Was The Civil War Our Bloodiest Time? Maybe Not As Bloody As Today.

We usually think of the Civil War as the bloodiest conflict in U.S. history based on the number of men who went off to fight and never returned home.  The definitive book on how this veritable avalanche of death changed American social culture was written by the historian Drew Gilpin Faust, who otherwise spends her days running a little university in Cambridge, Mass.  Her book describes how in just four years, more than 600,000 men perished at a time when the country’s total population (including slaves) was slightly above 31 million.

To put this into perspective, total mortality in World War II was 405,000 out of a national population count of 132 million.  In other words, in the conflict with the second-highest number of casualties, the mortality rate was .003 percent.  The Civil War mortality percentage was .019, almost ten times the casualty rate of World War II.  And in fact, the Civil War numbers may be understated, according to recent scholarly publications, by as much as 25%. Wow!

Given my interest in the medical response to gun violence, I decided to look at the Civil War data in a little more depth.  First, and this is a well-known fact, two-thirds of all Civil War mortality, perhaps even higher on the rebel side, were not from battlefield injuries, but from contagious diseases which spread like veritable wildfire among stationery troops.  The biggest killer was typhus, which continued to decimate armies up through World War I.   Next in line was ‘acute diarrhea,’ followed by dysentery, pneumonia and various types of ‘fevers,’ that were classified as ‘miasmatic’ disease.

All of the above information and much more can be found in a remarkable document, The Medical and Surgical History of the War of the Rebellion, a 6,000-page collection that was prepared and published by the United States Surgeon General five years after the war came to an end.  Most of the data was collected from military medical units that were located at or near the battlefields themselves, or ran the military hospitals that sprang up in larger cities, particularly Washington, D.C.  By war’s end there were more than 20,000 beds in military hospitals in and around the nation’s capital, one of which happened to provide a bed for my mother when she gave birth in 1944 to me.

Roughly 90,000 men in the Union army were killed in battle or died from gunshot injuries either during or after they were being treated for their wounds.  The figure has to be used with caution because, in fact, the numbers for troops who lost their lives while fighting did not come from the Surgeon General, but from the Office of Adjutant General, which was responsible for verifying battle deaths in order to figure out pension/survivor benefits during and after the war.

Now check this out.  In fact, physicians and surgeons treated more than 235,000 cases of gunshot wounds over the course of the conflict, of which less than 15% ultimately died.  That would be a pretty impressive case fatality ratio for what was the birth of trauma surgery, except that roughly 70% of all gun wounds were to the extremities, particularly arms and hands, two areas of the body which are not particularly vulnerable to injuries which lead to death.  What this reflected, Pickett’s Charge at Gettysburg notwithstanding, was that most battles involved troops who were stationed behind stone walls or in trenches with the torso well out of sight.

If we could construct a case fatality ratio covering contemporary gun violence, I would suspect that current numbers might be worse.  The best we can do is compare fatal to non-fatal gun injuries from the CDC, which shows a ratio of the former to the latter of 16%. Which might mean that guns are much more lethal today than they were in America’s bloodiest war, and by the way, compare an annual average of 22,500 gun deaths during the Civil War to 30,000+ gun deaths today.  Were the years 1861-1865 America’s bloodiest time?  I’m not so sure.

 

 

 

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Should We Compare Civilian Gun Violence To Military Gun Violence? You’ll Learn How Violent We Really Are.

            I was at a hospital conference this morning where the speaker happened to mention that gun violence claimed more American lives since 1968 than were lost in every military engagement fought by U.S. troops since the country began. And while this is a shocking notion – the idea that we are more the victims of our own violence than the violence suffered when our country is at war with other countries – I decided to take a deeper look at those numbers, in particular the gun injury numbers from the Civil War.

            Why look at the Civil War?  For two reasons.  First, in terms of wartime deaths, it was far and away the costliest war of all.  We used to think that the final toll was somewhere over 500,000; that number was recently revised upwards to 750,000, which appears to be closer to the real mark. But this global number hides a significant issue that must be explained when it comes to comparing war deaths to civilian gun violence, namely, that two-thirds of the soldiers who died between 1861 and 1865 were victims not of wounds from warfare, but died from diseases caused by unsanitary conditions on and off the battlefield, and at least another 15% died from other causes not related to battle engagements at all.  In fact, it is estimated that only 20% of all the men who died on both sides during the Civil War actually were killed during the fighting itself.

            According to the Congressional Record Service, and I tend to think their research on all issues is about as valid as any research can be, the total number of battle deaths suffered by U.S. troops since 1775 is 575,000.  This number excludes casualties from Iraq and Afghanistan, and also doesn’t count Confederate soldiers who lost their lives between 1861 and 1865.  Throw them into the overall figure and we are still something just beyond 600,000 victims of gun violence in warfare over the entire history of the United States.  According to the CDC, the total number of gun deaths for the civilian population of the United States since 1999 is 497,632.  And everyone thinks that gun violence has claimed more lives than Americans lost in battle if we go back to 1968?  Give me a friggin’ break. How about just go back to 1995?

            I don’t think that comparing civilian gun deaths to overall military fatalities is a valid comparison at all.  For the simple reason that men and women in uniform die from all sorts of causes, natural and otherwise, which may have nothing to do with whether they were victims of hostile fire or not.  Soldiers are not infrequent victims of accidents in training, military suicides may be declining lately but they are certainly not unknown.  As far as we can tell, the great flu pandemic of 1918 probably first infected Western countries from an outbreak in a military base in France. The ratio of all military deaths to combat deaths in all American wars is in the neighborhood of 2:1. The percentage of marines killed in Desert Shield – Deseret Storm, of all the Devil Dogs serving in the Gulf, was one-one hundredth of one percent. Hell, you would have been safer walking around with the 1st Cavalry Division in Wadi Al-Batin than traipsing down Prospect Avenue in the South Bronx.

            Know what?  I’m sick of the 2nd Amendment and I’m sick of all the dopes and dupes who email me nonstop to remind me that the 2nd Amendment gives them the ‘right’ to protect themselves with a gun.  Because the truth is that the number of people who successfully use a gun to protect themselves and everyone else is about as many as the number of troops who lost their lives protecting Kuwait from Saddam Hussein.  Which by no means should be taken as even the slightest rebuke of those who participated in the Persian Gulf War of 1990-91. But carrying a weapon into battle and carrying a weapon as you walk through Walmart just isn’t the same thing.