Shell Shock: From WWI Firing Squads to Blast Waves That Scar the Brain

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By December 1914 as many as 10 percent of British officers and 4 percent of enlisted men were breaking down with tremors, mutism, amnesia and the thousand-yard stare, often with no visible wound. Charles Myers named it shell shock in The Lancet in 1915, assuming a link to bursting shells, but men who had never been under artillery showed the same symptoms. The army split cases by proximity to an explosion: W for wounded, with a pension and wound stripe, or S for sickness, with neither, a rule medics found nearly impossible to apply.

Officers such as Lord Gort called it weakness absent in good units. Lewis Yealland used electric shocks and lit cigarettes on a mute patient, and 346 British death sentences were carried out, 268 for desertion and 18 for cowardice, with pardons only in 2006. When 40 percent of casualties at the Somme were shell-shocked, the army kept men near the front and later banned the term. A century on, research at Johns Hopkins and the Uniformed Services University has found astroglial scarring from blast overpressure, a physical injury distinct from CTE.

The episode opens with a lieutenant who clawed at the earth, then went limp and mute after a shell blew the roof off his dugout.
About 10 percent of cases showed what is now called conversion disorder, such as blindness or paralysis without physical damage.
By 1939 some 120,000 British veterans drew pensions for psychiatric disabilities, about 15 percent of all such pensions.
Siegfried Sassoon and Wilfred Owen both spent time at Craiglockhart War Hospital.
A 2023 report found US artillery crews in Iraq and Syria suffering brain damage from firing their own guns.

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