Reviewed by: Invisible Wounds: Mental Illness and Civil War Soldiers by Dillon J. Carroll Jane E. Schultz (bio) Invisible Wounds: Mental Illness and Civil War Soldiers. By Dillon J. Carroll. (Baton Rouge: Louisiana State University Press, 2021. Pp. 368. $45.00 cloth; $30.16 ebook) Dillon Carroll's book on soldiers' mental health mines the relationship between war injury and postwar debility, enriching the literature on Civil War medicine. Invisible Wounds traces the history of the physical and psychological conditions resulting from battle trauma that led physicians to better understand the etiology of psychiatric and psychosomatic diseases. These advances were slow to come because wartime surgeons and "alienists" (psychiatrists) often attributed patients' mental decline to moral lapses instead of traumatic injuries sustained in combat. Physicians "were convinced that disease, hereditary factors, intemperance, masturbation, and moral impurity could, and did, result in insanity" (p. 196). Through close examination of patient records at St. Elizabeth's Hospital outside Washington D.C., and asylums in Virginia, South Carolina, and Georgia, Carroll builds a case for how medicine mostly failed traumatized veterans by warehousing them, sometimes for decades. Carroll applies and contextualizes the symptomology of posttraumatic stress disorder to these war-scarred men, illustrating physicians' increasing awareness of the psychic damage wrought by physical trauma, an insight, he suggests, southern practitioners embraced more readily than northern peers. Even so, the effects of trauma sat differently upon different individuals: "The repeated traumas of war psychologically broke down some men and planted seeds of later trauma in others," whereas some utilized therapeutic strategies (letter writing, dissociation) to escape the chronic setbacks that bedeviled the more vulnerable (p. 27). Carroll observes crucial [End Page 434] differences between Black and white soldiers' responses to traumatic events, concluding that after experiencing slavery, Black men were so gratified to fight and thereby redeem their manhood, they skirted the traumas that compromised white soldiers. Though Carroll cites ample evidence of Black men's cathartic martial enthusiasm, the lack of data surrounding Black mental healthcare and limited Black access to medical institutions, matters to which the text alludes, might alter the impression of Black imperviousness.1 Soldiers' family members are central participants in Invisible Wounds both in their responses to diagnoses and medical decision making, though only one of the book's eleven chapters is devoted to the familial contexts of mental healthcare. When St. Elizabeth's released putatively violent, insane men to their homes without adequate travel support, family members found themselves ill-equipped to care for them. Wives like Charlotte Gilkison of Ohio and Elizabeth Harris of Washington fought to keep their husbands institutionalized lest they endanger their families. Still, others created elaborate ruses to keep their soldiers' mental illnesses under wraps. Readers must wait until chapter ten to get to the meat of the book, an extended institutional account of St. Elizabeth's, where we learn about staffing problems, overcrowding, the treatment of what would later be called traumatic brain injuries, and how practitioners and patients worked to "decode" the menace of long-term impairment (p. 206). Early chapters rehearse camp and battlefield conditions for white men and then Black, describe weaponry and ballistics, and even define "contraband" without explaining the relevance of these issues to the book's mental health focus. Thus, the argument about mental illness causation is delayed, discussion of the surgeons Carroll follows is fleeting (notwithstanding that of neurologist Weir Mitchell in chapter twelve), and the segmented structure of chapters leads to extraneous analysis. [End Page 435] The multiple mechanics problems—from infelicitous syntax and historical errors (e.g., referring to Sir Isaac Newton as "Thomas") to redundancies, repetitions, and simple typos—interrupted the flow of ideas and thus diminished the important insights Carroll presents in the last several chapters of the book. Historians will no doubt profit from the source base introduced here, but Invisible Wounds offers only a partial step toward understanding the devastating effects of Civil War wounds as physicians, patients, and family members interpreted them. Jane E. Schultz JANE E. SCHULTZ is professor of English, history, and medical humanities at Indiana University-Purdue University-Indianapolis. Her project on the relationship between language and the Civil War surgical corps' professional ambitions is...
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