EDITOR’S NOTE: In commemoration of the sesquicentennial of the American Civil War, Midlothian resident Karen Esberger has written a series of columns of historical facts relating to the War Between the States.

Third in a series

The question has been raised: which was deadlier — bullets or disease during the War Between the States? The unequivocal answer is DISEASE.

A noted historian of the War wrote, “The most destructive enemies of the Confederates were not the Yankees but the invisible organisms which filled the camps with sickness.” Today’s “childhood diseases” were prevalent since vaccines had not yet been developed. Diseases that could easily be treated with antibiotics nowadays had to run their courses without medications to even else soldiers’ discomfort, much less save their lives.

The Confederate medical corps was perennially short of personnel and supplies. Local hospitals and soldiers’ aid societies existed in most cities, but the sick and wounded did not get enough food or medicines, especially in later years of the war. Even surgical instruments were in short supply, and doctors often had to use ordinary knives as scalpels. Many who died could have been saved with enough supplies and personnel.

Soldiers felt little hope of receiving proper care or of surviving. The high mortality rates increased their dread.  No one received enough appropriate attention. One doctor to 70 patients was common.  Much unnecessary suffering occurred due to incompetent physicians. Thus the soldiers were justified in feeling little faith in the healing abilities of physicians or hospitals or in their own chances.

Many diseases ran rampant in Confederate camps. One quarter of deaths due to disease among the Confederates were due to typhoid. The rate would increase when new inductees reported, then drop off again.  Smallpox was not reported by the Rebels until after the battle at Sharpsburg, Maryland. Perhaps the germs were on some Yankee clothing. Deaths due to smallpox were high, in spite of isolation, quarantine, and vaccinations.

Other major offenders in Confederate camps were measles, scarlet fever, gangrene, malaria, and dysentery.  Seventeen percent of the Rebels got pneumonia. In some locations, pneumonia was taking hundreds and was even more fatal than typhoid fever.

Many had rheumatism, then thought to be due to cold and dampness. Also prevalent were scurvy and other vitamin-deficiency diseases, chronic arthritis, erysipelas, and yellow fever. The only way to lessen cases of yellow fever was to move the troops away from swampy, low, moist areas, e.g. stagnant bayou water.

Whole units might be affected at once by measles, diphtheria, malaria, diarrhea or dysentery, for example.   Even if few died from a particular diagnosis, entire units might be out of action temporarily.

Malaria, dysentery and diarrhea were the most prevalent camp diseases. One sixth of admissions to Chimborazo Hospital, Richmond, Virginia, were for dysentery/diarrhea, and, of those, a tenth died. If they survived, diarrhea left them weak and susceptible to other diseases.  Poor diet and exhaustion left the Confederates very vulnerable to dysentery/diarrhea and lead to increased fatalities.

The rates of bronchitis, catarrh, scurvy, erysipelas and tuberculosis fluctuated at various times with weather, food supplies, and the number of new inductees.  Mumps occasionally appeared.  Venereal diseases increased when the camps were located near cities or when the men were granted furloughs. “Camp itch” due to scabies or lice or other parasites was common; this condition would lessen when camp officers were serious about camp hygiene.

Frequent problems specifically in Walker’s Texas Division included brain fever, flux, black tongue (pellagra), measles, pneumonia, and typhoid fever.  Some believed that the high rates of typhoid fever that occurred after First Manassas showed that the central government could not properly care for its wounded and dying men.


Karen Kay Esberger, Ph.D., R.N., is a retired nurse who is now President of Daffan-Latimer 37, the Chapter of the United Daughters of the Confederacy in Ellis County. For further information, see www.txudc.org