Did Civil War Veterans have PTSD?: Part II
Did Civil War veterans suffer with Post Traumatic Stress Disorder (PTSD)? In the last post I argued why Civil War veterans may not have been afflicted with the disorder. In short summary, PTSD is tied to the social and cultural times in which it was conceptualized, in this case the post-Vietnam American landscape. The social and cultural landscape of the Civil War Era was much different. Death was constant and ever present; something to ponder and prepare for. Most Americans carried deeply held beliefs of spiritual resurrection and fervently believed that death would result in a reunion with family and friends. Moreover, Americans held civic notions of sacrifice for the state, and finally, trauma was conceptualized as physical not mental. The idea of a traumatic memory, the bedrock of PTSD, would not be proposed until the 1890s.
However, despite the fact that the social and cultural world did not lend itself to the greater awareness and acceptance of psychological trauma, it is still possible that Civil War veterans were afflicted with PTSD. Indeed, despite the fact that death was a constant in the life of Civil War soldiers, combat in the war was like nothing they could have imagined in their worst nightmares. No lithograph or dime novel could capture the sights, sounds and smells of the battlefield, much less the emotions it could generate. "You ask me how I felt when the battle commenced, if I feared I should fall," Oliver Norton wrote to his parents back home following the Battle of Malvern Hill. "That is a very hard question to answer." Another soldier responded to his wife's inquiry about how he felt during combat: "I can't describe my feelings when the battle began." Most soldiers, however, being farm people used meteorological analogies to describe combat. Battle was a hurricane, or a thousand thunderstorms raging at once. For those that survived, the war presented new and terrible forms of mutilation and suffering that could shock even the most battle hardened survivor.
As Paul Cimbala argues, most Civil War soldiers found ways to cope and adjust to the stresses of soldier life. They became battle hardened, inured to a level of violence and death that would shock even their civilian contemporaries. When the war ended, veterans generally successfully transitioned into civilian life. The war was, for many, a complex experience rife with multiple and sometimes conflicting emotions, but an experience that was successfully incorporated into who they were. For some, though, the memories of the war were too painful.
It is important to note that we can never know absolutely for sure whether Civil War veterans were in fact suffering with PTSD. We can't send a psychiatrist back in time to diagnose Civil War veterans, and often questions of personal and family history, possible syphilis infection, or other possible explanations loom unanswered. However, if we assume that human brain chemistry has not changed significantly in the past 150 years, it seems plausible that a handful of Civil War veterans could have suffered with the disorder. The most important symptom of PTSD is re experiencing a traumatic event or moment through nightmares, flashbacks and hallucinations. The historical record is replete with Civil War veterans struggling with dreams of war.
Thousands of soldiers, and later veterans, who were emotionally and psychologically struggling, were sent to the various private and state insane asylums that dotted the country's landscape. These asylum records can give historians a window into one aspect of the Civil War veteran experience. One such case was Thomas Lynch, who was a veteran of the First D.C. Volunteers. Lynch and the First D.C. Volunteers had protected the capital before being sent to fight Stonewall Jackson and his Confederates in the Shenandoah Valley, Harper's Ferry, and the Second Battle of Bull Run. In the spring of 1863, Lynch mentally dissolved, so much so that he was sent to the Government Hospital for the Insane, an asylum in the capital. He was discharged briefly, relapsed, and was sent back where he remained until his death. Records from the asylum describe Lynch as "intemperate" and suffering with "delusions and hallucinations."
Veterans who ended up as patients in an asylum were rare, indeed only an estimated 1,500 veterans became patients at the Government Hospital for the Insane between 1865-1890. The vast majority of veterans did not enter an asylum during their lifetimes. However, historians can still glean some evidence of postwar psychological suffering among veterans who never entered an asylum. Medical records or hospitals and other care facilities can occasionally present such a case. David Schively was an eighteen year old kid from Pennsylvania who the prior year had volunteered with the 114th Pennsylvania Regiment. At the Battle of Gettysburg he had been terribly wounded. As he raised up to fire his rifle during the second day of fighting an enemy musket ball ripped through his right shoulder. As he was leaving the field to seek medical care, he was shot again, this time in the face, leaving him partially blind in his right eye. In the 1890s, he checked into a specialized clinic in Philadelphia. "The patient has a frequent roaring in his head and black specks before the eyes," wrote the physician in Shively's case report. "He has suffered much from an attack of nervous prostration, attributed to suffering from the wound...he was melancholic, had hallucinations, depressing forebodings, and horrible dreams."
Finally, sometimes in their postwar memoirs, veterans recounted frightening dreams that plagued them for decades after the war. In his postwar memoir, Napoleon Perkins, who had been a soldier in the Fifth Maine Battery, recounted his experience at the Battle of Chancellorsville. While unhitching a wounded horse, he himself was wounded when a ball struck him in the leg just above the knee. Disabled from the injury, Perkins was carried by comrades to a plantation house near the battlefield that had been hastily turned into a field hospital to treat the avalanche of wounded soldiers. Perkins found little rest at the field hospital, on account of his leg, which became "badly swollen & inflamed" and the other wounded soldiers all around him. "Some were groaning, others were praying, while others were singing, while still others were swearing...others delirious," Perkins recalled. The night he passed in that retched house was a disturbing experience, one that haunted him in his dreams after the war. "I shall never forget that night and have often dreamed of it," Perkins wrote. Perkins' memoir demonstrates both the possibility that Civil War veterans suffered with PTSD, and also evidence that they interpreted and experienced it in a completely different way. He admits that the night he passed in the field hospital frequently haunted him in his dreams, yet he also did not consider himself damaged, much less mentally ill. By all accounts, Perkins was a successful example of a veteran who was able to transition to civilian life. His leg was eventually amputated, and after a long and frustrating search for work he found work in a millinery shop in Groveton, New Hampshire. He eventually was briefly elected to the state legislature before he was appointed as postmaster of Groveton.
All of this should be interpreted carefully. Because in addition to the fact that we don't know for sure whether Civil War veterans had PTSD, we also don't know how PTSD might change in the future. As Frances Clarke warned historians recently: "our diagnoses are no more stable than were those in the past, partly because the way we understand the workings of the human mind has changed considerably and will continue to do so." The human mind is one of the last great frontiers, along with the deep reaches of the ocean and space. The brain is a three pound universe of 100 billion synaptic connections, an evolutionary marvel that we have yet to completely understand. Indeed, new cutting edge research suggests that PTSD may be more pathological than we once previously imagined. Neuropathologists' working in the Pentagon's brain bank of recently deceased American veterans have discovered a mysterious dust like scarring along the synapses connecting the gray matter with the white matter of the brain. They have hypothesized, in an article recently published in The Lancet Neurology that perhaps PTSD has neurological implications, literally destroying the brain almost like CTE.
However, if we listen to the voices of asylum doctors, and Civil War veterans themselves, a handful are telling us, sometimes screaming at us that they were scarred by the war in a disturbingly similar way to PTSD.
 Oliver Willcox Norton, Army Letters, 1861-1865 (Chicago: N.P., 1903), 106.
 Shephard Green Pryor to Penelope Pryor, 4 October 1861, Shephard Green Pryor Papers, Hargrett Rare Book and Manuscript Library, University of Georgia.
 Thomas Lynch Case Notes, 2 February 1912, Case 1328, Records of St. Elizabeths Hospital, Record Group 418, National Archives and Records Administration, Washington, D.C.
 John K. Mitchell, Remote Consequences of Injuries of Nerves and Their Treatment: An Examination of the Present Condition of Wounds Received 1863-1865, with Additional Illustrative Cases (Philadelphia: Lea Brothers & Co., 1895), 81.
 Napoleon B. Perkins, Memoirs of N.B. Perkins, New Hampshire Historical Society.
 quoted from Jonathan W. White, Midnight in America: Darkness, Sleep, and Dreams during the Civil War (Chapel Hill: The University of North Carolina Press, 2017), 195.
 Robert F. Worth, "What if PTSD is more Physical than Psychological," New York Times Magazine, 10 June 2016 (https://www.nytimes.com/2016/06/12/magazine/what-if-ptsd-is-more-physical-than-psychological.html?_r=0)