A Proposed Scheme for the Relief of Disabled Soldiers, 1863
In 1863, the U.S. Sanitary Commission – a relief agency that assisted wounded and sick Union soldiers – made recommendations to the War Department on what provisions should be made for the numerous men disabled during the Civil War. These recommendations exemplify contemporary beliefs regarding the meaning of disability, charity, and community. Of interest are propositions seven and eight, which respectively suggest the establishment of a Sedentary Corps and an Invalid Corps. On April 28, 1863, Secretary of War E.D. Townsend issued General Orders 105, establishing an Invalid Corps, to consist of soldiers who were (1) rendered unfit for active duty due to wounds or disease acquired in the line of duty, (2) fit for garrison duty, and (3) determined to be meritorious and deserving.
A Catalog of Wounds
The Civil War was one of the first armed conflicts to be documented in photographs; medical officers also took advantage of the new technology to document clinical cases. In May 1862, US Surgeon General William Hammond ordered the establishment of the Army Medical Museum (now known as the National Museum of Health and Medicine), which would collect all morbid anatomy and surgical specimens that might be of value to medical personnel in studying physical injuries and improving on wound repair. Many of these photographs were published in an eight-volume set, Photographs of Surgical Cases and Specimens (links to volumes digitized by MHL below).
The case of Private Samuel H. Decker (pictured above): Private Decker was injured at the battle of Perryville, Kentucky, on October 8, 1862, when the artillery piece he was loading went off prematurely, severing all of his right hand and most of his left. The remains of both hands were amputated below the elbow, and the stumps healed completely by January 1863. According to the catalog’s narrative, Decker began experimenting with artificial limb design and by March 1865, had created the apparatus included in the photograph. This device allowed him to write legibly, pick up small objects, carry packages, and feed and clothe himself.
Volumes of Photographs of Surgical Cases and Specimens available in MHL’s collections:
Note: Some material in this source may be considered graphic or unsettling to viewers. Discretion is advised.
Shell Shock
One of the most shocking results of the Great War (later renamed World War I, 1914-1918), was a condition then-known as shell shock. Over time, this condition has been recorded as war neurosis, combat fatigue, post traumatic stress syndrome (PTSD), and posttraumatic stress disorder, although as this 1917 text points out, the symptoms have been varied and difficult to quantify. The authors of this text sought to write a guide that would provide in-depth information that was accessible to non-expert audiences. They emphasized that part of the difficulty in treating and rehabilitating victims of shell shock came from Britain’s general inadequacy in providing early interventions for those exhibiting signs of mental illness and their failure to provide appropriate treatment (unless the person had the means to pay) until the individual was beyond help.
Reconstructing the Crippled Soldier
Improvements in antiseptic and aseptic surgical techniques improved the survivability rates for severe injuries by the end of World War I, just as mechanized war had increased the rate at which men were wounded or killed. Douglas C. McMurtrie, of the Red Cross Institute for Crippled and Disabled Men in New York, produced a pamphlet at the end of the war surveying re-education (known as rehabilitation today) programs across Europe to teach vocational skills to men who had lost physical abilities in the war. This photograph illustrates one such program in England, where soldiers were sent to a training school for young boys and girls with physical impairments and paired with an “orderly” – a younger boy with a similar impairment. Thus, through example, the veteran was intended to learn to cope with his new reality
They Don’t Want Your Charity
Carry On was a magazine in circulation for a little over a year, from June 1918 until August 1919. It was published by the American Red Cross on behalf of the U.S. Surgeon General’s Office, which also oversaw editing. The magazine was distributed to subscribers interested in the “reconstruction” of soldiers and sailors disabled during war service. Articles conveyed inspiring stories of soldiers who, despite physical handicaps, had gone back to their original occupations and resumed their places in families and communities. The overall emphasis of the magazine was in convincing care givers and philanthropies – and through them, the general public – of the necessity of vocational support and retraining, not charity.
Disability Discharges among Enlisted Men
Americans during and since the second World War have remembered the conflict as the Good War, fought to oppose fascism and racism. The popular image of the WWII veteran, therefore, was a man who quickly and easily readjusted to civilian life, and suffered no long-term psychiatric effects (unlike the veterans of World War I who came before or those of the Vietnam War, afterward). This chart, however, challenged those assumptions. One of the headlines from these findings was that nearly 45 percent of all soldiers discharged were neuropsychiatric causes, with psychoneurosis topping the list. This umbrella term was used to describe conditions that would fall under modern diagnoses such as compulsive disorders, anxiety, and phobias. In contrast, physical traumas – including amputations and bone fractures – accounted for less than one percent of those discharged disabled.
The Invisible Injuries of War
In February 2008, seven years after the U.S. Invasion of Afghanistan and five years after the start of the War in Iraq, the US Navy established the Center for Combat and Operational Stress Control (COSC). This center for research and treatment on psychological stress and traumatic brain injury – two of the leading causes of chronic disability in 21st-century veterans – is part of the Navy’s Medical Corps. Shortly thereafter, COSC launched Mindlines, a quarterly magazine for distribution to medical personnel, sailors, Marines, and their families with information of interest regarding mental health. The Navy Bureau of Medicine and Surgery Office of History has digitized several issues of the quarterly magazine, as well as Combat & Operational Stress Research Monthly.