This original and pioneering study, which first appeared nearly thirty years ago, is still important, worthwhile, and necessary for anyone concerned with the issues discussed. Yet what disappointed then continues to do so.
The author is somewhat inconsistent in his use and evaluation of indirect and inferential evidence. He notes that official statistics are notoriously inaccurate and misleading when it comes to drug addiction. And remarks that this is nearly as true now as it was a century ago. As a corrective, he judiciously presents journalistic and epistolary examples to underscore his position. This inspired reliance on non-traditional sources adds a lot of depth and strength to the book.
It is likely that a more thorough examination of non-quanitative source material would have enhanced the discussion of opiate addiction among Civil War veterans. The so-called Army Disease was chiefly the result of widespread medical and non-medical use of opiates among those mobilized North and South, the total being close to three million, or nearly ten percent of the US population in 1860. The author neither ignores nor dismisses this, but I think he errs on the side of caution in judging the effects.
Reliance on opiates during the war was widespread and profligate. In addition to prescription by military surgeons and corpsmen, opiates were also distributed by volunteers working for the NGOs of the day in hospitals and in the field. The merchants who accompanied the armies to sell GIs tobacco, newspapers, and stationery were also sources of "patent medicines" with high opiate content.
The everyday hardships endured by enlisted men and officers were by any standard titanic. It would be unwise to underestimate the shattered physical and mental condition of many of these survivors. In the small towns and villages to which the veterans returned, there was available an impressive range of opiate-based medications. For those without the resources to obtain these through a physician, there was easy access through over-the-counter purchase. The temptation to self-medicate must have been considerable. Small town Protestant America was then subjected to the enormous moral and peer influences of the Temperance Movement: Opprobrium might be directed at the barfly, but not at a consumer of Soothing Syrup, especially at a time when opiate addiction was itself somewhat of a mystery. And even more so if that consumer was a venerated, decorated, and sympathetic veteran. Especially in the North, veterans enjoyed status and prestige. Hence their medications of choice likely had a sort of halo-effect, providing a celebrity endorsement for family, friends, and neighbors seeking a non-alcoholic buzz.
Opiate addiction at this time may have been considerably less class-specific than the author maintains. And likely far more widespread. Informed conjecture is perforce necessary when confronted with fragmentary and unreliable official reporting. I hope that in the next edition there is more spadework undertaken to reveal correspondence, diaries, and popular literature concerning this question.
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