The first systematic discussion of the relationship between physical and psychological stress dates back to World War I. The history of that discussion Linsitinib molecular weight provides an informative context for current controversies concerning PTSD and TBI.1 Combat techniques in World War I introduced new types of combat stress that had not existed during previous wars. Soldiers engaged in trench warfare were relatively immobile and therefore more vulnerable. They were also chronically exposed to new and perversely Inhibitors,research,lifescience,medical lethal threats, such as poison gas, machine gun fire, mortar attacks, land mines, and tanks.

Casualties were devastating, and fatality rates were frightening. Men watched their friends die beside them, and they confronted Inhibitors,research,lifescience,medical the possibility of their

own demise on a daily basis. Alternatively they might be maimed and consigned to a life of chronic disability. As the war progressed, the high casualty rate made it clear that. Britain and continental European countries were losing many of an entire generation of young men―a social loss from which they would be slow to recover. This sense of futility and despair was eloquently expressed by British war poets such as Wilfred Owen and Siegfried Sassoon: Earth’s wheels run oiled with blood. Forget we that. Let us lie down and dig ourselves in thought. Beauty is yours and you have mastery. Inhibitors,research,lifescience,medical Wisdom is mine, and I have mystery. We two will stay behind and keep our troth. Let us forego men’s minds that are brute’s natures, Let us not sup the blood which some say nurtures, Be we not swift with swiftness of the tigress. Let us break ranks from those who trek from progress. Miss Inhibitors,research,lifescience,medical we the march of this retreating world Into

old citadels Inhibitors,research,lifescience,medical that are not walled. Let us lie out and hold the open truth. Then when their blood hath clogged the chariot wheels We will go up and wash them from deep wells. What though we sink from men as pitchers falling Many shall raise us up to be their filling Even from wells we sunk too deep for war Even as one who bled where no wounds were. Wilfred Owen Strange Meeting Project Gutenberg Etext of Poems by Wilfred Owen In this context of brutal bloodshed and omnipresent fear, a new and somewhat unfamiliar type of disability emerged that had not been described in previous wars: a syndrome characterized by confusion, memory impairment, Rolziracetam headache, difficulty concentrating, tremor, and sensitivity to loud noises. This was initially assumed to be due to exposure to explosions, leading to concussions of the brain (“commotion cerebri”) in the absence of visible signs of external head trauma, and the disorder began to be referred to as “shell shock.” Postmortem examination of two cases revealed a variety of abnormalities, particularly vascular damage and congestion.2 As the war progressed, the number of shell shock casualties grew alarmingly.