In the summer of 1862, John Hildt lost a limb. Then he lost his mind.

The 25-year-old corporal from Michigan saw combat for the first time at the Seven Days Battle in Virginia, where he was shot in the right arm. Doctors amputated his shattered limb close to the shoulder, causing a severe hemorrhage. Hildt survived his physical wound but was transferred to the Government Hospital for the Insane in Washington D.C., suffering from “acute mania.”

Hildt, a laborer who’d risen quickly in the ranks, had no prior history of mental illness, and his siblings wrote to the asylum expressing surprise that “his mind could not be restored to its original state.” But months and then years passed, without improvement. Hildt remained withdrawn, apathetic, and at times so “excited and disturbed” that he hit other patients at the asylum. He finally died there in 1911—casualty of a war he’d volunteered to fight a half-century before.