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Did Civil War Soldiers Have PTSD?
One hundred and fifty years later, historians are discovering some of the earliest known cases of post-traumatic stress disorder
Smithsonian Magazine  January 2015

The wounded soldiers above were photographed at a hospital in Fredericksburg, Virginia, between 1861 and 1865. (Library of Congress, Prints and Photographs division)

Hildt, a laborer who’d risen quickly in the ranks, had no prior history of mental illness, and his siblings wrote to the asylum expressing surprise that “his mind could not be restored to its original state.” But months and then years passed, without improvement. Hildt remained withdrawn, apathetic, and at times so “excited and disturbed” that he hit other patients at the asylum. He finally died there in 1911—casualty of a war he’d volunteered to fight a half-century before.

The Civil War killed and injured over a million Americans, roughly a third of all those who served. This grim tally, however, doesn’t include the conflict’s psychic wounds. Military and medical officials in the 1860s had little grasp of how war can scar minds as well as bodies. Mental ills were also a source of shame, especially for soldiers bred on Victorian notions of manliness and courage. For the most part, the stories of veterans like Hildt have languished in archives and asylum files for over a century, neglected by both historians and descendants. 

This veil is now lifting, in dramatic fashion, amid growing awareness of conditions like post-traumatic stress disorder. A year ago, the National Museum of Civil War Medicine mounted its first exhibit on mental health, including displays on PTSD and suicide in the 1860s. Historians and clinicians are sifting through diaries, letters, hospital and pension files and putting Billy Yank and Johnny Reb on the couch as never before. Genealogists have joined in, rediscovering forgotten ancestors and visiting their graves in asylum cemeteries.

Jogues R. Prandoni (above, in the cemetery at St. Elizabeths) helps families locate the graves of their ancestors. (Tom Wolff)

“We’ve tended to see soldiers in the 1860s as stoic and heroic—monuments to duty, honor and sacrifice,” says Lesley Gordon, editor of Civil War History, a leading academic journal that recently devoted a special issue to wartime trauma. “It’s taken a long time to recognize all the soldiers who came home broken by war, just as men and women do today.”

Counting these casualties and diagnosing their afflictions, however, present considerable challenges. The Civil War occurred in an era when modern psychiatric terms and understanding didn’t yet exist. Men who exhibited what today would be termed war-related anxieties were thought to have character flaws or underlying physical problems. For instance, constricted breath and palpitations—a condition called “soldier’s heart” or “irritable heart”—was blamed on exertion or knapsack straps drawn too tightly across soldiers’ chests. In asylum records, one frequently listed “cause” of mental breakdown is “masturbation.” 

Also, while all wars are scarring, the circumstances of each can wound psyches in different ways. The relentless trench warfare and artillery bombardments of World War I gave rise to “shell shock” as well as “gas hysteria,” a panic prompted by fear of poison gas attacks. Long campaigns in later conflicts brought recognition that all soldiers have a breaking point, causing “combat fatigue” and “old sergeant’s syndrome.” In Vietnam, the line between civilians and combatants blurred, drug abuse was rampant and veterans returned home to an often-hostile public. In Iraq and Afghanistan, improvised explosive devices put soldiers and support personnel at constant risk of death, dismemberment and traumatic brain injury away from the front.

Civil War combat, by comparison, was concentrated and personal, featuring large-scale battles in which bullets rather than bombs or missiles caused over 90 percent of the carnage. Most troops fought on foot, marching in tight formation and firing at relatively close range, as they had in Napoleonic times. But by the 1860s, they wielded newly accurate and deadly rifles, as well as improved cannons. As a result, units were often cut down en masse, showering survivors with the blood, brains and body parts of their comrades.

Many soldiers regarded the aftermath of battle as even more horrific, describing landscapes so body-strewn that one could cross them without touching the ground. When over 5,000 Confederates fell in a failed assault at Malvern Hill in Virginia, a Union colonel wrote: “A third of them were dead or dying, but enough were alive to give the field a singularly crawling effect.”

Wounded men who survived combat were subject to pre-modern medicine, including tens of thousands of amputations with unsterilized instruments. Contrary to stereotype, soldiers didn’t often bite on bullets as doctors sawed off arms and legs. Opiates were widely available and generously dispensed for pain and other ills, causing another problem: drug addiction.

Nor were bullets and shells the only or greatest threat to Civil War soldiers. Disease killed twice as many men as combat. During long stretches in crowded and unsanitary camps, men were haunted by the prospect of agonizing and inglorious death away from the battlefield; diarrhea was among the most common killers. 

Though geographically less distant from home than soldiers in foreign wars, most Civil War servicemen were farm boys, in their teens or early 20s, who had rarely if ever traveled far from family and familiar surrounds. Enlistments typically lasted three years and in contrast to today, soldiers couldn’t phone or Skype with loved ones.

These conditions contributed to what Civil War doctors called “nostalgia,” a centuries-old term for despair and homesickness so severe that soldiers became listless and emaciated and sometimes died. Military and medical officials recognized nostalgia as a serious “camp disease,” but generally blamed it on “feeble will,” “moral turpitude” and inactivity in camp. Few sufferers were discharged or granted furloughs, and the recommended treatment was drilling and shaming of “nostalgic” soldiers—or, better yet, “the excitement of an active campaign,” meaning combat.

At war’s end, the emotional toll on returning soldiers was often compounded by physical wounds and lingering ailments such as rheumatism, malaria and chronic diarrhea. While it’s impossible to put a number on this suffering, historian Lesley Gordon followed the men of a single unit, the 16th Connecticut regiment, from home to war and back again and found “the war had a very long and devastating reach.” 

The men of the 16th had only just been mustered in 1862, and barely trained, when they were ordered into battle at Antietam, the bloodiest day of combat in U.S. history. The raw recruits rushed straight into a Confederate crossfire and then broke and ran, suffering 25 percent casualties within minutes. “We were murdered,” one soldier wrote.

In a later battle, almost all the men of the 16th were captured and sent to the notorious Confederate prison at Andersonville, where a third of them died from disease, exposure and starvation. Upon returning home, many of the survivors became invalids, emotionally numb, or abusive of family. Alfred Avery, traumatized at Antietam, was described as “more or less irrational as long as he lived.” William Hancock, who had gone off to war “a strong young man,” his sister wrote, returned so “broken in body and mind” that he didn’t know his own name. Wallace Woodford flailed in his sleep, dreaming that he was still searching for food at Andersonville. He perished at age 22, and was buried beneath a headstone that reads: “8 months a sufferer in Rebel prison; He came home to die.”

Others carried on for years before killing themselves or being committed to insane asylums. Gordon was also struck by how often the veterans of the 16th returned in their diaries and letters to the twin horrors of Antietam and Andersonville. “They’re haunted by what happened until the end of their lives,” she says.

Gordon’s new book on the 16th, A Broken Regiment, is but one of many recent studies that underscore the war’s toll on soldiers. In another, Living Hell: The Dark Side of the Civil War, historian Michael Adams states on the first page that his book describes “the vicious nature of combat, the terrible infliction of physical and mental wounds, the misery of soldiers living amid corpses, filth, and flies.”

Not all scholars applaud this trend, which includes new scholarship on subjects such as rape, torture and guerrilla atrocities. “All these dark elements describe the margins not the mainstream of Civil War experience,” says Gary Gallagher, a historian at the University of Virginia who has authored and edited over 30 books on the war. While he welcomes the fresh research, he worries that readers may come away with a distorted perception of the overall conflict. The vast majority of soldiers, he adds, weren’t traumatized and went on to have productive postwar lives. 

Tony Horwitz is a Pulitzer Prize-winning journalist who worked as a foreign correspondent for the Wall Street Journal and wrote for the New Yorker. He is the author of Baghdad without a Map, Midnight Rising and the digital best seller BOOM.

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The Civil War and P.T.S.D.

Dillon Carroll

The New York Times   May 23, 2014

Edson Bemis was a hard man to kill. Rebel soldiers tried three times, and three times they failed. At the Battle of Antietam, a musket ball ripped through his left arm. Two years later, in the horrible fighting in the Wilderness, he was shot in the abdomen, just above the groin. The ball was never extracted, remaining in his body until the day he died.

The Confederates came the closest to killing Bemis in February 1865. At Hatcher’s Run, Va., a Minié ball struck him in the head. He lay near death for several days, his skull cracked and leaking brain matter. Most passed him off for dead. Dr. Albert VanDevour, however, did not, and instead performed a risky surgery to remove the bullet from his skull. Bemis improved immediately, eventually recovering, much to the shock of everyone.

The war was finally over for Bemis. He moved to Suffield, Conn., with his wife, Jane, where they hoped to start a new life. He began working for W.W. Cooper’s, a local merchant house, but very quickly it became clear to everyone that Bemis was not right. One of his colleagues at W.W. Cooper’s, George N. Kendall, described his health as “never very good,” and Bemis began to suffer from “spells of vertigo” or “something that afflicted his head” so much so that he frequently could not work.

Kendall noticed that Edson was also “very forgetful.” He had wild mood swings, and Kendall wrote “any little thing irritates him.” He was increasingly subject to memory loss. Sometimes, for several hours each day, he had no memory of where he had been or what he had done. Eventually he had to stop working at W.W. Cooper’s because of his condition.

In 1890, Bemis suffered what appeared to be a stroke, and his condition, which was already bad, got exponentially worse. A pension official came to Suffield to interview the Bemis family and friends, and immediately noticed that although Bemis was only 55 in 1895, he walked “like a man of 80!” His wife had to assist him in dressing, she had to “cut his meat and wash his potatoes” and she described him as being “like a child.” The pension official wrote that Bemis’s only job each day was to go to the post office “right below here for the mail and to a few houses above for a pail of milk every day this is all he can do.”

In 1900, Jane had apparently had enough, and Bemis was examined and institutionalized in Westboro Insane Hospital in Westboro, Mass. By this time, his condition had spiraled even further. A doctor at Westboro, Lewis Bryant, wrote that Bemis believed he was “thirty years old” but he could not recall the present “year month or day of the week.” Bemis believed that “the civil war is still going on” and, occasionally, would “see dogs in the room.” Bryant described him as “silly, emotional, crying and laughing without apparent cause” and having “little memory confusing the present with the past…soils his clothing has had delusions and false sights, and at times requires the care and attentions usually given a child.”

Celestia Bemis, his sister, who coincidentally married a man with the last name Bemis, came to Westboro and took charge of Edson, taking him to her farm in North Brookfield. Celestia and Jane did not get along, and their feud spilled over into the notes of the pension official who occasionally checked up on Bemis. Jane claimed that Celestia ordered her to stay away from him, because her presence excited him too much, while Celestia claimed that Jane had never once tried to visit Bemis, and was content to keep cashing his pension checks without ever seeing him. Jane last saw her husband in August of 1900; he died two months later. She continued collecting a pension until her death in 1917.

Bemis’s story was not an uncommon one among Civil War veterans. Historians are beginning to uncover what was a virtual epidemic of emotional, psychological and neurological trauma that afflicted soldiers after the war. Veterans labored under emotional and psychological stress in ways that are disturbingly similar to the present. Alcoholism was rampant, as was unemployment. Suicide was endemic. Civil War veterans dotted the wards of insane asylums across the country.

Modern science would most likely have given Bemis a diagnosis of traumatic brain injury, caused by a blow to the head or a penetrating injury of the skull. Such injuries are all too common among veterans of Iraq and Afghanistan today. Symptoms of T.B.I. range from headaches, confusion, lightheadedness and dizziness to fatigue, mood changes, depression, changes in sleep patterns, restlessness and agitation. That seems to be consistent with Bemis’s litany of postwar complaints.

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If so many Civil War veterans were troubled with emotional and psychological trauma, why has it taken us so long to discover them? Veterans were loath to admit they were traumatized. In the 19th century, mental illness carried a tremendous stigma, and most veterans fought a private battle rather than disclose their trauma.

Additionally, most families preferred to care for mentally ill loved ones at home. Bemis’s care as his mental health declined became a community project. Jane certainly performed the lion’s share of the work. She dressed him, fed him, and sometimes had to help him in the bathroom. But she could not watch him all the time. A.P. Sherwin, a local doctor, later testified that everyone “in town knows soldier to be mentally afflicted” and all the people in Suffield near the Bemis household “watch him closely.” Jane Bemis testified that she did not watch him “on the street” because “everybody knows him” and that he only “goes a short way from home.”

Finally, the relationship between warfare and psychological trauma has only recently become better understood. War trauma has distressed veterans in nearly every war, but the whispers of shell shock and combat fatigue never really entered the public consciousness. It was not until after Vietnam that veterans’ groups successfully lobbied the American Psychiatric Association to include post-traumatic stress disorder in the Diagnostic and Statistics Manual of Mental Disorders. Since then, our understanding and empathy for veterans afflicted with psychological trauma has grown rapidly. Bemis’s life demonstrates that combat has been damaging to the human brain and the human psyche long before we were willing and able to give the maladies a name.

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Sources: Soldier’s Certificate No. 59,267, Cpl. Edson D. Bemis, Company K, 20th Massachusetts Volunteer Infantry, National Archives; Case Files of Approved Pension Applications of Veterans Who Served in the Army and Navy Mainly in the Civil War and the War with Spain, 1861-1934, National Archives; Steven T. DeKosky, “Traumatic Brain Injury: Football, Warfare, and Long-Term Effects,” in the New England Journal of Medicine 363, No. 14 (Sept. 30, 2010); Rebecca J. Anderson, “Shell Shock: An Old Injury with New Weapons,” Molecular Interventions 8, No. 5 (Oct. 2008); Emily Singer, “Brain Trauma in Iraq,” Technology Review 111, No. 3 (May–June 2008); Jeanne Marie Laskas, “Game Brain,” GQ, Oct. 2009; Ben McGrath, “Does Football Have a Future?” New Yorker, Jan. 31, 2011.

Dillon Carroll

Dillon Carroll is a graduate student in history at the University of Georgia.

 

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