Shellshock

The sacrifices made by those who have fought for our freedom affects us more than we may think. Without their bravery we would not be able to travel freely, have freedom of speech or religion or access to a balanced education and the freedom to choose what career path we wish to take.

Sadly, without the sacrifices of these young men and women medicine would not be as advanced as it is today. Many breakthroughs in medicine can be attributed to war. A few notable examples would include French military medic Dr Dominique Jean Larrey founding the idea of modern hospital triage or Canadian Dr Henry Bethune developing the first effective system for mobile blood transfusions. Air ambulances were first used during the Korean War as a means of quickly transporting the wounded away from the front line for aid.

Veterans have also been of immense value in the treatment of psychological issues, namely Post Traumatic Stress Disorder.

Before World War One Post Traumatic Stress Disorder (PTSD) was a relatively unknown entity. During the 19th Century, when railway accidents were frequent some victims of railway accidents displayed symptoms of PTSD. John Erichsen published the first medical study of the condition called ‘On Railway and Other Injuries of the Nervous System’ and ths the condition was coined as ‘Railway Spine’ or ‘Erichsen’s disease’.  German neurologist Hermann Oppenheim suggested the symptoms of Railway Spine were attributed to physical damage of the brain or spine where as British and French doctors attributed the symptoms to a form of hysteria, although this theory was discarded as ‘men cannot suffer with hysteria’.

Of course, during World War 1 many soldiers were displaying similar symptoms. By December 1914 as many as 10% of officers and 4% of enlisted men were suffering from a condition that was becoming known as ‘shell shock’. The phrase shell shock was it was assumed that the concussive blasts of artillery shells were causing damage to the soldier’s brains. as the war began to unfold though     As the war progressed men were developing symptoms of shellshock away from areas affected by artillery fire which led doctors to believe that the condition was of a psychiatric and not a physiological nature. Many were taken from the front line for treatment in psychiatric hospitals, somewhat for fear of their unpredictable behaviour,  but sadly over the course of the war 346 British soldiers were executed for crimes relating to “cowardness”. It is thought that many of these were suffering from shell shock.

By the Battle of Passchendale in 1917 the British Army had a method of dealing with shellshock. Those displaying symptoms were sent away from the line for a few days rest by their medical officer. This seemed to be effective in dealing with the condition as 75% of men sent back were able to return to duty without further treatment being required.

The phrase shell shock was dropped in 1917 and by the outbreak of World War 2 Post Concussion Syndrome and Combat Stress Reaction (CSR) was used to describe the symptoms. Throughout WW2 soldiers were treated in a similar manner to those treated at Passchendale. They were sent away from the front lines for a few days and then returned. This was again largely successful in treating CSR and by the Korean War all soldiers were allowed a period of rest and recuperation to get away from the front lines.

However, it wasn’t until 1980 that PTSD was officially recognised with the introduction of DSM III following the psychiatric treatment of soldiers who fought in the Vietnam War. The idea that any stressor can cause a long term psychological effect on a person filled a big void in psychiatry and is often to diagnose a wide range of patients who often go on to get the treatment they need.

So to conclude; the sacrifices made by soldiers has allowed us our well fare. Not only in terms of our freedom but our understanding of how people work and how we can overcome trauma. No matter how large or small. For that, we should all be thankful.

Thank you

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