Controlled Assessment Shell Shock Case Study 2012

SHELL SHOCK CASE STUDY

Captain Charles Myers, a British Physician authored a

significant case study of three wounded soldiers with
“shell shock” in the Lancet, the publication of the British
Medical Society. Myers begins his discussion of the three
cases by calling them “remarkably similar.”
Your task is to identify the symptoms of each case.
1. Rank the severity of each symptom within each case
study- FOR ALL 3 SOLDIERS
2. Identify the similarities between cases and create
your own definition of shell shock.

Soldier # 1:
Myers says of the first soldiers combat experience:
“The patient says he was buried for 18 hours owing to a shell bursting and
‘blowing in’ the trench in which he lay.”
This soldier also has lost his sense of smell and much of his sense of taste.
While some “memory” of the events around the time of his injury returned,
comparison to his later description of events was not consistent with what other
soldiers who survived the battle remembered. While Myers seemed troubled by
the conflict in these stories, it can clearly be explained by the brain injury
symptom of “confabulation” (the replacement of a gap in a person's memory by
a falsification that he or she believes to be true)
Soldier # 2:
Myers describes the second soldiers’ case as follows: “During the (retreat) from this
trench at 1:30 p.m., they were “found” by the German artillery. Up to that time he had
not been feeling afraid; he had rather ‘been enjoying it’ and was in the best of spirits until the
shells burst about him… He was trying to creep under wire entanglements when two or three
shells burst near him. As he was struggling to disentangle himself from the wire, three more
shells burst behind and one in front of him. After the shells had burst he succeeded in getting
back under the wire entanglements. … Immediately after the shell burst in front of him his
sight became blurred. It hurt his eyes, and they burned when closed. At the same moment he
was seized with the shivering, and the cold sweat broke out especially around the loins “like a
punch on the head, without any pain of it’. The shell in front cut his haversack (supply bag)
clean away, bruised his side, and apparently it burned his little finger. …“When he got to
treatment… he was crying the whole time and worrying as to whether he was going blind. …
At the dressing table station he was crying and shivering; he was taken thence to a hospital by
horse ambulance… He thinks he must have slept on the ambulance, as he remembers nothing.
 Controlled Assessment Shell Shock Case Study 2012
(Emphasis in original.) Three months post injury ‘says he has lost the sense of taste and smell
since the shell’s burst around him.’ Woke up last night and found himself crying: ‘not
thinking of anything in particular’. Past history: He had been for two months in the Aisne
district on the lines of communication, sleeping badly all the time owing to lumbar (lower
back) pain… He had failed to pass a medical examination some time previously because of
renal (kidney) trouble.

Soldier # 3:

Myers detailed the history as follows:

The patient says was blown off a heap of bricks, 15 feet high, owing to a shell bursting
close to him. Thinks he must have fallen into a pool of water, as he next remembers finding
himself, about 3 p.m., the same afternoon in a cellar near a church with his clothes drenched.
He does not know how he got there or how he left the cellar, but he remembers being in
another hospital before he was admitted here.” Myers details this soldier’s symptoms as
follows: “A healthy-looking man, well-nourished, but obviously in extreme nervous
condition. He complains that the slightest noise makes him start. His legs feel weak and he
has pain in the precordial (chest) region. His sight has been very much impaired since the
shock. …

He has slept very little the last two nights. Hands tremulous. Knee jerks normal, but the first
attempts to evoke them provoked a spasm of the calf muscles and a few general convulsive
movements as the patient lay in bed. His hands became very tremulous and his forehead
sweated profusely. He appeared as if about to faint and says that he felt cold and dizzy, and
experienced round and round movements of the stomach. … The slightest touch on the legs
provoked well-marked spasm of the quadriceps muscles of the same thigh. Extensor muscles
of the toes appeared to be in a state of clonic contraction. Left nostril fails to detect smell of
ether, peppermint, eucalyptus, ammonia, carbolic acid, or iodine tincture, all of which are at
once recognized when placed beneath the right nostril. No signs of nasal obstruction. Taste:
Only tastes very strong solutions of sugar, salt and acid…”

Symptoms Severity Similarities

10= Severe to other
1= Low
cases?
1.

2.

3.

4.
 Controlled Assessment Shell Shock Case Study 2012

5.

MY DEFINITION OF SHELL SHOCK IS:

Controlled Assessment Shell Shock Case Study 2012