Insanity during the Civil War

[major bill]

At the start of the Civil War some of the states were building public insane asylums. Union doctors rejected any recruit whom they felt was insane. Still it is reported that 819 Union soldiers were discharged due to insanity.

Probably some recruits who were insane made it into the armies. Still it is probable that some soldiers were insane once in service. Treatment was still in its infancy.

The Civil War was one of the earliest American conflicts where insanity was recognized by doctors and treated by them.

 

[chucksr]

Here's an unfortunate example of cruelty that eventually led to insanity.

 

[diane]

Thomas Benton Smith is a very sad case. He was alright for a few years after that horrific injury. The doc just basically picked the dirt and twigs out of his brain and stuck it back in his head. There were a number of cases of head injuries that turned out that way - fine for a while then all of a sudden...well, not. William B Cushing is another sad case. His daring exploit with the CSS Albemarle gave him a broken back and hip. Again, he recovered and was alright for a few years but then started getting pain, which grew worse. He died in an asylum and it was never clear if it was opioid addiction or insanity from the pain. There were also people who developed epilepsy from head injuries and ended up in asylums - that was considered a mental illness then.

 

[lelliott19]

Thanks for posting in the Medical Care Forum @major bill

Hopefully our resident psychologist (or is it psychiatrist?) @amweiner will be along to weigh in on your post.

Here's an unfortunate example of cruelty that eventually led to insanity.

Wow. I had never heard of this unfortunate incident. Do you know if William L McMillen received any punishment? Was he court martialed?

 

[major bill]

I have had friends and even soldiers who worked for me end up in Army medical facilities for mental health issues, and can not imagine how different their treatment was campared to the Civil War era treatment. For example the Confederate Army often sent their soldier showing signs of insanity to the nearest civilian insane asylum. These public funded insane asylums were at often at best primitive and the doctor's knowledge of how to treat them very limited. The Union Army was not really much better.

 

[diane]

Thanks for posting in the Medical Care Forum @major bill


Wow. I had never heard of this unfortunate incident. Do you know if William L McMillen received any punishment? Was he court martialed?

He was court-martialed early in the war for cowardice - forget the battle - but was acquitted. He was also a doctor, I believe, before the war. Smith had surrendered, giving him his sword, and he used it to bash in his skull. Apparently this incident was not generally known, or not mentioned, because he received a promotion. His unit had gotten a beating from Smith's, so the incident was regarded as emotional. Still don't see how he got a promotion!

 

[huskerblitz]

Glancing at my roster for the 22nd Ky, they had three declared insane. One was sent to the New Orleans Insane Hospital.
http://irreverentpsychologist.blogspot.com/2012/06/new-orleans-city-insane-asylum.html

 

[chucksr]

Thanks for posting in the Medical Care Forum @major bill

Hopefully our resident psychologist (or is it psychiatrist?) @amweiner will be along to weigh in on your post.



Wow. I had never heard of this unfortunate incident. Do you know if William L McMillen received any punishment? Was he court martialed?

Apparently nothing serious --again, from Wiki:

He led his brigade at the Battle of Nashville. After the Confederate General Thomas Benton Smithsurrendered and had been disarmed during the engagement, McMillen reportedly berated the disarmed prisoner and then attacked General Smith with Smith's own sword (one source says "wantonly and repeatedly"[1]), causing brain injuries sufficiently severe that Smith spent most of the rest of his life in a nearby state hospital for the insane. McMillen was brevetted as a brigadier general in 1865, retroactive to the date of the battle, and commanded the district after Robert E. Lee's surrender.

In July 1867, he was brevetted Major General of U.S. Volunteers, retroactive to March 13, 1865. In Smith's obituary, it was stated that when McMillen's role in Smith's injuries became public knowledge, he was asked to relinquish his office in the New Orleans chapter of the Grand Army of the Republic.[2]

 

[AUG]

As mentioned on Wiki, Thomas Benton Smith was able to attend reunions after the war. The fallowing article from the Confederate Veteran details one reunion in 1910 in which he was still able to lead the men through their drills.

At a recent reunion of the 20th Tennessee Regiment at Nashville, Tenn., in the beautiful Centennial Park where was held the Tennessee Centennial Exposition in 1897, Gen. Thomas Benton Smith, an early commander of the regiment, who has been in the Tennessee Insane Asylum nearly ever since the war from a saber cut on the head after he surrendered in the battle of Nashville, was in command for a drill and short parade. The regiment was formed as a company, and the drill master, though now somewhat venerable, although he is said to have been the youngest brigadier general in the Confederacy, carried the men through the manual of Hardee's tactics as if half a century were half a year.

General Smith was self-poised, as full of the animation of the old days as could be imagined. When they stood at "Right dress! Eyes right!" he said: "Throw them sticks down; you don't need them!" A picture of that scene and a repetition of all he said would be most pleasing. General Smith has times of deep depression, and is sad over his long "imprisonment", but he is always happy at Confederate gatherings, and is still a magnificent specimen of Confederate manhood.
(CV 18, p. 577)

​

A good article on him was posted here: https://civilwartalk.com/threads/thomas-benton-smith-50-years-a-prisoner.99276/

 

[KeyserSoze]

The Civil War was one of the earliest American conflicts where insanity was recognized by doctors and treated by them.

Recognized by other's too. "South Carolina is too small to be a country and too large to be an insane asylum." - James Petigru, 1860.

 

[amweiner]

Thanks for posting in the Medical Care Forum @major bill

Hopefully our resident psychologist (or is it psychiatrist?) @amweiner will be along to weigh in on your post.



Wow. I had never heard of this unfortunate incident. Do you know if William L McMillen received any punishment? Was he court martialed?

Thanks for letting me know about this, @lelliott19 - I didn't see the OP with all the NYE prep going on!

Thanks to @major bill for bringing up an important topic, as well. It was relevant during the Civil War and remains important now in terms of how we treat both visible - and invisible - wounds of war.

Anyway, as you probably know, "insanity" in modern times is a legal rather than a psychiatric concept. During the 19th century, it made for a good catchall for anyone dealing with mental health symptoms: depression, thought disorders, mood disorders, anxiety, even the behavioral effects from brain injury - you name it - would be considered insanity back then because doctors didn't have the diagnostic language to understand it. Perhaps even more importantly, no one had any idea that combat and trauma could actually trigger such symptoms where they might not have existed previously. The concepts of combat fatigue and acute stress reaction were unknown, although the term "cannon fever" crops up here and there.

But to set aside the cold, clinical side of things for a moment, I encourage people to think about the conditions men endured during the war: marching, barely sleeping and running on primarily caffeine, the stress of combat (for example, the almost nonstop combat in the Overland Campaign), watching friends die and watching your unit get decimated. What does that do to the human psyche? The short answer is, nothing good. The mind needs ways to understand this nonstop stimulation and trauma, and without it, our ability to cope and control becomes limited very quickly. Not to excuse what McMillen did, but it's possible he just reached a limit of what he could stand, and lost all control. Sadly, a possibly traumatized individual handled his experiences by inflicting trauma on another - it's not uncommon, even today.

On another note, I read a passage in A Stillness At Appomattox by Bruce Catton that suggested during late 1863 and through 1864, substitute brokers would indeed enlist people with pretty obvious cognitive and emotional impairments. If you were a warm body, you might well end up in the army regardless, and Catton suggested that more than a few doctors (whose job it was to weed people out during the initial exam) were bribed to accept people who had no business being out of the 1860s equivalent of supervised care.

I don't know if any of this was useful, but hope so....just some thoughts on an interesting, heartbreaking topic.
Adam

 

[diane]

There's a lot of speculation about McMillen's motive in attacking Smith. One interesting thought was the battle in which Smith had played a part was embarrassing for McMillen because his sergeant had ended up leading the final assault - for unknown reasons if he did - and had berated him for not being there. Another, from our good pal Shelby Foote, is really simple - Smith was young and handsome! (McMillen was not.) A dandy like that had no business thumping someone with experience and all. And, yet another, says the Ohio officer was drunk - that's a standby, of course. I think he was just totally furious and out of control. Then again - multiple and/or combinations. Smith was related to two well known Confederate scouts, Dee Smith and DeWitt Jobe. Jobe was tortured to death and Dee Smith, hearing of the manner of his cousin's death, decided to 'kill every Yankee who crosses my path'. Which he did. One night he slit the throats of 14 Union soldiers while they slept - he was always a quiet boy! They figure he may have done in as many as 50 before Union troops finally surrounded him and shot him dead. None of which excuses McMillen - but Smith might have been paying for what his kinsmen did as well as anything else in McMillen's mind.

 

[major bill]

We modern folk seem to think that sometime around the 1950s mental illness simply appeared in American and that it did not exist in 1860. This assumption is wrong.

We also want to believe that there was little or no Post Combat Stress at the time of the Civil War. Perhaps in the 1940s human brains rewired and Post Combat Stress appeared.

 

[NH Civil War Gal]

Timely subject - I've been wondering what the role of poor nutrition, especially among Confederate soldiers, as the war went on, on their mental health. AND, I've wondered if the very lean and lank old soldiers, again especially among Confederates, is a hangover of starvation diets during the war. Starvation diets effects during WWII showed up decades down the road among population groups.

 

[chucksr]

Timely subject - I've been wondering what the role of poor nutrition, especially among Confederate soldiers, as the war went on, on their mental health. AND, I've wondered if the very lean and lank old soldiers, again especially among Confederates, is a hangover of starvation diets during the war. Starvation diets effects during WWII showed up decades down the road among population groups.

And yet, the vast majority of these men went back to their communities after the surrender and became productive citizens, rebuilding the nation--exactly what happens with most soldiers that have experienced combat. Which speaks volumes about the ability of the human mind to compartmentalize trauma based on temporary circumstance. There is a admirable toughness in the human mind and heart.