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.

Shell shock is one of the iconic wounds of the Great War. The strains of this industrial warfare led to many kinds of war neuroses in soldiers involved in the conflict. In British armies, the term “shell shock” was first published in 1915 by Charles Myers (1873–1946) to define various troubles [1]. In the absence of pathognomonic symptoms of shell shock, several causative explanations were discussed. A direct result of physical damage of the nervous system was evoked by some medical doctors. Others were convinced that shell shock was purely psychological and regarded it as a conversion disorder. In order to send these soldiers back to the front as quickly as possible, some coercive psychotherapy techniques were developed. Suspicion of malingering also had a perverse impact on treatment methods. Aggressive electrotherapy was used mainly in France and to a lesser degree in -Germany.

In London, at Queen Square, from late 1915, the neurologist and temporary captain Edgar Adrian (1889–1977) and the resident medical officer Lewis Yealland (1884–1954) devised an intensive electrotherapeutic treatment [2]. Edgar Adrian was later awarded the Nobel prize for research on the functions of neurons [3]. This procedure was similar to the faradic psychotherapy developed in France by Clovis Vincent (1879–1947) and Gustave Roussy (1874–1948) and to the persuasive electrotherapy of Fritz Kaufmann (1875–1941) in Germany [4, 5]. Adrian and Yealland were mainly in charge of shell-shocked soldiers affected by objective disorders such as paralysis, gait disorders or loss of speech. Their faradic procedure, based on 3 principles – suggestion, re-education and discipline – seemed to induce positive results [2].

As for the French neurologists using “torpillage,” Adrian and Yealland considered that the pain accompanying the use of faradic current was necessary for both therapeutic and disciplinary reasons. They wrote:

The current can be made extremely painful if it is necessary to supply the disciplinary element which must be invoked if the patient is one of those who prefer not to recover, and it can be made strong enough to break down the unconscious barriers to sensation in the most profound functional anaesthesia [2].

This point of view was, at that time, widely accepted among military neurologists [6]. At the end of 1917, Adrian parted company with Yealland because he became convinced that the method did not prevent relapse. Yealland further developed his electric procedure [7]. After the war, Adrian went back to shell shock and its electric treatment explaining that war hysteria was a complex and difficult phenomenon. Frequently the bodily symptoms were only a minor part of a much more complex disease including headaches, depression, insomnia, irritability. According to Adrian, the controversial electric treatment was only able to remove motor or sensitive symptoms: “obviously there is still something wrong and the removal of bodily symptom has not been enough” [8].

There are no conflicting interests or financial support related to this work.

1.
Myers CS: A contribution to the study of shell shock. Lancet 1915; 185: 316–320.
2.
Adrian ED, Yealland LR: The treatment of some common war neuroses. Lancet 1917; 189: 867–872.
3.
Pearce JMS: Lord Adrian, MD, PRS, OM. Eur Neurol 2017; 79: 64–67.
4.
Tatu L, Bogousslavsky J, Moulin T, Chopard JL: The “torpillage” neurologists of World War I: electric therapy to send hysterics back to the front. Neurology 2010; 75: 279–283.
5.
Linden SC, Jones E: German battle casualties: the treatment of functional somatic disorders during World War I. J Hist Med Allied Sci 2013; 68: 627–658.
6.
Tatu L, Bogousslavsky J: World War I psychoneuroses: hysteria goes to war. Front Neurol Neurosci 2014; 35: 157–168.
7.
Linden SC, Jones E, Lees AJ: Shell shock at Queen Square: Lewis Yealland 100 years on. Brain 2013; 136(pt 6): 1976–1988.
8.
Adrian ED: Unpublished talk cited; in Shephard B (ed): A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century. Cambridge, Harvard University Press, 2001.
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