Shell Shock Diagnosis

[lelliott19]

Southern Watchman, Dec. 24, 1862. page 2

"It is not known who exactly coined the term "shell shock," but the first mention may be a story published in the Times on February 6, 1915." http://www.jmhhb.org/article.asp?is...;issue=2;spage=85;epage=87;aulast=Ganesh#ref2

Or maybe it was much earlier? Here are a couple of examples from 1862:

Aaron Harrington Co B 3rd Michigan Infantry, a 33-year-old a farmer possibly living in Shiawassee County MI, enlisted on May 13, 1861. Listed as 5'6' with black eyes and hair and a light complexion. He was wounded in the left hand and back shocked by shell on May 31, 1862, at Fair Oaks, Virginia, and was absent wounded in Judiciary Square hospital in Washington, DC, from July though August, but by early July was reported as up and about. He never returned to duty, however, and allegedly deserted on September 21 at Upton's Hill, Virginia. He was reported absent sick from October through December, and in a hospital in Philadelphia, Pennsylvania from January of 1863 through February. He was discharged on March 11, 1863, at West's Buildings hospital in Baltimore, Maryland, for "anchylosis and distortion of the left hand and thumb." http://thirdmichigan.blogspot.com/2009_01_01_archive.html

John H Ginn Co D 16th Georgia Infantry, a 40 year old farmer from Madison County GA, enlisted August 11, 1861 at Richmond, Va. Carded records at Fold 3 reveal that John H Ginn appears on a list of casualties in McLaws' Division in the battles before Federicksburg Va Dec 11-13, 1862 - Remarks: wounded slightly. But the list of casualties sent to the Athens GA Southern Watchman (published Dec 24, 1862, page 2) states that his condition was "shock by shell." Normally, one might assume that this meant he was physically impacted by the shell, but reading the rest of the list reveals a number of other casualties listed with contusions by shell in various body parts. (See image above.) J H Ginn was later killed on May 6, 1864 at the Battle of the Wilderness.

 

[Tom Elmore]

Laura,

I have interpreted "shock by shell" in the context of its usage to be related to the concussion caused by a bursting shell - a physical injury, not a psychological one (at least not initially). Examples follow from the battle of Gettysburg:

- Milton Bossard (or Buzhardt), Lieutenant, A/3 SC, killed, shocked by bursting of a shell.
- William Marshall, I/10 VA, shocked by (a) shell.
- Archibald D. Van Pelt, Private, H/10 VA, shocked by shell.
- J. H. Whitlock, G/22 GA, shocked by a shell.
- J. P. Coffee, F/26 NC, shocked by shell.
- R. N. Hodspethy, Sergeant, F/26 NC, shocked by shell.
- Ambrose Hutson, F/26 NC, shocked by shell.
- J. W. Brown, Captain, I/47 NC, shocked by bursting of shell.
- John Ransdell, 14 TN, shocked by shell explosion, lost hearing right ear.
- Mathias O'Neal, Private, 33 NC, bomb shell exploded near his face shocking and injuring him.
- George Taylor, K/14 SC, shocked with shell.
- Jonathan L. Fortner, E/49 GA, nervous shock from shell explosion near head, nervous prostration and permanent brain damage, spine also affected.

 

[lelliott19]

I have interpreted "shock by shell" in the context of its usage to be related to the concussion caused by a bursting shell - a physical injury, not a psychological one (at least not initially).

Thanks Tom! I wondered exactly what condition was referred to in those two examples.

 

[alan polk]

Very interesting thread, lelliot19! Tom Elmore put a scalpel to the issue! So I'm trying to figure:

"Shocked by shell" means concussion (of sorts): a "physical" wound;

And "shell shock" (think WWI) means psychological affects related to warfare?

Am I thinking right on this issue?

 

[AUG]

In WWI I believe "shell shock" could be either psychological or physical, but often I'm sure it was blast force TBI (traumatic brain injury).

Here's a National Geographic article on the effects of blast force TBI on today's Iraq and Afghanistan vets:
http://www.nationalgeographic.com/healing-soldiers/blast-force.html

 

[JPK Huson 1863]

Was there a known term for what we know is PTSD? It's such a comprehensive condition for victims of trauma, can't imagine many were not affected. Perhaps extreme cases? One of my grgrgrandfathers whose regiment saw some of the bloodiest fighting unraveled badly through decades. Medical records say nothing psychological, we just know he did.

 

[dlofting]

He never returned to duty, however, and allegedly deserted on September 21 at Upton's Hill, Virginia.

I'm thinking this soldier might have experienced "shock by shell", a brain injury caused by shell concussion, as noted by other posters or "shell shock", a psychological injury......or possibly both. There's really no way to tell.

 

[JohnW.]

"Shell shock", or it's Civil War predecessor "shocked by shell" is the same. AKA PTSD or "The Thousand Yard Stare" or "battle fatigue" are all one in the same.

 

[diane]

I wondered about the difference, if any, as well. There were stories of soldiers being injured or even killed - never hit by anything. The old wooden navy of the Brits - there were stories of whole gun crews falling over dead from the concussion of a passing shot. (Could be embarrassing, too - Parker, the British captain at Sullivan's Island during the Revolution, had his britches blown right off by passing shot! He was real cheeky real fast... )

 

[FarawayFriend]

Very interesting thread, lelliot19! Tom Elmore put a scalpel to the issue! So I'm trying to figure:

"Shocked by shell" means concussion (of sorts): a "physical" wound;

And "shell shock" (think WWI) means psychological affects related to warfare?

Am I thinking right on this issue?

From what I read (which is also in the German version of the article "Shell shock" in Wikipedia, strangely there seem to be no English one), at first the psychological effects were said to be due to the brain having been tossed against the skull because of a detonation (either the loudness or the shock wave) - so a mechanical effect was believed to cause the psychological effect.
What I always regard as extremely cruel, is that the treatment for it was to give these poor patients extremely painful electroshocks - as if they had not suffered enough!! Putting out fire with gasolene, in my eyes, but it was believed otherwise, and we must hope meant to do them good.

 

[JohnW.]

From what I read (which is also in the German version of the article "Shell shock" in Wikipedia, strangely there seem to be no English one), at first the psychological effects were said to be due to the brain having been tossed against the skull because of a detonation (either the loudness or the shock wave) - so a mechanical effect was believed to cause the psychological effect.
What I always regard as extremely cruel, is that the treatment for it was to give these poor patients extremely painful electroshocks - as if they had not suffered enough!! Putting out fire with gasolene, in my eyes, but it was believed otherwise, and we must hope meant to do them good.

I agree totally!!! People with this diagnosis were regarded in the same light as the self inflicted gunshot wound until after the Vietnam War when it became better understood that these people had a DISEASE and were not malingerers or cowards.

 

[FarawayFriend]

I agree totally!!! People with this diagnosis were regarded in the same light as the self inflicted gunshot wound until after the Vietnam War when it became better understood that these people had a DISEASE and were not malingerers or cowards.

Another word was "bomb shell disease" - but I don't know if the word disease indicates that it was really taken seriously, or if it was meant ironically or rather cynically - which would be disgusting! In German, soldiers with PTSD who had developed a tremor - trembling of the limbs - were called "Kriegszitterer" (war tremblers) and that was certainly said with a good deal of contempt.

 

[diane]

Jacob Mendes Da Costa, I believe, was the first investigative clinician to notice 'soldier's heart' and try to find out what it was about. He was seeing too many soldiers with the same symptoms but no physical reason - they couldn't all be hysterics! I wondered, since it was American Civil War soldiers he noticed this in, if being an American at that time had something to do with it. For a very long time Americans were well insulated.

 

[JohnW.]

I wondered, since it was American Civil War soldiers he noticed this in, if being an American at that time had something to do with it. For a very long time Americans were well insulated.

That is a great question!!

 

[lelliott19]

Jacob Mendes Da Costa, I believe, was the first investigative clinician to notice 'soldier's heart' and try to find out what it was about. He was seeing too many soldiers with the same symptoms but no physical reason - they couldn't all be hysterics! I wondered, since it was American Civil War soldiers he noticed this in, if being an American at that time had something to do with it. For a very long time Americans were well insulated.

Yes, Costa believed that the "cadiac" symptoms - anxiety, elevated pulse, trouble breathing, heaviness in chest, shortness of breath with exertion, etc - were indeed cardiac symptoms related to some kind of injury to the heart from the detonation/shock waves. He thought it was caused by overstimulation of the heart's nervous system and he named it "Da Costa's Syndrome." I wonder if non-cardiac symptoms like tremors, partial paralysis, inability to speak, etc were attributed to physical/mechanical processes?

 

[AUG]

"Shell shock", or it's Civil War predecessor "shocked by shell" is the same. AKA PTSD or "The Thousand Yard Stare" or "battle fatigue" are all one in the same.

The term "Shocked by shell" being used here is most likely physical blast-related trauma - not the same as PTSD or "battle fatique," which is considered psychological trauma. "Shell shock" in WWI was sort of a loose term used to describe both physical or psychological trauma.

 

[FarawayFriend]

Yes, Costa believed that the "cadiac" symptoms - anxiety, elevated pulse, trouble breathing, heaviness in chest, shortness of breath with exertion, etc - were indeed cardiac symptoms related to some kind of injury to the heart from the detonation/shock waves. He thought it was caused by overstimulation of the heart's nervous system and he named it "Da Costa's Syndrome." I wonder if non-cardiac symptoms like tremors, partial paralysis, inability to speak, etc were attributed to physical/mechanical processes?

Yes, I'm convinced they were.
I have thought about why the earlier warriors did not seem.to have suffered from it. Maybe because it was hand to hand fighting, they saw their opponent (and if they lived to remember the fight, obviously they had won it) while, with the invention of rifles, the snipers could aim unseen from a distance, so whenever a warrior moves, he has to fear that he is already a target for an enemy sniper, adding a hint of helplessness to a dangerous situation. No matter how strong you are, if you are badly ambushed or hit by artillery that was placed miles away, unseen... you can't help being wounded.
Of course this is what a civilian, me, imagines. I have never served, so maybe this is all wrong, but I can imagine that the feeling of being delivered to a situation I cannot influence must be pretty unnerving!

 

[diane]

Yes, I'm convinced they were.
I have thought about why tge earlier warriors did not seem.to have suffered from it. Maybe because it was hand to hand fighting, they saw their opponent (and if they lived to remember the fight, obviously they had won it) while, with the invention of rifles, tge snipers xould aim unseen from a distance, so whenever a warrior moves, he has to fear thst he is already a target forvan enemy sniper, adding a hint if helplessness to a dangerous situation. No matter how strong you are, if you are badly ambushed or hit by artillery that was placed miles away, unseen... you can't help being wounded.
Of course this is what a civilian, me, imagines. I have never served, so maybe this is all wrong, but I can imagine that the feeling of being delivered to a situation I cannot influence must be pretty unnerving!

I've thought that, too - that it was a phenomenon of modern warfare, new weaponry. Much more terrifying to be killed straight out of the blue! The ancient Romans who saw long service and lots of huge casualty battles didn't seem to have a problem - as you say, eyeball to eyeball - nor did the Mongols or other warrior people.

 

[Yankeedave]

Imho there was classic shell shock among the cw vets, but the volume shells in ww1 produced so many cases. I think the shocked by shell in the cw realm is along the lines of the shell exploded, the guy died with no visible wounds.

 

[John Winn]

The term "Shocked by shell" being used here is most likely physical blast-related trauma - not the same as PTSD or "battle fatique," which is considered psychological trauma. "Shell shock" in WWI was sort of a loose term used to describe both physical or psychological trauma.

Imho there was classic shell shock among the cw vets, but the volume shells in ww1 produced so many cases. I think the shocked by shell in the cw realm is along the lines of the shell exploded, the guy died with no visible wounds.

I'm with these guys.

An interesting question and thread. We had one before about PTSD in the Civil War which I don't think was recognized much but do think happened.