How Did The First Hokage Died

At the request of sasuke uchiha, orochimaru releases the souls of the first four hokage from the stomach of the shinigami so that he can reincarnate them. How did hashirama senju die? The exact cause behind the first hokages death is never definitively outlined, but kishimoto has revealed a few details about his demise. Hashirama died during the first shinobi world war, necessitating his brother tobirama senju replace him as second hokage. 1 tobirama would also die during the war,.