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The sheer overcrowding.

From March 1864, the system of prisoner-exchange had been ended by Grant, who saw that the Confederates were running out of manpower.

In the South, where troops and civilians alike were on strict rations by this time, the Union prisoners were bottom of the food-chain.

At Andersonville, Georgia, the privations led to gang warfare, murder and even cannibalism. The camp governor was eventually hanged for allowing things to get as bad as this.
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