War Neuroses and Arthur Hurst: A Pioneering Medical Film about the Treatment of Psychiatric Battle Casualties

Abstract

From 1917 to 1918, Major Arthur Hurst filmed shell-shocked patients home from the war in France. Funded by the Medical Research Committee, and using Pathé cameramen, he recorded soldiers who suffered from intractable movement disorders as they underwent treatment at the Royal Victoria Hospital in Netley and undertook programs of occupational therapy at Seale Hayne in Devon. As one of the earliest UK medical films, Hurst’s efforts may have drawn inspiration from the official documentary of the Battle of the Somme and films made in 1916 by French Army neurologists. Although initially motivated to make use of a novel medium to illustrate lectures, Hurst was alert to the wider appeal of the motion picture and saw an opportunity to position himself in the postwar medical hierarchy. Some “before treatment” shots were reenacted for the camera. Hurst, like some other shell shock doctors, openly used deception as a therapeutic measure. On the basis that the ends justified the means, they defended this procedure as ethical. Clinicians also took advantage of changes in military regulations to address functional symptoms. Claims made of “cures” in the film and associated publications by Hurst were challenged by other doctors treating shell shock. The absence of follow-up data and evidence from war pension files suggested that Hurst may have overstated the effectiveness of his methods. Nevertheless, the message conveyed in the film that chronic cases could be treated in a single session had a powerful resonance for ambitious or charismatic doctors and was revived in World War II.

Shell Shock: Psychogenic Gait and Other Movement Disorders - A Film Review

“…For example, Hurst fails to describe the exact definitions of “persuasion and re-education”. In a separate documented interview, Hurst commented that re-education encompassed bed rest, isolation from loud noises, fresh air, isolation from sunlight, and fake surgery 8. When treating a patient he often removed any references to the war, recommended resting the body and mind, recommended refraining from alcohol, and he also recommended the repression of all memories of recent events 6.…”

“…In 1905, he won a Radcliffe traveling fellowship that shaped his future practice as a physician. He chose to go to France and Germany, where he met some of the greatest neurologists of the time, including Dejerine, Babinski, and Marie 8,9. In 1907, Hurst was appointed initially as a physician of the Electrical Department, but was quickly promoted and started the first Neurology Outpatient department at Guy’s Hospital.…”

“…In 1915 he left to serve in WWI, initially in the Gallipoli campaign, and later in Salonika, before he returned in 1916. Hurst then persuaded the military to convert Seale Hayne Agricultural College into a special hospital for the treatment of war neuroses 8. It was at this time in 1917 when he began his transformation into a leading light in the treatment of these conditions.…”

“…During this time he was able to persuade the French film industry, the Pathé Motion Picture Co., to help with production of the movie for 8 months. The film was used for training and research 8. The overall purpose of the film was educational, and aimed to clarify the diagnosis of various manifestations of shell shock and to document the effects of treatment.…”

‘Shell shock’ Revisited: An Examination of the Case Records of the National Hospital in London

“…(See Figure 3) A great diversity of abnormal, and often bizarre, gait patterns is documented in the Queen Square records and in medical publications of the time 83 as well as in Arthur Hurst's film on War Neuroses. 84 To illustrate this diversity of gait disorders, we have chosen five cases of soldiers admitted to Queen Square who presented with abnormal gait patterns:…”