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The First World War marked a turning point in British military medicine. Never before had the British Army's administrative structure had to cope with such an overwhelming number of cases of psychological disorder, and at different stages during the war the influx of shell-shock sufferers threatened to reach almost epidemic proportions. There can be little doubt that few within the military, or for that matter the Royal Army Medical Corps (RAMC), were adequately prepared for the sheer number of psychological casualties of trench warfare, especially during the protracted and bloody campaign on the Somme in 1916, in which British losses amounted to 420,000 men killed and wounded (Merskey 1995a, p. 53).
The disturbing nature of this chapter in military history has prompted the publication of a vast range of literature on shell-shock over the past 25 years. Psychoanalysis occupies a particularly prominent position in retrospective accounts in that it has come to be associated with the ‘humane and sympathetic’ approach of ‘analytic’ physicians. Many authors argue that it achieved a moral victory over the ‘vicious methods’ (Shephard 2002, p. xx) of doctors working in a ‘disciplinary’ tradition (this account after Eric Leed and Elaine Showalter in particular). This is an argument about the position of both psychoanalytic practice and underlying theory - Showalter (1985) argues that Freudian ideas gained significant ground during the war - but much of its literary power derives from the singling out of emblematic figures, particularly William Rivers, in the context of a struggle against barbarism at home as well as in the trenches. The British military establishment, and more particularly the Royal Army Medical Corps (RAMC), is consistently portrayed as philistine and