Outset of the great war, a dreadful rumor arose

History lesson on Combat PTSD
WWI "Shell Shock"

The Shock of War
World War I troops were the first to be diagnosed with shell shock, an injury – by any name – still wreaking havoc
Smithsonian Magazine
By Caroline Alexander
September 2010

In September 1914, at the very outset of the great war, a dreadful rumor arose. It was said that at the Battle of the Marne, east of Paris, soldiers on the front line had been discovered standing at their posts in all the dutiful military postures—but not alive. “Every normal attitude of life was imitated by these dead men,” according to the patriotic serial The Times History of the War, published in 1916. “The illusion was so complete that often the living would speak to the dead before they realized the true state of affairs.” “Asphyxia,” caused by the powerful new high-explosive shells, was the cause for the phenomenon—or so it was claimed. That such an outlandish story could gain credence was not surprising: notwithstanding the massive cannon fire of previous ages, and even automatic weaponry unveiled in the American Civil War, nothing like this thunderous new artillery firepower had been seen before. A battery of mobile 75mm field guns, the pride of the French Army, could, for example, sweep ten acres of terrain, 435 yards deep, in less than 50 seconds; 432,000 shells had been fired in a five-day period of the September engagement on the Marne. The rumor emanating from there reflected the instinctive dread aroused by such monstrous innovation. Surely—it only made sense—such a machine must cause dark, invisible forces to pass through the air and destroy men’s brains.

Shrapnel from mortars, grenades and, above all, artillery projectile bombs, or shells, would account for an estimated 60 percent of the 9.7 million military fatalities of World War I. And, eerily mirroring the mythic premonition of the Marne, it was soon observed that many soldiers arriving at the casualty clearing stations who had been exposed to exploding shells, although clearly damaged, bore no visible wounds. Rather, they appeared to be suffering from a remarkable state of shock caused by blast force. This new type of injury, a British medical report concluded, appeared to be “the result of the actual explosion itself, and not merely of the missiles set in motion by it.” In other words, it appeared that some dark, invisible force had in fact passed through the air and was inflicting novel and peculiar damage to men’s brains.

By 1917, medical officers were instructed to avoid the term “shell shock,” and to designate probable cases as “Not Yet Diagnosed (Nervous).” Processed to a psychiatric unit, the soldier was assessed by a specialist as either “shell shock (wound)” or “shell shock (sick),” the latter diagnosis being given if the soldier had not been close to an explosion. Transferred to a treatment center in Britain or France, the invalided soldier was placed under the care of neurology specialists and recuperated until discharged or returned to the front. Officers might enjoy a final period of convalescence before being disgorged back into the maw of the war or the working world, gaining strength at some smaller, often privately funded treatment center—some quiet, remote place such as Lennel House, in Coldstream, in the Scottish Borders country. read more of PTSD in WWI Here War Neurosis

The Century: America's Time - 1914-1919: Shell Shock
ABC News

Sounds like they should have figured out what to do to help soldiers heal. The truth is, they didn't.

WWII
After WWI they had thought the issues veterans faced had more to do with the "shells" and the compression taking a toll on their brains. By WWII, they knew they were facing something different.

"During the early years of World War II, psychiatric casualties increased by 300% when compared to WWI."

"At one point in the war, the number of men being discharged from the service for psychiatric reasons exceeded the total number of men being newly drafted."

23% of the evacuations were for psychiatric reasons. Readjustments Problems Among Vietnam Veterans, The Etiology of Combat Related Post Traumatic Stress Disorders (1978)

In the same article the Korean War was also discussed. Things changed for the better. They did something right.

Psychiatric evacuations dropped to only 6%. Why? Because clinicians were there when needed. "Clinicians provided immediate onsite treatment to affected individuals always with the expectations the combatant would return to duty as soon as possible. (Also from the above article)

By Vietnam, the number of soldiers diagnosed while deployed dropped. Why? Because they were in and out in a year. What followed was the number of Vietnam veterans needing help to heal.

Everything went up after that. Arrests, drug and alcohol situations made the news but homelessness, suicides, attempted suicides and everything else we see today happened to them, but no one cared enough to notice other than their own families.

Next time you hear some "expert" saying PTSD didn't exist before Vietnam, give them a history lesson.