William Aldren Turner (1864-1945).

William Aldren Turner (Fig. 1) was born in Edinburgh, the son of William Turner (1832-1916) who at the time was senior demonstrator in Anatomy at the University, later Professor (1867). His paternal grandmother was Margaret Aldren. He was not related to the American endocrinologist Henry Hubert Turner (1892-1970) who described Turner syndrome (monosomy X) in 1938. Fig. 1 William Aldren Turner (1864-1945).

Mr. Gilbert's World Tour: Rethinking Disabled Veterans Across British Imperial Spaces.

This article provides a comparative analysis of the treatment of disabled First World War veterans in 1920s Britain and the simultaneous care of Imperial Pensioners residing in Australia and South Africa via the detailed administrative reports of a British civil servant, G.F. Gilbert. Imperial Pensioners were disabled veteran migrants of the British Army residing overseas. A study of these veteran populations in Australia and South Africa provides two primary insights into the broader historiography of disabled veterans. Firstly, a comparative case study helps to show the way in which cultural notions of disability were part of broader ideas of nation-building overseas. Secondly, the specific disability diagnosis category chosen as a more in-depth case study can further complicate and contradict broader assessments of national responses. This article attempts to build upon recent transnational histories of veterans by transcending national boundaries and homogenous veteran profiles with an extension in methodological scope by providing an intra-national case study via the Imperial Pensioner.

Application of Deep Brain Stimulation in Refractory Post-Traumatic Stress Disorder.

Post-traumatic stress disorder (PTSD) is a mental disorder that produces crippling anxiety and occurs in response to an extreme, traumatic stressor. Compared to the prevalence of PTSD in the general population, the prevalence of PTSD in at-risk populations (e.g., army veterans, those affected by environmental calamities, and others) can reach up to threefold. The conventional treatment of PTSD involves using SSRIs (serotonin reuptake inhibitors) and other anti-depressants along with psychotherapy such as debriefing and CBT (cognitive behavioral therapy). Due to increasing resistance to conventional treatment, more novel treatment options, such as stellate ganglion block shots and neuromodulation, are being explored. These neuromodulation techniques include transcranial magnetic stimulation (TMS), transcranial direct current stimulation (TDS), and deep brain stimulation (DBS). The rationale behind employing these techniques in refractory PTSD is the altered neurocircuitry seen in PTSD patients, which can be visualized on imaging. Studies involving the use of DBS for PTSD primarily target specific areas in the brain: the amygdala, the prefrontal cortex, the hippocampus, and the hypothalamus. This article aims to provide a brief overview of the various neuromodulation techniques currently employed in the management of treatment-resistant PTSD and an in-depth review of the available literature on animal models in which DBS for PTSD has been researched. We also shed light on the human clinical trials conducted for the same.

Current Treatments of Post-traumatic Stress Disorder and Amygdala Ablation as a Potential Cutting-Edge Therapy in Its Refractory Cases.

Post-traumatic stress disorder (PTSD)is a very common psychiatric disorder occurring in an individual of any age, gender, or race who underwent trauma, with women being twice more at risk than men. It is generally seen more in American Indians, United States Latinos, and African American ethnic groups. A patient is diagnosed with PTSD if the symptoms of intrusion, avoidance, changes in cognition and emotions, arousal, and mood reactivity changes persist for more than a month and cause the individual severe difficulty in their everyday cognitive and psychological functioning. The psychological treatment includes numerous therapies including trauma-focused therapies such as cognitive behavioral therapy, cognitive processing therapy, prolonged exposure therapy, eye movement desensitization and reprocessing, and non-trauma-focused therapies such as relaxation techniques, interpersonal therapy, and mindfulness. Various pharmacological measures have also been tried with mixed results such as selective serotonin reuptake inhibitors, benzodiazepines, adrenergic drugs, atypical antipsychotics, and mood stabilizers like lithium and valproate. As numerous studies have proven, PTSD is linked with right-side stimulation of the amygdala. The purpose of this article is to highlight the use of extremely selective laser ablation of the amygdala-hippocampal unit as a successful surgical intervention for medically unresponsive PTSD and as a revolutionary solution and prospective cutting-edge therapy in the near future.

Elton Mayo and Thomas Henry Reeve Mathewson: the forgotten Australian pioneers of the treatment of patients with shell shock, neurasthenia and nervous breakdown.

The contributions of Australians on shell shock are absent from the literature. However, two Australians were pioneers in the treatment of shell shock: George Elton Mayo (1880-1949) and Dr Thomas Henry Reeve Mathewson (1881-1975). They used psychoanalytic approaches to treat psychiatric patients and introduced the psychoanalytic treatment of people who suffered from shell shock. Their 'talking cure' was highly successful and challenged the view that shell shock only occurred in men who were malingering and/or lacking in fortitude. Their work demonstrated that people experiencing mental illness could be treated in the community at a time when they were routinely treated as inpatients. It also exemplified the substantial benefits of combining science with clinical knowledge and skill in psychology and psychiatry.

Shell Shock: The Response of UK Neurology.

The neurological and psychological manifestations of trauma, confinement, and terror became apparent throughout Europe as soldiers were evacuated from the trenches of the Western Front. The response in the UK evolved as a result of the experience of medical staff embedded with the troops in base hospitals and the philosophy of those treating returned soldiers in specialist establishment. There were widely disparate approaches to the management encompassing simple supportive care, a psychanalytic approach and radical electric shock therapy. The latter was partially driven by the Queen Square experience in the UK but was also concurrently widely pursued throughout Europe. With experience, care was increasingly undertaken close to the front lines using a philosophy of immediacy and expectation of recovery. Post-war analysis was startlingly unsympathetic, yet the experiences and management of shell shock have guided psychiatric and medical understanding of functional illness and post-traumatic stress over the subsequent century. In this historical review, we have sought to present features of the UK response to the neurological manifestations of trauma, the way in which these changed as the war proceeded and the political and medical response in the aftermath of war.

When war came home: air-raid shock in World War I.

During World War I, civilians became a target of the war machine. Air raids transformed the lives of those not involved in active combat and blurred the lines between the home front and the war front. This paper argues that the experience of air raids in World War I was comparable to the combat stress at the Western Front. The author bases her argument on contemporary publications in medical journals, measures taken by British authorities to prevent air-raid shock, and contemporary case records. The narratives of air-raid shock - similarly to those of shell-shocked soldiers - reflect the feelings of terror and loss of control, and demonstrate the profound effect these experiences could have on individuals' mental health.

Hurst Rehabilitated: the treatment of functional motor disorders by Arthur Hurst during the First World War.

Arthur Hurst was a British First World War physician, best known for his films of shell shock, 'War Neuroses'. He has often been portrayed an innovative pioneer of somewhat mysterious 'suggestion' techniques for functional motor disorders but also as an ambitious clinician who exaggerated the effectiveness of his treatments and failed to address psychological factors. His use of suggestion, persuasion and re-education together with occupational therapy, for chronic or severe cases of shell shock stirred controversy at the time because of the dramatic nature of some of his treatment responses and lack of outcome data. In part, this was a turf war between neurologists and psychiatrists for a dominant therapeutic model. A re-evaluation of his publications and new research into soldiers treated at Seale Hayne in Devon show that Hurst pioneered multidisciplinary and empathetic treatments for functional motor disorders with good short-term outcomes, though insufficient data survives to assess longer term outcomes.

Between Shell Shock and PTSD? 'Accident Neurosis' and Its Sequelae in Post-War Britain.

This article focuses on the concept of 'accident neurosis', popularised by neurologist Henry Miller in studies published in 1961. It aims to realise two goals. First, it introduces Miller's concept of accident neurosis to the broader history of trauma-to a field, that is, more preoccupied with military traumata and clear-cut psychiatric aetiologies. Secondly, I use Miller's studies, and the considerable legacy they created, to reflect on how historians of trauma construct historical narratives, asking whether there is sufficient appreciation of the ways in which events seem to leak into or retroactively animate one another.

Abrupt treatments of hysteria during World War I, 1914-18.

Case reports of the abrupt recovery of hysterical disorders during World War I (1914-18), though undoubtedly subject to publication bias, raise both aetiological and treatment issues regarding pseudo-neurological conversion symptoms. Published clinical anecdotes report circumstantial, psychotherapeutic, hypnotic, persuasive (and coercive) methods seemingly inducing recovery, and also responses to fright and alterations of consciousness. The ethics of modern medical practice would not allow many of these techniques, which were reported to be effective, even in the chronic cases.

Edgar Adrian (1889-1977) and Shell Shock Electrotherapy: A Forgotten History?

The English electrophysiologist Edgar Adrian (1889-1977) was the recipient of the Nobel Prize for physiology in 1932 for his research on the functions of neurons. During World War I, at Queen Square in London, he devised an intensive electrotherapeutic treatment for shell-shocked soldiers. The procedure, developed with Lewis Yealland (1884-1954), was similar to "torpillage," the faradic psychotherapy used in France. Adrian and Yealland considered that the pain accompanying the use of faradic current was necessary for both therapeutic and disciplinary reasons, especially because of the suspicion of malingering. According to Adrian, this controversial electric treatment was only able to remove motor or sensitive symptoms. After the war, he finally admitted that war hysteria was a complex and difficult phenomenon.

Canadian Military Nurse Deaths in the First World War.

This paper examines the lives of sixty-one Canadian Nursing Sisters who served during the First World War, and whose deaths were attributed, more or less equally, to three categories: general illness, Spanish Influenza, and killed in action. The response by Canadian Army Medical Corps (CAMC) physicians to the loss of these early female officers who were, in fact, Canada's first female war casualties, suggests a gendered construction of illness at work in the CAMC. While nurses tried to prove themselves good soldiers, military physicians were quick to attribute their illnesses and deaths to horrific war conditions deemed unsuitable for women. This gendered response is particularly evident in how CAMC physicians invoked a causal role for neurasthenia or shell shock for the nurses' poor health. The health profile of these women also suggests that some of these deaths might have occurred had these women stayed in Canada, and it encourages future comparative research into death rates among physicians and orderlies.

The relationship between the First World War and neurology: 100 years of "Shell Shock" / A relação entre a Primeira Guerra Mundial e a neurologia: 100 anos do "Shell Shock"

ABSTRACT The First World War was a global war, beginning on 28 July 1914, until 11 November 1918. Soon after the beginning of the war, there was an “epidemic” of neurological conversion symptoms. Soldiers on both sides started to present in large numbers with neurological symptoms, such as dizziness, tremor, paraplegia, tinnitus, amnesia, weakness, headache and mutism of psychosomatic origin. This condition was known as shell shock, or “war neurosis”. Because medically unexplained symptoms remain a major challenge, and considering the close relationship of symptoms described in shell shock with clinical neurology, we should study their history in order to improve future care.

RESUMO A Primeira Guerra Mundial foi uma guerra global, iniciada em 28 de julho de 1914, até 11 de novembro de 1918. Logo após o início da guerra, exatamente há 100 anos, houve uma “epidemia” de sintomas neurológicos conversivos. Soldados de ambos os lados começaram a apresentar com frequência sintomas neurológicos, tais como: tontura, tremor, paraplegia, zumbido, amnésia, fraqueza, cefaleia e mutismo de origem psicossomática. Esta condição ficou conhecida como shell shock, ou “neurose de guerra”. Como muitos sintomas e doenças inexplicadas continuam sendo um grande desafio, e considerando a estreita relação dos sintomas descritos no shell shock com a neurologia clínica, torna-se importante estudar essa parte da história com o objetivo de entendermos e melhorarmos os cuidados aos pacientes.

Narcisismo y neurosis de guerra / Narcissism and war neurosis

En el presente artículo nos proponemos vincular la introducción del narcisismo con una serie de problemas distintos a los que habitualmente se destacan. Intentaremos justificar, en primer lugar, que algunos de los problemas económicos desarrollados en 1920 habían sido delineados anteriormente, en torno a las perturbaciones narcisistas provocadas por ciertas colocaciones de la libido en el yo. En segundo lugar, que el narcisismo no sólo habría sido importante en la discusión con Jung sino también en los debates con otras orientaciones psicopatológicas en torno a las neurosis de combate. Por último, que dicho concepto no sólo alude a la constitución del yo sino también a la disolución de la unidad yoica, tal como ocurre en ciertas neurosis "narcisistas" como la demencia precoz, la melancolía o las neurosis de guerra.

In this article we propose to link the introduction of narcissism with some problems that are different from those that usually stand out in the literature. We try to justify, first, that some economic problems developed in 1920 had already been raised before, around narcissistic disturbances caused by certain investiture of libido in the ego. Second, that narcissism would not only have been important in the discussion with Jung but also in discussions with other psychopathological orientations around the combat neurosis. Finally, that this concept not only refers to the constitution of the self but also the dissolution of the ego, as in certain "narcissistic" neuroses as dementia praecox, melancholy or war neuroses.

Freud's hysteria and its legacy.

Though Freud was himself interested in neurologic disorders, the model of hysteria he developed - of the repression of painful experiences, and their conversion into physical symptoms - made the disorder psychiatric, as the increasingly complex explanations came to rely on the "meaning" of events, which could not easily be understood neurologically. This evolved to become a prototype for psychiatric illness more broadly, a model which, though challenged by the First World War, enjoyed great success, notably in the USA, dominating psychiatric thinking for most of the 20th century. Concerns about the empiric basis for his ideas latterly led to a rapid decline in their importance, however, exemplified by 1980's "etiologically neutral" DSM-III. Hysteria, now renamed conversion disorder, retained its Freudian explanation for another 30 years, but as psychiatry lost its faith in Freud, so psychiatrists stopped seeing the disorder he had made theirs, and returned it once more to neurology.

Professor Camillo Negro's Neuropathological Films.

Camillo Negro, Professor in Neurology at the University of Torino, was a pioneer of scientific film. From 1906 to 1908, with the help of his assistant Giuseppe Roasenda and in collaboration with Roberto Omegna, one of the most experienced cinematographers in Italy, he filmed some of his patients for scientific and educational purposes. During the war years, he continued his scientific film project at the Military Hospital in Torino, filming shell-shocked soldiers. In autumn 2011, the Museo Nazionale del Cinema, in partnership with the Faculty of Neurosciences of the University of Torino, presented a new critical edition of the neuropathological films directed by Negro. The Museum's collection also includes 16 mm footage probably filmed in 1930 by Doctor Fedele Negro, Camillo's son. One of these films is devoted to celebrating the effects of the so-called "Bulgarian cure" on Parkinson's disease.

The Colour Treatment: A Convergence of Art and Medicine at the Red Cross Russell Lea Nerve Home.

When the Red Cross opened its new convalescent home at Russell Lea in Sydney in 1919, it contained a coloured room designed for treating 'nerve cases'. This room was painted by Roy de Maistre, a young artist, and was modelled on the Kemp Prossor colour scheme trialled at the McCaul Convalescent Hospital in London for the treatment of shell shock. Dubbed the 'colour cure' by the popular press, this unconventional treatment was ignored by the Australian medical profession. The story of de Maistre's colour experiment is not widely known outside the specialist field of Australian art history. Focusing on the colour room as a point of convergence between art and medicine in the context of the First World War, this article investigates Red Cross activities and the care of soldiers suffering from nervous conditions.

Australasian contributions to the "shell shock" literature of World War I.

OBJECTIVE: Australasians contributed to the medical literature on shell shock during and after World War I. CONCLUSIONS: AW Campbell, Elliot Smith, Carmalt Jones and AG Butler made significant contributions, and several 'frontline doctors' recorded astute observations.

A Physiologist's War: Captain T. Graham Brown RAMC (1915-1919).

During the five years before the outbreak of the First World War, Thomas Graham Brown (1882-1965) conducted research into the control of locomotion that gained him a deserved and long-lasting reputation as a neuroscientist and, in 1927, was recognized by election to the Fellowship of the Royal Society. In 1915, with the First World War raging, he agonized about continuing his research or joining the Royal Army Medical Corps (RAMC). Told by his father to seek a commission, he served two and half years in Macedonia with the British Salonika Force. Whilst in Greece, he kept a daily diary. The entries from June 1916 to May 1917 are extant. They are unpublished and provide the background to the narrative to follow. Casualties with traumatic injury to the brain and spinal cord afforded him the opportunity to carry out careful observations, particularly concerning sensory localization, which resulted in novel findings and his observations on shell shock led to him being called as an expert witness to the national inquiry into the nature and treatment of the condition. In 1920, Graham Brown was appointed to the Chair of Physiology in Cardiff, which he held until 1947.

Shell shock in Ireland: The Richmond War Hospital, Dublin (1916-19).

The history of mental disorders occasioned by World War I is a complex and important history, indelibly linked with social, political and cultural circumstances, and the history of the war itself. The Richmond War Hospital was a 32-bed establishment on the grounds of the large Richmond District Asylum in Dublin which, from 16 June 1916 until 23 December 1919, treated 362 soldiers with shell shock and other mental disorders, of whom more than half were considered to have recovered. Despite the limitations of the Richmond War Hospital, it was a generally forward-looking institution that pointed the way for future reform of Ireland's asylum system and, along with the other war hospitals, brought significant changes to the practice of psychiatry.