Voices from the past: Mental and physical outcomes described by American Civil War amputees

Abstract

ABSTRACTStudies of trauma commonly concentrate on the psychological and physiological effects of recent violent events. Although today connections are becoming more explicitly drawn, early studies of the aftermath of amputation serve to shed light on modern understanding of the interaction of the physical and emotional. The study of combat amputation, dissociation, and related posttraumatic stress largely began with the work of 19th-century Philadelphia physician Silas Weir Mitchell, who brought attention to the phenomenon of phantom limb pain. Less known, however, are the data he and his son, John K. Mitchell, also collected on the mental outcomes of trauma. Using an archived collection of original surveys of double-amputee patients dating largely from 1893 housed at the Historical Medical Library at the College of Physicians of Philadelphia, an interdisciplinary team explored the historical, anthropological, and psychological background of the study of combat trauma. Almost 30 years following the end of hostilities, the majority of the sample of U.S. Civil War veterans indicated that their general disposition, general health, and sleeping or eating patterns had changed following limb amputation. More telling, possibly, are the written comments on the surveys and letters that indicate frustration with the continuous suffering and the knowledge of their mental and physical changes. These data illustrate the value of historical archives in documenting the development of the study of trauma and modern concepts of combat experiences.