When we think about the Civil War, we may think of the uniforms made familiar through re-enactors, movies, paintings, even some old black and white photos. We may think of political giants and charismatic generals; of disease and primitive medical care; of a soldier writing letters home, or fighting in battle. But typically we don’t make the connection between people’s experiences in that war and what we now call Post-Traumatic Stress Disorder, or PTSD.
Maybe that’s because the war was - and sometimes still is - romanticized as gallant, even chivalric; fought by the North to advance two great and noble causes: preserving the Union and ending slavery - and fought in the South for what was seen by some as a noble but Lost Cause.
And despite enormous interest in the Civil War over the century and a half since, including more than fifty thousand published books, PTSD has received virtually no attention, at least until comparatively recently.
We may know that in World War II PTSD was called “combat fatigue”; in World War I, “shell shock,” referring to the tremendous bombardments that soldiers in the trenches had to endure. But for most of us, it’s as if PTSD didn’t exist in the American Civil War, or other, earlier wars, for that matter.
And yet it did; medical reports and records, letters and diaries make that clear. Much historical research has yet to be done on PTSD in the Civil War, but Eric T. Dean, Jr.’s book Shook Over Hell, Post-Traumatic Stress, Vietnam, and the Civil War, published by Harvard University Press in 1997, makes a good start.
Dean explains that in the Civil War there were at least four categories of combat-related stress disorders: first, what they called “insanity;” second, “homesickness” or “nostalgia,” - a kind of extreme depression; third, “irritable” or “trotting heart ” also called “soldiers heart”, the notion being that combat causes a physical change to the heart. And fourth, what they called “sunstroke,” attributed to “excessive exposure to the sun.” But whatever the name, clearly some Civil War soldiers and veterans displayed many of the same signs of PTSD that we are seeing today.
Dean also observes that it wasn’t just combat that caused PTSD. Letters and reports from some of those Civil War surgeons and their assistants who amputated limbs for hours on end - and are often portrayed today as callous and uncaring - strongly suggest that they, too, suffered from PTSD, as did some of those who cared for the wounded and sick; some of the thousands of soldiers assembled to witness the execution of deserters; prisoners of war for whom “constant disappointment and loss of hope” were mentally devastating; and civilians who were traumatized by fear, battle, bombardment, and bands of marauders.
That PTSD did in fact exist during and after the Civil War should serve as yet another caution against the temptation to romanticize that terrible conflict.
