Today, our society recognizes that warfare is highly traumatic, that soldiers can come through battles without physical injury, yet still be crippled by the horrors and the stress they endured. The term post-traumatic stress disorder, or PTSD, is familiar to us all, but it was officially recognized only in 1980.

The soldiers of the Civil War were surrounded by death, both on the battlefield and at camp. Death from disease was the constant backdrop of military life during the Civil War. Out of the 750,000 deaths that occurred during the war, it is estimated that two-thirds were caused by disease. The war was fought in the midst of plague. The war by itself was more than enough to cause overwhelming stress for the troops—add to that the constant stress of seeing friends and comrades killed by disease.

In addition to the constant threat of disease, soldiers endured the stress of battle. Beyond the horrors witnessed during battle, the blood that drenched the field, and the deaths of fellow soldiers, the aftermath of the battles left a permanent mark on the minds of all those present. The sight of amputated legs and arms piled up in a great heap outside the field hospital tent was profoundly disturbing. The sights inside the hospital tents were worse: amputations were, at times, performed without the benefit of anesthesia, and doctors rooted around inside of wounds, searching for bullets, while their patients gritted their teeth and tried to hold still.

Right after the Battle I helped carry a wounded man back to the Field Hospital where the wounded who required Surgical Operations were carried, + I had a chance to look around + see what was being done. Just outside the Hospital tent was a pile of legs + arms about 3 feet high. In the Tent one man was fastened to an iron frame, his leg had been taken off above the knee—and a Surgeon + his attendant were taking up the arteries. Another man, also strapped to an Iron frame, + a Surgeon was sawing off the bone of his arm above where it was shattered by an exploding Shell. A man was sitting in a chair with hands clasped tight to the sides of the chair, his teeth set, his face white as a Sheet, while a Surgeon was probing for a bullet among the cords of his neck. Another man lying on a cot arrangement with an eye partly gouged out by a piece of shell—2 Doctors were consulting as to whether the eye would have to be taken out entirely or put back in place. A large powerful looking man was lying on his back on a stretcher with a bullet hole in his forehead. He was only just alive, it was a mistake to bring him there. But I will stop or change the subject somewhat. Pardon me if I have gone too far in depicting the horrors of war. I never had any desire after that to look into a Hospital tent right after a Battle.

~ Mark S. Nickerson, letter to his niece, circa 1911,
describing his experiences at the Battle of Antietam.
(Copy of original letter, Collection of Cornwall Historical Society)

Soldiers anticipated their own deaths, leaving instructions with friends for returning their personal effects to their families. Joseph Payne, the Quarter Master Sergeant with Company G of the Connecticut Second Heavy Artillery, was killed in battle at Cold Harbor. Payne had prepared a final letter to be sent to his sister in the event of his death. The letter consisted of a comforting poem, which began

O, think of me not as afar, when you meet
  Where the oft bereft circle sits closer around,
Look not with despondence on one vacant seat,
  Nor think of me there as beneath the cold ground
From my home in the mansions of Glory above
  I may visit you often in those circles of love.

Payne also included a personal message: “Sister Lottie, Do not be at your wits end wondering who this comes from, but receive it as the words of your now Sainted brother Joseph. From one who loves thee with thoughts too dear to tell, let us recognize each other in heaven.”

During the Civil War, thousands of soldiers suffering from extreme stress were diagnosed with “nostalgia,” or homesickness. The term nostalgia, defined as a serious medical condition, was coined in 1678 by Johannes Hofer, a Swiss medical student. Civil War doctors diagnosed 5,547 Union soldiers with nostalgia and attributed 74 deaths to nostalgia. The primary symptoms were consistent with severe depression: sadness, listlessness, uncontrollable crying, and loss of appetite. In extreme cases, nostalgia could lead to fever, delirium, and death from malnutrition and starvation. The recommended cure, if caught early, was a furlough. In advanced cases, the only treatment was a discharge.

One doctor took an interest in some of the more mysterious ailments troubling the Civil War soldiers. Jacob Mendez Da Costa was appointed as a visiting physician at the military hospital in Philadelphia during the Civil War, and diagnosed something he called “irritable heart.” Da Costa studied some three hundred soldiers during the war, publishing his findings in 1871. Da Costa recognized that the problem no doubt existed throughout the history of warfare, and he believed that at least part of the cause was connected to sending civilians into battle without adequate training. The symptoms of “irritable heart” were consistent with what we would term anxiety attacks: heart palpitations, chest pain, shortness of breath, headaches, rapid pulse, dizziness, indigestion, and diarrhea.

While some of Da Costa’s patients made full recoveries after a long rest, others were plagued by recurring attacks for years. In one telling case, a patient attempted to return to work as a baker, but suffered from “frequent smothering sensations.” He improved when he quit his job and went to work on a farm, taking care of horses.

By World War I, Da Costa’s syndrome had been nicknamed “soldier’s heart” and was generally recognized by the medical profession, but the cause was still misunderstood. Some doctors theorized that “soldier’s heart” was caused by hyperthyroidism, constitutional instability, or infection, while others recommended simply ignoring the problem.

While Civil War doctors struggled to understand the causes and best treatment for “irritable heart” (anxiety attacks), other warning signs of post-traumatic stress disorder went unnoticed. Those warning signs include depression, nightmares, flashbacks, panic attacks, survivor’s guilt, emotional numbness, detachment from daily life, outbursts of anger, and an overwhelming sense of hopelessness.

Cornwall’s Captain Edward Gold appears to have suffered from debilitating PTSD. In 1890, his cousin wrote that “I think the exposure and responsibility of his soldier’s experience unsettled his mind.” Two Cornwall soldiers are known to have committed suicide after returning home. Newton W. Cogswell, who served in Company B of the Connecticut Second Heavy Artillery and who was wounded at the Battle of Cold Harbor, killed himself in 1876. John Tully, who served in Company G of the Second Heavy Artillery, committed suicide in 1881.

The aftermath of the Civil War and the enduring trauma suffered by its soldiers led to the creation of homes for soldiers and war orphans. Some of the soldiers who were so severely traumatized that they were unable to return to daily life wound up in the newly created Connecticut Hospital for the Insane. Countless others, however, struggled on their own to return to their lives. Theodore Sedgwick Gold, in his 1877 history of Cornwall wrote, “Political economists, in attempting to account for the present hart times, for the stagnation in business, fail to take account of one important element—the immense loss the country sustained in so many of her most enterprising, active young men, who now, in the prime of life, would have been foremost in every enterprise.” Gold was referring only to the soldiers who died, but his observation applies just as much to men like Captain Edward Gold, who survived the war, but never returned to normal.