'A Prey to His Primitive Instincts'
Shell-shock was an early example of a common modern phenomenon: a medical debate, hedged with scientific qualifications, taken up by public opinion and the media in an oversimplified way. "This class of case," a doctor noticed, "aroused more general interest and attention and sympathy than any other." The early medical model of shell-shock, dominated by the image of the shell itselfa violent, concussive deus ex machina, which arrived from out of the heavens and left the soldier a shattered, gibbering wreck, his nerves destroyed and his special senses, like eyesight and hearing, impairedimbedded itself [. . .] in the public imagination.
Historians have yet to explore in detail the coverage of shell-shock in the popular press, though one doctor said later that "two years of vivid journalese in the home press prepared the minds of the drafts." Certainly, a glance at two mass-circulation papers in September 1915 shows that trench warfare was grafted easily on to the pre-war culture of "nerves." An enormous advertising campaign for the drug Phosferine (denounced by the BMA in 1912), carried photographs and endorsements from serving soldiers who told readers how, "in the nerve-racking atmosphere of the trenches, just as much as in Civil Life after a hard day's work," the tonic generated the "vital energy to overcome the dulling of the senses, the numbing of the faculties, caused by the tremendous cannonade." The drug claimed to provide the "extra nerve force to overcome the bodily discomforts, the brain fatigue experienced under shellfire."
We do, however, know how shell-shock was presented to more literate readers. "The effects of severe shelling," The Times [London] reported early in 1915, "tend to show themselves in a dazed state which may on the one hand be developed into complete unconsciousness, on the other lightened till a condition comparable to neurasthenia is observed."
The soldier, having passed into this state of lessened control, becomes a prey to his primitive instincts. He may be so affected that changes occur in his sense perceptions; he may become blind or deaf or lose the sense of smell or taste. [. . .] At night insomnia troubles him and such sleep as he gets is full of visions; past experiences on the battlefield are recalled vividly; the will that can brace a man against fear is lacking.
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The fact that phrases like "wounds of consciousness" or "the wounded mind" filled the newspapers and that questions were asked in Parliament about the "nerve-shattered soldier" had a direct effect on military policy. Late in 1915, the Army Council in London broke with past practice and for the first time officially recognized the existence of a grey area between cowardice and madness. It tried, however, to impose on shell-shock the traditional military distinction between "battle casualties" and sickness: between woundswhich carried honour and dignityand simply breakdown, which did not. This distinction was to be defined by "enemy action"whether or not the soldier had been under enemy shellfire. The Army in France was instructed 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 entitled to rank as 'wounded' and to wear on his arm a 'wound stripe.' " If, however, the man's breakdown did not follow a shell explosion, it was not thought to be "due to the enemy"; and he was labeled "Shell-shock, S" (for sickness) and was not entitled to a wound stripe or a pension.
[. . .] The Army Council's writ did not always have much impact on medical practice at the front, where doctors continued to label patients "Mental" or "Insane" or even "GOK" (God Only Knows) before sending them to the Base. But it soon became clear that soldiers were quick to respond to the Army Council's invitation and were seizing on the advantages of shell-shock. "We have seen too many dirty sneaks go down the line under the term shell-shock," medical officers complained to [distinguished Cambridge psychologist Dr. Charles] Myers, "to feel any great sympathy with the condition." The word had become a "parrot cry," on the tongue of all officers and men, the "invariable answer" soldiers evacuated to Aid Posts gave to doctors' enquiries. "Shell shock should be abolished," Myers was told. "The men have got to know the term and will tell you quite glibly that they are suffering from shell shock when really a very different description might be applied to their condition."
Myers was in "hearty agreement" with these views, having "also seen too many men at Base Hospitals and Casualty Clearing Stations boasting that they were 'suffering from shellshock, Sir,' when there was nothing appreciably amiss with them save funk." "It had," he wrote later, "proved impossible to legislate for the bad, without doing injustice to the good, soldier." Some men were being given an easy option out of the trenches and were taking it, whereas others, who were genuinely suffering, were being denied proper treatment. He cited the case of an artillery officer who tried to keep going after a bombardment, collapsed, and ended up being labeled "Nervousness" (by which was meant "Shell-shock S") while two of his men, who gave way immediately, were sent down the line marked "Shell-shock W" because their mental condition originated (according to regulations) "immediately on their exposure to the effects of a specific explosion due to enemy action." The two soldiers, "by giving way immediately, became entitled to rank as wounded and wear a wound stripe"; the officer, by bravely refusing to do so, was sent down later stigmatised as "nervous."
Excerpted from A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century by Ben Shephard, published by Harvard University Press. Copyright 2000 by Ben Shephard. Used by permission. All rights reserved.
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