During the Spanish-American War more soldiers were killed by disease than actual spanish gun fire. One of the main causes of disease was bad meat due to the unsanitary factory conditions during the time.
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Smallpox.
disease and famine were the greatest tragedies befalling NorthAmerican Indians.
tombora from Indonesia
the most casualties in a war was the American Civil War with 495,332 deaths and behind it is WW2 with 405,399 deaths.
gas set off by the Germans or probably sanitation issues in the hospitals