The Great War, Library of Congress

Revisiting the Mental Health Fallout from the Unprecedented Horror of the First World War

All the armies in the Great War had a word for it: the Germans called it “Kriegsneurose”; the French “la confusion mentale de la guerre”; the British “neurasthenia” and, when Dr. Charles Samuel Myers introduced the soldiers’ slang into medical discourse in 1915, “shell shock.” Twenty-five years later, it was “battle fatigue.” By the end of the twentieth century, it became post-traumatic stress disorder (PTSD).

In December 1914, a mere five months into “the war to end war,” Britain’s armed forces lost 10 percent of all frontline officers and 4 percent of enlisted men, the “other ranks,” to “nervous and mental shock.” An editorial that month in the British medical journal The Lancet lamented “the frequency with which hysteria, traumatic and otherwise, is showing itself.”

A year later, the same publication noted that “nearly one-third of all admissions into medical wards [were] for neurasthenia”—21,747 officers and 490,673 enlisted personnel. Dr. Frederick Walker Mott, director of London’s Central Pathological Laboratory, told the Medical Society of London in early 1916, “The employment of high explosives combined with trench warfare has produced a new epoch in military medical science.”

This development need not have surprised Britain’s military physicians. Major E. T. F. Birrell of the Royal Army Medical Corps (RAMC) had observed nervous breakdowns in surprising numbers while supervising a Red Cross medical mission to the Balkan Wars between Turks and Bulgarians in 1912 and 1913. The new heavy weapons that Germany’s Krupp and other European industrialists sold to both sides inflicted carnage that doctors had not witnessed before…

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