The document traces how the terminology used to describe mental health issues in soldiers has evolved over time from the American Civil War to today. It begins with terms like "shell shock" and "battle fatigue" that were used for Civil War and World War I/II soldiers and discusses the transition to the current term "post-traumatic stress disorder" (PTSD). The document also provides perspectives from Vietnam veterans who argue PTSD does not fully capture their experiences and preferences for older terms like "soldier's heart" that recognize the trauma stems from following orders in war.

1. The Literature of Shell-Shock to Post Traumatic Stress
Disorder.
SUBTITLE
JAMES SULLIVAN 4/24/20

2. This brief presentation will highlight how the terms of Shell-shock
changed to reflect the methodology of treatments that men and
women suffered from mental, physical and some, the loss of their
souls, during intense combat from the Civil War to Vietnam.
• Examples of men in combat of the Civil War and their post war adjustment.
• Terms to describe Shell-Shock from the Civil War and beyond.
• Stories of Civil War Soldiers under fire.
• Highlighting examples of Vietnam vets and their treatment at home from the war.
• Poetry from some of the Vietnam Veterans to help ease their transition back to the
“world.”
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3. The American Civil War from 1861-1865 killed over 650,000 Americans, thousands wounded,
some physical, all mentally changed. Some re-adjusted back to life, others fell apart. Others, just
committed suicide. This is just some of the stories.
• Total Union enlistments during 1861-1865 was 2, 213, 363 men The Union Dead from 1861-1865 were 140,414 men.
• Total Confederate conscription during 1861-1865 were 1,050,000. The Confederate dead from the same period was 74, 524 men.
• During the Civil War, combat induced injuries did not contain themselves to amputations, but to constant shelling,
long marches with heavy equipment as well as brief but intense encounters with frontal assaults upon prepared
defenses. Medical capabilities at the time were very limited, so such terms as “homesickness,” “Railroad Spine,”
“cowardice,” “deserter,” “battle Fatigue, and then, the agreed upon term in the Civil War, became simply, “Shell-
shock.”
• These are not just names or titles, these are real mental and physical disabilities that these men suffered daily, weekly,
yearly.
• Professor John Keegan, military historian, wrote in his landmark study, The Face of Battle, he challenged historians to
examine “what battles were like from those who fought them. Keegan wanted to know what they saw, felt, experienced,
how he fought, what did he fight with, and what did the soldier see in his sphere of battle, what were the physical
circumstances from which he fought.
• Source: http://Infoplease.com/us/American-wars/Americas-wars-us-casualties-and-veterans
• Keegan, John. The Face of Battle. London, 1976.
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4. Caption
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The Battle of Gettysburg on July 1-3, 1863 has been considered by many historians as
a major “turning point,” in the Civil War. “The Field of battle is a sight never to be
forgotten,” wrote Sergeant George Bowen of the 12th New Jersey regiment. Sgt. Bowen
had seen the revolting aftermath of carnage enough, the dead mules and horses, the
men, or what was left of them, scattered about the ground. He had seen enough, but
could not ever get accustomed to the huge amount of slaughter scattered across miles
and miles of the battlefield.
“The sight and sound were terrible, no one can give an idea of what is was like, the
pain and misery of those poor fellows whom we shot down only a few hours ago-it is a
heartbreaking sight” Lt. Colonel of the 2nd South Carolina regiment, wrote to his wife
after Gettysburg, “it was the most shocking battle that I have ever witnessed.” His
mental scars of the battle never left him and never truly healed.”
Gramm, Kent. Battle: The Nature and Consequences of Civil War Combat. Tuscaloosa, 2008.

5. SULLIVAN 5
The 2,000 Yard Stare by
Tom Lea: His World
War II illustrations

6. Siegfried Sassoon 1886-1967
The Hero
Jack fell as he'd have wished,' the mother said,
And folded up the letter that she'd read.
'The Colonel writes so nicely.' Something broke
In the tired voice that quavered to a choke.
She half looked up. 'We mothers are so proud
Of our dead soldiers.' Then her face was bowed.
Quietly the Brother Officer went out.
He'd told the poor old dear some gallant lies
That she would nourish all her days, no doubt
For while he coughed and mumbled, her weak eyes
Had shone with gentle triumph, brimmed with joy,
Because he'd been so brave, her glorious boy.
He thought how 'Jack', cold-footed, useless swine,
Had panicked down the trench that night the mine
Went up at Wicked Corner; how he'd tried
To get sent home, and how, at last, he died,
Blown to small bits. And no one seemed to care
Except that lonely woman with white hair.
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Decorated for bravery,
became of WWI’s leading
critic and poet against the
war. “Lions Led by
Donkeys,” was one of his
thoughts. Became a focal
point of dissent against the
war. Submitted a Soldier’s
Declaration of 1917 against
the futility of war.

7. SULLIVAN 7
Shell Shock to Post Traumatic Stress Disorder

8. Vietnam and Post Traumatic Stress Disorder
Shell-Shock was endeared to many such names. The affliction has had many names over the
centuries demonstrating that it is not a condition accompanying not just modern wars nut all wars.
It’s a cluster, a Venn diagram per se, of a variety of effects that combat trauma has on the body,
mind and the soul. In 1678, Swiss soldiers were diagnosed as “nostalgia.” German doctors called it
“Heimweh, and the French called it Maladie du pays; both mean homesickness. The Spanish called
it estarr roto,“to be broken. Civil War American’s called it soldiers heart, irritable heart or
nostalgia. In WWI it was called Shell-Shock; in WWII and Korea, combat fatigue.
Vietnam Vet Bob Cagle has traveled back to Vietnam twice, objects to the expression of “post
traumatic stress disorder”:
When I first heard the term PTSD, it sounded like one designed to describe what
my wife experiences when she sees a spider and then calls me at the top of her
lungs, to come and kill it. This is not a reasonable diagnosis for something so en-
compassing that it can and will engulf a person’s life, ruin any chance for intimacy,
keep horrid scenes in ones’ mind for thirty-six years or for life. To be angry at the
world, jump at the slightest sound or movement, and live within one’s own mind
because you know that no one would understand or try to help us with this hell.
Another Veteran says PTSD is “a name drained of both poetry and blame. He prefer “soldiers heart”
because it is a disorder of warriors, not men and women who were weak or cowardly but….who
followed orders and who at a young age put their feelings aide and performed unimaginable
tasks….PTSD is a disorder of a good warrior.
Tick, Edward, PH.D War and the Soul: Healing Our Nation’s Veterans from Post Traumatic Stress Disorders
Quest, 2005.
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Stills from the movie Platoon

9. SULLIVAN 9
The Longest War by Jan Berry
The Longest war is over
Or so they say
Again
But I can still hear the gunfire
Every night
From
My bed.
The Longest nightmare
Never seems to
Ever
Quite come
To
An end.
The terms of Shell-Shock has evolved through
many terms to the current PTSD. This poetry is an
attempt to grapple with a nightmare, a national
madness. It is poetry written out of fire and under
fire. The war goes on, we are, a part of the evil. And
the fire still burns.
Winning Hearts and Minds. Rottman, Larry & Jan
Barry, Basil T. Paquet, ed. Brooklyn, 1972.

10. Final Thoughts
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“You don’t have to talk military language to really understand the
emotions of it. You should never say, I understand,’ because you can
never understand unless you have been there. However, you can just
explain to me a little more why you feel that way or what draws you
to the conclusion to feel guilty. It’s a moral injury, not a
psychological problem, it’s a problem of conscience, of spirituality,
of the Soul.
“I don’t want your sympathy,” she said. “but your understanding
would be nice, and maybe some empathy?”
Sarah was a photographer that was wounded in an ambush, many
things still trigger her PTSD, groups of kids, back-firing cars, she is
still not ready to speak about her time overseas. She may never.
Wood, David. “What Have I done: The Moral Injury of Our Longest Wars.”