American Civil War Union General William Tecumseh Sherman put it succinctly when, in a letter to city officials in Atlanta during the war he stated, “War is cruelty, and you cannot refine it” (It is believed he shortened this to “War is Hell” during an address at the Michigan Military Academy but no proof exists). Nothing could be more accurate. The American Civil War was the deadliest and most destructive war in American history. It is estimated that 620,000 soldiers died – some historians now place that number closer to 750,000 – with the Union and the Confederacy seeing significant losses.
According to the American Battlefield Trust, prison camps during the war were potentially more dangerous and more terrifying than the battles themselves. Prisoners of war had to deal with unsanitary conditions with contagious illnesses spreading like wildfire. While the exact number of prisoners who died in Civil War camps isn’t known, it’s estimated that 56,000 died in captivity, which exceeded the U.S. combat losses in World War I, the Korean War, and the Vietnam War.
To compile a list of the top causes of death for Civil War soldiers in prison camps, 24/7 Tempo reviewed reports by consumer data site Statista, which drew on Library of Congress and Oxford University Press information about Union prisons during the American Civil War from 1861 to 1865. Doctors had little knowledge at the time of how diseases were spread, and with limited equipment to help, many contagious illnesses, like dysentery, measles, and typhoid, infected prisoners at a high rate. These deaths would likely be preventable today.
In 1864, Union General Ulysses S. Grant halted the prisoner exchanges as he and the Union believed Confederate soldiers would return to the battlefield and prolong the war. Consequently, prison camps teamed with prisoners who perished in great numbers as disease took a ghastly toll. (These are the most devastating battles in U.S. history.)
9. Bronchitis
- POW Camp: Union
- Confederate deaths: 133
An inflammation of the airways leading to the lungs, bronchitis is caused by the same virus that causes the flu. The virus spreads through close contact with others via coughing, touching, or coming in contact with an object harboring the virus. A crowded prison camp with few sanitary measures would be a perfect breeding ground for the disease.
8. Wounds and uncertain maladies
- POW camp: Union
- Confederate deaths: 252
Many soldiers entered prison camps wounded after battle. Without prompt and proper medical care, they succumbed to their wounds, as medical supplies and other items were diverted to the front lines.
7. Scurvy
- POW camp: Union
- Confederate deaths: 351
Before the Civil War, armies recognized the importance of supplying their soldiers with fresh fruits and vegetables to prevent scurvy, a disease caused by vitamin C deficiency. Congress passed a law before the war that would provide desiccated vegetables – a compressed mixture of string beans, turnips, carrots, beets, and onions – to soldiers.
But soldiers found the taste unpleasant and refused to eat the rations. In prison camps, even the vegetable mixture, much less fresh produce, was mostly unavailable, and prisoners suffered from scurvy symptoms such as bleeding gums, loose teeth, and bleeding under the skin – sometimes to the point of death.
6. Malaria
- POW camp: Union
- Confederate deaths: 1,026
About 20% of all prisoner patients were treated for malaria, a disease borne by mosquitos. However, physicians at the time believed malaria was transmitted via swamp fumes, the breath of infected men, or camp excrement, so were unable to take preventative measures.
5. Typhoid/typhus
- POW camp: Union
- Confederate deaths: 1,109
Crowded, unsanitary conditions led to massive typhoid and typhus fever infections among prisoners. Bacterial diseases, both infected soldiers through poorly maintained latrines that contaminated food and water. Symptoms included fever, a general feeling of malaise, and red skin lesions.
4. Other diseases
- POW camp: Union
- Confederate deaths: 1,729
One common illness that claimed Confederate lives was gangrene, a disease that kills healthy tissue, typically due to a bacterial infection or lack of blood flow to the tissue. Battle wounds are particularly vulnerable to gangrene.
If a limb was severely damaged by a .58 minie ball, common ammunition during the war, the only recourse to prevent gangrene was amputation. According to an article in “Clinical Infectious Diseases,” 60% of Civil War soldiers suffering from gangrene died.
3. Smallpox, measles, scarlet fever, erysipelas
- POW camp: Union
- Confederate deaths: 3,453
Smallpox was a deadly disease during the Revolutionary War, killing three out of 10 Continental soldiers, but due to the availability of the smallpox vaccine in the 19th century, it was less of a problem for Civil War soldiers. However, other infectious diseases like measles, scarlet fever, and erysipelas (bacterial skin infection) were more prevalent.
2. Inflammation of the lungs and pleurisy
- POW camp: Union
- Confederate deaths: 5,042
One of the most common causes of death during the Civil War was pleurisy, an inflammation of the lungs caused by pneumonia. Doctors at the time didn’t know how such infections spread and were powerless to stop them (antibiotics weren’t invented until 1928).
It has been often reported that Confederate General Thomas J. “Stonewall” Jackson died of “pleuro-pneumonia,” another name for pleurisy, after being shot during the Battle of Chancellorsville, but modern scholarship says that his death was more likely due to a pulmonary embolism.
1. Diarrhea/dysentery
- POW camp: Union
- Confederate deaths: 5,965
The leading cause of prisoner deaths in Civil War prison encampments was diarrhea and dysentery, which ran rampant. Poor sanitation and contaminated drinking water led to an epidemic of bowel diseases. So common was diarrhea – and dysentery, which is bloody diarrhea – among the troops it became jokingly known as the “Virginia Quickstep” or the “Tennessee Trots,” proving that severe cases of diarrhea could be fatal and wasn’t much to joke about.