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Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War, by Eric T. Dean, Jr., Harvard University Press, Cambridge, Massachusetts, (617) 495-2600, 329 pages, $35.

In his remarkable book Shook Over Hell, historian and attorney Eric Dean takes on several amorphous topics–the psychiatric casualties of the Vietnam and Civil Wars, the validity of psychiatric diagnoses, the ambivalence combat veterans felt toward civilians, and the postwar manipulations veterans and politicians used against one another–and he turns them into a concrete study of a rarely discussed aspect of the Civil War: stress and the soldier.

Dean’s book is based upon a careful study of the medical records of 291 Civil War veterans committed to the Indiana Hospital for the Insane in Indianapolis between 1861 and 1920. Dean also reviewed each man’s military record and pension application, as well as records of the county proceedings that justified their commitment to the asylum. The records showed that in 40 percent of those cases, a clear connection existed between a soldier’s military experience and his eventual mental instability, but in the remaining 60 percent, “the records are too fragmentary to reach an informed judgment as to causation of the man’s psychological problems.”

The symptoms these veterans suffered seem much like those associated with today’s “post-traumatic stress disorder”–extreme fearfulness, trembling, hyper-vigilance, insomnia, episodes of violence, loss of morale, and a wish for isolation. Because psychiatric beliefs as we know them today did not exist in the 1860s, men who broke down or ran away in combat were called “skulkers,” “shirkers,” or “deserters” and were more likely to receive a court-martial than sympathy.

Dean’s conclusions are as rife with paradox as is the Civil War itself. The Civil War soldier yearned for mail from home, Dean points out, but was frustrated that his civilian correspondents failed to comprehend army life. The soldier wanted to return home, but after getting there, he felt uneasy, and his thoughts wandered back to his comrades at camp or in the grave. He hated the war, yet felt it was the most meaningful and exalted experience of his life. The war was fought for justice and civil liberties, but by 1900 Jim Crow laws had made life for blacks indistinguishable from slavery. In the Civil War and other pre-Vietnam wars, doctors ignored psychological difficulties, while in recent wars doctors have used psychiatric diagnoses to advance the prestige and influence of the medical profession.

These numerous contradictory observations, all of which seem true, are major factors in Dean’s struggle to reach a conclusion. Another problem he found is the lack of useful military and medical records. Such records had been kept for short-term, utilitarian purposes by people long ago, and they do not submit easily to analysis or summarization 130 years later. I once read several volumes of the records of the New Mexico Territorial Insane Asylum from the late 1800s. In them, each patient received one line in a ledger that spelled out his name, age, date of admission, date of discharge or death, and cause of illness. A typical cause was “broken romance.” These are slim pickings for a researcher. Dean has performed a valuable service in locating and using the commitment proceedings records, in which the distraught wives, terrified children, and concerned neighbors of the veterans added narrative and details to otherwise sketchy stories.

The recent best-selling novel Last Living Confederate Widow Tells All showed, in a compassionate and insightful way, how the psychic wounds of the Civil War reverberated down the corridors of time even to our present day. Dean has added hundreds of true stories to this saga, reminders that war–any war–is about blood and fright, and that many men never recover.

Readers of Civil War Times undoubtedly will be more interested in Dean’s findings on the Civil War, but his take on Vietnam is no less valid. Dean writes that the severity of combat there was no worse than it was in other wars; the postwar veteran’s benefits–medical, psychiatric, educational, and financial–exceeded those of any previous war; and the persistent image of the Vietnam veteran as victim is a creation of the media, politicians, and antiwar activist psychiatrists.

Dean’s research calls to mind the search for authenticity within the community of reenactors, for which the Civil War is best known. Even with absolute accuracy in weapon, uniform and drill, one essential element is absent–terror. The veterans at the Indiana asylum had “seen the elephant.” Dean found that the soldiers worn down with fatigue, diarrhea, malnutrition, and painful, unhealed wounds were most likely to break mentally under the stresses of war. No surprise there.

It might be a surprise, however, that the Civil War, the subject of tens of thousands of books, can still yield new understanding, but only through the painstaking and diligent work in primary sources, such as that which went into Shook Over Hell.

Thomas P. Lowry
University of California