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War Surgery and Medicine

[section]

page 630

In war the spiritual is to the material as three to one.’—

Napoleon

LITTLE appreciation of the problems of neurosis was shown during the early part of the First World War, and there were even courts martial imputing cowardice to men suffering from the effects of battle strain. Later the pendulum swung the other way and cases of war neurosis were labelled ‘shell shock’, though the large majority had never been affected by any concussion.

Special centres were formed in England, notably by Sir Arthur P. Hurst at Seely Hay, for the study and treatment of these cases. Psychoanalysis and persuasion were the basis of the treatment adopted, but hysterics were treated by suggestion, aided sometimes by anaesthesia. Loss of voice was comparatively common in hysteria escape syndrome.

In the 1914–18 War the percentage of those invalided in British hospitals through neurosis rose on occasion to 40 per cent and, in 1918, of 100,000 pensioners, 32,000 were functional nervous and mental cases. Three years later the number rose to 65,000, and even in 1938, 29,000 were still drawing pensions. There were also 44,000 pensions granted for effort syndrome, which was looked upon as an organic disability.

In New Zealand pensions were also granted for shell shock and effort syndrome. From 1 NZEF, from May 1916 to December 1918, 1370 men were invalided to New Zealand with nervous disease or shell shock. This was about 10 per cent of the sickness invalidings over the period.