Antiseptic and Hygienic Practices During the Civil War

 - Jonathan Yu

The Civil War is considered to be one of the deadliest conflicts in American History (Digital History, n.d.). A significant reason for this was the rapid advancements in military technology, particularly the introduction of the Minié ball- a new type of lead bullet that had a shorter reload time, improved accuracy, greater range, and devastating power (HistoryNet, n.d.). Upon impact, the Minié ball splintered inside the body, causing catastrophic injuries. This led to a dramatic rise in amputations and, consequently, a surge in infections. Exacerbation resulted in a rise in infections. Exacerbated by unhygienic practices, disease and illness were responsible for over two-thirds of deaths during the Civil War.

Septic practices during the war were still in their infancy. The vast majority of physicians and the public believed in the “Miasma” Theory, a theory centered around the belief that inhalation of air infected with corrupting matter was the root cause of disease (Halliday, 2001). This belief shaped the design of military camps, where latrines were often placed at the edge of camp to prevent the spread of “bad air”. However, because the latrines were so far away, some soldiers used the opportunity to desert. Guards were eventually stationed near latrines, but the distance and lack of privacy discouraged their use. As a result, many soldiers relieved themselves near their living quarters, contaminating food and water supplies (Civil War Monitor, n.d.).

Not all military camps were equally unsanitary. Dr. Mütter, a renowned surgeon and professor at Jefferson Medical College, was an early proponent of cleanliness. His student, Colonel Daniel Leasure, commanded a Union infantry regiment and instilled strict hygiene practices among his men during the Civil War and instilled the principles of hygiene within those that he commanded (Price, 2020). His remarkable success in limiting deaths by disease demonstrated the lifesaving importance of sanitation.

Disinfectants also began to see wilder use during this period, however, not precisely in the way that we conventionally think they are used today. In line with miasma theory, hospitals were kept smelling fresh to prevent the transmission of disease. When fresh air was unavailable, “disinfectants” such as lead nitrate, zinc chloride, charcoal, sulfate of lime, and carbolic acid were used to mask odors (Price, 2019). Still, despite the rise in disinfectant usage, people were predominantly using them to make the air smell better, rather than to disinfect tables and surgical tools.

Antiseptic practices also began to arise during the Civil War despite the lack of acceptance of Germ theory. In 1863, Dr. Goldsmith experimented with the use of bromine as an antiseptic to help treat hospital gangrene while serving the Army of the Cumberland. Goldsmith’s application of bromine reduced mortality from 46% to 3% (McIntire, 2023). Additionally, some surgeons began quarantining patients and ensuring that each had their own sponge, towel, and bedding. These small, but significant measures foreshadowed later advances in antiseptic technique.

The overall toll of disease on the Union Army was devastating. Pneumonia caused 1.7 million cases and 45,000 deaths; typhoid, 149,000 episodes and 35,000 deaths; diarrhea/dysentary, 360,0000 cases and 21,000 deaths; and malaria, 1,316,000 and 10,000 deaths (Sartin, 1993). These harrowing statistics highlight the devastating role of disease in the war.

One striking example occurred during General McClellan’s Peninsula Campaign in the Spring of 1862. He planned to land troops on the Virginia Peninsula and take over Richmond. However, diseases like malaria, typhoid, and dysentery ravaged his army, reducing his strength by more than one-third. There were nearly three disease episodes per soldier over 9 months. In the end, McClellan had to retreat after losing several battles to Robert E. Lee, likely prolonging the war by 1 to 2 years (Sartin, 1993).

American physicians also drew inspiration from Florence Nightingale’s reforms during the Crimean War, which emphasized ventilation and cleanliness. In 1861, Richmond, Virginia., saw the construction of the first pavilion-style hospital in the United States. These hospitals, designed to maximize airflow, helped patients recover more quickly and achieved mortality rates as low as 8% (Price, 2018). Their success led to rapid construction of similar styled hospitales throughout the war.

The creation of the United States Sanitary Commission in 1861 further advanced military medicine. The commission inspected soldiers and camps, advised on disease prevention, and lead relief efforts (Ullman, n.d.). It published a series of essays to guide physicians, many of whom had come from small towns with little experience treating battlefield injuries, in camp hygiene and appropraite care for the sick and wounded. These essays provided a much-needed standard of practice during the conflict.

Today, antiseptic and hygienic practices are vastly different. The acceptance of germ theory transformed medicine, allowing physicians to understand how disease spreads, and how to prevent it. Surgical instruments are now sterilized between each operations, and surgeons wear masks, gloves, and gowns to reduce infection risk. Sewage systems and modern toilets prevent contamination of water and food supplies. Building on the principles of pavilion-style hospitals, modern clinics are designed with private rooms and that there is adequate ventilation. The practices and techniques developed and understood during the Civil War serve as a critical foundation for modern medicine in the United States today.


Works Cited

Digital history. (n.d.). Retrieved September 19, 2025, from https://www.digitalhistory.uh.edu/disp_textbook.cfm?smtid=2&psid=3062#:~:text=The%20Civil%20War%20was%20the,and%20World%20War%20II%20combined.
Halliday S. (2001). Death and miasma in Victorian London: an obstinate belief. BMJ (Clinical research ed.), 323(7327), 1469–1471. https://doi.org/10.1136/bmj.323.7327.1469
Minie ball: The civil war bullet that changed history. (n.d.). HistoryNet. Retrieved September 19, 2025, from https://www.historynet.com/minie-ball/
McIntire, T. (2023, July 19). Hospital gangrene in the civil war. National Museum of Civil War Medicine. https://www.civilwarmed.org/hospital-gangrene-in-the-civil-war/
Price, D. (2018, February 20). The innovative design of civil war pavilion hospitals. National Museum of Civil War Medicine. https://www.civilwarmed.org/pavilion-hospitals/
Price, D. (2019, October 1). Fighting disease with smell: “Disinfection” during the civil war. National Museum of Civil War Medicine. https://www.civilwarmed.org/disinfection/
Price, D. (2020, June 29). Germ theory from antiquity to the antebellum period. National Museum of Civil War Medicine. https://www.civilwarmed.org/germ-theory-antebellum/
Reilly R. F. (2016). Medical and surgical care during the American Civil War, 1861-1865. Proceedings (Baylor University. Medical Center), 29(2), 138–142. https://doi.org/10.1080/08998280.2016.11929390
Sartin J. S. (1993). Infectious diseases during the Civil War: the triumph of the "Third Army". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 16(4), 580–584. https://doi.org/10.1093/clind/16.4.580
The enemy within. (n.d.). Civil War Monitor. Retrieved September 19, 2025, from https://www.civilwarmonitor.com/article/the-enemy-within/
Ullman, D. (n.d.). The united states sanitary commission. American Battlefield Trust. Retrieved September 19, 2025, from https://www.battlefields.org/learn/articles/united-states-sanitary-commission