Civil War Hospital Ship

The U.S.S. Red Rover, a captured Confederate vessel, was refitted as a hospital ship.

Evolution of Civil War Nursing

The evolution of the nursing profession in America was accelerated by the Civil War.

The Practice of Surgery

Amputations were the most common surgery performed during the Civil War.

Army Medical Museum and Library

Surgeon-General William Hammond established The Army Medical Museum in 1862. It was the first federal medical research facility.

Civil War Amputation Kit

Many Civil War surgical instruments had handles of bone, wood or ivory. They were never sterilized.

Showing posts with label Addiction. Show all posts
Showing posts with label Addiction. Show all posts

Wednesday, May 3, 2017

Civil War Alcohol Abuse: Forty-rod, Blue Ruin & Oh Be Joyful

By David A. Norris, 9-20-15

With a plethora of colorful nicknames, alcohol was widely abused in both Union and Confederate armies during the Civil War.

Union General Benjamin Butler was baffled. Every night a picket guard went to an outpost 1½ miles from Fort Monroe, Virginia. The soldiers departed for their shift perfectly sober, yet when they returned to the post the next morning they caused trouble “on account of being drunk.”

Investigations failed to reveal the source of their whiskey. Searches of canteens and gear turned up nothing suspicious. But there was one odd thing about the detachment: someone in Butler’s command noticed that the men always held their muskets straight up in a peculiar manner. The mystery unraveled when their muskets were examined. “Every gun barrel,” wrote Butler, “was found to be filled with whiskey.”

Excessive drinking was a constant problem in both armies during the Civil War. “No one evil agent so much obstructs this army as the degrading vice of drunkenness,” wrote Union Maj. Gen. George B. McClellan in February 1862. “It is the cause of by far the greatest part of the disorders which are examined by court-martial.” The complete abolition of alcohol, he believed, “would be worth fifty thousand men to the armies of the United States.” And across the Mason-Dixon Line, the Norfolk Day-Book complained that Confederate enlisted men and officers in the vicinity were drinking whiskey “in quantities which would astonish the nerves of a cast-iron lamp-post, and of a quality which would destroy the digestive organs of an ostrich.”

Whiskey the Drink of Choice for Most Soldiers
Many if not most soldiers were already well acquainted with alcohol from the antebellum era. Whiskey was far and away the most popular drink in 1861. Often made from corn instead of grain, it was distilled at countless locations across the country. Popular nondistilled drinks included cider and beer. Cider, made from apples, was more common, but beer was quickly growing in favor, its rise fueled by the steady German immigration into Northern states.

With a plethora of colorful nicknames, alcohol was widely abused in both Union and Confederate armies during the Civil War.

Low-grade whiskey carried with it the threat of poisoning the drinker, so makers might start with clear alcohol, water it down, and then doctor the mixture to simulate the color and flavor of the real thing. Chewing tobacco, for example, helped approximate the amber tint of whiskey or brandy. Harsher ingredients added the bite that drinkers expected in their whiskey. An 1860 inspection of liquor samples in Cincinnati found whiskey containing sulfuric acid, red pepper, caustic, soda, potassium, and strychnine. It was no wonder that “rotgut” was the most prevalent nickname for cheap liquor during the era.

Countering the growth of alcohol consumption was the temperance movement, which sought to make all forms of alcoholic beverages illegal. Maine enacted a prohibition law in 1851. Several other states or territories passed dry laws in the following years. In most cases, these laws were repealed or overturned within a short time. Per capita consumption peaked in 1830 at an equivalent of 7.1 gallons of alcohol annually. A swift decline followed, with the annual per capita figure dropping to 2.53 gallons by 1860.

“Spirit Rations” Abolished
Alcohol still had an official presence in the U.S. Army in 1861. A daily spirit ration for American soldiers had been abolished in 1832, but officers were permitted to issue special servings of whiskey to relieve fatigue and exposure. Soldiers, naturally, had countless sneaky ways to obtain whiskey. While diligent officers could restrict the flow of whiskey into camp, soldiers could still drink when they received a pass to leave camp. In the Confederate Army, the phrase “running the blockade” meant slipping in and out of camp for illicit purposes, usually involving alcohol.

On February 27, 1862, the Confederate Congress passed a law allowing President Jefferson Davis to suspend habeas corpus and declare martial law in areas threatened by the enemy. Immediately, martial law was declared in Portsmouth and Norfolk, Virginia, followed by Richmond on March 1. Richmond came under control of the provost guards commanded by Brig. Gen. John H. Winder, who prohibited the manufacture of liquor and closed the city’s saloons. By then liquor sales had caused so much trouble and crime among Confederate soldiers and civilian that many in Richmond welcomed martial law. Winder also barred rail shipments of whiskey into the Confederate capital. Apothecaries were allowed to dispense liquor only with a doctor’s prescription.

Martial law did not stop the distribution of whiskey, but merely drove it underground. There were still countless cases of drunk and disorderly behavior, as well as arrests for illegal sales of alcohol. Corruption flourished among the provost guards, some of whom forged prescriptions for alcohol. After obtaining the liquor, they then arrested the apothecaries who had dispensed it, thus adding insult to injury.

A ‘Creature Comfort’ Care Package From Home
A great deal of whiskey was sent to army camps on both sides by well-meaning relatives back home. It was a common practice, especially among the Union soldiers, for families to send their loved ones packages of fresh, canned, or smoked food and other small creature comforts. Commanding officers quickly realized that a great deal of whiskey was also being smuggled into camp inside these care packages. General Butler later testified before Congress that a search of an Adams Express Company depot yielded 150 different packages of liquor in crates and boxes on their way to his command.

Every parcel intended for a soldier had to be opened and inspected by officers of his regiment or brigade. Union Private John D. Billings, in his classic memoir Hardtack and Coffee, recalled, “There was many a growl uttered by men who lost their little pint or quart bottle of some choice stimulating beverage, which had been confiscated from a box as contraband of war.” Billings noted some ingenious ways that innocent-looking gifts concealed whiskey. One favorite ruse was hiding a bottle of whiskey inside a well-roasted turkey. Whiskey bottles also came into Billings’ camp in tin cans of small cakes or in loaves of bread with holes cut in the bottom.

Smuggling whiskey in legitimate-looking containers with false labels was a common practice. A helpful sutler showed Butler several little bottles that supposedly contained hair oil packaged by a New York City firm. Instead, each bottle contained half a pint of whiskey, with a little olive oil on top. The bottles were sold wholesale at eight cents each, but soldiers paid 25 cents for them in camp. The distributor claimed to have sold thousands of such bottles at Fort Monroe.

Alcohol Restrictions Lead to Officer Impersonation
In February 1863, the Union guard boat Jacob Bell searched the supply schooner Mail at Alexandria, Virginia. Aboard the schooner were 428 dozen cans labeled “milk drink” packaged by Numsen, Carroll & Company, a Baltimore firm. Upon closer inspection, Lt. Cmdr. E.P. McCrea learned that the milk drink was actually “villainous eggnog.” Commodore Andrew Harwood noted that the cans were not soldered in the usual way. The top and bottom had been heated with a resinous substance and the edges bent over so that the cover at either end could be removed to convert the can into a drinking cup. Harwood issued orders to the Potomac Flotilla to seize any vessel caught smuggling alcohol.

Sutlers were in a good position to profit from liquor sales. Regulations prohibited them from selling liquor to enlisted personnel, but many of the officially licensed merchants evaded the rules. Sutlers could openly stock whiskey because they were still allowed to sell it to officers. Brassy enlisted men frequently borrowed a pair of officers’ shoulder straps and purchased whiskey in the shops. Others stole bottles from sutler huts, wagons, or tents.

With a plethora of colorful nicknames, alcohol was widely abused in both Union and Confederate armies during the Civil War.

Impersonating an officer was only one of the many ways that Union and Confederate soldiers managed to get around the rules restricting their drinking. Assignment to guard duty also provided opportunities for mischief. In eastern North Carolina in April 1862, several men in the 51st Pennsylvania were ordered to guard the commissary tent in which a newly arrived shipment of whiskey barrels was stored. One night the guards took the barrels off their muskets. After unscrewing the breech plugs, each soldier had a long iron straw, which he inserted into the bung-hole of a whiskey cask and sucked himself into intoxication.

Among the busiest routes for smuggling alcohol to the Union Army was the Long Bridge, which crossed the Potomac River, linking Washington, D.C., to Virginia. On November 23, 1863, all contraband liquor seized on the bridge was turned over to the Army Medical Museum, located not far from the Washington end of the bridge. At the time, tissue specimens saved for the museum were wrapped in cloth and preserved in a keg of alcohol or whiskey. Each specimen was identified by a small wooden block, with a description written on it in pencil so that the alcohol would not dissolve the writing. Confiscated liquor was distilled again by the museum into uniform grade 70 percent alcohol, which was deemed perfect for preserving specimens.

Liquor Smuggling Gets More Sophisticated
Surgeon John H. Brinton recalled that ground around the museum was piled high with “kegs, bottles, demijohns, and cases, to say nothing of an infinite variety of tins, made so as to fit unperceived on the body, and thus permit the wearer to smuggle alcohol into camp.” Another medical officer, Acting Assistant Surgeon Ralph S.L. Walsh, marveled at the ingenuity of liquor smugglers. Goods confiscated for the museum, ranging from blackberry wine to straight alcohol, were packed in many peculiar vessels. Frequently women were arrested with belts under their skirts to which were fastened tin cans holding between a quart and a gallon of whiskey. In a number of cases the women sported false breasts, each holding a quart or more of contraband liquor. Guards seized so much alcohol at Long Bridge during the war that the Army Medical Museum had enough alcohol for its specimens until 1876.

In many camps sutlers were allowed to sell patent medicines. Often these remedies were nothing more than liquor flavored and tinted with herbal concoctions. Countless posters and newspapers touted the healing power of bitters, liquor strongly flavored with herbs. Some medicinal bitters were served as drinks in saloons. The highly advertised Drake’s Plantation Bitters, which blended herbs with St. Croix rum, was enormously popular at sutler tents.

“Snake Smuggling”?
Lieutenant Luther Tracy Townshend, the adjutant of the 16th Vermont, was also the president of the regimental temperance society. Once, in the absence of the regiment’s sutler, it fell to Townshend to order a shipment of necessities and luxuries for the troops. Some of the men persuaded Townshend to order several cases of Hostetter’s Bitters to help soldiers who were suffering from chills. The merchandise soon arrived in their camp in Louisiana. As Townshend reported, “Some of the men, who were more chilly than the others, took overdoses and in consequence became staggeringly drunk.” Only then did the mortified adjutant learn that Hostetter’s Bitters was almost pure whiskey.

An exception to the ban on sutler sales of alcohol to enlisted personnel existed in some German units of the Union Army. Brig. Gen. Louis Blenker, for one, ordered sutlers to sell beer to the soldiers of his brigade, who were predominantly German immigrants, to keep up their morale. His orders caused resentment among non-German units, although this was mollified by sutlers selling beer to soldiers outside the brigade.

Perhaps the most creative dodge was used by a soldier of the 11th Ohio, who killed a snake and, in the words of a marveling comrade, “carefully dissecting the varmint obtained a long, white cartilage, which he carefully cleaned and coiled up. Proceeding to the hospital, he politely requested a small quantity of spirits in which to preserve the curiosity (which he represented as a tape worm). The surgeon not only agreed, but complimented the man highly for the interest he manifested in natural science!”

Whiskey abuse was not confined to land-based armies. Both Union and Confederate navies faced abuses of their own. In the 18th century the British Royal Navy routinely issued a ration of spirits, usually rum, to enlisted personnel. Originally the ration was eight ounces of distilled spirits per day. Naval rum was diluted with water, resulting in the traditional drink called grog. The practice was associated with Admiral Edward Vernon, a famed officer of the mid-1700s whose service nickname was “Old Grog” because he wore a coat made of grogham cloth. (Laurence Washington, George Washington’s older brother, served with Vernon. When Laurence died, George inherited his plantation Mount Vernon, which had been named for the admiral.)

Alcohol Smuggling in the Continental Navy
The Continental Navy, as well as the early U.S. Navy, adopted the British ration of half a pint of grog per day. Before the War of 1812, imported rum from Britain’s Caribbean colonies was dropped in favor of American-made whiskey. Despite the switch, sailors and the general public continued calling the naval ration grog. On land, lower class saloons were called grog-shops or groggeries. Aboard ship, the crew’s barrels of whiskey and the officers’ private stores of liquors and wines were kept locked up in the “spirit room.” At the captain’s discretion, extra rations of spirits were doled out before and after action, or even during a battle. During the long fight with CSS Virginia, the crew of USS Monitor was braced by a special issue of two ounces of whiskey per crewman.

With a plethora of colorful nicknames, alcohol was widely abused in both Union and Confederate armies during the Civil War.

Captains also issued extra liquor as a reward for hard work such as the tedious and backbreaking job of loading coal aboard steam warships. Confederate sailors outfitting Sea King, which was secretly being converted at sea into CSS Shenandoah, received a serving of grog every two hours. Mariners saw the spirit ration as well-deserved compensation for their long months of hard work and isolation at sea. With some reason, temperance advocates saw it instead as a severe problem and focused considerable effort on luring sailors away from the bottle. In 1832 reformers persuaded Congress to cut the naval ration to one gill, or four ounces, daily. Sailors under the age of 21 and anyone who chose not to draw a spirit ration received instead a small cash commutation, which had risen to five cents a day by 1861.

After reducing the naval grog ration, Congress debated but did not act further on the temperance movement’s demands for tighter restrictions. A chance to end the grog ration arose again when Southern members of Congress left the nation’s capital after the beginning of the war. Northern representatives and senators were more sympathetic to the temperance cause, and with Southern seats now vacant, there were enough Northern votes to abolish the naval spirit rations. A July 14, 1862, act of Congress set August 31 of that same year as the last day for the grog ration. A correspondent aboard an unnamed vessel wrote to the Philadelphia Press that Congress had made a great mistake. He warned that ending the spirit ration would drive all the old seamen out of the service. Aboard the receiving ship North Carolina in New York City harbor, the men met the restriction with muttered growls, but no signs of incipient mutiny were readily apparent.

Kegs Auctioned Off & Turned In To Medical Staff
Spirit kegs remained under lock and key until naval vessels returned to port. About 3,000 kegs were auctioned off and others were turned over to the naval medical service for hospital use. Excess whiskey in the North Atlantic Blockading Squadron was stored aboard the aptly named ship Brandywine. As compensation for the loss of the spirit ration, the Navy added five cents per day to sailors’ pay, a raise of between 8 and 10 percent. Despite the banning of grog, there was still some alcohol aboard Union naval vessels. “Distilled spirituous liquors” were allowed on board ship as medical stores. And officers, trusted by Congress more than common sailors, were still allowed to have private stores of liquors and wines.

Grog was served in the Confederate Navy as well. Rebel tars were entitled to one gill of spirits or half a pint of wine per day. As in the Union Navy, a small cash commutation was paid to sailors not taking their spirit ration. Confederate Navy officials had considerable trouble obtaining enough spirituous liquor for rations and hospital use. Naval requirements clashed with state regulations that reserved corn and grain for food rather than distillation of spirits. Eventually a distillery was set up in Augusta, Georgia, to produce whiskey for naval use. Despite the trouble in obtaining liquor, the Confederate Navy never got around to banning its spirit ration, and it remained on the books until the war ended in 1865.

Illicit alcohol resulted in a number of embarrassing incidents at sea. Midshipman James Morris Morgan, in his memoir Recollections of a Rebel Reefer, wrote about an alcohol-fueled riot on the cruiser CSS Georgia in October 1863. Sailors slipped into a coal bunker and bored through a thin bulkhead separating the coal from the spirit room. Then they drilled a hole into the head of a barrel of liquor and inserted a lead pipe. The pilfered grog was distributed among the crew, said Morgan, “and soon there was a battle royal going on the berth deck which the master-at-arms was unable to stop.” Georgia’s first lieutenant went below and induced most of the men to give themselves up for punishment. One holdout defied the officers, but Morgan tackled him and the master-at-arms handcuffed him. Several crewmen were placed in irons and sentenced to a spell in the brig on bread and water.

Whiskey As Spoils of War
The British blockade-running schooner Sting Ray, under the command of a Captain McCloskey, was captured in the Gulf of Mexico by USS Kineo on May 22, 1864. An acting ensign with a prize crew of seven men took charge of the vessel and followed in Kineo’s wake. McCloskey produced a stash of whiskey and offered it to the prize crew. By the time Acting Ensign Paul Borner realized what had happened his men were so drunk that they were unable to get back on deck without assistance.

Borner locked the hatch to keep the men from getting any more whiskey, but McCloskey and his crew jumped Borner, took his pistol, and reclaimed the ship. Union sailor William Morgan fell overboard, and McCloskey tossed a spar into the sea as an improvised life preserver. Another man jumped into a ship’s boat, cut the painter, and escaped. The Confederates followed Kineo for a time before changing course and making a dash for shore. Seeing Sting Ray change course, Lt. Cmdr. John Watters of Kineo opened fire with a 20-pounder gun. McCloskey managed to beach the vessel after dodging several Union shells. Borner and five of his sailors were captured by the 13th Texas. Only two of Borner’s crew avoided capture and were picked up later by Kineo. Morgan, according to Watters, was “in a beastly state of intoxication, crazy drunk and howling.”

Doctors at the time incorrectly believed that alcohol was a stimulant, so they prescribed it to treat sick or wounded soldiers. Some drugs were soluble in alcohol, and patients received them in doses with whiskey or brandy. One treatment for diphtheria was a dose of brandy mixed with ammonia. Alcohol itself was seen as having curative powers for some illnesses. Laudanum, a mixture of alcohol and opium, was a widely prescribed painkiller. Ether was made by distilling alcohol and sulfuric acid, called “spirits of nitre.” A purer form of alcohol called alcohol fortius was used to make ether and to dissolve various compounds.

A Prized Commodity in Medical Treatment
Whiskey or brandy, either alone or mixed with other ingredients, were routinely used to treat patients suffering from wounds or illnesses. Usually whiskey was prescribed in frequent but small doses, perhaps one ounce or one tablespoon every few hours. Sometimes it was administered by itself, but it might also be mixed in eggnog or milk punch. One example concerned the case of Private Augustus C. Falls of the 1st New York Heavy Artillery. Falls was admitted to Douglas Hospital in Washington with diarrhea on August 5, 1864. A surgeon prescribed 11/2 ounces of whiskey each day at dinner. Three days later the dosage was raised to two ounces of whiskey three times a day. On September 29, the dosage was again increased to three ounces of whiskey every four hours. Despite the special treatment, Falls died on October 5.

With a plethora of colorful nicknames, alcohol was widely abused in both Union and Confederate armies during the Civil War.

One of the few effective drugs of the era, quinine, could prevent malaria or ease symptoms for patients who already had the disease. Soldiers often balked at taking their malaria medicine, though, because of its markedly bitter taste. To cajole soldiers into taking quinine, some surgeons mixed it with whiskey. This created the opposite problem; some soldiers enjoyed the quinine-whiskey dose so much that they sneaked through the line for a second prescription. While stationed at New Bern, North Carolina, the men of the 44th Massachusetts found that their medical officers took precautions to limit the soldiers to one dose each. Instead of serving quinine in whiskey, the drug came blended with medical alcohol, water, and cayenne pepper. “No soldier,” wrote a veteran of the regiment, “is known to have acquired a dangerous hankering for the mixture.”

Guilty on Charges of Drunkenness
Southern medical officers struggled to obtain sufficient quantities of medicinal alcohol. Surgeon General Samuel P. Moore established distilleries in Montgomery, Columbia, Salisbury, and Macon to produce medicinal alcohol. Volunteer committees gathered food, clothing, medicines, and creature comforts from civilians and shipped them to military hospitals. On November 22, 1861, the Charleston Mercury highlighted the first quarterly report of the city’s Ladies’ Christian Association. Among numerous shipments sent by the association to hospitals in Virginia were 34 boxes or crates of alcoholic beverages, including wine, brandy, blackberry brandy, claret, Madeira, port, whiskey, ale, bay rum, and additional alcohol in the form of medicines and bitters.

Drunkenness could be overlooked if it occurred when a soldier was off duty and did not compound his offense with other crimes. Court-martial of officers charged with drunkenness was handled differently from those of enlisted men. Officers found guilty could be cashiered with forfeiture of pay. In addition to dismissal, a Confederate law of 1862 allowed a public reprimand of officers convicted of drunkenness. An officer dismissed from the Confederate service could also be conscripted back into the ranks as an enlisted man. Enlisted personnel found guilty of drunkenness usually faced some form of confinement, corporal punishment, or public shaming. Penalties varied depending on the degree of the soldier’s offense and the policies of his commanding officer. Common punishments for drunken enlisted men included confinement in a guard tent or guardhouse, wearing a barrel with a placard noting that the culprit was a drunk, extra duty, or a spell carrying a log or marching with a knapsack filled with rocks.

Generals were not immune from abusing alcohol. Indeed, their vast responsibilities encouraged such abuse. Most notoriously, rumors of alcoholism dogged Union General Ulysses S. Grant. After Grant’s capture of Vicksburg, several gentlemen warned President Lincoln that Grant drank to excess. Lincoln was said to have asked what sort of whiskey Grant drank, because “if it makes him win victories like this Vicksburg, I will send a demijohn of the same kind to every general in the army.”

Generals Just As Guilty As Their Soldiers
A serious instance of generals drinking on duty contributed to the Union defeat at the Battle of the Crater on July 30, 1864. After successfully detonating a huge explosion in a tunnel dug under the Confederate lines outside Petersburg, Union forces moved in to exploit the break in the Rebel defenses. Brig. Gens. James H. Ledlie and Edward Ferrero remained behind the lines drinking liquor in a bombproof while their neglected divisions floundered without guidance from their commanders. The attack, which had the potential of taking Petersburg and shortening the war, bogged down, and the Union regiments were devastated by Confederate counterattacks. After investigations into their drinking and dereliction of duty, Ledlie was allowed to resign from the army, but Ferrero escaped serious penalty. He even managed to be brevetted to major general before the end of the war.

Offenses were not limited to line officers. Confederate hospital matron Phoebe Yates Pember wrote of one case in which a drunken surgeon treated a patient whose ankle had been crushed by a train. After the injuries were set and bandaged, the soldier remained in excruciating pain and his condition worsened. Checking the patient, Pember found that the bandaged leg was perfectly healthy, while the other leg was “swollen, inflamed, and purple.” The attending surgeon had been so drunk that he set the wrong leg. Fever set in and the patient died at the hospital.

Plagued with food shortages, inflation, and transportation problems, Southern soldiers and civilians dealt with severe shortages of alcohol caused by state legislatures restricting the use of grain, corn and foodstuffs for distilled liquor. Private distilling took a blow after the Federal capture of Chattanooga in September 1863 and advancing Union forces captured copper mines desperately needed by the South. Not only did their loss crimp production of brass artillery pieces, it also threatened the manufacture of percussion caps and artillery friction primers. The Confederate Ordnance Bureau confiscated scores of copper whiskey stills in western North Carolina. Metal from the stills went into many of the South’s percussion caps made during the remainder of the war.

Persimmon Brandy & Other Homemade Recipes
Southern blockade runners brought wine, whiskey, brandy and other potables from Europe. Less popular than wine and brandy, but still showing up in blockade runner holds, were rum, gin, Scotch whisky, champagne, ale, porter, and schnapps. Occasionally one might even find imported cut glass decanters to serve the imported liquors. Pure alcohol, intended as medical supplies, also passed through the blockade. Blockade-run liquor was beyond the financial means of most Confederates, forcing many people to turn to home-made substitutes. Despite wartime laws, some corn and grain found their way into whiskey. When these standard ingredients were not available, distillers turned to sweet potatoes, rice, sorghum seeds, and persimmons.

On October 21, 1863, the Charleston Courier published a recipe for persimmon brandy. Mashed by a pestle or simply with one’s hands, persimmons were mixed with warm water and left to ferment for five or six days. Then the mash was ready for distillation. In thrifty fashion, the writer suggested saving the persimmon seeds. They could be used for buttons, or parched and mixed with dried sweet potatoes to make a coffee substitute. Beer and wine were simpler to make at home than whiskey, as they needed no distilling apparatus. Newspapers published numerous recipes for persimmon beer. Wine and brandy were made from any kind of available fruit, including peaches, pears, cherries, blackberries, plums, and even watermelons.

With a plethora of colorful nicknames, alcohol was widely abused in both Union and Confederate armies during the Civil War.

F.P. Porcher’s 1863 work Resources of Southern Fields and Forests listed uses for hundreds of plants that grew in the Confederacy. He gave recipes for making beer from corn, persimmons, and boiled sassafras shoots. Blackberries could also be used to make wine, and with the addition of spices and whiskey, a healthy cordial could be concocted. Porcher also mentioned dozens of medicines that could be prepared from native herbs added to whiskey, wine, or brandy. Another way of coping with the lack of alcohol was to make a joke of it. By early 1864, “starvation parties” were becoming a fad in Richmond. Attendees wore the best finery they could manage. Unlike antebellum parties, there were no imported wines or liquors. The fine punchbowls and glassware remaining from the days before the war held only water from the James River.

Robert E. Lee once remarked that it was not possible to have an army without music. He might just as well have said that it was not possible to have an army without whiskey. Whether serving as an innocent aid to relaxation, medication to treat wounds or disease, or a lure to the evils of vice and desertion, whiskey and other types of alcoholic beverages were firmly rooted in the armies of the 1860s. The many creative ways alcohol found its way to soldiers and sailors, and the methods used to control its influence, are intertwined with the story of battles, generals, regiments, and ships of war.

Offenses were not limited to line officers. Confederate hospital matron Phoebe Yates Pember wrote of one case in which a drunken surgeon treated a patient whose ankle had been crushed by a train. After the injuries were set and bandaged, the soldier remained in excruciating pain and his condition worsened. Checking the patient, Pember found that the bandaged leg was perfectly healthy, while the other leg was “swollen, inflamed, and purple.” The attending surgeon had been so drunk that he set the wrong leg. Fever set in and the patient died at the hospital.

For Some, Private Distilling Filled the Gap
Plagued with food shortages, inflation, and transportation problems, Southern soldiers and civilians dealt with severe shortages of alcohol caused by state legislatures restricting the use of grain, corn and foodstuffs for distilled liquor. Private distilling took a blow after the Federal capture of Chattanooga in September 1863 and advancing Union forces captured copper mines desperately needed by the South. Not only did their loss crimp production of brass artillery pieces, it also threatened the manufacture of percussion caps and artillery friction primers. The Confederate Ordnance Bureau confiscated scores of copper whiskey stills in western North Carolina. Metal from the stills went into many of the South’s percussion caps made during the remainder of the war.

Southern blockade runners brought wine, whiskey, brandy and other potables from Europe. Less popular than wine and brandy, but still showing up in blockade runner holds, were rum, gin, Scotch whisky, champagne, ale, porter, and schnapps. Occasionally one might even find imported cut glass decanters to serve the imported liquors. Pure alcohol, intended as medical supplies, also passed through the blockade. Blockade-run liquor was beyond the financial means of most Confederates, forcing many people to turn to home-made substitutes. Despite wartime laws, some corn and grain found their way into whiskey. When these standard ingredients were not available, distillers turned to sweet potatoes, rice, sorghum seeds, and persimmons.

From: warfarehistorynetwork.com

Columbus and Coca-Cola (excerpted)

From: americancivilwarstory.com

John Stith Pemberton was injured during the Battle of Columbus. He received a saber slash across his chest during the struggle for the 14th Street bridge. Like many other wounded veterans, he became addicted to the morphine that was used for a pain-killer.

Pemberton was a pharmacist and decided to work on a medicine that would help relieve his addiction. Eventually he came up with a formula which was basically a wine infused with coca (cocaine), kola nut (caffeine), and damiana (purported aphrodisiac). This was essentially an imitation of a very successful French medicinal wine called Vin Mariani, but Vin Mariani used only coca not Pemberton's other two ingredients. He called his new medicine, "Pemberton's French Wine Coca," and began selling in several drugstores in Atlanta, Georgia.

In 1886 he ran into a problem. Temperance legislation was enacted in Atlanta and Fulton County. This forced him to try to come up with a new, non-alcoholic formula for his drink.

With the help of a druggist named Willis Venable, he came up with a recipe to blend his base syrup with carbonated water. This way it could be sold as a fountain drink. A man named Frank Mason Robinson came up with a catchy new name for the drink, and on May 8, 1886, the first Coca-Cola was sold at Jacob's Pharmacy in Atlanta, Georgia.

So, if the Battle of Columbus hadn't happened, John Pemberton would not have been injured. If he had not been injured, he would not have gotten addicted to morphine. Without an addiction he would not have searched for a cure, and if he had not been searching for a cure, we would never have gotten Coke!

Tuesday, March 28, 2017

Minds at War

By Jeffrey Allen Smith and B. Christopher Frueh, 3-20-13

Any attempt to calculate the carnage of the Civil War, the number of sick, wounded, dismembered and dead, leaves one numb in the struggle to make sense of it all. The conditions and horrors faced by those who fought the war exacted a horrific toll.

One would assume that the physical price paid by the men who fought in the war would have a rough equivalent in the mental price, that the experience of that terrible war would have left countless survivors with horrible psychological scars. But that may not actually be the case: according to official Union war records, adverse psychological reactions to combat across a variety of categories never matched, or even approached, the shocking physical losses from the war.

Serving as the official medical record of the Union Army, “The Medical and Surgical History of the War of Rebellion, 1861-65” was a groundbreaking effort to systematically record the medical impact of one of the first “modern” wars while it was happening. Undertaken by the Army Medical Department, and using exclusively military and governmental records, the six-volume publication contained thousands of pages of medical case studies, pictures, graphs and statistics. With more than 100 separate tables charting some 150 “diseases,” ranging from serpent bite to gunshot wounds and dysentery to suicide, the study provided one of the first medical tallies of the impact of warfare on its combatants.

Looking over the exhaustive array of medical data found in “The Medical and Surgical History,” a subtle trend lies beneath the jaw-dropping numbers of physical wounds and maladies suffered by those who fought the war. Across a variety of potential psychological categories, the number of cases and deaths for both white and black troops was often well below 1 percent, surprisingly low even after adjusting for the possibility of underreporting.

In a paper we published in a peer-reviewed psychiatric/psychological journal, the highest annual rate of cases reported for any year of the Civil War for Union troops was .017 percent for insanity, .032 percent for “nostalgia” (or depression), .005 percent for concussion of the brain, .045 percent for delirium tremens, .034 percent for inebriation and .06 percent for chronic alcoholism. The data also revealed there were a total of 278 documented suicides over the four years of the war, fewer than the 349 military personnel who died by suicide in 2012 alone.

The excessive use of alcohol has historically been a common coping mechanism for troops under the stressors of combat. Yet the annual rate of reported inebriation and chronic alcoholism remained below 1 percent throughout the duration of the war, save for two interesting spikes. First, Union troops in the “Pacific Region” had in excess of a tenfold increase in rates of inebriation relative to their Atlantic and Central counterparts – probably more a function of boredom than combat stress. Second, all regions and racial groups reported a discernible spike in reported inebriation in the year following Appomattox, a perhaps understandable surge given the ending of the war.

Likewise, chronic alcoholism and delirium tremens mirrored these patterns, but with significantly fewer reported cases. While these numbers reflect what was socially considered drunkenness by 1860s standards, they also highlight that most troops were not outside that intangible norm, and when low levels of delirium tremens are taken into account, it further underscores how relatively few men had to “sober up” for duty.

Union Surgeon General Joseph K. Barnes acknowledged in the “The Medical and Surgical History” that “obviously troops stationed in the neighborhood of large cities furnished the greater number” of alcoholism cases, and he credited “the government and discipline of the camps” for keeping rates from getting out of hand. Of course, the adverse effects of combat have the power to do more than simply drive a person to drink.

For some Union troops, military service became a mental burden too great to bear. The psychological stressors of combat began to physically manifest themselves in reported cases of nostalgia and insanity. Psychologically naïve by modern standards, Civil War combatants and medical personnel struggled to identify and understand psychiatric disorders and behavior health problems that resulted from combat. For example, the term nostalgia, described as “a temporary feeling of depression… on account of discomfort, hardships and exposures” in the “The Medical and Surgical History,” was treated as “a camp disease of war” that proved “dangerous to their efficiency.” Some current examinations of the “disease” ascribe to it symptoms comparable to post-traumatic stress disorder.

Nevertheless, regardless of terminology, official cases in the Union Army of nostalgia and insanity were quite rare and they peaked during the first two years of the Civil War, and then dropped markedly over the duration of the conflict in many regions, with some exhibiting declines by half or more. The trend of early, elevated levels of diagnosed cases of nostalgia and insanity that diminished as the war went on was also evident in segregated colored units, even with official military incorporation not until 1863.

To be sure, accusations of malingering and an evolving understanding of these psychological reactions to combat probably resulted in a degree of underreporting. As with nostalgia and insanity, Civil War health professionals’ understanding of suicide was limited by the paucity of research on the topic.

With the French sociologist Émile Durkheim’s groundbreaking book “Suicide” still 30 years in the future, most Civil War doctors and nurses had few tools with which to interpret Union Army suicides. During the war annual suicide rates for white Union troops fluctuated between 8.74 and 14.54 per 100,000, while surging to 30.4 for 1865-1866. Serving in segregated units, African-American troops’ suicide rate ranged from 17.7 per 100,000 in 1863, to 0 in 1864 and 1.8 for 1865-1866. These figures appear consistent with some of Durkheim’s conclusions about suicide, including that whites had higher rates of suicide than blacks during the 19th century.

Looking deeper into these numbers in his 2011 paper “Felo De Se,” R. Gregory Lande noted seasonal variations in Union suicides, with rates spiking reliably every spring. However, as with any of these psychological variants tracked in the “The Medical and Surgical History,” a certain amount of caution must be taken, as the data is 150 years old, and the study’s strict reliance on government medical records undoubtedly led to some undercounting.

These statistical limitations were not lost on the compilers of the “The Medical and Surgical History,” for as was noted in its introduction, the publication “cannot be regarded as complete,” but while “most imperfect,” the data “embrace so large a proportion of the troops concerned that they cannot fail to serve fairly as a reliable basis for deductions with regard to the health of the whole army.”

The men who fought in the Civil War participated in a brutal modern war, as soldiers’ letters, photographs and newspaper articles bear testament. Yet often obscured by the ghastly casualty figures and recounts of battles won and lost were the personal struggles that the troops fought on a daily basis – an internal conflict constantly waged against the self-evident, understandable mental and physiological pressures of military service and combat.

Nevertheless, what should be made of the relatively low-recorded instances of psychological casualties in the Civil War? Was it a result of flawed data collection or analysis? Did Victorian or religious social pressures result in under reporting or unwillingness to recognize these invisible wounds?

While considering diagnoses of modern psychiatric conditions extrapolated from records kept 150 years ago during the Civil War is problematic at several levels, perhaps the larger take away message is a heartening one of human resiliency. The data seem to demonstrate that exposure to combat alone does not weaken the human psychological condition. Instead, as with most things in life, there are a multiplicity of factors that result in psychosocial casualties. One of the real tragedies of the conflict was not the sheer number of men who fought to win the Civil War, but the few who lost the war within. On the other hand, these data remind us there is good reason to be optimistic that the psychological consequences of war are not inevitably devastating to all those who serve.

Jeffrey Allen Smith is an assistant professor of history at the University of Hawaii, Hilo.

B. Christopher Frueh, a clinical psychologist and a professor of psychology at the University of Hawaii, Hilo, is a McNair scholar and directs the research programs at the Menninger Clinic in Houston.

From: opinionator.blogs.nytimes.com

Wednesday, June 29, 2016

History & Economics of Tobacco

From: healthliteracy.worlded.org

Tobacco has a long history in the Americas. The Mayan Indians of Mexico carved drawings in stone showing tobacco use. These drawings date back to somewhere between 600 to 900 A.D. Tobacco was grown by American Indians before the Europeans came from England, Spain, France, and Italy to North America. Native Americans smoked tobacco through a pipe for special religious and medical purposes. They did not smoke every day.

Tobacco was the first crop grown for money in North America. In 1612 the settlers of the first American colony in Jamestown, Virginia grew tobacco as a cash crop. It was their main source of money. Other cash crops were corn, cotton, wheat, sugar, and soya beans. Tobacco helped pay for the American Revolution against England. Also, the first President of the U.S. grew tobacco.

By the 1800's, many people had begun using small amounts of tobacco. Some chewed it. Others smoked it occasionally in a pipe, or they hand-rolled a cigarette or cigar. On the average, people smoked about 40 cigarettes a year. The first commercial cigarettes were made in 1865 by Washington Duke on his 300-acre farm in Raleigh, North Carolina. His hand-rolled cigarettes were sold to soldiers at the end of the Civil War.

It was not until James Bonsack invented the cigarette-making machine in 1881 that cigarette smoking became widespread. Bonsack's cigarette machine could make 120,000 cigarettes a day. He went into business with Washington Duke's son, James "Buck" Duke. They built a factory and made 10 million cigarettes their first year and about one billion cigarettes five years later. The first brand of cigarettes were packaged in a box with baseball cards and were called Duke of Durham. Buck Duke and his father started the first tobacco company in the U.S. They named it the American Tobacco Company.

The American Tobacco Company was the largest and most powerful tobacco company until the early 1900's. Several companies were making cigarettes by the early 1900's. In 1902 Philip Morris company came out with its Marlboro brand.

They were selling their cigarettes mainly to men. Everything changed during World War I (1914-18) and World War II (1939-45). Soldiers overseas were given free cigarettes every day. At home production increased and cigarettes were being marketed to women too. More than any other war, World War II brought more independence for women. Many of them went to work and started smoking for the first time while their husbands were away.

By 1944 cigarette production was up to 300 billion a year. Service men received about 75% of all cigarettes produced. The wars were good for the tobacco industry. Since WW II, there have been six giant cigarette companies in the U.S. They are Philip Morris, R.J. Reynolds, American Brands, Lorillard, Brown & Williamson, and Liggett & Myers (now called the Brooke Group). They make millions of dollars selling cigarettes in the U.S. and all over the world.

In 1964 the Surgeon General of the U.S. (the chief doctor for the country) wrote a report about the dangers of cigarette smoking. He said that the nicotine and tar in cigarettes cause lung cancer. In 1965 the Congress of the U.S. passed the Cigarette Labelling and Advertising Act. It said that every cigarette pack must have a warning label on its side stating "Cigarettes may be hazardous to your health."

By the 1980's, the tobacco companies had come out with new brands of cigarettes with lower amounts of tar and nicotine and improved filters to keep their customers buying and to help reduce their fears. The early 1980's were called the "tar wars" because tobacco companies competed aggressively to make over 100 low tar and "ultra" low tar cigarettes. Each company made and sold many different brands of cigarettes.

In 1984 Congress passed another law called the Comprehensive Smoking Education Act. It said that the cigarette companies every three months had to change the warning labels on cigarette packs. It created four different labels for the companies to rotate.

Since the 1980's, federal, state, local governments, and private companies have begun taking actions to restrict cigarette smoking in public places. The warning labels were the first step. Tobacco companies cannot advertise cigarettes on television or radio. It is against a law that was passed by Congress in 1971. Many cities across the U.S. do not allow smoking in public buildings and restaurants. Since 1990, airlines have not allowed smoking on airplane flights in the U.S. that are six hours or less. State taxes on cigarettes have increased.

As it becomes more difficult for tobacco companies to sell their products in the U.S., they are looking outside. U.S. tobacco companies are now growing tobacco in Africa, South America (Brazil and Paraguay), India, Pakistan, the Phillipines, Greece, Thailand, and the Dominican Republic. Fifty percent (50%) of the sales of U.S. tobacco companies go to Asian countries, such as Thailand, South Korea, Malaysia, the Phillipines, and Taiwan.

Soldier's Disease

From: drvitelli.typepad.com, 2-6-11

The American Civil War (a.k.a. The War Between the States) was long and terrible. Beginning in 1861, the four-year war is still the deadliest in American history with an estimated 620,000 soldiers killed and an indeterminate number of civilian casualties. Approximately ten percent of all Northern males and 30 per cent of all Southern males were killed in the fighting and the social and political costs left their mark on the United States for generations afterward. 

As one of the first "modern" wars with heavy artillery and other weapons of mass destruction, physicians on both sides of the conflict were faced with unprecedented medical challenges in dealing with wounded soldiers.  Military surgery was still in its infancy and antiseptic practices were largely unknown so casualties remained high despite the best efforts of doctors and nurses.

To deal with patient suffering, doctors relied on two medical innovations that had only become available a few years previously:  the hypodermic needle and morphine sulphate. First developed in 1804, the opium derivative received its name from the Greek god of dreams, Morpheus, and widely advertised to physicians as a safe and effective analgesic.  Given that surgery was often traumatic due to the lack of proper anesthesia, the use of morphine (spurred on by the development of the hypodermic needle in 1857) began to spread. Opium pills were also widely dispensed when hypodermic needles were unavailable. During the Civil War, solders were often dosed with enormous amounts of morphine or opium to kill the pain of amputations and other surgeries. 

While the potential for addiction was already known at the time, simple humanitarian concerns ensured that soldiers remained liberally dosed with morphine and whatever other analgesics were available.

Anecdotal accounts of Civil War doctors on both sides dispensing opium seem descriptive enough. One Confederate doctor, William H. Taylor, gave a plug of opium to every patient reporting pain depending of whether or not they were constipated.  A Union doctor, Nathan Mayer, diagnosed patients from horseback.  If the wounded soldier needed morphine, Mayer would pour out an "exact into his hand and had the patient lick it off  (not a recommended method, by the way). 

Since medical epidemiology was still unknown, actual statistics relating to morphine addiction remain scarce.  Some sources have suggested that as many as 400,000 veterans were left addicted to morphine due to their wartime experiences.  These addicts were readily identified by the characteristic leather thong around their necks to which a small bag was attached.  The bag carried a supply of morphine sulphate tablets as well as  a hypodermic needle.  Upon their discharge from the army, this was all that was given to the returning soldiers to ease their return to society (no Veterans' Administration services in those days).  In recognition of the medical issues that these veterans faced, the term "Soldier's disease" was coined  (as opposed to "Soldier's Heart" which was an early name for Posttraumatic Stress Disorder). 

But how prevalent a problem was Soldier's Disease?  As some historians have noted, there were few descriptions of widespread morphine addiction during the 19th century.  The existence of thousands of morphine addicts in the United States following the end of the Civil War would have likely made far more of an impact than later medical authorities noted.  Veterans certainly had good reason to conceal their addiction since public exposure might have cost them their service pension (drug addiction was not a recognized medical condition).  The greatest social impact of the war and the addicts who survived it was likely from 1865 to 1900 when most addicts had died off. 

While the explosive growth of opium addiction from 1865 to 1895 was certainly noted,  the few drug addiction surveys undertaken during this period showed that women were more likely to be addicts than men.  Many of these women addicts had become addicted to the opiates that had been legally prescribed for them by their physicians (often as treatment for "female problems").  

Although 19th century newspaper editorials expressed alarm over substance use, it almost always focused on opium and the insidious "opium dens" which were seen as a threat to American society (there were often racist overtones to these editorials given that they focused on how "white women" could be ensnared into smoking with "Chinese men").

Despite concerns relating to morphine addiction (and the thousands of addicts who had supposedly been released into society after the war), physicians continued to prescribe morphine for their patients.  As a catch-all medical solution for a wide variety of problems (which could range from headaches to diarrhea),  hypodermic-wielding physicians likely created more addicts than the typical opium den.   In an 1880 medical text titled The Hypodermic Injection of Morphia, the author stated that "here is no proceeding in medicine that has become so rapidly popular; no method of allaying pain so prompt in its action and permanent in its effect; no plan of medication that has been so carelessly used and thoroughly abused; and no therapeutic discovery that has been so great a blessing and so great a curse to mankind than the hypodermic injection of morphia".   


Not only did the demand for morphine create a steady market for the drug, it also created a strong demand for hypodermic needles as well.  The 1897 Sears and Roebuck catalogue advertised a hypodermic kit (including a syringe, two needles, two vials, and a carrying case) for a mere $1.50 (quite a bargain, really).   Patent medications, largely unregulated at the time, were advertised for the treatment of a wide variety of complaints and, naturally, morphine and opium were popular ingredients.  The self-medication that these patent medications made possible certainly aggravated the problem of substance abuse but the lack of formal government controls helped drive sales.

It seems inevitable that alternatives to morphine would become available as medical researchers learned more about the chemical composition of opium.  Codeine was first isolated in 1832 by French chemist, Pierre Robiquet, although it proved not to be as popular as morphine.  The real breakthrough came in the 1870s when  English chemist C.R.A. Wright first isolated the opiate compound that would later be marketed under the brand name of heroin.  When Bayer Pharmaceuticals released their product some time later (the name heroin was taken from the German word for heroic, heroisch), it was billed as a perfectly safe alternative to morphine. 

And heroin was hardly the only new product available.  With the development of chloroform, nitrous oxide, and various other anesthetics, pain-free surgery and dentistry became all the rage. At the same time, however, there was a growing fear of the social dangers surrounding opiates (including morphine and heroin).  Following the Spanish-American War and the American annexation of the Philippines in 1898,  public alarm over opium addiction became even more widespread.   As a result of U.S. pressure,  the first International Opium Commission was held in Shanghai in 1909.  A second meeting was held in 1911 and the first comprehensive policy regulating opiate use was signed.

In the United States, anti-drug lobbyists began agitating from more stringent safeguards.  Hamilton Wright was appointed as America's first Opium Commissioner in 1908 and, after attending the Shanghai meeting, would comment that "Of all the nations of the world, the United States consumes most habit-forming drugs per capita. Opium, the most pernicious drug known to humanity, is surrounded, in this country, with far fewer safeguards than any other nation in Europe fences it with".    Once again, drug abuse was linked to racial unrest as Wright went on to comment that "cocaine is often the direct incentive to the crime of rape by the Negroes of the South and other sections of the country" (while cocaine is not an opiate, the drug reformers insisted on classifying it as a narcotic as part of their platform). 

Newspaper editors and academics alike weighed in on the dangers of drug addiction and the horrendous social costs involved.   Racism was readily apparent and the editorials were filled with accounts of "drug-crazed, sex mad negroes" and "Chinamen" seducing white women on drugs. Various drug "experts" testified on the proliferation of drug-addicted "Negroes" stalking and attacking white women while under the influence.     

By 1914, forty-six states had passed legislation regulating or banning opium, morphine, or heroin. The fact that World War One had just broken out in Europe became a factor as well since experts began raising concerns about the cases of Soldier's  Disease that had arisen from the Civil War and the possibility of American involvement in the new year leading to more cases.  

In 1915, Jeannette Marks published a highly influential article in the American Journal of Public Health describing the "hydra-headed drug curse" following the Civil War and expressed alarm that the problem would shortly resurface.  She was also the first to suggest that there had been as many as 400,00 morphine addicts following the war although she was given to exaggeration (she had also estimated there being 4,000,000 drug addicts in the U.S. in 1915).    

While other experts disputed her estimate, the consensus that drug regulation was needed seemed clear enough.  After quiet deliberation, the Harrison Narcotics Tax Act was signed into law on December 17, 1914. Technically focusing on taxing narcotics (again, cocaine was included), the act also imposed still penalties for the sale and importation of all narcotics.  Although morphine and other opiates could still be prescribed by a physician, the anti-drug era had begun in force.  

As for Soldier' Disease, its popularity as a diagnosis began to level off during the 20th century when substance abuse in the military became better understood.  Despite the role of the diagnosis in helping to shape U.S. drug policy and the numerous wars that have been fought in the past century, the use of a distinct diagnosis for returning soldiers addicted to pain medication has been largely discarded in the clinical literature.   While drug experts continue to disagree on the actual number of Civil War morphine addicts (the estimates range from 45,000 to 400,000).  Still, the controversy remains over how any valid estimate could ever be made given the lack of reliable data from that era. 

What isn't in dispute however, is that substance abuse among military personnel continues to be a political minefield regardless of the actual medical needs of soldiers dealing with chronic pain or posttraumatic stress.  Despite research initiatives by the National Institute on Drug Abuse and the Department of Veteran's Affairs,  the substance abuse problems that returning soldiers face are still waiting to be solved.

Wednesday, June 15, 2016

Suicide, Alcoholism, and Psychiatric Illness Among Union Forces During the U.S. Civil War

By B. Christopher Frueha, Jeffrey A. Smith

Abstract
Little is known about post-combat psychological reactions of warriors prior to the Twentieth Century. We estimated rates of suicide, alcohol abuse, and probable psychiatric illness among Union Forces during the U.S. Civil War via examination of data compiled by the Union Army. White active-duty military personnel suicide rates ranged from 8.74 to 14.54 per 100,000 during the war, and surged to 30.4 the year after the war. For blacks, rates ranged from 17.7 in the first year of their entry into the war (1863), to 0 in their second year, and 1.8 in the year after the war. Rates for most other relevant domains, including chronic alcoholism, “nostalgia,” and insanity, were extremely low (<1.0%) by modern day standards. Data provide contextual information on suicide and psychiatric variables for combatants during the U.S. Civil War, a brutal modern war with vastly higher casualty rates than recent wars in Iraq and Afghanistan.

Highlights

► Suicide rates among active duty military personnel have doubled. ► We do not have estimated rates of military suicides prior to modern psychiatry. ► Medical records compiled during the U.S. Civil War provide suicide data. ► Military suicide rates are far higher now than during the U.S. Civil War. ► Historical data suggest that suicide is not an inevitable consequence of combat.

From: sciencedirect.com

Monday, April 11, 2016

Snuff 'n Sniff

From: teaching history.org

Question:
I recently read that nasal snuff was initially popular because it allowed one to drown out unpleasant smells of people not bathing and of piled up sewage. Is it true that a few hundred years ago cities stank all the time?

Answer :
The claim about snuff is doubtful, or at least exaggerated, but yes, cities did often stink. A modern urban dweller, traveling back in time, but remaining in the same place, might well be bowled over by the olfactory experience.

What Snuff Was Used For
In 1494, a friar who accompanied Columbus on his 2nd voyage noted that the Indians they encountered used tobacco in two ways. The first was by smoking it through a cane pipe, the end of which they placed into their mouths. The second was by inhaling powdered tobacco through the pipe directly into their noses—“which purges them very much,” according to the friar. The European explorers took up both practices, of smoking and snuffing, and spread them simultaneously worldwide.

An anonymous poem published in London in Read’s Weekly Journal in 1761, entitled, “Six Reasons for Taking a Pinch of Snuff,” begins with the verse: “When strong perfumes, and noisome scents,/ The suf’fring nose invade,/ Snuff, best of Indian weeds, presents/ Its salutary aid.”

Popular medical theory of the day attributed many diseases to ill winds or “miasmas” of various kinds, so good odors in the nose, introduced by way of perfumed handkerchiefs, powdered wigs, incensed smoke, or scented snuff, were thought to be able to block or counter illnesses.

Despite this, the popularity of snuff was not due solely, or even primarily, to its usefulness in drowning out unpleasant smells. Users of the 17th and 18th century waxed particularly poetic about snuff’s own palette of scents, its ability to promote fellowship and sociability among friends and strangers, and the physiological effects consequent upon imbibing nicotine, but without the smoke.

The Delicate Subject of Body Odor
Personal cleanliness has long been seen as a social virtue, as a way to be polite to others. Consequently, failure in this has been regarded as an offense against others. Steps toward cleanliness were also seen as steps toward gentility, as progressive steps advancing in social class, as distinguishing oneself from the lower classes. Until fairly recently, in urban America, washing one’s body, like washing one’s clothes, has been more fastidiously attended to the higher up the scale of social class in which one has found oneself. Keeping oneself and one's living space clean is easier, too, if one can hire servants to do the chores, and if one does not engage in heavy physical labor in order to make a living, and if one can afford a place to live that has indoor plumbing.

The considerable animus against immigrants that was especially strong in the 19th century led to a presumption that odorlessness would be one desired outcome of immigrants' assimilation into American society. The elimination of body odor was part of that, it also referred to exotic perfumes, as well as the smells of ethnic cuisine, especially its characteristic spices and aromatic vegetables, in various city neighborhoods.

The raft of related social reform movements that began in the U.S. at the beginning of the 19th century included hygiene, considering cleanliness as a kind of moral virtue, embodying the cleanliness of the soul, and purifying the body politic. The emission of body odors signaled a moral lapse, an assault on others’ privacy and personal space. The antidote was cold water, applied liberally to the system, inside and outside. In the 20th century, widespread military service introduced people to an enforced regimen of soap and water that they continued when they returned to civilian life.

Changing over time as well has been the conventional judgment of whether the larger society has the right or obligation to demand personal cleanliness, to purify those who offend against the nose, and even to exclude them from public places. Advertising for personal hygiene products demonstrates that the public was progressively sensitized, from about 1920 to 1960, to more stringent social stigmas attached to emitting body odors of various kinds, most especially underarm odor and bad breath. The basic message was that if you had such odors, you had no hope of landing a desirable mate.

Smells of the City
City smells used to be a lot more pungent than they are today. Humans shared their space with populations of horses, pigs, cows, and chickens. Visitors to Cincinnati in the early 1800s, for example, often wrote about the omnipresence of semi-feral pigs that wandered through the streets, adding to the odor of the enormous pork processing industry of the city.

It was not until the early 19th century that many people had the notion that public cleanliness—as a measure against garbage in the street, offal, noxious effluvia from industrial processes going on right in the midst of the city, and polluting smoke—was something that civil authorities should attempt to police. This resulted in street paving, public water supplies to individual dwellings, municipal garbage collection, waste treatment plants, and industrial zoning regulations.

Nevertheless, civil authorities did not consider odor to be the prime offender to public peace. Metropolitan municipalities in the 19th century were spurred to clean up their cities in order to combat the spread of disease, especially at first in port cities such as New York, Philadelphia, San Francisco, and New Orleans. These cities were periodically afflicted by cholera, yellow fever, smallpox, and typhoid. The abatement of odors was a byproduct, rather than a goal, of these efforts.

Sunday, March 13, 2016

Civil War Cigarettes

From: examiner.com, 1-8-15

In the Mexican War (1846-1848), cigars were a popular smoke. Others chewed tobacco, used snuff or smoked it in pipes. By 1850, Phillip Morris was offering hand-rolled cigarettes from Turkey in his shop in London. Cigarettes did not become popular in the country until right around 1860. The first cigarettes made in America did not occur until 1865. But imported cigarettes were abundant throughout the war.

Early on the cigarette was considered unmanly to smoke. A New York newspaper in 1854 said the following about the cigarette: “Some of the ladies of this refined and fashion-forming metropolis are aping the silly ways of some pseudo-accomplished foreigners in smoking tobacco through a weaker and more feminine article, which was more delicately denominated cigarette”.

Around 1860, W. T. Blackwell Company sold Bull Durham tobacco in pouches complete with the papers needed for rolling your own. Later the Bull Durham brand became one of the most famous in the world. Within a few years, the federal government instituted a tax on tobacco to help pay for the war. That tax brought in approximately $3 million.

When the Union marched into the South, they grabbed often tobacco when they came across it and hand rolled it into cigarettes.

The Union Navy received cigarette rations. By 1864, Confederate rations included cigarettes though officers of the Confederacy did not get cigarette rations. The Confederate officer’s smoke of choice was the cigar. Later the Union rations also included cigarettes.

Common occurrences during the war were the swapping of Southern tobacco for Northern coffee.

Directly following the war, factories in New York (F. S. Kinney and Sons), in Durham (Washington Duke and Sons) and in Richmond (Allen and Ginter) employed immigrant women who had learned the craft back home. The best women at the trade could roll four to five cigarettes in a minute. It was Washington Duke’s factory that produced the first commercial cigarette.

In the 1880s, Duke’s cigarettes contained booklets showing the history of various Civil War generals including General Logan, General Sherman, General Hooker and General Butler.

Wednesday, February 24, 2016

"Opium-the Poor Child's Nurse"

By Rob Kennedy

This Harper's Weekly cartoon dramatizes the widespread use of opium in the 19th century, emphasizing its application as teething medicine or a soporific to the children of the poor.
Opium use dates back to antiquity, and existed in many cultures, although it was particularly associated with China and India. It was considered to be a medical cure-all until other painkillers and therapeutics began to be developed in the 19th century. In England and the United States in the mid-19th century, physicians prescribed opium readily, yet it could be purchased without a prescription. It was often an ingredient in pills, tablets, cough drops, lozenges, plasters, and other medicinal forms. Opium was used extensively in medicines for gynecological maladies, resulting in a high rate of addiction among women (three times higher than in men).

There was an awareness of the problem of addiction to opium, but druggists were usually ignorant about safe dosages. The invention of the hypodermic needle in the mid-19th century was considered a partial solution because it was erroneously supposed that intravenous use would not cause addiction. Opiates were administered by hypodermic needles to wounded or ill soldiers. The result in the United States was the addiction of thousands of servicemen during the Civil War.

Harper's Weekly reported on the prevalent use of opium in the late 1850's. The journal's inaugural issue of January 3, 1857, carried the essay, "A Recent Confession of an Opium-Eater," and in 1858 and 1859, the newspaper ran advertisements for Thomas de Quincey's Confessions of an English Opium-Eater . News stories and illustrations took readers into opium dens, as well as reported the Second Opium War in which Britain fought to keep open its lucrative opium trade after the Chinese government prohibited the narcotic.

Harper's Weekly alerted the public that the opium habit was spreading in New York City and across America. Custom houses reported 300,000 pounds imported in 1858, estimating 90 percent was intended for recreational use. It was a problem which affected all classes and ethnic groups, from Broadway to the Bowery. The effects of opium addiction could be noted in the "glassy eyes in Fifth Avenue drawing-rooms and opera-stalls," and in the babies of beggar-women. The infants' sleepiness was induced by laudanum (an opium derivative), which kept the children "fuddled continually, and permanently stupefied." It was, in fact, a common remedy used by American and British parents, especially poor ones, for infants who were experiencing teething or other pains.

Not until the late-19th century was opium use identified with the underworld of prostitutes, gamblers, and criminals, more than with medical therapy. By the turn of the century, opium addiction was recognized as a worldwide problem. The first U.S. federal law regulating drug use was the Harrison Narcotics Act of 1914.

Image Artist: Unknown

From: nytimes.com

Sunday, January 24, 2016

Coffin Nails: The Tobacco Controversy in the 19th Century

From: tobacco.harpweek.com

Although a few women shared the tobacco habit in nineteenth-century America, it was overwhelming a male endeavor.  The most popular ways for American men of the time to consume tobacco were pipes, cigars, and chewing tobacco.  Snuff had largely gone out of fashion by mid-century, except for occasional sniffs by high-society youth.  Pipes were a favorite of all social classes, and varied in style from expensive, elaborately carved wood or stone to simpler, moderately-priced versions to cheap ones made of clay or corncob.  Chewing tobacco was common throughout the century in rural and urban areas alike, requiring spittoons in the cities’ public buildings.  It was popular among working class and poor Americans, but was shunned by polite society in the late-nineteenth century.
American soldiers were introduced to cigars during the Mexican War (1846-1848) and they became a fad with men in the 1850s.  Cigars ranged in price from cheap to expensive, but were associated for the rest of the century with affluence, respectability, and success in the male bastions of business, politics, and the military.  Cigars were the most exclusively male of all tobacco products, while cigarettes, in contrast, were considered unmanly until the end of the nineteenth century.  The manufacturing of cigarettes in the United States began in the early 1860s and mass production was achieved in the early 1880s.  There were two basic kinds of cigarette products:  high-end, expensive brands made of imported tobacco; and low-end, cheap brands made of domestic tobacco.

High-end cigarettes were linked with the moral decadence of Europe, the Middle East, and Latin America, where the products were both manufactured and popular.  Hand-rolled cigarettes, also made from imported tobacco, implied the user had the leisure to indulge the habit, and was not participating in his manly duty to earn a living and provide for a family.  Thus, the cigar represented the family man who gained wealth through hard work and self-sacrifice, and who respected traditional morality and authority; the cigarette symbolized the man whose inherited wealth allowed him to remain in a sort of perpetual, self-centered adolescence—unmarried, disrespectful of conventional morality and authority, and attracted to things foreign.

An article in the May 28, 1870 issue of Harper’s Weekly mocked “The Hero of a Fast Novel” (“fast” means immoral or socially improper).  He was constantly pleasure seeking, and lived in luxury by spending other people’s money or going into debt.  The cigarette was as much an identifying mark of the “fast” youth as his expensive food and wine.  “When out shooting, these gentlemen, who are ‘roughing it,’ toss the dogs foie gras and truffles, and drink delicate Burgundies to their perfumed cigarettes.”

A cartoon in the October 14, 1882 issue depicted a “Swell Struggling with the Cig’rette Poisoner.”  Like the “fast” young man, a “swell” was wealthy, self-indulgent, and egotistical.  In the cartoon, he wore evening clothes and top hat for a riotous night on the town.  His floral boutonniere may have mimicked the practice of Oscar Wilde, who toured the United States that year wearing or carrying lilies and sunflowers (that may be a lily pad in the swell’s buttonhole).  The text and image made it clear that the cartoonist considered cigarette smoking to be addictive and deadly.  The multiple cigarette “ribs” of the snake signified chain-smoking, which restricted his free will by encircling him.  According to the caption (which may have been sarcastic) he struggled (or should have struggled) against its hold on his life.  The skeletal view of the snake and the designation of cigarettes as “poison” delivered the powerful message that cigarette smoking is deadly.

Although cigarettes made with domestic tobacco had always been cheaper than those containing imported tobacco, two things lowered the price more.  The first was the drastic reduction of the federal tax on cigarette manufacturers in 1883.  Originally imposed to help pay for the Union war effort during the Civil War, two decades later Congress cut the tax by almost 29%, and manufacturers like James Buchanan “Buck” Duke of North Carolina, passed the savings along to customers.  In the February 25, 1882 issue of Harper’s Weekly, a cartoon by Thomas Nast criticized the call for the tax reduction.  The artist presented two stylishly dressed young men in a tobacco haze.  Their cigarette habit made them stupid and lazy, the opposite of the “manly air” they wanted to project.

The second important factor occurred when Duke contracted in 1883 with James Bonsack to perfect the latter’s invention for mass-producing cigarettes.  On April 30, 1884, the machine lasted an entire ten-hour shift, making 120,000 cigarettes.  The device reduced manufacturing costs and, in turn, consumer prices as it increased production and availability.  By the early 1890s, Duke had a near monopoly of the cigarette market via his American Tobacco Company (broken up by the U.S. Supreme Court in 1911).

The markets for cheap, domestic cigarettes in the late-nineteenth century were primarily boys and immigrant men from southern and eastern Europe, where the habit was common.  The low cost and convenience of cigarettes also encouraged urban working-class men to take up the practice over the next few decades.  Cigarettes could be smoked quickly while walking to and from work, on lunch breaks, and when the boss was not around.  They were also less offensive than other tobacco product to nonsmokers in the congested and rapidly growing cities of America.

These groups of cigarette smokers reinforced the stereotype that the habit was unmanly.  Boys were immature, and presumably did not have the responsibility of providing for a family (actually, some working-class boys did, at least in part).  In 1885, an editorial in The New York Times chastised men for smoking cigarettes and warned of the dangers it posed to the nation’s political survival.  “A grown man has no possible excuse for thus imitating the small boy…  The decadence of Spain began when the Spaniards adopted cigarettes and if this pernicious habit obtains among adult Americans[, then] the ruin of the Republic is close at hand…”  (The focus on Catholic Spain probably also reflected anti-Catholic sentiment among the dominant Protestant population in the United States.)

Poor and working-class men (which included most immigrants) were considered unsuccessful financially, and not socially (and sometimes, morally) respectable.  Therefore, they did not fit the middle-class ideal of American manhood in the late-nineteenth century.  A one-sentence item in the “Personal” column of the July 12, 1888 issue of Harper’s Weekly proclaimed, “Washington is proud of the fact that not one Congressman smokes cigarettes.”  It is certain, though, that many used cigars, pipes, or chewing tobacco.

The public attitude against men smoking cigarettes began to change with the Spanish-American War in 1898.  Many of the young American soldiers, particularly those from rural areas, were introduced to cigarettes as they came in contact with residents of the (former) Spanish colonies of Cuba, Puerto Rico, Guam, and the Philippines, where cigarettes were smoked by most of the population.  Although U.S. military officials approved enlisted men using pipes and chewing tobacco, they tried unsuccessfully to discourage cigarette smoking.  In fact, American sailors threatened to mutiny if deprived of cigarettes.  They had practical advantages over other tobacco products.  They could be carried easily in a uniform pocket, smoked quickly, and did not spoil in humid weather like cigars.  In cramped military quarters, particularly on long sea voyages, the milder cigarette odor would be less offensive to nonsmokers than strong cigar smoke.

At first, Harper’s Weekly presented cigarette smoking as a Spanish practice.  In the August 13, 1898 issue, at one point in a news story on a truce in the fighting in Cuba, the correspondent identified the two sides by their respective choice of tobacco:  “Meanwhile the little men in light blue [Spanish soldiers] sit calmly on the edge of their trenches and smoke cigarettes, while the big men in dark blue [American soldiers] sit on the edge of theirs and good-humoredly cast tobacco juice toward [the city of] Santiago.”  However, in the next week’s issue, in a news story on “The Taking of Guam,” the correspondent referred to American sailors aboard the U.S. transport, Australia, using cigarettes, cigars, and chewing tobacco.  The situation was similar in Puerto Rico, from where Charles L. Hofmann of Battery A, Pennsylvania Light Artillery, wrote home, “You can buy the best cigars here… and their cigarettes are good and strong.”

In the aftermath of the Spanish-American War, E. S. Martin questioned, in his “This Busy World” column from the December 24, 1898 issue of Harper’s Weekly, the presumption that cigarettes undermined “American manhood.”  Instead, he connected the habit explicitly with American servicemen, who smoked so many cigarettes in Cuba that they ran out of supplies.  He emphasized that cigarette smoking among American military personnel was simply a fact from the recent war, “which every one must recall.”  In the February 25, 1899 issue, a feature article on “Our New Possessions—Puerto Rico,” discussed the “Tobacco Culture” of the island, a new American territory after the war.  The author argued that with minor changes to cigarettes made in Puerto Rico, they would find a ready market in the United States.

The years between the Spanish-American War and America’s entry into World War I in 1917 were a period of transition for the public attitude toward men and cigarette smoking.  The notion in earlier decades that the foreign origin of high-end cigarette made the manliness and morality of male smokers suspect appears to have diminished by the late 1890s (even before the Spanish-American War).  An advertisement for the Nestor cigarette brand in the March 19, 1898 issue of Harper’s Weekly declared proudly that its product was “THE MODERN EMBODIMENT OF ANCIENT ORIENTAL LUXURIOUSNESS”:  so much for middle-class respectability and the work ethic.  A Nestor ad in the January 21, 1899 issue marketed to “smokers of refined taste” and featured a sketch of an Arab man (or perhaps a British man in Arab attire).

That there was still uncertainty, however, about cigarettes and American manhood is demonstrated in two other ads.  In the September 3, 1898 issue, the Van Bibber brand of cigarettes were called “LITTLE CIGARS,” to associate them with the unquestionably acceptable tobacco product for men.  In the February 18, 1899 issue, an illustrated ad for Lucke’s Rolls cigars stated, “They are not a smoke for boys or cigarette smokers.”  (Notice another Nestor ad at the top of the page.)  The fact that the cigar ad insulted cigarette smokers also indicates that the cigar company was experiencing competition from cigarette manufacturers.

Historians have attributed a drop in cigarette sales for a few years in the late-1890s and early-1900s primarily to the return of economic prosperity, which allowed more male smokers to afford cigars over the cheaper cigarettes.  In his “This Busy World” column from the August 19, 1899 issue of Harper’s Weekly, E. S. Martin noted that after increasing for 12 years, domestic cigarette production dropped during the previous year.  He observed, though, that the sale of luxury cigarettes had increased (evidence of the improved economy).

In the early-twentieth century, military officials continued their unsuccessful attempts at suppressing cigarette smoking.  In 1903, the Military Academy at West Point banned cigarettes (but promoted pipes) and soon court-martialed two cadets for possession.  However, the prohibition lapsed into disuse when the chief medical officer of West Point admitted in 1915 that “a large percentage” of cadets were “habitual cigarette smokers.”  Similarly, intense opposition from sailors caused the U.S. Navy to reverse a 1907 ban on cigarettes for those less than 21 years old.

By the time the United States entered World War I in 1917, cigarette smoking seems to have been widespread in the military.  The public association of cigarette smoking with the manly image of American servicemen, which had begun with the Spanish-American War in 1898, was reinforced in World War I.  The difference was that instead of military officials resisting the practice, as they had done in the earlier conflict, the U.S. military, federal government, and auxiliary associations officially approved, promoted, and distributed cigarettes among American military personnel.  Whereas cigarettes had been linked previously with moral decadence and considered a “gateway” drug for the use of stronger substances, they were now viewed as a partial substitute for bad (or worse) behavior:  alcohol was banned to servicemen, and military camps had prostitute-free zones around them.

Cigarette smoking would never again be considered unmanly, which was too bad for men.  By 1955, over half of American men smoked cigarettes.  Nine years later, the U.S. Surgeon General issued a report declaring that cigarette smoking caused cancer in men.   Today, despite a lower percentage of male cigarette smokers than in the past, lung cancer (overwhelmingly caused by smoking) is the leading cause of cancer-related deaths among American men.  The habit also increases the risk of heart disease, strokes, and other types of cancer.

Harper's Weekly References
1)  May 28, 1870, p. 343
article, “The Hero of a Fast Novel,” he smokes perfumed cigarettes
2)  October 14, 1882, p. 651, c. 3-4
cartoon, “Swell Struggling with the Cigarette Poisoner”

3)  February 25, 1882, p. 128, c. 1-2
cartoon, “A Bill To Make Idiots,” Nast, regarding proposal to lower tobacco tax; identifies smokers as “lunatic” and “idiot”

4)  July 12, 1888, p. 527, c. 3
item from “Personal” column:  “Washington is proud of the fact that not one Congressman smokes cigarettes.”

5)  August 13, 1898, p. 802-804
“The Truce,” Americans soldiers chewing tobacco, Spanish smoking cigarettes

6)  August 20, 1898, pp. 829-830, c. 1
“The Taking of Guam,” American sailors using cigars, cigarettes, and chewing tobacco

7)  December 24, 1898, p. 1263, c. 3
item in “This Busy World” column, by E. S. Martin, discusses laws against cigarettes, fear of undermining American manhood, but points out American soldiers in Cuba were smoking them

8)  February 25, 1899, pp. 193 and 196
feature article, “Our New Possessions—Puerto Rico,” discusses the “Tobacco Culture” of the island, argues that making minor changes to the cigarettes would give them a ready market in the United States

9)  March 19, 1898, p. 287, c. 1-2
ad, Nestor brand cigarette, “Oriental Luxuriousness”

10)  January 21, 1899, p. 75, c. 1-2
ad, Nestor brand cigarette, “An absolute necessity to smokers of refined taste”

11)  September 3, 1898, p. 879, c. 4
ad, marketed as “little cigars”

12)  February 18, 1899, p. 179
cigar ad, “They are not a smoke for boys or cigarette smokers.”

13)  August 19, 1899, p. 809, c. 1
item in “This Busy World” column, domestic cigarette production down, but sales of (foreign) luxury cigarettes up

Sources Consulted
Kluger, Richard, Ashes to Ashes:  America’s Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris (NY:  Alfred A. Knopf, 1996)
Moyer, David, M.D., “The Tobacco Reference Guide,” http://new.globalink.org/tobacco/trg/Chapter15/table_of_contents.html

“Pennsylvania Volunteers of the Spanish-American War:  Letters Home,” http://paspanishamericanwar.com/letters/hofmann.html

Tate, Cassandra, Cigarette Wars:  The Triumph of the Little White Slaver (NY:  Oxford UP, 1999)

“Tips for Tobacco Users:  Tobacco Use During the Civil War,” http://www.shasta.com/suesgoodco/newcivilians/tobacco.htm

Slade, John, M.D., “Tobacco Epidemic: Historical Lessons,”

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