Culture and Panic Disorder

By Devon E. Hinton; Byron J. Good | Go to book overview

4
The Irritable Heart Syndrome
in the American Civil War

Robert Kugelmann

THE INVENTION OF THE STETHOSCOPE posed new possibilities for perceptions of the body, particularly of the heart, which became the contested site for two quite different concepts. On the one hand, the heart in the West has been seen as the center of emotion and character and, especially in wartime, as an echo of the thumos pounding away in the chest of the warriors at Troy. Thumos, neither a physical organ nor a mental entity, was the center of irascible passions, such as courage and anger, but like a horse, tamable. On the other hand, the heart has been conceived as a muscle that pumps blood, an engine subject to overwork and overstrain, to tearing, backflow, and rupture (see Romanyshyn 1982:100–141). I rritable heart, a medical condition that emerged as a diagnosis during the Civil War and that with every war thereafter has been revived, with new names, diagnoses, and treatments, has served as a mediating concept between these two contrasting conceptions of the heart.

Physicians during the American Civil War claimed to observe this disorder for the first time, and it is important first to determine the character of that novelty. To do so, I consider the medical and social contexts within which irritable heart received recognition and a name. I am not interested in finding out what irritable heart “really” is according to present cosmopolitan medical criteria. Rather, I locate it within its own world and within the practices and discourse of the mid-nineteenth century during, to boot, a war. Irritable heart belonged to a set of concepts and concerns about excess, fatigue, masculinity, disease, and courage. I analyze events and actions and sensations—the signs and symptoms described and interpreted by soldiers and their physicians of the time. I then consider the enduring relevance of

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