French neuropsychiatry in the Great War: between moral support and electricity

In World War I, an unprecedented number of soldiers were suffering from nervous disturbances, known as war psychoneuroses. Mechanisms of commotion, emotion, and suggestion were defined in order to explain these disturbances. In France, emphasis was placed on the mechanism of suggestion, based on pithiatism, introduced by Joseph Babinski (1857-1932) before the war to highlight the concept of suggestion and its hazy border with simulation. As a result, many soldiers suffering from war neuroses became considered as simulators or malingerers who were merely attempting to escape the front. A medical-military collusion ensued with the aim of sending as many of these nervous cases back to the front as possible through the use of painful or experimental therapies. Aggressive therapies flourished including torpillage, a particularly painful form of electrotherapy developed by Clovis Vincent (1879-1947) and subsequently by Gustave Roussy (1874-1948). At the end of the war, some psychiatrists, such as Paul Sollier (1861-1933), Georges Dumas (1866-1946), and Paul Voivenel (1880-1975), developed a more psychological approach. In Great Britain, where Charles Myers (1873-1946) coined the term shell shock in 1915 to describe these cases, psychological theories were more successful. In Germany, aggressive therapies developed by Fritz Kaufmann (1875-1941) emerged in the second part of the war. In Austria, the future Nobel Prize winner Julius Wagner-Jauregg (1857-1940) was accused of performing violent therapies on patients with war neuroses. These methods, which now seem barbarian or inhuman, were largely accepted at the time in the medical community and today should be judged with caution given the cultural, patriotic, and medical background of the Great War.