Abstract
This project illustrates as-yet-uncharted psychiatric patients from the Royal Edinburgh Asylum (REA) around the time of World War I, predominantly ‘shell-shocked’ soldiers. Primary patient notes help to elucidate definitions, symptoms and perceptions of ‘shell-shock’, in addition to its links with other psychiatric conditions. This includes general paralysis of the insane (GPI), alcohol excess, mania and melancholia. Whereas the majority of these patients were suffering from shell-shock, it is not once explicitly listed as a diagnosis; it was a term whose use was discouraged by the War Office and key medical experts from 1916 onwards. As such, this paper demonstrates effects that canonical views held by the War Office and military psychiatrists on shell-shock aetiology had on language used in psychiatric patient notes. The results corroborate wartime views that mental distress due to a physical head injury was preferable to shell-shock without obvious cause; that neurasthenia was a more desirable diagnostic label than hysteria; and that mental illness was predominantly due to an inherited flaw in someone's character. Language used by psychiatrists to describe their patients was influenced by contemporary perspectives on gender, class and mental illness. More broadly, this paper adds to discussions about definitions and symptomatology of shell-shock that are being uncovered in historical patient notes from this period.
Highlights
In the early days of World War I, psychiatrists were optimistic that the war would act as a cure for insanity: patriotism and unity under a common purpose would provide an outward perspective to cure citizens of their self-absorbed melancholia.[1]
This paper demonstrates effects that canonical views held by the War Office and military psychiatrists on shell-shock aetiology had on language used in psychiatric patient notes
Shell-shock is often seen as the direct product of World War I, but in reality medical and lay perceptions towards shell-shocked soldiers were shaped by contemporary attitudes towards class, gender and insanity.[3]
Summary
In the early days of World War I, psychiatrists were optimistic that the war would act as a cure for insanity: patriotism and unity under a common purpose would provide an outward perspective to cure citizens of their self-absorbed melancholia.[1]. By 1917, local newspapers reported ‘much mental derangement among young soldiers’, and by 1918, ‘numbers treated at Craig House were greater than they had ever been’.2. These reports demonstrate what asylums across Britain were coming to realize: there was an epidemic of psychiatric disturbance affecting soldiers, on a scale no one was prepared for. Changing diagnostic terms for shell-shock by military psychiatrists as World War I progressed—from hysteria and neurasthenia, to shell-shock Sick (S) and Wound (W), Not Yet Diagnosed? Shell-shock is often seen as the direct product of World War I, but in reality medical and lay perceptions towards shell-shocked soldiers were shaped by contemporary attitudes towards class, gender and insanity.[3]. Shell-shocked soldiers changed all of these preconceived notions, and their narratives continue to help frame discourse around mental illness and relationships between physicians, patients and communities today
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