Civil War Medicine: Common Diseases of the Civil War

Disease was a critical problem among Civil War armies. Out of more than 700,000 soldiers who died during the Civil War, two-thirds of soldiers died from disease or infection rather than battle wounds themselves. Why was disease such a big issue? What diseases were the most common?

Winter Encampment at Centreville, VA 1861-1862. LOC

Unfortunately, at the beginning of the Civil War, medical personnel limited modern knowledge about diseases. While there were studies in bacteriology and anatomy, doctors had little knowledge of what caused illness, how it affected the body internally, and how it spread. Thus, physicians focused on treating the symptoms of the disease, not the cause itself. Unsurprisingly it did not take long for disease to spread through camps.

At the beginning of the Civil War thousands of soldiers gathered in camps young and old, urban and rural. While soldiers from cities were not as strong as those who grew up working on a farm, they lived in densely populated areas and had a stronger immune system due to exposure of different diseases. Many soldiers from rural communities lacked this exposure to various illnesses such as smallpox and measles, causing a high rate of infection.

A comparison of smallpox and cowpox vaccinations, early 19th century. Public Domain.

There were several epidemics (defined as a widespread occurrence of an infectious disease in a community at a particular time) that spread throughout the armies during the Civil War.  Many history enthusiasts may have heard of the smallpox epidemics that took place during the American Revolution. These epidemics were so deadly, killing 3 out of 10 Continental soldiers, that Washington ordered all troops inoculated in 1777. The process of inoculation involved taking a scab that had fallen off a smallpox patient and rubbing it into a cut on a healthy patient’s arm. The patient would get sick, but not as sick as contracting the virus naturally and one they recovered they would to be immune to the disease. By the 19th century, smallpox vaccination was discovered by giving patients cowpox, a similar virus found in animals that gave immunity to smallpox. This reduced the amount of smallpox cases. From May 1861 to June 1866, there were only 12,236 recorded cases of smallpox in the U.S. Army which numbered millions.

Much more prevalent during the Civil War was measles, which was often ignored since it was considered a childhood disease.  The symptoms of measles are like smallpox. Victims had a fever, cough, runny nose, and eventually a rash of red spots that could cover the entire body. With camps teaming with people never exposed to measles, many soldiers were highly susceptible to the disease. By the end of the Civil War, 67,000 Union soldiers contracted measles and more than 4,000 died.

Boiling Lice. National Museum of Civil War Medicine.

On top of the rapid rate of spread among soldiers, lack of adequate hygiene routines could make camps just as dangerous as the battlefield. Garbage piled up in camps without proper disposal. Latrines were dug too close to water sources causing contamination. Soldiers bathed infrequently creating a suitable environment for pests, such as lice. To rid themselves of these pests, some soldiers sanitized lice-infested clothing in a pot filled with boiling water. They then cooked food in the same pot.

Many of these soldiers had little experience with cooking. Before enlisting in the army their wives, mothers or enslaved had taken care of that for them. As a result, many soldiers over-boiled meat and vegetables cooking all the nutrients out of them. While food was plentiful at the beginning of the war, it did not take long for food to become scarce. Fresh fruits and vegetables that had proper vitamins and nutrients did not last long so soldiers had little access to them. Soldiers received some meat, but often, it spoiled or was too full of preservatives to eat. With the lack of proper nutrients, a soldier’s immune system became more susceptible to disease.

Some of the most common diseases found during the Civil War were intestinal diseases caused by contaminated food and water, as well as poor living conditions. Most common was a bacterial infection called typhoid fever. Symptoms include muscle aches, headache, stomach pain, diarrhea and it was one of the most feared diseases throughout camp because it was so common. Known as “camp fever” it caused about ¼ of the deaths caused by disease.  Unfortunately, doctors did not know the cause of typhoid fever and so treated only the symptoms with opiates, turpentine, quinine, capsicum (an herbal medicine), and calomel (mercury chloride).

19th Century Medicine Chest. National Park Service.

Another intestinal disease, dysentery was caused by bacteria or parasites caused by poor living conditions or contaminated food or water. Marked by bloody diarrhea, fever, nausea, and cramps, it acquired many humorous names from soldiers. Some called it the “the runs”, the “Tennessee Trot”, or the “Virginia Quickstep”. Purgatives like turpentine or castor oil were used to treat dysentery. The disease was not always fatal, but it did cause many deaths because of the treatments used. For example, in October 1863, Private John Leopold of the 74th Pennsylvania was admitted to the hospital with dysentery. Surgeons tried medicines such as turpentine, lead acetate, aromatic sulfuric acid, tincture of opium, silver nitrate, belladonna, and calomel to treat the disease, but unfortunately, he died after twelve days of treatment.

A woodcut of soldiers being distributed quinine. March 11, 1865. Harper’s Weekly.

Even the environment was a hazard to soldiers’ health Mosquitos carried parasites that caused many deadly illnesses. Most common were yellow fever and malaria. They both have similar symptoms including fever, tiredness, vomiting, headache and in severe cases, yellow skin, seizures, and death. But, while yellow fever is a virus, malaria can be treated with medicine.  In the 1860s, there two treatments were found to help alleviate the symptoms: arsenic and quinine. During the Civil War, many soldiers were issued a ration of quinine, often mixed with whiskey to cover the unpleasant taste. This method proved effective and is still used today to treat the disease.

While many of these illnesses are still around today, they are not nearly as prevalent or deadly as they were 161 years ago.

7 Responses to Civil War Medicine: Common Diseases of the Civil War

  1. In 1861, measles, in an adult , was a fatal disease.

    In 2022, measles in an adult, is still a fatal disease.

    Childhood diseases doesn’t mean that the disease is benign. It means that you are supposed to get this as a child.

    Those who refuse the vaccine are the ones at risk.

  2. My great-great-grandfather, Ralph G. Terry was in Company C of the 24th Michigan Infantry Regiment. He mustered in on August 15, 1862, On October 6, 1862, he contracted Infantry Fever. Not knowing what that was, I contacted the Museum of Civil War Medicine in Frederick, Md. They told me that Infantry Fever was probably malaria. Ralph Terry was in and out of hospitals for quite some time, but was released just in time for Gettysburg. Besides malaria, he was wounded four times. On May 11, 1864, he received a gun shot wound in his right hand at the Battle of Laurel Hill. On June 5, 1864, he received a gun shot wound (shown on a Casualty List but location and nature of wound was not specified), at Cold Harbor. On June 18, 1864 he received a flesh wound on his right ankle during the Seige of Petersburg, Va. On July 4, still at Petersburg, he received a flesh wound on his left arm. The fever continued to plague him throughout the remainder of the war.

  3. As a physician with civil war medicine as a hobby, I found the above article to be well done and largely correct. The second paragraph, however, suggests that ‘bacteriology’ was studied in medical schools. This specialty did not really begin until the studies of Koch in Germany and Pasteur in France were recognized a number of years later. And it would take several more decades for the concept of infectious disease and the need for antisepsis in surgery to be accepted. Of interest is the fact that with the common contamination of drinking water with infective agents, boiling was the only way to prevent infection. Ironically, Northern troops’ obsession with coffee, when available, forced them to boil the beans in water to make their coveted brew and indirectly provided them with a safer source of water. Because of the blockade, Southern troops had little access to coffee.

    1. Nice comment Professor!

      Practices such as quarantine were also used to combat the spread of disease. The 20th Maine was unable to participate in the Battle of Chancellorsville in April-May 1863, due to a quarantine prompted by a tainted smallpox vaccine that had been issued to the unit’s soldiers. And this practice of quarantine was continued up to World War II. A polio out-break at Fort Bliss necessitated a quarantine of soldiers.

      1. Excellent point. Although the causative agents were not known, isolating groups with a disease was sometimes found to be effective. And actually, the structure of the military has been more effective with quarantine than attempts in a civilian population, where individual rights arguments can sometimes counter a quarantine attempt.

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