"Adventures in Neurasthenia," from Running on Empty, an unpublished ms, by Jordan Richman

Shell shock, neurasthenia and war neurosis

Two Official British figures claim that 80,000 cases of shell shock passed through the various medical facilities during WW1 but many cases were covered up by sending psychiatric cases to ordinary hospitals and the true figure could be approximately 200,000 cases. German records recorded a figure of 613,047 cases of nervous disorders between 1913-1918.


'Neurasthenia' was a term used by an American neurologist, George Beard, M.D. in 1869. He described patients as neurasthenic when they were depressed and inert. 'War neurosis' was described as nervous exhaustion through overwork and the Weir Mitchell Cure was applied - isolation, rest and a diet rich in milk-based foods.

The term 'shell shock' was first used in the public domain by Charles Samuel Meyers, a Cambridge psychologist, in an article he wrote about the cases he had been treating. He felt uncomfortable about using the term because it did not describe the mental conditions that these men were suffering.

Shell shock was literally the shock felt by a soldier near to an exploding shell and the feelings of having one's senses assaulted by the detonation flash, heat, displacement of the air and the ground tremors as the shell formed a crater in the earth.

By the mid-nineteenth century in America, fatigue, viewed as a nervous disorder brought about by the brain work or the professional classes, rather than the physical work of the working classes, received sympathetic treatment from the American and European medical profession.

Fatigue, bordering on exhaustion, was seen as a central focus of a cluster of nervous conditions. These conditions were named by the neurologist George Beard in 1869 as neurasthenia. 

Neurologists worked with Civil War soldiers who suffered from battle fatigue and other nervous conditions brought on by the war. These physicians eagerly accepted the term as one that differentiated insanity from neurosis.

Even earlier at the beginning of the nineteenth century, an English physician, Thomas Trotter, in A View of the Nervous Temperament (1807), had identified the nervous disorders of mental workers as the chief medical problem of the new century, surpassing fever, which he believed had been more common in the previous century.