The Empty Chair, the Next Generation: Disease in the Civil War

Soldier's graveyard, winter camp, Falmouth. Forbes, Edwin, 1839-1895, Library of Congress

 Disease was a persistent problem during the Civil War for several reasons. Camps were completely unsanitary and periodic long periods of encampment, especially during the winter, led to the spread of a wide assortment of illnesses.

The main factor in disease at this time was the state of medicine. The “germ theory,” as some older physicians called it, was still not widely accepted and older, established physicians rejected it as the cause of infection and disease. In general, physicians knew that certain conditions could and would result in illness, but they couldn’t identify what was present in those conditions that would cause illness.

Medical care was available from the beginning on both sides, but sanitation was not. Once the Sanitary Commission was created in 1861 the deaths from infection in hospitals went down dramatically. This did not apply to camps, however.

The Union’s Falmouth camp, across the Rappahannock River from Fredericksburg, Virginia, was notorious for illness. Some of the soldiers in Burnside’s army, including the 15th Connecticut, had spent months guarding the bridges that crossed the Potomac into Virginia. The Potomac was, as it is now, a swampy river, and at the time it was rife with malaria and dysentery. A mosquito bite was often a one way ticket to a casket.

 Respiratory illness, intestinal illnesses causing diarrhea, fever such as that caused by malaria, and infections were the most common illnesses.  In his Outlines of the Chief Camp Diseases of the Present War (1863)  Joseph J. Woodward, M.D., a regimental surgeon, writes: "Diarrhoea and dysentery have been the most frequent of all damp diseases, and although not nearly so fatal as fevers, have caused a very large mortality" (p. 206). He observes that diarrhea probably caused more deaths that were listed as caused by the condition, possibly because the soldier may have died of something else but was weakened by chronic diarrhea, or, if the soldier was discharged because of the condition, he might have died later at home. Discharging a soldier on disability was an option if a soldier became so sick, and was one that George Lewis was offered. He declined, however, fearing that he would be seen as a coward.

Diarrhea could have been seasonal, caused by contaminated water or unripe fruits and vegetables. With intestinal diseases diet was a huge factor. The diet of soldiers in camp was horrendous by modern standards, including bacon, which meant lots of grease; hard tack, which one soldier famously observed was so hard that it could stop a lead bullet; and whatever could be gathered from the countryside. Fresh fruit was intermittent, and vegetables were boiled so long as to leach any and all nutrients from them. In short, their dismal diet set up soldiers for intestinal problems that potentially could be fatal.

Occasional diarrhea was very common, but common enough was acute diarrhea such as George Lewis had. The symptoms that George's sergeant describes fit with the description of this condition. It included abdominal pain, fever, and weakness:

Occasionally, however, the disease . . . may persist, and pass into a chronic form, eventually terminating in one or another of the varieties of chronic diarrhoea  hereafter to be described; or, instead, it may run rapidly on to a fatal issue. In the latter case, the abdominal pain and tenderness increase, the febrile action assumes an adynamic character, the pulse becomes frequent and feeble, the mind wanders, delrium sets in, the tongue becomes dry and red, the evacuations from the bowels exceedingly frequent, and death terminates the scene (pp. 219-220).

In short, the person dies from dehydration, although oddly, that term did not exist at the time.

There were treatments including the use of opiates, which in sufficient strength can cause constipation and relieve pain. George's sergeant suggested taking some medicine which was probably some sort of opiate, and he felt better for awhile. Improvements in diet were also prescribed. Good luck with that in winter camp.

What physicians could not have understood at the time was that replacing the fluids lost in diarrhea would help significantly. Anyone who has had a sick child with diarrhea knows to keep Pedialite or something similar at hand. They also did not have antibiotics. If something as simple as penicillin had been available at that time the death rate would have been much lower.

A Union Hospital (source: www.thechaplainkit.com)

In general, disease killed twice as many soldiers as battlefield wounds. This was true up to and including the First World War. Soldiers were routinely exposed to dismal conditions and forced to eat bad food which either led to infection and illness or predisposed them to it.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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