Tuesday, September 24, 2013

Opium in the Civil War

Under the Influence: Marching Through the Opium Fog 

by James Street, Jr.

By the beginning of the Civil War, there was probably some opium of some form in most household medicine cabinets. In The Plantation Mistress, a 1982 study of women's life in the antebellum south, author Catherine Clinton writes that she found home remedies, all containing opium, for many common illnesses. She observes, ”Laudanum was commonly used throughout the antebellum era, prescribed with unfortunate frequency for 'female complaints'.....contrary to the 20th Century image....., the late 19th Century profile indicates that addicts were disproportionately upper-class, Southern, white and female. The women of the Jefferson Davis family, treated by a Dr. liberal in his dosages, became dangerously addicted." Most people using opiates did not become addicted.

Confederate society figure Mary Chestnut, writing in her diary in Richmond, Virginia, during July 1861, told of her refusal to take laudanum, a tincture of opium mixed with alcohol and water. "I have no intention of drugging myself now." she asserted. "My head is addled enough as it stands, and my heart beats to jump out of my body at every sound." Later, in March 1865, Mrs. Chestnut was a refugee in Lincolnton, N.C. She was accidentally given an overdose of Dover's powder, a mixture of opium and ipecac (what??!!). She slept for 2 days and nights. After her Dr. remarked that she was hard to kill, Mrs. Chestnut speculated,” Maybe I was saved by the adulteration so often complained of in Confederate medicine."

When called to the colors, whether Union or Confederate, doctors who used opiates liberally on civilian clients continued to use them liberally on their military patients. William H. Taylor was an assistant surgeon in the Confederate Army of Northern Virginia, an organization known for its rapid marches. After the war he wrote that he had simplified sick call on the march to one basic question: "How are your bowels? If they were open, I administered a plug of opium; if they were shut I gave them a plug of blue mass (an unstable mercury compound)." A Federal surgeon devised an even speedier sick call method. He performed diagnosis from horseback, dispensing morphine powder by pouring it into his hand and letting the patient lick it.

Morphine, injected by the recently developed hypodermic syringe, was the preferred form of opium for treating the wounded. And though syringes were scarce, even in the better-equipped Federal armies, 29,828 ounces of morphine sulphate was dispensed to Union soldiers. That figure seems almost trifling compared to the almost 10 million opium pills and 2,841 million ounces of other opiates administered by Federal medical authorities by 1865.

While not as ubiquitous in the Confederate army, opium was in reasonable supply until the very end of the war, thanks to captured medical stores and imports smuggled through the naval blockade of the southern ports. Though opiates were used profusely in the treatment of illnesses, it was in relieving the pain of wounds and surgery that they were most effective. The desire for that relief cause many injured soldiers to become opiate addicts, for pain lingered long after medical treatment in those days. And after the war it was easy to find veterans who suffered agony from war wounds or war-related illnesses for the rest of their lives.

In his book, "Dark Paradise: Opiate  Addiction in America Before 1940", David Courtwright quotes from an 1868 study titled The Opium Habit, with suggestions as to the remedy: Maimed and shattered survivors from a hundred battlefields, diseased and disabled soldiers released from hostile prisons, anguished and hopeless wives and mothers, made so by the slaughter of those dearest to them, have found, many of them, temporary relief from their sufferings in opium."

Just as the Civil War army surgeon was a ready source of alcohol for non-medicinal purposes, so was he or his staff a handy source of opiates--not just for sneaky scroungers but for high-ranking officers too. If a general wanted opium pills, what surgeon would deny him the relief he sought, when the surgeon probably prescribed them in the first place? A surgeon had only to turn to his medicine chest to satisfy such a request, or the officer could help himself from the open stock usually arrayed on shelves in the unit's medical quarters.

Dr. Charles Beneulyn Johnson, a Union regimental medical steward, described the contents of the medical chests. "During a campaign our stocks of medicines were necessarily limited to standard remedies." He recalled, among which could be named opium, morphine, Dover's powder, quinine, rhubarb, Rochelle Salts, Epsom salts, castor oil, sugar of lead, tannin, sulphate of copper, sulphate of zinc, camphor, tincture of iron, tincture of opium, camphorate, syrup of squills, simple syrup, alcohol, whiskey, brandy, port wine, sherry wine etc. Upon going into camp, where we were likely to remain a few days, these articles were unpacked and put on temporary shelves made from box lids; on the other hand, when marching orders came, the medicines were again packed in boxes, the bottles protected by old papers, etc." Johnson continued, "Practically all the medicines were in powder form or in the liquid state. Tablets were not yet come into use and pills were very far from being as plentiful as they are today...." The doctor noted, "....one of the very few pills we carried in stock...was composed of two grains of camphor and one of opium. Asafetida, valerian and opium and its derivatives (sic) were about all (we) had to relieve nervousness and induce sleep."

Among the aphorisms attributed to that barely literate but extraordinarily effective Confederate, Lieutenant General Nathan Bedford Forrest, is one that states, "War means fighting and fighting means killing." Not all civil war generals could muster so direct such an approach to war and violence. Many preferred to try any means of defeating an enemy except fighting. These were usually the same generals who could not overcome their troops' natural desire to remain where they were, so long as they were safe. Historian T. Harry Williams called this phenomenon the "inertia of war," that moment when "the general's own army, begins to offer resistance....when the whole inertia of the war comes to rest on his will, and only the spark of his own purpose and spirit can throw it off... a commander has to have in his make-up a mental strength and moral power that enables him to dominate whatever event or crisis may emerge on the field of battle."

But were the war's inert generals fundamentally flawed leaders or was there another reason for their lapses into feebleness? When cataloging the attributes of a successful general, Marshall Maurice Saxe, France's great military mind of the early 18th Century, presented the usual list including bravery, intelligence etc. then he added one more, health. It is doubtful that the outcome of the Civil War would have been any different if all the generals had been healthy. But the fact is they were not, and perhaps much of their erratic and lethargic behavior can be ascribed to their frail state of health--and to opium, the panacea their doctors described at every turn.

Braxton Bragg's health should have excluded him from any consideration for a field command. By 1861, when the first shot of the war was fired at Ft Sumter, Bragg had developed a long list of chronic ailments, including malaria, dyspepsia (deranged or impaired digestion) and boils. His wife and friends were aware that the greater the pressure on him, the more he complained and the more likely he was to develop boils, headaches and other painful maladies. His behavior as commander of the Confederate Army of Tennessee was as mystifying to his contemporaries as it is to current scholars. And Bragg's penchant for turning away from victory, quitting battle when he had the upper hand, was the basis for a story that when he died, he went to heaven: as he approached the Pearly Gates, they opened; then Bragg retreated.

Some critics and historians offer stupidity, incompetence or cowardice as reasons for Bragg's failures. But his blunders may have resulted from his health and the rudimentary, even primitive level of medicine prevalent during the war. Bragg's behavior showed signs of opiate use. In the field, he appeared to withdraw as battle developed, to lose track of where he was. He became unable to adapt his plans to changing situations on the battlefield. But Bragg certainly was not stupid, as evidenced by the swiftness of his September 1862 movement from Tennessee into Kentucky, to wrest the Bluegrass State from Union Major General Don Carlos Buell. He was not a coward, as his record during the Mexican War and the Battle of Shiloh demonstrated. But, as he was promoted to higher command, Bragg became more distant from the troops, appearing to avoid active command during battle. His behavior could have been the result of a combination of poor health and the use of opiates. Bragg may very well have believed the unfounded contents of his Dec.31,1862 telegram to President Davis--that he had won victory after the first day of the Battle of Stones River. Opium-induced euphoria could have induced such an effect, leading him to believe what he so desperately wanted to be true. Euphoria could have led Bragg to back away from Buell's troops after capturing the entire Federal garrison at Mumfordville, Kentucky in Sept. 1862 and seizing Frankfort, the state capital. That same euphoria may have prompted his dispatch to Richmond before the Oct. 1862 Battle of Perryville, Kentucky, claiming his army had joined with Major General Edmund Kirby Smith's when Smith's force was actually more than 100 miles away. Bragg's skewed visions of success, his paranoia towards his officers after each defeat , could have been the result of his medical care.

The gallant John Bell Hood, aggressive, vigorous and effective while with the Army of Northern Virginia, became a victim of delusions after a series of shattering wounds struck him. He left his finest attributes and his common sense on the surgeon's table. The pain from the stump of his right leg must have been horrendous when he rode strapped to his saddle. The bouncing and jolting, the abrasive rubbing of the stump against the rough cloth of a dressing or pad could not have been endured without some sort of pain-reliever.. An opiate was the standard prescription. The drug would have made Hood sleep at Spring Hill while the Federals escaped his trap. The pain was a terrible burden to inflict on Hood, but it was even worse to inflict Hood on the Army of Tennessee.

Union Major General Joseph "Fighting Joe" Hooker's affinity for spirituous liquors and spirited women was a matter of record by the time he led the Army of the Potomac to battle at Chancellorsville, Virginia, in May 1863. If Hooker was truly an alcoholic, and if he kept his pledge not to drink while commanding the army, it is highly likely he was treated with opiates to help him through withdrawal (opiates were commonly used to treat delirium tremens). This medical scenario may account may account for his poor battlefield performance. Or, there may have been another. Hooker's plans for the Battle of Chancellorsville were excellent. It was his leadership that faltered as he became more and more lethargic. The general admitted this much himself. Then, on May 3, Hooker claimed that, while he stood on the porch of a house, he was hit on the head by a column that was knocked loose by a cannon shot. He claimed he was in great pain. The Medical Director of the Army of the Potomac, Doctor Johnathan Letterman, later substantiated Hooker's claim, but failed to mention the extent of the injury, the amount of pain and whether any alcohol or morphine was administered.. But Hooker's behavior the rest of that day indicates he may have received an intoxicating prescription, for he abandoned control of his army to sleep in his tent. Opium, in smaller doses than whiskey, is an effective soporific.

The three generals mentioned here were not the only ones to experience radical behavior changes during battle, changes that may indicate the use of opium or alcohol. Bragg, Hood and Hooker were merely the highest ranking examples. Opiates may have contributed to the timidity of Confederate Lieutenant General Richard Stoddard Ewell, who in July 1863 dashed boldly into Gettysburg, strapped to his horse and minus a leg, and chased the Federals out of town, but then sank into inertia. And what of Bragg's enemy, Buell, who after an accident with his horse sat out the Oct. 1862 Battle of Perryville behind his lines? There are others, too. This is not to imply that all the Civil War's military leaders were alcoholics or drug addicts.

Ulysses S. Grant was certainly known as a two-fisted drinker, but liquor did not keep him from forging victories. Perhaps a more important observation about Grant is that he was never forced by poor health to rely on the services of a surgeon. That fact alone may have been a blessing for the Union. Due to the state of medical arts and sciences during the Civil War, some officers, tenuously steadied with alcohol or opiates, managed to hold positions of great responsibility even though they were unfit for any military service.

Others were retained after suffering debilitating wounds or illnesses, when they should have been discharged or assigned non-combat roles. But instead, history was sometimes made by men who saw their battlefields through the cloud of intoxication.

From: "Civil War Times" May 1988


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