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

In the summer of 1862, John Hildt lost a limb. Then he lost his mind. The 25-year-old corporal from Michigan saw combat for the first time at the Seven Days Battle in Virginia, where he was shot in the right arm.

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

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

Doctors amputated his shattered limb close to the shoulder, causing a severe hemorrhage. Hildt survived his physical wound but was transferred to the Government Hospital for the Insane in Washington D.C., suffering from “acute mania.”

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 Hildt remained withdrawn, apathetic, and at times so “excited and disturbed” that he hit other patients at the asylum.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.

“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.

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