Civil War Medicine: Andersonville’s Medical Horrors

Historians are still getting their arms around the number of men who served in the Federal and Confederate armies. For a long time it was over 3 million: 2.75 for the North, .6 for the South.1

Recent scholarship, however, has shaken all of this up. Drew Gilpin Faust, for one, has placed the two opposing armies’ numbers at 2.1 million Northerners and 880,000 Southerners.2 The number of war deaths has also shifted. 618,000 was the long-accepted figure (360,000 U. S. and 258,000 C. S.)3   J. David Hacker has shaken all of this up by refiguring the two armies’ casualties after looking at postwar census records. He has concluded that the total casualty count was much higher than the traditional 618,000 number—rather, it stood at least at 752,000, perhaps as high as 851,000.4

How many of these were captured and imprisoned? In 1903 Adjutant General F.C. Ainsworth stated to historian James Ford Rhodes that 193,743 Northerners and 214,865 Southerners had been prisoners during the war. Of these, more than 30,000 Federals and almost 26,000 Confederates had died in captivity.  This led Professor Rhodes to calculate that 12% of imprisoned Rebels and 15.5 % of Federals died in their places of confinement.5 More recently, Drew Gilpin Faust has tinkered with the numbers of those imprisoned: 194,743 Federals, 215,865 Confederates. Of these, 30,218 Northerners and 25,976 Southerners succumbed.6

What were the deadliest of these hell-holes? Lonnie R. Speer provides a helpful tabulation7:

             DEATHS            MOST HELD
Andersonville GA 12,919 32,899
Camp Douglas IL    4,454 12,082
Salisbury NC 3,700 10,321
Point Lookout MD 3,584 22,000
Elmira NY 2,933 9,441
Fort Delaware DE 2,460 12,600
Camp Chase OH 2,260 9,423
Rock Island IL 1,960 8,607
Camp Morton IN 1,763 5,000
Alton IL 1,508 1,891

Diseases, of course, were the big killers, and their types reflected the horrid conditions in the camps. By order of Dr. Samuel P. Moore, the Confederate Surgeon General, Dr. Joseph Jones conducted a medical inspection of Andersonville. In mid-October 1864 he filed a report of his findings. “Diarrhea, dysentery, scurvy and hospital gangrene were the diseases which have been the main cause of this extraordinary mortality,” Jones reported to Richmond.8 As we know today, diarrhea and dysentery were gastrointestinal ailments primarily caused by ingestion of foul food and dirty water. The latter contributor was easily explained: prisoners at Camp Sumter drew their drinking water that had already been fouled by the excrements of Confederate guards. The same “sewage system” applied to the prisoners, who relieved themselves into its water farther downstream. Little wonder, then, that prisoners strained to fetch stream water, which flowed in from the west, as close to the stockade wall as they could, without violating the dead line.

Scurvy was more than a dietetic disorder, according to Dr. Jones; it exacerbated every other ailment, “modified the course of every disease, [and] poisoned every wound, however slight.” Among enlightened scientists, scurvy was known to have been combated by the ingestion of fruits and vegetables—the very food groups, however, that were in such short supply in the Confederate army’s food distribution apparatus. Dr. Jones elaborated:

The effects of scurvy were manifest on every hand, and in all its various stages, from the muddy pale complexion, pale gums, feeble, languid, muscular motions, lowness of spirits, and fetid breath; to the dusky, dirty, leaden complexion, swollen features, spongy, purple, livid, fungoid, bleeding gums, loose teeth, oedematous limbs, covered with livid vibices and petechiae, spasmodically flexed, painful and hardened extremities, spontaneous hemorrhages from mucous canals, and large ill-conditioned spreading ulcers covered with a dark purplish fungous growth.9

“Hospital gangrene” was the term of the time, basically expressing physicians’ puzzlement, decades before the germ theory of disease took hold, at how wound infections could seemingly leap from patient bed to patient bed. Dr. Jones, a man of no small scientific acumen, was so perplexed that in the fall of 1864 circulated an eight-page questionnaire to Confederate surgeons, soliciting their comments on the origin ad observable symptoms of gangrene.10

In his lengthy report, Dr. Jones quantified the lead killers among the Union prisoners at Andersonville. He covered the period from March 1 to August 31, 1864.11

Disease Number of cases Number of deaths % deaths/cases
diarrhea 12,082 3,530 27%
scurvy 9.501 999 10.5%
dysentery 4,682 999 21%
malaria 2,608 113 .4%
dropsy (kidneys) 1,510 315 20.9%
pneumonia 478 234 49%
typhoid fever 472 185 39%

One quickly notices the discordantly low death rate from malaria. In the Civil War medical armamentarium, quinine was the only effective therapy, having been found providential in the treatment of the disease.12

So a lot of Yankees were dying at Andersonville in the summer of 1864. (The largest number of deaths on one day was 127, on August 23.13 ) By that time, the third year of the war, hatreds among the warring peoples ran so deep that the more vengefully-hearted partisans could actually revel in the enemy’s death toll.

This is what one sees on the front page of the Atlanta Daily Intelligencer of August 19, 1864.14 We quote it in its entirety.


During one of the intensely hot days of last week, more than three hundred sick and wounded Yankees died at Andersonville. We thank Heaven for such blessings.

A curious calculation has passed through our mind, dated on this information.

We find that this would make 1800 feet, equal to 600 yards, or more than a quarter of a mile of dead Yankees.

A procession of wagons, one to each man, reckoning twenty feet to the wagon, would make a line 6000 feet or more than a mile long.

To bury them side by side, would require a trench 600 feet long, equal to 200 yards, 7 feet wide and five feet deep.

It would require 120 men to dig the graves.

200 carpenters to make boxes.

25 drivers to the wagons.

25 assistants to bury them.

25 wagons to haul them.

40 mules to pull them.

It would require 6 good, steam saw mills constantly running, to furnish sufficient lumber to make the coffins, reckoning the work of each mill at 2500 feet per day.

At 50 feet for each coffin the sum total would be 15,000 feet.

To the funeral cortege we will allow for charity’s sake 00000000 mourners.


1 J. Wm. Jones, “Relative Numbers of the United States and Confederate States Armies, Southern Historical Society Papers, vol. 32 (1904), 46; J. G. Randall, The Civil War and Reconstruction (Boston: D. C. Heath and Company, 1937), 685.

2 Drew Gilpin Faust, This Republic of Suffering; Death and the American Civil War (New York: Alfred A. Knopf, 2008), 3.

3 Randall, Civil War and Reconstruction, 687.

4 J. David Hacker, “A Census-Based Count of the Civil War Dead,” Civil War History, vol. 57, no. 4 (December 2011), 307.

5 William B. Hesseltine, “Introduction” in Hesseltine, ed., Civil War Prisons (Kent OH: Kent State University Press, n.d.), 6.

6 Faust, Republic of Suffering, 134.

7 Lonnie R. Speer, Portals to Hell: Military Prisons of the Civil War (Mechanicsburg PA: Stackpole Books, 1997), 323-39.

8 Jones report, Oct. 119, 1864, OR, ser. 2 vol. 7, 1012.

9 James O. Breeden, Joseph Jones, M.D.: Scientist of the Old South (Lexington: University Press of Kentucky, 1975, 191.

10 Stephen Davis, “A Confederate Hospital: Surgeon John Patterson and the Clayton During the Atlanta Campaign, 1864,” Journal of the Medical Association of Georgia, vol. 75, no. 1 (January 1986), 19.

11 Joseph Jones, “Observations upon the diseases of the Federal prisoners confined at Camp Sumter, Andersonville,” OR, ser. 2, vol. 8, 614.

12 Paul E. Steiner, Disease in the Civil War: Natural Biological Warfare in 1861-1865 (Springfield IL: Charles C. Thomas, 1968), 5.

13 Ovid L. Futch, History of Andersonville Prison (Tallahassee: University of Florida Press, 1968), 44.

14 “DEAD YANKEES AT ANDERSONVILLE,” Atlanta Daily Intelligencer, Aug. 19, 1864.

2 Responses to Civil War Medicine: Andersonville’s Medical Horrors

  1. Im puzzled by the data that reports about the sawmills, lumber, and carpenters for making the coffins. The first dozen or so prisoners were buried in pine coffins. From then on they were buried naked, shoulder to shoulder with any coffin.

  2. The logistics involved in the treatment of the dead was simple because the process had to be simple. Take the clothing off the body (if it hadn’t already been removed by fellow prisoners), load the body on a cart or wagon and transport to a nearby place for burial. Upon arriving, the bodies were literally thrown into a trench that was not very deep. The bodies were often so close that one could also say they were on top of each other. All of this process was necessitated by expediency and available resources.

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