“All Broke Down:” Negotiating the Meaning and Management of Civil War Trauma

By Ashley Elizabeth Bowen-Murphy

B.A., Reed College, 2005 M.A., Georgetown University, 2009 M.A., Brown University, 2013

Dissertation

Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of American Studies at Brown University

PROVIDENCE, RHODE ISLAND May 2017

© Copyright 2017 by Ashley E. Bowen-Murphy

This dissertation by Ashley E. Bowen-Murphy is accepted in its present form by the Department of American Studies as satisfying the dissertation requirement for the degree of Doctor of Philosophy.

Date______Richard A. Meckel, Advisor

Recommended to the Graduate Council

Date______Steven Lubar, Reader

Date______Michael Vorenberg, Reader

Approved by the Graduate Council

Date______Andrew Campbell, Dean of the Graduate School

iii Biographical Statement

Ashley Bowen-Murphy was born in Dallas, Texas on July 14, 1983. She received her

BA in Art History from Reed College in 2005 and was inducted into Phi Beta Kappa. In

2011, she earned her MA in Communication, Culture, & Technology (CCT) from

Georgetown University. She graduated with distinction for her thesis “Old Times There

Are Not Forgotten: Civil War Reenactment and the Creation of Heritage.” Bowen-

Murphy worked in public health and reproductive justice organizations in the

Washington, DC region for several years before entering Brown University. While working toward the Ph.D., she earned an MA in Public Humanities after a practicum at the Smithsonian’s National Postal Museum.

Her dissertation research has been supported by a pre-doctoral fellowship from the

Smithsonian Institution’s National Museum of American History and the Francis Clark

Wood Institute for the History of Medicine at the College of Physicians of Philadelphia.

During her time at Brown, Bowen-Murphy completed several professional development in teaching certificate programs through the Harriet W. Sheridan Center for

Teaching and Learning. From 2014 to 2015 she served as head teaching consultant for the humanities and social sciences for the Sheridan Center. She was appointed a Brown-

Wheaton Faculty Fellow for the 2015-2016 academic year. She participated in the

American Historical Association’s Tuning Committee Assignments Charrette at its annual meeting in 2016.

Her review of the National Museum of Health and Medicine appeared in the

December 2013 issue of the Journal of American History. Bowen-Murphy has presented her work at a number of conferences in the US and abroad, including the annual meetings

iv of the American Studies Association (ASA), the American Historical Association (AHA), and the Organization of American Historians (OAH). In March 2016, The National

Museum of Civil War Medicine hosted her for a lecture based on her dissertation research. She has also written for the general public in outlets including Atlas Obscura,

Book Riot, the Smithsonian Institution’s blogs, and the National Museum of Civil War

Medicine’s blog about Mercy Street.

v Acknowledgments

I could not have asked for a better dissertation committee than Richard Meckel,

Steven Lubar, and Michael Vorenberg. All three set high standards, helped me when I asked for it, and were patient enough to let me struggle when I needed to. I am especially grateful for their guidance on issues beyond the dissertation’s scope. My job search would have been even more stressful without their valuable perspectives. Richard

Meckel, my committee chair, once told me historians cannot use exclamation points.

While acknowledgments are technically outside the dissertation, they are a kind of emotional history. To that end, my last act of rebellion as their advisee will be to say, thank you!

Research for this dissertation was supported by a Smithsonian Institution pre- doctoral fellowship at the National Museum of American History in Washington, DC, where Katherine Ott provided invaluable guidance, insight, and support at a crucial, early phase of this project. I am also indebted to the curators of the military history collections, the Smithsonian’s librarians, and everyone else who ensured that my time in DC was productive. I owe a special debt to Rebecca Sharp at the National Archives and Records

Administration who helped track down existing case files for patients at St. Elizabeths.

The Charles C. Wood Institute for the History of Medicine also provided support for research in Philadelphia at the College of Physicians and Jefferson Medical College archives. I presented an early draft of the chapter on care taking at “Military Masculinity in the Long Nineteenth Century,” a fantastic conference at the University of Hull in the

UK. I am grateful to the organizers and participants for their thoughtful feedback. I also presented early findings at the American Historical Association’s 2016 meeting and am

vi thankful for the warm reception my work found there. The conversations I had at that conference kept me motivated in the midst of the writing process.

Sarah Yahm provided emotional and intellectual support for the duration of this project. Without her willingness to read half-written, semi-planned pages, I have no doubt the project would have taken twice as long and been half as good. Sarah’s sense of the absurd and ability to give exactly the right pep talk at exactly the right moment, not to mention her shared interest in old asylums, are real and wonderful gifts. Other members of my informal, brilliant, and almost wholly online writing group who provided valuable feedback on drafts include Rachel Manwill, Wendy Korwin, Penney Berryman, and

Rosalie Ray. Twitter’s active, thoughtful, and supportive #Twitterstorians regularly came through when I needed help deciphering a nineteenth century physician’s handwriting or when writing goals felt insurmountable.

My family and friends deserve a medal and a stiff drink for putting up with me over the past several years. Graduate school, not to mention the dissertation, has occupied my intellectual and emotional energy for the better part of six years and I am deeply grateful for the support of my parents and the patience of my friends. There are far too many to name here; if you fed me, laughed with me, gave me a pep talk, distracted me, or listened to me prattle on about the intricacies of pension law, rest assured that you are on the list.

Finally, Jonathan Murphy, who never doubted me (or this project) for a moment.

My deepest gratitude has always been for you.

vii Table of Contents

Introduction ...... 1 Chapter One: “A Peculiar Functional Disorder” Naming and Defining Irritable Heart ...... 23 Chapter Two: “With Patience and Due Allowance” Pension Records as Patient Narratives ...... 73 Chapter Three: “Cared for ‘Otherwheres’” Broke Down Soldiers’ Sites of Care ...... 110 Chapter Four: “I Shall Get So Decayed with Laziness” The Ideology of the Broke Down Veteran in Miss Ravenel's Conversion ...... 150 Conclusion ...... 197

Appendix: Pension Records and Court Martial Cases Consulted ...... 204 Bibliography ...... 207

viii List of Figures

Figure 1. Jacob M. DaCosta. Undated, color photoprint. National Library of Medicine, Bethesda, MD. Available from: http://resource.nlm.nih.gov/101412377 (accessed November 5, 2016)...... 24

Figure 2: Marey Sphygmograph, produced by Breguet in Paris, 1866-1900. A piece of smoked paper would go on the right and the needle would trace the heartbeat. National Museum of American History, Smithsonian Institution, Washington, DC. Author’s photograph...... 66

Figure 3: Sphygmograph tracing paper. National Museum of American History, Smithsonian Institution, Washington, DC. Author’s photograph...... 67

Figure 4: Allan McLane Hamilton, “Types of Insanity.” Figure from Allan McLane Hamilton, Types of Insanity, an Illustrated Guide in the Physical Diagnosis of Mental Disease. New York: William Wood & Co., 1883. Page 13...... 68

ix The world will not stop to fathom obscure meanings, but it likes to be instructed, if the instruction come in plain language and with some grace of expression. It is not moved to take an interest through colorless thoughts, or… in topics discussed in tame and bloodless phraseology. Above all, it will not be a patient listener if all you know, however valuable, is flung at you at once. It resents the intrusion and flings it back. Let us always be mindful of Bacon's wise saying, “If you have a handful of truths, open but one finger at a time.”

- Jacob M. Da Costa, The Higher Professional Life, 1883

x Introduction

April 10, 1888 Honorable J. C. Black, Having served the Government on many hard fought fields, I conceive it not altogether improper to ask of you, one of its officials a little information… The information I want is this—is a soldier who has proven his disability incurred in military service, entitled to the same rate of a wounded soldier, it being established by proper proof that the degree of disability to labor is as great or greater? I know that injustice is done me and many other soldiers who have lost their health. I have served faithfully for three years. I can prove that I have done duty without shirking in scores of battle and skirmish fields, and because it was my fortune to escape wounds, losing health instead, it seems that I am to be cut off with about one third of the amount of pension that would be give a man who had received a wound causing a similar degree of disability, even though he might have received that wound the first week of his service. It seems to me that such laws, rulings, or decisions of doctors (I do not know which) are manifestly unjust. Please tell me whether it is the law, the doctors, or the rulings of the Department that is responsible for the existing inequality that I may ‘cuss’ with proper discrimination. Sgt. Frederick L. West Co. D, 154th New York Volunteers1

Sergeant West wrote to the United States Pension Office2 about his specific claim but his letter is representative of the feelings many veterans of the American Civil War had in the years after the conflict. From the outset of his interactions with the Pension

Office, West sought compensation for the general loss of his health beyond a specific set of diagnoses. He consistently demanded that he be compensated for a constellation of

1 Letter from Frederick L. West to Pension Office, April 10, 1888, Soldier’s Certificate No. 988.65, Frederick L. West, Sergeant, Co. D, 154th New York Volunteers. Emphasis in original. 2 The official name of the Pension Office changed several times between 1862 and 1989, when it became part of the Department of Veterans Affairs. Following the style used by the National Archives and Records Administration, I will use the term Pension Office to refer to the government agency that handled the adjudication of pension claims. See Claire Prechtel-Kluskens, “‘A Reasonable Degree of Promptitude’: Civil War Pension Application Processing, 1861–1885,” Prologue Magazine, Spring 2010, http://www.archives.gov/publications/prologue/2010/spring/civilwarpension.html. 1 illnesses and pains that physicians were unable to alleviate. In one of his earliest letters to the Pension Office, dated just three years after the close of the war, Sergeant West wrote that he had, “employed but one physician, since my discharge as neither he, nor the Army

Surgeons who treated me, seemed to do me any permanent good, or gave me any hope that they could, and I have been too poor to throw money away in useless attempts to regain my health.”3 In his interactions with the Pension Office, West and men like him rejected the language of specific diseases or diagnoses in favor of a holistic account of their suffering. They wanted to be compensated for the overall loss of vitality and strength that they traced directly to their service in the Union Army.

This is a dissertation that begins where West’s letter ends. It is about the ways in which veterans and other Americans made sense of what happened to the bodies of soldiers who survived the Civil War paradoxically broken but physically whole. For soldiers, a broken body meant far more than scars. When they complained of feeling

“broken down,” veterans referred to a broad category of bodily experiences that encompassed both physical complaints (e.g. heart palpitations, diarrhea, tremors, weakness, fatigue, and more) and their emotional responses to the ways in which those complaints limited their lives. Unlike their peers who returned from the front missing limbs or peppered with scars, physically whole men still experienced the lingering effects of their service in visceral, personal, and largely invisible ways for decades after the war.

Not every man who served in the Civil War lost his health on the battlefield, but an enormous number did. Nearly one quarter of men who served in the Union Army

3 Letter from F.L. West to the Pension Office, November 12, 1868, Soldier’s Certificate No. 988.65, Frederick L. West, Sergeant, Co. D, 154th New York Volunteers. 2 complained of chronic diarrhea a decade after the war.4 Other men suffered from recurring fevers, consumption (tuberculosis), and the painful, inflamed joints of rheumatism for many years. For veterans who were able to return to their pre-war careers, some found that their bodies deteriorated much more rapidly as they aged than men who had not served.5 The inability to provide for a family and the threat of poverty weighed heavily on their minds. Scholar Simon Parkes explained of the Civil War soldiers’ eighteenth century predecessor that,

The broken soldier—like the poor in general—is seen in terms of his labor, his recognizable value. He is not just a broken man but a broken job title, and being broken he is “not working;” he is “out of order,” “wrecked,” “damaged,” “defeated” and therefore apparently inactive and useless.6

Throughout this description is the uneasy pairing of a man’s physical capacity to work with his emotional resilience after war. Rather than view the bodily experience as distinct from the mental or emotional response to that experience, as many historians and medical professionals have done since the war, I attempt to recover a more unified view of the broken soldier’s body, mind, and culture.

War unmade the soldier’s body in literal and figurative ways.7 New weaponry tore through flesh, camp diseases ravaged nearly everyone at some point, and poor nutrition slowed or prevented the body’s recovery. The soldier’s understanding of his

4 Brian Matthew Jordan, Marching Home: Union Veterans and Their Unending Civil War, First edition (New York: Liveright Publishing Corporation, 2014), 127; Margaret Humphreys, Marrow of Tragedy: The Health Crisis of the American Civil War (Baltimore, MD: Johns Hopkins University Press, 2013), 98, 243– 70; and Paula N. Canavese, “Factors Determining Health Status: An Analysis of Diarrhea in the Union Army, 1861–1920” (PhD diss., The University of Chicago, 2005). 5 See, for example, John William De Forest, letter to Pension Office dated 19 January 1898, Soldier’s Certificate No. 1098.147, John William De Forest, Captain, Co. I, 12th Connecticut Volunteer Infantry and 14th Volunteer Reserve Corps; and Soldier’s Certificate No. 227.705, Joseph Work, Private, Co. I, 12th New Jersey Volunteer Infantry. 6 Simon Parkes, “Wooden Legs and Tales of Sorrow Done: The Literary Broken Soldier of the Late Eighteenth Century,” Journal for Eighteenth-Century Studies 36, no. 2 (June 1, 2013): 194. 7 See Brian Craig Miller, “A Song for the Suffering: The Interminable Civil War,” South Central Review 33, no. 1 (2016): 53. 3 health and bodily integrity also shifted. The cumulative effects of exposure, poor nutrition, sickness, accidents, and injury reshaped men’s expectations of their bodies. As historian William Etter found, “all those who fought in the Civil War experienced, whether directly or as witnesses, the destruction of any conventional understanding of physical normality.”8 Although an enormous number of men lost limbs during the war,

60,000 by most estimates, a much greater number of men returned from the Civil War with bodies that looked normal, or at least whole and minimally scarred, but were nevertheless broken. For the veterans suffering from any number of other physical complaints, the normal body became a somewhat meaningless designation. In their letters and applications for pensions, veterans suffering from chronic and general complaints abandoned any sense of the normal body and instead embraced the idiosyncratic experiences of their bodies.

On a figurative level, bodies broken by war challenged deep cultural assumptions about masculinity, family structure, and the value of work. The presence of crippled and ill men in public life, coupled with advances in medicine and an expanding bureaucratic state, created a moment when the meaning of the white, male, infirm body was in flux.

The social framing of ill or disabled bodies has never been neutral. This is particularly true of ill and disabled soldiers because the disabled soldier’s body is simultaneously an object of pity and a symbol of great national sacrifice. At the close of the Civil War, this dual role became particularly charged as families, communities, and the nation were forced to confront the number of broken soldiers returning home.9 Americans negotiated

8 William Etter, “Cripple, Soldier, Crippled Soldier: Alfred Bellard’s Civil War Memoir,” Prose Studies 27, no. 1–2 (April 2005): 82. 9 Following Charles Rosenberg, I use the language of framing rather than constructing. This language better accounts for the ways that biology shapes the meanings available to a particular disease or condition. For 4 the new meaning of the sick, white soldier in medicine, government, their own families, and in popular culture. The specifics of this negotiation differed in each sphere, but all of them were concerned with containing or neutralizing the problems created by men who could no longer work—the role from which all other social positions in family, community, and culture grew. Anxieties about the dependent veteran animated many of these debates while, at the same time, the veteran who could no longer physically work represented a noble sacrifice on behalf of the nation.

The framing of a soldier’s body was made all the more complex by his dual relationship to the state; he was both its dependent and its savior. During war, a soldier gave up control over his life in ways that would have been anathema to a civilian during peacetime. In exchange for submitting to the military’s demands, he expected that it would provide for his basic needs during the war.10 The relationship between a soldier’s body and his nation did not end at the conclusion of the war. Though no longer in use by the state, a soldier’s maimed or wearied body proved useful as a marker of national superiority and patriotic sacrifice. To that end, soldiers’ bodies remained public property long after their discharge from the service. The state and the veteran’s fellow citizens had an interest in his body. In a literal way, through pensions and other benefits, citizens paid for the impact of war on a body so it was in their best financial interest to be sure that

more on the language of framing and constructing, see Charles E. Rosenberg, “Framing Disease: Illness, Society, and History [Introduction],” in Framing Disease: Studies in Cultural History, ed. Charles E. Rosenberg and Janet Lynne Golden, Health and Medicine in American Society (New Brunswick, NJ: Rutgers University Press, 1992), xv. For more on the cultural construction of bodies, see Edward Hall, “‘Blood, Brain and Bones’: Taking the Body Seriously in the Geography of Health and Impairment,” Area 32, no. 1 (March 1, 2000): 21–29. 10 Margaret Geneva Long, Doctoring Freedom: The Politics of African American Medical Care in Slavery and Emancipation (Chapel Hill, NC: University of North Carolina Press, 2012), 71; James M. McPherson, For Cause and Comrades: Why Men Fought in the Civil War (New York: Oxford University Press, 1999), 47–48. 5 veterans recover their health—or, at least, that veterans did not receive more support than they required. For civilians, the veteran’s body became a fascinating record of war’s reality. The broken body begs questions—about war’s costs, effects, and purpose—subtly asking, “was it worth it?”11 Veterans of the Civil War expressed this sense of being simultaneously a private person and public body shortly after the end of the war. In the

1869 novel John Smith’s Funny Adventures on a Crutch by Alonzo Hill, the narrator complains that a soldier who has returned from the front “is looked upon as public property, and is almost bored to death with questions, by the many curious strangers he meets… I can never have a moment’s rest in any public place.”12 This dual sense of self, public body and private person, weighed heavily on some men. John Smith claims that, “I would be far happier if I were still a mark for the bullets at Malvern Hill, Bull Run, or

Antietam! This accursed quizzical disposition on the part of the public has made me feel, at times, that life was actually a burden to me!”13

Rather than demand that Civil War veterans answer another set of questions from a curious spectator, I have tried to allow their personal stories and vocabulary to shape this project. At the center of this dissertation are the individual experiences of soldiers and their families. This approach requires accepting the ambiguity, messiness, and uncertainty that characterize personal encounters with professional medicine and bureaucracy—in the nineteenth century and today. I took Civil War veterans at their word and did not try to fit their experiences into the limited diagnostic labels available to them,

11 On the language of cost and worth in relationship to health, see Elaine. Scarry, The Body in Pain: The Making and Unmaking of the World (New York: Oxford University Press, 1987), 75–77. 12 Alonzo Hill, John Smith’s Funny Adventures on a Crutch, or The Remarkable Peregrinations of a One- Legged Soldier after the War (Philadelphia: J. E. Potter and Company, 1869), 48. 13 Ibid., 52–53. 6 nor did I narrow their lives into the data points required for a pension application.

Instead, I focused on the moments where veterans did not conform to the standard understanding of post-war health, work, or family. Tension between medical thought, federal policy, family expectations, and cultural roles is most explicit in the moments when men do not easily meet the expectations of any authority. Documents from men treated by prominent physicians, veterans who fought for decades to have their illnesses recognized, or the soldiers who never quite qualified for pension benefits reveal how human, imperfect, and ambiguous the systems were that determined the care and support available to veterans and their families. In their applications, testimony, and letters to the

Pension Office, these men complicated, and sometimes contradicted, a simple narrative of progress in veterans’ benefits. They insisted on exceptions to every rule and appealed to justice over technical qualification.

Leaving behind the neat categories of experience promised by medicine and law was difficult. When I began this project, I expected to write exclusively about Dr. Jacob

Mendes Da Costa and his work identifying and diagnosing an ailment known as irritable heart. As I read soldiers’ pension records and Da Costa’s published writings, however, it became clear that individual soldiers’ lives almost never fully aligned with a story of medical progress or benevolent government programs. Men mentioned being “broke down” or “used up” by the war—expressions that manage to simultaneously encompass everything and refer to nothing—at least as often as they complained of heart trouble, piles, or rheumatism. Rather than assume that these soldiers simply did not know the correct language for their conditions, an assumption that may be technically true but is more than a little condescending, I chose to trust what these men said about their

7 experiences. They wanted to express something beyond or in addition to the clinical, physiological reality on which their physicians and pension evaluators so narrowly focused. This is not to suggest that the Pension System was malicious. It developed in fits and starts in the aftermath of the largest public health and social welfare crisis the United

States had ever seen. That Pension Office workers made any attempt to listen to veterans and review their claims based on new information was commendable. However, the system had real limitations and demanded that individual soldiers and their wives and children advocate on behalf of the broken down veteran.

My decision to favor veterans and their families’ own perspectives on their lives is an explicitly political one. Choosing to trust patients and their experiences in the face of contradictory, preliminary, or imperfect expert opinions is a radical and potentially transformative act. As scholars and citizens, we should trust that people are experts in their own lives and know their own bodies. This trust should apply doubly to the men

(and now women) whom we ask to go to war on our behalf. This is neither a plea for an anti-intellectual, anti-expert approach to medical history that is common among certain advocacy groups on both the far right and far left nor is it a case for uncritically praising anyone who serves their country. Rather, I strive to balance the findings of experts against the testimony of people who live those findings daily. Not only does this approach foreground the consequences of a medical treatment or social policy, it reminds us that what is at stake in these debates is more than the advancement of science, a balanced federal budget, or entertainment. Real families suffered or thrived because of these policies. Men regained their health or remained ill because of the medical treatment made available to them. Veterans either found their place in the post-war community or

8 were marginalized because of their representation in popular culture. The tension between these two registers—expertise and experience—ultimately points to a question that should be at the core of medical history: what does it mean to be sick under a particular set of circumstances?

To answer that question as it relates to the broken veteran after the American

Civil War, I draw on three related approaches: medical history, social history, and cultural studies, especially trauma studies and disability studies. In her excellent book on suffering in the Union Army and on the home front, Frances Clarke argues that, “pain, and by extension suffering, has never been simply a bodily phenomenon. Suffering exists at once in the body and the mind.”14 I agree with Clarke’s assessment and would add that suffering exists in relation to culture. Scholars and theorists working in cultural studies, particularly in the fields of trauma studies and disability studies, have identified the ways that bodies are framed as both social and medical subjects. Initially, researchers and activists positioned the medical model of disability, in which disability is a pathological problem for an individual, in opposition to the social model of disability, in which society creates systems and standards that exclude or harm the disabled.15 Although this binary was useful for initial theories of disability, and the activism it inspired improved the lives of many disabled people, it reinforced the idea that the body was passive or something outside of the self. In his critique of this polarity, Edward Hall argued for the development of “an embodied understanding of the body and impairment, which sees the

14 Frances M. Clarke, War Stories: Suffering and Sacrifice in the Civil War North (Chicago: University of Chicago Press, 2011), 8. 15 The classic text on the social model of disability is Michael Oliver, The Politics of Disablement: A Sociological Approach (New York: St. Martin’s Press, 1990). See also Hall, “‘Blood, Brain and Bones,’” 24. 9 body as social and society as bodily.”16 In other words, researchers working on disability should view the body as neither wholly physical nor wholly social. Social context defines the experience of biological processes even as the body restricts how someone engages with that social context.17 After the Civil War, this approach to the body happened almost naturally—if not exactly easily. In their work on the pension system, historians Larry

Logue and Peter Blanck found that Civil War pensions, “in general, fit somewhere between the medical and social paradigms of disability.”18 A pension is an acknowledgement that society has an obligation to reduce the “obstacles to a dignified life” for the men who fight its wars while also accepting the view that disability is tied to the body and needs medical management. Many modern scholars working in disability studies agree that the binary between the medical and social models of disability is outdated.19 The men and women who make up the bulk of my project study understood themselves as broken by war. Their bodies were a problem that needed real, direct management. Veterans also understood that policy and culture created conditions that disadvantaged them in relation to their peers.

Trauma studies—a subfield in cultural studies that brings together clinical researchers, social scientists, and humanities scholars—has provided essential theoretical and methodological insights into studies of war and soldiering.20 The productive, if sometimes uneasy, mix of medical research and the humanities underscores the extent to

16 Hall, “‘Blood, Brain and Bones,’” 24. 17 Ibid., 26. 18 Larry M. Logue and Peter David Blanck, Race, Ethnicity, and Disability: Veterans and Benefits in Post- Civil War America, Disability, Law and Policy Series (New York: Cambridge University Press, 2010), 18. 19 For an excellent and brief review of recent work on the medical versus social model of disability, see Janet E. Price, “Engaging Disability,” Feminist Theory 8, no. 1 (April 1, 2007): 77–89. 20 My arguments in this paragraph about the development of trauma as a category in various fields come from Ruth Leys, Trauma: A Genealogy (Chicago: University of Chicago Press, 2010). 10 which the soldier’s emotional and physical response to battle remains unexplained and unexplainable. From Sigmund Freud’s initial research into trauma through today’s neurobiological approach to traumatic memory, researchers have struggled to reconcile the relationship between mind, body, and experience that creates pathological trauma.21

In 1997, Eric Dean’s foundational book Shook Over Hell: Post-Traumatic Stress,

Vietnam, and the Civil War applied these new insights to the Civil War era. In his book,

Dean outlined a basic chronology of how physicians and soldiers understood battle trauma from “nostalgia” and “sunstroke” to the late twentieth century concept of post- traumatic stress disorder (PTSD). Dean’s work provides a powerful, historically grounded rebuttal to accounts of Civil War soldiering that emphasize the heroic or sublime. Although Dean’s work comes dangerously close to retrospective diagnosis,

Shook Over Hell ushered in an enormous number of studies that looked to contemporary psychological diagnoses and conversion disorders for new ways to interpret the records that soldiers left behind about their bodies and minds.

The availability of PTSD as a legitimate medical diagnosis shapes, both implicitly and explicitly, much of the current writing about how soldiers from all eras process their time in war. So much of this work was written in the wake of the Vietnam War and

PTSD’s inclusion in the Diagnostic and Statistical Manual (DSM) in 1980 that it sometimes ignores the ways in which PTSD is in itself a culturally contingent diagnosis.

PTSD gained legitimacy as a result of a campaign by psychologists, media, and

21 For more see Ibid., 23; Edgar Jones and Simon Wessely, “A Paradigm Shift in the Conceptualization of Psychological Trauma in the 20th Century,” Journal of Anxiety Disorders, Challenges to the PTSD Construct and its Database, 21, no. 2 (2007): 164–75; Bailey A. Wentworth et al., “Post-Traumatic Stress Disorder: A Fast Track to Premature Cardiovascular Disease?,” Cardiology in Review 21, no. 1 (2013): 16– 22. 11 politicians responding to the outcome of the Vietnam War.22 Sociologist Jerry Lembcke forcefully argued that PTSD is “as much a cultural and political category as a mental health category and that the content of PTSD—alienation, survivor guilt, and flashbacks—were derived from [late twentieth century] popular culture.”23 When historians like Eric Dean use PTSD as a lens through which to examine the experiences of Civil War soldiers, they accept a static experience of post-combat trauma over time.

Psychiatrist Jonathan Shay’s groundbreaking work in both Achilles in Vietnam: Combat

Trauma and the Undoing of Character and Odysseus in America: Combat Trauma and the Trials of Homecoming presented the veteran as a figure with common experiences, concerns, and responses dating back to the Peloponnesian War.24 Shay, Dean, and many other trauma studies scholars provided a needed and important corrective to the tendency of much popular history to focus on the soldier as a one-dimensional patriot. Their work assured modern veterans that they were “not alone across time.”25 The potential therapeutic value of this view should not be ignored but, for historians, focusing on traumatic experience across time may have over-corrected for popular history’s focus on the Civil War soldier’s heroism. Focusing too narrowly on the similarities across centuries has produced an ahistorical view of trauma that is informed more by well- meaning sympathy for the suffering soldier than an understanding of the ways in which he experienced his suffering in unique, culturally defined ways.

22 Jerry Lembcke, “The ‘Right Stuff’ Gone Wrong: Vietnam Veterans and the Social Construction of Post- Traumatic Stress Disorder,” Critical Sociology 24, no. 1/2 (June 1998): 37–64. 23 Ibid., 38. 24 Jonathan Shay, Achilles in Vietnam: Combat Trauma and the Undoing of Character (New York: Scribner, 1994); Jonathan Shay, Odysseus in America: Combat Trauma and the Trials of Homecoming (New York: Scribner, 2002). 25 I am borrowing the motto of Outside the Wire, a theater company that uses the Greek classics in outreach to veterans. Outside the Wire and Jonathan Shay’s work are discussed in Wyatt Mason, “You Are Not Alone Across Time: Using Sophocles to Treat PTSD,” Harper’s Magazine, October 2014. 12 In the late 1990s, historian Edward Ayers urged his colleagues to embrace a more complex, ambiguous, and reflective history of the Civil War.26 Ayers’ challenge to the profession, coupled with Dean’s work in Shook Over Hell, ushered in an era of so-called

“dark history” and “new revisionism.” Leading scholars began to focus on the Civil

War’s moral and ethical ambiguities, soldiers’ pain, multiple narratives of the war’s meaning, and individual suffering. Prior to this shift, studies of soldiers’ pain, sickness, or injury tended to be the exclusive reserve of medical historians.27 These researchers, often physicians themselves, focused on advances in surgical techniques, sanitation or public health initiatives, quantitative studies of the war’s impact, and the work of high-profile physicians like S. Weir Mitchell or John H. Brinton.28 Although the pain and suffering of soldiers is present in these early studies, it is often refracted through the observations of physicians who kept memoirs or mentioned pain as a way to justify the study of medical history in general. Suffering as a defining personal experience rarely rose to the level of analysis.

Like the nineteenth century doctors Louisa May Alcott chided, early Civil War medical historians sometimes regarded, “a man and his wound as separate institutions, and seemed rather annoyed that the former should express any opinion on the latter, or claim any right in it, while under [their] care.”29 In recent years, social historians have

26 Ed Ayers, “Worrying about the Civil War,” in Moral Problems in American Life: New Perspectives on Cultural History, ed. Karen Halttunen and Lewis Perry (Ithaca, NY: Cornell University Press, 1998), 145– 66; For an excellent discussion of the legacy of Ayers' call for a new revisionism, see Yael A. Sternhell, “Revisionism Reinvented?: The Antiwar Turn in Civil War Scholarship,” The Journal of the Civil War Era 3, no. 2 (May 7, 2013): 239–56. 27 For an overview of the historiography of suffering in the Civil War, see Brian Craig Miller, “A Song for the Suffering: The Interminable Civil War,” South Central Review 33, no. 1 (2016): 54. 28 Examples of this early approach to Civil War medical history is George Washington Adams, Doctors in Blue; the Medical History of the Union Army in the Civil War (New York: H. Schuman, 1952); Richard H. Shryock, “A Medical Perspective on the Civil War,” American Quarterly 14, no. 2 (July 1, 1962): 161–73. 29 Louisa May Alcott, Hospital Sketches and Camp and Fireside Stories (Boston: Roberts Brothers, 1869), 91. 13 turned their attention to the dynamic connections between physical suffering, policy, and culture. Their work has illuminated the meaning of a soldier’s suffering in the decades after the war. Research into mourning practices, the emotional responses to Lincoln’s assassination, and the impact that the war’s destruction had on American life have added important nuance to scholarly conversations about death and suffering in the Civil War.30

Of course, the boundaries between social history, medical history, and cultural studies are blurry at best. Starting with Roy Porter’s 1985 plea to produce a “sufferer’s history—medical history from below,” the line between medical history, social history, and cultural studies has been shifting.31 It is no longer enough to trace the development of medical technology over time with no regard for the policies and practices that shape research. Likewise, cultural theory that lacks grounding in the material reality of a disabled person’s life avoids acknowledging how that theory is practiced. As the “dark history” of the Civil War matures in its approach, a methodology that combines the strengths of medical history, social history, and cultural studies is capable of illuminating parts of the past obscured by too narrow a focus on either expertise or policy. This interdisciplinary approach gets at the ways a soldier’s broken, sick, or deteriorating body is both a medical subject, a private experience, and a social construct.

This project focuses narrowly on the experiences of white Union veterans because their conflict with the state is both smaller and subtler. Although African American soldiers certainly did break down under the hardship of their service, a broken black man

30 Respectively Drew Gilpin Faust, This Republic of Suffering: Death and the American Civil War, (New York: Alfred A. Knopf, 2008); Martha Hodes, Mourning Lincoln (New Haven, CT: Yale University Press, 2015); Megan Kate Nelson, Ruin Nation: Destruction and the American Civil War, Uncivil Wars (Athens, GA: University of Georgia Press, 2012). 31 Roy Porter, “The Patient’s View: Doing Medical History from below,” Theory and Society 14, no. 2 (March 1, 1985): 182. 14 and a broken white man would have been interpreted differently by physicians, popular culture, and Pension Office clerks. As Jim Downs’ work in Sick From Freedom emphasized, black bodies were viewed as distinctly different from white bodies. Downs wrote that “some Union doctors refused to touch sick black people… Many physicians also had no experience treating African American patients.”32 In her book Intensely

Human: The Health of the Black Soldier in the American Civil War, Margaret

Humphreys explained the ways in which white physicians used black soldiers to

“explore, exploit, and explain black bodies” in the name of science.33 Outside their interactions with physicians, black soldiers experienced the hardships of war differently from their white counterparts. For a variety of reasons, all of them rooted in racist policies and beliefs, black soldiers were far more likely to die of disease during the war.34

After the Civil War, contradictory assumptions about the inherent inferiority of black bodies and their supposedly higher pain tolerance profoundly shaped how African

American veterans claimed their humanity, citizenship, and status as an honored (or even recognized) veteran. Logue and Blanck explained that, if they survived the war and applied for a pension, African American soldiers faced additional levels of scrutiny, both formal and informal, because of their race. Pension officials thought that African

32 Jim Downs, Sick from Freedom: African-American Illness and Suffering during the Civil War and Reconstruction (New York: Oxford University Press, 2012), 35. 33 Margaret Humphreys, Intensely Human: The Health of the Black Soldier in the American Civil War (Baltimore, MD: Johns Hopkins University Press, 2008), xi. 34 A number of historians and demographers have studied the health disparities between white and black soldiers in the Civil War. In addition to Humphreys’ Intensely Human, see also Margaret Geneva Long, Doctoring Freedom: The Politics of African American Medical Care in Slavery and Emancipation (Chapel Hill, NC: University of North Carolina Press, 2012), 70–89; Jim Downs, Sick from Freedom: African- American Illness and Suffering during the Civil War and Reconstruction (New York: Oxford University Press, 2012). For an example of disease specific studies of health disparities, see Douglas J. Lanska, “Vitamin A-Deficiency Eye Disease Among Soldiers in the U.S. Civil War: Spectrum of Clinical Disease,” Military Medicine 180, no. 7 (July 2015): 774–79. 15 American veterans were “at once devious… and naïve.”35 The bias of government officials cannot be overstated. However, a number of additional factors, especially literacy and economic deprivation before and after the war, limited African American soldiers’ ability to secure a pension. Logue and Blanck found differences in these factors between freedmen who entered the service and enslaved men who served in the Union

Army. They argued that lumping all African American soldiers together obscures the ways that status prior to the war was an important indicator of a man’s health, wellbeing, and likelihood of securing a pension after the war.36

I recognize that focusing on white veterans is limiting at best and, at worst, risks reinforcing the “otherness” of African American soldiers that defined nineteenth century approaches to white and black veterans. White veterans’ high status was a given, their failure to conform to social expectations an aberration that needed to be fixed or managed. In contrast, African American soldiers’ place in the nation was new, tenuous, and conditional. The white veteran’s challenge to the state is at once smaller and more revealing. He did not ask the nation to question core assumptions about who should be a citizen, but he did question how far from the norm someone could deviate before finding himself outside the state’s protection. I believe that before undertaking a comparative study of black and white broken soldiers, it is important to establish that the category of brokenness not only applied to white men but accommodated their physical, social, and economic failures in ways unavailable, perhaps even unfathomable, when used in relation to African American troops. Because physicians assumed that the black body was

35 Larry M. Logue and Peter Blanck, “‘Benefit of the Doubt’: African-American Civil War Veterans and Pensions,” The Journal of Interdisciplinary History 38, no. 3 (2008): 377. 36 Ibid., 386. 16 uniquely prone to disease, disability, and laziness, it is essential to enumerate the boundaries for the white veteran’s body, imagined as the medical norm, without recourse to the imagined, frail black body. It is my hope that future researchers will pick up where this project ends and begin a sustained, comparative study of what it meant to be broken as a black soldier in relation to social expectations of invalid white veterans.

All Broke Down: Structure and Overview

This project moves outward from the broken soldier’s encounter with medical authorities, through his negotiations with the Pension Office’s bureaucratic processes, into the family, and finally out into popular culture. Physicians, Pension Office clerks, families, and authors had different stakes in the management of soldiers who returned from the Civil War physically and emotionally worn out by their service. Although these sites were never entirely distinct, each managed the broken soldier’s body and attempted to contain or limit his disruptive potential in unique ways. By focusing on each site where the meaning of a soldier’s broken body was negotiated, this project foregrounds the ways in which the bodies of broke down veterans resisted efforts to move on from the suffering caused by the war.

I begin by examining how elite surgeons working in Union Army hospitals and their patients struggled to find a common vocabulary for soldiers’ suffering. Drawing on published medical writing, pension records, court martial records, and soldiers’ letters, this chapter analyzes how two different registers of understanding a soldier’s suffering were mobilized in the clinical encounter. Chapter one evaluates how one elite physician,

17 Jacob Mendes Da Costa, 37 studied, defined, and named a new cardiac condition in soldiers: irritable heart. At the same time Da Costa and his colleagues in Philadelphia pressed toward ever more specific diagnostic language, soldiers and their families held onto the more general, evocative language of break down. This language comfortably contained all of a soldier’s physical complaints and his mental or emotional distress.

Rather than focus on the specific disorder or set of symptoms, this language offered a holistic view of a man whose body and mind suffered during the war. Although medical discourse held, and still holds, tremendous power to grant legitimacy to physical complaints, it never replaced the concept of break down. At best, medical language added legitimacy to a broken soldier’s symptoms in circumstances when his suffering needed to be quantified or confirmed.

Chapter two leaves the hospital and turns to the United States Pension Office’s evaluation of broken men. The pension record, which historians have typically used for quantitative data, is at the heart of this chapter. I read veterans’ pension records, which included far more than medical and service information, as patient narratives to highlight the ways in which veterans both employed the language of specific diseases and insisted on the totality of their illness experience. Some men spent years fighting for recognition for their illnesses and pain. Along the way, they produced rich documentation of what it meant to insist on the reality of your own physical experience in the face of bureaucratic rationality. Unlike men who lost a limb during the war or who could point to a scar or bullet wound, broken soldiers needed to make their case to the Pension Office in terms

37 There are a few variations on the spelling of his name. I have used Jacob Mendes Da Costa since that is how he spelled it in his published work. Some authors, both in the nineteenth century and today, spell his name as Jacob Mendez Da Costa or Jacob DaCosta. 18 that honored their experience but also conformed to the Office’s expectations about sickness, injury, and personal worth. Although the Pension Office tried to standardize the process of applying for a pension and evaluating the claim, individual veterans’ lives never conformed to these categories and forms. The discretion afforded to pension officers evaluating a broken soldier’s claim only contributed to the sense that the contours of an individual life, not the standardized process, determined someone’s chances of obtaining a pension for an invisible wound or chronic condition.

Chapter three focuses on the day-to-day management of a soldier’s broken body.

The Pension Office provided financial support for Civil War veterans too sick or disabled to work, but women provided the labor. Military leaders and policy makers always wanted men cared for at home. Not only did they believe in the value of home-based care for improving a man’s health, they did not want to take on the added expense and responsibility of providing direct services to veterans. Veterans’ wives, mothers, sisters, and other female kin therefore had to care for the soldier’s body. This chapter focuses on three families—the Bedors, Fifes, and Dousts—to make visible the invisible caretaking work of women caring for kin. In different ways, all three families failed to thrive after the war took the health of their veteran. In addition to providing direct care, the women in this chapter negotiated their husbands’ care in various custodial institutions, served as their husbands’ legal guardians, and interacted directly with the Pension Office and other government agencies. In so doing, women who cared for veterans challenged gender roles inside and outside the home and put pressure on a system that did not acknowledge their work as labor.

19 American popular culture struggled to reconcile the myth of the citizen soldier, made physically stronger and more emotionally resilient from his service, with the reality of men who came home ill, disabled, or dependent on the women in their lives. In chapter four, I offer an extended analysis of Miss Ravenel’s Conversion from Secession to

Loyalty, a novel by veteran John William De Forest, to evaluate how popular fiction managed the ill veteran. De Forest blended, with mixed results, detailed descriptions of battle and field hospitals with the story of a courtship and marriage between a northern soldier and southern woman. Originally published in 1867, De Forest’s novel presents a happy outlook for the returned veteran. The stoic veteran who learned to accept life’s challenges in the hardship of service will be more than ready to start a family, compete in the post-war economy, and lead the nation toward a virtuous future. However, by the time De Forest revised the novel in the mid-1880s, his outlook had dimmed considerably.

With his own health failing and his writing no longer able to provide a living, De Forest revised Miss Ravenel’s Conversion and excised the sections about the veteran’s hopeful future. The author’s shifting attitude to soldiers’ bodies and lives underscores the complicated place of the veteran in postwar American culture.

Finally, I use the conclusion to explore the ways in which both irritable heart and the broken Civil War soldier have become convenient points of origin for histories of

PTSD and suggest that, although this is a compelling narrative of progress, it flattens important distinctions in medical and social thought. In so doing, I add to the growing chorus of scholars working in a variety of fields for a sustained program of “veterans’ studies” in history and related fields.

20 I view this dissertation as not only about the past but also about how history has been used and co-opted in the present. If medical practitioners or patients mine the past to spark insight into today’s medical problems, I applaud them. However, I join Roger

Cooter in feeling ambivalent about the desire to map nineteenth century disease categories and personal understandings of the self onto modern categories. He wrote in

The Lancet that retrospective diagnoses “are always inherently condescending—we know what the guys in the past did not, and since we have the biological ‘truth’ of the disease, we can only laugh or cry at their ignorance.”38 I worry that a rush to embrace “the dark turn” in Civil War history has blinded us to the ways in which PTSD, trauma, and even physical complaints are historically contingent. The broken soldier of 1870 certainly shares some traits with his 2016 counterpart but that does not mean that diagnoses available to soldiers today are in any way useful when applied retroactively. The Civil

War solider understood the self, family, and nation in radically different ways than a soldier today. Rather than try to find equivalencies between the past and the present by forcing a contemporary category of understanding onto historical circumstances, we should accept the nineteenth century soldiers’ perspective on the self, body, family, and nation.

I do not want to suggest that the men and women who find comfort in the term

“soldier’s heart” or believe that generations of soldiers before them also suffered from

PTSD are wrong. The feeling that “you are not alone across time” is powerful and probably motivates just as many historians as it does veteran activists. Historian

Katherine Foxhall reminds us that we should be attuned to the ways in which

38 Roger Cooter, “The Life of a Disease?,” The Lancet 375, no. 9709 (January 15, 2010): 111. 21 retrospective diagnosis encourages people to recognize “something of their own experiences in historical traces.”39 However, as professional historians we have both an obligation and the skills needed to add nuance to any discussion that presumes to assert the validity of contemporary diagnostic categories when applied to the past. Instead, researchers should consider why labeling Union soldiers as traumatized holds such a powerful appeal to today’s veterans, historians, and activists. Who benefits from this practice? What does it suggest about how we view veterans of all American wars?

Foxhall urged historians to “examine the historical contexts that give rise to retrospective diagnoses, and to be aware that meanings or kinds of evidence may be silenced in the process.”40 She reminds us that the urge to retrospectively diagnose tells us as much about the present as it does the past. By focusing so narrowly on the twentieth-century concept of trauma, today’s historians have ignored the unique ways that soldiers’ bodies were altered by war in the nineteenth century.

In other words, this is a project that attempts to make clear the ways that medicine, government, families, and popular culture managed the “broken” veteran’s body while highlighting the ways that individual veterans responded to these efforts.

Their struggle to negotiate the meaning and value of their bodies, broken by war and sometimes scorned by post-war American culture, forced the nation to reckon with the very nature of post-war social organization from the personal to the national level.

39 Katherine Foxhall, “Making Modern Migraine Medieval: Men of Science, Hildegard of Bingen and the Life of a Retrospective Diagnosis,” Medical History 58, no. 3 (July 2014): 373. 40 Ibid., 374. 22 Chapter One A Peculiar Functional Disorder: Naming and Defining Irritable Heart

Dr. Jacob Mendes Da Costa (Fig. 1) examined Private Joseph Work for the first time at Satterlee General Hospital in west Philadelphia in July 1863.1 Just before the

Battle of Gettysburg, Work's heart had given out. He experienced pain in his chest, exhaustion, and serious heart palpitations—all symptoms of a newly identified disorder.

Da Costa named this new “peculiar functional disorder of the heart” irritable heart.2

Unlike organic diseases, functional disorders refer to those diseases that do not correspond directly to a lesion or other malformation of physiology. Da Costa's encounters with soldiers like Work provided him with the clinical material to distinguish irritable heart from related cardiac disorders and the more general status of soldiers who

"broke down" under the strain of Army life. Soldiers’ encounters with Da Costa offered them a legitimate medical explanation for the overwhelming physical and emotional toll that war took on their bodies and minds. Soldiers who broke down without a diagnostic label were explicitly or implicitly accused of cowardice, suspected of shirking their duties, or allowed to slowly succumb to their poor mental and physical health. Together, physicians like Da Costa and patients like Private Work co-created a new diagnostic category that drew on advances in scientific medicine and patient experience.

1 Surgeon General’s Report, 20 November 1882, Soldier’s Certificate No. 227.705, Joseph Work, Private, Co. I, 12th New Jersey Volunteer Infantry. 2 Jacob M. Da Costa, “On Irritable Heart: A Clinical Study of a Form of Functional Cardiac Disorder and Its Consequences,” The American Journal of the Medical Sciences 61, no. 121 (January 1871): 17–52. 23

Figure 1. Jacob M. Da Costa. Undated, color photoprint. National Library of Medicine, Bethesda, MD. Available from: http://resource.nlm.nih.gov/101412377 (accessed November 5, 2016). Da Costa discharged Work after a few months of treatment with rest, digitalis, and gentle exercise. Judged healthy enough to leave the hospital but not strong enough to return to the field, Work was transferred by the Army to the Veteran Reserve Corp. The two men met at least twice more before Da Costa presented his authoritative study of the condition, once in June 1864 and again in November 1870. Da Costa's 1871 article “On

Irritable Heart,” the lengthiest study of the condition he ever produced, includes a detailed statement on the excellent post-war health of Private Work. According to Da

Costa,

Just as this paper was going into the hands of the printer, a tall, broad-chested, fine-looking young man came into my office, in whom at first I did not recognize the puny soldier of 1864. He told me that he served his term out, of about one year, in the Veteran Reserve, first at Washington, and then for seven months in the interior of Ohio. Here he was on detached service... was mounted, lived very constantly in the open air, and did sometimes hard riding... Neither this nor any other service brought back the cardiac disorder. In fact he was never off duty, and

24 neither pain nor shortness of breath, and only twice an attack of palpitation, happening after a 'bilious spell...' Never has anything now that reminds him of his former trouble. Can go up and down stairs rapidly, or run, without being soon out of breath; weighs 127 pounds; still takes cold occasionally. The pulse is about 78; the impulse of the heart of good strength, not in least jerky...3

Da Costa's cheery summary of Work's health and recovery, including a statement that he could have enlisted for active service once again, was not mirrored in Work's own assertions about his health. In 1880, a decade after he and Da Costa met for the last time,

Work applied for and received a pension on the grounds of his cardiac condition. His application, coupled with supporting affidavits from coworkers and neighbors, explained that Work never managed a full day's labor after the war. A neighbor told the Pension

Office in 1881 that Work spent “a great deal on medicine” and used “some kind of inhaling apparatus which helps him a bit.”4 According to Work’s application, supported by the testimony of others, even the slightest exertion left him prostrate and in pain. For the next thirty-five years, Joseph Work received payment for his wartime injuries but the chest pain and difficulty breathing never fully left him.

Given the distinct perspectives each man had on irritable heart, and the various purposes attached to recounting the course of a newly discovered disease in a medical journal or pension application, it is perhaps unsurprising that their interpretations of

Work's progress differed so substantially. However, the extent to which their accounts radically differed also points to the ways in which illnesses contracted during the Civil

War lingered on in the lives on men. Work retained a general, all-encompassing understanding of his condition despite knowing that treatment by Dr. Da Costa meant that

3 Ibid., 28–29. 4 Edward Wisner affidavit, June 23, 1881, Soldier’s Certificate No. 227.705, Joseph Work, Private, Co. I, 12th New Jersey Volunteer Infantry. 25 his condition was both serious and unique. Da Costa eschewed these personal, idiosyncratic descriptions of poor health in favor of a specific diagnosis with a clear course and the promise of improvement or cure.

Breakdown

Advances in knowledge and new priorities pushed nineteenth century physicians toward more specific diagnostic labels like irritable heart. Individual soldiers and their families, in contrast, used general but evocative phrases to describe their illnesses. The blurry distinction between a soldier who was “all broke down” and one diagnosed with irritable heart illustrates the tension between patients’ perspectives on their symptoms and the medical establishment’s need to name, define, and establish the boundaries of specific disease categories. Da Costa’s identification of irritable heart as a specific disease meant more to the medical profession than it did to individual patients. His landmark 1871 paper “On Irritable Heart” improved his professional standing and represented a new era in American medical research.5 As valuable as his insights were, irritable heart did not replace the more general language of “break down” among soldiers who lost their health during the war.6 Describing soldiers as “broken” pre-dates the

American Civil War by nearly two hundred years.7 For men applying for pensions or explaining the full impact of the war on their health, feeling “broken down” retained its descriptive power long after Da Costa and his fellow physicians introduced new

5 For more on the Civil War’s role in buttressing American medical research, see Shauna Devine, Learning from the Wounded: The Civil War and the Rise of American Medical Science, Civil War America (Chapel Hill, NC: University of North Carolina Press, 2014). 6 Eric Dean acknowledges this language in his study of Civil War veterans but folds it into the diagnostic category of a stress disorder rather than examining it as its own category of understanding. See Eric T Dean, Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War (Harvard University Press, 1997), 113. 7 Parkes, “Wooden Legs and Tales of Sorrow Done,” 193. 26 diagnostic labels. The usefulness of this term is linked to its ability to describe not only the soldier’s body but to implicitly refer to his place in the labor market. The broken man was not working; he was economically useless in addition to the ways in which his body failed him personally.8

Born in Philadelphia in 1844, Joseph Work had been a farmer before entering

Company I of the 12th New Jersey Infantry in August 1862.9 Prior to enlisting in the

Army, Work and his neighbors reported that he was a hearty boy and hard worker, a far cry from Da Costa's description of him as “not strong” when he began his service.10 The two men agreed that he struggled to perform the duties of a soldier, in part because of his youth and in part as a result of the intermittent fevers from which he suffered for much of

1862 and 1863.11 Ultimately, “the long march from Falmouth, Virginia to Gettysburg, broke him down completely,” according to Da Costa’s account. “On the second day of the march, he threw away his knapsack and extra clothing, and could even then scarcely keep up with the regiment.”12 Da Costa did not go into detail about Work's experience at

Gettysburg or his treatment in the days that followed. John Hoffman, a fellow soldier in the 12th New Jersey, testified that Work fainted a number of times during the march to

Gettysburg and had to be carried in an ambulance. What role, if any, Work played during

8 Ibid., 194. 9 There is some confusion about Work’s date of birth. Pension records indicate that he was 18 when he enlisted in 1862. However, it is possible that he was born as late as 1846, making him 16 upon enlistment and, per Da Costa's findings, more likely to succumb to irritable heart than an older soldier. See Soldier’s Certificate No. 227.705, Joseph Work, Private, Co. I, 12th New Jersey Volunteer Infantry. 10 Surgeon General’s report, November 30, 1882, Soldier’s Certificate No. 227.705, Joseph Work, Private, Co. I, 12th New Jersey Volunteer Infantry, and Da Costa, “On Irritable Heart,” 28. 11 Da Costa, “On Irritable Heart,” 28. 12 Ibid. 27 the three-day battle is unclear. Like many of the other Gettysburg injured, Work was transferred to the hospital in Philadelphia within a week of the battle.13

The slippery distinction between the lay language of physical and emotional

“break down,” the moderately specific claims of “cardiac disease” employed by the

Army’s bureaucratic systems that developed alongside physicians’ refined diagnoses, and the narrow, clinical language of irritable heart created problems for nineteenth century physicians, patients, their families, and government officials. Men who wrote home complaining about a complete breakdown could have been describing any number of conditions, including overwhelming emotions, physical exhaustion, general debilitation, or some combination of mental and physical symptoms. Likewise, the symptoms characteristic of irritable heart overlapped with a number of other nineteenth century diagnoses. Arriving at a stable medical definition of irritable heart took decades and, even then, it never fully replaced nonspecific terminology for the worn out, exhausted, or enfeebled soldier. Well into the 1880s and 1890s, soldiers and Pension Office medical examiners described men as being completely “worn out” or broken as a result of the war even when a veteran's symptoms aligned with a diagnosis of irritable heart. Even men who came under Dr. Da Costa's care did not apply the term to themselves. Instead, they employed more general medical terms like “cardiac disease.” Irritable heart's instability as a diagnostic category allowed it to become a touchstone in late nineteenth and twentieth century debates about the war’s impact on physiology, emotions, and anxiety.

Physical conditions in the Civil War were truly horrific and contributed to the rampant disease and general ill health among soldiers from both the North and South.

13 John J. Hoffman affidavit, Dec 1881, and the Surgeon General’s November 30, 1882 report in Soldier’s Certificate No. 227.705, Joseph Work, Private, Co. I, 12th New Jersey Volunteer Infantry. 28 Margaret Humphreys began her study of the various health crises sparked by the Civil

War by stating that, “the American Civil War was the greatest health disaster that this country has ever experienced.”14 New research supports Humphreys’ claim and underscores, as one study suggests, that the “human cost of the Civil War was greater than historians have long believed.”15 In his groundbreaking study of Civil War death rates, David Hacker estimates that as many as 750,000 men died during the war—a number twenty-five percent higher than traditional estimates.16 Of those 750,000 casualties, nearly twice as many soldiers succumbed to disease than to battlefield injuries.

Even men who entered the service healthy, vaccinated against smallpox, and well-fed might endure outbreaks of infectious diseases, including measles, mumps, pertussis, pneumonia, meningitis, malaria, and typhoid, among many other less serious complaints.

Ongoing food shortages created conditions ripe for scurvy and other diseases of malnutrition. Soldiers complained constantly about rain and the cramps, fevers, chills, and rheumatism it generated.17 Exposure caused heat stroke in the summer and frostbite in the winter.

Awareness of the importance of sanitation mitigated only some of the problems faced by Union soldiers. The era’s emphasis on miasma and the importance of fresh air meant that clean water was an important but ultimately secondary concern. Although physicians and reformers understood basic sanitation by the 1860s, armies on both sides had difficulty enforcing sanitary policies. Rather than walk to the “sinks” (latrines),

14 Margaret Humphreys, Marrow of Tragedy: The Health Crisis of the American Civil War (Baltimore, MD: Johns Hopkins University Press, 2013), 1. 15 J. David Hacker, “A Census-Based Count of the Civil War Dead,” Civil War History 57, no. 4 (2011): 307–48. 16 Ibid. 17 Kathryn Shively Meier, Nature’s Civil War: Common Soldiers and the Environment in 1862 Virginia (Chapel Hill, NC: University of North Carolina Press, 2013), 45–47. 29 soldiers tended to relieve themselves just outside their tents, creating a “soup of fecal organisms” in which men ate, slept, and drilled.18 The United States Sanitary

Commission (USSC), a charitable organization, worked with the Army to enforce sanitation measures in camps, inspect hospitals, and provide soldiers with food and clean clothing to supplement their Army provisions.19 In theory, these efforts would have improved soldiers’ health, promoted discipline, and ensured military preparedness. In practice, however, the USSC’s conservative politics and strained relationship with the

Army Medical Department limited its effectiveness. The Commission’s policies could even exacerbate the problems for soldiers struggling under the emotional and physical strain of wartime. In her study of Civil War soldiers’ bodies, scholar Lisa Long forcefully argued that the USSC’s insistence that health and military discipline were linked insidiously damaged soldiers’ mental health by blaming them for their inability to thrive at the front.20

Given the rough material reality of a Civil War soldier’s life, it is unsurprising to find soldiers who suffered from emotional and psychological distress on top of physical complaints. In recent decades, military and medical historians have begun to investigate the mind of the Civil War soldier. Eric Dean’s book Shook Over Hell ushered in a series of studies that linked various twentieth century diagnoses with Civil War soldiers. These studies promised a more detailed understanding of the soldier’s inner life but tended to

18 Humphreys, Marrow of Tragedy. 19 There are several excellent studies of the United States Sanitary Commission. See Lisa A Long, Rehabilitating Bodies: Health, History, and the American Civil War (Philadelphia: University of Pennsylvania Press, 2004); Judith Ann Giesberg, Civil War Sisterhood: The U.S. Sanitary Commission and Women’s Politics in Transition (Boston: Northeastern University Press, 2000); Jeanie Attie, Patriotic Toil: Northern Women and the American Civil War (Ithaca, NY: Cornell University Press, 1998); See also the United States Sanitary Commission's official history, The Sanitary Commission of the United States Army: A Succinct Narrative of Its Works and Purposes (New York: United States Sanitary Commission, 1864). 20 Long, Rehabilitating Bodies, 92–93. 30 flatten important distinctions between nineteenth and twentieth or twenty-first century understanding of the relationship between the mind, body, and soul. Although physicians, both during the war and after, had difficulty categorizing the mental health of soldiers, and they acknowledged that some men seemed better able to cope with the stress of

Army life than others.

When confronted with failing emotional and/or physical health, many American civilians and soldiers alike invoked the phrase “broke down.” In “lay nosology,” the phrase accommodated a huge variety of physical complaints — among them pneumonia, chronic diarrhea, exhaustion, malnutrition, and poor sleep— as well as mental states like acute melancholia or mania.21 The state of being broken down could be either chronic or acute. Sometimes men broke down completely and had to be removed from the field.

Other men simply fell out of their units for a time and rejoined them at a later date.22

Despite the incredible breadth of symptoms associated with this diagnosis, it nevertheless did not constitute anything and everything that caused discomfort. Soldiers and their families still referred to specific diseases like small pox or intermittent fevers without invoking the phrase “broke down.” When the phrase was used, it contained an implicit sense that both the emotions and the body contributed to the state of being broke down.

This lay language proved better able to contain the complex, idiosyncratic experience of mental anguish linked to physical distress than a more specific and limiting diagnostic label.

The two interrelated concepts of breakdown—physical and mental—complicated medical care during the Civil War. Physicians understood that the mind had an impact on

21 For more on the relative absence of lay nosologies in medical history, see Porter, “The Patient’s View.” 22 For more information on straggling as a kind of self-care, see Meier, Nature’s Civil War, 126–46. 31 the body but were unsure about the nature of the connection. For centuries, physicians struggled to distinguish between psychogenic complaints that arose in the mind and somatic complaints that were the result of an organic disease.23 The former were often considered less “real” than the latter which, in turn, made the notion of psychogenic complaints suspect in the view of military and medical authorities. Without physical changes to the body, doctors simply did not know how to diagnose these complaints.

Military doctors encountered men who came to them with a number of physical complaints that they believed were the result of the totality of the experience of Army life, not necessarily the result of a specific ailment or injury. Army physicians needed to distinguish between men suffering from an organic disease, the insane or mentally unfit, and those men who wanted to shirk their duty based on the physical symptoms presented to them. In practice, these categories almost never remained entirely distinct.

This difficulty in categorizing emotional or mental complaints reflects in part the extent to which physicians lacked a rich, descriptive vocabulary for mental disorders.24 In 1865, few if any American physicians adopted a psychological view of the insane. Among elite physicians, neurology dominated the study of psychological conditions.25 Even among alienists and asylum superintendents, there was little distinction between the various specialties.26 Those physicians who worked in asylums rarely earned the respect of their medical peers until several decades after the Civil War. This division reinforced the view

23 Edward Shorter, From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era (New York: Free Press, 1992). 24 Meier, Nature’s Civil War. 25 Paul Foley, “The Encephalitis Lethargica Patient as a Window on the Soul,” in The Neurological Patient in History, ed. L. Stephen Jacyna and Stephen T. Casper, Rochester Studies in Medical History (Rochester, NY: University of Rochester Press, 2012), 184–211. 26 L. Stephen Jacyna and Stephen T. Casper, “Introduction,” in The Neurological Patient in History, ed. L. Stephen Jacyna and Stephen T. Casper, Rochester Studies in Medical History (Rochester, NY: University of Rochester Press, 2012), 1–17. 32 that a mental health condition and irritable heart might coexist in a patient but were not the result of the same disease process. Aware of both hypochondria and hysteria, which though considered mental health conditions nevertheless had physical components, nineteenth century physicians had not yet posited the existence of a “conversion” disorder, in which a patient experiences physical symptoms that express an unconscious emotional state. Conversion disorders did not appear until the last decade of the nineteenth century, prior to which the emotions’ impact on the body was understood in terms of acute response to an emotional state or chronic derangement of the nerves, not the result of a subconscious or unexpressed emotional disturbance.27

Despite these limitations, physicians did have diagnoses available to them that captured a soldier’s mental or emotional state, including nostalgia and homesickness. As a diagnosis, nostalgia had been in use to describe the “grave despondency” of soldiers since at least the late seventeenth century.28 By the Civil War, the military medical department understood the disease as a mental condition that might cause physical symptoms and was “not infrequently fatal.” The 1863 manual provided to Union Army surgeons explained that,

Considered as a mental disease— and there can be no doubt that the primary phenomena of [nostalgia] are mental— it belongs to the class Melancholia. The extreme mental depression and the unconquerable longing for home soon produce a state of cachexy, loss of appetite, derangement of the assimilative functions, and, finally disease of the abdominal viscera.29

27 Matthew Allin, Anna Streeruwitz, and Vivienne Curtis, “Progress in Understanding Conversion Disorder,” Neuropsychiatric Disease and Treatment 1, no. 3 (September 2005): 205–9. 28 David Anderson, “Dying of Nostalgia: Homesickness in the Union Army during the Civil War,” Civil War History 56, no. 3 (2010): 247–82. 29 Roberts Bartholow, A Manual of Instructions for Enlisting and Discharging Soldiers: With Special Reference to the Medical Examination of Recruits, and the Detection of Disqualifying and Feigned Diseases (Philadelphia: J.B. Lippincott & Co, 1863), http://collections.nlm.nih.gov/catalog/nlm:nlmuid- 62430200R-bk; Dean, Shook over Hell. 33 The relationship between a soldier’s body and mind was complicated by the fact that ill soldiers often experienced nostalgia at much higher rates than their healthy peers. In the

Surgeon General’s massive study of Civil War injury and disease, the Medical and

Surgical History of the War of Rebellion, the Army found that “a temporary feeling of depression” was the “natural result of existing discomfort.” While under its influence, men found themselves distracted by the comforts and familiarity of home.30 Not simply the concern of doctors, homesickness worried soldiers. They often wrote their families about their anxiety around becoming homesick or fellow soldiers particularly prone to acute homesickness.31

While these low spirits typically created little more than low morale, occasionally they did rise to the level of medical disorder. Soldiers suffering from nostalgia tended to become ill at higher rates than their peers.32 The military also observed that nostalgia could either precipitate or follow “some other morbid condition—as a cause still abiding or a result. In either instance the complication was of a serious character, as the mental depression seemed to destroy the recuperative power.”33 Eric Dean suggests that the distinction between categorizing someone as a mental or medical case may have been simply the result of the order in which a soldier’s symptoms manifested. If nostalgia and general malaise pre-dated the soldier’s physical complaints, they were attributed to the mental condition. If a soldier was wounded in battle or suffered from a physical

30 Joseph K. Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), vol. 1, part 3 (Washington, DC: US Government Printing Office, 1888), 884. 31 See McPherson, For Cause and Comrades, 77–80, 163–65. 32 Anderson, “Dying of Nostalgia.” 258. 33 Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), 1, part 3:885. 34 complaint like chronic diarrhea or rheumatism and then came down with nostalgia, he would not be listed as a psychiatric case but a medical case.34

The problems presented to physicians by a soldier’s description of himself as

“broke down” did not exist for soldiers and their families. To them, this category easily and usefully encompassed the sufferer’s complex blend of emotional, mental, and physical ailments. In early 1865, Charles Steedman, a Union naval officer, wrote to his wife from North Carolina about a friend. He explained that,

Poor Taylor has gone home, having completely broken down physically… he was so depressed and wretched in spirits at the idea of having to leave on the eve of a second attack. His health, at no time robust, with an extremely nervous temperament, broke down under the excitement incidental to our exposure, flood and field, in the last two or three weeks.35

The nature of Taylor’s physical breakdown is lost to history. Steedman did not include a list of symptoms or complaints but, elsewhere in the letter, explains that a series of accidents killed or wounded “more men than in the whole fleet in the two days’ action.”36

Steedman clearly indicates that Taylor’s proximity to the accidents, coupled with heavy fire in a battle a few days earlier, contributed to his physical condition. Steedman stops short of suggesting that these difficulties caused Taylor’s breakdown. Instead, he emphasizes the extent to which they contributed to the physical decline of a man already burdened with a weak constitution.

34 Dean, Shook over Hell, 144–46. 35 Charles Steedman, “Letter from Charles Steedman to Sally Steedman, January 6, 1965,” in Memoir and Correspondence of Charles Steedman, Rear Admiral, United States Navy, with His Autobiography and Private Journals, 1811-1890, ed. Amos Lawrence Mason, Private Printing (Cambridge, MA: Riverside Press, 1912), 397. 36 Ibid. 35 The medical opinion on break down gained importance as the military’s disciplinary process began to take account of these conditions in judgment and punishments. Decades after the war, Rufus Dawes, a member of the famed Iron Brigade that saw combat at both Antietam and Gettysburg, published a memoir of his time in the service. While describing his time as president of the 5th Army Corps’ examining board, a panel designed to “weed out incompetent and cowardly officers,” he reflected on how after,

[A] campaign of sixty continuous days, the excitement, exhaustion, hard work and loss of sleep broke down great numbers of men who had received no wounds in battle. Some who began the campaign with zealous and eager bravery, ended it with nervous and feverish apprehension of danger in the ascendancy. Brave men were shielded if their records on other occasions justified another trial, which ordinarily resulted well, but cowards met no mercy.37

The set punishment for cowardice in the Union Army was execution, although this particular sentence was rarely used. Getting a physician’s diagnosis might save a soldier’s life— not only because of the treatment regimen.

At the same time that break down provided a language for the anguished mental condition of soldiers, it also revealed the continued influence of mechanistic or

“iatromechanical” medicine, which emerged in the eighteenth century and, according to sociologist and historian Andrew Scull, quickly became a powerful explanatory model for all kinds of diseases or disorders.38 Mathematics and physics informed the bulk of iatromechanical medicine. This theory of medicine explained illness through Newtonian concepts of movement and hydraulic pressures in the body. Even in its heyday, however,

37 Rufus R. Dawes, Service with the Sixth Wisconsin Volunteers (Marietta, OH: E.R. Alderman & Sons, 1890), 299-300. 38 Andrew Scull, Hysteria: The Disturbing History (New York: Oxford University Press, 2011). 36 iatromechanical medicine never exerted a substantial impact on the practice of medicine.

Instead, it provided a theoretical model that explained illness in new ways.39 Americans could employ the same phrase to explain a malfunctioning wagon, engine, or other mechanical apparatus and the malfunctioning human body. Although the specific cause of a deterioration of health was not always clear to the patient or his physician, the language of break down implies a neat cause-and-effect relationship. As physicians began to identify more conditions like irritable heart, which had complicated and unclear causes, the allure of a clear explanatory model must have been substantial.

This iatromechanical model also offered the promise of recovery or repair. Just as a broken wagon could be fixed, theoretically so too could a broken down soldier. In reality, many soldiers who lost their health during the Civil War never fully regained their pre-war vigor. For these men, the break down that began in the war lasted until their deaths decades later. In the intervening years, they took different approaches to recovering their health. Many applied for pensions, some self-medicated with patent medicines or alcohol (not always substantially different), and a few withdrew from civil life.

Hospital Medicine

The field surgeons and regimental physicians in the Union Army dealt directly with injuries, acute illnesses, and emotional casualties of broke down soldiers. When men needed more care than could reasonably be provided by these surgeons, the Army transferred them to general hospitals away from the front lines. In these hospitals, soldiers were comparably well-fed and allowed lengthy recovery periods.

39 Wayne Wild, Medicine-by-Post: The Changing Voice of Illness in Eighteenth-Century British Consultation Letters and Literature (New York: Rodopi, 2006), 62. 37 Soldiers with complicated or unique injuries that required the attention of elite physicians were transferred to one of a number of new hospitals set up for the care of specific injuries or diseases. These specialty hospitals were unusual in the United States at the time and represented an important pivot toward scientific medicine by both leading physicians and the Army Medical Department.40 Early in the war, Philadelphia physician and noted neurologist S. Weir Mitchell spearheaded efforts to concentrate neurological patients in a single hospital in Philadelphia. When Mitchell’s friend and fellow neurologist, William Hammond, became Surgeon General in July 1862, Army policy changed to concentrate patients suffering from related complaints in single, specialty hospitals. Patients suffering from neurological and cardiac conditions from the entire eastern theater of war ended up in Philadelphia, first at Filbert Street Hospital and later at the 275-bed U.S. Army Hospital for Injuries and Diseases of the Nervous System,

Turner’s Lane—usually referred to simply as Turner’s Lane Hospital.

The Army Medical Department’s decision to concentrate nerve cases in one hospital mimicked the practice of leading French research hospitals at the time.41 Within just a few months of Hammond’s order, American physicians had the opportunity to undertake large-scale research projects on vast numbers of patients who were required to follow hospital protocols.42 The physicians who staffed these specialty hospitals shared the goal of alleviating suffering of individual patients but also used the injured, ill, and broken men produced by the war to advance medical knowledge. The opportunity to

40 Devine, Learning from the Wounded, 132–34. 41 Ibid., 135; Charles F. Wooley, “Jacob Mendez Da Costa: Medical Teacher, Clinician, and Clinical Investigator,” The American Journal of Cardiology 50, no. 5 (November 1982): 1145–48. 42 Bonnie Ellen Blustein, “‘To Increase the Efficiency of the Medical Department’: A New Approach to U.S. Civil War Medicine,” Civil War History 33, no. 1 (1987): 22–41. 38 study large numbers of patients suffering from the same condition was unique and men like Da Costa and Mitchell understood its potential.43 Patients, at least in theory, benefitted from the attention of the elite, highly trained physicians who staffed their wards.

Physicians in the nineteenth century, much like today, named and defined diseases within a specific context shaped by both medical science and their patients’ expectations, social status, and personalities.44 Prior to the war, physicians like Da Costa and Mitchell were dependent on the goodwill of wealthy Philadelphians for their income, status, and professional development. These patients could “doctor shop” if they were displeased with the treatment or diagnoses offered by a physician. During the Civil War, however, the patients’ position in relation to their physicians became less equal because military discipline entered the hospital. At least in theory, the men in Turner’s Lane and other Union general hospitals were obligated to stay under military rule until discharged.

Men could not leave the hospital without a pass and were required to refrain from non- medicinal drink— or at least refrain from becoming drunk. Unlike men and women who sought out doctors in the era before and after the war, soldiers did not have the option of moving from doctor to doctor until they received a diagnosis or treatment regimen they found palatable. There is evidence that men deserted from hospitals either to obtain better care or because there were simply more opportunities to abandon the service.45 Joseph

Work’s service record indicated that he deserted briefly from a hospital in 1862 before

43 Devine, Learning from the Wounded, 141. 44 For an excellent discussion of this phenomenon, see Robert A. Aronowitz, Making Sense of Illness: Science, Society and Disease (New York: Cambridge University Press, 1999), 58. 45 Humphreys, Marrow of Tragedy, 168. 39 rejoining his unit at a later date.46 In civilian life, physicians could not ensure compliance with treatment protocols or long-term observation required for the studies undertaken by

Da Costa and Mitchell.47 At a military hospital, however, physicians could exert much more control over their patients. Military discipline, and the threat of military punishments, shaped the practice of scientific medicine during the Civil War. For physicians, this population of patients unable to leave, forced to maintain military discipline, and rarely able to resist treatment provided excellent material for study. By concentrating patients and employing elite Philadelphia physicians at Turner’s Lane, the

Army laid the foundation for important advances in medical knowledge during the war.

Da Costa’s Biography

Jacob Mendes Da Costa’s journey to the cardiac wards at Turner’s Lane Hospital followed a new trajectory in American medicine in the 1850s. Born into a family of

Sephardi Jewish bankers and merchants in St. Thomas, West Indies in 1833, Da Costa and his family left the islands in 1837. Da Costa spent the next decade in London and continental Europe. The family moved to Philadelphia in his early teens, where he lived for a few years until he entered high school (gymnasium) in Dresden, Germany. By the time he returned to the United States for medical school, Da Costa had mastered several languages—including French, German, Dutch, and Spanish, as well as Greek and Latin— and had spent most of his life in Europe.48

46 For more on straggling and desertion as self-care, see Meier, Nature’s Civil War. 47 Blustein, “To Increase the Efficiency of the Medical Department.” 26 48 Mary A. Clarke, “Memoir of J.M. Da Costa, MD,” Journal of the Medical Sciences 125, no. 2 (February 1903): 318–29; Nancy Hartevelt Kobrin and Jerry L. Kobrin, “J. M. Da Costa, M.D.—A Tinok She- Nishbah?: An American Civil War Converso Physician,” Shofar 18, no. 1 (October 1, 1999): 16–39. 40 A series of financial reversals that shrank the family’s businesses meant that Da Costa needed to enter a profession that could support him and his family.49 Given his talent for languages and familiarity with European culture, Da Costa initially favored entering politics or serving in the American diplomatic corps.50 Instead, at the urging of his friends, Da Costa entered Jefferson Medical College in 1849.

Da Costa studied under the prominent physician Thomas D. Mütter in 1849, a

“golden age,” for Jefferson Medical College.51 At the time, Jefferson Medical College’s faculty represented the vanguard of American medical scholarship. In addition to studying under Mütter, Da Costa would have been instructed by well-known physicians like Dr. John Kearsley Mitchell, father of Da Costa’s peer S. Weir Mitchell and professor of medicine; Franklin Bache, great-grandson of Benjamin Franklin, who taught chemistry; Charles D. Meigs, a leading obstetrician who rejected anesthesia during childbirth but promoted the cultured medical man; and Joseph Pancoast, who oriented his lectures on anatomy toward medical and surgical practice.52 Unique among medical schools, immediately after its founding, Jefferson Medical College created a clinic in which medical students would provide medical care to the city’s poor for free. This distinguished Jefferson Medical College from all other medical schools in the nation.

Even the University of Pennsylvania did not offer this type of clinical experience and training to their students. The College quickly gained a reputation for educating exceptional physicians and set a model for future medical education.53

49 Clarke, “Memoir of J.M. Da Costa, MD”; Kobrin and Kobrin, “J. M. Da Costa, M.D.—A Tinok She- Nishbah?” 50 Clarke, 319. 51 Wooley, “Jacob Mendez Da Costa,” 1145. 52 Ibid.; Frederick B. Wagner, ed., Thomas Jefferson University: Tradition and Heritage, vol. 1, 3 vols. (Philadelphia: Lea & Febiger, 1989). 53 Wagner, Thomas Jefferson University: Tradition and Heritage. 41 Da Costa graduated with honors in 1852 at age nineteen. After graduation, he returned to Europe for eighteen months of post-graduate training in Paris and Vienna. As a student of Mütter, Da Costa would have had more exposure to scientific medicine and opportunities to treat patients than many of his peers at Jefferson, let alone students at less prestigious medical schools.54 Even with this training, Da Costa’s commitment to research and scientific medicine required that he visit Paris and Vienna. Abroad, students attended additional lectures, enrolled in private classes/tutorials, and worked directly with patients and physicians in hospital wards. Mary Clarke, his personal secretary and biographer, emphasized that his skill with language allowed him to “make far better use of his opportunities than was usual with American students.”55

In Paris, then the center of medical knowledge and training, Da Costa gained valuable experience in pathology and diagnostic techniques at prominent hospitals like la

Charité and la Salpêtrière. The Parisian medical tradition emphasized lesions and observable phenomenon working on bodily systems or organs.56 In Parisian medicine, physicians brought together physical examination, autopsy, and statistical thinking to improve patient outcomes.57 Though not yet truly scientific medicine, because Parisian practitioners did not yet embrace the laboratory, this hospital work laid the foundation for later trends in clinical research. Additionally, the time in Paris exposed Da Costa to men like neurologist Jean-Martin Charcot, who transformed la Salpêtrière into a leading

54 For more information on Dr. Thomas D. Mütter as a clinician and instructor, see Cristin O’Keefe Aptowicz, Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine (New York: Gotham Books, 2014). 55 Clarke, 319. 56 Jacyna and Casper, 4. 57 Charles F. Wooley, The Irritable Heart of Soldiers and the Origins of Anglo-American Cardiology: The US Civil War (1861) to World War I (1918), The History of Medicine in Context (Burlington, VT: Ashgate, 2002). 42 neurological research center that included a laboratory, photography, and new teaching styles in the mid-1850s where he also undertook in-depth studies of hysteria.58 From

1853 to 1856, Charcot served as Chef de Clinique at la Salpêtrière.59 It is likely that Da

Costa knew of both Charcot’s techniques and initial neurological studies of hysteria.

Charcot’s ideas about hysteria, pathology, and nervous disorders shaped the research practice at Turner’s Lane and other specialty hospitals in Philadelphia.

After several months in Paris, Da Costa left for Vienna, a rising center of medical thought. While there, he absorbed the German medical tradition that emphasized centralized and specialized scientific research. He worked closely with Joseph Skoda, a well-known and widely respected specialist in internal medicine.60 Skoda, a pioneer in thoracic medicine, used insights from autopsies and anatomical studies to improve clinical treatment of living patients, a technique that Da Costa would employ in his studies of irritable heart.61 Skoda also worked to reduce the subjectivity of diagnosing cardiac and other chest complaints by replacing the French practice of comparing diagnostic sounds to nature with a standard set of terms derived from concepts in physics and acoustics.62 In addition to this training, Da Costa studied microscopy under Josef

Hyrtl, a leading anatomist and microscopist. At the end of Da Costa’s study with him,

Hyrtl gave him a set of his own microscopic specimens.63 The training in Vienna prepared Da Costa for a rigorous research practice grounded in scientific practice.

58 David R. Kumar et al., “Jean-Martin Charcot: The Father of Neurology,” Clinical Medicine & Research 9, no. 1 (March 2011): 46–49. 59 Ibid. 60 Wooley, “Jacob Mendez DaCosta.” 1146. 61 Wooley, The Irritable Heart of Soldiers and the Origins of Anglo-American Cardiology, 100. 62 Ibid. 63 Clarke, 320. 43 By the time he returned to the United States in 1853, Da Costa had settled on

“pathological anatomy, visceral disease, the heart and lungs, and the diseases of the skin in their relation to general medicine” as his focus, “in a word, internal medicine in its broadest sense.”64 He rapidly developed a reputation as an excellent diagnostician and teacher. Although he intended to enter private practice, Jefferson Medical College quickly recruited him to teach. Like many of his fellow physicians, Da Costa combined private practice with clinical instruction. Although his practice grew slowly, he eventually emerged as a leading physician, teacher, and medical researcher. During the years between his return to the United States and the outbreak of the Civil War, he made inquiries into the nature of yellow fever, studied typhoid, and edited or translated a number of medical texts.

No records of Da Costa’s personal beliefs about slavery, the Confederacy, or the

Civil War exist. He married Sarah F. Brinton in 1860, linking him by marriage to a prominent Philadelphia family that included John Brinton, the first curator of the Army

Medical Museum, and General George McClellan. Given his wife’s family ties to the

Union Army—her cousin George Brinton McClellen’s ill-fated Peninsular Campaign provided much of the “clinical material” to Turner’s Lane—it is unsurprising that he joined the Union war effort in 1862 as an acting assistant surgeon.65 Unlike surgeons who enlisted in the Army, these physicians served at home and maintained their private practices and/or teaching obligations. Although they could be called into the field if the

64 J.C. Wilson quoted in Wooley, “Jacob Mendez DaCosta,” 1146. 65 Jacob Da Costa to William Hammond, 9 May 1862, Papers of J.M. Da Costa, Personal Papers of Medical Officers and Physicians, box 144, entry 561, RG94, National Archives and Records Administration, Washington, DC. 44 need arose, this rarely occurred.66 Da Costa spent his entire wartime service in

Philadelphia, first at the hospital on 16th and Filbert Streets, then at Satterlee General

Hospital, and finally at the much larger Turner’s Lane Hospital.

Irritable Heart

Over the course of the war, Da Costa studied more than 300 patients suffering from cardiac complaints who cycled through Turner’s Lane.67 Soldiers have suffered from chest pain and exhaustion for centuries, a fact Da Costa himself admitted.68 Like

Private Work, many Union soldiers arrived at Turner’s Lane complaining of a wide variety of cardiac symptoms. Da Costa was the first clinician to classify broke down soldiers’ cardiac complaints into a discrete, named disease: irritable heart. Records to indicate why he began to consider irritable heart a distinct disorder do not survive, only that he did so no later than 1862, when he initially brought it to the attention of the

Surgeon General’s office. Da Costa explained his decision to name the disease:

The disorder not being recognized, is no proof of its not having existed; for when we reflect how almost entirely the accurate knowledge of disease of the heart is the knowledge of our times, we can readily understand how difficult or impossible it may have been to have distinguished the less marked groups.69

Da Costa’s justification for naming the condition explicitly affirmed the power of contemporary diagnostic techniques. Implicitly, the decision to name the condition revealed Da Costa’s efforts to narrow medical practice to the specific, observable, and

66 Gettysburg and Antietam are the notable exceptions. However, it appeared that Da Costa did not leave Philadelphia even after the Battle at Gettysburg. Wooley, “Jacob Mendez DaCosta,” 1146. 67 Da Costa studied 300 soldiers suffering from irritable heart during the war, at least 200 at Turner’s Lane after the Army made arrangements to concentrate the cases there. See Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), 1, part 3:862. 68 Da Costa, “On Irritable Heart,” 17-18. 69 Ibid, 2. 45 consistent signs of disease instead of the more general, idiosyncratic, and personal experience of disease.

The shift from general to specific diagnoses, like irritable heart, characterized much of mid- and late-nineteenth century medicine. Historian Charles Rosenberg explained that “recognizably modern notions of specific, mechanism-based ailments with characteristic clinical courses were a product of the nineteenth century.”70 He went on to suggest that developments in pathological anatomy, combined with the beginnings of chemical pathology, microscopy, and studies of normal and abnormal physiological functions “all pointed toward the articulation of stable disease entities that could be— and were—imagined outside their embodiment in particular individuals and explained in terms of specific causal mechanisms within the sufferer’s body.”71 Certain categories of knowledge, mostly those derived from anatomy, physiology, and chemistry, emerged as universally applicable to all patients.72 In Rosenberg’s account, much of this shift from the general, personal, and idiosyncratic explanations for disease causation had already taken place by about 1860—decades before the triumph of germ theory.

Da Costa’s diagnostic process reflected the trend described by Rosenberg. He used the phrase “broke down” to describe Private Work’s health before entering the hospital. Then, after Work arrived at the hospital with the rest of the Gettysburg wounded, Da Costa applied the specific diagnostic category of irritable heart. In so doing,

70 Charles E Rosenberg, “The Tyranny of Diagnosis: Specific Entities and Individual Experience,” The Milbank Quarterly 80, no. 2 (June 2002): 237–60. 71 Ibid. 72 John Harley Warner, The Therapeutic Perspective: Medical Practice, Knowledge, and Identity in America, 1820-1885 (Cambridge, MA: Harvard University Press, 1986). 46 he prioritized the physical condition over the emotional and reinforced the boundaries of legitimate suffering for soldiers who appeared otherwise healthy.

His interest in internal medicine and well-known skill as a diagnostician prepared

Da Costa to create a new cardiac condition among the men sent to him in Philadelphia.

His experience with physical examination in various teaching hospitals in Paris and

Philadelphia, combined with his affinity for scientific medicine, made him “quick and keen” in diagnosis. The first edition of his popular textbook Medical Diagnosis with

Special Reference to Practical Medicine (1864) opens with a lengthy chapter on the importance of a proper diagnostic practice that highlights studying the patient’s current condition and his past health.73 He explained that, “the plan which I habitually prefer is to take a general survey of the history and of the prominent symptoms, and, having thus obtained some clue to the part most likely to be affected, to explore that with care.”74

This method of examination, though less “purely scientific” than taking a complete health history before performing a physical exam, allowed Da Costa to focus on the current condition and its immediate causes. This technique would have served him well in a busy military hospital. To that end, he began his examination of soldiers by asking them to describe their complaint, including the presence or absence of pain or any other symptoms. Next, Da Costa undertook careful observation of the physical signs of disease.

He described the method of palpitating a soldier’s chest and how “when the hand is

73 Jacob M. Da Costa, Medical Diagnosis with Special Reference to Practical Medicine: Guide to the Knowledge and Discrimination of Diseases (Philadelphia: J.B. Lippincott & Co, 1864). 74 Jacob M. Da Costa, Medical Diagnosis with Special Reference to Practical Medicine: A Guide to the Knowledge and Discrimination of Diseases, Third edition revised (Philadelphia: J.B. Lippincott & Co, 1870). 47 applied to the praecordial region, it may note the quick impulse happening in a regular manner, or it takes cognizance of the irregularity of rhythm of the irritable organ.”75

After feeling for the heart, Da Costa advises that the physician should “enlist the sense of hearing” in order to detect the progress of a disease in “cavities into which the eye cannot penetrate.”76 Da Costa found that in a patient suffering from irritable heart, the first sound of the heart will sound more quiet than the second sound. He also described hearing missing beats, double beats, and sometimes intermissions. The heart sometimes sounded indistinct or dull.77

Finally, Da Costa carefully differentiated between various available diagnoses. In

Medical Diagnosis, Da Costa outlined his theory of the diagnostic process:

To find out the precise meaning of the abnormal manifestation in an individual case, we have to draw our inference from all the signs encountered—to compare them with each other; to seek out those that are in the background. We are thus arriving, step by step, and the explanation of the morbid appearances, the starting- point in deduction always being what is known of the affection whose presence is suspected, and whose symptoms we are contrasting with those before us.78

In identifying irritable heart as a distinct disease Da Costa followed his own best practices. He carefully observed the symptoms patients presented and compared them with extant disease categories. Much of his published work on irritable heart emphasizes the ways in which the disease did and did not resemble conditions already well-known to the mid-nineteenth century physician, including tuberculosis, valvular diseases, and heart murmurs.

75 Da Costa, “On Irritable Heart,” 26. 76 Da Costa, Medical Diagnosis (1870), 18. 77 Da Costa, “On Irritable Heart,” 26. 78 Da Costa, Medical Diagnosis with Special Reference to Practical Medicine (1870), 20. For more information on using textbooks to recover diagnostic standards and practices, see Stephen T. Casper, “The Patient’s Pitch: The Neurologist, the Tuning Fork, and Textbook Knowledge,” in The Neurological Patient in History, ed. L. Stephen Jacyna and Stephen T. Casper, Rochester Studies in Medical History (Rochester, NY: University of Rochester Press, 2012), 21–43. 48 In a few cases Da Costa extended the diagnostic process to autopsies after death.

Like his instructors in Paris and Vienna, he believed that a careful study of diseased anatomy would improve diagnostic criteria and indicate new options in treatment.

Although he did not report on all the autopsies that he performed on his patients, the quest for identifiable, visible lesions lead him to use a microscope to examine both cardiac fibers and the “nervous filaments” of the heart.79 These autopsies provided evidence about perhaps the most important new discovery around irritable heart: its apparent ability to transform from a functional into an organic disease. Da Costa recognized the importance of this observation and the extent to which it opened up a new ground in the understanding of the distinction between organic and functional diseases.

“Holding at the time the common belief that functional and organic affections are widely separate,” he wrote, “I failed at first to seize the fact that the apparently dissimilar states were in reality one, or rather, that one grew out of the other.”80 If organic and functional diseases were linked in the nineteenth century, most medical men expected to see an organic disorder cause a functional impairment. A functional disorder that then generated changes to pathology, though not wholly new, was unique enough to warrant the attention of elite medical men inside and outside the Army, particularly since, according to Da Costa, the “mass of cardiac disorders is not organic but functional.”81 He speculated that rapid heart rates and strain caused the heart to enlarge over time.

79 Da Costa, “On Irritable Heart,” 35. 80 Ibid. 21. 81 JM Da Costa, “Observations on the Diseases of the Heart Noticed among Soldiers, Particularly the Organic Diseases,” in Contributions Relating to the Causation and Prevention of Disease, and to Camp Diseases; Together with a Report of the Diseases, Etc., Among the Prisoners at Andersonville, GA, ed. Austin Flint (New York: United States Sanitary Commission by Hurd and Houghton, 1867), 360–82. 49 However, he only speculated about the mechanism for the initial functional disorder and its subsequent evolution.

Men with irritable heart suffered from a stable and common set of symptoms: a rapid heart rate, anywhere from 100-140 beats per minute, with one patient presenting a pulse that measured 192 beats per minute; heart palpitations; chest pain that patients described variously as radiating across the entire chest, passing down the left arm, or concentrating directly over the heart; general fatigue and weakness; digestive disorders like chronic diarrhea or constipation; difficulty sleeping or bad dreams; shortness of breath; nervous conditions like excessive sweating or itching; dizziness; and headaches.82

Not every patient experienced all of these symptoms but all irritable heart patients would present at least a rapid pulse, heart palpitations, and chest pain, often following some kind of digestive disturbance. Da Costa noted that nervous symptoms, like poor sleep or headaches, were characteristic but less universal than the cardiac symptoms.

Although he observed that certain traits or activities tended to precipitate an attack of irritable heart, Da Costa never definitively identified the cause of the disorder.

Younger soldiers appeared to be particularly susceptible to the disease. A full two-thirds of all cases Da Costa studied were between the ages of sixteen and twenty-five.83 He did not observe a causal relationship between tobacco use or “frequent seminal emissions” and irritable heart but did note that heavy use of stimulants like tobacco and “venereal excess” predisposed some men to the disease or inhibited recovery.84 Behavior and age alone did not appear to explain the condition. He looked to a confluence of factors that

82 Da Costa, “On Irritable Heart,” 20-26. 83 Ibid., 40. 84 Ibid. 50 might make the heart more prone to exhaustion: age, habit, hard service, heavy equipment, and digestive problems.

Private Work represented the typical presentation of irritable heart. Da Costa described the usual case:

A man who had been for some months or longer in active service, would be seized with diarrhea, annoying, yet not severe enough to keep him out of the field; or, attacked with diarrhea or fever, he rejoined, after a short stay in hospital, his command, and again underwent the exertions of a soldier’s life. He soon noticed that he could not bear them as formerly; he got out of breath, could not keep up with his comrades, was annoyed with dizziness and palpitation, and with pain the chest; his accouterments oppressed him, and all this though he appeared well and healthy. Seeking advice from the surgeon of the regiment, it was decided that he was unfit for duty, and he was sent to a hospital, where his persistently quick acting heart confirmed his story, though he looked like a man in sound condition.85

The importance of clear diagnostic criteria and careful, methodical practice was essential during the Civil War. While physicians always needed to be on the lookout for fakers and hypochondriacs, military surgeons were acutely aware of the risk of malingering soldiers who feigned illness to serve out the war in a general hospital, where the food was typically better and the workload substantially lighter (and the gunfire less frequent). Despite the popular acceptance of “broken down” as an explanation for illness, soldiers understood the inherent value of a specific diagnosis. Efforts to mimic irritable heart suggest that a diagnosis was viewed as essential to getting away from the front.

Soldiers could imitate a rapid heart rate for a time, but true irritable heart proved difficult to fake. Da Costa explained that,

A malingerer, as is well known, may keep up a rapid action of the heart by a tight bandage around the upper part of the abdomen and lower part of the chest. But,

85 Ibid.,19. 51 excepting if this be done, the imitation is a very clumsy one. The impostor knows nothing of the character of the cardiac pain. Further, making him lie down after undressing causes the heart to return to its natural beat; and then on his resuming the erect position, or walking around quietly, it will not, as an irritable heart does, regain its former frequency or irregular rhythm.86

Detecting fakers became especially important as military courts increasingly recognized the legitimacy of true cardiac diseases in adjudicating cases of desertion or cowardice.87 Although few if any court martial cases used the phrase irritable heart, still a new diagnosis even at the close of the war, a few cases include a soldier describing his poor health in terms consistent with Da Costa’s findings. In October 1861, a court found

Robert Raeden, a private in Company I of the 20th New York Volunteers, guilty of sleeping while on post but proffered a lenient sentence given his health conditions.

Echoing the description of irritable heart’s symptoms that Da Costa would describe about a year later, Raeden explained that, “when I was on guard, this pain or burning commenced in my heart and water came out of my mouth and not being strong or determined enough to resist, I sat down, and unconsciously fell asleep.”88 Dr. Charles

Heiland, a witness for the defense, offered medical confirmation of Raeden’s account. He told the court that he had examined Raeden and found him suffering from “‘palpitation’ an affection of the heart, that might possibly after having been exposed to fatigue and a loss of sleep bring on such drowsiness that it would be difficult to keep awake.” He went on to say that, “I think it requires of [Raeden] more than ordinary exertion to keep awake,

86 Ibid., 36-37. 87 There does not appear to have been a consistent standard for when heart palpitations or cardiac disorders mitigated a soldier’s punishment. 88 Robert Raeden, Court Martial Case, ii485. 52 when under the influence of the disease.”89 The physician’s testimony ensured that

Raeden was merely discharged as a result of sleeping on post.

Reaching a stable definition of the condition and definitive diagnosis allowed Da

Costa to begin a treatment regimen that emphasized rest and the alleviation of symptoms.

Nineteenth century physicians employed treatment programs that, unlike their diagnoses, retained an individualized orientation into the latter half of the century. Historian John

Harley Warner explained that, “by stressing the specificity, not universalism, of therapeutic (and to some extent diagnostic and prognostic) knowledge, physicians expressed their conviction that knowledge pertinent for certain places or individuals could be inappropriate for others.”90 It was in deciding how to treat individual patients that specificity lost its power. Physicians who identified the particular disease or disorder still evaluated individual patient needs to appropriately and carefully match the treatment to the individual. Da Costa applied a general course of therapy to his irritable heart patients but allowed for some variation in treatment, especially when it came to the use of pharmaceuticals.

Although the rest cure is most closely associated with neurasthenia and S. Weir

Mitchell, Da Costa used a modified version on many of his cardiac patients. Mitchell refined and perfected the rest cure in the years after the war when he applied it to

“women of the class well known to every physician,— nervous women, who as a rule are thin, and lack blood.”91 He began his initial studies of the rest cure, however, at Turner’s

89 Ibid. 90 Warner, The Therapeutic Perspective, 59. 91 S. Weir Mitchell, Fat and Blood: And How to Make Them (Philadelphia: J.B. Lippincott & Co, 1877), 7. 53 Lane where he applied it Union soldiers suffering from a variety of nervous complaints.92

Mitchell identified rest as essential for the injured soldier who needed to repair or rejuvenate nerve tissue. This treatment regimen involved extended periods of bed rest, isolation, heavy meals, and passive exercise through massage and electrical stimulation.

Likewise, Da Costa emphasized the importance of rest in the recumbent posture for reducing strain on the patient’s heart.93 This focus on rest meant that “the treatment is never a short one.”94 Many of Da Costa’s patients were forced to lay down for several hours a day. He reported on one cavalry soldier who spent two weeks in bed and whose heart rate dropped from 98 beats per minute to just 78 beats per minute after two weeks bed rest. Other soldiers improved with just a few days in bed, including an infantry soldier who suffered from irritable heart, broke his leg, and was thus forced into bed for a few days. Even without drugs, this soldier on the rest cure could feel his heart rate fall to normal levels and his episodes of palpitations almost completely cease.95 Da Costa’s only caution about this part of the treatment was the “almost impossibility of enforcing this mode of treatment in soldiers who, except for the rapid beating of the heart, do not consider themselves sick.”96 Eventually, periods of absolute bed rest gave way to light duty around the hospital.

There is no evidence that Da Costa employed passive exercise in his treatment of irritable heart. Instead, he recommended the slow return to marching and other tasks to prepare the soldier to rejoin to his unit. Even if a soldier’s heart rate returned to normal,

92 Nancy Cervetti, S. Weir Mitchell, 1829-1914: Philadelphia’s Literary Physician, Penn State Series in the History of the Book (University Park, PA: Pennsylvania State University Press, 2012). 93 Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), 1, part 3:863. 94 Da Costa, “On Irritable Heart,” 51. 95 Ibid, 42. 96 Da Costa, “On Irritable Heart,” 41. 54 Da Costa was wary of sending a soldier back to his unit too soon, only to have him break down again under the strain of hard duty, heavy knapsacks, and exposure to the elements.

To ensure a complete recovery, he also tested patients while running and performing other exercises to see “how the action of the heart was affected.”97 In addition to this regimen to rebuild strength, Da Costa advocated for the careful exercise and gradual build-up of soldiers’ tasks in the military at large. He warned the Army that failure to carefully and systematically build up recruits’ strength would deprive commanders of manpower. Without carefully breaking in soldiers, the Army risked prematurely breaking them down.

Da Costa’s focus on the slow, thoughtful introduction of exercise and exertion was tied to the causal relationship he observed between “hard field service, particularly excessive marching” and the onset of cardiac symptoms. Anxieties around heavy marching informed a variety of lay and professional opinions on soldiers’ health. His advice did not differ substantially from what individual soldiers valued in a commander or what commanders realized about the readiness of their men. Late in the war, Illinois soldier Charles W. Wills complained that he had covered the same fifteen-mile stretch of ground five times. However, for the first time in the war, his commanders used “real judgment… in breaking the men in. We always before made from 15 to 25 miles the first day and broke down about one-fourth of our men. This time you see, our first two day's marches were short and the 15 miles to-day seemed to affect no one.”98

97 Ibid. 98 Charles Wright Wills, “Diary of Charles Wright Wills, 3 May 1864,” in Army Life of an Illinois Soldier: Including a Day by Day Record of Sherman’s March to the Sea: Letters and Diary of the Late Charles W. Wills, Private and Sergeant 8th Illinois Infantry, Lieutenant and Battalion Adjutant 7th Illinois Cavalry, Captain, Major and Lieutenant Colonel 103rd Illinois Infantry, ed. Mary E. Kellogg (Washington, DC: Globe Printing Company, 1906), 297-298. 55 Soldiers at Turner’s Lane did not have access to the excessively heavy and fatty diets recommended by Mitchell in the decades after the war. However, hospitals, with the help of the USSC, tended to provide better rations to their patients than the Army provided to soldiers in the field.99 Da Costa did not offer any guidance for the diets of irritable heart cases in his published works on the disorder. Writing after the war, Da

Costa expressed some anxiety about skeptics who might argue that simply being in the hospital improved soldiers’ health. In “On Irritable Heart” he wrote that, “it may therefore be asked, were not the rest and food rather than the medicine employed the chief agents of cure; and was it not the amelioration of the general health alone that caused any beneficial results?”100 He tacitly acknowledged that hospital rations and rest improved general health but was clear that additional measures, mostly from the pharmacopeia, were essential to treat these men.

Pharmaceutical interventions distinguished Da Costa’s iteration of the rest cure from Mitchell’s program. Over the course of the war, Da Costa experimented with a number of different compounds listed on the Army’s standard supply table for Union general and post hospitals on irritable heart patients: digitalis, aconite, veratrum viride, gelsemium, belladonna, opium, hyoscyamus, cannabis indica, acetate of lead, and iodide of potassium.101 Although many of these compounds had some effect, he found the strongest effect with aconite and belladonna. Aconite, a plant derivative, is a powerful cardiotoxin and neurotoxin.102 An 1857 manual warned physicians that, “[aconite] is

99 Humphreys, Marrow of Tragedy, 115–17. 100 Da Costa, “On Irritable Heart,” 50. 101 Ibid., 42; Guy R. Hasegawa, “Pharmacy in the American Civil War,” Pharmacy in History 42, no. 3/4 (2000): 85. 42. 102 Thomas Y.K. Chan, “Aconite Poisoning,” Clinical Toxicology 47, no. 4 (April 2009): 279–85. 56 quite too energetic to be a safe medicine in the profession at large.”103 No member of the

“profession at large,” Da Costa nevertheless admitted that, fearing its power as a sedative, he “hesitatingly and doubtingly” began using aconite on irritable heart cases. With practice and careful observation, Da Costa learned to employ it “fearlessly and sanguinely” in “a very different manner.”104 His access to high quality aconite prepared at the Union Medical Laboratory in Philadelphia may also have helped him fearlessly administer this drug.105 Although it did not slow the pulse, aconite did reduce its force and decreased tension on the heart, in turn, preventing hypertrophy.106 Belladonna also proved useful for many of Da Costa’s patients. Like aconite, belladonna is a powerful neurotoxin that must be used carefully. Da Costa employed it to reduce the heart rate and correct irregular beats.107 After just sixteen days of treatment, belladonna “gave back to the heart perfect regularity of movement, while lowering its frequency by ten beats, quieting the pain, and greatly lessening the palpitations.” Administering belladonna and aconite in combination proved a particularly useful, if somewhat risky, treatment plan.

Perhaps unsurprisingly, patients who received opium tended to experience a reduction in their heart rate and reduced pain. Da Costa used opiates to treat his patients’ diarrhea but not their pain because he worried about “making the patient an opium eater” and tended to look to other pharmaceutical treatments for control of the heart and pain reduction.108

103 Thomas D. Mitchell, Materia Medica and Therapeutics: With Ample Illustrations of Practice in All the Departments of Medical Science and Very Copious Notes of Toxicology: Suited to the Wants of Medical Students, Practitioners, and Teachers, Revised and Enlarged (Philadelphia: J.B. Lippincott & Co, 1857), 99. 104 Da Costa, “Observations on the Diseases of the Heart Noticed among Soldiers,” 379. 105 Hasegawa, “Pharmacy in the American Civil War,” 72. 106 Da Costa, “Observations on the Diseases of the Heart Noticed among Soldiers,” 379; Da Costa, “On Irritable Heart: A Clinical Study of a Form of Functional Cardiac Disorder and Its Consequences,” 44; Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), 1, part 3:863. 107 Da Costa, “On Irritable Heart.” 46. 108 Ibid. 48. 57 All three drugs, if prepared poorly or administered carelessly, could have killed the patient, let alone mimicked the symptoms of irritable heart.

Underscoring Da Costa’s ongoing commitment to specific therapeutics, Work received digitalis rather than either aconite or belladonna for his heart. Da Costa reported finding digitalis less effective in many cases but credited it with the slow, steady improvement of Work’s symptoms.109 Like both aconite and belladonna, digitalis can be extremely toxic if not administered carefully. Its action on the heart is well-known and widely studied today. Some twenty-first century pharmaceutical companies still use digitalis derivatives in heart medications. Digoxin, the commercial form of digitalis in use today, is used to treat heart failure and atrial fibrillation.110

Irritable heart rarely proved fatal, in Da Costa’s view, although the enlarged heart it caused could contribute to a soldier’s death. This prognosis is not to suggest that the diagnosis was unimportant or inconsequential. As a functional disorder, irritable heart did not produce lesions and did not enlarge the heart until late in the course of the disorder.

Yet, physicians agreed that this disease was real and different from the hypochondria and hysteria that worried physicians in civilian practice. Physicians worried about illnesses of all kinds impacting morale and reducing troop readiness. Functional disorders may have been particularly insidious because they did not correspond to a physical change on or in the body.

Da Costa was not alone in identifying irritable heart as a distinct disease. In the decade leading up to the Civil War, American physician Austin Flint began to study and

109 Ibid. 28. 110 “Digoxin (By Mouth),” Truven Health Analytics, National Center for Biotechnology Information, (March 1, 2015), http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0009944/?report=details. 58 categorize functional heart diseases.111 Da Costa certainly owed a substantial intellectual debt to Flint’s 1859 A Practical Treatise on Diseases of the Heart. Flint dedicated a lengthy chapter to the study of functional disorders of the heart, which he defined as

“disturbed action occurring independently of either inflammatory or organic affections.”

Flint indicated that, “in most instances the disturbed action of the heart is evidently due to morbid conditions seated elsewhere. It is usually symptomatic of either blood-changes, or affections of the nervous system, and, not infrequently, of both conjoined.”112 In findings that Da Costa would confirm just a few years later, Flint found that although functional disorders were deeply distressing to the patient, they rarely proved “serious.” He also outlined the broad categories of cause that Da Costa would observe among Civil War soldiers: “mental emotions, muscular exercise, ingestion of food or stimulants, &c.”113

The second edition of Flint’s book acknowledges the prevalence of functional disorders among soldiers in the “late Civil War.” Flint, however, credited the discovery to Dr.

Henry Hartshorne, a Philadelphia physician and peer of Da Costa mentioned in the

Medical and Surgical History of the War of Rebellion.114 The Surgeon General’s office credits Hartshorne with observing a condition he called cardiac muscular exhaustion, on which Da Costa later focused and refined into the irritable heart diagnosis.115 Physicians working in England also identified a similar condition. Da Costa was likely aware of the

111 “Austin Flint (1812-1886),” Heart Views: The Official Journal of the Gulf Heart Association 12, no. 4 (2011): 183–84. 112 Austin Flint, A Practical Treatise on the Diagnosis, Pathology, and Treatment of Diseases of the Heart, 2nd ed. (Philadelphia: Henry C. Lea, 1870), 456. 113 Ibid., 457. 114 Ibid.; J. Cheston Morris, “Henry Hartshorne,” Proceedings of the American Philosophical Society 39, no. 164 (October 1, 1900): iii. 115 Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), 1, part 3:862. 59 work done by W.C. MacLane on British soldiers, whose report used the term irritable heart and described similar symptoms.116

Da Costa included the condition in his 1864 textbook, wrote notices to the Army

Medical Department in 1862 and again in 1864, and published the foremost study of the disorder in 1871. Nonetheless, at least one other Union Army physician believed that his research into functional cardiac complaints in soldiers took precedence over Da Costa’s research—particularly after Da Costa “modified his views” in the decades after the publication of “On Irritable Heart.”117 In February 1886, Dr. Morse K. Taylor wrote to a friend and argued that he should get credit for the identification of irritable heart. Taylor, a major and surgeon in the United States Army, explained that he undertook research during his field service at Corinth, Mississippi in May 1862 and later at the general hospital in Keokuk, Iowa. The chief piece of evidence in his claim for precedence in the identification of irritable heart was an 1867 article he published, “Remarks on Heart

Diseases as Observed in the Military Service from 1861 to 1865 Inclusive,” in the

Transactions of the American Medical Association. Apparently unaware of Da Costa’s writing on cardiac disorders for the USSC in 1867, Taylor asserted that this article confirmed his claim to the identification and description of the functional heart disorder.

Taylor did not employ the phrase irritable heart in this article, but he did focus on irregular heartbeats and high pulse rates. Unfortunately, although the Surgeon General’s office recognized his research into soldiers’ cardiac complaints, these conditions were “of a wholly different character from those studied in the Philadelphia hospitals.”118

116 Wooley, The Irritable Heart of Soldiers, 12. 117 Morse K. Taylor, “Letter to Ira Bartholomew,” February 13, 1886, mssHM 80479, The Huntington Library, San Marino, CA. 118 Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), 1, part 3:864. 60 Heart or Mind

The decision to house cases of cardiac distress in the same hospital as nervous conditions complicated the extent to which irritable heart was viewed as purely a cardiac condition. Although technically the cardiac wing and nerve wings of the hospital were distinct, Da Costa and Mitchell worked as colleagues and were close friends.119 Given the extent of their personal and professional connections, it is probable that the two men discussed their patients. The presence of Da Costa’s cardiac wing inside a hospital run by neurologists and housing mostly patients suffering from nerve injuries shaped Da Costa’s opinions about treatment, causation, and disease specificity.

Ultimately, and in line with the overall mission of Turner’s Lane, Da Costa defined irritable heart as neurological if not, necessarily, a nervous condition. He drew on recent developments in neurology to explain the action of the heart in these soldiers:

In endeavouring [sic] to explain the nature of the malady… It seems to me the most likely that the heart has become irritable, from its over-action and frequent excitement, and that disordered innervation keeps it so. But our knowledge of the nerves of the heart, and their special functions, is as yet too incomplete, to say which nerves lie at the root of the disturbance.120

Describing the condition as irritable heart links it to a much longer tradition of irritability in medicine. According to psychiatrist and historian Edward Shorter,

“irritation acquired a kind of spurious legitimacy” in the eighteenth and nineteenth centuries because it was often conflated with inflammation.121 Unlike inflammation, which is a biological disease process that causes the impacted area to become hot, red, painful, and demonstrate some loss of function, irritation only manifests as a loss of

119 Cervetti, S. Weir Mitchell, 1829-1914, 70. 120 Da Costa, “On Irritable Heart,” 40. 121 Shorter, From Paralysis to Fatigue, 21. 61 function.122 Irritation could thus explain functional disorders unaccompanied by any lesion or sign of injury to the body. This provided an attractive conceptual model for Da

Costa as he faced a functional disorder with serious, debilitating symptoms that only occasionally caused physical changes in the anatomy. Given the difficulty locating the cause of the disorder inside or outside the physical body, some physicians and doctors turned to the mind as a cause. While they stopped far short of the kind of clinical descriptions used for PTSD today, nineteenth century doctors did recognize the extent to which a man’s emotional or mental state might impact the functioning of his heart or nerves. The Surgeon General’s office observed that,

Overaction of the heart during an engagement was due perhaps as much to nervous excitement and anticipation of danger as to overexertion. The recruit might control movements of his voluntary muscles but not those of the sympathetically accelerated heart. Even soldiers accustomed to the alarms of battle were not at all times exempt from the results of mental impressions. The call to action usually dissipated the feelings which gave rise to this acceleration and substituted a beat of greater force, although perhaps not of lessened frequency if the exertion of the occasion was violent or prolonged. Many cases of irritable heart were received into the general hospitals after the continued exertion, anxieties, and excitement of the seven days’ fight from Richmond to Harrison’s Landing, VA.123

The extent to which chronic heart palpitations and fatigue appeared as a physiological problem as opposed to a flaw in character vexed military and medical authorities during the war. Charles Rosenberg explained that the ambiguous status of emotional problems in the mid-nineteenth century drew physicians’ moral judgment. Until the last third of the century, these illnesses and altered emotional states did not become “legitimate until and if they became somatic.”124

122 Ibid. 123 Barnes et al., The Medical and Surgical History of the War of the Rebellion (1861-65), 1, part 3:862–63. 124 Charles Rosenberg, quoted in Wooley, The Irritable Heart of Soldiers, 2002, 140. 62 In the court martial case of Frank A. Schmeisser, a private in the 6th Connecticut

Volunteers, the role that fear played in the production of his symptoms formed an essential point of discussion regarding Schmeisser’s culpability. Schmeisser reportedly left his place in the ranks while on the march from McKay’s Point to the Battle of

Poctaigo Bridge and told his captain that “he was ‘going to do a job for himself.’” His captain ordered him to follow the company but Schmeisser refused, saying that “he had been far enough.”125 Schmeisser pled not guilty to the charge of cowardice and several witnesses testified that he had heart disease, frequently complained about pains in his chest, and was unable to keep up during a double-quick march. Edward Backley, the regimental surgeon, testified that he did not find evidence of organic disease and that functional disorders, like irritable heart, were rarely fatal. He ultimately ascribed the cause of the heart palpitations to nervous debility. A judge advocate asked Backley,

“would that palpitation be caused by fear?” and the doctor replied that, “it might, sir.

Anything that would affect the nervous system, might produce palpitation.”126 The court found him not guilty of the charge of cowardice but guilty of the specifics (e.g. talking back to his officers) and of abandoning his unit. However, the court was comparatively lenient with his sentence. Instead of being executed or branded, the court ordered

Schmeisser’s head shaved and that he be drummed out of camp in the presence of his regiment.127 While this is hardly compassionate treatment for a soldier coping with a physiological or psychological condition, the court apparently took into consideration the

125 Frank A. Schmeisser court martial, kk347 126 Ibid. 127 Ibid. 63 extent to which a man with a heart condition might not be physically or emotionally capable of performing his duties.

During the war, physicians rarely moved beyond general discussions of the mind’s relationship to a disordered body. The “mind-body problem” has vexed philosophers, physicians, and psychologists since at least the Enlightenment.128

Nineteenth century physicians who practiced scientific medicine, with a focus on the observable and measurable, obtained precision in physiological diagnosis at the expense of their patient’s self. The development of microscopy and other diagnostic technologies, in which Da Costa and other elite physicians were steeped, allowed the physician to focus on tissues and cells. Unfortunately, explained historians Anne Harrington and Theodore

Brown, these new tools “also fragmented the notion of organismic unity implicit in classical and early modern medical theory.”129 The ability of physicians to focus on specific disease entities meant that they no longer needed to account for the emotional or mental state of their patients. Da Costa and his peers at Turner’s Lane were working at a moment when rapid advances in scientific medicine promised to make the individual’s emotions irrelevant to his physiology. Even those physicians, like Austin Flint, who made mention of the relationship between emotions and disease tended to look for a physiological explanation. In his Principles and Practice of Medicine, Flint described functional cardiac disorders as being like “when [the heart] is temporarily excited by fear

128 A full reckoning with the philosophical underpinnings of the mind-body connection is far beyond the scope of this project. For a basic introduction to Enlightenment theories of the mind-body problem, see William Bristow, “Enlightenment,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Summer 2011, http://plato.stanford.edu/archives/sum2011/entries/enlightenment/. 129 Anne Harrington and Theodore Brown, “Emotions and Disease: The Balance of Passions,” an exhibition for the National Library of Medicine (Bethesda, MD: 2000), accessed 25 October 2016 . 64 or some other powerful mental emotion.”130 Unlike Da Costa, who never mentioned his patients’ emotional state, Flint was concerned with the dynamic relationship between heart palpitations and mental disturbance. Writing in 1867, Flint observed that “cases of functional disorder are characterized, as a rule, by much mental anxiety and depression…

The effect which it produces on the mind reacts on the disorder, and tends to perpetuate it.” When it came to explaining the causes of the disorder, Flint returned to concerns about the blood, digestion, and exhaustion following mental or physical excitement.131

Despite these initial forays into reuniting the body and the emotions in the practice of scientific medicine, neurologists favored the methodical study of the bodies of their patients over a psychological approach to stress or trauma. Flint, who saw a reciprocal relationship between functional disorders and mental states, nevertheless suggested that the physician study the physiological causes of the condition (e.g. anemia, over-indulgence in food or drink, dyspepsia, etc.).132 S. Weir Mitchell chastised his fellow physicians in 1894 for failing to study blood pressure, vision, and other physical conditions of the insane.133 Mitchell, Hammond, Flint, and Da Costa may have observed certain emotional characteristics in their patients but they believed that a physiological explanation underpinned the emotional component of the condition. With enough data about their patients’ bodies, they could uncover the precise way that a disordered heart changed someone’s personality.

130 Austin Flint, A Treatise on the Principles and Practice of Medicine: Designed for the Use of Practitioners and Students of Medicine, 2nd ed. (Philadelphia: H.C. Lea, 1867), 328. 131 Ibid. 132 Ibid., 329. 133 Charles F Wooley, The Irritable Heart of Soldiers (Burlington, VT: Ashgate, 2002). 142. 65 Measurements and specificity occupied Da Costa’s thinking during the war.

Despite the presence of thousands of wounded men in Philadelphia and a busy hospital schedule, Da Costa focused on incorporating new technology into his practice. Late in the war, Da Costa “begged” his friend and colleague, William Keen, to purchase him new diagnostic instruments while he was abroad in Paris. Among the items he requested was a

Marey sphygmograph.134 Invented in Germany in 1854, a refinement of the design by a

French clinician allowed the sphygmograph to become commercially available by

1860.135 Sphygmographs allowed physicians to measure the pulse and blood pressure and represent those measurements graphically (Figs. 2-3). Da Costa’s relatively early interest in this technique underscores his commitment to providing accurate diagnoses based on data and the best available science.

Figure 2: Marey Sphygmograph, produced by Breguet in Paris, 1866-1900. A piece of smoked paper would go on the right and the needle would trace the heartbeat. National Museum of American History, Smithsonian Institution, Washington, DC. Author’s photograph.

134 Ibid., 20. 135 Marey Sphygmograph, 1866-1900., January 2, 2007, Image number: 10290004, http://www.sciencemuseum.org.uk/images/i029/10290004.aspx. 66

Figure 3: Sphygmograph tracing paper. National Museum of American History, Smithsonian Institution, Washington, DC. Author’s photograph.

Although there are no records indicating when he received the device or if he used it in the wards at Turner’s Lane, pulse tracings became an important source of evidence in the 1880s and 1890s when neurologists, psychiatrists, and asylum superintendents began to evaluate the relationship between physiology and psychology in the nerve patient.136 After the war, former Surgeon General William Hammond posited that heart conditions might contribute to insanity due to changes in the amount of inter-cranial blood.137 Hammond was hardly alone in linking changes in the heart and circulation of blood to insanity. American alienist Allan McLane Hamilton included reproductions of sphygmograph tracings in his 1886 Types of Insanity (Fig. 5). In Hamilton’s account,

“heart disease has been found to exist in connection with nearly every form of insanity.”138 For men educated to look for lesions as the cause of disease, this move toward an integrated view of the mind and body was profound. It linked a functional disorder to a mental state before the development of the concept of a conversion disorder and provided a conceptual bridge between functional disorders and mental conditions.

136 J.M. Keniston, “Cardiac and Vascular Diseases in Insanity,” Proceedings of the Connecticut State Medical Society, 1893, 61–74. 137 William Alexander Hammond, A Treatise on Insanity in Its Medical Relations (New York: D. Appleton and Company, 1883), 702. 138 George Fielding Blandford and Allan McLane Hamilton, Insanity and Its Treatment: Lectures on the Treatment, Medical and Legal, of Insane Patients Together with Types of Insanity: An Illustrated Guide in the Physical Diagnosis of Mental Disease, 3rd ed. (New York: William Wood, 1886), 345-6. 67

Figure 4: Allan McLane Hamilton, “Types of Insanity.” Figure from Allan McLane Hamilton, Types of Insanity, an Illustrated Guide in the Physical Diagnosis of Mental Disease. New York: William Wood & Co., 1883. Page 13.

The supposed link between heart conditions and insanity that physicians developed a decade later connected irritable heart to shell shock and, later, PTSD. No such clarity in diagnosis existed at the time of the Civil War. Da Costa, as a leading teacher and researcher, would have been aware of Flint's work both before and after the war. Despite irritable heart’s nerve component, Da Costa stopped short of considering the disorder a kind of male hysteria or a stress response. In contrast, Mitchell and others had been circulating the concept of the male hysteric by the time of the Civil War. Mitchell even described some of the men in Turner’s Lane as having hysterical symptoms.139

No one suggested that irritable heart was not real. The men who came into

Turner’s Lane were undoubtedly suffering—their hearts raced, they felt real pain, they

139 Scull, Hysteria; Cervetti, S. Weir Mitchell, 1829-1914. 68 could not sleep—but were they suffering specifically from the emotional stress of battle and military life? Or were they suffering from the physical disintegration of nerves, heart muscles, and bodily systems as the result of injury and exposure? That heart conditions proved legible to medical, military, and civilian authorities during the war granted them an important form of legitimacy which, in turn, incentivized Civil War soldiers to frame their symptoms in the language of a physical disease understandable by their physicians.

Edward Shorter emphasized that, throughout time, the sick have drawn on a “symptom pool,” a series of templates for how to behave when ill, to present themselves in a way that is recognizable and understandable to their physicians.140

Different groups of patients adopt different “somatic styles,” or ways of processing and prioritizing the signals that they receive from their bodies and minds.141

These styles are the result of cultural values around the legitimacy of some kinds of complaints over others. For Civil War veterans, the symptoms associated with irritable heart had two main benefits. First, they corresponded to what physicians like Da Costa expected to see in patients with “irritable” nerves. Second, the symptoms were difficult to fake and, in turn, disprove.142 That a man could appear outwardly healthy yet still be diagnosed with irritable heart insulated the patient from accusations of cowardice, weakness, or effeminacy.

If a veteran struggled with an invisible injury, it needed to conform to a particular expected framework. Joseph Work, like the many pension applicants discussed in the

140 Shorter, From Paralysis to Fatigue. 2. 141 Edward Shorter, From the Body into the Mind: The Cultural Origins of Psychosomatic Symptoms (New York: Free Press, 1994), 60. 142 For more on understanding how patients benefit from drawing on particular kinds of symptoms, see Shorter, From Paralysis to Fatigue. 277. 69 next chapter, positioned himself as ill with cardiac complaints. The language of “break down,” which served him well in civilian life and among his peers, did not prove quite legible to medical and government authorities. For them, he pointed to the seat of his trouble—his heart—but did not employ a specific diagnostic label, instead preferring to let the medical examiners and Pension Office clerks read into his application a diagnosis that justified payment. This strategy was compromise between the experience of sickness and the expertise of the medical man.

Conclusion

Reading retroactively, historians have seen in the accounts of irritable heart and nostalgia the nascent concept of post-combat trauma and PTSD. Irritable heart’s link to

“hard service” and its physical symptoms, when combined with the emotional aspects of nostalgia, provide a tempting origin point for the trajectory of medical conditions associated with battlefield trauma that culminates with PTSD in the late twentieth century. While a few of the men Da Costa studied did report disturbed sleep and tunnel vision, the majority did not connect their physical suffering to the emotional dynamics associated with specific or general incidents of combat.

Long after the Civil War and improved medical understanding of the heart, nerves, and mind, “all broke down” continued to hold tremendous explanatory power. In a spring 1876 letter, Clara Barton, Civil War nurse and founder of the American Red

Cross, explained to a friend that, “my cough had left me, but I was weak, and fearing its return went to Washington as soon as I could for the winter, broke down again with

‘prostration of the nervous system,’ if anyone knows what that is, which was deepened

70 and nearly rendered fatal by the illness of my only sister…”143 Barton’s dismissal of the diagnostic term applied to her condition—going so far as to place quotation marks around it—demonstrates the extent to which these more general terminologies simply felt more accurate and appropriate for the personal experience of an all-encompassing state of ill- health. Likewise, veterans with far less medical training than Barton applied for pensions on the grounds that their health never recovered after the war. They cited a number of symptoms associated with their breakdowns, including the symptoms of irritable heart.

Post-war physicians, when faced with men who presented a complex mixture of symptoms and disease histories, also defaulted to the language of permanent breakdown to justify their disability ratings for the Pension Office.

Even veterans who used medical terminology tended to avoid the specific in favor of the more general. Private Work embraced more general terms like “cardiac disease” when applying for his pension. When he applied for a pension at age 36, he based his claim on “heart disease caused by exposure” combined with an “affection of lungs and weakness of back aggregated by subsequent hard service.” He dated the onset of his disease as December 13, 1862—a full eight months before the Battle of Gettysburg that

Da Costa identified as the origin of Work’s complaints.144 For Work, it was not the anticipation of battle at Gettysburg that broke his health but the 12th New Jersey’s long winter march from Washington, DC to Falmouth, Virginia.

Da Costa and his peer physicians’ emphasis on the specific and scientific never fully displaced more general and personal understandings of illness that circulated during

143 Clara Howe Barton, “Letter from Clara Barton to Edmund Dwight, 1876,” in The Life of Clara Barton: Founder of the American Red Cross, vol. 2, 2 vols. (Boston: Houghton, Mifflin & Co., 1922), 91–92. 144 Declaration for Original Invalid Pension dated June 12, 1880, Soldier’s Certificate No. 227.705, Joseph Work, Private, Co. I, 12th New Jersey Volunteer Infantry. 71 the Civil War. Whereas Da Costa presented Joseph Work’s symptoms as a “classic,” or representative case, of irritable heart, Work struggled with this interpretation both while under Da Costa’s care and decades later when he applied for a pension. If Da Costa’s life story represents the ascension of scientific medicine in the United States, Private Work’s life represents the ambivalent response of the American public and bureaucratic structures to ever-more specialized medical knowledge.

72 Chapter Two “With Patience and Due Allowance:” Pension Records as Patient Narratives

Private Joseph Work was among the approximately 26,000 men who had received a pension because of some kind of heart disease or disorder by June 30, 1888.1 Work left the Veterans’ Reserve Corps in July 1865 but his entanglement with the United States’ medical and military bureaucracy was only just beginning. After about fifteen years as a housepainter in the Philadelphia area, Work determined that his health prevented him from working full time. By then, he had married and had a child, so the pressure to provide for his family must have been acute. Like thousands of other men rendered unable to labor by the Civil War, Work entered a pension system designed to compensate men for injuries received in the war that prevented them from earning a living by manual labor. The application process included a medical examination and approval was fairly straightforward for men who had lost a limb, could point to a gunshot scar or hernia, or had documentation of a disease like malaria to justify their claims. Men like Joseph

Work, however, did not easily fall into the categories outlined by the Pension Office’s policies. Even being able to link his illness and treatment to the respected Dr. Da Costa, a physician employed by the Army Medical Department, did not insulate him from the complicated standards of proof for illnesses without a clear, physical sign. Da Costa’s cheery summary of Work’s health no doubt complicated matters further. In the ongoing, decades-long dialog between veterans like Private Work, physicians, and the Pension

Office is evidence of diverse and complicated relationships between individual soldiers

1 William Henry Glasson, Federal Military Pensions in the United States, ed. David Kinley (New York: Oxford University Press, American Branch, 1918), 138. 73 and the government they served. Embedded in the enormous amount of paperwork produced by soldiers are individual life stories that foreground the experience of illness in the post-war period. The men who complained to the Pension Office about the unjust interpretation of law and policy, who insisted on the existence and importance of their pain, or who refused to give up on a lengthy application reveal a great deal about the day- to-day workings of a bureaucracy that struggled to balance individual clerks’ sympathy for applicants with standardization and efficiency. Far more than a way to express suffering, these statements had the power to reshape policy and shift both the personal and official perception of illness.

Scholars in a variety of disciplines have looked at how the Pension Office’s policies and practices shaped attitudes toward social welfare provision, disability, and family life in the late nineteenth century. Historians, especially policy historians, have typically looked to the development of the Pension Office as a way to study the growth of

America’s welfare state. Theda Skocpol’s essential book, Protecting Soldiers and

Mothers, outlined the ways in which soldiers’ pensions provided a form of social support to the “worthy” poor in the period before the New Deal.2 She also explained the link between military pensions and later maternalist structures of social welfare provision. For too long, Civil War historians have looked at Pension Office records only as evidence of bureaucratic processes and the growth of the state. At the same time, literary scholars, like Susan Schweik in The Ugly Laws: Disability in Public, have evaluated the role that the specter of disabled or disfigured Civil War veterans played in forming cultural values

2 Theda Skocpol, Protecting Soldiers and Mothers: The Political Origins of Social Policy, Paperback (Cambridge, MA: Belknap Press, 1995), 7. 74 around the abnormal body and social support for veterans.3 Legal scholars writing in reaction to the 1990 Americans with Disabilities Act, like Peter Blanck, have examined the relationship between disability and stigma in the pension system.4 These studies provide a helpful bridge between policy-level discussions and the ways that cultural beliefs about disability and labor shaped individual lives in the nineteenth century.

Unfortunately, few scholars have investigated the ways in which individual patients negotiated, managed, or rejected the Pension Office’s process for determining disability status. Skocpol analyzed disability status on the policy level but her work did not extend to the ways in which individual veterans, their wives, or orphans exerted pressure on a complicated system that unevenly applied discretion to applicants’ cases.

Pension files demonstrate that, either through formal complaint or in their ongoing interactions with the Office, applicants insisted on specific and personal interpretations of general policy. Ceding study of the Pension Office to policy and legal historians has contributed to a narrative of the Office devoid of individual human agency motivated by sympathy, revulsion, or duty. This is especially frustrating because, as Roy Porter reminded scholars thirty years ago,

It takes two to make a medical encounter—the sick person as well as the doctor; and for this reason one might contend that medical history ought centrally to be about the two-way encounters between doctors and patients. Indeed, it often takes more than two, because medical events have frequently been complex social rituals involving family and community as well as sufferers and physicians.5

3 Susan M Schweik, The Ugly Laws: Disability in Public (New York: New York University Press, 2009). 4 See Peter David Blanck and Michael Millender, “Before Disability Civil Rights: Civil War Pensions and the Politics of Disability in America,” Alabama Law Review 52, no. 1 (Fall 2000): 1–50; Peter David Blanck, “Civil War Pensions and Disability,” Ohio State Law Journal 62, no. 1 (2001): 112–218. 5 Porter, “The Patient’s View,” 175. 75 Although many historians acknowledge the patient, they tend to default to stories about physicians, scientists, and government officials. In part, this is a product of the documentary record; most patients simply did not leave detailed accounts of their illnesses. Unique among archives, the documents generated by veterans for the Pension

Office and documents produced by the Pension Office in response to veterans’ claims include a broad spectrum of information about the ways that individual veterans challenged the medical and governmental definition of their disability or illness status.

Pension files, particularly for men applying on the grounds of an invisible or non-specific medical condition, incorporate personal statements, detailed accounts of family dynamics, and vivid descriptions of illness that did not align with the typical cases presented by physicians like Jacob Da Costa. Reading pension records with a focus on the contours of individual experience and personal perception of the diseased body can enrich scholars’ understanding of health and sickness as it was understood by patients in the late nineteenth century.

In an effort to re-center the patient in medical history, scholars and activists in the twentieth century began to advocate for the inclusion of patient narratives in studies of illnesses. Drawing on methods and approaches in literary theory and anthropology, scholar Ann Jurecic defined an illness narrative as an “autobiographical account of illness spoken or written by patients” that “developed both as acts of resistance to the medical establishment and as necessary complements to modern medicine.”6 The patient's perspective on an illness provides an important check on the case studies presented in medical literature. Although Jurecic wrote about late twentieth century patient narratives,

6 Ann Jurecic, Illness as Narrative, Pittsburgh Series in Composition, Literacy, and Culture (Pittsburgh, PA: University of Pittsburgh Press, 2012), 2, 10. 76 often in the form of self-conscious memoirs, her insights into the purpose and form of personal accounts of illness provides a model for reevaluating Civil War pension records.

Veterans penned their own accounts of the chronology, severity, and type of their illness outside government and medical practice as part of an ongoing effort to prove that their illnesses were both severe and meaningful. Instead of memoirs or essays produced for the public, Civil War veterans positioned their illnesses in relation to a government agency and social expectations of the deserving poor.

The Pension Office explicitly instructed its surgeons to record patient’s own accounts of their illnesses not long after the close of the war. The forms used by surgeons required that they list “the claimant’s statement” of his symptoms “as briefly and as completely as possible.” Although they encouraged brevity, these instructions also emphasized that “in all inquiries it will be necessary to receive the applicant's statements with patience and due allowance.”7 Letting soldiers’ explain their illnesses, wounds, or pain was understood as an essential part of the process of applying for and receiving a pension. Although the degree to which physicians documented their patients’ statements varies widely, these statements provide personal and subjective evidence about invisible disabilities.

The pension application process built in tension between the physician’s account of his patient’s history and the patient’s own account of his illness. The two accounts of a

Civil War soldiers’ health, ultimately adjudicated by a third party, makes clear a

7 J. D. Cox, “Report of the Commissioner of Pensions,” in Executive Documents Printed by Order of the House of Representatives, 1870-71, vol. 4, Congressional Edition 1449 (Washington, DC: U.S. Government Printing Office, 1871), 437. 77 phenomenon physician and anthropologist Arthur Kleinman described a century later in

The Illness Narratives: Suffering, Healing, and the Human Condition:

The recording of a case in the medical record, a seemingly innocuous means of description, is in fact a profound, ritual act of transformation through which illness is made over into disease, person becomes patient, and professional values are transferred from the practitioner to the ‘case.’ Through this act of writing up a patient account, the practitioner turns the sick person as a subject into an object first of a professional inquiry and eventually of manipulation. The patient’s record is an official account, in the language of biomedicine, that has legal and bureaucratic significance.8

Medical evidence may have more significance in the patient record but traces of patients’ voices and experiences remain present in the official narrative. A close reading of these documents reveals how individual patients described conditions like irritable heart. The language that they used, the metaphors that they drew on, and the importance that they ascribed to some symptoms over others complicates the descriptions offered by physicians like Da Costa. Soldiers adhered to the basic formula for presenting their case—hale and hearty before the war, sick afterwards—but managed to use that formula to present a much more nuanced account of their broken bodies than typically acknowledged by researchers. Despite the standard formula, veterans nonetheless pushed against a system designed to view disabilities as objective, identifiable conditions experienced in one way.

Theoretically, patient statements were present primarily to guide physicians’ examinations, but they also surely increased a physician’s sympathy toward the men who came before the board. Even though physicians did not record their emotional response to statements like “he feels as though his heart has stopped,” accounts of delirium,

8 Arthur Kleinman, The Illness Narratives: Suffering, Healing, and the Human Condition (New York: Basic Books, 1988), 130–31. 78 “nervous prostration,” or fainting on doing even the lightest work, the Pension Office’s response to doctors indicates that medical professionals were moved by them. The

Pension Office’s ongoing concern that physicians would imagine themselves as advocates for the men who came before their board suggests that listening to patient statements “with patience and due allowance” generated enough willingness to provide the veteran with the benefit of the doubt to approve applications that relied on minimal physical evidence. Clerks, many of whom were veterans themselves, likewise came under scrutiny. Yet, it is in these statements that examining surgeons and pension officers learned about individual experiences of pain, frustration at an inability to work, or anxiety about providing for a family. When read in conjunction with the social evidence provided in the testimony of fellow soldiers, neighbors, or clergy, a complex picture of a man’s sickness and health emerges.

The Pension Office

Congress approved pensions for Civil War soldiers in July 1862. The Pension

Office began to adjudicate claims not long thereafter. What began as a relatively simple system for paying soldiers for disabilities contracted “as a direct consequence of… military duty… from causes which can be directly traced to injuries received or disease contracted while in military service,” evolved into a complicated system with room for discretion, initiative, and interpretation by doctors and officials.9 Of the 406,702 pension applications approved between 1862 and 1888, a full 41 percent of them were granted for gunshot, shell wounds, amputations, or battlefield injuries. The other 59 percent of pensions were granted on the grounds of diseases and disabilities that may have been the

9 Glasson, Federal Military Pensions in the United States, 125. 79 result of wartime experience but may not have been directly tied to a particular injury or disease.10 After 1890, the Pension Office expanded eligibility to include length of service, disabilities of any origin (provided they were not the result of "vicious habits"), and eventually age. According to legal historian Peter Blanck, The Disability Pension Act of

1890 was “the most costly and liberal pension measure” anywhere in the world.11

The Pension Office, an enormous bureaucracy with a central office in

Washington, DC and additional staff around the nation, processed hundreds of thousands of applications for veterans, their widows, orphaned children, and dependent parents.12 In

1898, a popular guidebook to Washington, DC marveled at the 2,000 or more clerks at work in the Pension Office’s enormous building. The men who staffed the bureau could locate a single pension application among the hundreds of thousands stored in “rows upon rows of cabinets” in just a few short minutes.13 In her 1873 book, Ten Years in

Washington, Mary Clemmer Ames assured her reader that, “the clerks in this office have always compared favorably, both in industry and capacity, with those of other

Bureaus.”14 The office’s staff included “many an old soldier wearing in his coat lapel the bronze button; and there may be seen, too, many an armless sleeve.”15 Although veterans employed by the Pension Office might be expected to attend to their duties with unusual dedication, the magnitude of the operation meant that some inefficiency was inevitable.

10 Blanck, “Civil War Pensions and Disability,” np. 11 Ibid. 12 In 1866, as many as 160 new applications per day arrived at the Pension Office. Immediately after the war, between 400 and 500 applications arrived each day. See “Pension Claims,” The Tiffin Weekly Tribune, January 18, 1866. 13 Charles Bingham Reynolds, Washington: A Handbook for Visitors, The Standard Guide (New York: Foster & Reynolds, 1898), 122. 14 Mary Clemmer Ames, Ten Years in Washington: Life and Scenes in the National Capital, as a Woman Sees Them (Hartford, CT: A. D. Worthington & Company, 1873), 431. 15 Reynolds, Washington: A Handbook for Visitors, 122. 80 However, Ames notes that given the scale of the undertaking, a number of “worthless and inefficient” clerks were sure to be employed. Though small in number, their impact on the Office’s overall efficiency and public image was nevertheless substantial. Complaints about “red tape,” duplicate requests for information, and unanswered letters underscore the extent to which the Pension Office, though staffed by men with empty sleeves and carrying out a lofty mission, was nevertheless an unwieldy bureaucracy like any other.

Red tape aside, Civil War veterans encountered a pension system developed to be, in the words of Secretary of the Interior J.P. Upshur, “the wisest and most munificent enactment of the kind ever adopted by any nation.”16 By 1885, about 54 percent of pension applications were approved for some kind of disability payment.17 These pensioners represented the “righteous core of a generation of men” who deserved the public's financial support. However generous and munificent the pension system, veterans and their widows needed to navigate a series of bureaucratic processes designed to standardize their experiences, eliminate fraud, and reduce the budgetary burden of pension payments on the federal government. Despite little evidence of widespread fraud or abuse of the system, newspapers regularly ginned up anxiety about the able-bodied pensioner living off the largess of a grateful nation. Edwin Godkin, founder of The

Nation, wrote in 1895 that the pension system “sprinkled knaves and loafers throughout villages, to make fraud, and perjury, and malingering seem harmless and even soldierly.”18 Occasional concern about fraud did little to reform the system and the

16 Quoted in Skocpol, Protecting Soldiers and Mothers, 106.. 17 Blanck, “Civil War Pensions and Disability.” np. 18 Edwin Godkin, “The Sanctity of the Grad Army,” The Nation, April 25, 1895. 81 numbers of Civil War soldiers, their widows, and orphans receiving pension payments continued to grow well into the 1890s.

Some veterans moved through the application process in just a few months while others might have been stuck in limbo for over a decade. Often, applicants with invisible disabilities like heart conditions or non-specific complaints of general ill-health, faced additional evidentiary requirements. They may have been asked to provide affidavits from employers; statements from family, friends, neighbors, or fellow soldiers about the applicant’s past health status; documentation of treatment from either the family physician or the regimental surgeon; or various other forms of supporting evidence. The requirements of the law, opaque at best, created confusion among the men and women trying to comply with the law. Ames reported that,

You will not be astonished to be told that very often [evidentiary requirements] are not met, or that in thousands of cases the testimony is unequal to the gradgrind [sic] requirements of the law. A want of knowledge of the provisions of the law— more than of willful knavery—is the great acknowledged difficulty with which the Office has to contend.19

The department’s correspondence relating to documentation and asking for clarification on various details generated hundreds of letters each day and extended the time between a soldier’s initial application and his award. For men applying for an increase in their rating or reapplying as the law expanded to allow more disabilities and age-related conditions, this cycle of application, negotiation, and award could play out repeatedly over the course of a lifetime.

To make their initial application for a pension, veterans completed a standard blank form, provided either by the Pension Office or the veteran’s lawyer, and employed

19 Ames, Ten Years in Washington, 423. 82 similar phrases. Accounts often begin with a statement about how, prior to entering the service, the applicant was a “hale and hearty” man capable of performing a full day's manual labor around his family farm. While these documents conform to a shared format and purpose, the contours of individual lives are nevertheless apparent. Official Pension

Office medical forms required that doctors record the veteran’s own account of his symptoms and the objective evidence of disability. Additionally, the application process included ample information about a man’s work ethic and work history. These nineteenth century documents represent an attempt to obtain payment under series of specific, defined, and reasonably well-publicized criteria. Pensioners understood that they needed to justify their application in terms of manual labor and physicians examined veterans for recognizable signs of disease or disability.

Instead of arguing about specific medical diagnoses like irritable heart, many veterans presented their good health before the war as a key point of evidence to justify compensation for their ill health, broadly understood, after the war. For the invalid veteran, the experience of illness did not lend itself to specificity or easy cause-and-effect relationships. Instead, they presented themselves not as individual body parts or organs to manage but as men whose whole lives had been impacted by their time in the service.

Veterans used their application process and the medical encounter to advance a variety of understandings of health, disability, and the deserving poor. Careful study of individual pension records reveals a great deal about the contours of individual veterans’ suffering and underscores how veterans with invisible injuries forced the Pension Office to adopt a more holistic view of disability compensation. These records capture a negotiation between patients’ understanding of their lives, bureaucratic categories, and the

83 community members that viewed some veterans’ illnesses as more appropriate than others. Efforts to establish a uniform and objective standard for measuring illness and disability invariably came up against the messy reality of specific lives.

Despite this nod toward a more holistic pension application that took into account a patient’s subjective experience of their illness or disability, these same 1870 guidelines went on to state that, “justice requires that no rate of pension shall be recommended on any mere statement of physical disqualification, unsustained by the existence of such structural changes or pathological conditions as are known to accompany the particular form of injury or disease complained of.”20 The Pension Office took their lead from the medical profession and prioritized organic diseases over functional disorders.

A central tension in these negotiations is what constituted proof of an illness and its relationship to military service. Despite its myopic focus on the bodies of soldiers, the

Pension Office never managed to conform to either a strictly medical or strictly social model of disability.21 The medical model defines disability as an individual’s physical or cognitive state that requires management or treatment by experts organized around finding a cure. In some ways, Civil War pensions conformed to the idea that disability was something that needed to be identified, managed, and corrected using medicine and prostheses. In contrast, the social model of disability adopts a constructivist approach that understands society as disabling the cognitively or physically impaired through social exclusion.22 The medical model of disability management available in the 1870s and

20 Cox, “Report of the Commissioner of Pensions,” 437. 21 Larry M. Logue and Peter David Blanck, Race, Ethnicity, and Disability: Veterans and Benefits in Post- Civil War America, Disability, Law and Policy Series (New York: Cambridge University Press, 2010), 37. 22 Tom Shakespeare, “The Social Model of Disability,” in The Disability Studies Reader, ed. Lennard J. Davis, 4th ed. (New York: Routledge, 2013), 214–21; Barbara A. Gannon, “A Debt We Never Can Pay, A Debt We Refuse to Repay: Civil War Veterans in American Memory,” South Central Review 33, no. 1 (March 31, 2016): 69–83. 84 1880s relied on some elements of the social model of disability. Pension payments also represented a collective response to reducing the obstacles to a “dignified” life.23 In practice, a “dignified life” tended to mean only that a family would not fall into abject poverty as a result of a man’s service during the Civil War. Since physicians needed to determine the amount of work a man could do before they assigned a disability rating, physicians and Pension Office clerks never confined their evaluation of patients’ physical state. Pension applications brought medical evidence and medical thinking together with social descriptions of a veteran’s ability (or inability) to participate in the workforce. A close inspection of pension records left by patients with heart diseases and other non- specific complaints of ill health reveals that veterans, their caretakers, and pension officers attempted to prove a man’s disability, defined as the inability work and support a family, in both physical and social terms throughout the latter half of the nineteenth century.24

This combination of biological and social evidence created a unique document that does not fall neatly within what disability scholars today refer to as the medical model of disability. The process for applying for a pension required multiple kinds of evidence at different points in the process. First, veterans completed a “declaration for invalid pension” in which they provided basic information (e.g. name, unit, address, etc.) and a brief statement about their illness or disability that rendered them unfit for manual labor as well as its relationship to their time in the service. After completing this form, men appeared before a panel of three surgeons who examined the applicant based on his statement, recorded evidence of medical conditions, and assigned him a disability rating

23 Logue and Blanck, Race, Ethnicity, and Disability, 37. 24 Much of this paragraph draws on insights from Skocpol, Protecting Soldiers and Mothers. 85 based on their findings. Then, officials in the Pension Office evaluated both the medical board’s suggested rating and the veteran’s legal standing in relationship to oft-changing pension laws. They checked the veteran’s account of his service and medical history with both the Surgeon General’s office and the Adjutant General’s office. Only then did they reach a final determination of a veteran’s eligibility, disability ranking, and appropriate monthly payment.

The 600-plus physicians appointed by the Pension Office in 1863 filled a dual role; they were expected to protect the government from fraudulent or inappropriate claims while also providing critical evidence in a veteran’s file. In many cases, the examining surgeons were members of the community in which they served and understood, at least generally, the social position of the veterans (or their families) that they examined. This dual role, as advocate and inspector, invariably generated tension between physicians, the central office in Washington, DC, and veterans.25 On one hand, the central office required that its physicians to listen to their patients. On the other hand, officials directed physicians to avoid basing claim findings on the subjective experience of a patient. Instead, physicians needed to rank veterans’ disabilities based on empirical findings and physical evidence.

Given the degree to which disability determination depended on a veteran’s ability or inability to work, physicians and Pension Office officials needed to evaluate a variety of evidence outside the “strictly medical” information contained on forms designed to document a physical examination. Although physicians provided essential evidence for pension claims, pension officers rarely stopped at the statements of medical

25 John William Oliver, History of the Civil War Military Pensions, 1861-1895, vol. 4, History Series 1 (Madison, WI: University of Wisconsin, 1917), 13. 86 men when determining a veteran’s disability rating. Even when physicians observed the same symptoms in a patient, the Pension Office acknowledged that, “the degree of disability in any case is very greatly a ‘matter of opinion,’ about which the surgeons may very will differ.”26 Ultimately, judgments about a veteran’s disability ranking came down to the personal knowledge, values, and beliefs of the examining surgeons. Although the program to provide benefits to Union soldiers ensured that all men would be evaluated using the same rubric, individual prejudices and preferences influenced the administration of the program.27

Pension Officer Discretion

The Pension Office’s guidelines for its examining surgeons went to great lengths to explain how surgeons should record symptoms, which forms to use, and to remind surgeons that they were not, and should not imagine themselves to be, an advocate on behalf of the veterans who came before them.28 The office provided physicians with ample guidance for evaluating missing limbs, mangled hands or fingers, and gunshot or sword wounds in an effort to standardize payments and ratings. In 1870, for example, the

Pension Office’s instructions to surgeons offered guidelines for comparison. “The simple loss of an eye is a one-half disability. The loss of an index finger or great toe is three- eighths; of a thumb, one-half; of a finger or one of the smaller toes, each one-fourth.”29

Even as the office offered up these points of comparison, they acknowledged that these ratings could not be absolute. The same guidelines also noted that “no general rule can be

26 United States Pension Bureau, Instructions to Examining Surgeons for Pensions (Washington, DC: Government Printing Office, 1884), 14. 27 Logue and Blanck, Race, Ethnicity, and Disability. 28 Oliver, History of the Civil War Military Pensions, 13. 29 Cox, “Report of the Commissioner of Pensions,” 438. 87 laid down.” Instead, surgeons were encouraged to estimate the disability based on “the circumstances surrounding the specific cases.”30 These Pension Office payment schedules changed over the years but, in general, the loss of a limb, eyesight in one or both eyes, or a disability that required the regular aid and attendance of another person guaranteed a high rating and payment.31 These disabilities were reasonably self-evident. The more complicated questions revolved around people with invisible wounds. On these cases, the

Pension Office remained relatively silent in terms of guidelines. Disability schedules produced by the Office did not enumerate disabilities that lacked clear physical evidence.

Instead, a host of different kinds of illnesses and disabilities fell under the general heading “incapacity to perform manual labor.” If a surgeon found a soldier entirely disabled as the result of an illness, he was instructed to include the notation that the soldier’s illness, “‘is equivalent to the loss of a hand or foot for purposes of manual labor,’ and permanent in that degree.”32

In the absence of physical signs, examiners defaulted to social information about a man’s capacity to perform manual labor. When John G. Fowler, a private in Company

E of the 9th Minnesota Infantry, appeared before a medical examination board in 1886, he had already been on the pension rolls for over twenty-three years. He received a disability discharge after contracting rheumatism and resulting disease of the heart from hardship and exposure early in the war. His family physician testified in 1881 that, “any act of overexertion or over excitement might… cause sudden death.”160 Five years later, when

30 Ibid., 437–38. 31 Oliver, History of the Civil War Military Pensions, 4:21. 32 Cox, “Report of the Commissioner of Pensions,” 438. Emphasis in original. 160 Testimony of Dr. A.L. Dornberg 22 July 1881, Soldier’s Certificate No. 203.366, John G. Fowler, Private, Co. E, 9th Minnesota Infantry. 88 Fowler applied for an increase in his payment, the Pension Office’s surgeons approved his request for a pension increase based on “disability from disease of the heart equivalent to the loss of a hand and foot.”161 Various physicians described his heart disease as heart insufficiency, irregular heart (Da Costa’s Syndrome), hypertrophy of the heart, having a murmur, and “no disease evident but posing a dull beat.”162 While these diagnoses are not necessarily mutually exclusive, they are hardly conclusive. What remained constant in Fowler’s records, however, are physicians equating his inability to work to that of a man “missing a hand or foot.” During a 1914 appearance before the medical board, Fowler’s examiners found that he was entitled to “$24/mo because he is so disabled as to equate to loss of a hand or foot.”

In practice, the Pension Office’s plan to use “equivalent” to the loss of a hand or foot as a way to establish parity between visible and invisible disabilities created as much resentment and confusion as it promised to alleviate. Fowler’s disability was clearly serious enough to conform to this way of thinking but other veterans complained about the vagueness of this process. The Pension Office’s evaluation of conditions as indistinct as “broke down,” chronic diarrhea, general loss of health, or “nervous prostration” especially came under scrutiny by veterans and their families.33 Frederick L. West, whose letter to the Office opened this dissertation, wrote a lengthy and angry letter to the

Pension Office in April 1888 in which he asked:

Is a soldier who has proven his disability incurred in military service, entitled to the same rate of a wounded soldier, it being established by proper proof that the degree of disability to labor is as great or greater?

161 Fowler, John G. Surgeon Examination July 23, 1886, Soldier’s Certificate No. 203.366, John G. Fowler, Private, Co. E, 9th Minnesota Infantry. 162 Applications dated July 22, 1881, Sept. 5, 1881, June 23, 1886, May 1914, Soldier’s Certificate No. 203.366, John G. Fowler, Private, Co. E, 9th Minnesota Infantry. 33 Skocpol, Protecting Soldiers and Mothers, 107. 89 I know that injustice is done me and many other soldiers who have lost their health… Please tell me whether it is the law, the doctors, or the rulings of the Department that is responsible for the existing inequality that I may ‘cuss’ with proper discrimination.34

West had reason to feel frustrated. The 154th New York Volunteers saw action at

Chancellorsville and Gettysburg in addition to a number of smaller skirmishes. In 1875, after several years in the application process, West finally received a pension for tuberculosis and an atrophied testicle. In the decades following the initial award, West modified his claim to include an enlarged heart, heart palpitations, fatigue, and a hacking cough, along with a variety of other complaints. Thirteen years after his initial pension award, West continued to feel that the military did not appropriately value either his sacrifice or his physical illnesses. Despite his testimony that the pain in his groin had gotten worse and that the heart palpitations left him incapacitated for extended periods of time, the medical board denied his request for an increase of pension in 1879. A decade later, when he wrote the above letter to the Pension Office, West had appeared before medical boards at least twice. On both occasions the physicians noted that he was in pain and struggled with work. His resting pulse measured from 80-100 beats per minute—high but not excessive by Da Costa’s standards. Despite these observations, physicians also remarked that, “the heart and all its relations are normal” and “no disease” was present.

West’s testimony about his pain, his inability to work, and his overall loss of health did not rise to the level of evidence in this case.

His clear lack of confidence in the medical profession (and the Pension Office’s competence) comes through in almost all of his correspondence with the department.

34 Letter from Frederick L. West to Pension Office, April 10, 1888, Soldier’s Certificate No. 988.65, Frederick L. West, Sergeant, Co. D, 154th New York Volunteers. Emphasis in original. 90 Although more explicit in his frustration than many veterans, West’s dissatisfaction with the Pension Office and its physicians’ inability to account for unclassified physical symptoms (e.g. rapid pulse, difficult breathing, and pain) indicate the extent to which even nineteenth century patients used their accounting of symptoms as a way to confront the medical system’s “rational” approach to a body.

Not all soldiers who received a pension, however, were unemployed manual laborers. Unlike many soldiers who applied for pensions, both John Fowler and Frederick

West were employed in office jobs; Fowler worked as a registrar of deeds in Minnesota and West as a notary and town clerk. These veterans complicate the assertion that it was manual labor that defined disability. They made claims about the value of their health as its own good rather than as instrumental to their labor.

A physician’s beliefs about the etiology of a given disease or the appropriateness of rating someone fully disabled based on the patient’s economic or social standing in the community could also shape these decisions. Ultimately, the Pension Office’s examining surgeons needed to evaluate a host of factors that were not, strictly speaking, medical. In his evaluation of the administration of social safety net programs in the twentieth century, legal scholar Frank S. Bloch explained that, “much of the proof required to resolve vocational issues is foreign to medical personnel; even the evaluation of medical issues can require consideration of ‘nonmedical’ evidence.”35 Although this nonmedical evidence may not have directly entered the examination room, Pension Office staff collected affidavits and statements from friends and neighbors and physicians heard the

35 Frank S. Bloch, Disability Determination: The Administrative Process and the Role of Medical Personnel, Studies in Social Welfare Policies and Programs, no. 13 (Westport, CT: Greenwood Press, 1992), xvi. 91 patient’s estimation of his own capacity to work. The files are full of statements from soldiers who frame their account of symptoms in terms of their inability to perform manual labor.

For soldiers with a variety of complaints all altering their ability to work, the disorder easiest to observe often determined the pension rate. Rhode Islander Leonard

Hunt spent the later portion of the war at Danville and Libby Prisons in Virginia. During his time there, he suffered from exposure and malnutrition and eventually developed diarrhea and disease of the heart. Although he received some treatment from a “Rebel

Physician,” Hunt was eventually furloughed after being exchanged.36 A fellow prisoner of war, George Easterbrook, told the Pension Office that Hunt has for years complained of the lasting health effects of his time in prison, especially general weakness and inability to do much physical labor. Hunt’s heart diagnosis included phrases like

“disordered action,” “irregular,” and “irritable.” The physicians who examined Hunt used these phrases as adjectives to describe the symptoms they encountered, but did not offer a specific diagnosis. However, these phrases aligned with Da Costa’s observations and suggest that Hunt suffered from something similar to the patients at Turner’s Lane

Hospital. The examining surgeons reported that he told them that, “it feels as though his heart stopped, his lips become numb and he feels as though he should fall;” those physicians measured his pulse at 104 beats per minute at a June 1883 examination.37

During the same examination, he explained that during one of his “violent attacks of

36 Easterbook Affidavit, January 17, 1884, Soldier’s Certificate No. 263.429, Leonard A. Hunt, Private, Co. C and I, 4th Rhode Island Infantry and Co. D, 7th Rhode Island Infantry. 37 Hunt, Examining Surgeon, June 6, 1883. Soldier’s Certificate No. 263.429, Leonard A. Hunt, Private, Co. C and I, 4th Rhode Island Infantry and Co. D, 7th Rhode Island Infantry. 92 palpitation” in the winter of 1882, “his [left] eye became almost blind & he has had trouble with it ever since.”

Upon examining Hunt, the medical examiners reported that, “we find a very rapid pulse,” and the “heart’s action irregular, neither sound is distinct, nor is there a murmur to be detected. There is a genl [sic] muscular tremor as from weakness.”38 Ultimately, they noted that his disability was “perhaps” a result of his time in the service. Despite evidence of Hunt’s weakened heart and his testimony that he suffered from chronic diarrhea, the physicians declined to state that his disability definitely originated in the service or was the result of his time in prison. “It is impossible to judge how much his general condition is due to diarrhea & how much to heart disease. If it is known that he has chr. diarrhea we should rate at ‘Total’= 8. per mo.”39 When faced with inconclusive evidence, physicians and examining surgeons tended to accept gastrointestinal complaints as legitimate more often than complaints about the nervous system or general ill health.40

Despite official admonition, the Pension Office staff sometimes employed a kind of generalized sympathy for men who suffered tremendously as a result of a number of nonspecific disabilities to justify awarding a pension. This was particularly the case for men who entered the service quite young. Da Costa identified age of enlistment as a risk factor for irritable heart and, even when men did not employ the language of irritable heart in their applications, the Pension Office seemed to apply a lower burden of proof to the claims of men who enlisted as teenagers. William Apsley was just nineteen when he

38 Ibid. 39 Ibid. 40 See Figure 8 in Blanck, “Civil War Pensions and Disability.” np. 93 enlisted with Company D of the 118th Illinois Volunteer Infantry.41 He served for only one year (1862 – 1863) and received a disability discharge while being treated for nostalgic melancholia at St. Elizabeths Hospital (the Government Hospital for the

Insane). When he first applied for a pension in the 1880s, the tie between his varicose veins, heart trouble, and military service was tenuous at best. However, pension officers felt that,

In consideration of the youth of the soldier at the time of enlistment (about 15 years, Dr. Witmer) and the general effect upon his system of the hardships of the service as shown by the record, we are warranted upon medical grounds in admitting the varicose veins as a result of military service.42

Despite this suggestion from the Pension Office’s medical staff, confusion about his conditions’ links to his military service delayed approval and Apsley ultimately allowed his claim to lapse for over a decade.

By the 1890s, pension awards no longer needed to be directly tied to a specific illness incurred in military service. Instead, the system awarded payments on the grounds of length of military service or age.43 Under this expanded system, Apsley reapplied for a pension in 1901 at age 58 on the grounds of general disability resulting from a number of conditions, including ulcerated varicose veins and a weak heart. This claim was quickly approved and Apsley began receiving $10 per month. When he applied for an increase in his rating in 1904, he described his condition to a panel of examining surgeons with

41 There is some confusion about Apsley’s age at the time of enlistment. He indicates that he was 58 years old in 1901, indicating that he was born in 1843. However, the Pension Office indicates that he was 15 at the time of his enlistment. See Soldier’s Certificate No. 392.163, William N. Apsley, Private, Co. D, 118th Illinois Volunteers. 42 Medical Division note dated April 9, 1888, Soldier’s Certificate No. 392.163, William N. Apsley, Private, Co. D, 118th IL Volunteers. 43 Peter David Blanck and Chen Song, “‘Never Forget What They Did Here:’ Civil War Pensions for Gettysburg Union Army Veterans and Disability in Nineteenth-Century America,” William and Mary Law Review 44 (2003): 1109–71. 94 phrases like “heart trouble ever since 1868” and “that he is broken.”44 His stay in St.

Elizabeths, treatment for insanity, and his age at enlistment went unmentioned in these documents. When he appeared before the medical examiners a few years later, they catalogued the condition of his veins (discolored, thickened) and heart (sounds muffled, increased force, no murmurs). Under the heading “General Disability,” the physicians included a broad spectrum of disability including early-stage senility, soft muscles, tremors, “no useful teeth,” and that he appeared “emaciated and aged and broken.”45 The panel of surgeons found that, in aggregate, Apsley’s condition nevertheless warranted no increase. He was judged to be disabled at $10 per month. Discretion thus worked both in

William Apsley’s favor and against it. Early on, the sympathy Pension Office employees felt toward men who enlisted as teenagers provided him with the benefit of the doubt.

Later, however, discretion meant that difficult-to-diagnose disorders would not justify an increased pension payment.

In a few cases, where a widow or veteran’s eligibility remained unclear despite lengthy examination process, special examiners tried to err on the side of awarding a pension if a man or his widow conformed to ideas of the “deserving” poor. This discretion became particularly noticeable in the cases of widows applying for pensions after the death of husbands who had only a tenuous claim to pension payments. In the case of Virginia and Peter Bedor, discussed in detail in the next chapter, Virginia’s legal status as Peter’s guardian at the time of his death, her name appearing on various land deeds, and her success at stewarding their Kansas farm to profitability complicated

44 Surgeon’s Certificate, May 25, 1904, Soldier’s Certificate No. 392.163, William N. Apsley, Private, Co. D, 118th Illinois Volunteers. 45 Ibid. 95 Virginia’s status as a dependent widow. After several years of investigation, a Pension

Office special examiner stated that the case was one “‘where, if the scales poise doubtfully, Mercy should touch them with her down hand and turn the balance on the gentler side’.”46 His findings were no doubt influenced by Virginia Bedor’s sterling reputation, efforts to pay off her husband’s debts, and her status as “quite the business woman.”47 Although told not to advocate on behalf of individual applicants, it is clear that by the time a case entered the special examination process, objective evidence alone could not provide nearly enough evidence to determine a claim. At that point, individual biases, sympathy, and economic status shaped officers’ decisions.

Pain’s Value

Pain and individual accounts of pain presented a complicated problem to nineteenth century physicians (as indeed it still does for twenty-first century doctors).

Unlike symptoms that could be observed, even if the ultimate cause was unclear, chronic pain was neither observable nor clearly tied to a specific injury. For example, surgeons often awarded pensions for individuals suffering from chronic diarrhea even if they could not be absolutely sure that it originated during a veteran’s time in the service. That ailment had a clear, unpleasant physical symptom that a physician could foreground in his recommendation to the Pension Office. Pain, especially in patients with invisible injuries or diseases, forced physicians into a complicated relationship with their patients.

46 This quotation employed by the Special Examiner is apparently a reference to the play “From the Peasant Boy,” which appeared in the collection The Home Reference Library: Speaker and Entertainer. J.C. Winston Company, 1900. Report of the Special Examiner, May 19, 1906, Soldier’s Certificate No. 507360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 47 Report of the Special Examiner, May 19, 1906, Soldier’s Certificate No. 507360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 96 When he enlisted with Company K of the 2nd Rhode Island Volunteer Infantry in the summer of 1861, James W. Dennis of Newport, Rhode Island was a 28-year-old hearty and healthy seaman. Dennis and other members of the 2nd Rhode Island saw action at some of the largest and most infamous battles of the Civil War, including the Peninsula

Campaign and Manassas/Bull Run.48 One year after enlisting, Dennis left his unit to convalesce at the Government Hospital in Harrison’s Landing, Virginia. A few months later, in late January 1863, Dennis’ military career came to an end. Now age 30, “valvular disease of [the] heart” had rendered him “incapable of performing the duties of a soldier.”49 At the time of his discharge, he had already missed 61 days in the field.

Although discharged on account of his heart disease, Dennis did not apply for a pension for another ten years. In 1873, he complained of low energy, rapid pulse, and difficulty breathing after even moderate exertion.50 Although he did not use the diagnostic language of irritable heart, his symptoms align closely with Da Costa’s description of the functional disorder. The Pension Office rated him as totally disabled and awarded him $8 per month. Over the course of the next few decades, Dennis applied for increases and modifications in his disability ranking on several occasions. Twenty-seven years after his discharge, he complained to the Pension Office that, “I have a griping pain around my heart. A dull ache in my left side and across the small of my back, a cold heavy weight across the upper part of my stomach dizzy and fainting spells with a tired all [over]

48 “2nd Regiment, Rhode Island Infantry.” Soldiers and Sailors Database, November 26, 2014. http://www.nps.gov/civilwar/search-battle-units-detail.htm?battleUnitCode=URI0002RI. 49 Discharge papers, January 25, 1865, Soldier’s Certificate No. 108.293, James W. Dennis, Sergeant, Co. K, 2nd Rhode Island Infantry. 50 1873 Declaration for an Invalid Pension, 1873, Soldier’s Certificate No. 108.293, James W. Dennis, Sergeant, Co. K, 2nd Rhode Island Infantry. 97 feeling with a cough and shortness of breath.”51 Despite his claims regarding a “griping pain,” the Pension Office did not accept a patient’s own account of pain as grounds for increasing his pension.

Union veterans and medical examiners or pension agents met each other across the kind of unknowable chasm that is pain. In her landmark investigation into the meaning and theory of pain, Elaine Scarry explained that pain is both an undeniable and an unconfirmable fact. “To have pain is to have certainty,” Scarry explained.52 People in pain cannot deny the physical and idiosyncratic sensations of their pain even as they struggle to find the appropriate or correct metaphorical language to explain it to other people. The limitations in the language of pain also ensure that, “to hear about pain is to have doubt.”53 Pension Office surgeons needed to have doubt in order to do their jobs.

Their doubt, central to the efficient and cost-effective functioning of a bureaucratic system, profoundly limited the kinds of claims available for scrutiny by the medical board. Scholar of literature Lucy Bending emphasized that,

The inability of the medical profession to find a definition for pain is seen to invalidate private experience. It was certainly the case… that no one knew exactly what pain was in scientific terms—that is, how it works rather than how it feels— but such a claim is, nevertheless, an aggressive denial of experiential understanding.54

Although the Pension Office accepted that soldiers would complain of pain, the Office’s orientation toward physical traces of illness meant that surgeons could not easily adjust a rating based on those patient complaints. The 1884 Instructions for Examining Surgeons

51 Declaration for Increase of an Invalid Pension, February 6, 1888, Soldier’s Certificate No. 108.293, James W. Dennis, Sergeant, Co. K, 2nd Rhode Island Infantry. 52 Scarry, The Body in Pain, 4, 13–14. 53 Ibid., 13–14. 54 Lucy Bending, The Representation of Bodily Pain in Late Nineteenth-Century English Literature (Oxford: Clarendon Press, 2000), 57. 98 for Pensions included the stricture that, “a claimant’s statement, unsupported, of increased pain is not a ground for increase.” What qualified as appropriate support was never defined. However, if a physician believed that a previous medical examiner rated the patient “unjustly low,” he had the discretion to suggest his own rating and justify the change, despite no change in injury.55 In cases where a surgeon increased a man’s payment, either because of increased disability or low ranking, the main office expected surgeons not only to provide information about the condition but to explicitly compare the current state of the patient’s health to the condition for which he was originally pensioned.56

Nineteenth century doctors knew how to control pain—anesthesia had been around since the mid-1840s and a variety of opiates had been in use for generations—but were deeply uncertain about the physiological mechanism(s) that generated or benefited from pain. This complicated its role in evaluating disability. In 1887, The Lancet asked

“What is Pain?” and answered with “no one knows.”57 They offered some basic description of pain as the result of nervous excitation but beyond some basic descriptions

(compression, bruised, etc.) did not provide a definitive statement on how pain developed. Instead, they emphasized that pain “is a sensation that more or less rapidly and acutely assails the faculty of endurance” and that “pain is felt at some seat of sensation” that may be distinct from the point of injury. 58 Likening the nervous system to a telegraph wire, The Lancet suggested that pain might travel across the body. Physicians

55 United States Pension Bureau, Instructions to Examining Surgeons for Pensions, 14. 56 Ibid., 16. 57 “What Is Pain?,” The Lancet 130, no. 3337 (August 13, 1887): 333–34. 58 Ibid. 99 needed to look for the origin point of the pain, not only the site where patients identified being in pain.

This physiological explanation for pain did not account for the social and emotional dimension of pain. Today, neurologists believe that it is appropriate to consider pain as both a physical sensation and an emotional response to that sensation.59 If pain includes an emotional component, then it is even more difficult to evaluate from a clinical or bureaucratic perspective because it lacks clear origin or meaning. Two people will respond to similar stimuli in different ways; even day-to-day, one patient may experience a stimulus differently. The perceived link between physical distress and nostalgia, for example, underscores the ways in which pain could generate emotional disorders.60 The Pension Office’s anxieties about using pain as a metric for rate increases indicates the extent to which nineteenth century physicians, like their twenty-first century counterparts, cannot really know how a given individual experiences pain. Even attempting to evaluate a person’s level of pain is an inherently subjective experience depending as it does on the use of metaphor and analogy. Civil War physicians might have heard their patients describe a “gripping,” “pressing,” “pulsing,” or “searing” kind of ache that feels like it “burns” their skin. Alternatively, a patient might have compared their heart condition to the natural world. One soldier told Da Costa that his heart palpitations felt like “the fluttering of a chicken, when taken by the legs.”61 Deciding if a heart like a “fluttering chicken” was more serious than a searing pain above the heart

59 Edward R. Perl, “Ideas about Pain, a Historical View,” Nature Reviews Neuroscience 8, no. 1 (January 2007): 71–80. 60 Bartholow, A Manual of Instructions for Enlisting and Discharging Soldiers: With Special Reference to the Medical Examination of Recruits, and the Detection of Disqualifying and Feigned Diseases; Dean, Shook over Hell; Anderson, “Dying of Nostalgia.” 61 Da Costa, “On Irritable Heart,” 22. 100 requires physicians to make judgment calls far outside any objective measure of symptoms.

The language that Dennis and veterans like him adopted demonstrates how putting pain into language required that the speaker ascribe agency language to their internal experience. Elaine Scarry explained that, “the expressive potential of the language of agency” is precisely what allows it to “naturally” appear in the language of individuals expressing pain.62 The “gripping pain” Dennis described implicitly evokes an outside force acting on (gripping) his chest. This language allowed Dennis to objectify the felt characteristics of his pain as well as create a reference point for its interpretation.

Scarry cautioned that this is an inherently unstable practice, as it depends on the ability of the listener to link the external action to an internal and invisible state.63

The Pension Office’s decision to push physicians away from accounting for a patient’s pain removed an important symptom from consideration. In “What is Pain,” The

Lancet’s editors argued that, “it may be heroic to bear necessary pain, but to turn a deaf ear to the warning cry of pain is to commit an act of folly.”64 For veterans facing nonspecific ailments, who lacked concrete diagnoses, or who modified their claims as they aged, the Pension Office’s decision not to evaluate pain as itself a valuable complaint severely limited their access to financial benefits and social legitimacy.

However, it did not limit a veteran’s ability to self-medicate or seek medicine from their local physician. Pain was not denied under this system, but it was made irrelevant, which

62 Scarry, The Body in Pain, 17. 63 Ibid. 64 “What is pain?,” 334. 101 ultimately may have done more to make a whole class of disabled veterans invisible in the late nineteenth century.

Dennis died “from melancholia” in January 1900.65 Dennis’ death provides an almost too neat example of an understanding of pain as an emotion that is, like all emotions and sensations, located in the heart.66 Beyond a simple notation on his death certificate from a Newport, RI notary, Dennis’ pension file contains no mention of melancholia in any of his previous medical records. If he received any form of treatment for the condition, or entered an asylum or soldier’s home during this phase of his life, there is no official documentation of it in his pension file. Few, if any, physicians at this time connected mental health conditions to wartime service, in part because the failure to cope with Army life represented a failure of masculinity and patriotism.67 However, asylum superintendents and leading neurologists had started to link heart disease and mental disorders. While no documents chronicling Dennis’ descent into melancholia exist, his death from this condition would not have been a surprise to men like Allan

McLane Hamilton. In his 1886 study Types of Insanity, Hamilton found that sphygmograph tracings in melancholia “vary, but are usually of an asthenic character. In complicated traces with cardiac hypertrophy the pulse is rapid, hard” while in other presentations of melancholia the “heart impulse is weak, the tracing almost straight,

65 Dennis, death certificate 66 Jun Chen, “History of Pain Theories,” Neuroscience Bulletin 27, no. 5 (October 2011): 343–50; Perl, “Ideas about Pain, a Historical View,” 71. 67 For more on the period’s silence on links between combat and mental health, see Diane Miller Sommerville, “‘Will They Ever Be Able to Forget?’ Confederate Soldiers and Mental Illness in the Defeated South,” in Weirding the War: Stories from the Civil War’s Ragged Edges, ed. Stephen William Berry (Athens, GA: University of Georgia Press, 2011), 321–39. 102 broken only by a feeble systolic elevation and tremulous valvular indentation” (see chapter 1, figure 4).68

Freud and his theories of the unconscious had arrived in the United States by the time of Dennis’ death but medical professionals still tended to avoid connecting a soldier’s time in the field with his later mental distress. A connection between a heart condition and a veteran’s psychological state remained a simpler solution to the problem of men coping with a heart condition and mental distress. Echoing Hamilton’s findings from the 1880s, A. Zederbaum explained to members of the Colorado State Medical

Society in 1901that, “just as the heart is easily and promptly affected by the slightest of our emotions, so is a similar result in the brain caused by every marked change in the circulation.”69 While we cannot know for certain that Dennis’ decline into melancholia was a result of his heart condition, it is not outside the realm of possibility that nineteenth century physicians may have viewed these two diagnoses as linked.

Hereditary Disability

Jacob Fife, a private in Company B of the 1st Ohio Cavalry discussed more in chapter 3, never received a pension. He applied on several occasions and supplied testimony from his fellow soldiers, many neighbors, and his family physicians. His wife,

Sophia, spoke movingly about his rapid deterioration after his service in the Army, which included participating in the Battle of Chickamauga and accompanying General Sherman on his “March to the Sea.” After returning from the war, Fife spent some time in both the

Dayton, Ohio Soldiers’ Home and the Government Hospital for the Insane in

68 Allan McLane Hamilton, Types of Insanity, an Illustrated Guide in the Physical Diagnosis of Mental Disease (New York: William Wood & Co., 1883). 69 A. Zederbaum, “Mental Disturbances in the Course of Cardiac Disease,” Transactions of the Colorado State Medical Society, 1901, 222–33. 103 Washington, DC. Ultimately, the Pension Office found that, “an examination of the whole record in this case leads to the conclusion that this man was afflicted in some degree with nervous disorders long prior to enlistment, and that his troubles have been cumulative with the passage of time without reference to the incidents of his military service.”70 Fife appealed the rejection of his claim but the Pension Office affirmed its decision to reject his claim. Despite well over a decade of paperwork, Jacob, Sophia, and their children never received any payment for his time in the service and subsequent declines in his health. He died at the Government Hospital for the Insane in June 1887, two years after Sophia was appointed his guardian. The Fifes’ case underscores the complicated relationship between medical and social evidence regarding the heredity and sequence of certain conditions in the decades after the war.

Jacob Fife never received a definitive diagnosis that accounted for all of his symptoms. He complained of chronic diarrhea and pain throughout his chest and around his heart to family and neighbors. The examining surgeons recorded that his pulse rate reached 90 beats or more per minute. Over time, a jerking and twitching motion of his muscles became the dominant symptom that prevented him from either caring from himself or working. At the end of his life, physicians at the Government Hospital for the

Insane listed his death as the result of chronic dementia with chorea and hemorrhagic

Pachymeningitis Interna—essentially, bleeding and inflammation of the membrane around the brain.71 Combined with the insanity that came upon him late in life, Fife probably suffered from Huntington’s disease—a genetic, neurodegenerative disorder that

70 Special Examiners Report, September 21, 1887, Soldier’s Application No. 228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 71 “Internal Hemorrhagic Pachymeningitis,” Journal of the American Medical Association 35, no. 10 (September 8, 1900): 630. 104 tends to manifest in “adult or middle life” with both spastic muscle movements and progressive cognitive impairment.72 Fife’s examining physicians rated him one-half disabled due to chorea (uncontrollable shaking).

At the time Fife applied for a pension, however, Huntington’s disease remained a relatively new condition. Dr. George Huntington’s landmark paper, “On Chorea,” appeared in 1872, a full eight years after Fife began his application process. In this paper,

Huntington identifies and describes the condition he terms “hereditary chorea.” Whereas many soldiers received pension payments for nervous prostration and chronic diarrhea, in

Jacob Fife’s case, the presence of a hereditary condition precluded payment for any condition not just the preexisting condition. He never received payment for his heart condition, chest pain, diarrhea, or other disorders linked to his time in the service. In the eyes of the Pension Office, these were all secondary to the chorea either because they resulted from the condition or because the shaking and jerking caused the primary disability. Fife’s application came under special scrutiny on the grounds of his past health status.

It is unclear precisely what made the Office consider his application as a possible case of hereditary disease and investigate the extent to which his spasms were the result of a hereditary condition not his time in the field. If his condition pre-dated the war or was the result of hereditary infirmity, he would not be eligible for pension payments on those grounds. Jacob Fife returned from the war in 1865 and his friends and family immediately noticed the decline in his health. One of Jacob’s in-laws, James Bower, filed an affidavit as part of Fife’s 1893 application in which he reflected that he had “never

72 Huntington G, “On Chorea,” Archives of Neurology 17, no. 3 (September 1, 1967): 332–33. 105 knew of [the Fifes] to be sick, except Jacob L. after he returned from the army in 1865, who complained terribly of his breast hurting him, also of heart trouble and generally disabled and continued to become worse became very nervous and so disabled.”73 Sophia expanded on these observations in a moving and lengthy statement she provided to the

Pension Office when she became his guardian in 1885:

[Jacob] never stammered or stuttered, or trembled in any way prior to the war. The first I noticed anything wrong with him was the day after he came home from the army. We were visiting my father… My husband was handed a cup of coffee and he let it fall in center of the table. After supper we talked the matter over. He said he could not help it, he was so nervous or something like that at night I noticed he was restless; he seemed to be turning about and uneasy. From that time on he appeared restless and uneasy more or less every day and night. The next day he worked with my father, who at night told me Jacob was not the man he used to be… I had washed and shaved him before the war, but not because he was unable to do it. The third day after he came home, I shaved him. I was afraid to have him try it. I do not know who had shaved him before. He did not attempt to shave himself after coming home… The second or third day I noticed his hands trembled eating…74

Sophia’s lengthy statement about feeding, shaving, and otherwise caring for her husband reveals the extent to which he became, like so many other veterans, “twice a child.”75 Eventually, his inability to work for lengthy periods of time also impacted the family’s material circumstances. Fife included several similar statements, which provided conflicting evidence about the degree to which he was able to work. Neighbors and coworkers interviewed by the Pension Office about Jacob’s ability to work said that he had been an excellent farm hand prior to entering the Army but, after his time in the

73 James Bower affidavit, February 4, 1893, Soldier’s Application No. 228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 74 Sophia Fife statement, December 15, 1885, Soldier’s Application No. 228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 75 I borrow this phrase from R. B. Rosenburg, “Twice a Child,” in The Civil War Veteran: A Historical Reader, ed. Larry M. Logue and Michael Barton (New York: New York University Press, 2007), 347–55. 106 service, could not shear sheep or even hold the shears. In contrast, other neighbors remembered him and his mother shaking a great deal before he went into the Army.

Fife’s initial pension application emphasized that prior to entering the war he was healthy, worked on a farm, and had successfully passed the Army’s medical inspection. A friend and fellow soldier of Fife’s, Joseph Shear, even filed an affidavit stating that,

“[Fife] and I were in the same room together and examined by the same surgeon and we both passed. So far as I know he was a sound man.”76 By invoking the previous official medical findings, particularly around the Army’s own finding that he was fit to enlist in the service, Fife attempted to insulate himself from accusations that he had hereditary illnesses or insanity that was relevant to his case.

Adding to the conflicting accounts of Jacob Fife’s physical and mental break down, former soldiers in his cavalry unit provided varying accounts of when, and indeed if, Fife displayed any muscular trembling or insanity during his time in the service. John

Bell, also a member of the 1st Ohio Cavalry, told the Pension office that Fife was a good soldier. He occasionally suffered from diarrhea “but never shirked his duty even when he was ill.”77 Given the extent to which Civil War soldiers suffered from poor food and unclean water, occasional bouts of diarrhea are hardly surprising. Many veterans who applied for pensions listed diarrhea, either in the service or lasting long afterward as a chronic condition, as part of their claims. In contrast, George Shaw remembered Fife as

“very scary and seemed nervous.” Although he did “not remember any particular disease

76 Affidavit from Joseph Shear, May 17, 1864, Soldier’s Application No. 228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 77 John J. Bell affidavit, August 14, 1894, Soldier’s Application No. 228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 107 or sickness at the time in the service,” Shaw nevertheless felt that something was strange about Fife.78

The medical evidence indicated that chorea prevented him from performing manual labor but the social evidence was much murkier. The suggestion that the disease was hereditary rested on a few memories of Fife’s mother. Once Fife’s condition was tainted with a hereditary origin, his other physical complaints were subsumed to that larger diagnostic category. The focus on insanity and the hereditary nervous disease that caused his twitching meant that pension officers tended not to look into other kinds of illnesses that may have been the direct result of his time in the service. The focus on the familial connection made it almost impossible for Fife to prove a link between his illnesses and his time in the Army.

Conclusion

The pension system that developed to compensate Civil War veterans for their lost earning potential was the first, and in many respects the most liberal and expansive, social welfare policy yet enacted in the United States. By 1890, it absorbed nearly half of the federal budget, drove Republican party politics, and provided financial support to tens of thousands of soldiers, their widows, and orphans.79 Despite its “wise and munificent” policies, many veterans found the Pension Office unable or unwilling to recognize their service-related disabilities, especially in the decades before the 1890 General Law expanded eligibility requirements. Even after these new requirements went into effect, many veterans found themselves excluded on the grounds of heredity, unclear disease

78 George Shaw statement, December 29, 1885, Soldier’s Application No. 228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 79 Blanck and Song, “‘Never Forget What They Did Here:’ Civil War Pensions for Gettysburg Union Army Veterans and Disability in Nineteenth-Century America,” 1113. 108 origins, or simply as a result of pension officers finding their conditions illegible under the existing evaluation categories.

An example of neither the medical nor the social model of disability, the Pension

Office’s policies instead point to the ways in which payment of pensions was the product of intense negotiation between the government, soldiers and their families, and individual clerks. The Office’s own records reveal that individual pensioners intentionally complicated the neat operation of this federal bureaucracy in an effort to secure compensation for their general loss of health after the war. Instead of bending their symptoms to fit pre-defined categories, pensioners challenged the ratings of their undefined illnesses. At the same time, families like the Fifes pressed the Office to consider conditions in addition to a hereditary disorder. The ongoing nature of these negotiations, lasting anywhere from a few months to decades, underscores the Pension

Office’s failure to solidify the meaning, value, or boundaries of pensionable disorders.

109 Chapter Three Cared for “Otherwheres:” Broke Down Soldiers’ Sites of Care

Diagnostic categories and official recognition for injuries or disabilities contracted in the service provided some form of solace to men who returned from the

Civil War broken down. The extent to which pension payments or named conditions improved the lived experience of illness is less clear. Pension payments for wartime injuries may have kept a Civil War veteran and his family out of the poorhouse, which no doubt proved beneficial for their health, but did not necessarily guarantee effective treatment, pain management, or long-term financial stability. Although the federal government willingly took on the provision of financial compensation, unlike the twentieth century’s Veterans Administration hospitals and clinics, it did not provide direct services to sick, crippled, or traumatized veterans.1 These broken men turned to their female kin and local physicians to manage the ailments, such as irritable heart, that they brought back from the war. Since nearly all nineteenth century women were expected to care for their family members during times of sickness, the vast majority of

Civil War veterans received their medical and mental healthcare at home once they mustered out of the service. Women provided care for a wide array of chronic conditions, including irritable heart, diarrhea, tremors, and rheumatism. They received no compensation or support for this work but folded it into their existing household duties.

This chapter focuses on the Bedor, Fife, and Doust families because their stories provide a window into the shifting gender and social service landscape of the post-Civil

1 The federal government established the National Home for Disabled Volunteer Soldiers in March 1865. However, the system expanded unevenly and struggled to meet the demands placed on the system. For more information, see Brian Matthew Jordan, Marching Home: Union Veterans and Their Unending Civil War, First edition (New York: Liveright Publishing, 2014). 110 War era. Through their records, we get a glimpse of changing gender relations inside and outside the home, the expansion of asylums and soldiers’ homes, and government narratives of the “deserving poor.” The Bedor, Fife, and Doust stories, like all family stories, are unique but by no means exceptional. In focusing narrowly on these three families, I take a methodological cue from historian Linda Gordon. She explained that this kind of study ensures both that “the peculiarities of every situation are inescapable,” and “that my generalizations are seen for what they are: abstractions” that speak to

“typical” cases that are indicative of larger trends.2 These families may have been representative but should not be understood as the “correct” or only way to offer care to a wounded veteran after the war.

Because this work was not officially recognized and can be hard to locate in the archive, historians have had trouble quantifying, studying, and outlining the home-based networks of care that supported Civil War veterans. This chapter argues that the apparatus of caregiving is much larger than has previously been acknowledged. It encompasses family members, community members, the medical profession, a growing networking of social service agencies and charities, the court system, and many more institutions that enter into a caring relationship with the ill, disabled, or otherwise dependent veteran. Other studies have considered the home, hospital, and asylum in isolation when, in reality, the same patients moved back and forth between various sites of care throughout their lives. Their family members negotiated care inside, between, and outside these sites of care. They also worked to make the provision of care visible to a government uninterested or unable to provide support to individual caregivers. The life

2 Linda Gordon, Heroes of Their Own Lives: The Politics and History of Family Violence: Boston, 1880- 1960 (New York, N.Y., U.S.A: Viking, 1988), 18. 111 stories of Peter Bedor, Jacob Fife, and William Doust underscore the complicated ways that men cycled in and out of formal and informal sites of care.

By the time he died at age sixty in 1904, Peter Bedor had led a full, complicated life. He had immigrated to the United States from French-speaking Canada; served as a private in the 1st Connecticut Heavy Artillery; been under arrest for mutiny; fought at

Gettysburg; witnessed the fall of Petersburg; received treatment for acute mania in the

Government Hospital for the Insane; married his wife, Virginia Bedor, and fathered eight children; entered the Cloud County, Kansas jail; and had spent time at the state asylum in

Topeka, Kansas. After his final stay in the Kansas state asylum, Peter returned home where he lived out the final fifteen years of his life.

Jacob Fife, a private in Company B of the 1st Ohio Cavalry, led an even more complicated life in the years after the Civil War. Jacob was never an ideal pension applicant; accusations that his family had a history of insanity, coupled with suspicions that he had been ill prior to entering the service, prevented even the most generous official from granting him a pension. His diagnosis of hereditary chorea trumped his application on the grounds of a cardiac condition that resembled irritable heart, diarrhea, and nervous prostration. Although Fife never received a pension, he was able to take advantage of the Soldiers’ Home system and the Government Hospital for the Insane, and after Jacob’s death his wife, Sophia, received a pension under the 1890 general law.

White farm women across the nation struggled to balance the demands placed on them by invalid veterans, children, a farm, and the bureaucracy that provided an important portion of a family’s income. At the same time, Peter and Jacob’s journeys from the family home into jails, asylums, and the government funded National Home for

112 Disabled Volunteer Soldiers (NHDVS) system (colloquially known as the soldiers’ home), and then back to a family home demonstrate how multiple loci of care were mobilized to care for Union soldiers. These veterans’ encounters with institutions also demonstrate the shifting reality of custodial care in the late nineteenth century.

Caregiving as a Field of Study

Drawing on insights from contemporary social work and the emerging field of emotions history, in addition to medical and social history, this chapter analyzes the various sites in which veterans received care for various physical and emotional complaints. I use “sites” in its broadest sense. For example, Peter Bedor physically received care in St. Elizabeths Hospital and the Government Hospital for the Insane in

Washington, DC; his family home in Cloud County, Kansas; the Cloud County jail; and the Topeka Asylum. He also received care through a variety of institutions that were not explicitly in the business of providing physical help to the ill but which, nevertheless, entered into a caring relationship with him. His care within the home was possible in part because of the pension Peter received from the federal government. Although this was not tied to a physical location, the pension payment represented a kind of care intended to improve the soldier’s quality of life. When his wife, Virginia, became his guardian in the

1880s, the Kansas court system became involved in ensuring his wellbeing. Although

Virginia provided the bulk of the care Peter required, the court oversaw her guardianship through annual reports.

The care women provided at home represented only one “loci of care” for Civil

War veterans.3 The family home, soldiers’ home, and asylum should be understood as

3 Peregrine Horden, “Household Care and Informal Networks: Comparisons and Continuities from Antiquity to the Present,” in The Locus of Care: Families, Communities, Institutions, and the Provision of 113 part of a continuum of care that veterans moved through during their lives. Not all veterans moved smoothly through the home, soldiers’ home, and asylum systems. Peter

Bedor, for example, never spent time in a branch of the NHDVS although one was near his home in Kansas. Instead, he lived in at least two asylums and a jail during his lifetime. Other men stayed in their homes and received care from wives and unwed daughters for decades after they mustered out of the service. Considered as sites along a continuum of care, the family home, the soldiers’ home, and the asylum provide a way to think about how the presence of a large number of invalid men challenged gendered assumptions about the receipt of care, the meaning of home, and the role of the asylum at the end of the nineteenth century.

While the story of the pension system provides a useful point of origin for

America’s welfare state, it overlooks the ways in which the federal government pushed the physical, emotional, and spiritual care of veterans onto unpaid and unseen women.

Even when the NHDVS opened its doors, the system never managed to meet veterans’ demand for a place in an old soldiers’ home. Women’s participation in caregiving also underscores the ways in which a single veteran’s wartime experience rippled through his family life for years after an initial wound or sickness. A focus on women’s work as caregivers expands the definition of veterans’ medical care in the decades after the war and re-centers the human exchange at the core of the provision of long-term medical care.

Writing in 1994, sociologist and gender studies scholar Arnlaug Leira explained that, “the provision and distribution of caring responsibilities and costs are underresearched, and the importance and meaning of care in everyday life are

Welfare since Antiquity, ed. Richard Smith and Peregrine Horden, Studies in the Social History of Medicine (New York: Routledge, 1998), 21–67. 114 undertheorized.”4 Little has changed in the intervening decades. The historian interested in how individual patients moved between home, hospital, and custodial institution over the course of their life will find ample studies of isolated sites of care. 5 For example,

Patrick Kelly’s investigation of soldiers’ homes in Creating a National Home acknowledged that men often moved between their family home and the NHDVS but did not investigate the dynamics that shaped how and when men received care in different settings.6 Likewise, historians of custodial institutions have tended to focus on the institutions themselves rather than the ways that individuals negotiated life in and between various sites of care. These scholars often view the care provided at home as a precursor to the more serious, sustained, and professionalized care offered by physicians.7

However, feminist historians like Emily Abel and Megan McClintock have rejected this account of home care as “less than” the care provided by institutions. In different ways, their work foregrounded the family as a site of social, economic, and political change in the decades after the Civil War. Historians of women and gender have focused extensively on the provision of care to children by other women, midwives, and kin.

Extended studies of women caring for adult men—husbands, brothers, or fathers—are sorely lacking. The notable exception to this is Emily Abel’s Hearts of Wisdom. Abel’s

4 Arnlaug Leira, “Concepts of Caring: Loving, Thinking, and Doing,” Social Service Review 68, no. 2 (June 1, 1994): 185. 5 One notable exception to this is the edited collection edited by Peregrine Horden and Richard Smith, eds., The Locus of Care: Families, Communities, Institutions, and the Provision of Welfare since Antiquity, Studies in the Social History of Medicine (New York: Routledge, 1998). However, even this collection tends to reaffirm isolated sites of care and categories of illness rather than viewing patient experience holistically. 6 Patrick J Kelly, Creating a National Home: Building the Veterans’ Welfare State, 1860-1900 (Cambridge, MA: Harvard University Press, 1997). 7 Gerald N. Grob, Mental Illness and American Society, 1875-1940 (Princeton, NJ: Princeton University Press, 1983); Constance M. McGovern, “The Community, the Hospital, and the Working-Class Patient: The Multiple Uses of Asylum in Nineteenth-Century America,” Pennsylvania History 54, no. 1 (January 1, 1987): 17–33; David J Rothman, The Discovery of the Asylum Social Order and Disorder in the New Republic (Boston: Little Brown and Company, 1971). 115 book explained how nineteenth and early twentieth century women provided skilled, long-term care to ill family members and friends while also deftly navigating the changing landscape of professional medicine on behalf of their loved ones. Her study examined the stories of individual women who provided skilled nursing care to their husbands and children while also organizing professional medical care provided in the home by doctors and, eventually, overseeing care provided in a hospital or clinic setting.8

McClintock’s work on the Pension Office’s fundamentally conservative view of family structure presents a view of caring for veterans that focused so narrowly on the family that it overlooked the larger, institutional options for caring for veterans.9

Recent scholarship outside of history, notably in social work, public health, and economics, has identified informal caregiving as essential to the functioning of society. In addition to assigning monetary value to the unpaid, and too often under-valued, care that women provide to their families, these scholars have investigated the complex interplay between emotion, culture, political economy, and medical care. Although this body of scholarship provides useful models for the historian, it ought not be uncritically applied retroactively to nineteenth century families. Despite the different social, demographic, and medical environment from which these studies emerged, considering care and, implicitly, dependency as essential elements of the human experience across time is

8 Emily K Abel, Hearts of Wisdom American Women Caring for Kin, 1850-1940 (Cambridge, MA: Harvard University Press, 2000); Emily K. Abel, “A ‘Terrible and Exhausting’ Struggle: Family Caregiving During the Transformation of Medicine,” Journal of the History of Medicine and Allied Sciences 50, no. 4 (October 1, 1995): 478–506; Emily K. Abel, “‘Man, Woman, and Chore Boy’: Transformations in the Antagonistic Demands of Work and Care on Women in the Nineteenth and Twentieth Centuries,” The Milbank Quarterly 73, no. 2 (January 1, 1995): 187–211. 9 Megan J. McClintock, “Civil War Pensions and the Reconstruction of Union Families,” The Journal of American History 83, no. 2 (September 1, 1996): 456–80; McClintock, Megan J., “The Impact of the Civil War on Nineteenth-Century Marriages,” in Union Soldiers and the Northern Homefront: Wartime Experiences, Postwar Adjustments, ed. Paul A. Cimbala and Miller, Randall M., The North’s Civil War Series (New York: Fordham University Press, 2002), 395–416. 116 valuable. These contemporary scholars ask critical questions about the nature of formal and informal caring relationships that can help make explicit some of the assumptions about care that structure accounts of Civil War veterans’ lives.

The nature of the caring relationship requires that the caregiver enter into an emotional and functional relationship with the recipient of care. Care is thus both an emotional state and a series of tasks that ensure a basic level of comfort, dignity, and health. For historians, the labor component of care is the easiest to identify and quantify.

Nineteenth century Americans left ample records in pension applications, private diaries, and periodicals about the kinds of work required to maintain a veteran. Emily Abel uses the term “instrumental care” to refer to tasks like moving patients in and out of bed, helping with hygiene, cooking special meals, and procuring or producing various bandages or tonics.10 Identifying care work as work is especially important to feminist historians who argue that women’s contributions to the household have been both undervalued and overlooked.

However, limiting the understanding of care to merely a series of tasks underemphasizes that, in sociologist Arnlaug Leira’s words, “caring always involves relating personally to another human being.”11 Real, physical labor is the core task associated with providing care to someone but this labor should not be understood as identical to the production of a commodity. Even when the person providing care is a skilled, highly-paid professional and not a member of the family, the nature of the caring relationship demands human connection rather than the rote progress through a series of

10 Abel, Hearts of Wisdom, 60. 11 Leira, “Concepts of Caring,” 187; see also Ann Burack-Weiss, The Caregiver’s Tale: Loss and Renewal in Memoirs of Family Life (New York: Columbia University Press, 2006). 117 tasks. Of course, not all caring relationships are motivated by love or affection. Social obligations and financial realities may outweigh personal enmity in a person’s decision to provide care for an ailing parent at home and stories of elder abuse or child neglect indicate the extent to which the mere provision of basic necessities does not rise to the level of “care.” However, in a model caring relationship the caregiver and the recipient of care enter into a personal relationship that is greater than the sum of the required tasks.

Loci of Care: Home, Soldiers’ Home, and Asylum

The Home

The family home served as the first, and in many cases primary, site where chronically ill soldiers received care. Early in the war, Henry Bellows, president of the

USSC, emphasized the primacy of the home in caring for returning veterans. He wrote in

1862 that “their natural kindred are the first protectors of our invalids… the local community the next.” He worried that removing veterans from their homes would strike

“a most dangerous blow to domestic order, and to the sacredness of home affections and responsibilities.”12 Even with the federally supported NHDVS caring for thousands of soldiers at its peak, only about five percent of veterans were ever institutionalized in soldiers’ homes, asylums, jails, or poorhouses.13 Although hospitals began to expand in the decades after the Civil War, chronic conditions were still treated in the home.

Physicians offered advice but rarely stayed in the home for long-term treatment; only the wealthy could afford to hire in-home nurses to provide assistance in cases of chronic

12 Henry Bellows, qtd. in Kelly, Creating a National Home, 24-25. 13 James Marten, “Exempt from the Ordinary Rules of Life: Researching Postwar Adjustment Problems of Union Veterans,” Civil War History 47, no. 1 (2001): 69; Skocpol, Protecting Soldiers and Mothers, 140– 41. 118 illness. Unlike the professional staff of those institutions, women did not receive financial support, training, or emotional support in their care of veterans.

Emotional, cultural, and spiritual aspects form an essential counterpoint to the manual labor of care work. Emily Abel explains that nineteenth century women were expected to be emotionally available to their patient and to prepare the sufferer’s soul for death through Bible study.14 Given the degree to which nineteenth century physicians saw a close connection between the body and mind, caregivers needed to ease emotional and mental distress in order to facilitate healing. The emotional requirements of caregiving contributed to the gendering of this work as feminine. Americans assumed that women would take on caregiving work in the home. According to Abel, “female kin were considered especially qualified to offer the attention, sympathy, and reassurance that alleviated emotional stress and facilitated healing.”15 Men learned that wives, and to a lesser extent sisters, would provide near infinite support to their veterans. The Satterlee

Hospital Literary and Debate Society shared English poet Henry Kirke White’s essay

“Home” and urged men to find a wife. With a wife, White wrote, a man will have a happy home and someone to “nurse you when you are sick… mourn for you when you are dead.”16 Expanding on White’s plea for marriage, a resident of Ward A in the

Satterlee Hospital, wrote a paean to the “Wife” in the Hospital Register. After praising the generic “Wife’s” purity and devotion, the writer explains that, “I have seen her denying herself all the luxuries, comforts, nay, almost necessaries of life, to promote his pleasure and well-being: I have seen her beside his couch in the hour of sickness,

14 Abel, Hearts of Wisdom, 60. 15 Ibid, 3. 16 Henry Kirke White, “Home,” Hospital Register 2, no. 36 (April 30, 1864): 142. 119 enduring fatigue with uncomplaining patience.”17 These generic wives represented an ideal form of domestic organization that would influence how the Pension Office,

NHDVS administrators, and veterans represented themselves in official documents.

The emotional care that women provided is difficult to identify and quantify. The wives at the center of this chapter, Virginia Bedor and Sophia Fife, did not leave behind personal letters or diaries. To recover the labor they gave to their veterans requires reading their official statements to the Pension Office with an eye toward their tone and word choice. Within these narratives are hints about their feelings regarding their experiences as a caretaker. The professional staff of soldiers’ homes and asylums, likewise, completed bureaucratic reports that contain traces of the emotional labor required to manage a veteran’s physical and mental illnesses.

The caretaking relationship could be a source of identity and power. Emily Abel noted that, for some women, fulfilling these roles “could be a source of pride.... In overcoming challenges, some women discovered new resources” that provided them with an opportunity to display competence. Successfully expanding her family’s farm, paying down debts, and negotiating with a bureaucracy may have provided Virginia Bedor with a sense of accomplishment and control over her life that did not depend, at least directly, on Peter. Virginia’s neighbors and tenants testified that, after she became Peter’s legal guardian, she quickly learned how to succeed as a farm manager and head of household.

In these tasks, women surpassed the narrow confines of direct caretaking to take on much larger, more general tasks required to care and provide for a whole family.

17 Ward A, “Wives,” Hospital Register 2, no. 23 (January 30, 1864): 90. 120 Peter Bedor, Jacob Fife, and William Doust would have placed substantial demands on their wives’ energy and attention. Peter Bedor, a broken veteran if there ever was one, complained of a variety of physical illnesses, including headaches, constipation, urinary incontinence, rheumatism, general weakness, heart palpitations, and piles

(hemorrhoids).18 A family physician told the Pension Office that he prescribed for Peter regularly starting in the 1870s and found that Peter suffered a great deal from his bowels and headaches. Peter himself complained of an inability to “hold his water.” The documents in his pension file do not go into detail about what exactly this meant, perhaps reflecting a degree of Victorian decorum, and Virginia never provided a detailed description of tasks with which Peter required assistance.19 However, given the symptoms that he described, it is safe to assume that he created a great deal of laundry by soiling his bedclothes, sheets, and other linens. Laundry presented special challenges to women before the introduction of washing machines because it required drawing large, heavy amounts of water, caustic soaps that chapped the hands, and vigorous, exhausting scrubbing. Peter probably also required help with personal hygiene and his complaints of

“general weakness” may indicate that he needed assistance with basic physical tasks.

According to his surgeons’ certificates, Peter carried about 160 pounds on his five foot eleven inch frame. Records of Virginia’s size do not exist, but it is difficult to imagine that she would have been able to easily lift or move a man of Peter’s size. Additionally,

Virginia would have been expected to provide intimate care to her husband like cleaning up his urine, feces, and mucus. Other wives, like Sophia Fife, shaved their husbands

18 Various surgeon’s certificates included in the pension file for Peter Bedor. Soldier’s Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 19 Virginia’s silence on the specifics of her work is not unusual. See Abel, “A ‘Terrible and Exhausting’ Struggle.” 121 when their hands shook too much to safely hold a razor.20 Although Jacob could feed himself, it took over an hour and, according to his physician, “when he has finished he is soiled all over and everything about him is in a soiled condition.”21

If a family could not afford or did not see the need to consult a physician, women turned to “recipe books” for guidance on how to treat specific conditions. Virginia Bedor, an immigrant from Canada like her husband, may have consulted the 1869 edition of Dr.

Chase’s Recipes, or, Information for Everybody printed in London, Ontario. This practical guide to home nursing provided suggested cures for everything from drunkenness to croup, uterine hemorrhages, and tips on tooth extraction. Neither irritable heart nor insanity were listed in its table of contents, but nervousness, diarrhea, night sweats, and several associated symptoms and their treatment did appear in the book.22

The Household Physician, an American book printed in 1870, included detailed but simple information on anatomy, hygiene, exercise, and various diseases and their treatments.23 This book was not strictly a recipe book since it focused narrowly on medical care. Yet, it was as popular as a modern cookbook. It went through multiple editions and more than 30,000 copies were in circulation by 1870. In the book’s preface, its co-author, Dr. Ira Warren, explained that this “book aims... to popularize, and adapt to

20 Sophia Fife statement, 15 December 1885, Soldier’s Application No. 228789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 21 Physician’s affidavit, 28 February 1905, pension application No.228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 22 A. W. (Alvin Wood) Chase, Dr. Chase’s Recipes, Or, Information for Everybody: An Invaluable Collection of about Eight Hundred Practical Recipes, for Merchants, Grocers, Saloon-Keepers, Physicians, Druggists, Tanners, Shoemakers, Harness Makers, Painters, Jewelers, Blacksmiths, Tinners, Gunsmiths, Farriers, Barbers, Bakers, Dyers, Renovators, Farmers, and Families Generally : To Which Have Been Added a Rational Treatment of Pleurisy, Inflammation of the Lungs, and Other Inflammatory Diseases, and Also for General Female Debility and Irregularities : All Arranged in Their Appropriate Departments (London, ON: F.A. Taylor, 1869). 23 Ira Warren and A.E. Small, The Household Physician; for the Use of Families, Planters, Seamen, and Travelers, Being a Brief Description in Plain Language of All the Diseases of Men, Women, and Children, with the Newst and Most Approved Methods of Curing Them (Boston: Ira Bradley & company, 1870). 122 the many what has been claimed as belonging only to the few.” Warren went on to emphasize that, “it has been written in plain, simple English, and brought within the comprehension of all who have medium powers of mind. It has not been thought needful to reduce its language to the simpering style of baby-talk; that is done only by those who don’t know much about the people.”24 Virginia or Sophia, both of whom were literate, may have consulted a book like The Household Physician when faced with their husbands’ chronic conditions.

Providing care “dominated” nineteenth century women’s lives.25 All women provided a broad spectrum of personal care to their families. Family, friends, and neighbors provided help and expected that help reciprocated when their families took ill, but the years of constant care required by the chronically ill typically fell to immediate female relatives. For farm women, these tasks occurred in addition to the regular, unending household chores like cooking, sewing and mending clothing, laundry, seeing to animals, and tending a garden.26 As Abel argues, caring for family members formed a core component of a woman’s life, but “caregiving exacted a heavy toll. It imposed overwhelming household responsibilities, disrupted public activities, encroached on sleep and leisure, and caused an array of physical ills.”27

The emotional dynamics of caregiving were especially complicated in post-Civil

War families. Several people who provided statements to the Pension Office in support of

Peter’s application noted his violent and aggressive moods. His “sullen,” “morose,” and eventually “homicidal” moods would have disrupted family life and extracted a heavy

24 Ibid, iii. 25 Abel, Hearts of Wisdom, 37. 26 Ibid, 60. 27 Ibid. 123 toll on the emotional energy of his primary caretaker.28 Virginia never detailed specific incidents of abuse directed against her or her children, but Peter’s violent tendencies were well-known enough among his family, neighbors, and physicians that several people told the Pension Office that he was never left alone or allowed to leave the farm by himself.

For Virginia, who told the Pension Office in the 1880s that she did not know about his time in the Government Hospital for the Insane (GHI) prior to their marriage, this may have been an especially difficult obligation to meet. Not only would Virginia have attempted to shield their children from the worst manifestations of his mental conditions, caregivers were expected to draw on their own emotional reserves to bond with their patient and alleviate his fear or anxiety to facilitate healing.29

These marriages were undoubtedly shaped by the lasting effects of wartime service and chronically ill health. However, it is a mistake to assume that a veterans’ illnesses negated intimacy and affection. While the presence of children cannot be taken as evidence of affection per se, especially given Peter’s reputation for violence and aggression, most of the Bedors’ children and extended family remained in Cloud County and advocated on Peter’s behalf until his death.30

Historian Linda Gordon found that women in the 1870s and later, “did not seem to believe they had a ‘right’ to freedom from physical violence” despite wife-beating being illegal in almost every state at the time.31 A general consensus among reformers and activists that wife-beating was intolerable did little to help women who believed,

28 Respectively, Clementine Bedor’s affidavit, 14 March 1883; Surgeon’s Certificate, 5 August 1891; Soldier’s Certificate No. 507.360, Peter Bedor, Private, 1st Connecticut Heavy Artillery. 29 Abel, Hearts of Wisdom, 3; Sommerville, “Will They Ever Be Able to Forget?’" 325-6. 30 There is some confusion about the number of children Peter and Virginia had together. The Cloud County Historical Society has records for nine children but the Pension Office only lists six children. 31 Gordon, Heroes of Their Own Lives, 256. 124 rightly or wrongly, in the “inevitability of male violence.”32 For women living with disturbed or traumatized veterans of the Civil War, this sense of inevitability may have been particularly intractable. The specific dynamics of the Bedors’ marriage can never be known, as no diaries or personal letters survived, but the fact that an official record of his violent tendencies exists at all indicates that Virginia, her extended family, and community viewed Peter’s violence as outside “acceptable” levels of domestic conflict.33

Peter’s family connected his violent tendencies to his various illnesses rather than a failure of character. Peter’s father explained to a pension officer in 1883 that, “[Peter] seems to think that he is in the war again and do what we can, he still clings to that theory.”34 In the twenty-first century, Peter would probably be diagnosed with PTSD or a related condition.35 One hundred and fifty years ago, his family had few options except to hope that, “in years to come he might get all right and [to] humor him a good deal.”36

They attempted to manage his behavior, rather than treat it, by supervising his time away from the family farm and never leaving him unaccompanied. When this management failed, however, his family placed him into institutional care, first at the county jail and then in a Kansas asylum.

Like soldiers north and south who struggled with illness and insanity after the war, Peter and Jacob’s growing dependency on their wives, coupled with general idleness, positioned them as what one scholar called “twice a child”—not exactly

32 Ibid. 33 On negotiating acceptable levels of domestic conflict Ibid, 255-256. 34 Peter Bedor Sr. deposition, March 14, 1883; pension application No.507.360, Peter Bedor. 35 PTSD as a diagnosis does not emerge until the 1980s. The appropriateness of using PTSD as a diagnostic label for Civil War soldiers remains a point of contention among historians. See, for example, Dean, Shook over Hell; Sommerville, “Will They Ever Be Able to Forget?’” 36 Louis Bedor, affidavit dated 14 March 1883; Soldier’s Certificate No.507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery.

125 feminine, but not wholly masculine either.37 As the two men became more dependent on their wives and children for care and support, they ceded authority over issues that defined Victorian-era masculinity to their wives.38

When individual veterans could no longer manage their own affairs, women sometimes made those decisions independently—either as their husbands’ legal guardians or without formal legal authority to do so beyond the necessity created by caring for a disabled man in need of assistance. Both Sophia and Virginia eventually served as the legal guardians for their husbands. In this capacity, they upended notions about domesticity and propriety at the core of a system of home-based care and the Union pension system. In July 1883, sixteen months after Peter entered the Cloud County Jail, a court appointed Virginia his legal guardian on grounds of insanity. With Peter either in an asylum or home but unable or unwilling to work, Virginia took on the bulk of the farm management. Unlike the feminine tasks associated with caring for Peter’s body and emotional state, these tasks placed her firmly within the male world of land owners, contracts, and manual labor. By all accounts, she succeeded in this role. As Peter’s legal guardian, Virginia had authority denied to other women to determine the financial course of their families. She leveraged Peter’s pension payments to buy additional land and rent it out to tenant farmers.39 Although Peter died about $700 in debt and was not known to

“stand up to his contracts,” none of the people interviewed about Virginia criticized her

37 See R. B. Rosenburg, “Twice a Child,” in The Civil War Veteran: A Historical Reader, ed. Larry M. Logue and Michael Barton (New York: New York University Press, 2007), 347–55. 38 As early as the 18th century, laws in several US states allowed women to manage their family finances during the incapacity of a spouse. However, these laws tended to assume temporary incapacity. Future research should investigate how a man’s chronic insanity and inability to manage his own affairs may have complicated the extent to which his wife could act as his agent rather than as her own agent expected to steward resources held jointly. 39 Clarinda McCune affidavit, May 5, 1906, Soldier’s Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 126 management skills or the farm’s overall production.40 One of the officials assigned to investigate her claim to a widow’s pension noted, not without surprise, that she is “quite the business woman and has been very careful about contracting other debts, and is a very hardworking woman.”41

Sophia Fife became Jacob’s guardian in December 1885 due to his insanity and subsequent treatment at the GHI.42 Unlike Virginia, whose work on Peter’s behalf is well documented in her application for a widow’s pension and in the Kansas courts, Sophia’s guardianship work is much less clear. In part, this may reflect the fact that she served as his guardian for only eighteen months before he died in June 1887. Virginia, in contrast, served as Peter’s guardian for nearly twenty years. The Pension Office also approved

Sophia’s application for a widow’s pension after Jacob’s death more rapidly than

Virginia’s. Sophia received a widow’s pension under the expanded eligibility rules of

1890. She also presented herself as a typical widow. When Virginia applied for her widow’s pension after Peter’s death, the Pension Office refused to award any compensation on the grounds that she was not actually dependent. In the eyes of Pension

Office officials, women depended on their husbands for support and they assumed that a soldier’s widow was entitled to a pension. Historian Megan J. McClintock explains that,

“the order of family responsibility encoded in pension policy assumed that women first relied on husbands for support, then sons.”43 Sophia Fife and Daisy Doust, unlike

Virginia Bedor, clearly fit into this model. After her husband died, Sophia’s oldest son

40 W.W. Decker’s deposition, May 4, 1906; William Prairie deposition, January 24, 1889, Soldier’s Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 41 Report of the special examiner, May 1906, Soldier’s Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 42 See Soldier’s Application No. 228.789, Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 43 McClintock, “Civil War Pensions and the Reconstruction of Union Families,” 469. 127 became the guardian for her younger, “feeble” son who apparently suffered from a similar condition as Joseph. Sophia’s clear dependence on the men in her life, and the lack of any evidence that she expanded her role beyond wife, mother, caretaker, and short-term guardian rendered her application comparatively straightforward under the

1890 expansion.

Virginia’s application, however, presented a complicated picture of her caregiving duties and independence in relation to her husband. Peter’s pension contributed to the family’s ability to buy additional land but by all accounts the daily tasks associated with managing a farm fell to Virginia and the children. After investigating her claim, interviewing several neighbors and a tenant farmer on the Bedor land, the Pension Office concluded that the farm produced at least $250 a year in profit and was estimated to be worth about $6,000-$7,000 despite being an “ordinary farm.”44 Perhaps most confounding to the officers tasked with evaluating her claim, both Virginia and her husband’s name appeared on the deed to the family’s land.45 Although Kansas state law allowed women to hold property in their own names, regardless of marital status, Pension

Office policies enforced both legal technicalities around property ownership and/or inheritance and the social roles allotted to men and women. Investigators spent a tremendous amount of energy and time determining Virginia’s legal claim to that land in relation to her status as both a widow and someone legally allowed to execute contracts.

44 James McCahan testimony, 9 May 1906, Soldier’s Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 45 Laws determining married women’s property rights varied by state during the nineteenth century. Kansas’ 1859 state constitution allowed women to own property regardless of marital status. By 1868, Kansas law allowed women to control their own earnings and own property. However, the state law was less clear on wives’ control of property held by the household. As a federal agency, the Pension Office needed to respect state law while also enforcing national policies. The officers’ anxiety around Virginia’s claim to the family land and farm may reflect uncertainty about the particularities of Kansas law but also suggests a deep-rooted concern about her role as a business woman outside the domestic sphere. 128 She provided intimate care to Peter and raised his children but she also took on the role of a “business woman” and interacted with other residents of Cloud County in that role. To the men in the Pension Office, these two identities were almost completely incompatible.

When she appealed the decision against her claim, Virginia rejected her work as

Peter’s guardian, nurse, laborer, and the administratrix of their family finances. Instead, she emphasized a traditional family structure. She told the Pension Office there was no one legally obligated to care for her once her children were of age and that, despite her name being on the deed to the family’s land, she expected to receive only the “widow’s share” and would not make any additional claim on the estate.46 The competency she demonstrated as a manager of family and farm could not continue into her role as widow if she wanted to make a compelling claim for government’s support.

When home remedies fell short, the wives, sisters, and mothers of Civil War veterans continued to play an active role in the provision of care to their family members by serving as brokers between the family and the multiple healing practices circulating in the United States in the late ninetieth century. Women negotiated between allopathic medicine, homeopathic practices, and folk traditions, often employing different techniques as needed.47 Even if the family engaged a physician, most sick people remained at home through the nineteenth century, and women were expected to do the bulk of the required care for the sick.48 Short stays in asylums, soldiers’ homes, and poorhouses might provide some relief during particularly challenging periods of a

46 Report of the special examiner, May 1906, Soldier’s Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 47 Ibid, x. 48 Although hospitals expanded and professionalized during this period, rural areas were slower to embrace the hospital as a site of care. For more on the development of hospitals, see Charles E. Rosenberg, The Care of Strangers: The Rise of America’s Hospital System (New York: Basic Books, 1987). 129 veteran’s illness, but men typically returned to their families after their condition stabilized. Other than a handful of years when Peter Bedor lived in the Cloud County Jail or the state asylum, Virginia provided constant care for Peter during their nearly forty- year marriage. Likewise, Sophia Fife cared for Jacob at home for several years. Even after he moved into the Soldiers’ Home in Dayton, Ohio, Sophia continued to manage his pension application. She maintained an active correspondence with the Pension Office for decades as she attempted to secure payment for Jacob and, later, for herself.

Soldiers’ Homes

In the immediate aftermath of the war, the USSC and Congress pushed the burden of caring for individual soldiers onto families and the private sector.49 Veterans and their families ended home-based care for a number of economic, medical, and emotional reasons. When the family-based care system broke down, however, some old soldiers entered the NHDVS, known colloquially as the National Home or a Soldiers’ Home.

The decision to send a veteran out of the house to receive care was not at all uncommon but still represented a rupture in family life. Like Virginia Bedor, Sophia Fife managed her husband’s many illnesses and injuries. Jacob Fife suffered from a number of complaints including chest pain, heart trouble, chronic diarrhea, and serious, uncontrollable tremors (alternately diagnosed as St. Vitus Dance and chorea). In

September 1882, Jacob left the family home in Washington, Ohio for the central branch of National Home for Disabled Soldiers in Dayton, Ohio. A friend of the Fifes testified that when Jacob left the family, Sophia’s brother-in-law, William Fife, “became angry at

[her] as he desired one of her daughters to go and live with [Jacob] and because Mrs. Fife

49 Kelly, Creating a National Home, 59. 130 would not make her go and live with him.”50 It is unclear what exactly William Fife expected his niece to do for Jacob. Although the NHDVS administrators initially considered allowing men to live with their families in small cottages on the grounds, this plan was ultimately rejected and all the residents lived as bachelors.51 Like all families,

Sophia and William’s disagreement about Jacob’s care may have been about a number of other issues in the relationship. William once sent the Pension Office a letter that undercut the entire basis for Jacob and Sophia’s pension claim. She, in turn, described him as a man who, “would not hesitate to impugn or even defeat, the claim of the widow of his dead brother” with “wicked, malicious, [and] false” statements.52 Family dynamics played an important role in the provision of care to an invalid veteran. If Sophia felt unsupported by her in-laws, the decision to send Jacob to the NHDVS may have been that much more emotionally charged.

Unlike Sophia Fife and some other women who temporarily admitted their husbands to asylums or soldiers’ homes in the 1880s and 1890s, Virginia had the full support of her in-laws, indicating that the decision did not place her outside the family or open her to substantial criticism. Rather than interpret Virginia’s actions as a failure to live up to the era’s standards of feminine, in-home nursing care, her choices should be understood as part of the spectrum of caregiving decisions she made over the course of their marriage.53

50 James M. Bower, general affidavit, 4 February 1895, Widow’s Certificate No. 347.367, Sophia Fife, widow of Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 51 Jordan, Marching Home, 175-176. 52 Sophia Fife, sworn statement, 12 February 1890, Widow’s Certificate No. 347.367, Sophia Fife, widow of Jacob Fife, Private, Co. B, 1st Ohio Cavalry. 53 For more information on the decision to place a family member in institutional care, see Burack-Weiss, The Caregiver’s Tale; Katrina Gatley, “The Spouse, the Neurological Patient, and Doctors,” in The Neurological Patient in History, ed. L. Stephen Jacyna and Stephen T. Casper, Rochester Studies in Medical History (Rochester, NY: University of Rochester Press, 2012), 81–106. 131 Congress established the National Asylum for Disabled Volunteer Soldiers

(NADVS) in March 1865 just as the Civil War neared its close.54 General Benjamin

Franklin Butler, appointed as head of the NADVS as a way to get the unpopular General out of the field, began drafting plans for three sites in Maine, Ohio, and Wisconsin.

Reflecting cultural expectations about home-based care, Butler and the other members of the NADVS board of governors drastically underestimated the extent of the need. In

1869, Butler explained that they, "believed that few soldiers would take advantage of its provisions, that most of the disabled soldiers would be cared for otherwheres.”55 The hesitancy to build these sites also reflected American fears about the NADVS’ potential costs; uncertainty about the appropriateness of national, rather than local, action on behalf of veterans; and, contributing to a culture of dependency among veterans. Congress and the leadership of the USSC understood that wounded and chronically ill veterans would place a substantial burden on veterans’ communities. The USSC’s leadership studied

France’s Hotel des Invalides and England’s Chelsea Hospital but found in them symbols of a centralized state, antithetical to a republic like the U.S.56

The official name of the institution changed from Asylum to Home in 1873.

Historian Patrick J. Kelley explained that, the "managers’ use of a ‘homelike’ language helped establish the conceptual framework under which a generous institution for the care of veterans could be built and governed."57 The shift to home-like language moved the

NHDVS away from any stigma associated with asylums or poorhouses and instead emphasized mutual obligation between a soldier and his government, the network of care

54 The term “asylum” was replaced by “home” in 1873. 55 Congressional Serial Set, vol. 1385 (Washington, DC: U.S. Government Printing Office, 1869). 56 Kelly, Creating a National Home, 59, 74. 57 Ibid, 90. 132 and support required the care for the invalid veteran, and the positive feelings associated with the late nineteenth century home. During the war, a soldier reminded his fellow hospital patients that, “in order that man may be happy, he must have a home—a place which he may call his own.”58 He may not have envisioned the kind of home that the

NHDVS offered but it was better than becoming indigent or living as a bachelor.

In order to help the NHDVS sites feel more comforting, their location and design emphasized a peaceful, “home-like” character. Typically a few miles outside an urban center, NHDVS sites featured “agreeable” scenery. The buildings, which drew on

Thomas Kirkbride’s design principles for asylums, emphasized ventilation and natural light.59 Additionally, the institution’s superintendents offered a wide variety of amusements and pastimes. Visits to libraries, zoos, and theaters occupied residents’ time between chores and occupational training.60 The Milwaukee NHDVS operated a beer hall for its residents, in part to keep them out of nearby taverns and in part because it generated an enormous amount of income for the home. The homes encouraged visitors to stroll through their beautiful, park-like grounds. In this way, residents were able to mingle with civilians and their visiting families.

Even those inmates, as they were called in the NADVS’ early years, whose injuries rendered them incapable of supporting themselves or a family were expected to recover and return to their communities.61 The homes provided the opportunity for soldiers to obtain an education or learn a trade in what has been called “an early form of

58 White, “Home.” 59 Kelly, Creating a National Home, 110-113. 60 National Park Service’s Heritage Education Services and Federal Preservation Institute, “Daily Life at the National Home for Disabled Volunteer Soldiers,” NPS.gov, Veterans Affairs National Home for Disabled Volunteer Soldiers, accessed August 13, 2015, http://www.nps.gov/nr//travel/veterans_affairs/Daily_Life.html. 61 Marten, “Exempt from the Ordinary Rules of Life,” 61. 133 occupational therapy.”62 According to the NHDVS Board of Managers, job training and education encouraged “patients to replace morbid ideas with healthy, normal ones to incite interest and ambition and assist to restore a lost or weakened function either mental or physical.”63 Different homes offered different tasks to their residents, including cigar manufacturing, tailoring, and tin smithing. Although men entered the NHDVS because of their disability and resulting inability to support themselves through manual labor, all residents were nevertheless expected to contribute to the upkeep of the grounds, garden and farm labor, construction or repair of new buildings, and nursing their sick or ill peers.64 Work would occupy their minds and their hands. It also provided paid employment to many of the home’s residents. Kelly found that about two-thirds of

NHDVS residents prior to 1890 did not receive a pension. Thus, the paid labor provided an important way to reduce costs, provide men a sense of independence, and provide for families back home.65 A new trade would also help men return to their communities able to contribute to and support their families. A skilled trade also distinguished the NHDVS sites from the more typical, and stigmatized, sites of “indoor charity” offered at alms houses.

Although the NHDVS may have aspired to a home-like atmosphere for its patients, in practice the NHDVS often fell far short of its goals. “Bachelors’ lodgings are not homes,” according to a wartime hospital newspaper, and soldiers’ homes were no exception.66 In these institutions, soldiers lived with other aged or disabled veterans under

62 National Park Service’s Heritage Education Services and Federal Preservation Institute, “Daily Life at the National Home for Disabled Volunteer Soldiers.” 63 Quoted in Ibid. 64 Ibid. 65 Kelly, Creating a National Home, 160. 66 White, “Home,” 142. 134 quasi-military organization and discipline. Veterans reported finding their fellow residents unfriendly, at least outside of the beer halls. The realities of group living could be frustrating. A lack of privacy, the mixture of ethnicities and social classes, and inability to determine how one organized one’s own days generated deep resentment and frustration among the veterans who expected the NHDVS to provide them with a truly home-like setting.67

Despite the efforts of the federal government and home managers, many NHDVS sites became the subject of scandals when deplorable conditions, widespread drunkenness, or low morale became public knowledge. Alcohol presented a constant source of trouble and frustration to veterans and the homes’ managers. Some soldiers may have used alcohol as way to self-medicate for undiagnosed or misunderstood mental illnesses.68 Others, however, used alcohol as a way to pass the time in a place where routine and monotony characterized their days. More than five hundred residents lined up outside the Milwaukee home’s canteen, which served beer, each morning.69

Opportunities to mingle with the public also increased the likelihood of confrontations between the residents and civilians. In his review of the Milwaukee home’s disciplinary records, James Marten found that, “several inmates were charged with ‘exposing’ their

‘persons’ on National Avenue or at a nearby train depot” while others “insulted ladies on the grounds,” or attempted to molest schoolgirls visiting the home’s grounds.70 Since men

67 Kelly, Creating a National Home, 150-154. 68 Ibid.; Dean, Shook over Hell, 80, 168–70. 69 Kelly, Creating a National Home, 165. 70 Marten, “Exempt from the Ordinary Rules of Life,” 65. 135 could not bring their wives to live with them at the homes, it is perhaps unsurprising that prostitution flourished near NHDVS sites.71

If residents got bored or frustrated with the conditions at the home, or if they received word from a family member that they were welcome, they could check themselves out. Homes were always organized to serve as temporary sites for men in need. While many stayed for the duration of their lives, others came and went as the seasons, economy, and family circumstances allowed. Men who expressly entered the home temporarily were nevertheless required to go through a kind of mustering out process when they desired to leave the home and return to their families or occupations.

This process required that the veteran prove his capacity to care for himself and not become a burden to his community. The home's governor decided who could leave and on what terms. When a man desired to check himself out of the home, he reported to the governor of the home and stated his case for discharge. Butler explained that, "under such representations, if there is reasonable cause to believe them true, the soldier is discharged, and if his conduct has been exemplary he is furnished with a handsomely engraved certificate of honorable discharge, which should be a recommendation for employment."72

The pull of home and a wife or other female relative’s care proved difficult for many men to resist. All too often, however, men made their way back into NHDVS homes. Despite the governors’ attempts to distinguish between the dependent and the independent, NHDVS administrators found that men often returned to the home after a

71 Kelly, Creating a National Home, 175-178. 72 Congressional Serial Set, 6. 136 few months. According to them, the veteran's desire to return to his family, or simply his

“restless” nature, often caused him to,

Overrate or misrepresent his ability to take care of himself, and after a few months' absence he is found either applying for charity or having wandered into some state home or charitable institution, again applying for admission, adding to the expenses of the institution the amount necessary for his transportation.73

Not all deserving veterans managed to secure a bed in the NHDVS system.

Historian Brian Matthew Jordan estimates that at least 30,000 men ended up in city and county almshouses in the decades after the war. 74 Administrators at the NHDVS realized that the shortage of beds caused a great deal of hardship and worked to provide "outdoor" relief to soldiers in state and city institutions. However, the stigma associated with entering the poorhouse meant that at least some men chose to commit suicide rather than continue to fight for benefits, bed space, or work.75

As early as 1869, some men entered the home “only to die.”76 Death featured prominently in NHDVS life, especially as the population housed there aged. According to historian Michael Katz, families more often institutionalized older male relatives than their female kin.77 In part, this may reflect the physical challenges of women caring for men. As women aged, difficulty lifting a heavy patient would increase. Likewise, the children of veterans often argued that their own poverty or family obligations prevented

73 Ibid. 74 Jordan, Marching Home, 158. 75 Suicide rates for Union veterans have been notoriously difficult to pin down. However, recent work by Brian Matthew Jones and Diane Miller Sommerville compliments older research by Eric Dean. Taken together, this research suggests that the suicide rate may have been underestimated by past scholars. See Dean, Shook over Hell, 143; Jordan, Marching Home; Sommerville, “‘Will They Ever Be Able to Forget?’ Confederate Soldiers and Mental Illness in the Defeated South.” 76 Congressional Serial Set, 1385:3–4. 77 Michael B. Katz, In the Shadow of the Poorhouse: A Social History of Welfare in America, 10th anniversary ed., and updated (New York: Basic Books, 1996), 88. 137 them from caring for an older male relative.78 Homes offered the promise of a martial, dignified funeral with the attendance of a resident’s peers.79

Asylums Many men entered asylums when their families and/or the staff at a soldiers’ home could no longer cope with the demands of their physical or mental condition. In the

1870s and 1880s, the kind and scope of care provided by asylums transitioned from the reformist impulse that characterized pre-war asylums to the late nineteenth century’s custodial mission.80 Early in the century, reformers and asylum superintendents assumed that upwards of 80 percent of the insane could be returned to their communities after treatment. However, pessimism crept in and, by about 1870, American asylums had evolved into custodial institutions that housed the chronically insane, violent, senile, or otherwise “degenerate.”81 This moment of transition occurred just as more men than ever required the assistance of an asylum. After the Civil War, asylums north and south took in large numbers of veterans struggling to return to civilian life. Although hard numbers are not available, historian Diane Miller Sommerville found that, the “general impression prevailed in the years following the war that ‘insanity’ was on the rise.”82 Despite the glut of veterans entering asylums, few doctors assumed that mental illness among veterans was widespread or service-related. In part, Sommerville argues, connecting post-war mental illness to combat would challenge cultural assumptions about martial masculinity, self-sufficiency, and independence.83

78 Kelly, Creating a National Home, 138. 79 Ibid., 148–49. 80 Rothman, The Discovery of the Asylum Social Order and Disorder in the New Republic, 265. 81 Ibid.; Dean, Shook over Hell, 140. 82 Sommerville, “Will They Ever Be Able to Forget?’,” 324. 83 Ibid. 138 Many mentally ill or emotionally unstable veterans entered asylums at various points in their life post-war. Like soldiers’ homes, asylums provided temporary refuge for veterans between difficult times at home or when their symptoms became especially difficult to manage. Soldiers’ homes had neither the staff nor the capacity to care for the seriously mentally ill. The Dayton NHDVS, for example, operated an “insanity ward” to care for the most disturbed or dysfunctional veterans in the home. Mason Davis, a former musician in Company E of the 160th NY Infantry, challenged the limits of the NHDVS’ capacity to care for the severely and chronically insane. Prior to his December 1868 admission to the NHDVS in Dayton, Ohio, Davis’ sister-in-law cared for him at home.84

In October 1886, after eighteen years in and out of the NHDVS, Davis jumped out of a second story window. He survived the fall and the home’s staff explained this suicide attempt by saying that, “his mind had recently been much worse” and he now required constant restraint and surveillance.85 In the NHDVS, restraint typically meant the administration of drugs to sedate patients.86 One month after his suicide attempt, he traveled from Ohio to Washington, DC’s Government Hospital for the Insane (now St.

Elizabeths Hospital) to receive treatment for chronic melancholia brought on by “ill health.” The GHI discharged him a few months later and classified him as “improved.”87

Less is known about why Sophia Fife’s husband, Jacob, moved from the soldiers’ home

84 Mason Davis, Private, Co. E, 160th NY Infantry, Widow’s Certificate 304.659. See also Historical Register of National Homes for Disabled Volunteer Soldiers, 1866-1938; (National Archives Microfilm Publication M1749, 282 rolls); Records of the Department of Veterans Affairs, Record Group 15; National Archives, Washington, DC. 85 Mason Davis, Private, Co. E, 160th NY Infantry, Widow’s Certificate 304.659. 86 Dean, Shook over Hell, 142. 87 St. Elizabeths Hospital Register, volume 2, p. 110. Series: Registers of Cases, 1855 - 1963 Record Group 418: Records of St. Elizabeths Hospital, 1820 – 1987; National Archives Building, Washington, DC. 139 in Dayton to the GHI. However, moving veterans between NHDVS sites and the GHI was a common practice throughout the latter half of the century.

Sometimes, veterans cycled through other institutional settings before arriving at the asylum’s gates. Peter Bedor’s violent and delusional behavior forced Virginia, with the support of Peter’s parents and brother, to place him in institutional care—first in a county jail, then the state asylum in Topeka, Kansas. Peter’s various encounters with asylums and jails align with Americans’ shifting understanding of institutional care during the nineteenth century. Early in the century, short, temporary stays in asylums were the norm and reflected enthusiasm about the possibility of a cure for insanity.88

During the Civil War, doctors at the GHI declared Peter “recovered” when he left the hospital in June 1865 after just six months of treatment for acute mania.89 Despite growing professionalization of asylum superintendents and increasing differentiation between the purposes of asylums, almshouses, and jails in the later part of the nineteenth century, these institutions ultimately abdicated their reform agendas and embraced a custodial mission. In practice, however, urgent family needs may have been more important in determining sites of institutional care than the development of a profession or cultural beliefs about jails and asylums. Eric Dean found that the families of Union soldiers “would often first turn to the local jail” for help with a violent, insane veteran.

When men were “committed to jail” it often followed “some form of judicial process or community consensus.”90 The decision to place him in the county jail when a bed was not

88 David J. Rothman, The Discovery of the Asylum Social Order and Disorder in the New Republic (Boston: Little Brown and Company, 1971), 265-270. 89 See St. Elizabeths register book, Records of St. Elizabeths Hospital, 1820 – 1987, Record group 418, National Archives Building, Washington, DC. 90 Dean, Shook over Hell, 138. 140 open at the Topeka asylum may reflect both his family’s desperation as well as the extent to which cure had become a secondary mission for the asylum. Housing Peter in the county jail also kept him closer to the family’s home in Hollis, Kansas. Given the importance physicians placed on the influence of female kin on the sick, the relatively short twelve-mile journey from Hollis to the county seat may have appeared to be some small benefit of the jail over the asylum one hundred and twenty miles away. If Peter could not enter a specialized asylum, he could at least be near his family.

Records of what precipitated the family’s decision do not survive but whatever occurred must have been a major disruption to the family’s life if they accepted placing him in a jail, even one fairly close to home, rather than an asylum.91 Although his family no doubt hoped for improvement in Peter’s condition, by the 1870s asylums did not generally promise to cure their patients.92 Placing Peter in custodial care for a few years no doubt improved life in the Bedor family home. Removing a violent man from the home offered an immediate solution for the Bedors while his eventual return to the family suggests that beliefs about the beneficial effects of temporary professional care had not ended entirely. In Peter’s case, however, a few years in an institution apparently helped his mental state; by the late 1880s, Virginia reported that he had not had a violent episode in some time.93 The time in jail and the asylum apparently managed his symptoms but did not exactly cure his insanity or physical illnesses.

91 Cloud County did not keep court case or jail records from this date (email to the author from Lea Throckmorton, chief clerk of the district court, Twelfth Judicial District, 26 Feb 2015). See also Ibid., 139. 92 Rothman, The Discovery of the Asylum Social Order and Disorder in the New Republic, 265. 93 Virginia Bedor, deposition, 18 October 1888, in Soldier Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 141 The asylum promised to alleviate some of Peter’s suffering, and his family’s hardship, through productive labor and peaceful surroundings. Like NHDVS sites, nineteenth century asylum patients were expected to work around the hospital tending the grounds, sewing, gardening, or constructing new buildings. The Kansas asylum’s first superintendent, Dr. Barnard Eastman, explained to the state legislature that,

Removal from the worriment, the overwork, the unsanitary conditions and the unsuitable food of many homes... occupying body and mind in the new employment, cheering the drooping and melancholy and soothing the excited and irritable, are some of the elements of treatment of the greatest value, sometimes working rapid cures with but little medication.94

Unfortunately, the asylum’s records of Peter’s specific diagnosis, treatment, work assignment, and health at the asylum remain confidential, but at least his pension application is available.95 It reveals that social expectations about work formed a central tension in Peter’s life. His inability to work was complicated.

People interviewed about Peter’s pension case tended to use the language of refusal, rather than physical incapacity, to describe his idleness. When he entered the asylum, his mother explained that Peter did not labor around his farm much. She told the investigator that he “has been getting sullen and morose, refusing to do anything [sic] feed his horses or cows. Set [sic] around and sing.” Several surgeons examined him in the years after he left the Kansas asylum and made various observations on this point. In

1891, a physician observed that, “he is physically able to do some manual labor but does not do it except occasionally for a short time… The condition of his hands indicates that

94 Quoted in Mike Hall, “Topeka State Leaves Mixed Legacy: A Model Hospital at Times; a ‘Snakepit’ at Others,” The Topeka Capital-Journal, January 17, 2000, http://cjonline.com/stories/011700/com_tshlegacy17.shtml#.VPSInbPF-g0. 95 See Kansas Statute 65-5603. 142 he does very little if any manual labor.”96 A year earlier, a physician indicated that Peter

“can no doubt perform some labor under direct supervision. Is not competent to transact business though he does not at present require regular aid and attendance.”97 Was Peter incapable of working due to physical illness and insanity or did he simply refuse to work despite physical capability? Treatment depended on the ability to return Peter to productive employment in his family home. If he refused to work, this was a more pernicious problem that spoke to a larger disengagement with society than the respectable, if tragic, inability to work as a result of wartime injury. Refusing to work also would have put him in conflict with many of the asylum staff who believed in work as a restorative process. The process of determining if he refused to work or could not work extended long after Peter left the asylum. It took decades for the Pension Office to confirm that Peter’s mental incapacity and resulting inability to work qualified him for a pension. If the asylum did not return Peter to productive labor, at least it did control his violent tendencies. To that end, the asylum could claim some modicum of success in his case.

While veterans in custodial care were forced to work as part of their cure, veterans cared for at home were under no such obligation. In fact, wives could receive aid only if they could prove that their husbands could not work. With Virginia’s help, Peter applied for and received a disability pension on the grounds of insanity and resulting inability to perform much manual labor. After a lengthy approval process, Peter spent the

96 Surgeon’s certificate August 5, 1891, included in the pension file for Peter Bedor, Soldier’s Certificate No. 507.360, Peter Bedor, Private, Co. K, 1st Connecticut Heavy Artillery. 97 Surgeon’s certificate March 5, 1890, Soldier’s Certificate No. 507.360, Peter Bedor, Private, Company K, 1st Connecticut Heavy Artillery.

143 next twenty years living at home contributing to the family’s economic stability only through his pension payment. Peter apparently refused to work and continued to rely on

Virginia to nurse his body, manage his mental state, and run the farm until his death.

Sofia received compensation for Jacob’s illnesses only after his death and only as a result of the expansion of the pension rolls.

Other veterans who lived at home or in the NHDVS for years entered asylums as they aged and developed chronic dementia. The move into a custodial institution allowed the asylum to become a comparatively safe, reasonably comfortable place to await death.

After a short stay at the National Home, Jacob Fife spent three years in the GHI for dementia brought on by ill health from 1884 until his death in 1887.98 Unlike Peter

Bedor, who stayed only long enough to control his violent behavior, Jacob Fife required constant aid and serious medical support. For the families of men unable to take care of their ill veteran at home, an asylum promised at least a basic level of support and personal care that Sophia either could not or would no longer provide. In contrast, Peter

Bedor’s time in both the jail and the asylum is more representative of how many men moved into and out of sites of custodial care.

It is tempting to view asylums as the natural end point on the spectrum of care.

However, many soldiers moved back and forth between asylums, family homes, and the

NHDVS. Despite the shift toward a more custodial mission, many asylums still accepted only those cases deemed “curable.” As a result, asylums discharged men when they were at least marginally able to live independently or with the aid and assistance of a family or

NHDVS staff.

98 St. Elizabeths Hospital Register v2 p79. 144 Moving through these various sites of care sometimes brought veterans and their families into conflict with professional social workers and emerging regimes of social welfare. Veterans and their wives, particularly those who lived into the early twentieth century, needed to negotiate enough competency to justify their homemaking decisions but not so much competency that they no longer seemed dependent. For as many women who found a sense of purpose and competence in the care of their invalid husbands and children, other women did not embrace the care and nursing of their family members.

The Pension Office evaluated women’s relative competency throughout the period and criticized women deemed incapable of keeping up with their caregiving responsibilities.

However much the Pension Office’s policies attempted to promote a patriarchal family structure, it could not enforce expectations around home-based care for invalid veterans or their children.

Women like Virginia, who excelled at her caregiving and managerial responsibilities, challenged the Pension Office’s conception of a dependent widow.

Conversely, failure to provide any care for the veteran or his children at home constituted a failure of social norms but implicitly proved dependency. Unlike Sophia and Virginia, who took on caretaking responsibilities and corresponded with the Pension Office in their capacity as the primary caregivers to their invalid husbands, Daisy Doust came to the attention of the Pension Office when she abdicated her caregiving responsibilities. Daisy was about thirty years younger than her husband, William, when they married in 1892 and therefore already a suspect applicant. Political observers in the early twentieth century felt a great deal of anxiety about women who married older Civil War veterans

“merely for the sake of obtaining a life pension on their demise. They were even accused

145 of hanging around old soldiers’ homes for the purpose of enticing the inmates into matrimony.”99 Although the marriages were more than mercenary, women did marry the inmates of NHDVS homes. The veterans who married (or remarried) late in life were hardly hapless victims of female cunning. Given the limited space at soldier’s homes and the cultural value placed on a wife’s care, older veterans may have needed someone to help nurse them through their final illnesses. Exchanging access to a widow’s pension for nursing care improved the prospects for both members of the marriage. Likewise, women who had nursed an invalid veteran through his final days and received a widow’s pension were often loath to sacrifice that income upon remarriage. Women who received a widow’s pension and cohabitated with, but did not marry, their new partner also came under serious scrutiny.100 The Pension Office closely monitored marriages for evidence of fraud.

When William Doust applied for a pension in June 1891, eighteen months before he married Daisy, he suffered from a variety of complaints, including disease of the heart, diarrhea, piles, rheumatism, malarial poisoning, and deafness.101 He married Daisy in

December 1892 and, despite his ill health, the couple had three children. By the turn of the century the couple, both of whom were illiterate and signed their paperwork with an

“x,” lived in deep poverty. The family’s poverty and generally “pitiful” state went unquestioned by either the Pension Office or local authorities in Minnesota.

The Doust family’s circumstances brought them into conflict with a growing and professionalizing child welfare system and the mature Pension Office. While the Pension

99 Burton J. Hendrick, “The Democratic Appetite for Pork,” Colliers 58, no. 7 (October 28, 1916): 11. 100 McClintock, “Civil War Pensions and the Reconstruction of Union Families,” 473-80. 101 Pension Application, 10 June 1891, pension application No.133.130, William Doust, Co. D, 17th Wisconsin Infantry. 146 Office assumed that the home was the best place for an invalid veteran, even a poor veteran, by the 1920s the home did not always promise to improve the lives of poor children. The Pension Office and children’s welfare agencies sometimes came into conflict around the definition of a “deserving” widow. In 1924, the county Child Welfare

Branch wrote to tell the Pension Office that Daisy and William’s children had been

“removed from one of the worst homes in Crow Wing County” in 1920, a year before

William’s death.102 The state official did not go into what constituted “one of the worst homes” in the county but apparently conditions were bad enough that two of the couple’s three children became permanent wards of the state at the Owatonna State School for the

“feeble minded.”103 Since Daisy had apparently abdicated her responsibility to care for her daughters at home and did not send a portion of William’s pension to pay for the costs of their care at the state school, the state of Minnesota wanted to garnish Daisy

Doust’s widow’s pension payment in order to pay the fees associated with her two

“feeble minded” daughters.104 The state asked the Pension Office to withhold funding on the grounds that, by not caring for her children at home, Daisy Doust committed fraud.

While sympathetic to Crow Wing County’s position, the Pension Office replied that,

The law permits a payment of pension to a widow, together with an additional amount on account of each of her minor children by the soldier, without reference to the question whether these children are or are not in her custody. Consequently, it cannot be said that Daisy Doust has secured any money from the United States as pension through fraudulent methods, as you suppose, and for which you suggest that she should be prosecuted.105

102 Letter from the Minnesota State Public School at Owatonna, 8 February 1924, Soldier’s Certificate No. 790.758, William Doust, Private, Co. D, 17th Wisconsin Infantry. 103 William Hodson, “What Minnesota Has Done and Should Do for the Feeble-Minded,” Journal of Criminal Law & Criminology 10, no. 2 (1919): 208–17. 104 Letter from the Minnesota State Public School at Owatonna, 8 February 1924, Soldier’s Certificate No. 790.758, William Doust, Private, Co. D, 17th Wisconsin Infantry. 105 Ibid. 147

Whether Daisy Doust refused to care for her children, could not afford to keep them at home, or could not provide appropriate, effective care for them was not discussed by the authorities.106 What mattered to the Pension Office and the state of Minnesota was the extent to which her failure to provide care for her family constituted a breach of legal status. As long as Daisy remained William’s dependent widow, there was little the

Pension Office could do to strip her of her pension. The state of Minnesota, however, had no such boundaries on their understanding of a wife and widow’s responsibilities to her children.

Conclusion

The care that Virginia Bedor, Sophia Fife, Daisy Doust, and countless other women provided their veterans existed on the same spectrum as care at the NHDVS sites and in asylums. Considering the informal care provided by women as somehow separate from professional loci of care developing in the late nineteenth century erases the importance of women’s work in the aftermath of the Civil War and offers only an incomplete picture of the ways that entire communities cared for returning veterans.

Wives and other female kin, state and local courts, and custodial institutions like jails and asylums provided various forms of care to veterans outside of the scope of care work assumed by the Pension Office and Army officials.

This is not to suggest that the federal government abdicated its responsibilities to soldiers in the decades after the war. After all, the NHDVS slowly expanded and is often identified as an origin point in the American welfare state. However, focusing too

106 For more information on the difficulty distinguishing between poverty and “child neglect” in the nineteenth century, as well as historical attitudes toward child neglect, see Gordon, Heroes of Their Own Lives, 116-127. 148 narrowly on the federally funded institutional site or the provision of pension payments does a disservice to the millions of women engaged in skilled but informal care of the broken soldier. Typically, asylums shouldered the burdens of care when women and families could no longer provide adequate care safely in the home. The federally funded

Government Hospital for the Insane took in a number of patients but most ended up in state and local asylums. Again, the federal government produced some help for the soldier but pushed the bulk of care for insane soldiers onto states and municipalities. The

NHDVS and asylums are where men turned when informal structures failed, but the federal government relied primarily on informal structures for the provision of most post- war healthcare. When Butler said that he expected most men to be taken care of

“otherwheres” he meant in private homes, outside the fiduciary, physical, or emotional responsibility of the government that sent men to war.

149 Chapter Four “I Shall Get So Decayed with Laziness:” The Ideology of the Broke Down Veteran in Miss Ravenel's Conversion

The broken veteran defies representation.1 Neither his emotional nor physical pain lends itself to neat chronology or easy resolution. The bodily reality of his existence— weeping sores and chronic diarrhea, feverish sweating and painful joints, heart palpitations and nightmares—inspires disgust. Yet the broken, ill, disabled, or uncomfortable soldier was a fixture of American life for decades after the Civil War.

Thousands of men applied for pensions on the grounds of wartime illnesses that continued to affect their ability to live and work long after they returned home. Unlike amputees, these broken but whole men rarely appeared in popular culture.2 The disconnect between the lack of representation of these men in culture and the reality on display in pension files and medical records indicates that American culture struggled to make sense of these young, whole, but irreparably damaged men. When they do appear in nineteenth century literature, the invalid soldier and broken veteran tend to remain minor characters or objects of pity.

If the broke down soldier had to fight for bureaucratic recognition of his nonspecific medical complaints, he also needed to negotiate his position in the post-war cultural landscape. Union soldiers were acutely aware of the ways in which novels, short stories, and other forms of culture presented them to wary civilians.3 Representations of sick, wounded, or broken veterans contributed to the ways in which veterans and civilians

1 For an extended study of the ways that pain and warfare’s consequences defy representation, see Scarry, The Body in Pain. 2 A notable exception to this rule is Sarah Orne Jewett, “Decoration Day,” Harper’s Magazine, June 1892. 3 John A. Casey, New Men: Reconstructing the Image of the Veteran in Late Nineteenth-Century American Literature and Culture, Reconstructing America (New York: Fordham University Press, 2015), 18. 150 understood themselves in relation to each other, their government, and a rapidly changing economy.4 The broken veteran in literature had an impact on how Americans imagined the men who received pensions or charity after the war. Even seemingly apolitical novels added to the pool of available images mobilized to justify policy decisions about the deserving veteran.

This chapter focuses on a single work of fiction that clearly demonstrates the ways that a middling nineteenth century author and veteran negotiated the meaning of the ill, broken, or invalid soldier.5 An in-depth reading of John William De Forest’s novel,

Miss Ravenel’s Conversion from Secession to Loyalty, draws attention to the ways in which the broke down soldier became visible in literature for a brief moment at the end of the war before receding from popular literature. Written during and immediately after the war, Miss Ravenel’s Conversion came to market while the meaning of the war and veterans’ bodies were still in flux. Alice Fahs found that, by the 1870s, readers’ interest in the war had waned, and by the 1880s, the war was increasingly seen only as a military experience.6 Women’s perspectives on the war and discussion of the emotional upheaval that the war generated at home receded from literature in favor of stories of brothers in combat. The constriction of war literature’s focus limited the opportunities for authors to question or critique the war. The rapid growth of the Grand Army of the Republic (GAR) beginning in the 1880s and the turn toward a reconciliationist approach to the former

Confederacy circumscribed the kinds of stories that came to market and achieved popular

4 This approach is inspired by the work of Diane Price Herndl, Invalid Women Figuring Feminine Illness in American Fiction and Culture, 1840-1940 (Chapel Hill, NC: University of North Carolina Press, 1993), 9. 5 I draw my inspiration for this approach from John Casey’s New Men. 6 Alice Fahs, “The Feminized Civil War: Gender, Northern Popular Literature, and the Memory of the War, 1861-1900,” The Journal of American History 85, no. 4 (1999): 1464. 151 acceptance in the latter decades of the century.7 Despite the limitations of a narrow focus on a single novel, careful analysis of Miss Ravenel’s Conversion allows for greater depth into aspects of the invalid soldier’s depiction when that representation was still in development.8

About the Novel

Miss Ravenel’s Conversion follows Lillie Ravenel, a native of Louisiana and “a rebel” who “was colored by the soil in which she had germinated and been nurtured,” as she courts and marries a Union soldier.9 De Forest sets Lillie up to decide between two different examples of masculinity: Colonel Carter, a professional soldier, West Point

Graduate, and Virginia native and Captain Colburne, a lawyer, volunteer citizen-soldier, and native of New England. Both men meet Lillie and her father, a physician and scientist, in New Boston, Barataria (a fictionalized New Haven, Connecticut) “shortly after the capitulation of loyal Fort Sumter to rebellious South Carolina.”10 Unlike his daughter, Dr. Ravenel eagerly fled New Orleans when “this stupid, barbarous Ashantee rebellion drove [him] out.”11 Dr. Ravenel serves as the novel’s (tepid) voice for abolition, paternal authority, and the author’s conscience. Eventually, and against her father’s best judgment, Lillie marries the rakish, good looking Carter. Lillie quickly becomes pregnant with Carter’s child but her marriage to this Virginia caviler is neither happy nor long.

Carter squanders an enormous amount of money, defrauds the Quartermaster Corp to

7 Ibid. 8 Alice Fahs found that the war expanded the American literary imagination. It is only after the war that this narrowing down to a series of masculine, military narratives took place. See Alice Fahs, The Imagined Civil War: Popular Literature of the North & South, 1861-1865, Civil War America (Chapel Hill, NC: University of North Carolina Press, 2001), 16. 9 John William De Forest, Miss Ravenel’s Conversion from Secession to Loyalty (New York: Harper & Brothers, 1867), 17. 10 Ibid., 7. 11 Ibid., 10. 152 repay his debts, and drinks heavily. These offenses are bad enough to cast Carter as a negative example of professional soldiering, a suspect profession in the 1860s, but it is his affair with Lillie’s aunt, the sensual widow and New Orleans native Mrs. Larue, that dooms his marriage to Lillie. Through a variety of far-fetched circumstances, Lillie discovers a revealing letter from Mrs. Larue to Carter. After learning of the affair, Lillie falls into a fever and, while nursing her back to health, Dr. Ravenel writes to Carter and informs him that his infidelity has been exposed. Carter receives this note just before heading into battle, where he dies of a gunshot wound. His death on the battlefield, which his men view in standard heroic terms, keeps him from disgrace and preserves Lillie’s reputation. Throughout Lillie’s brief marriage to Carter, Colburne remains a steadfast family friend, excellent soldier, and humble officer. Upon his return to New Boston at the close of the war, Colburne reunites with the Ravenels. Now, as a widow and mother,

Lillie is prepared to see the best parts of Colburne. The two marry and move into his family home. The novel closes with Lillie, Colburne, Dr. Ravenel, and Lillie’s son ensconced in a happy, prosperous, and fairly traditional domestic arrangement. Several minor characters appear briefly in the novel but these characters tend to serve a specific, didactic purpose by characterizing a type (e.g. the coward, the drunk, the sensual southerner).

The novel, now forgotten by most casual readers of Civil War literature, contains richer descriptions of battle, injury, illness, and military life than many books about the war. Reflecting on the book decades later, scholar Gordon Haight compared it to Stephen

Crane’s The Red Badge of Courage and felt that it made Crane’s novel look

153 overwrought.12 Unlike Crane, De Forest wrote from experience. Though not strictly an autobiographical novel, Miss Ravenel’s Conversion closely tracks with De Forest’s life.

Like its hero, Captain Colburne, De Forest served as a captain for a Connecticut regiment in both Louisiana and Virginia where he participated in battle. He, like Colburne, did not move up in the ranks due, apparently, to a lack of political favoritism. Both the author and his character had fathers-in-law who, at one time, practiced and taught medicine in

Charleston, South Carolina. Unlike Colburne, however, De Forest was ill long before he entered the war and for decades afterward.13 While the author may have initially felt optimistic about his post-war prospects, by the 1880s De Forest’s health had declined considerably. He diagnosed himself with irritable heart and applied for a pension due to his inability to earn a living. These declining fortunes track with a revision to the manuscript made in the 1880s that excises parts of the text relating to Colburne’s success after the war.

De Forest’s identification with his characters makes the novel an interesting historical document even as it sometimes detracts from its prose. The novel’s narrator, an unnamed resident of Barataria, both is and is not De Forest. At points, De Forest’s voice seems to intrude on the action with personal reflection while at other times the anonymous narrator jumps in to provide additional information. In his review of the novel, Henry James complained of the “constant presence of the author upon the stage as manipulator of the figures… he is constantly favoring the reader with his own reflections and comments upon the action as it goes on, button holing him, so to speak, and taking

12 James W Gargano, “Introduction,” in Critical Essays on John William De Forest, ed. James W Gargano, Critical Essays on American Literature (Boston: G.K. Hall, 1981), 22. 13 John William De Forest, Miss Ravenel’s Conversion from Secession to Loyalty, ed. Gordon Haight (New York: Harper & Brothers Publishers, 1939), x. 154 him into his confidence.”14 It is exactly this intrusion of the author and his close association with his characters, however, that allows the novel to represent De Forest’s political and personal position.

De Forest wrote and finished the novel during the war. In 1865, while working at the Freedman’s Bureau, he sold it for $1,250 to Harper’s Monthly for serial publication.15

The magazine elected not to publish it in the magazine but as a stand-alone novel. The decision not to publish the story in Harper’s Monthly came after the editors raised concerns about the “propriety” of the work. De Forest agreed to a limited amount of

“moral reform of the story” but was clear that, “I think it ought to be understood, for the sake of vraisemblance, that the Colonel did frequently swear and that the Louisiana lady was not quite as good as she should be.”16

Some confusion surrounds De Forest’s involvement in the volume that went to market in 1867.17 Although De Forest consented to the book’s publication with minor changes, he was working for the Freedmen’s Bureau in South Carolina at the time and did not have access to the page proofs. De Forest apparently agreed to allow Harper’s

Monthly editor Alfred H. Guernsey to finalize and approve the pages. Despite this editing, the 1867 edition contains a number of errors. Twenty years later, De Forest purchased the copyright in hopes of producing a collected edition of all his novels.

Apparently, this is when he began working on changes to the text. Gordon Haight, who edited a later edition of the novel in 1939, is clear that De Forest did not change “the

14 Henry James, “Miss Ravenel’s Conversion,” Nation 4, no. 103 (June 20, 1867): 491. 15 De Forest, Miss Ravenel’s Conversion, 1939, xi. 16 De Forest quoted in Cynthia Wachtell, War No More: The Antiwar Impulse in American Literature, 1861-1914 (Baton Rouge, LA: LSU Press, 2010), 76. 17 This paragraph draws heavily on information in a lengthy footnote Gordon Haight included in his introduction to the 1939 edition. Ibid., n. 2. 155 characters, dialog, or descriptive passages” even while he did eliminate other

“digressive” parts of the text.18 The 1939 edition was printed from De Forest’s revised manuscript, then in the possession of one of his heirs. For this chapter, I have analyzed the text that appeared before the reading public in 1867. I include references to the 1939 edition only to illuminate the differences between the two versions and De Forest’s changing attitudes about veterans’ prospects over time.

Most scholars, in the nineteenth century and today, have focused on the novel’s realistic battle scenes and characterization of the roguish, professional soldier Colonel

Carter. Even Henry James, who wrote perhaps the most dismissive review of the book, said that, “Carter is well depicted; daguerreotyped from nature. We all have seen just such men, and all can recognize Mr. De Forest’s accurate and spirited portraiture.”19

Critics also celebrated De Forest’s efforts to capture the essence of battle. His literary peers, many of whom sat out the war, appreciated De Forest’s attempt to grapple with ways that war defied description. Critical praise and De Forest’s efforts to write the great novel of the Civil War did little to improve his sales or position in the culture. He published stories, poetry, commentary, and novels throughout the 1870s but failed to secure a lasting place in America’s literary canon. When De Forest died in 1906, most of his works were out of print and he had been living on his service pension for almost a decade. Starting in the late 1930s, critics returned to De Forest to trace the history of

American realism and great war novels.20

18 Ibid. 19 James, “Miss Ravenel’s Conversion,” 491. 20 For an excellent overview of recent scholarship on De Forest, see James W Gargano, Critical Essays on John William De Forest, Critical Essays on American Literature (Boston: G.K. Hall, 1981); Thomas H. Fick, “Genre Wars and the Rhetoric of Manhood in Miss Ravenel’s Conversion from Secession to Loyalty,” Nineteenth-Century Literature 46, no. 4 (1992): 473–94. 156 The relatively narrow scholarly focus on De Forest’s contributions to realism, the tendency to focus on Carter over Colburne, and the focus on the battle scenes have obscured the ways in which Miss Ravenel’s Conversion is also a book that wrestled with how war breaks men. The book uneasily blended a reunion romance with realistic scenes of combat, field hospitals, and sickness. In these scenes, bodies and their deterioration come to the foreground as the defining experience of war. De Forest reckoned with, but failed to resolve, the problem of the veteran invalid in the military and in American life.

Writing during the war and later during Reconstruction as staff in the Freedman’s

Bureau, De Forest could not escape an ideology of the veteran that assumed his wartime experience would prepare him for success after the war and that failure to regain health and succeed reflected poorly on the man, not his service as a soldier. Even ill soldiers tended to blame their personal faults for their post-war circumstances rather than seeing it as a consequence of their wartime service.21 Changes De Forest made to the manuscript in the late 1880s, when his own health failed him, suggest that the novel was more closely tied to the author’s politics and his health than previously acknowledged.

The book failed commercially although it received positive reviews in literary journals, magazines, and newspapers.22 William Dean Howells, editor of the Atlantic, praised the book and its commitment to realism. General readers, however, struggled with the uneasy blend of realism and romance in the book. An anonymous reviewer for

The Round Table appreciated that, “Mr. De Forest makes his characters so consistently natural,” but bemoaned the book’s politics, reliance on personal memories, and a

21 Casey, New Men, 60. 22 For a summary of the critical response to Miss Ravenel’s Conversion, see Gargano, “Introduction,” 10– 11. 157 “coarseness which the author is too apt to mistake for strength.”23 The title promises a marriage and courtship plot, which readers do get, but throughout the novel De Forest includes realistic representations of combat and wounded bodies, biting commentary on military bureaucracy, discussion of the post-war economy, and morality tales about temperance. By 1912, E.J. Edwards would argue that the title doomed the book to commercial failure. “It was a singularly unfortunate title for a war story published two years after the close of the war,” he wrote, because “no southern girl had been converted from secession to loyalty within that time.”24 The Round Table reviewer agreed, noting that, “Mr. De Forest might be even more successful with a more strictly military style of novel… and hope he may be induced to employ his pen in such a production.”25 Gordon

Haight’s effusive introduction to the 1939 edition of the novel celebrates De Forest’s realism, “fifty years ahead of his time,” and all but ignores the maudlin elements of

Colburne and Lillie’s courtship.26

De Forest’s novel is only superficially an example of a “reunion romance.”27 In her analysis of the genre, Nina Silber found that these stories used the language of marriage and courtship to engage with ideas about national reconciliation and reunion during and after Reconstruction. The gendered language of marriage mapped neatly onto to assumptions about the Union and the former Confederacy. The marriage of North and

23 “Reviews.: Miss Ravenel’s Conversion.,” The Round Table. A Saturday Review of Politics, Finance, Literature, Society and Art (1863-1869), July 20, 1867, 40; Jonathan Daigle, “Miss Ravenel’s Conversion, Evolutionary Realism, and the Moving Equilibrium,” American Literary Realism 45, no. 3 (2013): 189– 209. 24 E.J. Edwards, “New News of Yesterday: Fate of First Novel About the Civil War,” The Newport Plain Talk, January 18, 1912, Chronicling America: Historic American Newspapers. 25 “Reviews.,” 40. 26 De Forest, Miss Ravenel’s Conversion, 1939, ix. 27 According to Nina Silber's analysis, the language of marriage and reunion peaked in 1878, a full decade after De Forest's novel was published. See Nina Silber, The Romance of Reunion: Northerners and the South, 1865-1900, Kindle, Civil War America (Chapel Hill, NC: University of North Carolina Press, 1993), 65. 158 South positioned the North as the masculine partner able to dominate the feminine partner, the South, though still be bound in bonds of affection. Likewise, assumptions about the pre-war white South’s genteel, patriarchal culture offered reassurance to

Northerners worried about class antagonism, immigration, and women’s entrance to the public sphere. These novels used the marriage of a southern woman and Union soldier as a metaphor for national reunion and reconciliation. Marriage proved to be a good image of reunion because it promised something new, wholly unburdened by the past.28 Like many “reunion romances,” Miss Ravenel’s Conversion uses the story of a courtship and marriage to reflect on national reconciliation. Lillie Ravenel, though not a classic southern belle, first marries a roguish Virginian Unionist. When that unhappy marriage comes to an end, the southern woman realizes the inherent goodness of the New England volunteer and willingly submits to him. By uniting Lillie and Captain Colburne, De

Forest assures his readers that North and South can find common ground in post-war society. The popularity of the reunion romance as a genre not only promised commercial success but also allowed De Forest to explore the ways in which national events shaped personal lives.

Yet, Miss Ravenel’s Conversion fails to align with the characteristics Silber identified in her study of reunion romances. For example, De Forest’s narrator stops short of declaring Lillie an exceptional beauty, explaining that, “most of us fall in love, quite earnestly and permanently in love too, with rather plain women. Why then should I strain my conscience by asserting broadly and positively that Miss Ravenel was a first class beauty?”29 Likewise, Colburne does not come to “dominate” Lillie. Instead he hesitates

28 Ibid., 63–65. 29 De Forest, Miss Ravenel’s Conversion, 1867, 13. 159 and loses to the more masculine Carter. The novel does not eschew all the reunion romance’s tropes, however. Like many reunion romances, it is deeply concerned with the ways that the Ravenels experience their exile. Silber found that northern civilians came to understand Southerners as victims who suffer a reversal of fortunes. She emphasizes how the Victorian ethic of suffering allowed the ruined aristocrat to serve as a tragic figure, deserving of pity and sympathy. The economic dislocation of wealthy southerners appealed to a generation facing a rapidly changing economic system.30 Though Lillie never seems to worry about finances, all of the men in her life feel real anxiety about their income. Dr. Ravenel’s annual income shrinks substantially once he flees New

Orleans, Carter cannot manage to live within his means, and Colburne fears that he may make enough money to live but not enough to marry.

Miss Ravenel’s Male Bodies

The marriage between Colburne and Lillie is just one way to signal the reconciliation between north and south. De Forest also uses the representation of bodies and the language of medicine to make sense of both national reconciliation and personal healing. The changing and transforming bodies in Miss Ravenel’s Conversion provided a useful way to represent war’s impact, good and bad, on individual families and the nation. Many of the most realistic scenes in the novel depict Colburne’s anticipation of combat, experience on the battlefield, and observations about his own body as he recovers from injury and illness. With the exception of the battle scenes, few scholars have examined the bodies on display in Miss Ravenel’s Conversion. Both the male and female bodies in the novel are in states of transition, growth, decay, and destruction that

30 Silber, The Romance of Reunion, 51. 160 correspond to changes in Northern civilian anxieties about the civilian and veteran’s social position. Colburne’s economic anxiety, Carter’s vices, and Lillie’s particular brand of femininity all depend, to varying degrees, on their bodies to make these virtues and vices manifest. The language of physiology that infuses the book is used for both realistic descriptions of wounds and the emotional language of broken hearts and missing family members. De Forest regularly used descriptions of a character’s body to signal their internal emotional, political, or professional changes. This practice puts De Forest well within the boundaries of Victorian literature, which tended to use bodily states and illnesses as “indirect expressions of emotional meaning.”31 Dr. Ravenel’s medical training and interest in the sciences provide De Forest with a point of view conducive to observing the bodies of others in moments of distress and intemperance.

The first portion of the novel introduces the reader to New Boston and the danger of the “studious severities of a puritan university.” The young men of Barataria are described as,

Thin, pale and almost sallow, with pinched features surmounted by a high and roomy forehead, tall, slender, narrow-chested and fragile in form, shy, silent, and pure as the timidest [sic] of girls… Miss Ravenel… felt a contempt for [them] at the first glance, saying to herself, How dreadfully ladylike!32

Although Colburne is less sickly and pathologically studious than many of the men Lillie meets, she still finds Colonel Carter a welcome distraction from these men. The Virginia blue-blood is described as nearly the opposite of the New Englander. Carter possessed a full chest, broad shoulders, above average height, brown curling hair, and a “dark rich complexion which made one think of pipes of sherry wine as well as of years of sunburnt

31 Athena Vrettos, Somatic Fictions: Imagining Illness in Victorian Culture (Stanford, CA: Stanford University Press, 1995), 15. 32 De Forest, Miss Ravenel’s Conversion, 1867, 26. 161 adventure.”33 Even Colburne is impressed by the masculinity and life experience Carter displays. After his mother dies, freeing him of domestic responsibility, Colburne is free to emulate Carter and quickly joins the Army.

After enlisting, Carter and Colburne leave New Boston to serve under General

Butler in Louisiana. At first, the Tenth Barataria did only light duty. This stroke of luck allows Colburne to avoid the “malarious mud” and “feverish trenches” that broke down many unseasoned Union soldiers. Colburne experienced “no battles, no marches, no privations, no exposures, no anxieties: not even any weakening loss from the perilous climate.”34 Although his physical health remains robust during this period, Colburne struggles with the mental strain of a soldier’s life. “You take for granted… that we are in a state of constant and noble excitement,” Colburne writes the Ravenels, “but the extraordinary truth is that we are in a condition of wearisome ennui and deplorable desoeuvrement.”35 Much of the soldier’s life, according to Colburne, is spent “playing cards, smoking, grumbling at our wretched fare, exchanging dull gossip and wishing that we might be allowed to do something.”36 His letter implies that the bulk of military life is a waste of a soldier’s abilities. He also indicates that, while taxing, these comparatively minor complaints of apathy and boredom serve only to inspire in him a desire to participate in the war efforts.

By focusing on the body, De Forest made use of the ways in which literature produced during and immediately after the Civil War brought together literary, medical, and military discourse to generate a new kind of representation. Jennifer Travis, a scholar

33 Ibid. 34 Ibid., 126. 35 Ibid., 123. Emphasis in original. 36 Ibid. 162 of nineteenth century literature, explains that, “the Civil War occasioned what might at first seem an unusual alliance of military, medical, and literary languages that fashioned a new vocabulary about injury… Those who studied and maintained the war wounded and those who imagined a literature to describe it were partners in representation.”37 De

Forest’s emphasis on the physicality of battle and the embodied experience of emotions placed him at the forefront of this move toward realism. He drew on Victorian conventions about bodies and emotions to create a new, realistic way to communicate about warfare and its consequences.

Travis suggests that “realistic literature was a vehicle to provide some respite from obscure hurts.”38 It provided readers, men and women alike, with a model for understanding a world defined by wounds, sickness, and pain. The novel offered readers a useful way to understand social norms and examples of appropriate behavior. Captain

Colburne’s patience with Lillie, his stoic acceptance of deprivation, and desire to work provided a model response to many of the anxieties plaguing soldiers and civilians, men and women after the war. Although the book is not explicitly didactic, it represents the war as a generally positive transformative experience essential to fulfilling both personal and national promise.39 De Forest did not offer easy comfort about the war’s costs or the rapidity of national recovery but he did promise that individual soldiers and women’s sacrifices prepared them for whatever comes next.

37 Jennifer Travis, Wounded Hearts: Masculinity, Law, and Literature in American Culture (Chapel Hill, NC: University of North Carolina Press, 2005), 49. 38 Ibid. 39 Wade Newhouse, “Reporting Triumph, Saving a Nation: ‘Interesting Juxtapositions’ in John W. De Forest’s Civil War,” Studies in American Fiction 32, no. 2 (2004): 165. 163 Ideology of the Veteran

Miss Ravenel’s Conversion is an implicitly political novel. Though the characters never discuss elections and rarely mention specific policies, the novel is deeply concerned with the ways in which, to appropriate a modern phrase, the personal was political. Describing his own opinion in the text as coming from “an obscure American author,” De Forest explains that, “every great historical event reverberates in a very remarkable manner through the fortunes of a multitude of private and even secluded individuals. No volcanic eruption rends a mountain without stirring the existence of the mountain’s mice.”40 Unlike many domestic novels, De Forest did not position the home- front and battlefield as distinct. Lillie, Dr. Ravenel, Carter, and Colburne move between militarized spaces and the domestic space with relative ease throughout the book. Lillie and Dr. Ravenel even participate in the defense of Fort Winthrop as better combatants than some of the Union Army’s officers. Because De Forest resisted the urge to set up the domestic space and military space as distinct and opposite, he could present the war as a crisis of both family and nation, individual responsibility and collective obligation.41

Instead of accepting the traditional domestic-military divide, Miss Ravenel’s Conversion presents the beginning and end of wartime as the moments when tension between the individual and collective comes to the fore. It is the return to civilian life that challenges

Colburne’s health. “Pretty thoroughly worn out” by his service in Louisiana and then

Virginia, Colburne returns to New Boston as an invalid suffering from fever and nervous excitement.42 De Forest did not directly discuss pensions or the government’s obligation

40 De Forest, Miss Ravenel’s Conversion, 1867, 7. 41 Newhouse, “Reporting Triumph, Saving a Nation,” 166. 42 De Forest, Miss Ravenel’s Conversion, 1867, 475. 164 to its veterans but he was attentive to the ways that the transition from the military’s collective action to the individual ambition of the post-war economy strained even the best soldiers. The ideology of the veteran that infuses Miss Ravenel’s Conversion emphasized the primacy of civilian identity, the virtue of stoic acceptance of long-term suffering, and dedication to economic, political, and social stability.

De Forest’s novel made clear that the soldier’s reintegration to civilian life demanded more than simply a return to the domestic sphere. Even before the close of hostilities, northern civilians worried about the impact that thousands of young, unemployed men would have on northern cities and towns. Civilians appreciated the soldiers and their sacrifices but that appreciation did not extend to allowing a permanent class of military men to live among them. Captain Colburne, held up throughout the book as a model soldier and man, rushes to return to his pre-war identity. When he first calls on the Ravenels after his return to New Boston, he admonishes Lillie by saying, “Don’t call me Captain!” and goes on to say that, “the very word tires me, and I want repose.

Besides, I am a citizen, and have a right to the Mister.”43 Lillie believes his hesitancy to embrace the military title has to do with his failure to obtain a promotion. She, like other northern civilians, assumes that his military identity would explicitly shape his post-war identity. De Forest did not suggest that Colburne has left the war behind him but this assertion of a “right to the Mister” surely assuaged fears that soldiers would hold onto their military service as a mark of social, political, or economic distinction in daily life.

Like the title, Colburne quickly sheds the visible markers of his soldier identity. When

Dr. Ravenel enters Colburne’s room and says, “We are all ready here to worship your

43 Ibid., 484. 165 very rags,” he means, like many civilians, to thank Colburne for his service and his safe return to New England. Colburne, however, immediately responds that Ravenel can worship these rags “after I get rid of them. I must have a citizen’s suit as soon as possible.”44 Despite his condition, Colburne asks Dr. Ravenel to send for a tailor.

Soldiers’ old uniforms were typically extraordinarily dirty and often infested with lice.

For men conscious of their social status after the war, wearing dirty clothing may have carried more social stigma than any social capital derived from being a man in uniform.45

The return to his civilian clothes allowed De Forest to imply that the war was an interlude in Colburne’s life rather than its defining activity. Shedding the symbols of military life cannot, of course, erase the impact of the war on Colburne’s body or family. De Forest never implied that men should forget their service in the war or simply “move on” but he did emphasize that the return to civilian work, domestic life, and pre-war social structures was enthusiastically welcomed by good soldiers and good men.

Once he leaves the symbols of his military life behind, Colburne returns to practicing law. His desire to get back to work is, on the surface, about a desire to earn enough money to marry Lillie. But this anxiety about getting back to work also speaks to the ways in which a return to the domestic assured readers that veterans wanted to turn away from the war and their military life. Throughout the book’s final chapters, Colburne regularly expresses concern about work and laziness. After three months of rest to recover from a severe illness, Colburne says that, “I must go to work… I shall get so decayed with laziness that I sha’n’t be able to pick myself up. I shall cease to be

44 Ibid., 477. 45 Many historians write about the afterlives of Union and Confederate veterans. This particular theory comes from John Casey’s work in Casey, New Men. 166 respectable if I lounge any longer than is obsolutely [sic] necessary to restore my health.”46 This announcement prompts Dr. Ravenel, not quite responding to what

Colburne has said, to celebrate the ways in which the Union’s victory “is at bottom the triumph of laboring men living by their own industry, over non-laboring men who wanted to live by the industry of others.”47 Throughout the text, the doctor’s celebration of work easily moves between anti-slavery arguments and a general, pro-labor ideology for all men. Later in this exchange, he jumps from arguments against the “drones” produced by a slave system to suggesting that “we must all go to work. That is, we must be useful and respectable.”48 At no point in the novel does Ravenel identify with the slaves or freedmen that he encounters or turn to doing manual labor himself. His opposition to slavery is tied to a belief in free labor, not in racial equality. The “we” in this statement clearly refers to educated, white, middle-class men. For the doctor, and by extension the reader,

Colburne’s desire to get back to work as soon as his health permits suggests that he is

“obeying the teachings of this war, the triumphant spirit of our country and age.”49

Colburne takes the doctor at face value and rapidly returns to his law practice. By extension, Colburne does exactly what northern civilians want of veterans by reintegrating into the economic life of the nation.

Sections of the novel that deal with work include criticism for the kinds of soldiers who become “state paupers for life.”50 Toward the end of the book, De Forest refers specifically to the professional soldiers who never learn a trade other than

46 De Forest, Miss Ravenel’s Conversion, 1867, 499. 47 Ibid., 499–500. 48 Ibid., 500. 49 Ibid. 50 Ibid., 520. 167 soldiering and go on to demand “a foreign consulate or home collectorship [sic].” The novel never directly references the pensions available to veterans, despite Congressional approval for the program in 1862, but readers familiar with debates about returning soldiers could certainly understand “state pauper” as an expansive category that included the veteran unable or, more threateningly, unwilling to work.

In contrast to the suspect state pauper, De Forest assured the reader that Colburne came out of his wartime experience both physically stronger and with greater character than he had before the war. All the setbacks Colburne faced, including failure to achieve

“great military glory,” only gave “strength to his character… It has broken down his false pride, and taught him to use means for ends; moreover, it will preserve him from being enfeebled by a dropsy of vanity.”51 De Forest equated vanity and physical decrepitude to the extent that it prevented a man from doing all that he can to earn a living. Perhaps most astounding in De Forest’s account of Colburne’s newfound advantages is the suggestion that illness and physical hardships have prepared Colburne for a productive postwar life. Given the anxiety around returning soldiers and their capacity for work, this may have been more wishful thinking than real insight. Certainly, the enormous number of pension applications on the grounds of inability to work suggest De Forest’s claims were not based in reality. John Casey explained that, “De Forest’s strong pronouncement of his hero’s bright future is also meant as an affirmation of the bright future he hoped would await volunteer soldiers of the northern army.”52 For readers concerned about their social, economic, and health status after the war, reading about Colburne’s cheery family

51 Ibid. 52 John Casey, “Marked by War: Demobilization, Disability, and the Trope of the Citizen-Soldier in Miss Ravenel’s Conversion,” Civil War History 60, no. 2 (2014): 127. 168 and happy work-life may have placated anxiety better than any longitudinal story about a returning soldier.

The book closes just months after the end of the war and Lincoln’s assassination, in order to keep the novel focused on the war and its immediate impact. This narrow focus on the war years allowed De Forest to sidestep the complicated questions about the veteran’s position in American life already emerging by 1867. The cheery summary of

Colburne’s prospects would have rung false to readers even a few years later when it became clear that many men, broken down by their service in the war, simply could not live up to the expectation of wholly self-sufficient lives.

There are hints that De Forest himself softened his stance on the veteran’s responsibility to work later in his life. In 1897, he applied for a pension on the grounds that since the 1880s his “pen has earned nothing.”53 In a long letter to the Pension Office dated January 19, 1898, De Forest enumerated the many ways that his body broke down in the years after his Army service. He complained primarily of dyspepsia and irritable heart. Both conditions he attributed to the “fatigues of field service.”54 Once he returned to New Haven, De Forest visited several physicians, apparently to no avail. Unlike the men that Jacob Da Costa studied, De Forest did not contract irritable heart until long after his field service. He emphasized that it had been a constant source of illness since 1885.

It is unclear if he self-diagnosed the condition or received the label from a local doctor.

De Forest did not reference Da Costa or any other physician specifically. He complained of many of the symptoms that Da Costa described and noted that, “whether [irritable

53 John William De Forest, letter to Pension Office dated 19 January 1898, p. 4, Soldier’s Certificate No. 1098.147, John William De Forest, Captain, Co. I, 12th CT Volunteer Infantry and Co. I, 14th Volunteer Reserve Corps. 54 Ibid. 169 heart] is dangerous or not, I personally cannot judge. It has very often prevented slumber.

I have frequently gone to bed in the expectation of dying during the night.”55 Starting in

1885, the author found that he was no longer able to publish any of his writing in either magazines or as standalone volumes. De Forest attributed this failure not to a lack of talent or a change in the taste of the reading public but to disabilities he contracted in the service. This was a step away from his belief, a decade or more earlier, that economic failure was the result of an individual’s choices rather than life circumstances. In 1898,

De Forest was already over seventy years old but his inability to earn a living or support himself was linked to wartime illness and experience, not the simple passage of time.

In the late 1880s, about the time that his health began to fail, De Forest prepared a revised edition of Miss Ravenel’s Conversion.56 Although ultimately this revised edition did not get published during his lifetime, the revisions that De Forest considered suggest that his ideas about veterans had changed substantially since the novel’s initial 1867 publication. The revised edition, eventually published in 1939, excises the lengthy passages celebrating Colburne’s post-war prospects. In the revised edition, the novel concludes with the lines, “at last Colburne had his wife, and his wife had her home. For the last four years they have sailed separately over stormy seas, but now they are in a quiet haven, united so long as life shall last.”57 In 1867, the book goes on over several more pages to assert that, “we need have no fears about the prospects of Colburne” because he will “stand on his own base.”58 As De Forest’s health failed and he became more like the played out veterans he once maligned, he may have found that this view of

55 Ibid. 56 Casey, “Marked by War,” 128. 57 De Forest, Miss Ravenel’s Conversion, 1867, 519. 58 Ibid., 520. 170 Colburne’s future rang false. Sustaining the belief that the veteran “is a better and stronger man for having fought three years, out-facing death and suffering” became much more difficult as enormous numbers of broken men applied for pensions in the 1880s and

1890s. The claim that the veteran, “possessing more physical and intellectual vigor than is merely necessary to exist, [will] succeed in the duties of life, and control other men’s lives, labors, opinions, successes,” did not apply to the broken veterans of 1880.59

Stoic veterans appealed to the reading public because they did not challenge the social order. In his study of late eighteenth century British veterans, Simon Parkes found that, “the broken soldier is the living image of service, of deference in place of disruption, stoicism rather than subversion… a paragon of passive citizenship.”60 Colburne returns from the war completely broken down by his service but never questions the government’s policies or war’s costs. Part of his recovery included withdrawing completely from politics and public life. Once back in New Boston, Colburne “troubled himself very little about the world; and it got along at an amazing rate without his assistance... As to the battles Colburne only read the editorial summaries and official reports.”61 When he does reemerge after this period of breakdown, it is to middle-class domestic life rather than the life of a public servant or advocate for soldiers’ benefits. In the case of a broken veteran, his passivity may have meant the refusal to accept civilians’ pity (or charity) and relative hesitancy to upset the social order. These men demand deference but refuse disruption. Their pain rendered them exemplary citizens while also rendering them passive, unthreatening citizens.62 Miss Ravenel’s Conversion brings

59 Ibid., 520–21. 60 Parkes, “Wooden Legs and Tales of Sorrow Done,” 205. 61 De Forest, Miss Ravenel’s Conversion, 1867, 489. 62 Parkes, “Wooden Legs and Tales of Sorrow Done,” 205. 171 broken veterans to the forefront only to emphasize their place within the social order, not to advocate for social change.

Male Invalids

Temporary sickness or disability did not mark a man for life. Soldiers and civilians alike expected that exposure to the South’s climate would cause more than a few soldiers to fall ill for a time. Prior to the war, Americans still accepted environmental theories of disease causation and, along with them, the notion of “seasoning.” In this view, illnesses developed as a result of sudden changes in the climate or as the result of moving from one climate to another. “Seasoning” referred to the nearly inevitable process of “bodily adjusting to a new climate when one moved.”63 Some men, incapable of adapting to the environment, would die as a result of the new climate. A few

Confederates expected the South’s climate to give them an edge by killing or disabling the Union’s forces.64 Doctor Ravenel worries about Colburne’s ability to withstand a

New Orleans summer and survive in malarious country given his upbringing in New

England, ostensibly healthier than the swampy, warm New Orleans. Likewise, an injury or wound could render a man disabled during the course of his recovery but pose few problems to him later in life.

During and after the war, civilians had little patience for the ill or broken soldier.

Historian Kathryn Shively Meier found that this skepticism of the sick soldier blended a general suspicion of soldiers as a class, contemporary religious thought, and reformers’ link between sickness and individual responsibility. Though northern civilians might have felt concern for specific soldiers that they knew, they viewed soldiers as a group

63 Meier, Nature’s Civil War, 17. 64 Ibid., 52. 172 warily. “Soldiers had to look no further than the daily news to realize that sympathy for their suffering only went so far,” Meier writes.65 For men who suffered the long-term, debilitating effects of war, invalidism became a social identity and military designation as much as a medical category.66 Like the tuberculosis patients Sheila Rothman studied in

Living in the Shadow of Death, Civil War veterans had a patriotic and masculine obligation to seek a cure.67 Unlike many veterans, De Forest had the means to travel to recover his health. He spent time in Europe in efforts to improve his condition and spent the winter of 1880 at a health resort in Aiken, South Carolina.68 Like good veterans nationwide, De Forest assured the pension officers reviewing his case that he made substantial efforts to recover his health before turning to government assistance. Other men gave up efforts to heal when it became clear that physicians could do nothing for them. Representing the played-out soldier’s quest for health in sentimental literature like

Miss Ravenel’s Conversion proved to be more complicated than other forms of war story for two reasons. Unlike a disabling wound or injury, many soldiers lost their health over time. Physical, emotional, or mental breakdown and recovery ebbed and flowed. Second, representing the ill soldier risked placing him in a position of profoundly un-masculine dependency on women and/or the state.

This attitude reflects the difficulty of imagining men as chronically ill at a time when culture gendered the invalid as female. When Colburne returns to New Boston,

65 Ibid., 96. 66 Much excellent scholarship on tuberculosis has contributed to the idea of the invalid as a social role rather than a medical category. See Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in America (New York: Basic Books, 1994). 67 Ibid., 4. 68 John William De Forest, letter to the Pension Office dated January 19, 1898, Soldier’s Certificate No. 1098.147, John William De Forest, Captain, Co. I, 12th Connecticut Volunteer Infantry and Co. I, 14th Volunteer Reserve Corps. 173 worn out by his service, he is equated with a child. Colburne asks to see Lillie’s son and finds him “on the bed… well grown for a yearling, his fair face red with health, sunburn, and sleep, arms spread wide apart, and one dimpled leg and foot outside the coverlet.”69

Immediately following this tender moment, Dr. Ravenel urges Colburne, himself sunburnt but gaunt, to lie on the sofa propped up by pillows and covered with an afghan.70 Treating the invalid soldier and infant the same way speaks to the way in which sickness constrained veterans’ social position. At this point, Colburne resists the

Ravenels’ desire to care for him. The two remain worried about him but ultimately allow

Colburne to reject their offers of pillows, blankets, and other items. Instead, he bears his sufferings as a matter of fact not worthy of consideration.

The good soldiers in Miss Ravenel’s Conversion, like Colburne, go out of their way to refuse to even acknowledge sickness. When Colburne comes down with bilious typhoid fever, he neglects to mention it in his letters back to the Ravenels. Dr. Ravenel learns of Colburne’s sickness only because Cornelius Van Zandt, a second lieutenant and aid to Colburne, drunkenly exclaims that the captain had been “woefully broken up” by the disease.71 Colburne’s sense of duty and respect for Army regulations prevents him from taking brandy to treat the typhoid. Only pressure from Colonel Carter gets Colburne to succumb to the medicinal power of liquor, wool shirts, and rest. Though ostensibly recovered by the time Dr. Ravenel arrives in New Orleans, Colburne continues to look

69 De Forest, Miss Ravenel’s Conversion, 1867, 485. 70 Ibid., 486. 71 Ibid., 132. 174 “thin and pale.”72 Dr. Ravenel, concerned about Colburne’s health, observes that,

“[Colburne] doesn’t even mention that he has been sick. He is a noble fellow.”73

At several points in the novel the narrator remarks on Colburne’s ability to endure pain without complaint. A soldier’s ability to stoically accept the physical hardships of service came to represent a specific form of masculinity. In his analysis of soldiers’ memoirs, William Etter found that for the ill or wounded soldier, “the ability to endure pain, to battle his own body quietly and successfully, gives him a sense of self-worth while writing to family members who he wishes to be proud of him. The soldier’s impaired body is the enemy of himself as well as those attempting to mitigate his suffering and thus merely a reified pain.”74 At several points in the novel, Colburne describes his new-found stoicism to put other people at ease. First, when Dr. Ravenel encourages Colburne to stay indoors in the evening, Colburne simply laughs and explains his duty. Later, when the Ravenels encourage him to make use of blankets and cushions,

Colburne explains that, “a soldier’s life cultivates some of the Christian virtues… especially resignation and obedience... A man learns a vast deal of stoical virtue in field service. He learns courage, too, against sickness as well as against bullets.”75

The Ravenels cared for Colburne throughout the war in middle-class, domestic settings. Lillie mentions that, “it always seems to be our business to take care of you when you are sick… we nursed you at Taylorsville—that is, till we wanted some fighting done.”76 In ill health, his martial masculinity was softened just enough to bring him and

72 Ibid., 134. 73 Ibid., 141. 74 Etter, “Cripple, Soldier, Crippled Soldier,” 88. 75 De Forest, Miss Ravenel’s Conversion, 1867, 487. 76 Ibid., 484. 175 Lillie together. Alice Fahs argues that the wounded soldier in recovery experienced a softening of his aggressive, martial masculinity.77 In this condition, many observers found their ideal type of soldier: wounded but not fully dependent, masculine but soft, passive but with the promise of activity. The moments in the novel when Colburne requires nursing allow the romantic plot to move forward because they bring Lillie,

Colburne, and Dr. Ravenel into a familial relationship characterized by semi-dependency for an extended period of time. However, Lillie is careful to acknowledge that Colburne is not fully dependent on her. She positions him as a wounded warrior in need of nursing but capable of returning to the field when needed.

The broke down soldier retained his respectability only in so far as he pursued personal improvement and gainful employment. When he applied for a pension in 1898,

De Forest described the efforts he undertook to cure himself of his disorders but is also clear that these disorders prevent him from earning a living despite his best efforts. After failing as an author, De Forest cannot fall back on manual labor. His heart condition

“leaves me in tolerable peace if I do no manner of serious work; in other words, it permits life if I do not attempt to earn a living.”78 It is not that he had no desire to work, it is that he physically could not work and deserved support from the government because it was his service to the nation that prevented him from pursuing any paid labor.

This kind of illness, defined by non-specific complaints, risked turning men into dependent and feminized figures. Typically, nineteenth century Americans expected that

77 Fahs, The Imagined Civil War, 110. 78 De Forest, letter to Pension Office, January 18, 1898, Soldier’s Certificate No. 1098.147, John William De Forest, Captain, Co. I, 12th Connecticut Volunteer Infantry and Co. I, 14th Volunteer Reserve Corps. 176 women were invalids, not men.79 In fact, Lillie even jokes that Colburne’s passivity and stoicism “make[s him] as good an invalid as a woman.”80 Rather than be angry with

Lillie, Colburne suggests that, in fact, “I believe the war will give a manlier, nobler tone to the character of our nation. The school of suffering teaches grand lessons.”81 What, exactly, these grand lessons are Colburne never says. Resisting sickness, rather than accepting it, was the important characteristic. Passivity in the face of medical treatment defined the woman’s sickbed. When faced with declining ability to work and being professionally behind men who stayed home during the war, Colburne’s ability to endure pain could have provided a sense of self-worth that compensated, at least partially, for his failure to thrive post-war.82

De Forest did not suggest, however, that soldiers should never take time to recover their health. Colburne’s near manic desire to work while suffering a complete physical break down is portrayed as outside the scope of appropriate behavior. During their conversation about Colburne’s uniform and wish for a “citizen suit,” Dr. Ravenel threatens, only half in jest, to order a straitjacket for the good Captain if he refuses to remain in his room, resting.83 Clearly, too much desire to work becomes itself a pathology. Dr. Ravenel observes that “so many of these noble fellows die after they get home!”84 He does not explain why so many men die but, following as it does on the conversation about rest and civilization, it suggests that too rapid a return to work for the

79 For more on the gendering of the invalid, see Price Herndl, Invalid Women Figuring Feminine Illness in American Fiction and Culture, 1840-1940; Lorna Duffin, “The Conspicuous Consumptive: Woman as an Invalid,” in The Nineteenth-Century Woman: Her Cultural and Physical World, ed. Sara Delamont and Lorna Duffin (New York: Barnes & Noble Books, 1978), 26–56. 80 De Forest, Miss Ravenel’s Conversion, 1867, 487. 81 Ibid. 82 Etter, “Cripple, Soldier, Crippled Soldier,” 88. 83 De Forest, Miss Ravenel’s Conversion, 1867, 479. 84 Ibid., 480. 177 weakened soldier is profoundly dangerous. In a case like Colburne’s, a soldier should rest, eat, and bathe in order to retain his strength for the tasks before him. As both a medical man and friend of Colburne, Dr. Ravenel expresses real concern with the

Captain’s desire to work through his illness. The doctor tells Lillie that he would not be so anxious about Colburne except that he “thinks he has a vast quantity of company business on hand which must be attended to at once” (emphasis added).85 His tone indicates that the doctor cannot imagine Army paperwork being more important than a man’s health. As a civilian, of course, Dr. Ravenel would have no frame of reference to understand the muster rolls’ importance or why a man would follow Army regulation at the expense of his own well-being. He reports to Lillie that Colburne is a “very delicate and uncertain” case and the two immediately develop a regimen of care. Lillie proposes a compromise wherein she and her father help Colburne complete his business, making several copies of the company’s muster rolls. At the same time, the doctor plans to order him food and administer enough morphine for Colburne to sleep through the night. As was the case with so many other Union veterans, the women and older men in Colburne’s life take on responsibilities outside their social positions in an effort to ease the burden on a broken soldier. De Forest certainly included this scene in part to critique the vast amounts of paperwork required by the Army bureaucracy; it is also a prescient representation of the ways in which men came to rely on the women around them to complete tasks.

Dr. Ravenel expresses real concern that in his frenzy to complete the company’s muster rolls on time, Colburne “will tax his brain fearfully.” Usually calm and deliberate

85 Ibid. 178 about his action, Colburne becomes nearly unhinged by the thought of completing his company’s muster roll. “But it must be done” Colburne laments before explaining that,

It is an awful job… Just see what it is. I must have the name of every officer and man that ever belonged to the company—where, when, and by whom enlisted— where, when, and by whom mustered in—when and by whom last paid—what bounty paid and what bounty due—balance of clothing account—stoppages of all sorts—facts and dates of every promotion and reduction, discharge, death and desertion—number and date of every important order. Five copies! Why don’t they demand five hundred? Upon my soul, it doesn’t seem as if I could do it.86

His dedication to his paperwork is, on one hand, noble. Until Colburne completed the muster rolls his company men could not start their journeys home, receive back pay and bounties, or document their service for pension purposes.87 Colburne’s concern for his men above his own health only serves to underscore his honor. It also makes Colburne’s failure to rise in the ranks sting that much more. On the other hand, De Forest presented

Colburne’s desire to complete this paperwork as indicative of his poor mental condition and the absurdity of the military’s policies. Requiring a sick man like Colburne to carefully account for pay, promotions, and other transactions over four years of war is clearly an imposition in the eyes of his civilian physician and friend. Read this way, the

Army’s paperwork does little except over-tax men who could be of more use on the battlefront or recovering properly at home. De Forest’s criticism of paperwork echoed civilian concerns that bureaucratic forms both distracted soldiers from fighting and prevented them from receiving the supplies they needed in a timely fashion.88

The wholesome care provided by a family is celebrated throughout the novel.

After the war, veterans had access to a huge number of patent medicines that promised

86 Ibid., 483. 87 Casey, New Men, 23. 88 Amanda Claybaugh, “Bureaucracy in America: De Forest’s Paperwork,” Studies in American Fiction 37, no. 2 (2010): 208. 179 relief from rheumatism, nervous debility, irritable heart, and more.89 Veterans often mentioned using patent medicines in their pension applications. Skepticism of various cures and patent medicines animated many of the discussions of bodies and care in De

Forest’s work. De Forest presented Dr. Ravenel as a morally upright, studious man who understands the limits of his profession and the negative impact of hucksters selling patent medicine to the emotionally and physically vulnerable. While Lillie fusses over her son, the doctor reveals that he played a trick on his daughter by switching her son’s patent medicine out for colored water. The doctor implores his daughter to, “don’t, for pity’s sake, vitiate and torment your poor little angel’s stomach, so new to the atrocities of this world, with drugs. These mixers of baby medicines ought to be fed on nothing but their own nostrums.”90 Lillie, horrified that her father replaced her son’s colic medicine with red water, tells him that he will “have a great many sins to repent for,” to which Dr.

Ravenel replies, “poisoning my own grandchild is not one of them, thank Heaven!”91 By ensuring that he did nothing to his grandson, he kept his conscience clean. Later, the doctor would prescribe Colburne only rest, food, and opiates: a comparatively conservative treatment.

The emasculation of the veteran was made all the more complex by the 1870s when beliefs about men’s health focused on the benefits of a rugged, outdoor life as a tonic against modern forms of labor. Although Miss Ravenel’s Conversion, published in

1867, came out two years before George Beard identified neurasthenia as a unique

89 For an example of patent medicine advertisements directed to veterans, see Drs. K&K and United States Medical and Surgical Association, Guide to Health Dedicated to the Invalids of America [Pamphlet] (Detroit: The Free Press Book and Job Printing House, 1882), http://www.popularmedicine.amdigital.co.uk/Documents/Images/PM_113149_O/0. 90 De Forest, Miss Ravenel’s Conversion, 1867, 468. 91 Ibid. 180 condition, Colburne’s relationship to paperwork and the comforts of civilian life anticipated Gilded Age anxieties about intellectual labor, masculinity, and modernization that characterized the condition. Neurasthenia’s symptoms were vague and broad.

According to Beard, neurasthenia could be characterized by “neuralgia [nerve pain], lethargy, insomnia, anxiety, and depression.”92 Brought on by “excessive brain work” and identified most frequently in white, middle and upper-middle class, Protestant men, neurasthenia quickly emerged as a disease of the new era’s important and powerful.93

Men like Colburne, dedicated to their work as they were yet confined to the mental tasks of legal or commercial work, were uniquely poised to develop neurasthenia or nervous prostration.

The narrator’s enthusiastic praise for outdoor living and the ennobling effects of strenuous, physical work anticipated the so-called Camp Cures popular in the 1870s and later. Elite physicians, most notably S. Weir Mitchell, promoted the Camp Cure for men afflicted with neurasthenia, nervous exhaustion, or general weakness. As S. Weir

Mitchell, put it, “civilization has hurt—barbarism shall heal.”94 Even Dr. Ravenel tells

Colburne that, “the Indians die of civilization. So does many a returned soldier. You will have to be careful of yourself for a long time to come.”95 While Mitchell stopped far short of advocating for war in his Camp Cures—preferring trips to cattle ranches—the activities he described for improving health are the things listed by De Forest as

92 There is an enormous amount of writing on neurasthenia and its cultural component. See David G. Schuster, Neurasthenic Nation: America’s Search for Health, Happiness, and Comfort, 1869-1920, Critical Issues in Health and Medicine (New Brunswick, NJ.: Rutgers University Press, 2011), 19. 93 Schuster, Neurasthenic Nation; Cervetti, S. Weir Mitchell, 1829-1914; Francis G. Gosling, Before Freud: Neurasthenia and the American Medical Community, 1870-1910 (Urbana, IL: University of Illinois Press, 1987); Scull, Hysteria; Shorter, From Paralysis to Fatigue. 94 Silas Weir Mitchell, Nurse and Patient, and Camp Cure (Philadelphia: J.B. Lippincott & Co, 1877), 46. 95 De Forest, Miss Ravenel’s Conversion, 1867, 486. 181 positively transformative for Colburne as well. According to Mitchell’s 1877 pamphlet on the Camp Cure, these ill men, “wont to live in a house, shall sleep in a tent or, despite his guide’s advice, shall sleep under ‘the moon’s white benediction’.”96 Colburne complains that “three years spent out of doors makes a house seem like a Black Hole of

Calcutta.”97 The Camp Cure promised to restore vitality (i.e. masculinity) to men who had been enfeebled by modern life.

Like elite physicians a decade later, De Forest celebrated the Army life’s effect on soldiers’ overall health. Just before describing the battle at Port Hudson, the narrator praises Colburne’s health:

His constant labors and hardships, and his occasional perils, have preserved him from that enfeebling melancholy which often infects sensitive spirits... Always in the open air, never poisoned by the neighborhood of four walls and a roof, he never catches cold, and rarely fails to have more appetite than food.98

This passage is more wishful thinking than fact; filth diseases decimated Army camps, mosquitoes spread malaria, and food shortages were a constant source of complaint among Union soldiers. While sleeping outside, “irregular food,” and long marches did leave Colburne, “gaunt and wiry,” the narrator explains that he was “all the hardier and stronger for it, like a wolf.”99 In this outdoor life of military labor, the former lawyer manages to adapt to, and indeed thrive because of, the demands placed on his body. This physical transformation occurred throughout the ranks. The narrator explains that, “Colburne smiled with pleasure and pride as he glanced along the line of his

96 Silas Weir Mitchell, Nurse and Patient, and Camp Cure, 46. 97 De Forest, Miss Ravenel’s Conversion, 1867, 475. 98 Ibid., 276. 99 Ibid. 182 company.” Time in the service produced a marked “change in [the men’s] physiognomy.”

Now, the company,

Was a long row of stern faces, bronzed with sunburn, sallow in many cases with malaria, grave with the serious emotions of the hour, but hardened by the habit of danger, and set as firm as flints toward the enemy. The old innocence of the peaceable New England farmer and mechanic had disappeared from these war- seared visages.100

For a generation comfortable with phrenology and attuned to reading bodies for clues about character, this passage underscored the ways that war improved the men. Although many of the era’s Civil War novels contain lengthy descriptions of the trials of marches or the unbearable presence of lice, Miss Ravenel’s Conversion is perhaps unique in its presentation of the poor physical health caused by war as itself an ennobling transformation rather than an annoyance or trial.101 The sallow skin of his malarial soldiers inspires pride in Colburne, not pity or disgust, because it indicates that they have survived all the trials of Army life—not just the battle.

Readers may have struggled to reconcile Colburne’s generally positive experience in the Army, despite his breakdown at the end, with the returned veterans who complained daily of chest pain, incontinence, or nervous prostration for decades to come.

After all, these men had all slept outside, eaten irregular food, and marched endless miles before forging their manhood on the battlefield. Colburne does not return to active service after his illness but, instead, gives himself “three months of pure, perfect rest” to recover.102 Although Colburne does not take a proper, physician-supervised rest cure for his mental and physical exhaustion, his plan to experience perfect rest again aligned with

100 Ibid., 279. 101 For example, contrast De Forest’s description of illness and marching with Wilbur F. Hinman, Corporal Si Klegg and His “Pard,” 12th ed. (Cleveland, OH: The N. G. Hamilton Publishing Co., 1900). 102 De Forest, Miss Ravenel’s Conversion, 1867, 484. 183 contemporary beliefs about exhaustion and nervous debility. However, this too could be read as feminine given the gendering of cures in this period. Women took the rest cure.103

As described by Mitchell in Fat and Blood, the rest cure required women to retreat from society, lay passively in bed for extended periods, eat tremendous amounts of food, and become fully dependent on their physicians.104 This treatment conformed to Victorian expectations about women’s natural social role. For men to take the rest cure, or even an extended period of rest, placed them outside the norm. De Forest resisted the emasculation of the invalid soldier by emphasizing his independence and stoic acceptance of pain.

The Ill Veteran as a Martial Failure

If the sick veteran was a figure of skepticism, the invalid soldier was, to borrow

William Etter’s phrase, “a freak of nationalism.”105 The invalid soldier’s insufficient masculinity represented a threat to military discipline as much as it did to the social order.

Major Gazaway, a minor character in the De Forest’s novel, represented the civilian anxieties about sick soldiers. The first time the reader encounters Gazaway, the apparently robust man is sleeping and ensconced in mosquito netting. Before a group of

Texans arrive at the fort, Gazaway begins to complain of his health. De Forest describes the six-foot-tall, nearly two-hundred-pound Major Gazaway as “large-limbed, deep- chested, broad-shouldered… masculine and even stern in expression.”106 Despite his large physical presence, Gazaway claims to envy thin and pale Colburne, at the time

103 Far too much has been written about the gendered assumptions in the diagnosis of neurasthenia and the rest cure to include it all here. For a good overview of Mitchell’s recovery program, see Cervetti, S. Weir Mitchell, 1829-1914; Gosling, Before Freud; Schuster, Neurasthenic Nation; Scull, Hysteria. 104 Mitchell, Fat and Blood: And How to Make Them. 105 Etter, “Cripple, Soldier, Crippled Soldier,” 80. 106 De Forest, Miss Ravenel’s Conversion, 1867, 320. 184 recovering from a gunshot wound, for his ability to adapt to the Louisiana climate.107 He tells Colburne that, “I used to think I could [stand anything], but this climate fetches me. I swear I hain’t been by myself since I come to Louisanny.” De Forest’s narrator then quickly takes over and explains that “it is true” that Major Gazaway had not been “what he honestly thought he was.”108 That is, instead of a brave soldier, the former boxer proved himself to be nothing but a coward as a soldier who tried to hide it behind complaints about the climate. Unlike men who, in the heat of battle, felt an understandable rush of panic or fear of death, the Major’s cowardice “bordered upon mania or physical disease.”109 It extended into his daily life as a soldier and shaped his decisions as the senior officer in the fort. None of the characters in Miss Ravenel’s

Conversion believe that Gazaway suffered from any kind of illness or other physical breakdown in the service. However, the severity of his case of cowardice and the extent to which ill-health allowed Gazaway to deceive himself proves an important point of discussion. Even as nobody around him believes him, Gazaway maintains the delusion of ill health.

As the Texans approach, Gazaway wants to surrender the fort on the grounds that his unit “haint got the men to whip six thousa’n’ Texans.”110 Colburne responds to the

Major by saying, “Gentlemen, I go in for fighting,” while a nearby lieutenant “fingered his revolver threateningly, and swore by that was holy or infernal that he would shoot the first man who talked of capitulating.”111 Gazaway struggles to “gurgle a remonstrance”

107 Ibid., 322. 108 Ibid. 109 Ibid., 332. 110 Ibid., 330. 111 Ibid., 331. 185 but ultimately agrees to fight. Although he claims that illness, the result of his inability to adapt to the Louisiana climate, made him unsure about fighting, the men serving under him have already pegged him as a coward. For the rest of the afternoon, the common soldiers “amused themselves by slyly jerking bullets at him, in order to see him jump, fall down and clap his hand to the part hit by the harmless missile.”112 Gazaway could not even be bothered to issue orders or punish the pranksters. The mere threat of a rebel attack used up “every feeble source of manliness in him.”113 Colburne eventually leads the soldiers in a rousing defense of the small fort despite nursing his wounded arm. Even

Dr. Ravenel participates in the defense of Fort Winthrop. He picks up a dead soldier’s rifle and joins the fight, reasoning that, “after all, it is only a species of surgical operation” to shoot at a man.114 Once the fighting ends, Gazaway emerges from Lillie’s quarters and “complaining much of internal pains, but still able to dictate and sign a pompous official report of his victory, in which he forgets to mention the colic or the name of Captain Colburne.”115 This episode at Fort Winthrop encapsulates civilian concerns, not to mention soldiers’ own prejudices, about the degree to which cowards disguised themselves as invalids in order to avoid punishment. Later, the Colonel exclaims that, “three quarters of the hospitals are a disgrace to the service. They are asylums for shirks and cowards.”116

The narrator concludes this section by explaining that, some months later, the

Major managed to secure an honorable discharge on a disability certificate. According to

112 Ibid. 113 Ibid. 114 Ibid., 338. 115 Ibid., 344. 116 Ibid., 352. 186 the narrator, “the request was granted for some mysterious reason, probably of political origin; and this vulgar poltroon left the army, and the department with no official stigma on his character.”117 Without the official stigma of cowardice, Gazaway could blend in easily with the thousands of men who returned from the war with honorable records and honest claims to poor health brought on by the war. The representation of men like Major

Gazaway in popular culture added fuel to suspicion of sick veterans after the war.

Civilians could not be expected to determine an invalid veteran’s worthiness for charity.

The Veteran’s Sense of Self

Service in the Civil War was both mundane and extraordinary in its impact on a man’s sense of self. By confronting death, disease, and disability on a scale previously unimaginable, Civil War soldiers experienced a radical redefinition of their sense of the normal body. In Miss Ravenel’s Conversion, Captain Colburne bears witness to the physical aftermath of battle. These scenes, universally praised, foreground individual perspective and perception. De Forest felt deeply that prose almost always failed to capture the reality of battle. In 1887, he wrote that,

Nobody but [Tolstoy] has written the whole truth about war and battle. I tried, and I told all I dared, and perhaps all I could. But there was one thing I did not dare tell, lest the world should infer that I was naturally a coward, and so could not know the feelings of a brave man. I actually did not dare state the extreme horror of battle, and anguish with which the bravest soldiers struggle through it.118

De Forest may have stopped short of the true horror of battle, and yet the novel enables readers to imagine life on the battlefield. It is in this landscape of bodies in pieces, men in pain, and his own horror that Colburne, and by extension the reader, confronts the

117 Ibid. 118 John William De Forest quoted in “Editor’s Study,” Harper’s New Monthly Magazine 74 (May 1887): 987. 187 physical chaos created by war.119 Colburne finds the field hospital “deep in the profound and solemn woods, a full mile and a half from the fighting line.” Once there, he encounters “an immense collection of wounded men in every imaginable condition of mutilation, every one stained more or less with his own blood, every one of a ghastly yellowish pallor.”120 Suddenly, the whole, uninjured body becomes the exception rather than the norm. In his analysis of this novel and invalid soldier’s memoirs, William Etter argues that, “all those who fought in the Civil War experienced, whether directly or as a witness, the destruction of any conventional understanding of physical normality.”121 By shattering the healthy body on the pages of the novel, De Forest advanced a more nuanced understanding of the soldier’s physical presence in the war.

Colburne experiences both injury and illness during the course of Miss Ravenel’s

Conversion and, like many soldiers, he experiences far more illness than battlefield injury. However, it is in facing injury that Colburne’s understanding of his own body, and the bodies of his fellow soldiers, changes. The reader gets more access to Colburne’s inner life when he is in pain than when he is ill. After he is shot at Port Hudson, the narrator describes his body in anatomical terms that nevertheless bely pain and confusion:

Suddenly, he halted, powerless, as if struck by paralysis, conscious of a general nervous shock, and a sharp pain in his left arm. His first impulse,—a very hurried impulse,—was to take the arm with his right hand and twist it to see if the bone was broken. Next he looked about him for some shelter from the scorching and crazing sunshine. He espied a green bush, and almost immediately lost sight of it, for the shock made him faint although the pain was but momentary.122

119 Etter, “Cripple, Soldier, Crippled Soldier,” 83. 120 De Forest, Miss Ravenel’s Conversion, 1867, 292. 121 Etter, “Cripple, Soldier, Crippled Soldier,” 82. 122 De Forest, Miss Ravenel’s Conversion, 1867, 287. 188 Later, while recovering in the New Orleans hospital, Colburne experiences a distance from his own body. His arm becomes an object of investigation outside of himself. In an effort to convey the ways in which injury can define a man’s existence, the narrator explains the all-encompassing nature of Colburne’s pain by describing his arm and “a little world of pain; it radiated pain as the sun radiates light.”123 As he recovers, the injury becomes less engrossing and transitions to being something outside of himself. The usually vocal Colburne retreats here and, instead, De Forest’s narrator takes up the challenge of describing the experience of pain. Unlike the narrator/De Forest offering a comparison, after the most severe phase of the injury Colburne speaks about his own sense of the injury. He tells Dr. Ravenel that, “I am not sick at all above my left elbow.

Below the elbow the arm seems to belong to some other man.”124 Both of these efforts at representation rely on observing the pain of others and using language focused outside the immediate bodily experience of Colburne to make meaning of the sensation. In the former, any effort to represent Colburne’s own understanding of his pain has been eclipsed by the narrative need to communicate the seriousness of the wound. In the latter,

Colburne’s experience returns to the narrative but the fact of his pain is absent in favor of splitting the man from the body.125 The failure to adequately represent Colburne’s pain during his recovery underscores the indescribability of pain as well as the limits of De

Forest’s realism.

Chronic illnesses that disabled challenged American ideas about the chronology of the war. William Etter explained that, “crucial to the rhetorical construction of the

123 Ibid., 299. 124 Ibid., 204. 125 I draw here on insights from Scarry, The Body in Pain. 189 disabled veteran in American photography and literature was the portrait of the freakishly sudden injury, of disability abruptly fixed in time.”126 De Forest took some pleasure in portraying these “freakish” moments of severe injury and death, including the story of a soldier who, while resting with his “great coat rolled under his head for a pillow,” is killed while reading his newspaper.127 De Forest included nearly clinical detail about this unnamed soldier’s death, “the ball had struck him under the chin, traversed the neck and cut the spinal column where it joins the brain, making a fearful hole…”128 Like death, disability exists in the novel as created at a specific moment when the surgeon’s blade removes the limb. The novel then includes a lengthy description of a variety of battlefield injuries and emphasizes the moment of disability. One Irish gunner had his leg “knocked off above the knee by a round shot” but, thanks to the heat of the projectile, did not bleed.

Standing near the surgeon’s tables, Colburne observes a pile of feet, fingers, legs and arms beneath them. In one of his more callous moments, Lieutenant Van Zandt, a drunk and one of Colburne’s soldiers, invites him to “come up and see them butcher!”129

Colburne cannot watch the process of an amputation, like Van Zandt, with “eager smile of interest much like the grin of a bull-dog who watches the cutting up of a piece of beef.”130 Colburne identifies too much with the butchered, not the butcher. The soldiers described in this hospital scene are all gravely wounded but behave, essentially, honorably. The description of piles of limbs and the stench of blood adds weight to this scene but so too does the realization that the men who do manage to survive, this moment

126 Etter, “Cripple, Soldier, Crippled Soldier,” 83. 127 De Forest, Miss Ravenel’s Conversion, 1867, 302. 128 Ibid., 302–3. 129 Ibid., 293. 130 Ibid. 190 under the surgeon’s knife will define their physical existence for the rest of their lives.

For the disabled, especially amputees, their bodies carried the evidence of a before and an after. In Ruin Nation: Destruction and the American Civil War, Megan Kate Nelson argues that the amputee soldier “embodied both present and past.” Their missing limbs provided the evidence that allowed “veterans and their relatives to narrate their autobiographies by recalling where they were and what they were doing on a certain day.”131 Recognizing the freakish moment of injury allowed soldiers to divide their lives into before and after the wound. Tying disability to a moment encouraged Americans to think that that the destruction caused by the war could be contained by chronology. This illusion promised to limit the costs—in terms of both pensions and emotional fall out—of the war by creating a firm end point for the impact of war on bodies and personal lives.

Not that the illusion ever worked. Amputees complained of nerve pain, open sores, weeping wounds that never healed, and phantom limb for decades. Likewise, government programs to compensate amputees drew on national resources long after the cessation of hostilities. The promise was appealing and American culture embraced the amputee veteran as the symbol of and the symbolic vessel for the Civil War.

If the ideal veteran was the man who returned from the Union Army hardened but improved by his service, and the acceptable wound was an amputation, the chronically sick, broken, or invalid veteran complicated the picture of the war as an ennobling venture. Simultaneously occupying the social role of a veteran and the chronically ill required that men reconcile distinct ideas about themselves. Miss Ravenel’s Conversion provides a window into Colburne’s efforts to understand himself as a person with an

131 Nelson, Ruin Nation, 230. 191 injured body and failed health while also living up to the ideal of a returned citizen soldier. The invalid complicated these efforts. Unlike the wounded, the ill rarely had a before and an after because they struggled to pinpoint an exact moment of infection.

They too conflated the past and the present but without the promise of containment or completion. Stories about amputees were prevalent in American popular culture after the

Civil War. Perhaps the most well-known of these novels is the 1869 John Smith's Funny

Adventures on a Crutch, or The Remarkable Peregrinations of a One-Legged Soldier

After the War by A.F. Hill. The book opens with Smith explaining how he lost his leg at

Antietam. Despite the centrality of this event in Smith’s life, the book quickly turns to travelogue. While the war rages, Smith visits Niagara Falls and descends behind the waterfall, tours Mammoth Cave, and ice skates all on one leg. He complains regularly about the questions people ask him about his leg and the war. However, the book relentlessly looks forward to a life where Smith will undertake many physical feats. In contrast, Miss Ravenel’s Conversion is not an amputation story. It promises to contain the war because there are no lasting impacts to mitigate. This novel refuses to acknowledge that the war will reverberate decades into the future or that its consequences will be difficult to identify.

Historian James Marten emphasizes that, “military service was the most common denominator of middle-aged northern and southern men during the Gilded Age. Forty- one percent of all northern white men born between 1822 and 1845 and 81 percent of those born in 1843 served in the Union Army.”132 The shared experience did not detract from its impact on the lives of individual soldiers who identified the war as a key turning

132 James Marten, “A Running Fight against Their Fellow Men: Civil War Veterans in Gilded Age Literature,” The Journal of the Civil War Era 5, no. 4 (2015): 505. 192 point in their lives. The enormous number of men who experienced the Civil War reshaped the veteran experience from a temporary status into a wholly “new identity that was associated with a new state of consciousness.”133 These men understood themselves to be fundamentally changed by war and unlike their peers who could not or chose not to join the military. Like many veterans, the soldiers in Miss Ravenel’s Conversion believe that the experience of battle has made them distinct from the civilian men who remained at home. Colburne self-identifies as a veteran in the middle of the book after his unit’s first engagement but he attaches the status to fighting, not simply to having been in the service.134 Toward the end of the novel, Colburne takes serious offense to accusations that he sympathized with the Copperheads because of his respect for the Southern soldier’s prowess, anticipating the reconciliationist thrust of much Civil War literature.135

He grounds his objection not in politics but in his status as a former soldier, explaining that his accuser “has never been in the army—never smelled a pinch of rebel powder.

There were not Copperheads at the front; they were all here, at the rear, where he was. He ought to know them, and he says that I am one of them. Isn’t it amazing!”136

This changing meaning of veteranhood took time to filter into literature. In his study of Civil War veterans in Gilded Age literature, James Marten found that very few novels included characters who “come to grips with being a veteran.”137 De Forest, like his peers, did not include a lengthy study of Colburne’s postwar years or how he copes with the psychological, social, and economic consequences of veteranhood over the

133 Casey, New Men, 2. 134 De Forest, Miss Ravenel’s Conversion, 1867, 217. 135 For more, see David W. Blight, Race and Reunion: The Civil War in American Memory (Cambridge, MA: Belknap Press of Harvard University Press, 2001). 136 De Forest, Miss Ravenel’s Conversion, 1867, 490. 137 Marten, “A Running Fight against Their Fellow Men,” 505. Emphasis in original. 193 course of his life. If representing the essence of being a veteran posed a representational problem for authors writing immediately after the war, the veteran-invalid’s life required even more nuanced and complex representations. Miss Ravenel’s Conversion offers insight into how writers and veterans imagined an honorable soldier’s relationship to his deteriorating body. Throughout Miss Ravenel’s Conversion, the narrator describes

Colburne and Carter’s interior states in the language of emotion grounded in the physicality of the body. As Travis described, the war brought together languages of medicine, militarism, and emotion. De Forest’s novel employs the language of the body and the emotional heart in a way that restores the individual’s subjectivity. Joan Burbick found that, “heart language offered a counterpoint to the new physiologies of the body, and restored the voice of the speaking subject… Heart language insisted upon subjectivity… To speak from the heart was to speak from a felt interiority [sic] of the body, an apprehension of a sensed life different from the causality of physiology.”138 The characters consistently emphasize their bodies as ways to experience emotion. Body talk in Miss Ravenel’s Conversion indexes the intensity of an emotion. These moments when the body, in any condition, comes forward in the narrative also provide a way to think about the body as a site where social life, in addition to warfare, could cause distress.

Conclusion

Mark Twain called Miss Ravenel’s Conversion a “splendid novel” while Henry

James found it “a poor novel with a deal of good in it.”139 Regardless, by 1912 it had been out of print for decades and E. J. Edwards could publish an article about it with the

138 Joan Burbick, Healing the Republic: The Language of Health and the Culture of Nationalism in Nineteenth-Century America (New York: Cambridge University Press, 1994), 181. 139 Mark Twain quoted in E. J. Edwards, “New News of Yesterday: Fate of First Novel About the Civil War”; James, “Miss Ravenel’s Conversion,” 492. 194 headline “New News of Yesterday.”140 This first commercial failure doomed De Forest.

His subsequent novels were “perfunctory” and literary fame eluded him during his lifetime. Although he kept writing for various magazines and journals, his career essentially ended in the 1880s when his health began to deteriorate. Like Colburne, De

Forest’s prospects seemed bright in the years immediately after the war; he worked as a clerk in the Freedman’s Bureau, published his novel to critical praise, and seemed poised to achieve literary fame. He ended the novel before Colburne entered middle-age, weathered post war financial panics, or suffered from recurring fevers. Had De Forest continued Colburne’s story, it may very well have looked like his own. De Forest’s proposed changes to the novel suggest that, by the 1880s, he had lost faith in the veteran’s fate. With his own health failing and commercial literary success out of his grasp, De Forest excised passages that praised the veteran’s ability to earn a living without becoming a “state pauper for life.” The anxiety about returning veterans that demanded stories with an optimistic outlook on civilian life for men like Colburne cooled into ambivalence about the broken veteran. His later novels do not pick up the long- suffering veteran, favoring stories that feature amputee veterans, acute illnesses, or fictionalized memoirs.

Men who had their health broken by war do not lend themselves to easy representation. Their illnesses changed over time, lacked a clear moment of origin or cure, and carried the taint of cowardice. As invalids, former soldiers had an obligation to attempt to recover their health and rejoin society as healthy, productive citizens. As veterans, former soldiers had already done enough to earn the sympathy and material

140 E. J. Edwards, “New News of Yesterday: Fate of First Novel About the Civil War.” 195 support of their fellow citizens. This tension animated debates between individual soldiers and the Pension Office, fueled civilian critiques of the pension system, and influenced popular literature like Miss Ravenel’s Conversion. De Forest’s narrow focus on the war years allowed him to sidestep complicated conversations about how veterans experienced their bodies and health over decades. But, even in the war years, soldiers broke down and left the service, they became sick or injured, they healed. The changing bodies De Forest described in Miss Ravenel’s Conversion, and the meanings he ascribed to those bodies, moved within a literary and popular culture profoundly concerned about the bodies of returning soldiers.

196 Conclusion

If war made men, illness unmade them. Joseph Work, Peter Bedor, Jacob Fife,

Frederick West, John William De Forest, and thousands of other men lost their health during the Civil War. Unlike their peers who lost limbs or were marked by scars, these men negotiated the meaning of their broken bodies over and over again. The chapters in this project demonstrate that soldiers’ sick, ill, weak, or otherwise broken bodies meant different things to different stakeholders in the post-war decades. For physicians like Dr.

Jacob Da Costa and his peers, the soldier’s weak heart promised to advance scientific medicine, specific diagnoses, and medicine’s professional standing. Bureaucrats in the

Pension Office attempted to contain the costs of war by limiting the kinds of evidence available to demonstrate suitability for a pension. In families, the diagnosis and official recognition were secondary concerns to the realities of daily life with sick, injured, or mentally ill veterans. The women who provided direct care to Union soldiers managed the war’s legacy in ways that the Pension Office and federal government never even attempted. American popular culture continued to favor the working, productive veteran who managed to recover his health after the war.

Rather than being a project narrowly focused on the various groups who managed veterans—doctors, government clerks, families, and novelists—this is also a project about the ways in which veterans themselves fought and resented the categories established for them. When Frederick West wrote to the Pension Office in 1888 to demand that someone “tell me whether it is the law, the doctors, or the rulings of the

Department that is responsible for the existing [pension] inequality that I may ‘cuss’ with

197 proper discrimination,” he pinpointed the problem facing veterans.1 Their bodies were the charge of lawmakers, doctors, clerks, family members, and popular culture but rarely did their own experiences and perspectives on their health count as evidence. Men who could not point to a scar or “empty sleeve” fought for recognition of their suffering in several different arenas. They did not accept physicians’ or pension officers’ rulings uncritically.

They appealed decisions, wrote letters, and organized in the Grand Army of the Republic.

These small acts of negotiation, everything from sending a letter to the Pension Office or refusing to “throw money away in useless attempts to regain [their] health,” demonstrate how men insisted on the primacy of their individual bodies and minds in the face of government, institutional, and cultural standardization.2 Although not the dramatic demands for support staged by later veterans, these small acts of resistance highlight how the categories and policies designed to manage veterans broke down under pressure from broken veterans.

Compared to the lasting explanatory appeal of the “broken” soldier, irritable heart and related diagnoses had relatively short life spans. In World War I, physicians were still aware of Da Costa’s syndrome but were already moving away from diagnosing soldiers with irritable heart or effort syndrome. With the development of new diagnostic tools and practices, additional knowledge of the nerves, brain, and psychological aspects of health, physicians tended to further segment medical complaints into more and more nuanced categories. Irritable heart gave way to shell shock, which in turn gave way to battle

1 Letter from Frederick L. West to Pension Office, April 10, 1888, Soldier’s Certificate No. 988.65, Frederick L. West, Sergeant, Co. D, 154th New York Volunteers. 2 Letter from Frederick L. West to Pension Office, November 12, 1868, Soldier’s Certificate No. 988.65, Frederick L. West, Sergeant, Co. D, 154th New York Volunteers.

198 fatigue, which itself gave way to PTSD in the 1980s.3 Today, a century and a half after

Jacob Da Costa’s initial reports on exhausted, irritable hearts, historians, physicians, and soldiers alike have returned to the diagnosis as a way to understand the dynamic relationship between the mind and body.4 Some twentieth and twenty-first century soldiers have expressed a preference for the term soldier’s heart or irritable heart as a more accurate, all-encompassing label for the emotional, psychological, spiritual, and physical impact of wartime service.5 In his work with Vietnam-era veterans, psychotherapist Edward Tick found that the term appealed to men reeling from war because it “honors that they are wounded and must carry that heaviness their entire lives.”6 In addition to these shifting psychological approaches to trauma, irritable heart has also inspired a new round of physiological study. In 2015, researchers at the College of Public Health at Ohio State University found a strong, causal link between a PTSD diagnosis and congestive heart failure. Likewise, researchers at the Veterans

Administration found similar results in a 2014 study of the links between PTSD and heart disease.7

This contemporary research, while using vastly different methods and tools than

Da Costa, nevertheless returns to the complex interplay between mental state and

3 For examples of texts that employ this general chronology, see Allan Young, The Harmony of Illusions - Inventing Post-Traumatic Stress Disorder (Princeton, NJ: Princeton University Press, 1997), 50–52; Dean, Shook over Hell; Wooley, The Irritable Heart of Soldiers and the Origins of Anglo-American Cardiology, 2002. 4 Samit S. Roy et al., “Posttraumatic Stress Disorder and Incident Heart Failure Among a Community- Based Sample of US Veterans,” American Journal of Public Health 105, no. 4 (April 1, 2015): 757–63; Dean, Shook over Hell. 5 Edward Tick, “PTSD: The Sacred Wound,” Health Progress 94, no. 3 (June 2013): 20. 6 Ibid., 21. 7 Roy et al., “Posttraumatic Stress Disorder and Incident Heart Failure Among a Community-Based Sample of US Veterans”; “Heart-Mind Mystery: Unraveling the Link between PTSD and Heart Disease,” VA Currents, Spring 2014, http://www.research.va.gov/currents/spring2014/spring2014-1.cfm; see also Wentworth et al., “Post-Traumatic Stress Disorder.” 199 physical condition implied by the phrase “broken soldier.” While Da Costa and his fellow physicians understood the disease as a physiological problem that resulted from over- excited nerves that might alter the mind, today’s physicians understand that the psychological impact of war has an impact on the functioning of a soldier’s body long after s/he leaves the front. As more medical research confirms the link between exposure to trauma—among civilians and soldiers alike—and functional physical disorders, analyzing the complex framing of broken down Civil War soldiers may augment our current understanding of trauma, somatic illness, and the psychosomatic.

It is my hope that future research will use the analysis I provided of the broken veteran as a starting place for at least five related lines of historical inquiry. First, how do bodies index moments of social and personal transformation? There is little doubt that the men who joined the Union Army experienced a profound shift in their sense of self but how they physically experienced that shift has been comparatively understudied. Second, and related to the first line of study, how have families and friends of soldiers experienced the trauma of war secondhand? The ways that their lives are altered as a result of their relationship to a broken or traumatized veteran deserve sustained study.

Third, how has America’s culture of individualism been strained by (but ultimately survived) providing expensive and expansive benefits to veterans? Fourth, how is a veteran’s status as a disabled person complicated, negated, or subsumed by his or her intersecting identities? For example, African American Civil War soldiers faced different and additional barriers to having their health concerns legitimized by medical, governmental, and cultural authorities. Likewise, how and why did a soldier’s class background shape his experience of bodily disintegration? Finally, and related to this

200 question, is the role that veteran organizing played in the growth of disability rights movements in the late twentieth century. Although organizations like the GAR stopped far short of what can be described as disability rights activism, veterans certainly organized to pressure legislatures and American society to accommodate and protect the disabled veteran. There is ample space for research into how the disabled veteran’s status as a veteran related to his or her status as a disabled person.

To that end, I join John Kinder who closes his work in Paying with their Bodies with a call for “a New Veteranology, one that seeks not only to improve the lives of disabled veterans but also to ask tough questions about the cultural values underlying so much of the work on veterans’ behalf.”8 The New Veteranology, itself an evolution of an idea originally proposed by sociologist and World War II veteran Willard Wallar in his book The Veteran Comes Back, demands that we step back from the medical model of disability. Instead, scholars and activists should critically examine the ways that disability functions as an “elastic social category” defined as much by culture and policy as by medical conditions. Kinder goes on to suggest that, in line with disability activists’ rallying cry “nothing about us without us,” veterans’ lived experiences should be prioritized. Formal recognition of the disabled veteran’s agency is an essential step toward meaningful inclusion and justice.9 At the same time, scholars should be attuned to the ways in which social changes after any war generate conflict between the soldiers who served and the society that sent them to war in the first place. Sociologist Philip

Klein wrote in 1945 that, “the fact that not only is the veteran a changed man, but the

8 John M. Kinder, Paying with Their Bodies: American War and the Problem of the Disabled Veteran (Chicago: University of Chicago Press, 2015), 298. 9 Ibid., 299. 201 whole social and economic structure of his nation is altered and we have a conflict between two variables” must be acknowledged.10 Any account of the veteran’s post-war life that foregrounds his agency must also demonstrate an awareness of the ways that the culture he returned to both is and is not the same as the one he left.

As with the writers and researchers who ushered in the “dark turn” in Civil War history as they made sense of the legacy of the Vietnam war in the 1980s and 1990s, a new generation of scholars must reckon with how the wars in Iraq and Afghanistan have cast a shadow over their own approach to military history. The United States now faces the prospect of “war without end,” making the questions outlined in this dissertation more than mere intellectual exercise. Americans in the Civil War-era feared the creation of a

“warrior class” but today the United States increasingly pushes the physical and emotional burden of endless war off onto a small percentage of the population: fewer than one half of one percent of Americans currently serve as active duty military personnel, creating a de facto warrior class.11 Despite the comparatively small number of people involved in the wars in Iraq and Afghanistan, the costs for providing long-term care and support to sick and disabled veterans of the Global War on Terror is expected to exceed $600 billion to $1 trillion by 2030.12 These figures do not account for the unpaid labor provided by spouses and parents or place a value on someone’s health as an inherent good. To suggest that the broken soldier is a problem relegated to a medically

10 Philip Klein, review of The Veteran Comes Back, by Willard Waller, American Sociological Review 10, no. 1 (1945): 107. 11 David Zucchino and David S. Cloud, “U.S. Military and Civilians Are Increasingly Divided,” Los Angeles Times, May 24, 2015. 12 Linda J. Bilmes and Brian Smith, “Caring for US Veterans,” Brown University, Costs of War, (February 2015), http://watson.brown.edu/costsofwar/costs/economic/budget/veterans. 202 primitive past or limited to a small segment of the population is ignorant at best and a willful misrepresentation of the facts at worst.

I believe that the broken soldiers of the Civil War era can tell us something about how war alters bodies in unique, personal, and profound ways. To apply those lessons to the present requires not that we diagnose those soldiers with PTSD or a related condition but that we listen to the men who insisted on the value and accuracy of their bodily experience. Broken soldiers, made by war and unmade by illness, will tell us about the physicality of war and homecoming; we just need to listen to their voices in the margins of pension applications, medical textbooks, or popular novels.

203 Appendix: Pension Records and Court Martial Cases Consulted

Pension Records

All the pension records consulted for this project are part of the Case Files of

Approved Pension Applications of Veterans Who Served in the Army and Navy Mainly in the Civil War and the War with Spain (“Civil War and Later Survivors’ Certificates”),

1861–1934; Civil War and Later Pension Files; Records of the Department of Veterans

Affairs, Record Group 15; National Archives Building, Washington, DC. The table below includes the pension application and certificate numbers for the veterans whose records I reviewed for my study.

Soldier’s Name Service Application Certificate Widow’s Name (Last, First) Unit Number Number (Last, First) Abraham, Isaac Co. D, 36th IA 414.318 NONE -- Infantry Apsley, Co. D, 118th IL 509.896 392.163 -- William N. Volunteers Augustus, Co. A, 11th US 178.824 141.747 -- James Infantry Bedor, Peter Co. K, 1st CT 360.626 507.360 Bedor, Virginia Heavy Artillery Bissett, John Co. D, 7th MN 320.625 281.316 Bissett, Sarah Infantry Blake, Simon Co. C, 110th PA 449.398 NONE -- Infantry; Co. K, 133rd PA Infantry; Co. B, 22nd PA Cavalry Bricker, David Co. F, Ramsey’s 540.242 NONE -- Battery, PA Infantry; Co. A, 187th PA Infantry Bruce, James B. Co. M, 8th NY 806.258 572.463 -- Cavalry Butler, Albert Co. B, 3rd NY 459.322 NONE Butler, Frances H. Artillery

204 Chapman, Oren Co. A, 2nd WI 809.589 584.528 Chapman, Frances G. Infantry E. Clark, George Co. E, 153rd IN 797.753 579.800 -- W. Infantry Close, Henry Co. C, 10th WI 284.567 NONE -- M. Infantry Coppernall, Co. I, 140th NY 412.565 343.765 -- William Infantry Crisp, Anthony Co. J, 6th MN 960.760 659.277 Crisp, Martha Infantry De Forest, John Co. I, 12th CT 1201.030 1098.147 -- William Volunteer Infantry; Co. I, 14th Volunteer Reserve Corps Dennis, James Co. K, 2nd RI 150.741 108.293 -- W. Infantry Dewey, Chester Co. B, 59th NY 203.764 146.007 Dewey, Margaret Infantry Dixon, Samuel Co. B, 1st PA Light 387.600 254.987 Dixon, Hattie Artillery Doust, William Co. D, 17th WI 133.130 790.758 Doust, Daisy B. Infantry Fanning, Co. E, 17th NY 968.749 882.094 Fanning, Thomas D. Infantry; Co. I, 3rd Roseanna US Artillery Fife, Jacob Co. B, 1st OH 228.789 NONE Fife, Sophia Cavalry Fowler, John G. Co. E, 9th MN 346.712 203.366 Fowler, Sarah C. Infantry Francis, Co. B, 48th PA 644.670 411.910 -- William H. Infantry; 194 PA Infantry Hunt, Leonard Co. C, 4th RI 387.210 263.429 Hunt, Ella Sophia A. Infantry; Co I, 4th Barker RI Infantry; Co. D, 7th RI Infantry Kirkendall, Co. H, 1st USCT 136.137 434.117 Kirkendall, Richard Chrischania Klemroth, Co. A, 6th PA 104.0477 817.768 -- Edgar H. Cavalry; Co. L, 2nd PA Cavalry Landis, Jacob Co. J, 5th OH 629.13 811.06 Landis, Rebecca J. Cavalry Murray, John Co. F, 57th IL 376.725 438.640 Murray, Hannah Infantry

205 Nash, John Co. C, 1st TX 549.481 470.737 Nash, Malisa A. Cavalry Volunteers Palmer, Co. K, 11th WI 452.487 555.755 Palmer, Alwilda J. William H. Infantry; 8th WI (Ballinger) Light Artillery Ricker, Asa L. Co. C, 32nd MA 319.88 213.44 -- Infantry Romheld, John Co. C, 106th PA 457.838 255.875 -- Infantry; Co. H, 11th US Infantry; Co. D, 9th US Infantry Schreiber, Co. M, 4th NY 817.063 589.818 Schreiber, Oscar Cavalry Mathilde Smith, Alonzo Co. B, 1st MI 389.310 NONE -- Infantry Stare, William Co. I, 200th PA 447.280 327.699 Stare, Jane H. Infantry Twiss, Charles Co. G, 26th WI 575.635 433.387 Twiss, Julia H. Infantry West, Frederick Co. D, 154th NY 135.485 988.65 -- L. Infantry Williams, Co. H, 23rd MI 593.205 361.047 -- Charles P. Infantry Williams, Co. E, 9th MN 418.584 364.481 -- William E. Infantry Work, Joseph Co. I, 12th NJ 386.893 227.705 Work, Christiana Volunteer Infantry

Court Martial Cases

All the records of Court Martial cases that I consulted for this project are part of

Records of the Office of the Judge Advocate General (Army), Record Group 153,

National Archives Building, Washington, DC. With the help of Tom Lowry’s database of cases, I identified the records listed below by searching for the keyword “palpitation.”

Soldier’s Name (Last, First) Service Unit Case Number Andrew, George Co. A, 13th NH Volunteers LL3081 Klemroth, Edgar H. Co. A, 6th PA Cavalry kk406 Mott, John Co. I, NY State Militia ii750 Raeden, Robert Co. I, 20th NY Volunteers ii485 Schmeisser, Frank A. 6th CT Volunteers kk347

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