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Kate Blake Profile
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Shell Shock


I was just typing up some letters and was interested to read Pte Duncan Brown's opinion of Shellshock. His words are -
"I am quite allright - Shell shock is not an illness, only a shattering of the nerves. "
As he was writing to his mother maybe he was trying to put her at ease, but as one reads on, can't help but think how frightening it must have been -
"We were all rushing to the big dugouts for shelter when one came right on top of about 18 of us, including myself, killing three, wounding ten and giving two shell shock. I with two others got off free, only being knocked down and stunned . I picked myself up and tumbled over bodies lying all round. Anyhow that only shook me up, but when the other one came next time we went in the trenches and it landed almost at my feet. I went out to that one and got shell shock. I have been extremely lucky all the time. Once a bullet pinked the rim of my steel helmet and often shrapnel has just missed me, but I am safe ans sound yet. After I got shell shock the first thing I remember was lying in the casualty clearing station at Hazebrouk. From there I went to Argues Arks?? near St Omer to a special shell shock hospital. From there after six weeks away, I went back to Capelle, Armentieres, and three days after got knocked out again, and it was that shock that affected my speech. Then the push at Messines came and I went up with the rations to the men in the front line, over dead men, horses, mules, Fritz's shellholes and every other horror in that battle.
All the big battles have made me worse
I will probably get a base job here or on the coast of France at Havre.
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Re: Shell Shock


Very interesting quote. Thanks Kate. Pte Brown appears to be describing the immediate concussive effects of an explosion. The most dramatic end of the spectrum is sudden death. I have read quotes from soldiers who happened upon dead Germans inside intact pillboxes. There was not a mark on the bodies at all. Often, there will be blood visible from one or both ears. As with any concussive blow, unconsciousness is the next step down. Then there is semiconsciousness; often the person is described as dazed or confused. Other neurological problems are quite possible, such as slurring of speech. These would generally be temporary, with recovery occurring over hours or occasionally days. Loss of hearing would be more likely due to direct rupture of the ear drums.

Concussive effects relate in part to the violent movement of the head, causing the relatively soft brain to fly about inside the rigid skull. A penetrating injury is not required to cause these effects.

The other form of 'shell shock' that is often referred to is the complete mental dislocation of a soldier during or immediately after violent combat. Prolonged exposure to shellfire was one but not the only cause. In many cases, these episodes were associated with 'bizarre' and 'hysterical' reactions. There are many black and white films of soldiers suffering from 'shell shock'. Thankfully, we have come a long way in understanding the causes of these conditions. The wonder is that more people were not 'afflicted' in this way.

Robert
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Re: Shell Shock


Robert, you seem quite knowledgeable on medical matters. Could a nearby shell blast also 'stop the heart' ie the body is intact and unmarked but death was instantaneous from the concussion?
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Re: Shell Shock


Robert,thanks again for your detailed answer, great assistance.

Graeme,
I have a couple of Red Cross reports of 37th men who died from the concussion of shells. .I remember one is reported to have had a weak heart which caused his death when a shell exploded - he had no other mark on him.I will look it up and post it later.

Another is File: 1111001
1193 Sergeant James William Frew
37th BattalionRed Cross Missing and Wounded Files
Although a couple of conflicting reports most state that the concussion was main cause of his death
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Re: Shell Shock


Graeme

The heart is a very robust organ and is unlikely to be affected. More likely, the brainstem would be damaged (region just above the spinal cord and below the main part of the brain). The brainstem controls consciousness and breathing. If the latter stops, then the heart will stop a few minutes later. This is the area of the brain that will cause instant death when hit by a bullet, for example in an execution where the shot is fired into base of the skull from behind.

Very helpful reports, Kate. I am not sure that a 'weak heart' would have been responsible IMHO. As you know, this is a lay diagnosis, possibly as a result of someone hearing a murmur at the first medical exam. Anyone who can engage in the activities of a soldier without limitation must have good heart function. Which is not to say that sudden death cannot happen to fit healthy adults. There are rare heart conditions, some of which are congenital, and viral infections that very rarely cause sudden death. The former are not detectable usually, at least by the sort of examinations performed on new recruits. It is possible that the diagnosis of 'weak' heart was made after the event as a way of explaining the seeming anomaly of someone being killed without any external sign.

Robert
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Kate Blake Profile
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Re: Shell Shock


I agree with you Robert. I imagine the men discussing a death such as this (with no marks on body ) and the logical reason for someone without medical training would seem to be a weak heart.As the Red Cross reports are only statements made by witnesses they often conflict with each other and are open to each mans conjecture.
Do you have an opinion about the conditions the men were serving relating to their health. Acute illnesses/pneumonia/extremely high fevers, stress, possibly causing heart irregularities and what about the effects of the gas on the heart?
I found this interesting webpage worth having a read of -
http://homepage.ntlworld.com/oxfordtours/fred/


 
quote:

Who was the other one who was killed?
Fred - My other brother Henry. I buried 'im. He got killed sitting beside of me. Yus, four of us sitting in a slep. We didn't 'av a trench, we ad slep's all over the place, see, so we could connect up. He was a serjeant. We got dug in that mud, and he'd just come down there and we was going to settle down for the night waiting for dawn to attack a landmark. There was his mate, and my mate and we just settled down there, and we was splitting up some wood to make some chips an tea when this wizz-bang come over. He didn't have no wounds or anything. This wizz-bang hit the top and took his breath.



Last edited by Kate Blake, 8/4/2003, 2:33 pm
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Re: Shell Shock


I just found the one I was thinking of regarding weak heart- A.E.Collister - 1154 - 37th Battalion. KIA 18-6-1918
Snippets from the reports are

"Collister was killed by the concussion of a shell instantaneously"

"He was kiled at Villers Brett. by a dud shell which landed between his feet and he dropped dead."

"He had no wounds and must have been killed by shock"

"A Whizz-Bang burst on top of the shell hole where C. was killing him instantly from Concussion, there was not a mark on his body."

"A "dud" landed close by him and he was killed by concussion; he had a weak heart. There was no mark of injury on him. Time, about 11pm. I did not see the casualty happen but men who were with him told me. He only lived a few minutes and was not conscious."
(I think this agrees with what you have written Robert - re: Brainstem injury.)

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Andrew P Profile
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Re: Shell Shock


There was a POW from the 48th Bn who was captured in 1917 and was sent to work with other prisoners close behind the German lines. When they were doing this work the British started shelling the area they were in and this man suffered severe shell shock.
Quite soon after this he committed suicide. Apparently the severe shell shock made him do this.
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Re: Shell Shock


Kate

Given that the population of soldiers represents mostly fit younger men, heart problems would be rare. The most likely cause of pre-existing heart trouble at this time was probably rheumatic heart valve disease. Often this would go unnoticed. Medical examinations were very cursory and it would have to be a really in-your-face problem to not get past. Any serious pre-existing heart problem would cause effort-related breathlessness and fatigue, something that would show up during the rigors of training. However, less serious problems could go undetected, only to be exposed by some other problem later.

As you suggest, there are several conditions that were common in 1914-18 that could have secondary effects on the heart. Infections, such as pneumonia, dysentery and gangrene/other wound infections were common. Additional infections, such as parasitic infections including malaria, also occurred in Egypt, Palestine, Mesopotamia, Macedonia and Central Africa. By and large, you would not expect these to have significant effects on the heart unless there was a pre-existing problem (so infection might settle on a rhuematic heart valve for example) or the effects were so severe that all body systems were affected (such as blood poisoning). However, any of these could cause irregularities of heart beat, though not of the lethal variety.

Your query about the effects of gas is an interesting one. I have mentioned that hypoxia was a common consequence of significant exposure to gas. This will trigger heart irregularities and other problems. I am not aware that any of the agents were directly toxic to the heart but phosgene was associated with a late effect of exercise-related sudden death. This would happen some days (but not weeks) after initial exposure, when the person had seemingly recovered. It is possible that this was a delayed effect on the lungs, causing hypoxia, or an affect on the heart.

Direct heart infections can occur with viruses. It is quite possible that the influenza epidemic of 1918 would have caused heart damage and sudden death in some of it's victims.

Alcohol is one of the commonest causes of heart irregularities :-)

Just some preliminary thoughts

Robert
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Re: Shell Shock


On the 28th August 1915, Lieutenant Colonel Charles Ernest Thomas, Commanding Officer of the New Zealand Mounted Brigade Field Ambulance, was killed by shell concussion at Hill 60:

'Some time after the attack Lieut. Col. Thomas, N.Z.M.C. commanding the N.Z.M.B.F.A. was killed while leading stretcher parties to the vicinity of Hill 60. He had entered the sap leading to the fire trenches, the shell fire at this point was heavy, eventually a shell burst immediately over the party, the leader was killed instantly by concussion, and four of the bearers were wounded by the same explosion.'
(Carberry, Lieut. Col. A.D. The New Zealand Medical Services in The Great War, 1914 - 1918. p105-6).

Regards,
Bryn
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