Ashley Bowen-Murphy on Irritable Heart, Soldier's Heart

Author: Brown University

So I ran 18 miles this morning, and I'm wearing heels. So I want lots of applause at the end. Thank you. [APPLAUSE] So I'm in the American Studies department, which is something of a-- it's a very interdisciplinary field. And I use the kinds of insights from history, from literature, and from medical science to think about a particular diagnosis that was in use from roughly the Civil War until World War I. It's called irritable heart. And the way that I find out about this illness, the way I learn about not just the way physicians talked about it, but what patients understood about it is by using pension records.

These records come from the National Archives. And they tell incredible stories about Civil War soldiers, some of whom were at the front for only a few weeks, others who were at the front for the duration of the war and then went West afterwards. These records include everything from individual medical care to pulses to family stories that can tell us something about what it was like to be a veteran of the American Civil War. After the war, we saw lots of men come back to the United States, come back to the North, who had what we might now think of as something of a panic disorder, right? So they had things that were like high heart rate. They had irregular heart rates. They have incredibly intense chest pain that they would complain about. And this was something that was called irritable heart. It was identified by a man named Jacob DaCosta in 1862 at Turner's Lane Hospital outside of Philadelphia.

What he found among Civil War soldiers were an incredible kind of heart disease that he thought was fairly new to the American Civil War. He sent a letter to the Surgeon General in 1862, explaining that an over excitement of nervous energy-- and keep in mind that in the 19th century, nervous energy was not quite the same thing that we think of today when we think of nerves. It really was more nerves-- combined with exposure to battlefield conditions and poor nutrition were the kinds of things that would generate this sort of physical feeling in someone.

At the same time, we know that today, soldiers continue to suffer from heart problems at a higher rate, and earlier than we might expect. So just this past year, the VA hospital system released a report in which they found that even men who've been to combat, even if they don't end up with post traumatic stress disorder or an anxiety disorder that's sort of clinically recognizable, they do you have heart problems at an earlier age than we might imagine, and in higher numbers than we might expect. Jacob DaCosta totally knew this, right? My guy, he knew. So what my research does is try and think through the ways in which medical history can tell us something about what we're still seeing in the present. My research also looks at how individual soldiers made sense of their illnesses. So we'd have soldiers who would say things like, it felt like my heart stopped. But his heart rate was measured at 104 beats a minute in this case. So this isn't just a question of how physicians understood illness, but how individual patients understood that illness as well.

Ashley Bowen-Murphy on Irritable Heart, Soldier's Heart

So that's one half of my work-- patients, physicians, the people who either have the illness or study it. But I'm also interested in all the irritable hearts around these soldiers, the people who ended up caretaking, the people whose lives were impacted because the men in their lives came home from the war different. So the story I like to tell on this front is about a woman named Sophia Fife. In the years after the war, she told the pension office that she noticed the change in her husband immediately.

When he came back from the war, his hands shook so much that he couldn't hold a coffee cup. It would shake whenever she handed it to them. She also told the pension officer that she would shave him before the war, but not because he couldn't do it himself.

So it was common. That was a form of affection. It was a way to demonstrate care for a male family member.

But after the war, she was afraid to let him do it. Keep in mind this is a man diagnosed with a heart condition. But the shaking of his hands was indicative of so much more. And it changed their entire family dynamic. Eventually, the pension office decided that the Fife's weren't eligible for pensions. There were some irregularities in his family history.

There were some concern about him drinking, about loose women. It was the 19th century. So your value as a person that the government was going to pay was determined by those things. But after Jacob died, Sophia did receive a pension. And in the documents, the pension officers talk about how her life changed because of his experience in combat. And that itself was worth pensioning. So what I think that we can get from these records is not just the story of a particular illness, but about the way illness is experienced and made sense of by all of the people around them. Thank you.


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