In 1838, hundreds Knoxvillians died when an unknown illness (possibly malaria) swept through the town. Approximately one-tenth of the marked graves in the graveyard are dated "1838"— more than any other single year— and one tombstone mentions "the fever." The graveyard was open to new burials until 1857, but the last burial took place in 1879. During the Civil War, Confederate soldiers (who occupied the town 1861–1863) kept horses in the cemetery, and Union soldiers (who occupied the town 1863–1865) used the church as a hospital and barracks.