Some physicians believed a soldier’s class and education affected their pre-disposition to shell shock. In 1918 the neurologist, William Aldren Turner delivered the RCP’s Bradshaw Lecture, on the ‘Neuroses and Psychoses of War’. Turner said:
‘.. under compulsory training, many men have entered the army who are constitutionally and by upbringing and education unable to adjust their outlook to service conditions.’
The renowned neurologist, Sir Frederick Walter Mott considered other psychosocial factors, such as the soldiers’ state of mind before battle, their different temperaments and emotional history. He also suggested that there were soldiers who were ‘shell shy’, rather than shell shocked. Mott believed that some soldiers were not experiencing a new nervous disease but a manifestation of hysteria. The debate among physicians about shell shock would continue for years to come.
After the war there was limited funding for veterans with mental health problems caused by war. In 1920, the government provided a military pension for veterans suffering from war neurosis, however this was repealed in 1926 on the basis that men who were still disturbed so long after the war were clearly not suffering from a war related wound. Naming shell shock and trying to understand its physical and mental causes and effects was pivotal in the development and standing of the discipline of psychiatry. However, despite this significant medical development, veterans experiencing the ongoing mental effects of war still received little legal or financial protection under either the shell shock or traumatic neurasthenia diagnosis. Adequate mental health care provision for veterans was still a long way off.
Elizabeth Douglas, collections officer
Sources used in writing this post:
- The Royal College of Physicians, The Nomenclature of Diseases Drawn up by a Joint Committee Appointed by The Royal College of Physicians of London, 1917
- Sir Walter Morley Fletcher letter to Dr Guthrie, 13 January 1917, MS 2141/5/34
- Sir Walter Morley Fletcher letter to Dr Guthrie, 22 January 1917, MS 2141/5/39
- Turner, William Aldren, The Bradshaw Lecture on the Neurosis and Psychoses of War, The Royal College of Physicians, November 7, 1918
- Mott, F.W., War Neuroses and shell-shock, London, 1919
- Howard, R.D. & Howard, R.S., Shell shock or neurasthenia? The Queen Square experience in the First World War, National Hospital for Neurology and Neurosurgery, London, 2018 https://jnnp.bmj.com/content/90/3/e24.3
- Shepherd, B., A War of Nerves: Soldiers and Psychiatrists in the twentieth century, Harvard University Press, 2001
- Downing, T., Breakdown: The Crisis of shell shock on the Somme, 1916, London, 2016