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Soldiers fighting the Civil War had less to fear from bullets than from disease. Actual time spent in battle was sporadic and brief, but soldiers faced death from disease daily. Pneumonia often afflicted soldiers in the elevated and more northern areas where Civil War armies fought and camped during the winter months. Confederate troops overworked, underfed, ill-housed, and exposed to the elements often suffered most from the disease. Sick or wounded soldiers, whose immune systems were already impaired, were particularly susceptible to pneumonia, and many Southerners died from the disease in frigid Union prisons. One study showed that over a 19 month period from 1862 to 1863, more than 17 percent of the Confederate army fell victim to pneumonia; one out of about every six patients died.

Many wartime doctors believed pneumonia was an inflammation and that the patient needed to be bled, or "cupped." So many patients died after being bled, however, that doctors stopped that treatment. Instead, many prescribed treatments of liquor, opium, and quinine. Some Confederate patients were given herbal preparations when quinine was not available; on others, mustard plasters were applied.