the winter of 1861-62. As you acknowledged in your piece, extreme weather and the elements were excellent allies of illnesses and contagious diseases. These combined forces propelled the death rate in his camp so high that military funerals were suspended and burials were conducted without formal ceremony. Several weeks ago I submitted an article to ECW that shares my ancestor’s descriptions of the cold and wet hell he and his comrades endured. Hopefully it will build on your excellent introduction to the silent killers of the Civil War, adding first-person perspective and insight on the literal struggle for survival that played out in Union and Confederate camps that first winter of the war.

  5. Thank you for your thoughtful comments. It is a far too neglected topic and I appreciate you all providing additional information that I found fascinating. – Michael Aubrecht

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