Causes of death during the Civil War were many. Bullets and artillery took their share of lives on both sides, but more than twice as many men died from illness than from enemy fire.
The casualty statistics are staggering. According to an analysis of government records, slightly more than 350,000 Union soldiers died from various causes during the Civil War. The majority of deaths were from disease. Nearly 25,000 men died from causes such as suicide, execution, sunstroke, and accidents. The Union navy lost nearly 5,000 men to illness, accidents, and battle injuries.
Records of Confederate deaths aren't nearly as comprehensive as those of Union casualties; military and government files were destroyed during and after the war. However, a generally accepted estimate is 150,000 dead of disease and 95,000 killed or mortally wounded in combat. No statistics survive regarding deaths among Confederate naval personnel.
To put these figures in perspective, consider that more Americans died of disease and battlefield wounds during the Civil War than all other American wars combined, from the Revolutionary War to Vietnam, including both World Wars. In fact, the Battle of Antietam resulted in four times the casualties as the landings on the Normandy beaches on D-Day, June 6, 1944.
Casualty by Disease
The high number of battlefield deaths during the Civil War is easy to understand. Civil War-era weapons caused massive physical damage when they hit their targets, and outdated battle tactics often put large numbers of soldiers in harm's way. But the number of deaths related to disease requires a little explanation.
“I have a mortal dread of the battle field, for I have never yet been nearer to one than to hear the cannon roar & and have never seen a person die. I am afraid that the groans of the wounded & dying will make me shake, nevertheless I hope & trust that strength will be given me to stand up &do my duty.” — Private Edward Edes
The Civil War took place shortly before a number of important advances in human medicine. There were no vaccines for the most common of illnesses, and hygiene was poor, especially in mobile military camps. Young men who had lived their entire lives in relative seclusion in small towns and hamlets simply didn't have immunity to many types of illnesses, and they fell sick from the most innocuous of diseases.
One of the leading contributors to wartime illness was the latrine, usually a simple hole or trench used by all members of the camp. When the stench of the latrine became unbearable, it was covered over and a new one dug. As might be expected, camp latrines were veritable breeding grounds for every imaginable form of illness. They also attracted a lot of insects, particularly flies, which would deposit germs and bacteria on the food the men ate and the water they drank. Numerous outbreaks of diarrhea and epidemics of cholera and other contagious diseases resulted. Whooping cough, measles, scarlet fever, smallpox, and dysentery also took a huge toll, as did environmental ailments such as sunstroke, frostbite, and tetanus. Many soldiers suffered from gastrointestinal ailments and other complaints for almost the entire length of their enlistment.
Soldiers weren't the only ones to die during the Civil War. The conflict also took a huge toll on the civilian population, particularly in the South. While the number of Northern citizens who died as a direct result of the war is relatively small, some historians estimate that up to 50,000 Confederate citizens may have perished from various causes, including stray bullets and poor sanitation following the devastation of entire towns and cities.