Analysis: The Effects of Shell Shock
**Overview of Shell Shock and Its Effects on Soldiers in World War I**
Shell shock, a term coined during World War I, refers to the psychological trauma experienced by soldiers due to the intense stress of combat, particularly in the trenches. As warfare evolved, the understanding of mental health issues resulting from such extreme conditions became increasingly significant. Soldiers exposed to relentless mortar fire faced not only physical injuries but also profound mental strain, leading to symptoms like depression, anxiety, and memory loss. The stigma surrounding shell shock often labeled affected individuals as weak or cowardly, which complicated their recovery and acceptance in society.
Dr. W. R. Houston, a neurologist, documented the physical and psychological implications of shell shock, emphasizing the lack of treatment options available at that time. His observations highlighted the connection between visible and invisible injuries, suggesting that the brain could suffer trauma similar to other bodily organs. Despite his efforts to shed light on these issues, the medical community was still grappling with the complexities of mental health, leading to misconceptions about those affected. This period marked a pivotal moment in understanding combat-related trauma, paving the way for advancements in neuroscience and mental health care for soldiers in the years to come.
Analysis: The Effects of Shell Shock
Date: March 25, 1917
Author: W. R. Houston, M.D.
Genre: article; journal
Summary Overview
This document is a physician’s account of the effects of shell shock on the soldiers who were injured in the trenches in World War I. At a time when the traumatic effects of war on the brain were not well understood, hysteria was assumed to be at the root of many injuries, if no external cause could be found. Dr. Houston goes into significant detail concerning the physical symptoms that occur with shell shock along with some of the ways they could be treated. The various and terrible injuries that soldiers fighting in the trenches faced are explained, and the relative lack of knowledge about how to treat such injuries is indicated. Dr. Houston, a distinguished neurologist, does his best to explain how to deal with these injuries, but he leaves the readers of his article without a clear idea of what treatment would be helpful or effective—such was the state of medical knowledge at the time.
Defining Moment
World War I was a war unlike any that had occurred before. The day-to-day rain of mortar shells on men stuck in trenches and surrounded by mud, death, and offal created conditions that broke the spirits of many a soldier. Men who suffered from injuries, such as shell shock—also known as war neurosis—were often deemed weak or prone to failures of the nervous system and could be considered cowards because they seemed unable to cope with the pressures of battle. The explosions from shells created obvious physical injuries, but they also produced injuries that were not necessarily apparent through a physical examination. The Great War was one of the first times in history that mental trauma struck so many soldiers and to such a marked degree. This document is one that resulted from this new area of study—namely, how soldiers’ mental states played a role in their ability, or inability, to fight. Almost nothing was known about how the mind reacted to the stress of battle. Doctors tried to understand the problem, but not always with great results. Depression, anxiety, memory loss, and many other symptoms are now known to result from exhaustion and combat stress. In 1917, however, these issues were just emerging.
This article was published in the New York Times just weeks before the United States entered World War I. But even though American soldiers had not yet entered the trenches, American doctors, along with much of the country, were hungry for news and information from the front lines. Dr. W. R. Houston was interested in the new medical issues that arose from the fighting and presented his own observations on the subject. The main issue with such a document, especially since the true reasons for shell shock were not yet known, was that it spread the idea that suffering from shell shock—or what is now known as combat stress and post-traumatic stress disorder (PTSD)—was something shameful and only happened to weak men. Documents like this show how much neuroscience has advanced, due in large part to the study of soldiers in the twentieth and twenty-first centuries.
Author Biography
Very little information survives about the author of this document, Dr. W. R. Houston, other than the previously stated point about his being a doctor of neurology and a professor of clinical medicine at the University of Georgia. During World War I, Dr. Houston visited France in order to see first-hand the injured soldiers and the effects of the war traumas on their brains. It was from these experiences that he wrote the article examined below, which attempts to understand the physical reasons for the mental breakdowns experienced by so many soldiers. Dr. Houston wrote an article in The Annals of Internal Medicine in 1938 entitled “The Doctor Himself as a Therapeutic Agent.” That article examines the idea that a doctor needs to be more involved with his patient in order to create the best outcome. It is possible that this interest in healing the patient, beyond simply treating the symptoms, stemmed from his experiences with World War I injuries.
Document Analysis
The aim of this document is to address and explain some of the reports and rumors that were coming across the Atlantic Ocean concerning the war and its effects on soldiers. Dr. Houston, although he went to France in order to gain experience with these new forms of injury, also wants to enlighten the public about the conditions from which the soldiers were suffering. The article was written about two years after the term “shell shock” was first coined, and the condition’s nature was still largely unknown. About all that was known was that it was a stigmatized sort of injury and one that was said mainly to affect the cowardly and the weak.
Dr. Houston, in fact, opens his account with a theory of the type of men that are affected by shell shock. This theory has now been shown to be invalid, as most anyone can become deeply troubled by the horrors of war and develop physiological reactions or symptoms. At the time, however, shell shock was mostly associated with “the nervously frail, the men of unstable equilibrium.” Houston, in his opening paragraphs, does mention that there were many types of neurological conditions that have resulted from the war and its associated injuries. He seems to associate these types of injuries with the “air concussion” produced by exploding shells, as with internal injuries that sometimes left soldiers dead, yet seemingly uninjured to the eye. The link between the ideas that the internal organs can be injured to the point of death and that the brain can be injured to the point of breakdown, seems to be operative in Houston’s account, although perhaps not explicitly so.
As the author continues in the article, he describes the terrible wounds and ailments that left soldiers bed-bound and unable to fight or even care for themselves. His understanding of the physical nature of these injuries—even those that cause hemorrhages in the brain—is confident. What he seems unable to get at are other physical traces of damage to the brain and what such damage can lead to, such as partial paralysis or the inability to speak. Because shell shock was not fully understood, Houston does not fully differentiate between the mental inability to cope with war and the physical damage done to the brain that produced bodily symptoms. The instances in which Houston mentions such problems as loss of memory, “convulsive attacks…similar to…epilepsy,” and uncontrollable tremors show that, as is now known, the brain was likely damaged in such a way as to be mostly invisible to the naked eye. Traumatic brain injury and post-traumatic stress can be extremely harmful conditions, with lasting effects on one’s physical and mental health. It may hinder a soldier’s ability to move on in postwar life.
Bibliography and Additional Reading
Babington, Anthony. Shell Shock: A History of the Changing Attitude to War Neurosis. Wiltshire: Redwood Books, 1990. Print.
Hipp, Daniel. The Poetry of Shell Shock: Wartime Trauma and Healing in Wilfred Owen, Ivor Gurney, and Siegfried Sassoon. Jefferson, NC: McFarland, 2005. Print.
Houston, Dr. W. R. “The Doctor Himself as a Therapeutic Agent.” The Annals of Internal Medicine 11 (1938): 1416–1425.
Jones, Edgar, and Simon Wessely. Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War. East Sussex: Psychology Press, 2005. Print.
“Shell Shock and War Neuroses.” British Medical Journal 2 (1918): 260.