Civil_War_Quarterly_-_Summer_2016_

on the picket line, active movements in the

face of an enemy, forced marches, and ardu-

ous and exciting fighting and marching. It

was entirely opposite from other physicians’

positive interpretation of battle-related activ-

ities during the war.

In contrast to an overall lack of treatment

for mental disease, there were some treat-

ments in place for heart disease. Da Costa first

prescribed rest but also employed plant-based

remedies, including digitalis, aconite, vera-

trum viride, gelsemium, hyoscyamus (hen-

bane), belladonna and atropine, conium

(hemlock), and Cannabis indica.

Massive numbers of casualties made effec-

tive or even humane treatment difficult. Julia

Wheelock worked in Washington-area hos-

pitals from 1862 through 1865. She estimated

that there were 10,000 wounded in Freder-

icksburg, Virginia, at one time. All the public

buildings, including the courthouse, churches,

hotels, warehouses, factories, paper mill, the-

ater, school buildings, stores, stables, and pri-

vate residences were converted into shelters

for the wounded, until Fredericksburg was

one vast hospital.

Wheelock recounted wounded soldiers beg-

ging for pillows. “I’m wounded in the head,

and my knapsack is so hard,” said one.

Another wanted one for his stump. “I don’t

think it would be so painful if I only had a pil-

low, or cushion, or something to keep it from

the hard floor,” the soldier said. One

“wretched hospital,” a former grocery store,

had only a single small candle for light. When

someone moved the candle to another part of

the crowded room, Wheelock, afraid she

would stumble over the injured, crept on her

hands and knees to deliver cups of broth to

the wounded, starving soldiers. Many were

so fresh from the battlefield that their wounds

were still undressed. Given such conditions, it

was small wonder that the often over-

whelmed military medical establishment

could not care adequately for victims with

poorly understood psychological needs.

In 1855, Congress had established in Wash-

ington the Government Hospital for the

Insane, later St. Elizabeth’s Hospital. Its stated

goals were to provide “the most humane care

and enlightened curative treatment of the

insane of the army and navy of the United

States, and of the District of Columbia.”

Diversions of the mind were found to displace

morbid feelings. Such diversions included

church services, educational lectures, music,

books, and musical instruments, including

several pianos. Caregivers attempted “to ren-

der the institution not only a good hospital,

but a kind and sympathizing home.”

After the Civil War, Congress liberalized the

law governing admissions to the hospital.

Those accepted included former patients who

relapsed within three years of their discharge

from the hospital, those discharged from the

military for insanity, and “indigent insane

persons, who have become insane within

three years after discharge from such service

from causes which arose and were produced

by said service.” Giving veterans three years

after discharge to seek treatment was a rela-

tively forward-looking admission that men-

tal and emotional wounds, like physical

wounds, could take years to heal.

Some wounds never healed. A 2006 study

of military and Pension Board medical

records of 17,700 Civil War veterans found

an association between the men’s wartime

experiences and the occurrence of cardiac,

gastrointestinal, and nervous diseases

throughout the remainder of their lives. One

measure found a 51 percent increase in those

three disease categories.

Those removed from the battlefield were

marked by their experiences as well. A civil-

ian relief worker wrote that after the Battles

of the Wilderness and Spotsylvania, “The

surgeons were at work, probing, extracting

balls, amputating in the open air, while upon

every hand were cries of agony from the poor

fellows, which would have melted any but a

heart of stone.” Years later, nurse Lois Dun-

bar recalled, “I have had men die clutching

my dress till it was almost impossible to loose

their hold.” Even experienced doctors and

nurses could not easily forget such sights and

sounds.

One soldier summed up the literal deadli-

ness of nostalgia: “Would you believe—and

yet it is true—that many a poor fellow in the

Army of the Cumberland has literally died to

go home; died of the terrible, unsatisfied long-

ing, home-sickness?” Against the ravages of

nostalgia, he wrote, paraphrasing Shake-

speare’s Macbeth, “the surgeon combats in

vain, for, ‘who can minister to a mind dis-

eased?’” Sadly, the answer to Macbeth’s

rhetorical question remained largely true 2½

centuries later, during the Civil War. “Therein

the patient must minister to himself.” For

many soldiers, as for the guilt-stricken Mac-

beth, there was no cure at all.

A Union doctor from the 14th Indiana Volunteers tends to Confederate wounded after the Battle of Antietam

in September 1862. Blankets stretched over fence railings were the only protection from the elements at this

crude medical aid shelter.

Both: Library of Congress

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