Now all roads lead to France and heavy is the tread
Of the living; but the dead returning lightly dance.
Edward Thomas, Roads

Thursday, August 20, 2020

British Medical Responses to First World War Casualties. Part 2 of 2

British Dressing Station in Salonika

By Doreen Isherwood

Gas Casualties

Gas warfare was introduced on the Western Front by the Germans on 2 April 1915 when they discharged 160 tons of chlorine gas against Allied troops near Langemark in Belgium. The gas, which causes death by drowning in the excess fluid secreted by the lungs, was a chemical by-product of the German dye industry. Haig's Intelligence Chief, Brigadier John Charteris, who witnessed the first attack, wrote: “The horrible part of it is the slow death of those who are gassed. . . slowly drowning with water in their lungs. . . and the doctors quite powerless.” Gas warfare using phosgene to mustard gas was used by all sides, but with the development of more efficient respirators and problems with unpredictable wind changes in northern France and Belgium, it never became a decisive weapon. Respirators, however, were no defense against the blistering mustard gas that rolled through the trenches in a yellow cloud.

Survivors of gas attacks suffered lung damage for the rest of their lives, leaving them vulnerable to repeated chest infections and limiting their chances of employment. Such was the fear of gas attacks at the outbreak of WWII that masks were issued immediately to the civilian population in Britain.

The vast canvas of John Singer Sargent's painting Gassed, which was voted “Picture of the Year” by the Royal Academy in 1919 (Gilbert 474), now hangs in a separate room in London's Imperial War Museum art gallery.  Sargent's assignment from the British Ministry of Information was to promote the spirit of cooperation of “British and American Troops Working Together.” However, when he saw a line of soldiers blinded by mustard gas queuing for treatment at a dressing station on the Somme, he ignored his official assignment in order to capture this moving portrait of the helplessness of the young men.

Psychiatric Issues 

Men at the front not only suffered horrific physical injuries but also experienced a wide range of mental traumas that often went unrecognized. The catchall condition, “shell shock” was denied by British medical officers and the military because of the threat to morale and discipline in the ranks. Mentally ill men could be branded as deserters and executed, causing many to hide their condition rather than to seek medical help. Signs of traumatic neurosis were already apparent in the industrial workplace. Leese equates the development of protective mental process in factory workers with those of soldiers in the trenches, but this assessment denies the reality of life in the trenches where routine was absent and survival improbable. He describes the response of many soldiers to the effects of prolonged battlefield exposure as “seasickness or anesthetic injection…a feeling of overwhelming mental and physical exhaustion… the resultant sense of lost self-identity and individuality.” 

Eventually, men would be assessed at the front, dividing those with mild symptoms who could return to active duty after a period of rest, from the more serious cases that needed specialized treatment in Britain. Methods ranged from peace and quiet to electric shock treatments. Nearly 4,000 patients were treated by a new team of doctors and scientists at the Red Cross Military Hospital near Liverpool. The team leader, Richard Rows, a follower of Freud and Jung, rejected the harsh physical treatments and adopted a revolutionary approach using psychoanalysis. The War Office took the unprecedented step of funding the hospital and from 1917 ran training courses to transfer the techniques to new centres in Britain and France. The emphasis was on returning the mentally wounded to the front line as soon as possible, but the gradual recognition of battle trauma paved the way for the new field of psychoanalysis and increased the standing of psychiatrists in orthodox medicine. Martin Gilbert reports that “as many as 50,000 former British soldiers were receiving government pensions for the continuing effects of shell shock.” 

Source: This article originally appeared in the Summer 2012 issue of the Journal of the World War One Historical Association

1 comment:

  1. In the U.K. ‘Shot at Dawn’ has become just as synonymous with WW1 as trenches or gas. Starting in the late 1980’s public awareness became keen about the likelihood that these unfortunate men were victims of Post-Traumatic Stress Disorder, and should have been hospitalized or discharged. In 2001 a memorial park was constructed at the National Arboretum in Staffordshire, and books, stage plays, a documentary film and episodes of many popular British television series resulted in a symbolic Act of Parliament in 2007 that pardoned all of the men ‘Shot at Dawn’ (except the murderers).

    It seems worthwhile to consider the statistics at this point. The total number of British, Colonial, Canadian and New Zealand soldiers shot (again excluding murderers), was 309, of which 281 were British, 22 were Canadian, 5 were New Zealanders and one was a Colonial. No Australians, Indians or South Africans were executed for offenses against military discipline.

    In the course of the war, about 20,000 Commonwealth soldiers were found guilty of an offense that was subject to the death penalty and about 3,000 of these actually got the death penalty. However, most had their sentences suspended or commuted to a lesser punishment. Of the 309 who were shot, 266 were deserters and 91 of these had previously been court-martialed for desertion and received a lesser punishment.

    While the British came to regard this as a national shame, it is worth mentioning that the record of other armies in the Great War was significantly worse. Just among the Allies, the Italians executed about 1,100 men for offenses against military discipline and the French over 900.