Hospitals
What Queen Square notes show about shell shock
Open access · cc by · source: Europe PMC
Linden and Jones analyse 462 National Hospital case files and find motor-heavy “functional” syndromes, few psychogenic seizures versus Germany, and almost no malingering labels.
Study at a glance
- Design
- Qualitative / archival — Coded analysis of National Hospital functional neurological case files, 1914–1919
- N
- N=462 · 462 servicemen with functional neurological disorder of 1,212 military admissions
- Population
- Military patients at London’s National Hospital during World War I
- Outcome
- Motor-heavy functional syndromes, rare psychogenic seizures vs Berlin, and few malingering labels
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
Motor and sensory loss dominated; anxiety/depression and autonomic symptoms were common; psychogenic seizures were rarer than in Berlin (about 3.5 times less). Labels shifted from shell shock/traumatic neurosis toward functional disorder and, by 1918, hysteria. Average stay was 69 days; 83 percent were privates.
Methodology
They coded biographical data, service history, symptoms, diagnoses, and outcomes for every serviceman admitted with functional neurological disorder from 1914 to 1919 (462 of 1,212 military admissions).
Limitations
No follow-up proves cures lasted; officers are under-counted (separate hospitals; private notes lost). The files cannot settle organic versus psychical aetiology, only how Queen Square recorded and treated cases.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
Coding a full series of case files reveals patterns invisible in single cases. Linden and Jones coded biographical data, service history, symptoms, diagnoses and outcomes for 462 of 1,212 military admissions to the National Hospital from 1914 to 1919, finding motor and sensory loss dominant, psychogenic seizures about 3.5 times rarer than in Berlin, almost no malingering labels, an average stay of 69 days, and 83 percent privates. Labels shifted from shell shock toward functional disorder and, by 1918, hysteria.
Evidence for the claim as stated.
Case files record how an institution classified and treated, not what was biologically true. The National Hospital files cannot settle organic versus psychical aetiology, only how Queen Square recorded and managed cases, and no follow-up proves that recorded improvements lasted.
Evidence for the claim as stated.
Scale trades against voice. The 462-file coded series can quantify symptom profiles and lengths of stay but treats each patient as a set of staff-recorded variables; the single Lea file gives a patient's own words at length but is, as the authors say, one literate English-speaking patient's file and not a representative survey of Cape inmates.
Evidence for the claim as stated.
Studies differ on how far the patient can be heard through the record. The Lea letters and the almoner correspondence are presented as genuine patient voices, whereas the National Hospital files show only how staff coded cases, and the Morningside Mirror was edited before it reached print. The same category of source runs from near-direct testimony to fully mediated record.
Evidence for the claim as stated.
Open questions
Tensions this paper is part of
From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.
Scale trades against voice. The 462-file coded series can quantify symptom profiles and lengths of stay but treats each patient as a set of staff-recorded variables; the single Lea file gives a patient's own words at length but is, as the authors say, one literate English-speaking patient's file and not a representative survey of Cape inmates.
- Supports · Richard Lea’s letters from Cape asylums
Studies differ on how far the patient can be heard through the record. The Lea letters and the almoner correspondence are presented as genuine patient voices, whereas the National Hospital files show only how staff coded cases, and the Morningside Mirror was edited before it reached print. The same category of source runs from near-direct testimony to fully mediated record.
- Supports · Richard Lea’s letters from Cape asylums
- Supports · What did TB patients write to hospital almoners?
- Supports · The Morningside Mirror as moral treatment
Discoveries this paper informs or conflicts with
- The diagnosis moved three times while the patients stayed the same
This paper informs this development.
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Same topic cluster — not a recommendation engine.