In the early years of the Civil War it became clear that disease would be the greatest killer. Twice as many Civil War soldiers died of disease then that were killed in combat. This was due to unsanitary and filthy conditions, untrained Medical personnel and poor medical examination of new soldier's. One fact from the Civil War was 315, 000 soldiers died from illnesses that included: 44, 558 from diarrhea / dysentery , 10, 063 from malaria, 34, 833 from typhoid, 958 from typhus and 436 from yellow fever. The sanitary conditions that a cured during the civil war was shocking. Unsanitary hospitals and camps kept the wounded soldiers in large groups, which were ideal places for infection, fevers and disease to spread.

Soldiers were not immune to childhood diseases like the measles and small pox. Medical science had not yet discovered the importance of antiseptics in preventing infection. Water was contaminated and soldiers sometimes ate unripened or spoiled food. There weren't always clean rags available to clean wounds. Because of frequent shortages of water, surgeons often went days without washing their hands or instruments.

So now germs were passing from patient to patient. The Civil War was fought at the end of the middle Ages; therefore the Medical Corps was unqualified in all fields of medical care. Little was known about what caused disease, how to stop it from spreading, or how to cure it. Surgical techniques ranged from the tough to easy. Under qualified, understaffed, and under supplied medical corps, who was often referred to as quacks and butchers by the press, took cared of the men in the Civil War. During this period a physician received minimal training.

Nearly all the older doctors served as apprentices in lieu of formal education. Even those who attended one of the few medical schools were poorly trained. The average medical student trained for two years, received no experience, and was given virtually no laboratory instruction. Still, another reason for disease being the greatest killer in the Civil War was the bad medical examinations of recruits. The recruiting process allowed underage, overage men and those in noticeably poor health to join the army on both sides. Two hundred thousand recruits originally accepted for services were told to be unfit and discharged, either because they had become ill or because a routine examination revealed their bad condition.

Throughout the war, both the South and the North had trouble improving the level of medicine care given to their men. In many ways, their efforts assisted in the birth of modern medicine in the United States. More records of surgical activities were kept during the war than ever before, doctors became better at surgery and at the use of anesthesia, and most importantly, a greater understanding of cleanliness, with the patience.