Frederick W Mott

Sir Frederick Walker Mott (1853-1926) was a distinguished neurologist who applied his expertise to military psychiatry. In his early career he undertook work, some of it with Charles Scott Sherrington, on neurons and reflexes, the path of conduction in the spinal cord, localisation in the cerebral cortex and the biochemistry of the endocrine glands. He was the first to diagnose the ‘general paralysis of the insane’ as neurosyphilis. This disease, which had been unknown before the 1780s, was responsible for many of the admissions to asylums during the nineteenth century. He also played a key role in the development of the Maudsley Hospital.

These images show a soldier with 'hysterical contracture' of his feet and toes before and after treatment. Taken from: Frederick W Mott. War neuroses and shell shock. London: Henry Frowde: Hodder & Stoughton, 1919 [ IoP Historical Collection h/Mot]Mott’s research background put him in a very good position to clarify the nature of both neurological and psychiatric disorders associated with active service in wartime. However, the precise connexions between physical injury, predisposition to psychiatric illness, overwhelming stress and the manifestation of symptoms of psychological disturbance remained opaque.

Although Mott states in this book that ‘shell shock’ is a useful term if limited to cases where there is definite evidence of a shell or bomb bursting near enough to knock a man down or blow him up in the air and cause a temporary loss of consciousness, the phrase had its origins in popular discourse and psychiatrists found that it encompassed too many diverse symptoms to be of much nosological use.

The neurologist Henry Head was among many who rejected shell shock as a useful category. According to him, it was ‘a heterogeneous collection of different nervous affections from concussion to sheer funk which may have merely this in common, that nervous control has finally given way’. Political considerations, such as the desire not to encourage ‘malingering’, not to ‘waste’ money on war pensions and to return soldiers to the front as quickly as possible, also intruded; there is a section in Mott’s book on ascertaining the physical signs of malingering.

It is arguable that Freudian-influenced psychiatrists, such as WHR Rivers, made better sense in elucidating the social and psychological causes of war-induced psychiatric disorder. However, Mott’s training as a neurologist stood him in good stead when trying to understand the suspension of the ‘flight or fight’ reflex in cases of ‘war neurasthenia’. He surmised that the endocrine glands’ role in producing what is now known as adrenalin had failed under the immense strain of combat.

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