War history: Shell shock - a condition still surrounded in myth and controversy
PUBLISHED: 12:00 07 July 2015
Shell shock. Mike Peters, Galloway’s resident military historian, looks at one the most emotive and misunderstood aspects of the First World War.
Among the phrases guaranteed to trigger discussion about the First World War is the term “shell shock”. Like “shot at dawn” or “lions led by donkeys”, shell shock is sure to stir even the most uninformed, uninterested person to comment.
It has to be said that, like the other phrases I have listed, shell shock and the way in which it was identified and treated is still surrounded by myth and controversy. As with many of these contentious subjects, the facts are well-documented. When viewed from a balanced and informed perspective, we find − given the information available at the time − the authorities did the best they could.
It did not take long for the condition to manifest itself. In 1914 the ferocity of artillery fire had already exceeded that of previous wars. Medical officers began to record an increasing number of soldiers reporting sick with a range of symptoms including tinnitus, amnesia, headaches, dizziness, tremors and hypersensitivity to noise.
While these symptoms resembled those to be expected after a physical wound to the brain, the majority of patients had no physical injuries. By December, 1914, as many as 10% of British officers and 4% of enlisted men were suffering from what was described as nervous and mental shock.
Initially, doctors struggled to define what was causing it. Cases of what would later be termed shell shock could be interpreted as either a physical or psychological injury, or simply as a lack of moral fibre. Later studies would reveal it was in fact a reaction to the intensity of the bombardment and fighting that produced a helplessness appearing variously as panic and being scared, or flight, or an inability to reason, sleep, walk or talk.
In February 1915, Charles Meyers published an article in the medical journal The Lancet. It was Meyers who first used the term shell shock in an official report. He would later state the name was misleading and he regretted using it.
On the battlefield, the power of artillery was increasingly evident and both sides fielded more and more guns, increasing the volume and power of artillery barrages exponentially. This led, of course, to a corresponding rise in cases of shell shock. Yet throughout 1915 and into 1916, the term and the actual condition were still misunderstood.
Theories abounded as medical science struggled to understand a new human condition. Some doctors held the view it was a result of hidden physical damage to the brain, with the shock waves from bursting shells creating a cerebral lesion − causing the symptoms and potentially proving fatal.
Another explanation stated shell shock resulted from poisoning by the carbon monoxide formed by exploding shells.
At the same time, psychiatrists put forward an alternative view, describing shell shock as an emotional, rather than a physical, injury. Evidence for this point of view came from an increasing proportion of men suffering shell shock symptoms who had not been exposed to artillery fire.
In spite of this evidence, the British army continued to try to differentiate those whose symptoms followed exposure to explosives and those who had conventional injuries.
In 1915 the British Expeditionary Force policy on wounded men stated that shell shock and shell concussion cases should have the letter W prefixed to the report of the casualty, if it was due to the enemy. In that case, the patient would be classified as wounded and was entitled to wear a wound stripe on his uniform.
If, however, the soldier’s breakdown could not be attributed directly to a shell explosion, he was to be classified as suffering from shell shock and listed as sick – therefore he was not entitled to a wound stripe or to receive a pension for being wounded.
This policy was quickly ruled as impractical as, in the chaos of battle or when under artillery fire, it was almost impossible to say whether or not an individual soldier had been close to an exploding shell.
As the war went on, the number of shell shock cases continued to rise. More and more soldiers were being taken out of the front line. Something had to change. Next week’s article will look at how medical understanding developed and how shell shock casualties were treated.
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