The psychological cost of warfare in the ancient world

Then said Achilles, "Son of Atreus, king of men Agamemnon, see to these matters at some other season, when there is breathing time and when I am calmer. Would you have men eat while the bodies of those whom Hector son of Priam slew are still lying mangled upon the plain? Let the sons of the Achaeans, say I, fight fasting and without food, till we have avenged them; afterwards at the going down of the sun let them eat their fill. As for me, Patroclus is lying dead in my tent, all hacked and hewn, with his feet to the door, and his comrades are mourning round him. Therefore I can think of nothing but slaughter and blood and the rattle in the throat of the dying." - Iliad 19.226

As some of you know, I am the spouse of a veteran who has suffered from PTSD since service in Vietnam back in 1967-68. Although the psychological trauma suffered by those who have experienced a traumatic event now has a very modern-sounding diagnosis, it is not a recent phenomenon but has been a plague upon mankind, probably since men began engaging in warfare to wrest the territory or possessions from a competing group or avenge the losses incurred in such actions.

Some scholars have proposed PTSD is a modern phenomenon brought on by the use of explosive weapons like IEDs, land mines, or booby traps and the concussions that resulted from their use.  

In her paper, Caesar in Vietnam: Did Roman Soldiers Suffer from Post-Traumatic Stress Disorder?, classicist Aislinn Melchior admits that concussion is not the only risk factor for PTSD but says it is so strongly correlated that it suggests the incidence of PTSD may have risen sharply with the arrival of gunpowder, shells, and plastic explosives.

"In Roman warfare, wounds were most often inflicted by edged weapons. Romans did of course experience head trauma, but the incidence of concussive injuries would have been limited both by the types of weapons they faced and by the use of helmets," Melchior observes. Melchior also speculates that death was so common in the ancient world that it desensitized many of its residents to the prospect of unexpected death. 

But in his 1999 paper entitled "The Cultural Politics of Public Spectacle in Rome and the Greek East in 167-166 BCE"  Jonathan C. Edmondson points out that when King Antiochus IV introduced Roman-style gladiatorial combats in Syria in 166 BCE, the Syrians were terrified rather than entertained.

"In time gladiatorial contests came to be accepted and even popular, but only after Antiochus had instituted a local variation whereby fights sometimes ended as soon as a gladiator was wounded."

This hardly sounds like people desensitized to death.

Recently, scholars studying cuneiform medical texts left behind by ancient Mesopotamians point to passages describing mental disorders expressed by soldiers and even a king during the Assyrian Period (1300–609 BCE) when military activity was extremely frequent and brutal. The King of Elam is said to have had his mind changed.  Soldiers were described as suffering from periods where they were forgetful, their words were unintelligible, they would wander about, and suffer regular bouts of depression.

I also think scholars dismiss too readily the psychological aspects of PTSD in the ancient world because of their observations that the ancient world was a far more brutal environment than we have now (outside of inner city ghettos).  They point out how people were surrounded by death because of disease, accidents without proper medical treatment, and entertainments that featured the orchestrated deaths of both people and animals.  I propose that observed deaths occurring in a venue where the observer and the participants are separated both by physical barriers and social hierarchy (most human victims were criminals, prisoners of war, "Others" so to speak, or slaves, those whose social status separated them from the vast number of citizens in the audience) are distinctly different when compared to violent deaths of friends, family members, and comrades, your "band of brothers," fighting right beside you in a person-to-person battle scenario.

Furthermore, ancient executions were designed to further distance the audience from the victim through the use of mythological reenactments or by placement outside the city.

"Crucifixions were usually carried out outside the city limits thus stressing the victims rejection from the civic community. Because of the absence of bloodshed out of an open and lethal wound, which evoked the glorious fate of warriors, this type of death was considered unclean, shameful, unmanly, and unworthy of a freeman. In addition the victim was usually naked. Essential, too, was the fact that the victim lost contact with the ground which was regarded as sacrilegious." - J.J. Aubert, "A Double Standard in Roman Criminal Law?" from "Speculum Juris: Roman Law as a Reflection of Social and Economic Life in Antiquity"

We also cannot forget the medical personnel either.  The medical environment of an ancient treatment facility following a major battle was far worse than in a modern field hospital.  Ancient surgeons attempted to treat often thousands of wounded in a relatively short time compared to only handfuls at a time during the Vietnam conflict.  Ancient physicians were surprisingly quite skilled, especially Roman military surgeons, but they had little but herbal compounds (and honey if the Romans listened to the Egyptian physicians) to ward off infections.  Their patients' mortality rate was much higher than the relatively low mortality rate experienced in Vietnam. 

I sometimes wonder, though, if modern scholars think that ancient people just didn't value their lives as much as we do, since they did not shrink from casualties as high as 50,000 in a single military engagement or investment of an enemy city.  But if you've ever looked at some of the poignant grave goods found in ancient burials or studied the reliefs and inscriptions on ancient funerary monuments, I think you will conclude that we are only separated by time, not by our shared human nature.

This post is a condensed summary of a paper I wrote, "Concussion and PTSD in the Ancient World" back in 2013.  You can read the full article at:

https://ancientimes.blogspot.com/2013/01/concussion-and-ptsd-in-ancient-world.html

Terracotta plate, ca. 510 B.C.E. Greek, Attic, at the Metropolitan Museum of Art.  The weight of the wounded or dead Amazon is beautifully conveyed by the lowered spears and shield carried by her companion.

Terracotta kylix (drinking cup), ca. 500 B.C.E., Attributed to a painter of the Thorvaldsen Group at the Metropolitan Museum of Art. Sober depiction of a warrior. While his attendant looks on, he discards his shield and helmet and leans on his spear with a pensive, downcast face.