Winter: Shell Shock Flashcards
What were the two main categories of war casualties with symptoms of injury without visible wounds?
Neurological and psychological
Were physicians and serving officers skeptical of psychogenic disability?
Yes, many believed that the entire category was a cover for fraud by malingerers or cowards pretending to be disabled..
Who was less skeptical of psychogenic disability?
“Psychologists were more likely to accept that perfectly healthy men, without a trace of mental illness in their family histories, could be severely damaged without a scratch being visible on them. The psychological effects of heavy bombardment or the enormous stress of combat could produce disabilities even without physical injury to the soldier in question.”
When was the need for military physicians to prepare for handling the psychological casualties of war first discussed?
In the Russo-Japanese War of 1904–5.
What were some common disorders attributable to psychological casualties (note the wide variety)?
(1) Stupor (disorientation, delusions, amnesia, or unresponsiveness) (2) Paralysis (3) Tremors (4) Nervous collapse (5) Psoriasis (silvery-white, scaly patches called plaques, often appearing on the outer surfaces of the body, like the knees, elbows, scalp, buttocks, and nails.) (6) Delusional states
Did many physicians believe their military service was the original cause of these disorders?
No. It was common for physicians to believe that, even if military service precipitated the disorder, it was really a worsening of a prior disorder, or the transformation of a latent to an active disability. The war thus was not the source of the problem; either pre-war behavior or heredity was to blame.
Where did the term ‘shell shock’ originate?
In English. C. S. Myers, in an article in the premier British medical journal, The Lancet (early in the war: 13 February 1915). was the first to draw attention to a new category of battlefield injury. Myers later claimed that the term ‘shell shock’ arose from the ranks and he merely had adopted it.
What did Myers attribute to the great increase in cases of shell shock in WWI compared to previous wars?
The artillery war.
Which army established an independent department of
neuro-psychiatry;
Only the American army.
Did any army prepare for the carnage of WWI?
No.
Were there universal, effective treatments for shell shock?
No. “The choice of treatment depended on the symptoms of the patient and the predisposition of the physicians treating him. Many men found their symptoms diminished or vanished without medical intervention.” Note that there were “problems of relapse. Men supposedly cured broke down again,”
What was a common treatment for shell shock?
‘Electrotherapy’, or electroshock therapy.
What was an emerging alternative treatment for shell shock? Why was it unsuitable for wartime?
Psychoanalysis, advocated by Freud. But it was too protracted a treatment and too expensive to use in a war crisis.
Did shell shock enter the popular consciousness?
Yes, in German and French cinema, and in fiction. Even art (Dada and Surrealism.) illustrates the “blurring of the boundaries between the rational and the irrational”.
Can we guess at the proportion of casualties were shell shock?
Barely. “A band of probability described at its lower end at 4 percent of all casualties and at its upper end at 40 percent of all casualties in the two world wars may be the best we can do.”
