Abstract
This essay is a literature review of a single book and some articles of studies done by well known scientists to find out more about shell shock and what it could do to the human body. It will focus on such things like causes, symptoms, treatments, and some outcomes.
Introduction
World War I was a worldwide war which lasted for about four years (1914-1918) and had around 15 million deaths. These deaths could have been of normal civilians but most of them are most definitely deaths of men—warriors who risked their lives to go fight for their loving countries. These men’s death could have all been different but one thing is for sure, a huge portion of the men that survived this war had major injuries, were diagnosed with disorders, and even developed impediments. Disorders and impediments were most likely proven by scientists to be more about mental matters than anything else and one disorder was very common in soldiers, a disorder that not only brought impediments and sad events but also darkness and pain to the victim’s life.
Methods
Choosing this topic was very much our Professor’s doing but I appreciate it. Yes, at first I was not very fond of the thought of studying and writing about wars because of the thought of it being boring but as we started getting more into it and I got to find out that we would focus more about the mental matters of the soldiers obtained by this war, it slowly became more interesting. When it comes to the articles chosen for this paper, this paper being a group project let us plan the way we choose our articles differently. We would each just choose one and research it before sharing our notes with the rest and I chose Mott (1917). The reason why I chose this article was the fact that I could see and point out all the causes and treatments easily by just looking at it because I thought it was really helpful and made things easier. I will admit my teammates’ articles were more of a challenge but I am thankful of how much information their articles had.
Results
Transient paraplegia as said by T.R. Elliott, was an injury caused by shell explosions which paralyzed the lower body. In his article, Transient paraplegia from shell explosions, Elliot speaks about a case of a man buried by the explosion of a “Black Maria”, when he was dug out his legs were numb as powerless (p. 1005). Sadly, this patient died after five days and was too ill to give information about the accident when asked the day before (p. 1005). This proves that transient paraplegia is a huge symptom or factor of shell shock.
Just like PTSD these days, war neuroses could be a terrifying disorder built from what a soldier has seen and lived through out on the field. J. M. Clarke informs in his article, Some neuroses of the war, that memory after an injury would be very poor, so poor that their patient could not remember if he had breakfast or not (p. 61). Their memory being poor would affect their concentration and their reactions and even their speech.
Shell Shock was said to be derived from fear and like war neuroses and pretty much every other issue talked about in this paper, from traumatic events, making it once again similar to what PTSD is today. This disorder can not only affect your mental stability but can also affect your body and they way it functions. W. Garton speaks in his article, Shell shock and its treatment by cerebro-spinal galvanism, about a case of a 34 year old male soldier who was exposed to shell fire was suffering from pain in the back and legs, tremors, headache, fatigue without exertion, nervousness, insomnia, and mental depression (p. 585). This case specifically gives an example of the harm shell shock could have mentally and on the human body. Another example would be from F.W. Mott’s article, Mott speaks about a man who was sent home after being diagnosed with shell shock and after six months he was still tremulous and could hardly stand or walk.
War psychoses was most likely more on the mental side of the issue. Considering the causes and symptoms, war psychoses was most likely obtained by the horrible conditions these soldiers were living under. One of R. Eager’s cases in his article, War psychoses occurring in cases with a definite history of shell shock, he spoke about a soldier who had spent months in under trenches and shell experience when the soldier noticed he was unable to sleep at night and after two months, he was reported sick because of the fact that he was unable to complete his duty, refused to eat or drink for several days, and would not answer questions (p.423). Nowadays, these would have most likely been signs of an illness like depression which could be an early and primarily symptom to PTSD but back in 1918, these cases were treated and handled as war psychoses.
Causes
Years and maybe months of research brought so much information and results to researchers which made them able to decipher causes—events or certain things that could have caused these disorders and impediments. For example, the author of Shell Shock in France, Myers, suspected that soldiers that would remote the exploding missile was subjected to an emotional disturbance to mental strain or like Clarke (1916) informed that a traumatic sight or even a horrifying noise could also be a big cause of war neuroses (p. 49).
Mott (1917) found that fear could be a big factor behind mutism and aphonia and that an exploding shell or a fall could be a big factor behind functional paralysis (pp. 39, 40). He also suspected that aerial concussion was caused by high exposure (p. 39). Some of these would probably be quite obvious like Mott (1917) finding that deafness could be caused by an injured ear drum or some wax stuck against the drum, but others are really interesting and even shocking (p. 40).
Eager (1918) had found that patients who have been blown up could experience war psychoses and that is a very understanding cause for this disorder because of the fact of how traumatizing this could be (p. 424). Blowing a human up, from being so close to death to the impact of the bomb hitting, could be very shocking for anyone. Other causes mentioned were amnesia and hyperthyroidism (pp. 422, 424).
Aside from all these big and multiple causes for shell shock, Garton in his article published in 1919, Shell shock and its treatment by cerebro-spinal galvanism, believed that shell shock could be caused by streptococcal meningitis and normal meningitis (p. 584).
Symptoms
Every illness, disorder, injury—anything happening to the human body has to come with symptoms. Whether is a silly symptom or a big painful symptom, the human body will always show symptoms before diagnosis. Just like these researchers worked hard to give us causes and insights on their patients, they worked hard to give us the symptoms and treatments as well. Myers listed a few symptoms of shell shock in his book which were hysteria, neurasthenia, aphonia, paralysis in limbs, mutism, spasmodic movement, blindness, and amnesia. Now like most authors in this paper, Clarke (1916) found similar symptoms behind shell shock. Clarke’s list included hysteria, lesions of the central nervous system, paralysis off a single limb, sensory loss, muscle spasms, deafness, blindness, and speech impediment are some symptoms of neuroses through his patients (p. 51). Clarke also mentioned hysterical paralysis as a symptom of neuroses after one of his patients was unable to urinate, losing control over their rectum muscles (p. 54) and Elliott (1914) mentioned numbness and light movements as symptoms of transient paraplegia (p. 1006).
Different but also not so different symptoms to shell shock came when researching through Garton’s and Mott’s articles. Garton discovered that the loss of flesh, muscular weakness, loss of memory, mental depression, and bad dreams were also symptoms to shell shock (p. 586). Meanwhile, Mott discovered that sensory loss, muscular atrophy, and loss of functions of the central nervous system are also common for shell shock while also giving us some symptoms his patient might have left even after recovering which are less extreme ones like headaches, dizziness, tremors, feeble circulations, and exhaustion (pp. 39, 40). A lot of these symptoms each researcher has given are repetitive and similar in more ways than one which makes sense to how almost every article goes back to speaking about that one disorder, shell shock. Almost all of these disorders/illnesses today would fall under one disorder, PTSD.
Also very similar to PTSD, war psychoses was said to have symptoms like amnesia, hallucinations, confusion, delusion, headaches, insomnia, nightmares, anxiety, disorientations, tremors, and dilation of pupils by Eager (p. 422). These would also come with confusion, memory loss, impairments, facial tremors, and deep reflexes (p. 424).
Treatment
Like said before, every disorder and illness has to come with symptoms but it also has to have some type of treatment. Whether it is physical exercises or pills or mental therapy—treatments form an important part of any doctor or patient’s journey. Myers (1940) let us know some of his treatments on his book about shell shock and his different cases. Plunging a patient’s head several times daily with their eyes opened into cold water, a suitable environment, and hypnosis were three physical treatments mentioned. All of these researchers were more on the physical treatment side than medical which is amazing considering that the human body reacts more positively to physical exercises than to pills. Examples of researchers who were more big on the medicine type of treatment, Clarke, Elliott, and Garton are good examples seeing as Gorton injected a hypodermic syringe full of eucaine and adrenaline, Elliot applied iodine to irritated body parts, and Clarke had a simple and single treatment listed for was neuroses cases which was general anesthesia (p.51).
When comparing researchers’ ways of treatments, it is easy to tell the difference of how they choose to work. Not saying that one researcher must have had it any easier than the other but there are definitely different approaches when it comes to treating these disorders. Mott and Eager were more like Myers, on the physical and comfortability treatment side. Two of Mott’s treatments were to keep the patient warm and comfortable (p. 39), to give the patient a warm bath with warm milk to drink, and feed them digestive foods (p. 41). While Eager created rules for patients to gain control of their mind and body like exercising, psychotherapy, and hypnosis (p. 422).
Prognosis
War psychoses, war neuroses, shell shock, and transient paraplegia were the big topics of these research and the outcomes of these disorders were both refreshing and very sad so coming up with a prognosis will be quite hard considering the fact that I pretty much have read the outcomes and how the treatments worked out. The prognosis from war neuroses, war psychoses, and shell shock would have been hopeful full recovery or death. The prognosis for the transient paraplegia would have been either death, full recovery or the patient would end up in stable mental state but live with difficulties because of their paralysis.
Discussion
This research made it more clear that shell shock could be an old name for post-traumatic disorder but quite frankly, so can the others. These disorders all seem to have faded but when thinking about it, they did not really fade. Their names and treatments just changed and developed over time along with science and the human brain which is something that has happened to many disorders, illnesses, viruses, and even impairments. Shell shock and PTSD are a great example of scientific development from their names to the development of treatments.
