October is the season for ghost stories, but sometimes reality is even more chilling. There are grim truths and gory details from the Civil War that may sound like the stuff of horror films, but for many Americans during our nation’s defining conflict, they were reality.

When the Cure Is Worse than the Disease.

Fortunately for the wounded and sick, the “heroic era” of bloodletting, purging, and blistering to rebalance the humors of the body was on its way out by the time of the Civil War. Still, toxic "remedies" like mercury, lead acetate, and turpentine were commonly used to treat illness. In 1863, Union Surgeon General William Hammond attempted to remove calomel, a mercury-based compound, from standard military medical kits but lost his position instead. The  approximately 50,000 amputations performed during the Civil War might seem like another extreme cure, but medical historians agree that, in fact, amputations are something Civil War medicine got right.

The Invisible Assassin.

The deadliest killers in the Civil War wouldn’t be identified until after the fighting was over. While germ theory was in the works at the time, it was in its early stages and virtually unknown to medical practitioners in the field. Poor sanitation and hygiene in camps and hospitals meant that illnesses like dysentery, typhoid fever, pneumonia, mumps, measles and tuberculosis were more dangerous to soldiers than their human foes. For every three soldiers killed in battle, five died of disease.

Agony in the Aftermath.

Many soldiers who survived battle faced a host of horrors in the aftermath. Hypothermia. Hunger. A night spent alone among the dead (or fighting off wild hogs as in one account from Gettysburg) on newly hallowed ground while officers negotiated arrangements for recovering their casualties. Capture and imprisonment in overcrowded, disease-ridden prison camps. Bones shattered by Minie ball bullets. Phantom limb syndrome. Many wounded Civil War soldiers succumbed to their injuries well after the fighting was over – and those who didn't often faced a long and painful recovery process.

The Sheer Magnitude.

It's hard to overstate the devastation of the Civil War. About 2% of all Americans alive at the time, an estimated 620,000 soldiers, lost their lives in the line of duty. That figure is more than the combined total of Americans who died in WWI, WWII, and the Vietnam and Korean Wars. One in four soldiers who left home to fight in the war never returned. The young nation lacked the institutions and infrastructure to cope with so much death and destruction. Both North and South would struggle to honor and bury the dead, take care of the wounded, locate the missing, and comprehend so much loss.

For more about how U.S. culture and infrastructure adapted to deal with death on such an unprecedented scale, read Drew Gilpin Faust's This Republic of Suffering. For more frightful facts, watch the Trust's Halloween Facebook Live at the National Museum of Civil War Medicine.