Page:EB1922 - Volume 32.djvu/443

Rh in no essential manner differed from those affecting civilians of either sex (see 14.211 and 19.432).

Among the causes which led to the prevalence of cases diagnosed " shell-shock " was the neurological and psychological inexperience of medical officers in the diagnosis and treatment of psycho-neurosis. Another was the degree of discipline, moral and esprit de corps in a regiment; this largely depended upon the personality of the commanding officer, the medical officer and the quartermaster, their efficiency in performing their duties and their endeavours to supervise the welfare of their men so far as the emergencies of war permitted. Thus confidence and will-power were inspired in the men to face with them any situation, and " shell-shock " cases were relatively few in such regiments as compared with the number of cases in a regiment with poor moral and discipline, where suggestion played an important part.

It is generally accepted by medical authorities in England and abroad that the stress and strain of war, including exposure to shell-fire, does not produce psychoses such as epilepsy, manic depressive insanity, dementia-praecox, obsessional psychasthenia, or an organic disease like general paralysis, but it may excite or reveal them. It is, however, admitted that exhaustion or toxic psychoses with mental confusion of a temporary character are often due solely to the stress and strain of war.

Relation of "Shell-shock" to Court-Martial Procedure. As a result of questions in Parliament and a debate opened on April 28 1920 by Lord Southborough, a War Office committee, with Lord Southborough as president, was constituted July 1920 with the following terms of reference:

" To consider the different types of hysteria and traumatic neurosis called ' shell-shock ' ; to collate the expert knowledge of the service medical authorities and the medical profession from the experience of the war, with a view of recording for future use the ascertained facts as to its crisis, nature and remedial treatment and to advise whether, by military training or education, some scientific method of guarding against its occurrence can be devised."

In the House of Lords debate, in which Lord Home, Viscount Peel and Lord Haldane took part, a good deal of attention was devoted to court-martial procedure, and especially in relation to " shell-shock " and to death sentences in connexion with cowardice and desertion. From what was said it seems probable that in the early days of the war, before " shell-shock " was fully understood, a few men were shot who, in the light of further knowledge and experience, could not have been held responsible for their actions. The question arises, When is a man who has pleaded " shell-shock " (taken in its widest acceptance) to be held responsible for and conscious of the quality of his acts? The psychology of the emotion of fear in relation to the instinct of self-preservation and the will-power to control supplies a basis upon which to answer this question. The emotion of fear is associated with three instinctive reactions, as we see in animals: (i) flight; (2) immobility; (3) concealment. In war practically every man, even the bravest, before a battle may experience fear; but a soldier should, by suitable training and confidence in his superior officers, overcome this by will-power, and thus convert the primary reaction of fear into that of anger. How can a medical officer differentiate between cowardice and fear causing an irresponsible lack of will-power in a man to control his actions in the face of difficulties and dangers? The doctor should know the man's personality, his previous record and what his comrades thought of him. It is not so much what he says as what he did, or what he has done, which will help towards a decision. There are, however, certain signs in a man who refuses to go forward in action or who runs away, that show he cannot be held altogether responsible for his action. He may be dazed in consequence of " shell-shock " and be the subject of mental confusion; there may be physical signs of fear over which he has no voluntary control, namely rapid action of the heart, dilatation of the pupils, sweating, blueness and coldness of the hands, often protrusion of the eyeballs, and an expression on the face which is hard to simulate. These conditions, associated with trembling, are sufficient indications of true fear inhibiting the will.

Out of the psychology of fear arises the question whether in recruiting there is any test by which the unfitness for active service on account of a nervous disposition can be ascertained. And, if so, whether it would be desirable to eliminate from the army such a man without probation. It is a fact that many highly intelligent men with nervous instability may, if suitably trained, develop into most efficient officers and non-commissioned officers. Much depends upon the method of training and on those who undertake the training. A sensitive nature with self-esteem must not be broken by harshness or injustice, which produces a mental conflict ending in an anxiety-neurosis or neurasthenia. It is generally admitted that under no circumstances should an imbecile, an epileptic or an individual who has suffered with a previous attack of insanity be recruited.

For further information the reader is referred to Parliamentary Debates, House of Lords, Wed. April 28 1920, vol. xxxix., No. 29. See also Sir F. W. Mott, Shell Shock and War Neurosis (1919).

(F. W. Mo.) SHERMAN, JAMES SCHOOLCRAFT (1855-1912), American politician, was born near Utica, N.Y., Oct. 24 1855. He graduated from Hamilton College in 1878, was admitted to the bar in 1880, and practised in Utica until 1907. In early manhood he left the Democratic party, became a Republican, and as such was elected mayor of Utica in 1884. In 1886 he was elected to the National House of Representatives and was returned continuously until 1908, excepting the term 1891-3. He was a delegate to the National Republican Convention in 1892; chairman of the Republican State Convention in 1895, 1900, and 1908; and chairman of the Republican National Committee in 1906. For 12 years he was chairman of the House Committee on Indian Affairs a subject naturally of great interest to him, as he was a relative of Henry R. Schoolcraft (see 24.359) and the Sherman Institute in California, an Indian school, bears his name. At the Republican National Convention of 1908 he was nominated vice- president on the first ballot and was elected on the ticket with William Howard Taft. Four years later he was renominated, but he died at Utica, Oct. 30 1912, shortly before the elections.

SHEVKET, MAHMUD (1858-1913), Turkish pasha, was born at Bagdad in 1858, and from early youth showed marked qualities of intellect and personality. He received his military training at the military college in Constantinople, 1875-80, and after a very brief period of service with the troops was given an appointment on the general staff. Von der Goltz, who at that time was reorganizing the Turkish army, thought very highly of the young Shevket, and it was through his agency that the latter was sent to Germany to manage the reequipment of the Turkish army. As a result he remained from 1884 to 1894 in the small arms factory of Mauser Bros., at Oberndorf on the Neckar. He also studied armament problems in France for a short time, and in 1894, as the reward of his labours, was made inspector of military arsenals in Constantinople. From 1901 to 1903 he was military governor of the Hejaz, in Arabia, then in what amounted to a state of war. He next went in a like capacity to Kossovo (Uskub), and there came in contact with the Young Turk movement, which had its headquarters in Salonika. In 1908 Abdul Hamid averted the break-up of the old regime by summoning a National Assembly. This state of things, however, did not last long. In the spring of 1909 the Old and Young Turks were struggling for supremacy. A powerful Old Turk counter-revolution was prepared, but, in mid-April, the III. Army Corps, under Hussein Husni Pasha, marched from Salonika against Constantinople. At San Stefano Mahmud Shevket took over the command, and, after heavy fighting, forced his way on April 4 into Constantinople. Impressed by his victory the National Assembly no longer dared to oppose the will of the Young Turks, and on April 26 voted the deposition of Abdul Hamid. Mahmud Shevket was the hero of the day. But he did not care for politics, which he considered had been the ruin of the Turkish corps of officers, and preferred to confine his activities to purely military matters. The next few years afforded him plenty of opportunities. In 1910 and 1911 he put down a revolt of the Malissors with great energy, and in 1912 fought against the rebels in Albania. In the summer of 1912 he became Minister of War, and in Jan. 1913 succeeded Kiamil as Grand Vizier. He took a very