Delusional Insanity..... George Walter Hickman 4th Worcestershire Reg't

[wibs]

HI,

 

Are you able to help decipher the attached two pages, specifically the narrative text regarding his disability (i.e. primarily bottom half of first page and top paragraph from second page).  I'm keen to understand how his condition was written up by the medical team of the day.

 

I've never heard the term 'Delusional Insanity'......... then again I've not seen huge amounts of service / pension records, but even so it's a new one on me and keen to learn more....... assume it was a phrase to cover what we refer to as shell-shock?...... it seems Pte Hickman was under fire for much of his time (a quick look shows the 4th Bn in Gallipoli and then to France).  After being invalided out in May 1918 he was sent to an asylum and died 12 months later.  

 

I can read the bare bones of the text but rather than put my 30% transcript and ask you to fill in the blanks I'm hoping you can simply do a 100% transcript...... genuinely not being lazy (!) just thought it easier to do a 'clean' read through rather than have me do some of it, and do some of that wrong no doubt!

 

Many thanks in anticipation...

 

Paul

 

 

[ss002d6252]

1 hour ago, wibs said:

 

I've never heard the term 'Delusional Insanity'......... then again I've not seen huge amounts of service / pension records, but even so it's a new one on me and keen to learn more....... assume it was a phrase to cover what we refer to as shell-shock?...... i

I'd suspect more that it was some sort of schizophrenia or similar as he was starting to show some odd symptoms such as 'curious views on religion'. A lot of people who would probably not have otherwise manifested with various mental health issues did so because the stress brought them on or otherwise aggravated existing issues.

Craig

[Dai Bach y Sowldiwr]

What Craig said.

Or a schizoid personality type in whom delusions and pressure of speech came to the fore under severe stress of war.

[knittinganddeath]

Some bits that I've managed to decipher:

 

Generally indifferent.

Reflexes absent

Pupils equal + normal.

curious views on religion

was emotional

very obsessed with some religious connection

talking about his religion

12a) Attributable to service during the present war + exposure to shell fire.

 

He pretends not to understand
what is said + gives evasive answers.
His health is fair + he sleeps well.
Conduct good.

 

I'll try to work on it a bit more later.

 

[wibs]

Thanks all so far..... comments from Craig and DBS re combat stress bringing underlying issues out to the fore make sense, thanks.

 

10 minutes ago, knittinganddeath said:

I'll try to work on it a bit more later.

 

Fabulous stuff so far!!!....... I was defo right not to put my thoughts, I couldn't interpret half of what you have.... appreciate anything further as and when......

 

Paul

Edited 11 May , 2021 by wibs

[TEW]

The Lord Derby War Hospital Warrington may well have more on this man in the Cheshire & Chester Archives. Not sure it'll add much to the information in these sheets other than if there are case notes or discharge details that should link to the Asylum.

 

I looked through war period Asylum admissions at my local archive and picked out the military admissions as they were admitted under an Army form from EG. Warrington. Attached to the Army form there were additional sheets with letters from family, doctors' notes and sometimes discharge information or details of the death.

 

A long shot I know.

TEW

 

Army Form B 261

Edited 11 May , 2021 by TEW
Additional

[Dai Bach y Sowldiwr]

Generally indifferent.

Reflexes absent    KJs X [ Meaning = Knee Jerks (ie. refllexes) absent]

Pupils equal + normal.

 

[knittinganddeath]

Am mostly accustomed to transcribing German, and my brain is having a hard time making English words out of the scribbles ;-) So this is the best that I can do. Spoilered so as not to prejudice anyone else's reading of it.

 

Spoiler

 

Had 15 mos. service, went to Suvla about
Nov. 1915. Was under fire. Then to Limnos
& Cape Helles & to Egypt & thence to France in March 1916. Been
under fire for some time. Sent sick by adjutant. 93 . . . . emotional,
sleeps well. Generally indifferent. Reflexes absent K Js x. Pupils equal
& normal. He was admitted to 87 Field Amblcs. in France 12.6.16
thru to No.  . . . . in the field on 14.6.16. He was admitted to No. 8 Gen.
Hospl. Rouen on 16.6.16. He had curious ideas
about religion. Was emotional, . . . . + very obsessed with some religious
connection. Admitted to “D” Block Netley on 25.6.16. On 27.6.16
admitted to L[or]d D[erby] W[ar] H[ospital]. He was quiet, + . . . .
emotional + . . . .  Continually talking
about his religion.

 

Attributable to service during
the present war + exposure to shell
fire.

 

He is . . . . . . . . . . . .
. . . . . + talks . . . . Says . . . .
when he is . . . . he can . . . . . . . . + that
he is . . . . . . . . because he has been
cut + torn about so much he can’t
show the . . . . + eats because they are
all . . . . He pretends not to understand
what is said + gives evasive answers.
His health is fair + he sleeps well.
Conduct good. He is inoffensive.

 

 

Edited 11 May , 2021 by knittinganddeath
filled in missing words -- thanks TEW and Dai Bach y Sowldwir

[wibs]

8 minutes ago, knittinganddeath said:

Am mostly accustomed to transcribing German, and my brain is having a hard time making English words out of the scribbles ;-)

 

If that's what you can do in a second language then take a bow sir......... 

[TEW]

It may seem odd that given his condition was attributable to the war & exposure to shell fire that they don't mention shell shock. I think this is probably down to his unusual presentation, it doesn't conform to any presentations for functional disorders EG. mutism.

 

I note they originally had MALINGERING down as his disability, given they say he pretends not to understand they may have believed he was trying it on and there was 'swinging the lead' a bit.

 

Difficult to prove one way or another and after being in the Lord Derby for almost two years one would think they would have been able to establish a better understanding other than he pretends or the MALINGERING aspect. Malingering I doubt is a bona fide diagnosis but is an official army term for pretence, faking it, etc. Malingering had to be changed for something so Delusional Insanity was applied, it's not uncommon to see Delusional Insanity. His one day in D Block, Netley could be interpreted as they felt D block was not the place for him which suggests his condition was believed by Netley not to be that serious.

 

His death certificate could be quite telling though.

 

I have a record of a man who became mute but could verbally communicate by singing. He was also a serial malingerer, deserted for a year. He claimed to have shell shock and stuck to his detailed story and ended up discharged with shell shock. His story falls apart into fiction when one reads his unit diary for the day and that they they didn't go over the top that day.

TEW

[knittinganddeath]

2 hours ago, wibs said:

If that's what you can do in a second language then take a bow sir......... 

 

Thanks, English is actually my first language, but I mostly occupy myself with German soldiers' correspondence, so have very little experience reading handwritten English text ;-)

 

Like TEW, I thought the note that he "pretends not to understand + gives evasive answers" could indicate that they thought he was faking it. Did shell-shocked soldiers typically "sleep well"? Also, what kinds of connotations did "emotional" have then?

Edited 11 May , 2021 by knittinganddeath

[Dai Bach y Sowldiwr]

Missing words:

Suvla. Limnos, Cape Helles...

[edwin astill]

I am helping with the WFA project on disability.  I am just transcribing material, but in so doing it has struck me that some MOs were being generous in ascribing some conditions to war service.  Also, if a man enlisted with a condition that the initial examining MO failed to spot, to say that is was not due to war service would be a reflection on that MOs professionalism.  Nowadays you would have them up for substantial damages.  

 

No evidence - I've not seen the men - just a feeling I got going through hundreds of records!

So I wonder what our man was like on enlistment!

 

Edwin

[helpjpl]

First page: 

Had 15 mos* service.  Went to Lemnos about Nov 1915 was under fire. Then to Lemnos & Cape Helles & to Egypt & thence to France in March 1916. Been under fire for some time. Sent sick by adjutant. Is reticent, ____ sleeps well, Generally indifferent. Reflexes absent K Js X. Pupils equal & normal. He was admitted to 87 field amblce** in France 12.6.16 then to no. 29 C.C.S.*** in the field on 14.6.16.  He was admitted to no 8 Gen Hospl Rouen**** on 16.6.16. He had curious ideas about religion.  Was ____,  ____ & very obsessed with some religious conviction.  admitted to 'D' Block _____ on 25.6.16.  On 27.6.16  admitted Ld D.W.H. He was quiet, depressed ____ & _____. Continually talking about his religion. 

 

attributable to service during the present war & exposure to shell fire

 

*     mos = abbreviation for months

**    No. 87 Field Ambulance

***   No. 29 Casualty Clearing Station

****  No. 8 General Hospital, Rouen

 

Second page:

Not sure of the first 2½  lines: 

….. he can speak and that he is like gristle because he has been cut and torn about so much & that he can't show the scars & cuts because they are all inside.  He pretends not to understand what is said & gives evasive answers.  His health is fair & he sleeps well.  Conduct good. He is inoffensive.

 

JP

[wibs]

As ever, cracking support from the forum members, thank you all.  Despite a couple of bits and pieces that seem to have flummoxed us all, you've provided me with an almost total transcription.

 

Also given me food for thought....... I can definitely see the sense in positing the idea he was potentially faking it to some small or large extent.... that last sentence about ".... he pretends not to understand what is said and gives evasive answers..." seems to leave no room for any other interpretation.

 

That said I can't help but struggle with the fact he was in the medical care of the army for 2yrs before being discharged to an asylum and accepting that it was all a ruse....... I've ordered the death certificate anyway to see if that adds anything, and will look into the asylum / hospital archives as suggested above.

 

Every day's a school day..... thanks again to all.

 

Paul

[TEW]

I couldn't make out the name of the CO of LDWH Warrington. FA Hadden was the doctor. Research on these two men could determine something of their opinions regarding contemporary mental illness. Papers on BMJ or Lancet perhaps?

 

I think writing MALINGERING and crossing it out still makes a statement of their beliefs. Maybe they believed he was pretending to not understand etc. but perhaps they chose to believe it to fit their belief system.

 

Even using the term emotional could be a slur on him as anything other than suppressing emotions was not manly.

 

His admission to 87 FA was for mania, religious and to 29 CCS for NYD Mental.

 

I doubt he faked insanity from a FA back to LDWH for two years and another year in an Asylum then dying there. He left a wife and four children.

 

Interested to see what the DC details but I don't think the story so far bodes well.

TEW

 

 

 

 

[seaJane]

11 hours ago, TEW said:

note they originally had MALINGERING down as his disability,

I read the deleted word (above Delusional Insanity) as MELANCHOLIA.

 

[kenf48]

The term ‘shell shock’  was discredited, largely due to it’s prevalence amongst the soldiers who would self diagnose. The condition was known about before the war and the term was only in use for a relatively short period, less than two years.  On 21 November 1916 MOs were instructed to record cases of neurosis/mental exhaustion as NYDN (Not yet diagnosed Nervous).

Eventually, once the recognised mental condition was diagnosed then that term was used.  As the document was dated 1918 then delusional insanity or psychosis was the correct psychiatric diagnosis.  There may be a reference to shellshock elsewhere in the record as the original onset predates the instruction.

 

24 minutes ago, seaJane said:

I read the deleted word (above Delusional Insanity) as MELANCHOLIA.

 

Well spotted I knew it wasn’t ‘malingering’ but couldn’t put it together.  Melancholia,as you are no doubt aware,  frequently occurs in the literature,e.g. Medical Diseases of the War.

[seaJane]

2 minutes ago, kenf48 said:

you are no doubt aware

Rather! I have just posted up the latest version of the medical bibliography. It isn't divided by subject but it is searchable, and I have tried to provide links to online copies where possible.

[TEW]

Apologies for my MALINGERING.

 

I am looking at another man's pension file he was discharged 8/4/18.

His section 8. Disability in respect of which invaliding is proposed has - Shell Shock.

 

The Medical Report on an Invalid is a pension rather than medical form. For pension purposes it seems shell shock is a bona fide disability. I think the terms chosen depend on the doctor and the hospital. The disability noted in section 8 has a number code added on some files. They must have worked from lists of numbered disabilities.

 

I'm looking at other pension files and see a man who had a phobia of VD, his section 8 has Neurasthenia.

TEW

[wibs]

On 12/05/2021 at 08:53, seaJane said:

I read the deleted word (above Delusional Insanity) as MELANCHOLIA.

 

 

Great spot... once you see it it looks obvious!........ that said, still doesn't explain the statement that 'he pretends not to understand and is evasive'..... 

 

I searched for further info on the Lord Derby War Hospital and found the following article at the Cambridge University Press.  Cost a few quid but happy to share it for the benefit of others.

 

It says it's an admissions register but it's not exactly that i.e. it does not provide a line by line list of patient names / conditions / dates of admission / discharge etc.

 

It is, however, an interesting read and gives an insight into what was thought about mental health conditions identified in those that had served at home and abroad.

 

It's more a summary analysis of the admissions over a 12 month period..... why admissions were made, headline numbers split across different conditions, what characterized mental health at the time....... in some cases it also provides small precis references of individual cases using the soldiers initials, rank and sometimes regiment. 

 

Article is an extract only from the Journal of Mental Science, Volume 64, Issue 266 JUly 2018, 272-296.  Copyright @ Royal College of Psychiatrists 1918

 

"A Record of Admissions to the Mental Section of the Lord Derby War Hospital, Warrington, from June 17th 1916 to June 16th 1917"

 

Paul

a-record-of-admissions-to-the-mental-section-of-the-lord-derby-war-hospital-warrington-from-june-17th-1916-to-june-16th-1917.pdf

 

[seaJane]

2 hours ago, wibs said:

still doesn't explain the statement that 'he pretends not to understand and is evasive'..... 

Well - that sentence gives the doctor's interpretation, which may be wide of the facts...

[helpjpl]

On 12/05/2021 at 21:40, seaJane said:

Well - that sentence gives the doctor's interpretation, which may be wide of the facts...

 

I think the The Medical Report was completed by Lt Francis Albert Hadden, RAMC:

 

1.  Medical Directory 1915:

 

2.  1919 Probate Calendar (from ancestry):

 

3. Died 22 June 1919, age 54, and buried Willesden New Cemetery (CWGC):

https://search.findmypast.co.uk/search/british-newspapers?date=1905-10-15&date_offsetdate=1905-10-21&lastname=pell&modifiedfacets=true&exactnames=true&exactkeywords=false&_=1620816274737&d=asc&o=date

JP

[kenf48]

4 hours ago, TEW said:

The Medical Report on an Invalid is a pension rather than medical form. For pension purposes it seems shell shock is a bona fide disability.

The OH Medical Services Diseases of the War Volume II on page 58 has a table showing the four recognised classes for pension purposes drawn up by the Ministry of Pensions.

 

Class 1 Cases definitely attributable to shell shock i.e. explosions of all kinds (commotion)

(It is perhaps worth noting shell shock in the Army was originally diagnosed as Shell shock (W) wounds or Shell shock (S) sickness, the former being attributable to being blown up/buried etc)

Class II Cases due to war stress (emotion) and developing before discharge from the service

Class III as above but after discharge

Class IV Cases due to family and social conditions and financial distress developing subsequent to war service.

Nearly 50% were in Class IV with only 20% in Class 1

 

As a matter of interest though no longer relevant the same volume notes once in the UK 'malingering' was very rare and men were seen as suffering from mental illness.

 

[Matlock1418]

As per Medical Report: George Walter HICKMAN

One pension card on WFA/Fold3 for a Disability pension on discharge

1.5.18 = 15.5.18 to 2.6.18 at 27/6 pw = 100% disability for a Pte.

 

Two cards from WFA/Fold3 - as Walter HICKMAN

= A 20.1.1920 pension claim was made by his widow Elizabeth Ann [their strike-through 12/2/1926] of 68 Buckpool, Wordsley, Stourbridge

and further strike-throughs changing his name from George Walter HICKMAN on both cards [10/3/1926]

:-) M

Edited 12 May , 2021 by Matlock1418
addition