
Disease killed significantly more soldiers in the Civil War than bullets did. The Union lost 110, 000 killed in action and 225,000 from disease. The South lost 94,000 killed in action and 169,000 from disease. In addition, each side had about 30,000 men die in captivity, and almost all of those would have been die to disease, although in some cases aggravated by exposure and malnutrition. Four major killers were dysentery, typhoid fever, pneumonia, and malaria. The estimated totals from several diseases were:
Dysentery: 45,000 Union, 50,000 Confederate deaths
Typhoid: 35,000 Union, 30,000 Confederate deaths
Malaria: 30,000 total deaths, mostly Confederate (due to a lack of quinine in the south)
Pneumonia: 20,000 Union, 17,000 Confederate deaths
Tuberculosis: 14,000 total deaths
Measles: 11,000 total deaths
These estimates are probably low, because a great man men died of unspecified causes, or “a fever.”
Most disease losses were spread evenly over time and so represented a steady attrition made up for with continuous recruiting. But I thought that some representation of epidemics which could suddenly impact a field army’s fighting strength was in order.
A House Divided now includes event cards, one of which is drawn each turn, and there are unique decks for each of the years of the war after 1861. Every card is drawn and played once, and so every one of the historic events portrayed by the card occur, but players are unsure in what order within the year they will happen. One of the effects of a number of the cards is to cause an immediate loss of one unit by one or both players at the start of a turn, the sort of disruptive casualties that sometimes occurred with particularly virulent outbreaks of a disease. Over the course of the game five Union units are removed and four Confederate.

Some other non-disease losses occur due to events outside the player’s control. Those cards read as follows:
Trouble on the Frontier
*Union player removes any one active Union infantry to the Recruiting or Promotion Pool.
The Dakotah uprising in Minnesota, August 1862, force diversion of Federal troops north.
Southern Bread Riots
*Confederate player removes one Confederate infantry in play and place it six months later on the turn track. On that turn place it in the Recruiting or Promotion Pool.
The Southern Bread Riots were a response to dwindling food supplies in the Confederacy, and took place across the south in March and April of 1863. Militias were called out to restore order, diverting troops from the front.
New York Draft Riots
*Union player removes any one New York militia infantry in play and place it six months later on the turn track. On that turn place it in the Recruiting Pool.
Historic draft riots in New York, July 1863 caused diversion of troops to restore order.
Midwest Draft Riots
*Union player removes any 1 Illinois militia infantry in play and place it six months later on the turn track. On that turn place it in the Recruiting Pool.
In Charleston, Illinois the last pro-Confederate draft riots of the war took place in March 1864
Three Year Enlistments Expire (Union)
*Union player removes any two active Union Veteran infantry units to the Promotion Pool.
The enlistment terms of large numbers of the Union regiments enrolled for three years’ service in the summer of 1861 expired during the summer of 1864, just at the height of the Overland Campaign, which weakened the Army of the Potomac in particular.
Blockade Tightens
*Confederate player removes any one active Confederate infantry to the Recruiting or Promotion Pool. (If the Confederacy has been recognized by Europe, this card has no effect.)
Starvation in the South
*Confederate player removes any one active Confederate infantry in play and place it in the Recruiting or Promotion Pool.
As transportation broke down across the South in mid-1865, food often rotted in warehouses and starvation became widespread. Confederate soldiers increasingly left the ranks to look after their families.
In addition, weather can cause casualties as well as affect movement and game length, but that is the subject of a different article.
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