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Authors: David J. Morris

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In 1871, six years after Appomattox, Jacob DaCosta, a ­physician who had served with the Union Army, wrote a famous article describing three hundred cases of what he called “irritable heart.”
In it, he described a number of postbattle symptoms that today would be recognized as a simple reaction to overwhelming stress, or what psychiatrists today would call “hypervigilance,” one of the cardinal symptoms of post-traumatic stress. DaCosta, also present at the battle of Shiloh, observed men suffering from palpitations, chest pain, a rapid pulse, and a host of respiratory and digestive disorders brought on by “quick and long marches, heavy work . . . or even slight exertion in those whose constitution has been impaired.” Oddly, DaCosta never attributed these symptoms to the peculiar terrors of combat; believing them to be caused by an overstimulation of the nerves at the base of the heart, he treated them with a host of drugs, including opium, digitalis, belladonna, and cannabis indica. (Interestingly, in 1998, researchers at Boston University found the heart's reactivity to certain traumatic stimuli to be a useful indicator of combat PTSD in patients, so while DaCosta's explanation may not have been correct, his observations were.)

In the case of the Union troops at Shiloh who broke and ran, several thousand of them were later evacuated to the rear, with an uncounted number claiming to suffer from a condition known as “nostalgia.” A word that has taken on different meanings over the centuries,
nostalgia
during the Civil War was used to indicate a number of mental conditions that today might be called clinical depression or simple panic.
(“Nostalgia” has its roots in Homeric Greek and means “home-ache.”) Based on the French diagnostic category
nostalgie
, which had been in the medical lexicon since the 1700s, the term was often applied to soldiers serving far from home who suffered from a kind of mental deterioration while campaigning. Incidents of nostalgia were recorded as far back as 1633 in the Spanish Army, and they reached their apogee among Swiss soldiers fighting on the plains of France who were forbidden by their commanders from singing or even whistling the traditional “kuhreihen” alpine folk songs. (The phenomenon was even referred to as the “Swiss illness” for a time.)

By the 1860s, the term as a medical category was on the decline in Europe, but accounts of the Civil War are filled with references to it. In a time when few Americans traveled beyond their home states, the stresses of fighting far from one's home and family were real indeed. The Union Army recognized nostalgia as a mental disorder and included it in the handbook issued to medical officers.
A Manual of Instructions for Enlisting and Discharging Soldiers
describes it as “a form of mental disease which comes more frequently under the observation of the military surgeon . . . The extreme mental depression and the unconquerable longing for home soon produce a state of cachexy, loss of appetite, derangement of the assimilative functions, and, finally, disease of the abdominal viscera . . . As Nostalgia is not unfrequently fatal, it is a ground for discharge if sufficiently decided and pronounced.”

By war's end, the Union's surgical rolls listed some 175,000 men, or around 8 percent of the army, as victims of nostalgia, “insanity,” and other “nervous” disorders, though in an era when military record keeping was flawed and inconsistent, such a figure only hints at the true psychological toll.
Interestingly, because Civil War soldiers tended to look at themselves as civilians in uniform, the shame attached to those who did succumb to the stresses of war was less intense than what one sees in professional armies today. Desertions, especially after battlefield reversals, were common. Hundreds of thousands of soldiers from both sides deserted at various points during the war, often returning home to protect and sustain their families.
Commanders, especially in the South, were desperate for bodies to fill the ranks and often declared amnesties, permitting such “AWOLs” to return without charging them under military law.

This openly acknowledged fear of battle was on display during the early years of the war when Union commanders, plagued by paranoia about the enemy's intentions, quarreled with their superiors at every level of command, often hesitating rather than committing their troops to action. William Tecumseh Sherman, who later earned a place in history by declaring that “War is all hell,” first rose to prominence in October 1862, when his immediate superior resigned because of the “mental torture of his command.”
A month later, Sherman asked to be relieved for the same reason. Given a second chance by the army, his cool handling of the Confederate charge at Shiloh restored his reputation, reestablishing his career, even though he had initially dismissed a number of reports indicating that an attack was imminent.

When the war finally ended in 1865, the U.S. government, which had grown to an unprecedented size in response to the hostilities, oversaw a number of projects designed to manage the aftermath of the conflict. Included among these were the establishment of national cemeteries and a pension system to provide for the physically wounded and for the survivors of the fallen. Counseling psychology and biological psychiatry did not exist as the disciplines we know today, and the idea that veterans of the Civil War might require formal adjustment counseling simply didn't occur to Americans. The Veterans Administration, a fixture of modern American life, wouldn't emerge for another sixty-five years. Veterans of the Civil War who weren't physically wounded were expected to return home to their farms and neighborhoods and more or less pick up where they had left off. A number of states operated asylums, such as Indiana, which saw a peak in admissions from 1876 to 1890, a period from eleven to twenty-five years after the cessation of hostilities.
The idea of the “veteran experience” as a popularly accepted social category was a largely unexplored notion to Americans who had never before lived through a mass conflict like the Civil War.

Stephen Crane, as an up-and-coming newspaper reporter in the 1890s interested in the experience of the common soldier during the war, was frustrated by the lack of such accounts.
Like many young men of the time, Crane had grown up hearing veterans' stories and had read many articles about the war. After consulting the widely quoted
Battles and Leaders of the Civil War
, he found himself disturbed not by what he'd read but by what he hadn't read. “I wonder that
some
of these fellows don't tell how it
felt
in those scrapes,” he complained. What came out of this wonderment was the first proper American war novel,
The Red Badge of Courage
. Seemingly fated to be a classic, the novel, which recounts a soldier's baptism by fire (including his brief desertion), essentially established the coming-of-age war novel genre in the United States. Following a year later was a lesser-known tale, “The Veteran.” The story ends with Henry Fleming, a survivor of Chancellorsville, charging into a burning barn to save some trapped horses and disappearing in a “great funnel of smoke.” When Fleming first learns of the fire, his humanity seems to end. “His face ceased instantly to be a face; it became a mask, a gray thing, with horror written about the mouth and the eyes.” Created by one conflagration, the “veteran,” it seemed, was fated to meet his end in another, transformed into a “rose-hue'd” spirit swelling from the flames.

In fact, the violence loosed by the Civil War did not end after the South's surrender at Appomattox.
As other historians have pointed out, the war “let the genie out of the bottle,” leading to a wave of criminal violence that spread to every corner of an already blood-soaked nation. It was almost as if the war had untamed men to a certain extent. Thousands of men deranged by the fighting found themselves unable to return to their old lives and civil society. The widespread habit of violence cultivated by the war, combined with a lack of economic opportunity, particularly in the South, created a culture of lawlessness that defined the post–Civil War era. Jesse James, the West's most famous outlaw, learned his trade as a guerrilla fighter in Missouri during the war, and he operated in a similar fashion until he was killed in 1882.

Throughout the postwar South, newspapers reported a “frightening increase in crime,” driven by what were thought to be roving bands of former Confederate soldiers. In the North, two-thirds of all men sentenced to prison were war veterans, and in some states the number of men serving time shot up 400 percent. The postwar period also saw the rise of organized racial violence in the form of the Ku Klux Klan, an organization founded by another Confederate guerrilla fighter, Nathan Bedford Forrest.

While not technically criminal in nature, the Plains Indians wars, fought over the course of the 1870s, were dominated by the genocidal “total war” strategy devised by General Sherman. The Civil War's impact on the American Indian can be easily understood by a simple comparison of the strategies pursued by the U.S. Army. Before the war, the army followed an informal policy of containment, making and breaking treaties as was convenient. After the war, a scorched earth strategy prevailed, exemplified by General James Sheridan, a veteran of Shiloh, who declared that the only good Indian was a dead Indian.

The idea that war might promote crime and violence throughout society has occurred to many thinkers throughout history. Although the exact origins of this notion are difficult to trace, Erasmus, Sir Thomas More, and Machiavelli all speculated that wars lead to increased crime and violence. As researchers at the University of California, Santa Cruz, noted the year after the fall of Saigon, “During the Vietnam War, the murder and nonnegligent manslaughter rate in the United States more than doubled.”
The U.S. Navy's Health Research Center, looking into a similar set of issues among returning Iraq War veterans in 2010, found a “significant association between combat exposure and subsequent arrests and convictions that persisted when preservice background factors were controlled.”
The implications of these sorts of studies aren't hard to understand. Violence changes people in mysterious ways, and when the normal human prohibitions against murder and cruelty are lifted on a wide scale, it unleashes violent impulses that are not easily controlled. It should come as little surprise that the bloodiest era of lawlessness, racially motivated violence, and genocide in American history came immediately after its bloodiest war.

 

In many ways, the catastrophe of the American Civil War was merely a preview of the horrors to come in World War I.
The same technological elements that made the Civil War an era-demolishing bloodbath—improved firearms, motor transport, and the telegraph (now wireless)—were all present in World War I but in greater force. This bigger, bloodier, more thoroughly industrialized conflict, which was widely referred to as “The Great War” until relatively recently, destroyed over eight million lives outright and demolished four European empires, while putting a fifth—the British—on the road to bankruptcy. To a degree that is difficult to appreciate in America, which entered the war only in its last few months, World War I changed the course of history. More than that, the war was so disillusioning, so corrosive to the public spirit, that it actually destroyed people's belief in the
idea
of history as it had been understood up to that point. As Paul Fussell, one of the war's preeminent chroniclers, would say, “It reversed the Idea of Progress.”

The central metaphor of the period is, tellingly, a psychological one: shell shock. A post-traumatic phenomenon that one can, with a bit of poetic license, plausibly describe as the grandfather of PTSD, shell shock essentially began as a response to the horrors of twentieth-century technology—“the shock of the shell.” Partly because of its catchiness as a phrase, it went on to become something of a catchall for any English-speaking soldier suffering from a war-related psychiatric disorder, even after its early champions distanced themselves from it.
(The Germans and the French both had their own versions of shell shock—
Kriegshysterie
and
choc traumatique
—but the terms never quite caught on.) Many of the symptoms associated with shell shock would be familiar to today's PTSD sufferers—a coarse shaking of the hands, nightmares, jumpiness, and in the worst cases hysterical deafness, blindness, and mutism.

In addition to its gross historical impact, the war changed our basic view of human endurance. Before the war, a man was, in large measure, the captain of his fate. After the war, this view was colored by the fact that against the iron tide of industrialization, the lone man didn't stand a chance. The war killed eight million people, and in the process it killed off a number of popularly held beliefs about martial glory, manly honor, and the benefits of military service. From a psychological standpoint, the war destroyed the idea that a determined person can survive any adversity with their mind intact, that a “good” person can and will always overcome their circumstances. The war severely damaged the notion that post-traumatic sanity was a choice and that simply by not dwelling on the past, by “moving on,” one could remain healthy and whole.

While World War I did not bring PTSD into existence, it is inconceivable without it. The war disillusioned tens of millions of people, and in retrospect it can be seen as the opening engagement of a “war of nerves” that culminated sixty-six years later in PTSD's introduction to the DSM. The first conflict where war neuroses were officially identified and treated, World War I is one of the premier examples of what terror can do to the mind and how human memory, even when damaged in battle, can work to influence history.

One of the primary means for wounded minds to convey their experiences is through literature.
Perhaps unsurprisingly, the icons of shell shock are the poets Wilfred Owen and Siegfried Sassoon, figures who have come to represent not just the tragedy of the Great War but of modern war as a whole. This effect is most pronounced in Great Britain, where people still wear poppies every November in remembrance of the fallen. As Pat Barker, the author of a Booker-winning trilogy of novels dealing with shell shock, said in a 2004 interview in the
Guardian
, “I think the whole British psyche is suffering from the contradiction you see in Sassoon and Wilfred Owen, where the war is both terrible and never to be repeated and at the same time experiences derived from it are given enormous value . . . No one watches war films in quite the way the British do.”

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