okay, we're going to go ahead and get started with our final session. jonathan jones is currently assistant professor in the department of history at the virginia military institute, where he teaches courses on the civil era and american medical history. and i will say this is not part of his official bio, but in the fall he'll be moving into a position at james madison university. so be closer and we'll have opportunities to collaborate more on things. his first book, manuscript opium slavery, the civil war veterans and america's first opioid crisis, is forthcoming with

university of north carolina press. the book is based on jones's dissertation, which received the society of civil war historians 2021 and jay bailey dissertation prize as well as sue ann wise system wide inaugural chancellor, distinguished phd graduate dissertation award in 21 jones's research has appeared in the journal of the civil war era, washington post and other outlets. he received his ph.d. from binghamton university in 2020 and in 2022 2021, he was the inaugural civil war era postdoctoral scholar at penn state's george and ann richards, civil war era center. so please join me in giving a very warm welcome to jonathan jones. all right. well, thank you all for for being here. thank you, professor najjar, for that introduction. can everybody hear me okay? good. okay, perfect.

raise it up a little. perfect. yeah. there we go. that's much, much better. much deeper sounding. okay. thank you again, everyone, for being here. thank you to everyone who's going to be tuning in on c-span. mom, we're on tv. that's exciting. yeah, we'll tell her. it's on on cnn or pbs. i know, but i have always been interested. the aftermath, the afterlife of the civil war. i've always been curious about questions like how did the war with all of the carnage and the upheaval that we've been hearing about this morning, in this afternoon, how did these events affect americans, society and culture and medicine and most importantly, the individual people that survived this this mayhem after the conflict? but these are the questions that animate my current research project. the war is interesting, right? but what comes after the war is, to me, the real story and opioid

addiction among civil war veterans, which the subject of my talk this afternoon illustrates. these interests. it's also the subject of my forthcoming book called opium slavery, the civil war veterans and america's first opioid crisis, which forthcoming with unci press in the near future. sadly, i don't have any with me today, but please shoot me an email if you're interested. in the wake of the us civil war, there was an epidemic of opioid addiction among veterans and opium. slavery is a social, a cultural and really a medical history of this epidemic. so i'd like to open up this afternoon with a story that illustrates some of the key themes of the book. oh, hang on one second. technical. there we go. okay. so this story is the story of a man named alpheus chappell, and

he is a confederate veteran from amelia county, virginia. and during the war, a captain in the 14th virginia infantry and chapel, never entirely got over the wounds that he sustaid at the battle of gettysburg. as he explained in a tragic. 1886 letter, the captain was shot while storming union lines with general george pickett's ill fated virginia division on the hot afternoon of july 3rd, 1863. all of the officers above chapel's rank had apparently been shot, and so it fell to him to lead his unit through clouds of smoke and bayonets. but a white hot led mini ball or mini ball? if you're from texas like me, stop at chappell in his tracks and prevented him from completing the charge when it smashed into his left kneecap at full force and pancaked on impact with the bone, the ball angrily ripped through the cartilage and the soft tissue of chappell's leg at the joint,

tearing a massive exit hole in the leg. and so chappell dropped to the tall, dry grass in unspeakable pain. and that is where he lay until the dust settled that afternoon when retreating survivors of the 14th virginia chapels outfit dragged their captain back to a confederate field hospital from there, chappell hitched a ride back home, pennsylvania, into maryland and virginia, along with lee's 17 mile long wagon train. with union troops nipping at their heels for much of the way. every rut and rock in the road would have added to his agony and misery. now, as we've heard today, civil war battles like gettysburg, antietam produced thousands and thousands of war stories, just like chapels. and all too often, these cases, they ended in grisly deaths from infection or blood loss exposure. you name it, there's a million ways to die in the civil war. so judging by outward appearances, we might consider

chapel to be one of the lucky ones, because after all, he somehow managed to survive long enough to actually tell his story. in 1886, in the letter that we see here on the screen, but chapel didn't see it that w. he did not consider himself one of the lucky ones because him survival in the long aftermath of the battle of gettysburg was a living hell. and that is because 23 years after gettysburg the unexpected consequences of chapel civil war wound still dominated the old soldier's day to day life as he explained in that tortured 1886 letter quote the put me on morphine and i stop that. in other words, chapel had become and remained hopelessly addicted to the morphine that surgeons had given him in that field hospital to treat the pain from his gettysburg wound. and that it kept on taking as he bounced along the route into

pennsylvania, maryland and on and on. and so although the gunshot wound had long healed, the drugs given to the soldier during the healing process refused to release chapel from their chains, and he suffered it. nor was chapel alone. tens of thousands of civil war veterans became to opium and morphine, both during after the civil war. you may be aware that historians have actually long known about these individuals to a certain extent. we've been aware for quite some time that scattered cases of civil war veterans occasionally became addicted to medicinal opiates, that they were introduc century, individual veterans like chapel have made occasional appearances in various mediums, ranging from early 1900s social science, literature, 1970s television shows about the civil war, which was a story for another day, and even congressional debates about today's ongoing opioid.

as recently as a couple of years ago. yet addicted civil war veterans like alpheus chapple are almost always relegated to the footnotes, literally in the story of the civil war. and for me, this is surprising, considering that the civil war era is among the best documented periods in us history with sustained interest in the conflict for over 150 years. so it goes without saying that today there are many unanswered questions about this. for example, why did addicted veterans become, addicted to opiates and how prevalent was drug abuse among these old soldiers? was it merely a few scattered cases, individual cases like chapple or was he and others like him emblematic of a larger public health crisis afoot? what were the effects of addiction and veterans postwar lives and how did they try to mitigate those consequence? how did for their part, the american medical community, the

doctors, the media, even government officials respond to this epidemic, if there was one. and finally, what does addiction to opioids among civil war veterans reveal about the long term health consequences of the civil war, which unleashed so much suffering on survivors like chapel? and so taking up these questions for my book, i assembled a sample of about 200 individual cases, and the story that i just told is drawn from that sample. roughly two companies of soldiers. i sourced these individual stories from 19th century medical journals, mental asylum records, some from right here in virginia, medical advertisements and the pension applications that we've been discussing off and on today, which are such rich sources of the period. and so what i'm going to do this afternoon is describe some of these sources and my research process as we move through the talk. but ultimately, i'm going to make four key points.

first, i'm going to argue that the civil war did, in fact, cause an epidemic of opioid addiction among civil war veterans, not merely a few one off cases. second, we're going to assess the suffering that opium slavery. the 19th century term for addiction, visited on veterans and, their families. and i'm here to tell you that addiction truly dominated their lives to the point that few addicted ever got over the civil war or the aftermath of civil war battles. third, we're going to explore some we're going to scratch the surface of some of the ways that american physicians and the government reacted to the veterans opioid addiction crisis. and finally we're going to describe how this research i hope will advance our understanding of the civil war to lead us to a more humanized accounting of the of the conflict. but let's start the beginning let's start at causation. what actually caused civil war

veterans like chappell to become addicted to opiates? what sparked this epidemic? the civil war was a massive health crisis, actually the biggest health crisis up that point in american history. and the war truly caused mind bogglingly huge number. people to get sick, to suffer from pain. to put a number it. there were 1.5 million casualties from the war that we know of. out of 31 million americans. and so to put that in our terms, almost everyone knew someone or was someone got sick or shot or some kind of a physical health consequence from the war. in fact, recruits had a one in four chance of not coming back home at all, and many of those who did return came back shattered with long term health complications. and so deal with this unprecedented health crisis. doctors basically had to double down on tried and true medical therapies, which in the 19th century were opiates.

opium is actually humanity's oldest drug. it's a very, very old drug dating back to the stone age. doctors had been prescribing opium and its various derivatives, which include a drug that we all know today called morphine. still in use. and another kind of opioid known as laudanum, which is basically booze mixed with opium. so you can imagine the attraction of this drug. they've been giving these drugs for centuries in the lead up to the war. and in fact, they were among the most effective and only truly effective painkillers known in the late 1860s or in the in the mid 1860s. doctors in the u.s. learned to prescribe these drugs liberally in medical school and in apprenticeships and actually one antebellum medical student. i can never get over this this cover. a student at the university of michigan put it like this, quote, opium is a divine gift from heaven. and to literally illustrate that

point in his medical dissertation kind of like an exam that medical students would take at the end of their degree, he drew an angel bearing opium poppy down from heaven to earth. right. they took this literally. this is an intensely religious society. and so this isn't merely kind of a caricature. this was a literal belief that many doctors and also patients had that god had given them opium to ease their suffering by 1861, the year that the civil war broke out. opium and its derivatives are again laudanum and morphine are actually the most commonly prescribed medications. the united states. and opium present in somewhere about 50% of all prescriptions the mid 1800s in the united states. these drugs were so popular because they were utilitarian. we often think of opioids, things like oxycodone and for example, as painkillers you go and get morphine after surgery. you might be prescribed oxycontin back pain. but in the 19th century, these

drugs were for way more than just pain. in fact, by my count, and i had to actually count in the mid 1800s, opiates were used, treat around 150 different ailments, ranging from to cholera, pneumonia, insomnia and my favorite toothaches, especially among teething children. it's a good thing this is after lunch, right? um, actually, i kind of think of opium in the 19th century as being a combination of tylenol, pepto-bismol and nyquil combined. that's the function that it served in the 1800s. now, you might be did they know about the downside of these drugs? clearly, they had a lot going for them. but what about the risk of overdose and addiction? in fact, doctors did know going into the civil war that opiates were addictive and could kill you if took too much so emphatically. yes, they were aware of these downsides. in fact, this knowledge actually goes back to the era, the

american revolution, the founding of american medicine. i identified the research project several previously unknown and undescribed lived cases of individuals, one in the washington family addicted to laudanum and morphine, contained in the writings of benjamin rush, known as the so-called father of medicine. and so this is something that occurs before the civil war it's widely known about. it's also deadly addiction and overdoses often appeared in. coroners records in the antebellum era. so, for example, between about 1825 and 1845, opium was indicated as a cause of death in about 4% of the unexplained investigated deaths in new york city. the catch is that most people who suffered from these consequences of addiction and overdose before the civil war were not men. they, in fact, white women. of course, you may know that descriptions of chinese opium

smokers in the middle of the 1800s, as described in particular through the lens of american missionaries writings from china. these are also pervasive in the 1800s. pop culture and medical culture. but both of these groups, women and chinese opium smokers, were so often portrayed as naturally dependent on something their addiction, rather their dependency to opiates, was not seen as hugely problematic. it seemed almost normal like it wasn't a big deal. and so, again, although addiction was known, it wasn't at the forefront of cultural medical concerns. before the civil which would create for the first time in american history, a huge cohort of men who will become addicted. it's also mentioning that doctors, patients, health care, consumers had very little alternatives to opiates because. there were few other drugs. so effective as. and that became a fundamental

principle in civil war, medical care. during the war army surgeons are going to rely very heavily on opiates to treat pain and diarrhea. so think of those and amputations that are stereotypical of civil war medicine. but also think of diarrhea and dysentery, which are in reality the most medical complaints of the civil war. opiates are used to treat all these conditions and so predictably, opiate use goes off the chart. during the civil war, the union military, which kept medical records. so we know these these kinds of nitty gritty details. they used something like 2.3 million fluid ounces of liquid opiate. so morphine and laudanum and 10 million opium pills. in fact, a union government used a requisition, so much opium that they actually had to create for the first time in american history, government funded pharmaceutical labs to mass manufacture quantity of this drug to keep up with the rapid demand.

again, for the first time in u.s. history, for their part, the confederacy which has is enduring the civil war, an increasingly effective medical and blockade of other supplies. they tried to procure opium domestically by opium poppies on slave plantation in places like louisiana and virginia. when that failed, they even about halfway through the civil war to coax white southern women and children who are left on the home front to, cultivate private opium gardens and donate the poppies to local military hospitals. of course, that failed and i'm happy to talk more about that later on. but again, suffice it to say that surgeons both in the north and in the south doled out liberally in ways that were conducive to facilitating addicts addiction. i'll give you an example, and that comes from one union hospital, a hospital called turner's lane in philadelphia. philadelphia turned into essentially a giant hospital complex. but at this hospital, turner's lane, that's where the bad cases went the most severely.

individuals, particularly those who had nerve conditions. their surgeons began experimenting with, hypodermic morphine with a newfangled way to deliver morphine instantly. and so they ended up giving in one year during the civil war, 40,000 morphine injections to wounded and six soldiers that passed this hospital. and in fact, it was so successful that doctors elsewhere started emulating what was done at turner's lane after the war. and so, in a roundabout way, the civil war helps popularize the hypodermic syringe, which is, of course, today a mainstay american medicine. now, these medicines were really, really, really important for civil war armies, soldiers simply could not have functioned or remained in the field, returned to duty without them. and the confederate army medical handbook put it like this. it wrote, quote, opium is the one. and dispensable drug on the battlefield. important to the surgeon as to the ordnance and this image of

civil war hospital worker kind of like an apothecary posing with medicine bottles to me really illustrates the centrality opiates to civil war medicine also happens to be one of my favorite civil war images because of the stare. he's a very intense character. these are actual civil war prescriptions. part of my work involved counting quantifying opid prescribing and parsing out usage patterns in and outside civil war hospitals. so we look at the slide closely. we can see sections where there are red, underline ins. those are prescriptions that are compounded of various different plant based drugs that include opium, opiates underlined in red. these are written in latin. so that can complicate things a little bit. doctors handwriting is also notoriously bad, so imagine reading bad doctor's handwriting in latin and that's a taste of the research.

method. predictably, many soldiers going to become addicted during the war through surgeons prescriptions for pain and sickness. so, for example, alphas chapel, the story that i opened with today one of the most haunting examples that i found of. this phenomenon actually, though, comes from turner's lay in hospital in philadelphia. and that's a union soldier who is wounded early on during the war in 1861, when he was over by a train. there are many ways to become injured during the war. that is his unfortunate fate. and so he spends the entire course of the war, four years in turner's, in hospital, mostly bedridden. and during the process he undergoes six amputations or re amputation to amputate more and more and more of his leg to try to solve the cause of his pain. again, in a span of four years after the final surgery in 1865, the man's surgeon that he was good enough to be discharged except that he had developed

what the surgeon called a craving for opium. other veterans learned to actually use opiates from not the doctors, but from their fellow soldiers, their best mates, their comrades. and so camp life. the intensity of camp life. the boredom of camp life. the unhealthiness of camp life. served as a kind of acculturation to drug use, to opium use for a variety of reasons. i found that war soldiers would oftentimes send letters home to their mom or their father or a sister asking to receive a packet of laudanum or opium pills in the mail. and later on when they went back home, got sick later in life, veterans instinctually reached for the opium bottle, a behavior they had learned during the civil war because they knew that these medications could be very effective. of course, this is all unfolding during the temperance movement. there are major concerns both before the war, during the war and after the war about substance use among americans,

but particularly among kind of the rank and file of civil war armies. and so the temperance crowd is going ballistic as they're observing this behavior. they worry deeply about creating an opioid epidemic in the ranks. and after the war and these fears came true because self-medication during and after the war was actually a major vector for addiction. for example, one confederate soldier, a man named george m, house of the ninth alabama infantry, got the habit of taking a dose of morphine right before going into battle, so he would literally, as he's lined up, preparing, go into combat, down some because he found that it helped him calm his nerves. he felt jittery before combat and it would help him to cope with the carnage that he was about to be asked to endure. and also inflict. so fast forward several decades. in 1881, i discovered his case on the patient register of called the charity hospital in new orleans, where he had actually checked himself in

seeking some kind of help for his morphine addiction. and so, again, suffice it to say that is a major pathway way to addiction, just like surgeons prescriptions prescriptions. although opiates were very free flowing in both civil war hospitals and camps it's worth mentioning that white are far more likely to become addicted than black veterans. black soldiers made up about 10% of the union military. the army, the navy. so you would think that addiction would have occurred relatively frequently among black veterans, perhaps on par with white with white soldiers and white veterans. but i've actually found that this was not the case. and the reason for this is that american doctors before the civil war are mostly white, and they have been trained in medical schools that are teaching a white supremacist curriculum. the ongoing belief implemented during the war is that black soldiers, black bodies, could not actually feel pain on par with wounded white soldiers.

and of course, this belief is a form of medical racism that dates back slavery when it was developed by southern as a way to kind of parry or ward off abolitionist critiques whipping. in fast forward to the civil war because this idea black soldiers were far less likely to receive opiate painkillers from their surgeons. for example, in one case there was a black union soldier whose foot was severed in half by shrapnel. but he was not given morphine specifically, not given because his surgeon claimed that the man was not suffering much pain. of course, for a white soldier, this this sort of injury, the standard of care would have been morphine early and often, as we saw in alpheus chapel's case. but that was not the case typically for a black soldiers. the same is also true of diarrheal ailments. mortality from diarrheal sicknesses among troops in the union army was a relatively low, again, relatively low. we're talking about the civil.

17.3%. in contrast, the death rate for black troops was almost 34%. nearly double the rate of white soldiers. and so historians reading that kind of statistic, there's the staggering disparity was really emblematic of the racism of civil war era medicine. and it teaches us that not only were civil war doctors not giving out opiate painkiller ers, but also they were not prescribing opiate anti-virals to the black troops their care. now, this is so striking for me on emphasizing this point so much, because this is actually parallel with today's opioid crisis that has been ongoing for going on 20 years at this point, as we are talking in 2023, black americans still today are widely under opiate painkillers. and so again, we see some of the past and the present moment. but in any case, after the civil war's end in 1865, many, many veterans did return home with life threatening, life altering medical problems, missing limbs,

year, gunshot wounds, gastrointestinal effects, starving and prisoner of war camps. and gilded age doctors did continue to liberally prescribe opiates to ailing veterans after the civil war. and, of course, there's also facilitated addiction. for example, one doctor, george jones, cincinnati, enthusiastically embraced hypodermic morphine, giving 300 injections of morphine to a single pain patient over course of just 20 months. that's shocking. but keep in mind the context that this predates modern american pharmaceutical and drug laws. and so in the 19th century, there are really no legal for doctors to follow when prescribing opiates. there were no also no laws to prevent consumers from buying a prescription from a doctor and refilling an unlimited amount of times for and years and years. and for the record. you also didn't even need a prescription because drugs were available both over-the-counter

and by the mail from gilded age stores like sears, where you could buy a hypodermic needle kit and a vial of morphine for about a dollar 50. suffice it to say that conditions for public health crisis were ripe and that includes here in virginia, in stanton, virginia, not too far from pharmacist dispensed, about 79,000 doses, individual doses of opium in a year during the late 1870s. and so this raised some in the national media and the new york times dispatched an invtigator who ended up labeling stanton the so-called great opium city of, virginia. and i commute to work through stanton. so every time i do, i think about that according to the times, opium eating, which is another 1800s way of saying opium addiction was, quote, like an epidemic. it is in the atmosphere of the postwar shenandoah valley, which of course, had been devastated by the war. so in virginia and elsewhere, an addiction epidemic was born

among civil war veterans. i was caught guard as i was tracing the trajectory of this epidemic by how long this addiction crisis actually lasted. it was not limited to the immediate aftermath of battle or even to the 1870s. it was, in fact a really long term health consequence. the civil war, for example, one confederate veteran, appears in louisiana at of the early drug rehab clinics that are ultimately opened up by the federal government in the early 1920s. and he told doctors there that he had been addicted to morphine and had been taking daily since the civil war more five decades before. and of course, the majority of the man's life. another veteran who i write about in my book, a guy named perry bowser, became addicted to opium at a vicksburg hospital in 1864, where he had been checked in for a diarrheal disease. fast forward to 1915 and he died

in a soldiers hospital operated by the national home for disabled volunteer soldiers of that, the doctors called chronic morphine as again, that's in 1915, which means that he lived about two thirds of his life addicted to the drug. of course, for us to something in hindsight, an epidemic requires not just a large number of cases, but also people in the past to recognize that, an epidemic is afoot. and so, in fact, during the gilded age addicted veterans widely recognized so much that they were reported on and became somewhat of a stereotype in the media and even in fiction. one boston pharmacist summarized this stereotype in 72 when he reported to the state board of that was investigating the phenomenon on that quote, veteran soldiers a class are addicted to. this morphine addiction, civil war, veterans crisis actually left a long lasting impression

on american culture, drug laws and medicine as well. not just a stamp. the lives of individuals like alpheus chappell. in fact, the first american novel about hypodermic use drug addiction was published 1881, featured as its protagonist, a morphine addicted civil war veteran, not someone else. of course, today this is a huge genre of american literature. books like dopesick regularly make the new york times bestseller list. the first one of these portrayed the civil war during the progressive era in 1914, when congress debated creating for the time ever federal regulations on drugs like opium and other narcotics, civil war veterans came up over, over and over again as a congressman debated these new and far reaching laws on the floor of the house. when they referred to this phenomenon as the so-called soldier's disease, the pervasiveness of the addicted civil war veteran is surprising,

however, to historians of drugs because it runs counter to the narrative of what is called drug history. the story of drug use and abuse and regulation in the united states. typically, when historians of opiate addiction in the 1800s, the people who come to mind, come to mind the are usually chinese immigrant opium smokers or the white women who statistically made up the majority of addicted individuals. as i mentioned a few moments ago. and it's true that were a lot of americans who met those descriptions besides. civil war veterans using opium in, the postwar era as well, for example in the book, i write about a woman from virginia who used morphine to cope with the stress of living in a war zone. her husband leaves the army in 1865, returns home and is horrified to find that she's addicted to laudanum. he proceeds to force her into detox cold turkey. and so this creates real problems in the lives of many women. but because civil war veterans such a prominent, elevated place

in postwar society during the gilded age in politics and the media, also in health care, their addictions mattered more to doctors and government officials, even though they represent the minority of addicted people. and so this is one of the reasons why i describe this opioid crisis among civil war veterans as america's first opioid crisis. it was the first recognized opioid crisis. and again, if we think about an epidemic being to a certain extent in the eye of the beholder, people saw civil war veterans addiction while not seeing other folks addictions. so that's how the addiction epidemic started. the civil war and affected civil war veterans. but what was it like for these veterans actually be addicted to these really powerful, really terrible drugs on a day to day basis? this is a major part of my study investigating the historical experience and the perception of addiction. and so to answer this question, i followed my sample of about 200 individuals through sources

were previously unavailable or underutilized, and overlooked by historians for rare medical records from mental pension records from the u.s. pension bureau and former confederate states like virginia. that the last decade or so have really taken with historians. but there's so many that we're only now beginning to mine the gems that that live in these records and also newly master digitized medical journals and newspapers which represent a boon to digital historians. and what i learn from this process was essentially that addiction cost, like alpheus, chappell, everything, it cost their livelihood, their self-esteem, military entitlements like pensions, it cost them their families who abandoned them in many cases. oftentimes it cost them their freedom and even their lives. and so one major reason for this suffering is the cultural perception of opium slavery, addiction was not the word addiction. that is not commonly used until after the year 1900.

and so searching for to describe what they experiencing and what they were seeing 19th century americans routinely to opium addiction as slavery to opium. but this this phrase and the lived experience of that phrase defied cultural ideals about, manhood and whiteness and morality. and so it ran counter to what civil war veterans were supposed to be. addiction for that reason was widely seen by the civil war generation emasculating. again, there are several reasons for this. first is that before the war, most addicted americans had been women. and so the condition took on characteristics associated with women such as dependency associated in the 19th century. so speaking of dependency and self-control, society in the gilded age dictates. men are supposed to be self-controlled. they are supposed to be able to make decisions and carry out those decisions without any kinds of problems. but being dependent on opium and having to take the multiple

times a day no matter what, whether you want to quit or not, ultimately is the opposite of independence. resolving to quit and failing to make it through the withdrawal was also seen as a failure of self-control. another example this is pain relief ideas about pain, because again, according to civil war era doctors, there's a hierarchy of people that experience pain in different ways. and so according to gilded age, only the hypersensitive is in quotes bodies of white women are thought to actually need long term painkillers. men, white men were supposed to need painkillers at the moment of surgery, but not six months later. and so for an old soldier, a civil war wound from 20 years ago to need morphine every day or worse for someone with a lingering case, chronic diarrhea, that medicine in the 1800s can't cure this.

a cultural anathema. even when these individuals were obviously struggling with very serious medical complications. another example of, the emasculating nature of addiction is, impotence, because a common side effect of, opiate abuse is impotence. impotence clearly threatened veterans masculinity. but it had a bigger meaning that that escalated the urgency of the crisis in the gilded age and made it take on racial undertones in the context of gilded age. fears about immigration, white racial decline in the gilded age. there are these folks out there call themselves the race scientists. that's how historians refer to them. men like the infamous charles beard is famous for discovering a gilded age condition, known as nurse dania. they worried that addiction would prevent american from white american men from having children and that slowly, over time, coupled immigration. this crisis might spiral out of control and lead to a nonwhite nation and so, again, when you

couple the obvious kind of implications of a white confederate veteran, for example, like alpheus being enslaved to anything but let alone opiate addiction, this is a crisis that threatened to go off the rails very quickly. my favorite example, though, is actually the the visual ill effects of opiate addiction and what it did to civil war veterans, physical appearance, years and years of opiate abuse dramatically changed their bodies. veterans endured extreme weight loss and fatigue, and these side effects made them look different than how men were ideally supposed to look. gilded age men were supposed to be these barrel chested, strong teddy roosevelt looking guys that lifted weights, had a large circumference and their torso like the guy that we see here on your left. but addiction in reality meant that civil war veterans defied that ideal. some veterans in my sample lost over £50 during the course of their addiction.

and so they appeared skeletal, like the man that we see here on the left hand side of the. george w gardiner, a u.s. navy veteran from the civil war, addicted hypodermic morphine lost a full third of his body weight and he appeared in september of 1891 at a hospital in weighing just £100 as gardner's skin, like that of many veterans, was covered with needle puncture marks from his head on down to his toes. and his doctors were horrified. this again, because they believed that not only was gardner a sickly looking, but these needle puncture marks indicated a lack of manly self-control. eventually, the effects, the physical effects of addiction got so bad that men ultimately became unable to work fatigue, weight loss, being unable to focus without morphine, and also the financial cost of drugs added up. and when this veterans wives typically stepped to take over

the accentuating the dependency of addiction not only did veterans become dependent on the drug, but also other people to take care of them. for example union veteran john paterson, who was a physician by trade, described how opiate addiction ruined his medical practice after the war and left him bedridden and under the care of his wife. he wrote, quote, i could not sleep until an injection of morphine was administered. my wife would get up at all hours the night and use the syringe on me. my health became so poor that i was confined to my room and at last to my bed. i could not eat until i used morphine, let alone practice medicine this inversion of the social order, this inversion of the body was profound lee looked down upon, and again it contribue use to the lived consequences of addiction in veterans day to day lives after the civil war because was so stigmatized and frowned upon.

veterans often became isolated from their families and from their communities. for example, take the case of john fanny goldrick of fredericksburg, virginia john, as a teenage soldier, was shot during the leg in battle of petersburg in 1864 and eventually the confederate veteran became addicted to to cope with the pain. of course, the couple kept the addiction secret because this is a very stigmatized reality. and fanny, that john's what she called john's weakness and folly, would eventually get out into the papers because as it happens, the greeks were somewhat of a prominent family in fredericksburg. and so john promises over and over again throughout the 1880s and nineties that he will quit. but every time he relapses multiple times, causing a rift develop between the married couple. finally, in 1896, fanny returned to their house one afternoon and found him overdosed. morphine after promising a few days before yet again to quit, she snapped. she fled fredericksburg for

washington, d.c., where she declared publicly that she was going to file for divorce over his inability to quit the morphine. in a rare letter describing opiate addiction. from her perspective, from the perspective of addictive veteran's wife fanny wrote that john quote will beg and implore not to do this. but i must. i for i can bear neither for myself or our children. this life any longer. and so ultimately, the family the goodrich family stepped in to talk. fanny down from the ledge, but that raised the question what to do with with john goldrick, this addicted civil war veterans, families that had the means financially typically opted for what was called home care. again, because they're trying keep this addiction secret. and so for months, the war took john out into the countryside of fredericksburg to his brother's farmhouse, and literally locked him in a room in the dark to force him to detox turkey. and they hired nurses and even

armed guards to keep him there. and keep others from, you know, following the sounds to to hear what was going on in the house. this was obviously an awful ordeal. john barely survived. and, of course, it ripped massive hole in the fabric of the family that never healed. pensions are another great example of the tangible costs of addiction for veterans after the civil war. as we've learned today, the u.s. government and individual confederate states such as virginia created massive pension programs for civil war veterans and their families. and these ultimately will set the stage for 20th century welfare policies. so these are very important programs. the evolution of the federal government. but access to these entitlements was contingent upon an applicant's standing in the community and the person who was processing their applications perception of, the person's moral fiber and manliness. and so opium slaves people addicted to opium were usually denied pensions. if it was discovered during the

application process that they were addicted. take for example samuel martin, a union army veteran who was so unequivocally denied a pension when he applied for one that someone at the pension bureau in washington, d.c. literally pasted the gilded age equivalent of a sticky note onto the cover of pension application, stating quote, this claimant is a more fire eater, and i assume that that was put there in case he appealed later on, which he did. it was denied. the pension bureau often caught wind that an applicant might be addicted during the medical examination process. and so oftentimes they would dispatch these sort of elite examiners, men known as special investigators, to dig into applicants who are suspected of being addicted, their personal life, their businesses and also to physically examine the body, to discover these secrets. and so individual states would oftentimes do this as well. and this is what i suspected would have happened to alpheus.

chappell, who i opened up with this afternoon. again, this is the confederate captain who was shot through the knee at pickett's charge a decades after gettysburg. his debilitating wound and the morphine addiction left him in chronic pain and unable to work. so chappell, who had been a modestly wealthy man before the civil at this phase, 20 years out of the war, he had become desperately poor. his station was so badly reduced that he could not even afford to buy morphine, a basic necessity for the addicted veteran. just like food and water and shelter and so, as chappell explained in that may 1886 letter, quote, i can't stop taking morphine. but he continued on, i can't get often except people give it to me. and so in those situation in that in those circumstances, chappell applied for a confederate pension from the commonwealth of virginia in the 1880s, hoping that a one time payout from the state might make his life more bearable and might help him to support his wife and

children. but over and again, his application was inexpensive denied for reasons that were not stated, and that chappell not seem to wrap his head around. so he wrote that letter that i drew upon and have drawn upon throughout the talk today, hoping that the recipient, who was a former confederate general named william artery and kind of a at this point in richmond hoping that general terry could intercede and help chappell to procure a pension. i see, general, why the auditor don't pay me? chappell pleaded in the letter. but if you can do me any good, general, you will confer on me a great and lasting blessing, for i can never want it worse at this time. and for me, that quote speaks volumes of the experience and the suffering that addicted veterans felt in their postwar lives. for the record, denial of benefits even extended to the families of addicted veterans. for example, during his presidency, the 1880s, grover cleveland vetoed dozens of individual pensions awarded by

congress to the widows of civil war veterans who had overdosed death in the 1880s. an end these veto, which are full of of grover cleveland kind of personal thoughts about the morality and the manliness of addiction. critic cleveland criticizes veterans for their inability to bear the pain like a man should without overindulging in morphine. so this got personal for the president and for those who could not procure pensions. i see this kind of gatekeeping as a historian of medicine, a strain of drugs, as well as a civil war historian as an early way of the government drug use and abuse, denying a man a pension because he is deemed unworthy is, after all, a way to attach kind of a penalty to drug use, even though the act itself is not yet illegal at this point in u.s. history and won't be until the 19 tens. and so pensions, i argue, are actually a precursor to the united states as set of drug laws. and i'm happy to.

talk more about that in the q&a as. if losing out on pensions being forced into a closet to detox without medical assistance, as if these weren't bad enough, many addicted veterans ended up in prison or worse, a mental asylum where they were effectively for decades. in 1882, virginia named henry jay garret who was an ex-confederate was committed to a facility in stanton, the great opium city called the western state hospital for what doctors described as ill health and opium use. he died at the asylum in 1898. the turn of the century. and that means that he was held in a one room, effectively a jail cell for 17 years because of his addiction. again, all this without the act being a crime, it goes without saying that these asylums are not places you could be chained up, you could be tortured you could be made to work on the prison farm, on a kind of farm that helped feed the the asylum

patients for free. and so basically, these facilities became kind of like super prisons, but like pensions during the gilded age, i argue asylums also functioned as the states of de facto means policing addiction long before the current set of drug laws that govern these kinds of things. today, wherever enacted. now, you might be wondering, what about the what did they do for the crisis because although addiction is widely framed, a personal failure on the part of veterans, veterans themselves are going to vociferously blame the doctors. they try to pivot and, say it's the prescribing physicians fault. the surgeons gave me the morphine and i can't stop that. and so physicians worried very deeply about the effects of this opioid crisis, which threatened to undermine the reputation of their medical profession. doctors had a lot to lose. and so something had to be done, which is how the civil war veterans opioid crisis actually sparked major innovations in american medicine.

the 1880s and 1890 saw what one civil war surgeon called a revolt against opium and against the overprescribing of opioids. prescription rates plummeted. as doctors witnessed the addictive potential of opiates to the point that by 1900, opium was no longer widely the most widely prescribed in the u.s. it had been supplanted by supposedly less addictive alternatives drugs like cocaine and heroin. the the ironies developing addiction treatments. for the record, was also paramount for doctors developing and monetizing these addiction treatments. and so some of the first drug rehab clinics in american history actually emerged out of this postwar addiction crisis. for example, the penal hospital of richmond, virginia, which was chartered by the commonwealth for the reclamaon of opium eaters in 1876 at the behest of doctors who re so alarmed by what they were seeing in their

patients. many of them were former confederate veterans scores and scores of these facilities like. the pino hospital opened up throughout the postwar decades, everywhere from new york city to virginia, on out to texas and even california. there were none before the civil war. and again, are really the first iteration of the modern american drug rehab. so we continue to see the effects of this crisis today. equally important were patent medicine miracle cures or snake oil cures for addiction. these were prolific and big business during the gilded age. and so what i've discovered is that the civil wars addiction is actually an entire sub industry or niche industry of patent medicine sellers dedicated to curing, especially among civil veterans. for the record patent medicines are those snake oil over-the-counter miracle cures? a traveling salesman would often roll into town and sell you. or you could buy them through

the mail. and so after the civil war, a group of civil war veterans spotted a business opportunity here. they realized that veterans were desperate for a cure. there were no regulations on patent medicines. and so if you could convince someone that your medicine was the cure for addiction, there was a bonanza to be had. and so that's exactly what occurs. ultimately, this spiraled into a multimillion dollar business in the gilded age. and so here we see some classified advertisements being marketed to civil war veterans in the periodical, the national tribune, right alongside a pension lawyer who would sell you his services to help you navigate the labyrinthine process. so to wrap it up, my hope for this research, my hope for the book opium slavery, is that by telling this underage sordid civil war story, it will help us, historians and the american public to better understand the tragic but also the surprising ways that wars like the civil war affect people in the postwar

period. first of all, i hope that this project will call attention to the civil wars opioid crisis because it provides much needed historical context, i think for today's ongoing opioid crisis. i also think that this story illuminates the civil war as transformative medical legacy, both for individuals, but also how the war ultimately shaped and reshaped the institution of american medicine like the patent medicine industry and the rehab industry as well. but finally, most importantly, i think this story reminds us to take the aftermath of civil war battles seriously and to not skip over them when we're retelling the story of the civil war. because until very recently, historians assumed most civil war veterans simply moved on and left the war behind. then, opiate addiction, in my view, most of all shows the opposite that many survive years of civil war battles never truly over the war because they lived with its physical, social and cultural every day for the rest of their lives.

and so with that, i'll draw to a conclusion. i'm happy to take questions. thank you. i think we have a question here in the back. so we'll start we'll start in the back. when you were first talking about the introduction of hydrogen thermic needles to supply opium, is there any kind of statistics be it documented or just personal observations on how many patients until they got the dosage right since it was going hyper? that's a great question. one of the frustrating things about american medicine in the civil war and post-civil war

decades is that there very few systematic records. so there are so many mysteries about, this story that we just can't know. as a historian, nothing frustrates more than not knowing. so i've had to make peace with not knowing the overdose rate, for example, we do have this so rather quantitative records that say, you know, this percentage of people using opium died on accident of overdoses. we do have what are called evidence. so of individuals like alpheus, chappell and so effectively what i've had to fall back on are personal accounts by veterans like. chappell but also personal accounts by doctors of what they were seeing in their medical practices, comparing those to similar sources from before the civil war. again, that's frustrating, but we get impressed. sense that opiate use was rampant among civil war veterans. again, an unfortunate and surprising but also under-reported phenomenon after the civil war. that's a great question.

thank you. thank you for taking my question. i'm so you were talking a little bit earlier about how pensions were denied to opioid addicts. if you will. what was the primary means of how the federal government came to know about their addiction? that's a great question. and also frustrating methodological question for historians. this is a phenomenon because of all the reasons that we've been about people desperately tried to keep it a secret to the point that would lock their detoxing relatives in closets months to keep, you know the newspapers from finding out about it. and so that raises the question that that you're articulating how did the pension bureau find out secret that people were trying to keep that's the special investigators that's really where the special investigators came in their ostensible purpose you know the

reason they exist do the job that they do is to clamp down on pension fraud. there's not a whole lot of pension fraud, in my view. realistically, after the civil. but there's the fear that the federal is just wasting money on on fraudulent pension claims. and so these core of again, i kind of think of them like super investigators, they would come out to a veterans house. they would physically cause, you know, they would tell the veteran to physically they would examine the body. so oftentimes would discover needle punctures like the image i showed on the slide that we will return to. this was hard to keep secret. oftentimes, though, they would think more effectively they would interview the acquaintances, the friends, the business of folks. and that would be another common way to uncover this secret that these special investigators were fishing for. of course, remember, keep in mind also that because addiction is so stigmatized, the relatives the, you know, community of

these addicted veterans were not very inclined to be sympathetic. and so when the pension bureau came asking more often than not, they would tell tell the dark secret that the veteran in their families were trying to keep a secret. it's a real. i asked in the first session what, happened to the orphan schools. i happen to know a lot of the history about stanton's insane asylum. can you go back to the original picture of that place? absolutely, yes. and stay there until one finished? yes, absolutely. so here is again, stanton, the great opium city. is this the picture that you're trying to say? this is the original insane asylum, whatever you want to call it. yeah. no, no, that was the picture. okay. we'll go back. will, stay there. that's it. just remember that picture and the main building is right in the center. the one that's a little bit

probably three stories. okay now, what happened to that building it turned into the lunatic asylum or insane scene. my partner ran that place for 40 years and it closed and then the state it into a jail it was run as a jail it was and then of course there's houses all over the place at this point. now go to the last picture of it. okay. this is a total refurb creation of the jail. the rooms are the size of what the jails were. the rooms. and it now a four star hotel with luxury apartments for sale as well. however, when you go there to stay, the bedroom is of the jail cells and the bathroom is, the

other jail cells. so would and i went up to the pool. is that what it's called? over the top it's beautiful inside. if you can just. but i would never stay there because not only were they inside insane people in jail, it just made me feel. but this is a big hotel, not on the grounds or even much more beautiful. so some of our older, older buildings, on the history, on up. and i just wanted to share that with you but i think maybe that a salem asylum was due to opiate and he never mentioned that but that's their connection a lot of these asylums are that the patient populations of asylums in the gilded age you see both in virginia but in other states as well, populations are skyrocketing. during the 1870s, eighties and into the nineties early american

psychiatrists, also, government officials feared that just generally speaking, not just because of opium, but other reasons, as well, that the united states was experiencing an insanity crisis just like it was experiencing an opiate crisis. and so these facilities, it became overcrowded really fast, and the conditions then deteriorate at very, very, very quickly. and so i think that raises questions for us about what do we do with these old in the same way that a lot of historians are asking similar questions about what to do, the remnants of plantations today, should these facilities be luxury hotels? i don't know. but definitely a lot of food there for thought. i will add that these asylums also functioned. you know, i that they function as kinds of prisons they also experimented with ways to treat addiction in these facilities. and so a lot of the cases of veterans that i write about in my book were kind of slowly off of opiates, but never. and so, again, these could be places where you could get

cured, but that didn't necessarily mean that you would be released into society. so a place that you did not want to end up. but thank you. here. and so we have time for one last question. thank you gee, i hate to make this the last one, but i got to bring up a couple. i got to make up. can you hear it now? you're i'm a i'm a retired anesthesiologist who made my living. i'm giving these these drugs i was fashioning by your talk. i think you're right on spot. and i think you should probably hopefully teach the medical students a little bit some of these things that would be something that i hope that that's in your future. i do want to bring up something that you probably know about, but the audience doesn't. you take rats. i got two things to say and i'd like to do it in a short manner. but you take rats and you train them to get opioids on side and then food on the other. you know this, but the audience doesn't and they will preferentially go to the opiates to the point where that they are starving and they will die and

not go to the food and go preferentially to the opiates. so there's some some information there that obviously is related to to the human experience. i want to mention one other thing. i told you. i just love your presentation. thank you. and there's a book out there that, you know about empire of pain about the sackler family. you didn't mention that. you mentioned the other book, which is also good, but the one about empire of pain and today that's oxycontin is used and how they bypassed all the rules and regulations. they gave money to the people who should be checking on this. that's a book that people should be reading. it's fascinating. and i'll be quiet. thank you very much. i appreciate it. and this is yet, again, another way that we can see the civil wars traces in our own times, an unexpected and tragic way. but thank you all. i believe that we are out of time, but i appreciate it. all right. thanks, jonathan. so before we officially adjourn here, one sort of logistical

item. well, to really so authors wear available, you know, stick around for a little bit. if you didn't if you have a book you'd like us to sign, we're certainly more than happy to do that. i certainly hope that you have enjoyed this day as much. i have. i think that, you know, when i conceive of a conference and i'm writing wife incessantly, like i think we should talk about this at our conference. so she's a very patient woman. but my goal was to walk away from here today, understanding the very far reaching consequences of what happened on the battlefield. and i hope that you feel like i do that we've achieved that objective today. i do hope. to see you all at future events, whether it's, you know, cool spring this summer fort collier in september our fault in november or back here in the spring of 2024. so i'd like to thank all of our faculty who joined me today in helping to to bring this this

vision to life. so thank you all. i like to thank my students, kayla, mr. brooks, matt, who was outside and jenny, true, it who have, you know, use their time and their talents, their fear of failing my class to help as conferences systems today so you'll at least pass guys so but good job and then finally i to thank all of you you know since i came to shenandoah as a visiting professor 2014 and then transition time in 2017, this program has steadily grown over the years. and so i'm happy to see people coming back and happy to see some new faces. so again, thank you all very much for coming for your support i wish you all a great rest of your weekend and until we meet again that's it we're adjourned.

i'm sorry.

welcome, everyone and good evening and thank you for. coming out for this, women history women's history month event. but it is a panel