Soldier's Heart

"Soldier's Heart" is oftentimes claimed to be the name for PTSD during the War Between the States. When watching the PBS series Mercy Street, the writers used the term "Da Costa's" syndrome. The episode featured a young soldier who was clearly mentally unstable and did not wish to see his fiancee because he felt he was no longer the respectable man he had been due to his raw and uncontrollable emotions, which at times became violent. (If you want to know my opinion on Mercy Street, in summary, it being cancelled was a "mercy killing.")

Several years before watching the episode on "Soldier's Heart," I had already touched on the topic in my novels, (namely Long Road to Damascus, Exile, and in a large way in Prodigal), and had done some serious research on how Victorians dealt with soldiers who suffered from Post Traumatic Stress Disorder. Being friends and acquaintances with several veterans of our current conflicts, (as well as police officer and first responders), I've learned that mankind's destructive and cruel habit of waging war is not without a psychological toll. To have my character go through so much and not be affected at some point seemed wrong to me.

Another factor that led me to research the issue was the birth of my daughter. Born two and half months early, not only was her birth a terrifying experience, but it was then followed by forty days of sitting in a room full of babies hooked up to tubes and machines. While I by no means compare my experience to what combat veterans have gone through, and for the longest time thought I was suffering from an odd form of post par-tum depression, I happened to read a passage from a colonel in the military who had seen some harsh combat situations and also had a child born prematurely. He wrote that the stress he felt was a similar and awful form of PTSD, for the one hurting before his eyes was his child, and unlike in a combat situation, where he could usually take action and be doing something to fight against those causing the hurt, in this situation he was forced to sit by and helplessly watch.

In trying to work my way through this revelation, and then how once my daughter was home my sleeplessness, nightmares, and panic attacks receded, I decided that traumatic events become like a wound on your mind. I have only one, but those who repeatedly suffer through traumatic events gain one for each event. And for each "wound," there is some types of experience that can irritate it. I did not experience a flashback to how I once felt until my daughter went on her first sleep over, at which point I had a vivid nightmare of her calling for me and me wandering around that old hospital looking for her. The following morning I woke up with a horrible feeling of dread and doom dogging me, no matter how much I tried to reason it away. Then I suffered from a racing heart, buzzing head, and an inability to swallow when the parents watching her didn't immediately answer their phone when I called. The day after I was still not entirely myself, finding myself unsteady: I spilled coffee all over myself, dropped my phone several times and broke it, and went between feeling so exhausted I wanted to sleep to being restless and tackling jobs I'd put off.

I share this because while it is not scientific, it is my way of trying to understand what these soldiers had to deal with. Their minds would have been undoubtedly filled with these mental "wounds." And any number of things could trigger any number of them. Yet, in Victorian society, there was an added torture: the taboo of showing any weakness. For a man to admit to having any emotional problems was a terrible societal stigma. So how did the soldiers who fought through Crimea, the War Between the States, or any of the Victorian era conflicts deal with this common result of combat?

There's been some more attention given to the subject in recent years, one book being A Broken Regiment by Leslie Gordon. In it, the author follows members of the 16th Connecticut after the war. It was a unit that not only saw combat, but also rained down destruction on Southern civilians. There were not a few of the veterans who clearly suffered from the experience. Some committed suicide, others showed signs of domestic abuse, had trouble with relationships, and several were even admitted to hospitals. A friend of mine, when researching into her family history in the South, had a story of a great uncle who came back from the war so mentally tortured that he couldn't care for himself. He was shunted from one family member's care to the next until he died.

The official medical terms of the time seemed to vary by whatever way the trouble manifested itself. From "irritable heart" to "neurosis." Of course, going back to "soldier's heart" and "Da Costa's Syndrome," I have become hesitant to use those for describing PTSD. The reason for this is some research on a common ailment among soldiers of the time called "rheumatism." Found in the popular post war ballad, "I'm a Good Old Rebel," there is a stanza that says:

I followed Ol' Marse Robert

For four year, near about

Got wounded in three places

And starved at Point Lookout

I cotched the "roomatism"

A camping in the snow

But I killed a chance o' Yankees

I'd like to kill some more.

The "roomatism" the songwriter mentions is rheumatic fever. It was alarmingly common as it is caused by a combination of untreated strep virus coupled with poor nutrition. It also tends to be more prone to attack teenagers and young adults. One side affect of rheumatic fever, especially when it becomes reoccurring, is rheumatic heart disease. This occurs in 1/3 of those who suffer from rheumatic fever. Rheumatic heart disease is when the virus damages the heart valves. Sufferers will experience shortness of breath, chest pain, and arrhythmia. These are the symptoms described by Dr. Da Costa who went on to blame it on heavy knapsacks and harsh military life. 

Another culprit of such symptoms can be an overdose of quinine. Quinine was a common remedy for fevers associated with malaria, typhoid, and even sometimes STD's. It was so common, in fact, that a regularly used nickname for doctors of the time was "Old Quinine." This information has led me to believe, considering how common rheumatic fever and quinine use was among the soldiers, that "soldier's heart" and "Da Costa's" syndrome more often was a diagnoses of rheumatic heart disease or damage done by a quinine overdose.

Now that I've covered description and terminology, how did the average soldier suffering with PTSD handle the issue with Victorian manliness and dignity? A short answer was, he didn't. The men suffered and it was covered up, hidden, and wasn't generally spoken about, though hints to some recognition of a problem can be found in the number of veterans hospitalized for "neurosis" and "nervous insanity", and the surge in pharmaceuticals. Some of the prescribed medicines were "snake oil" cure-alls, others were nothing but flavored alcohol, an example being "Drakes' Plantation Bitters," and some were more serious drugs containing opium, cocaine, or cannabis. 

The word "addiction" was not used, but rather "habit." Many adds in the postwar years advertise products to help one end the "opium habit." 

An increase in opium abuse and alcoholism spurred the temperance movement that would eventually bring on prohibition in the early 20th century. Familiar products such as Dr. Pepper and Coca Cola were invented by Confederate veterans and originally included now illegal drugs. The least damaging drug soldiers took seems to have been cannabis, which at the time was not smoked but taken in pill form, dissolved in tea, or candied lozenges. Advertisements for popular companies selling the drug declared that it helped with: sleeplessness, irritable heart, neurosis, nervousness, and would "restore the bowels and appetite from an 'opium habit.'" These advertisements abounded in papers throughout the late 1860's up into the early 20th century.

Trouble did begin to arise from abuse of the different drugs, one early case being an 1870 account in New York City where it was reported too many women were digging into their husband's stash of cannabis tinctures and having cannabis parties. These parties became a growing public concern and the first discussions were had on how to control the substance.

Did some of the soldiers recognize addiction? The fact there were products billed to help with a "habit" of alcohol or opium tells me yes. However, I have not yet run across much in the way of an account of a veteran or soldier who openly discusses going through a "detox" process. I can only assume by the attention the ads give overcoming a "habit", that there had to be some.

While it was clear that veterans were self medicating with a wide array of substances that modern medicine has taught us they'd be better off without, there were other hints as to an earnest need to address the trouble veterans were having with civilian life and their struggle with traumatic events of the past. One of the most notable examples is the reunion movement, which started immediately after the war in the North and in the 1880's in the South. (Reconstruction dictated that ex-Confederate soldiers were not allowed to gather or form organizations while the South was under military rule, which ended by 1877.) Children and wives of veterans saw a deep depression, (Victorian terminology called depression "the black dog"), and wanted to find a way for their loved ones to work through their sadness. Some women got together to form organizations such as the United Daughters of the Confederacy to begin helping the men organize reunions and build monuments to the comrades who had fallen to help begin a healing process that was very much an internal healing for the hurting veterans. Many veterans found a healing outlet in organizations such as the Grand Army of the Republic for the North (GAR), and the United Confederate Veterans in the South (UCV). Chapters or "camps" of these organizations would meet regularly and were what we would call in modern times, truly a support group like the VA encourages veterans suffering from PTSD to participate in today.

As one can see, the topic at hand is extremely large, and much is left out, but I wanted to share a small insight into some of the research I have done concerning PTSD in the 19th century, and while I did not want to spend too much time in my novels on the topic, I did not want it to be ignored either. It was definitely an issue that many veterans had to deal with and the results of how to deal with it became woven into late Victorian society, hints of which we still see today.

Text copyright (c) S. H. Ford, 2017.