Transcripts For CSPAN3 The 20240703 : vimarsana.com

CSPAN3 The July 3, 2024

Greatest challenge. Thats why spark will, it seconds work around the clock to keep you connected. We are doing our part so its easier to do yours. Spark lite long with these Television Companies support cspan2 as a public service. We will go head and get started with our final session. Y assistant professor in y departjonathan jones is cur assistant professor in the department of history where he teaches courses on the civil war era and american medical history and i will say this is not part of his official bio but in the fall he will move into the position at James Madison university. He will be closer and will have opportunities to collaborate more on things. His first book manuscript. Americasfirst Opioid Crisis is forthcoming. The book is based on joness dissertation which received the 2021 prize as well as the system wide chancellor phd graduate award in 2021. Joness research has appeared in the journal of the civil war era, Washington Post and other outlets. He received his phd in 2020 and in 2020 to 2021 he was the civil war post doctoral scholar civil war center. Please join me in giving a warm welcome to jonathan jones. All right. Well, thank you all f or all right. Well, thank you all for being here. Thank you for that introduction. Could everybody hear me okay in good. Okay. Perfect. Raise it up a little. Perfect. There we go. Thats much better. Much deeper sounding. Okay. Thank you again everybody for being here. Thank you to everybody who will be tuning in on cspan. Mom, we are on tv. Thats exciting. We will tell her its on cnn or pbs. No but i have always been interested in the aftermath and the after life of the civil war. I have always been curious about questions like how did the war with all of the carnage and upheaval we have been hearing about this morning and this afternoon, how did it affect American Society and culture and medicine and most importantly the individual people that survived this mayhem after the conflict . These are the questions that interest me the most as the civil war teacher and these are the question that animated my Current Research project. The war is interesting, right . What comes after the war is to me the real story. Opioid addiction among Civil War Veterans which is the subject of my talk this afternoon illustrates the interests. It is already the subject of my book called opium slavery, americas first Opioid Crisis which is coming with unc press in the near future. I tonight have any with me today but email if you are interested. In the wake of United States civil war there was an epidemic of opioid addiction among veterans and it is a social, cultural, and really a medical history of this epidemic. I would like to open up this afternoon with a story that illustrates some of the key themes of the book. Technical. There we go. Technical. Okay hang on one second. Technical. There we go. Okay. So, this story is the story of a man named alfeyette. Is he a confederate veteran from virginia and during the war a captain in the 14 virginia infantry. He never entirely got ver the wounds that he sustained at the battle of gettysburg as he explained in a tragic 1886 letter. The captain was shot while storming union lines with the Virginia Division on the hot afternoon of july 3rd, 183. All the officers above chapels 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 lead mini ball stopped chapel in his tracks and prevented him from completing the charge when it hit his left kneecap at full force and pancaked on impact with the bone. The ball ripped through the cartilage and the soft tissue of his leg at the joint tearing a massive exit hole in the leg and so chapel dropped to the tall dry grass in unspeakable pain and thats where he lie until the dust settled that afternoon when retreating survivors of his outfit dragged him back to a confederate Field Hospital. From there he hitched a ride back home through pennsylvania and into maryland and virginia along with 17mile long wagon train with union troops at their heels for much of the way. Eve rut and rock in the road would have added to his pain and misery. Now as we have heard today civil war battles produced thousands of war stories like this and too often these cases ended in grisley death from infection and blood loss, exposure, you name it. Theres a million ways to die in the civil war. Judging by outward appearances we may consider him one of the lucky ones because he somehow managed to survive long enough to actually tell his story in 1886 in the letter that we see here on the screen. Chapel didnt see it that way he did not consider himself one of the lucky ones because to him survival in the long aftermath of the battle was a living hell. That is because 23 years after the battle the un expected consequences of his wound still dominated his day to day life. As he explained in that tortured 1886 letter, the doctors put me on morpine and i cant stop that. In other words chapel had become and remained hopelessly affected to the morpine that doctors gave him in that Field Hospital to treat the pain from his wound and they kept on taking as he bounced along the route into pennsylvania and maryland and on and on. So though the gun shot wound had healed the drugs given to had soldier during the healing process refused to release chapel from their chains. He suffered for it. Nor was he alone. Tens of thousands of Civil War Veterans became addicted to opiu m m orpine during and after the war. You may be aware that historians have known about them. We have been aware that scattered indicates of Civil War Veterans became addicted to opiates they were introduced to during the war. For over a century individual veterans like chapel have made appearances in various mediums ranging from early 1900 social science literature, 1970s Television Shows and even congressional debates about todays ongoing Opioid Crisis. Yetta districted Civil War Veterans like chapel are almost always relevant gated 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 United States history with sustained interest in the conflict for over 150 years. So it goes without saying that today there are many, many Unanswered Questions about this. For example, why did addicted veterans become addicted to opiates and how prevalent was it among the old soldiers . Was it a few scattered cases, individual indications like chapel or was he and others like him part of a larger Public Health crisis what are the effects of addiction in veterans post war lives and how did they try to mitigate the consequences . How did for their part the american medical community, the doctors, the media and government officials respond to this especially dim i can if there was one . Finally what does addiction too opioids among veterans reveal about the very Long Term Health consequences of the civil war which unleashed so much suffering on survivors like chapel. So, taking up these questions, for my book i put together a about 200 individual cases. Roughly two companies of soldiers. I sourced these individual stories from 19th century medical journals, some from here. Medical advertisements and the applications we have been discussing off and on today which are such rich sources of the period. What i will do this afternoon is describe some of these sources and my Research Process as we move through the talk but ultimately what ly make four key points. I will argue that the civil war did cause an epidemic of opioid addiction among Civil War Veterans, not merely a few one off cases. Second, we are going to assess the suffering that opium slavery visited on veterans and their families and im here to tell you that addiction truly dominated their lives to the point that few addicted men ever got over the civil war or the aftermath of civil war battles. Third we will explore some. We will scratch the service of some of the way that american doctors and the government reacted to the veterans opioid addiction crisis and finally we will describe how this research i hope will advance our understanding of the civil war to lead us to a more human accounting of the cost of the conflict. Lets start with the beginning. Lets start at cause. What caused the Civil War Veterans like chapel to becom addicted to opiates . The civil war was a massive Health Crisis. The biggest Health Crisis up to that point in American History, and the war truly caused a huge number of people to get sick, to suffer from pain, to put a number on it. There were 1. 5 million casulties that we know out of 31 million americans. To put that in our terms almost everybody knew someone or was someone who got sick or shot or suffered 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 home came back home shattered Long Term Health complications. To deal with this unprecedented Health Crisis doctors had to double down on tried and true medical therapies which in the 19th century were opi ates. Its a very, very old drug dating back to the stone age. Doctors have been prescribing opiu m and its deriatives like many, orpine and another kind called laudanum which is basically booze and opium. They have been giving these for centuries. They were among the most effective and true little effective painkiller known in the late 1860s or in the mid1860s. Doctors in the United States learned to prescribe the drugs in medical school and actually one medical student i can never get over this. A student at the university of michigan put it like this. Opium is a divine gift from heaven and to illustrate that point in his e and,xam he drew an angel with a poppy. This is a literal belief that many doctors and patients had that god gave them opium to help their suffering. By 1861 the year thats civil war broke out opium is the most commonly prescribed medication in the United States and its present in somewhere about 50 of all prescriptions in the mid1800s in the United States. These drugs were so popular because they were we often think of opiods as painkillers. You go and get morpine after surgery, you may be prescribed oxycontin for back pain but in the 18th century they were used more than pain. I counted and in the mid1800s they were used to treat around 150 different ailments ranging from insomnia and my favorite, tooth aches, especially among teething children. Its a good thing is after lunch, right . Actually i kind of think of opium as being a combination of tylenol and pept o bismol. Did they know about the side effects . In fact doctors did know going into the civil war that opiates were addictive and could kill if you you took two much. So yes they were aware of the downsides. In fact this knowledge actually goes back to the era of the american revolution. The founding of american medicine. I identified in the Research Project several previously unknown and undescribed cases of individual including one in the washington family. Addicted to morpine contained in the writings benjamin rush. This is something that occurs before the civil war is widely known about. It the widely deadly. Addiction and overdoses often appeared in coroners records in the era. Death in it was a cause of death in about 4 of the unexplained deaths in new york city. The catch though is that most people who suffer from the consequences of addition and overdose before the civil war were not men. They were white women. Of course you may know that descriptions of chinese opium smokers in the 1800s as described through the lens of american missionaries writings from china, also in pop culture but because both of these groups were so often portrayed as naturally dependant on something. Their addiction was not seen as hugely a problem. It seemed normal like it wasnt a big deal. So again although addiction was known it wasnt at the forefront of cultural or medical concerns before the civil war which would create for the first time in American History a huge cohort of men who will become addicted. Its also worth mention that doctors, patients, Health Care Consumers had very little alternatives to opiates there. Were few other drugs as effective and that became a fundamental principal. During the war army doctors will rely on opiates to treat pain so think of those gun shots and amputations from civil war medicine and also dysentery which are the most common medical compliants. Opiates are used to treat off of these so it geese off the charts during the civil war. The Union Military which kept careful medical records we know these details. They used Something Like 2. 3 million fluid ounces of liquid opiat es and 10 million opium pills. In fact the Union Government used so much opium they had to create for the first time an enAmerican History government funded labs to mass manufacturer quantities of this drug to keep up with the rapid demand for the first time in United States history again. For their part the confederacy which has an medical blockade, they tried to get opium by growing poppies. When they failed they attempted about to coax white southern women and children to cultivate private opium gardens and donate it. That failed. Again doctors in the north and in the south doled them out in ways that facilitated addiction. One hospital in philadelphia turned in to essentially a giant hospital complex but at this particular hospital thats where the bad cases went. The most severely wounded individuals. Particularly those who had nerve conditions. There union doctors started trying out hyperdermic morpine. So they gave in one year during the civil war 40,000 injections to wounded and sick soldiers that passed through the hospital. In facts it was so successful that doctors elsewhere started to emulate it after the war and so in a round about way the civil war helped make the syringe popular which is a mainstay of american medicine today. The medicines were really, really important for civil war armies. Soldiers couldnt have functioned or remained in the field, return to duty without them. The Confederate Army handbook said its important to the surgeon as gun powder to the ordnancx this image of like posing medicine bottles to me really illustrates opiates to civil war medicine. It is one of my favorite civil war images because of the stare. He is veryintense. These are cil war prescriptions. Part of my work involved counting opiod prescribing data and use patterns in and outside of civil war hospitals. If we look at the slide closely we can see sections where there are red under lines. Those are prescriptions that are compounds of different plant based drugs that include opio um under lined in red. These are written in latin and so that can complicate things. Doctors handwriting is also known for being bad to think about bad doctors hand writing in latin and thats a taste of the research method. Many soldiers are going to become addicted through prescriptions for pain and sickness so for example the story that i opened with today. One of the most haunting examples i found was in philadelphia and thats a Union Soldier who is wounded early on during the war in 1861 when he was run over by a train. There are many ways to become injured during the war. Thats his fortunate fate and he spends the course of the war, four years in turners lane hospital mostly bed rid skin he undergoes six amputations to amputate more and more of his leg to try to solve the cause of his pain in a span of four years. After the final surgery in 1865 the mans doctor reported he was good enough to be discharged except he had developed a craving for opium. Other veterans learned to actually use opiates from not the doctors but their fellow soldiers, their comrades. Camp life the intensity of camp life. The bore dom, the unhealthiness of camp life served was a kind of adjust member to opium use for a number of reasons. Civil war soldiers would send letters home to their mom or father or a sister asking to receive a packet of opium pills in the mail. Later on when they went back home and got sick later in life veterans often reached for the opium bottle. Behavior they had learned in the civil war because they knew that the medications could be effective. Of course this is all happening during the temperance movement. There are Major Concerns about Substance Use among americans but particularly among kind of the rank and file of civil war armies. The crowd is going crazy as they are observing this behavior. They worry deeply about creating an epidemic in the ranks and after the war and these fears came threw. Self medication during and after the war was a major vector for addiction. For example one soldier, a man named george m house of the 9th alabama infantry took a dose of morpine before he went into battle. As he lined up preparing to go into combat he would down morpine because it helped him calm his nerves. It would help him cope with the carna ge he was about to be asked toen tour and inflict. So fast forward several decades in 1881. I discovered his case on the patient register of a facility called the Charity Hospital in new orleans where he had che

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