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 Suicide. Show all posts
Showing posts with label Suicide. Show all posts

Wednesday, June 29, 2016

Suicide and the Civil War

Kathleen Logothetis Thompson

While Post-Traumatic Stress Disorder (PTSD) was not yet diagnosed in the 1860s, soldiers have always faced the physical and psychological consequences of soldiering. Combat stress manifests itself in many ways, suicide being the most shocking reaction to the stresses of war. Civil War soldiers had social and cultural tools to help them cope with the experiences of camp and battle, but in some cases those tools broke down, leading to psychological stress or suicide. Statistically, suicides were few in the armies. The Union army reported only 391 official suicides during the war (approximately 0.02% of Union soldiers) and there is no official number for Confederate suicides. While the official numbers are low it is very likely that the actual rate was higher through unreported or misreported suicides and veterans suicides after the war.

Suicide is a very personal experience, often seen as sudden and unexplainable to outside observers, so it is very difficult to pinpoint the cause, especially 150 years later. However, two experiences had a definite connection to mental stress and suicide: injury in battle and becoming a prisoner of war. Because most soldiers distrusted the army medical system, the fear of injury sometimes outweighed the fear of dying in battle. Injuries in combat also shook soldiers out of the adrenaline-induced state that allowed men to fight for hours, causing the body and the mind to react to the shock of battle in the midst of combat, not later when the fighting was over. At Fredericksburg, Thomas H. Evans of the 12th US Regulars reported passing over the battlefield on Marye’s Heights immediately after the engagement, hearing a shot, and then finding a body with a rifle lying across it, powder burns on the clothing, and the head shattered from the chin upwards. Evans wrote: “He had probably mistaken our approach for a body of the enemy, and in his agony and horror of becoming a wounded prisoner, had blown out the remains of his life by his own act.”

The Fredericksburg soldier had reason to fear becoming a prisoner of war, for they were another group that faced particular traumas. The foundations that soldiers clutched to manage their wartime experiences completely broke down in the environment of prisoner camps. Deprivation, monotony, cruelty, disease, and death forced some prisoners to sink into apathy and face long-standing psychological and physical issues and others to consider or commit suicide. Francis Amasa Walker wrote of his time as a prisoner of war that he suffered “a period of nervous horror such as I had never before and have never since experienced, and memories of which have always made it perfectly clear how one can be driven on, unwilling and vainly resisting, to suicide. I remember watching the bars at my window and wondering whether I should hang myself from them.” Walker resisted such temptation, but others could not, despite the restrictions of available materials in the prison camp. Crossing the “dead line” was an apparently popular form of committing suicide; this was a perimeter set up at many prison camps that marked the point prisoners could not pass without being shot by the guards. There is no question that these men wanted death; one soldier stepped over the line and challenged the sentry to shoot him, after two failed shots he yelled at the guard to do his duty and the third shot hit him in the head, killing him instantly.

When we say goodbye to Tom Fairfax, he has recovered from his physical wounds but still suffers from the mental stress of his experiences. He is caught between returning to the frontlines where he will re-experience the stress and trauma of combat and camp life and transportation to a POW camp where he faces an environment that broke many soldiers during the war. In the end he chooses to take his own life instead of facing either. It is important to note that even though Mercy Street chose to represent psychological casualties of the Civil War through a suicidal character, most traumatized soldiers suffered silently due to the cultural and medical constraints of the time.

About the Author:
Kathleen Logothetis Thompson graduated from Siena College in May 2010 with a B.A. in History and a Certificate in Revolutionary Era Studies.  She earned her M.A. in History from West Virginia University in May 2012. She is currently pursuing her PhD at West Virginia University with research on mental trauma in the Civil War.  In addition, Kathleen was a seasonal interpreter at Fredericksburg & Spotsylvania National Military Park and is co-editor for Civil Discourse, a blog of the long Civil War Era.

From: mercystreetpbs.com

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

Tuesday, May 24, 2016

A Burden Too Heavy to Bear

By Diane Miller Sommerville, 4-2-12

In late December 1861 Northern newspapers buzzed with rumors about a high-ranking Confederate officer who had committed suicide. Within days the victim was identified as Philip St. George Cocke, one of Virginia’s wealthiest and largest planters. Cocke, a West Point graduate, had been appointed commander of Virginia’s state forces by Governor John Letcher in the earliest days of hostilities. He lost his coveted rank of brigadier general, however, when Southern state militias were folded into the Confederate Army.

Although he received a promotion to brigadier general after the First Battle of Bull Run, Cocke never recovered from being demoted to colonel and felt that his battlefield successes were not sufficiently acknowledged. The perceived slights, on top of the strain of war, combined to take a huge toll on Cocke’s psychological and physical health. He retreated to his plantation a broken man, and on the day after Christmas 1861, he shot himself in the head with a pistol.

Cocke may well have been the highest-ranking Confederate soldier to die by his own hands during the Civil War, but he was not alone. The historical record is peppered with cases of soldiers, Northern and Southern, taking their own lives. While most suicides likely occurred as a consequence of what was then called “battle shock,” quite a few took place in camp, even before being shipped off to the front.

The Richmond Dispatch, for example, reported that a soldier identified only as E. White committed suicide while in camp near Savannah, Ga., in October 1861. The grandson of Kentucky Senator John Crittenden, a 26-year-old private named Coleman, who was attached to the 1st Florida Regiment, cut his throat in late August 1861 while stationed near Pensacola. No explanation was offered other than he had been “under a state of mental derangement.” A prominent lawyer from Mobile, Ala., had enlisted in one of the volunteer companies formed in that city in early summer 1861; he, too, slit his throat while making his way to the front.

None of these Confederate soldiers left a suicide note, so it is impossible to know with certainty what drove each to commit such a rash act. While it is entirely possible that non-war related factors – pre-existing conditions or an unstable home life, for instance – contributed significantly to their deaths, war and one’s looming participation in it, the common thread in all these suicides, almost certainly proved the decisive factor. But the question remains: why were so many of them Southern? Was there something about Southern society that, combined with the stress of war, made suicide more likely? And what effect did so many suicides have on a society that before the war had roundly, even punitively, condemned the act?

Each suicide is a thing unto itself, but we can offer a few conjectures. Importantly, men, especially white men in the South, well understood the expectations Victorian society demanded of them in wartime. Honor and duty required their martial participation. So in the wake of the firing on Fort Sumter and Lincoln’s call for troops, Southern white men heeded their new nation’s call to arms and flocked to recruiting stations.

The “Boys of ’61” were pulled into military service by rage militaire a sense of adventure, but they were also pushed into service by patriotic womenfolk who, despite reservations, implored their husbands and sons to enlist. To resist would raise questions about one’s manhood as well as commitment to nation. Consequently, thousands reflexively rushed off to war without much deliberation or contemplation.

As Southern recruits mustered in camps, the reality of what they faced set in. While many a green soldier longed to “see the elephant” – a colloquial term referring to engaging in battle – eagerness often gave way to anxiety and a plethora of fears: of dying, of killing, of failure, of the unknown. If any of those fears were made manifest, a soldier’s courage would be called into question, as appears to have been the case with Charles Robinson, a member of the newly constituted Independent Scouts of Mobile that was mustering in June 1861. When fellow recruits accused him of being a coward, Robinson retorted that he would show them how a Roman could die, then plunged a knife into the carotid artery in his neck.

While most new soldiers punched through that initial reservation and persevered, some became emotionally paralyzed in battle and ultimately unable or unwilling to fight. Take the case of Capt. Christopher Fisher of the newly formed Petersburg Cavalry, a “man of high social position at home.” Fisher first began to show signs that he was “laboring under mental aberration” as his company faced battle near Pig Point, Va., in the early weeks of hostilities. According to a newspaper account, Fisher had become “depressed in spirit” after recognizing that this company was about to be “cut to pieces by the enemy.”

Sympathetic officers and enlisted men, apprehending his weakened state of mind, persuaded him to leave his post and return home. Fisher complied, but en route he drew a pistol, shot himself and sustained an injury that felled him from his horse. He stumbled, ran a short distance, then shot himself again, through the head, dying a few minutes later. Suicide permitted the young captain to escape the taint of cowardice that surely would have followed him had he lived, just as it spared him the pain of facing loved ones as a man who had failed the battlefield test.

Suicide in the antebellum South, as in the rest of the nation, was roundly condemned in moral and religious terms. Protestant and Catholic theology decried suicide as a mortal sin, while laypeople often equated the act with cowardice and selfishness. Ministers railed against the act as an encroachment on God’s authority. Preachers admonished parishioners to follow the example of the long-suffering Job, who patiently endured endless personal suffering. And while the legal remedies to punish suicide victims had largely disappeared from American practice – namely, forfeiture of the suicide victim’s inheritance to the state – the stigma surrounding suicide steadfastly remained at the outbreak of the Civil War.

Indeed, the war stands as an important turning point in the way Southerners came to view suicide and helped usher in a more tolerant, sympathetic attitude toward those who died by their own hands. Consider the newspaper coverage of the death of Captain Fisher. We learn that Fisher “was greatly beloved by his company,” members of whom believed he was a brave man. Excessive concern for his company, not fear or shame, the newspaper explained, had caused Fisher to end his own life.

General Cocke, too, had been eulogized in similar fashion. The Richmond Enquirer even equated Cocke’s suicide with a battlefield death by proclaiming him a “martyr to his patriotism as if he had fallen in the field of battle.” Readers were assured that his “heart and soul were thoroughly enlisted in the noble cause of Confederate independence.” The Richmond paper further vindicated Cocke by denying he bore blame for the self-murder, explaining that he had shot himself while “under the impulsion of a mental aberration that extinguished all responsibility.”

Sympathetic responses extended to enlisted Confederate soldiers as well as officers. On Dec. 14, 1861, for example, the Richmond Daily Dispatch, reported on yet another soldier suicide, this one from the 9th South Carolina Regiment. While friends were at a loss to explain why Burgess killed himself, the newspaper surmised that he was “tired of life and had concluded to try the realities of another world.” Noting that this was the second such suicide in a few days, the newspaper abhorred “such deplorable waste of life.” The piece further opined that “men in war become more reckless of their lives and attempt, through a mistaken notion, to relieve themselves of a burden too heavy to bear.”

Another measure of changing attitudes toward Civil War victims of suicide can be seen in the public sympathy victims received after their deaths. The lawyer from Mobile who cut his throat en route with his company to the front was accorded considerable respect following his suicide. Two companies escorted his coffin to the cemetery for burial, where he received military honors. The Knoxville Register reported that “a large number of our citizens” attended the funeral, which was presided over by a minister, suggesting at least some religious rituals were observed. Similarly, a military detachment accompanied the remains of Thomas Stringham, a 22-year-old German Virginia man who killed himself while encamped near Norfolk with his company in October 1861. In a display of community reverence, members of the Norfolk Tailors Society appeared at burial-site services.

If some Southerners expressed compassion and support for soldiers who died by their own hands, others failed to make the connection between suicidal behavior and wartime experiences. Modern observers, many of whom witnessed American soldiers returning from Vietnam, Iraq and Afghanistan, are keenly aware of the possible contribution of trauma experienced in war to mental illness. But 19th-century Americans had no such understanding that exposure to battle sometimes resulted in psychiatric breakdown or debilitation.

Consequently, when a soldier (or, after the war, a veteran) developed severe signs of mental distress including suicidal tendencies, the causal connection to his military duty eluded many people, even family members and professional caretakers. As was common before the field of psychiatry matured, social pathologies like alcoholism were confused as a cause, not a symptom, of mental illness. Consequently, bystanders trying to explain why “a poor unfortunate soldier” attempted suicide in June 1862 said he had been made “delirious from liquor.” Likewise, masturbation was to blame for Joseph Henderson’s violent threats to himself and others, not his stint as a soldier in “Price’s Army” in Missouri or the “many fatigues” he had undergone there.

The stories of Confederate soldiers who attempted or committed suicide get us closer to a full accounting of the personal costs of the Civil War. Losses in dead, wounded and treasure have been well-documented; individual suffering, less so. And while suicides occurred among Union soldiers, there is evidence to suggest suicides occurred more frequently in the South during the war and following the defeat and collapse of the Confederacy, as broken soldiers returned home burdened with combat stress as well as the herculean task of rebuilding themselves, their families and the region.

Their stories also illuminate a “community of suffering” that emerged in the South during and after the Civil War that served as a catalyst for shifting ideas about suicide and manhood, opening the door for a more empathetic treatment of suicide victims. Southern soldiers who died by suicide, just as those who died by a sniper’s bullet, an exploding shell or typhoid were, to their minds, martyrs to patriotism.

Diane Miller Sommerville, an associate professor of history at Binghamton University, is the author of the forthcoming “Aberration of Mind: Suicide, Civil War and the American South,” for which she received a fellowship from the National Endowment for the Humanities. An expanded and fully cited version of this essay will appear in a forthcoming volume of Civil War History.

From: opinionator.blogs.nytimes.com

Tuesday, May 17, 2016

Historian Focuses on Civil War Suicides

By Eric Coker, 2-15-11

Diane Miller Sommerville’s latest research project, “Aberration of Mind: Suicide, the South and Civil War,” shines new light on an under-examined topic and has earned her a National Endowment for the Humanities Fellowship Award.

The $54,000 fellowship will allow Sommerville, an associate professor of history who also serves as director of undergraduate studies in Binghamton University’s History Department, to take a year off from teaching to focus on writing a book.

The project developed when Sommerville decided to look at how contemporary problems such as suicide and mental illness were handled in the past.

“I wondered how 19th-century southerners dealt with these problems that are so difficult for us in the 21st century,” she said. “Because I am a southern historian, it immediately took me to the place where a large number of people would have been taxed psychologically — the end of the Civil War.”

In examining the personal and societal costs of the Civil War in the South, Sommerville said that southern men and Confederate soldiers were “constrained by ideas of manhood that are shaped by ideas about courage and honor.” In the 19th century, courage was defined as not acknowledging fear.

“It was manly not to acknowledge that you were afraid,” she said. “By the 20th century, courage is actually knowing that you are scared but are managing it. The 19th-century soldier had not yet realized that.”

This led some soldiers to commit suicide before going off to war, en route to battle or after the fighting.

“To go home a failure or a coward was not an option because it would taint them for the rest of their lives,” Sommerville said. “The dilemma for many young men was: ‘What do I do? I’m afraid to fight but I can’t go home because I’ll be labeled a coward.’ That’s what I think is causing some of them to commit suicide.”

The Civil War was also harder on southern men than northerners because many returned to destroyed homes, while losing a key source of wealth in slaves. A combination of debt and being unable to provide for their families resulted in suicides.

Southern women were drawn to suicide because of the deaths of loved ones, Sommerville said. They found themselves in the unusual situation of no longer being protected by their husbands.

“In war, that arrangement is thrown out the window, and these women are asked to deal with new roles in society,” Sommerville said. “They have to protect their homes and children and they have not been prepared to do this. Many of them perform admirably in this role, but some are clearly stressed, especially in the latter part of the war where there is the threat of invasion.”

Whether to flee or stay at home is a new decision for women during the Civil War.

“For some it becomes too burdensome and they have what we consider nervous breakdowns and end up in asylums or committing suicide,” Sommerville said.

For Sommerville, asylum records have been some of the most useful research sources during the project. She has traveled throughout the South, focusing particularly on Atlanta and Columbia, S.C., checking cemetery records and newspaper accounts. Nineteenth-century municipal records, though, are mostly absent.

“Quantitative analysis of suicide is almost impossible to do in the American South,” she said.

Sommerville, whose 2004 book Rape and Race in the Nineteenth-Century South earned her the Best First Book Award by Phi Alpha Theta, envisions that the current project will produce a book that will reach a wide audience.

“Civil War interest is at an all-time high,” she said. “Ideally, I’d like to have the book done and out by 2015, which would be the (150th anniversary) of the end of the war. I think it would be a natural tie-in. … I know that my work is going to have a lot to say about something people don’t know a lot about.”

It is important to understand that there was significant emotional and psychological suffering in the south during and after the Civil War, Sommerville said.

“That’s not an easy thing to make a case for because they started the war and the war was over slavery,” she said. “Why should we be sympathetic? But I don’t intend to make judgments about that.

“There was a generation of men and women, especially in the South, who really suffered. This was a social consequence of the Civil War and so much of the war (research) has focused on the military and emancipation. This is an opportunity to learn something more about the Civil War. I don’t think these questions have been adequately raised and answered.”

Thursday, September 12, 2013

One Too Many: Civil War Suicide Estimates

By David Silbey, chronicle.com
 
Christopher Frueh and Jeffrey Smith recently attempted to estimate the military suicide rate during the American Civil War. They did this, in part, because the current military suicide rate has been going up rapidly during the last decade of constant war, and there is little historical data to which to compare it:

Suicide rates and post-traumatic psychopathology among U.S. military personnel have risen dramatically since 2001. We have little understanding of historical context to indicate whether this is a typical outcome of war, apart from Durkheim’s (1951) conclusion from 1897 that suicide rates tend to decline during the active phases of war. Data gathered by the U.S. Government during the Civil War provide a conservative estimated suicide rate among active-duty Union Forces of 8.74–14.54 per 100,000 among white troops during the war. In the year after the Civil War ended, the suicide rate for the small percentage (17.6%) of white forces that remained on active-duty climbed to 30.4, though it is unknown how representative these troops were to the larger group that had been discharged from military duty….In the final year of the war, when casualties were the highest, the suicide rate for white and black troops combined was 10.35. This is comparable to the rate of 11 among U.S. forces in 2001 at the start of the wars in Afghanistan and Iraq, although quite a bit lower than the current rate of roughly 20.

The conclusion: Thus, any way we view it, current suicide rates in the U.S. military are probably two to three times higher than those documented during the Civil War.

The authors acknowledge a few data problems, including collection issues and a 19th century naivete about depression and suicide, but miss a few other problems. For example, when they talk about racial differences in suicide rates– “Among black troops the suicide rate in their first year of official duty (1863–1864) was 17.7, dropping to 0 in the next and final year of the war” –the authors show no sense that it is quite likely that black suicides were tracked and recorded at a much lower rate than white suicides because of racism. Instead, they argue that it fits with “Durkheim’s (1951) conclusion that whites generally had much higher rates of suicide than blacks during the Nineteenth Century.” Possibly, but a suicide rate of zero for black troops in 1865 seems highly unlikely. The other issue is that the Civil War lasted a much shorter time than have the wars in Iraq and Afghanistan, with shorter enlistments (add in the difference between the current long-service force and the Civil War’s mix of volunteers and conscripts), and many of the Civil War soldiers may have been out of the service when they committed suicide and thus were not caught in the official tally that Frueh and Smith used.

Having said all that, however, even if the Civil War rate was substantially higher than Frueh and Smith have found and might even have been near the current rate, it’s not good news that American soldiers, sailors, and marines are killing themselves at such massively high levels. Wars aren’t limited to battlefields, and casualties aren’t, either.


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