Shell shock, Gordon Holmes and the Great War

Abstract

Gordon Holmes (1876-1965), an athletic choleric Irishman, was appointed consultant neurologist to the British Army in France in early 1915 and served until soon after the Armistice. After the war he established himself as a leading British neurologist and a master of systemic clinical neurological examination.1 Holmes wrote nothing of his views or experience with shell-shock patients in this war; his submission to the Committee of Enquiry into shell shock in 1922 was negligible.2 Yet McDonald Critchley's last conversation with Holmes indicated that, even at the age of 89, memories of these experiences were still upon him.3 It was on the battlefield that he began his work on the representation of vision in the cerebral cortex, perhaps his greatest achievement.4 His medical role in the army was an important one, for it was neurologists who attended the nervous patient—not psychiatrists, who worked in the asylums with the psychotic and organically impaired. We know from the bitter memoirs of Dr Charles Myers,5 whom Holmes appointed as 'specialist in nerve shock' and subsequently clinical psychologist to the British Army, that Holmes was highly influential in the management of shell-shock cases. This article proposes that Holmes participated in, and may have masterminded, a radical change of clinical practice.