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The Origins of the Anglo-American Research Alliance and the Incidence of Civilian Neuroses in Second World War Britain

Published online by Cambridge University Press:  17 May 2012

Stephen T Casper
Stephen T Casper
Affiliation:
Stephen T Casper, PhD, Clarkson University, Humanities and Social Sciences, 8 Clarkson Ave., Box 5750, Potsdam, NY 13699-5750, USA.
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Medical History , Volume 52 , Issue 3 , May 2008 , pp. 327 - 346
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Copyright © The Author(s) 2008. Published by Cambridge University Press

References

1 Desmond Flower, ‘London docks bombed, 7 September 1940’, and Frances Faviell, ‘The Blitz: Chelsea, 14 September 1940’, in John Carey (ed.), Eyewitness to history, New York, Harper Paperbacks, 1987, pp. 537–41.

2 ‘“Blind savagery” of night attacks’, The Times, 10 Sept. 1940, p. 2.

3 The Adolf Meyer Collection, Alan Mason Chesney Medical Archives of Johns Hopkins Medical Institutions, Baltimore (hereafter AMCMA), I/1659/16 Henderson, David K, letter from David Henderson to Adolf Meyer, 1 Jan. 1941; see also George O Kent, ‘Britain in the winter of 1940–41: as seen from the Wilhelmstrasse’, The Historical Journal, 1963, 6: 120–30.

4 Joanna Bourke, ‘Disciplining the emotions: fear, psychiatry and the Second World War’, in Roger Cooter, Mark Harrison and Steve Sturdy (eds), War, medicine, and modernity, Stroud, Sutton, 1998, pp. 225–34; Eric Hobsbawm, Age of extremes: the short twentieth century, 1914–1991, London, Michael Joseph, 1994, pp. 28, 143–77; Arthur Marwick, The home front: the British and the Second World War, London, Thames and Hudson, 1976; Ronald Blythe, The age of illusion: England in the twenties and thirties, 1919–1940, Harmondsworth, Penguin, 1964, pp. 294–316; Mark Mazower, Dark continent: Europe's twentieth century, London, Penguin, 1998, pp. 141–84; the late interwar political context can be found in Robert Rhodes James, The British revolution: British politics, 1880–1939, London, Hamish Hamilton, 1977, pp. 584–611; the medical context in Rosemary Stevens, Medical practice in modern England: the impact of specialization and state medicine, New Haven and London, Yale University Press, 1966, pp. 38–79. For the cultural context, see Modris Eksteins, Rites of spring: the Great War and the birth of the modern age, London, Bantam Press, 1989.

5 On rhetoric see, David Harley, ‘Rhetoric and the social construction of sickness and healing’, Soc. Hist. Med., 1999, 12: 407–35.

6 Numerous scholars have debated the role ideology plays in defining the truth of scientific knowledge. Steven Shapin, A social history of truth: civility and science in seventeenth century England, Chicago and London, University of Chicago Press, 1994, pp. 409–17; Steven Shapin, ‘History of science and its sociological reconstructions’, Hist. Sci., 1982, 20: 157–211; and Jean François Lyotard, The postmodern condition: a report of knowledge, Minneapolis, University of Minnesota Press 1989, pp. 3–67.

7 The origins of their collaboration cannot be disentangled from the context and rhetoric of the times, because it was the blitz that mainly prompted the crucial public outpouring of sympathy in North America for the British cause. Alan S Milward, War, economy, and society, 1939–1945, Harmondsworth, Penguin, 1987, pp. 55–98, on pp. 56–8; Nicholas Cull, Selling war: the British propaganda campaign against American “neutrality” in World War II, New York and Oxford, Oxford University Press, 1995, pp. 1–17; ‘The torrent of American sympathy. Help for the homeless poor in London. Mrs Roosevelt and the children’, The Times, 15 Oct. 1940, p. 5; see also ‘“All possible help for Britain”, Lord Lothian on American opinion. Growing cooperation with Canada. Governor-General's talks with President’, The Times, 21 Oct. 1940, p. 4. Not all of this aid to Britain was benevolent. “The loss of her allies and delays in home production forced Great Britain to buy from the United States large amounts of war and other provisions for which, under the terms of the Johnson and Neutrality acts, cash must be paid.” Alzada Comstock, ‘Financing national defense in Great Britain and Canada’, Ann. Amer. Acad. Pol. Soc. Sci., 1941, 214: 111–17, p. 116.

8 The most detailed study of the organization of science in America for this period remains Daniel J Kevles, The physicists: the history of a scientific community in modern America, Cambridge, MA, Harvard University Press, 1997; see also idem, ‘The National Science Foundation and the debate over postwar research policy, 1942–1945: a political interpretation of Science—The Endless Frontier’, in Ronald L Numbers and Charles E Rosenberg (eds), The scientific enterprise in America: readings from ISIS, Chicago and London, University of Chicago Press, 1996, pp. 297–319. For Britain, see David Edgerton, Warfare state: Britain, 1920–1970, Cambridge University Press, 2006.

9 The effect, Ben Shephard argues, was the unsurprising reduction of cases of neurosis and the feeling among some psychiatrists that they were being strait-jacketed by the system. Ben Shephard, ‘“Pitiless psychology”: the role of prevention in British military psychiatry in the Second World War’, Hist. Psychiatry, 1999, 10 (40): 491–524, pp. 522–3.

10 I thank one of my anonymous reviewers for helping me to see how this point could be more strongly developed. This paper does not seek to address the status of the medical literature on the subject of civilian neuroses throughout the 1930s and 1940s. Instead, it aims to place the first report on the incidence of neurosis in its proper context—this transnational collaboration—and to show ways that the report's content paralleled public and private discourse.

11 James Phinney Baxter, Scientists against time, Boston, MIT Press, 1946, p. 15; Bernard Katz, ‘Archibald Vivian Hill, 26 September 1886–3 June 1977’, Biog. Mem. Fellows R. Soc., 1978, 24: pp. 115–19.

12 Archibald Hill, ‘Science and defence. Anglo-American partnership in research. Speed in communication the key to success’, The Times, 17 June 1941, p. 5; see also Joseph Hinsey, ‘Herbert Gasser’, in Webb Haymaker and Francis Schiller (eds), The founders of neurology: one hundred and forty-six biographical sketches, Springfield, IL, Charles Thomas, 1970, p. 215.

13 Hill, op. cit., note 12 above, p. 5; see also Stanley Goldberg, ‘Inventing a climate of opinion: Vannevar Bush and the decision to build the bomb’, in Numbers and Rosenberg (eds), op. cit., note 8 above, p. 277.

14 For related examples, see Wellcome Library, Archives and Special Collections (hereafter WL), GC/135/B/1 Box 2, Service Psychiatry Monographs, 49, Ladislas Farago, ‘German psychological warfare: survey and bibliography’, New York, 1941, pp. 44–5, 50–2.

15 Saul Benison, A Clifford Barger, and Elin L Wolfe, ‘Walter B Cannon and the mystery of shock: a study of Anglo-American co-operation in World War I’, Med. Hist., 1991, 35: 217–49; Daniel J Kevles, ‘“Into hostile political camps”: the reorganization of international science in World War I’, Isis, 1971, 62: 47–60; Brigitte Schroeder-Gudehus, ‘Challenge to transnational loyalties: international scientific organizations after the First World War’, Sci. Stud., 1973, 3: 93–118; Wilder Penfield, The difficult art of giving: the epic of Alan Gregg, Boston, Little, Brown, 1967; For a broader account, see Daniel T Rodgers, Atlantic crossings: social politics in a progressive age, Cambridge, MA, Belknap Press of Harvard University Press, 1998.

16 The major history of the Medical Research Council remains A Landsborough Thomson, Half a century of medical research, 2 vols, London, HMSO, 1973–5, pages 292–332 of vol. 2, are the most relevant for this study. Joan Austoker, ‘Walter Morley Fletcher and the origins of a basic biomedical research policy’, in Joan Austoker and Linda Bryder (eds), Historical perspectives on the role of the MRC: essays in the history of the Medical Research Council of the United Kingdom and its predecessor, the Medical Research Committee, 1913–1953, Oxford University Press, 1989, pp. 23–33.

17 Walter Morley Fletcher, ‘The national organization of medical research in peace after war’, in Contributions to medical and biological research dedicated to Sir William Osler … in honour of his seventieth birthday … by his pupils and co-workers, 2 vols, New York, Paul Hoeber, 1919, vol. 1, p. 462; The only study that I know exploring the origins of the National Research Council is Nathan Reingold, ‘The case of the disappearing laboratory’, Am. Q., 1977, 29: 79–101.

18 Harry M Marks, The progress of experiment: science and therapeutic reform in the United States, 1900–1990, Cambridge University Press, 1997, pp. 98–100; Richard Rhodes, The making of the atomic bomb, New York, Simon & Schuster, 1986; ‘Dr Vannevar Bush, development of atomic bomb’, The Times, 1 July 1974, p. 16.

19 Alan Gregg Diary, Reel 3, Friday, February 14, 1941, p. 16. Rockefeller Foundation Archives, Rockefeller Archive Centre, Sleepy Hollow, New York (hereafter, RAC).

20 National Archives, Kew (hereafter NA), FD 1/6580, Executive order: Establishing the Office of Scientific and Research Development in the executive office of the President and defining its functions and duties, 28 June 1941.

21 Letter from Warren Weaver to Daniel O'Brien, 8 July 1941, folder 482, box 37, series 401, Record Group (hereafter RG) 1.1, RAC.

22 The impetus for this liaison seems to have come from John Fulton. Lewis Weed (1886–1952) is a neglected but interesting figure in American history. See Repository guide to the personal papers collections of Alan Mason Chesney Medical Archives Johns Hopkins Institutions, the Lewis H Weed Collection; www.medicalarchives.jhmi.edu/ sgml/weed.html (accessed 25 Jan. 2008). On Mellanby, see ‘Sir Edward Mellanby, diet and nutrition’, The Times, 31 Jan. 1955, p. 8; B S Platt, ‘Mellanby, Sir Edward (1884–1955)’, Oxford Dictionary of National Biography, Oxford University Press, 2004 (hereafter ODNB), vol. 37, pp. 744–5.

23 Philip Wilson, ‘Fulton, John Farquhar’, http://www.anb.org/articles/12/12-00308.html; American National Biography Online, Feb. 2000 (accessed 23 Sept. 2006).

24 NA, FD 1/6578, America, Co-operation with Research Problems 1 (hereafter FD 1/6578), letter from John Fulton to Edward Mellanby, 18 Sept. 1940.

25 NA FD 1/6578, letter from Edward Mellanby to John Fulton, 25 Sept. 1940.

26 NA FD 1/6578, letter from Edward Mellanby to Kenneth Franklin, 17 Oct. 1940.

27 NA FD 1/6578, letter from John Fulton to Edward Mellanby, 31 Oct. 1940; National Academy of Sciences, Washington DC, USA, National Research Council, manuscript (hereafter NRC, MS): Allied Cooperation 1940–April 1941, letter from John Fulton to Lewis Weed, 11 Nov. 1940; NRC, MS: Allied Cooperation 1940–April 1941, A memorandum on exchanging information.

28 One description of Fulton's time in Britain came to the Rockefeller Foundation from Hugh Cairns, Nuffield Professor of Neurosurgery at Oxford. “John Fulton is here and has been cramming in an enormous amount of valuable liaison work into a short time. He will be able to give you a well-balanced account of things when he goes back to US next week. He has I think seen a great deal of the Research work that is going on and has a really good view of the handicaps of a democracy at War, reduplications and overlapping of work, etc.” Letter from Hugh Cairns to Alan Gregg, 31 Oct. 1940, Maudsley Hospital Psychotherapy, folder 257, box 19, series 401, RG 1.1, RAC.

29 AMCMA, Fulton Diary, 14 Oct. 1940, p. 39, Fulton, John (Diaries) Oct. 1940–Aug. 1949, Lewis Weed Papers, Correspondence, The Lewis H Weed Collection.

30 On penicillin, see Robert Bud, Pencillin: triumph and tragedy, Oxford University Press, 2007, pp. 23–87; Virginia Berridge, Health and society in Britain since 1939, Cambridge University Press, 1999, pp. 18–22.

31 NA FD 1/6579, letter from Edward Mellanby to G E Brown, 7 Jan. 1944.

32 Letter from Daniel O'Brien to Alan Gregg, 8 May 1941, folder 271, box 26, series 401, RG 1.1, RAC.

33 NRC, MS: Allied Cooperation 1940–April 1941; Distribution of NRC Reports, Minutes, etc; letter from Edward Carmichael to Daniel O'Brien, 10 March 1941, folder 271, box 26, series 401, RG 1.1, RAC; see also M Fortun and S S Schweber, ‘Scientists and the legacy of World War II: the case of operations research’, Soc. Stud. Sci., 1992, 23: 595–613; moreover, it can be added that much of this work was facilitated informally by the Rockefeller Foundation as well as the NRC. “It is hard to write to friends in trouble without a sense of guilt and a discomforting feeling of being privileged and unfairly favoured. If letters alone could help, I would have written many long since. Please keep an eye open for what we might do to help and tell O'Brien.” Letter from Alan Gregg to Edward Mellanby, 11 March 1941, folder 647, box 60, series 401E, RG 1.1, RAC.

34 NRC, MS: Allied Cooperation 1940–April 1941, A memorandum on exchanging information.

35 The question of air raids and civilian neuroses had been raised as early as 1939. See ‘Treatment of neuroses in air-raids’, Lancet, 1939, ii: 1344–5. The literature on neuroses is enormous, but for my purposes the discussion in Ben Shephard, A war of nerves: soldiers and psychiatrists, 1914–1994, London, Pimlico, 2002, is adequate, especially pp. 169–86 and 279–97.

36 The most important recent consideration of the subject, which contains a useful survey of the content and status of the contemporary medical literature, appears in Edgar Jones, Robin Woolven, Bill Durodié, and Simon Wessely, ‘Civilian morale during the Second World War: responses to air raids re-examined’, Soc. Hist. Med., 2004, 17: 463–79; Adam Phillips, ‘Bombs away’, Hist. Workshop J., 1998, pp. 196–7; Ben Shephard op. cit., note 9 above, pp. 514–20.

37 Erick Wittkower and J P Spillane, ‘A survey of the literature of neuroses in war’, in Emanuel Miller (ed.), The neuroses in war, New York, Macmillan, 1945, pp. 1–32, on pp. 2–4; Edgar Jones, ‘War and the practice of psychotherapy: the UK experience 1939–1960’, Med. Hist., 2004, 48: 493–510.

38 Jones, et al., op. cit., note 36 above p. 479.

39 Reports of the decline in neuroses were already in circulation by November 1940. John Fulton, for example, upon his return from England, reported to Alan Gregg that the “neuroses developed at the time of Dunkirk are clearing up and that there are relatively few neuroses among the civilians”. Alan Gregg Diary, Reel 3, Friday, November 9, 1940, p. 146. Such statements and observations should be considered in light of the broader context of the British propaganda campaign against the United States. Philip M Taylor, ‘“If war should come”: preparing the fifth arm for total war, 1935–1939’, J. Contemp. Hist., 1981, 16: 27–51; Nicholas Cull, ‘Overture to an alliance: British propaganda at the New York World's Fair, 1939–1940’, J. Br. Stud., 1997, 36: 325–54.

40 Jones, et al., op. cit., note 36 above pp. 463–74.

41 ‘Air raids’ effect on health. Cases of shock fewer than expected’, The Times, 19 Feb. 1941, p. 2; see also Ministry of Pensions, Neuroses in war-time: memorandum for the information of the medical profession, London, HMSO, 1940, pp. 1–7; E E Krapf, ‘War-time psychiatry in Britain’, Britannica, 1944, 31: 11–23, pp. 13–22; Tom Harrisson, ‘Obscure nervous effects of air-raids’, Br. med. J., 1941, i: 573–4; Joanna Bourke, ‘Fear and anxiety: writing about emotion in modern history’, Hist. Workshop J., 2003, 55: 111–33, on pp. 114, 126–7, and fn. 7. Bourke cites an important Home Intelligence Report in her excellent discussion of the place of emotions in history, but misses the critical links between the Home Intelligence Reports and Home Guard Propaganda. See David K Yelton, ‘British public opinion, the Home Guard, and the defense of Great Britain 1940–1944’, J. mil. Hist., 1994, 58: 461–80, pp. 462–4.

42 Daniel O'Brien (1894–1958) was normally based in the Paris office, which was closed and relocated to Lisbon after the German occupation of France. O'Brien, however, after a war-time tour through Europe, took up residence at the Athenaeum and occupied offices at the Royal Society in London. For a discussion of the relationship between the Rockefeller Foundation and the MRC, see William Schneider, ‘The men who followed Flexner: Richard Pearce, Alan Gregg, and the Rockefeller Foundation Medical Divisions, 1919–1951’, in William H Schneider (ed.), Rockefeller philanthropy and modern biomedicine: international initiatives from World War I to the Cold War, Bloomington, Indiana University Press, 2002, pp. 7–59; see also Jean-François Picard and William H Schneider, ‘The Rockefeller Foundation and the development of biomedical research in Europe’, in Giuliana Gemelli, Jean-François Picard and William H Schneider (eds), Managing medical research in Europe: the role of the Rockefeller Foundation (1920s–1950s), Bologna, CLUEB, 1999, pp. 13–50, on pp. 34–40.

43 NRC, MS: Allied Cooperation 1940–April 1941, Index of Minutes, Recommendations, etc., pp. 1–2.

44 The best discussion of neurology and psychiatry in America appears in Andrew Abbott, The system of the professions: an essay on the division of expert labor, Chicago and London, University of Chicago Press, 1988, pp. 281–308. For the British context, see W F Bynum, ‘The nervous patient in eighteenth- and nineteenth-century Britain: the psychiatric origins of British neurology’, in W F Bynum, Roy Porter, and Michael Shepherd (eds), The anatomy of madness: essays in the history of psychiatry, 3 vols, London, Tavistock, 1985–1988, vol. 1, pp. 89–102.

45 See, for instance, Guy McKhann, ‘A forty-year journey’, in Ingrid G Farreras, Caroline Hannaway and Victoria A Harden (eds), Mind, brain, body, and behavior: foundations of neuroscience and behavioral research at the National Institutes of Health, Amsterdam, IOS Press, 2004, p. 281.

46 Jack Pressman, Last resort: psychosurgery and the limits of medicine, Cambridge University Press, 1998, pp. 25–8.

47 For example, see WL, GC/135/B/1 Box 2, Service Psychiatry Monographs, Alan Gregg, ‘“What is psychiatry?” An address by Dr. Alan Gregg, director of the medical services division of the Rockefeller Foundation, given on Dec. 2nd, 1941 to the Trustees of the Foundation’. See also folder 19, box 2, series 906, RG 3, RAC.

48 A history of the development of British psychiatric clinics is in C P Blacker, Neurosis and the mental health services, London and New York, Humphrey Milford and Oxford University Press, 1946, pp. 14–15, 17–21 and 47. This report also analyses the various groups handling cases of neuroses.

49 NA, FD 1/6580, Neurological Problems: Co-operation with America, Extract of the National Research Council in the United States, Division of Medical sciences, 14 Jan. 1941.

50 On Fremont-Smith, see Who was who, volume 6: 1974–1976, Suwanee, GA, Marquis, 1976, p. 148; for more on the Macy Foundation, see Pressman, op. cit., note 46 above, p. 370; Abbott, op. cit., note 44 above, pp. 304–8.

51 Alan Gregg Diary, Reel 3, Thursday, September 26, 1940, p. 125, RAC.

52 Letter from Daniel O'Brien to Alan Gregg, 2 May 1941, folder 1455, box 206, series 100, RG 1.1, RAC. He may be referring to Air Vice Marshal H E Whittingham, Director General of RAF Medical Services 1941–46.

53 Gerald N Grob, From asylum to community: mental health policy in modern America, Princeton University Press, 1991, pp. 5–23; Jones, op. cit., note 37 above, pp. 499–33. It should be noted, however, that some general practitioners were receptive to psychological approaches to disease. See Rhodri Hayward, ‘Desperate housewives and model amoebae: the invention of suburban neurosis in interwar Britain’, in Mark Jackson (ed.), Health and the modern home, Abingdon, Routledge, 2007, pp. 42–62.

54 NRC, MS: Allied Cooperation 1940–April 1941, Memorandum on liaison between the United States and Great Britain, pp. 1–4.

55 Alan Hodgkin, ‘Edgar Douglas Adrian, Baron Adrian of Cambridge, 30 November 1889–4 August 1977’, Biog. Mem. Fellows R. Soc., 1979, 25: pp. 1–73.

56 NA, FD 1/6580, letter from Edgar Adrian to Edward Mellanby, 3 April 1941.

57 Ibid.

58 Ibid.

59 NRC, MS: Allied Cooperation 1940–April 1941, letter from Edward Mellanby to Lewis Weed, 16 April 1941.

60 Ibid.

61 Chandak Sengoopta, ‘“A mob of incoherent symptoms?” Neurasthenia in British medical discourse, 1860–1920’, in Marijke Gijswijt-Hofstra and Roy Porter (eds), Cultures of neurasthenia from Beard to the First World War, Amsterdam and New York, Rodopi, 2001, pp. 97–115, p. 107.

62 Nikolas Rose, The psychological complex: psychology, politics and society in England, 1869–1939, London and Boston, Routledge, & Kegan Paul, 1985, pp. 146–219, esp. p. 210; Shephard, op. cit., note 9 above, pp. 522–3.

63 University College London Francis Walshe Papers, MS ADD 301 fd. B3, Anon., ‘Mind: doctor or patient?’ The Listener, 4 July 1934.

64 NA, FD 1/6580, letter from Edgar Adrian to Edward Mellanby, 20 April 1941. Edward Arnold Carmichael was also sent the extract, and he was equally dubious about an unofficial observer on neuroses. He wrote, “this form of tourist and sight-seer, often collecting wrong information and sending uncritical observation to America, appears to me to be likely to lead to confusion more than anything”. NA, FD 1/6580, letter from Edward Carmichael to Edward Mellanby, 10 May 1941.

65 On Gordon Holmes, see Stephen Casper, ‘The idioms of practice: British neurology, 1880–1960’, PhD thesis, University College London, 2006, pp. 174–95; on Holmes's impatience with neurotics, see R J Minney, The two pillars of Charing Cross: the story of a famous hospital, London, Cassell, 1967, pp. 174–5.

66 NA, FD 1/6580, letter from Edgar Adrian to Edward Mellanby, 20 April 1941. The brackets are Adrian's.

67 Biographical details on Aubrey Lewis, folder 915, box 121, series 401, RG 2, RAC.

68 Hugh Series, ‘Lewis, Sir Aubrey Julian (1900–1975)’, ODNB, vol. 33, pp. 586–7.

69 ‘Sir Aubrey Lewis: leading psychiatrist of his time’, The Times, 22 Jan. 1975, p. 14; see also K Angel, E Jones, and M Neve (eds), European psychiatry on the eve of war: Aubrey Lewis, the Maudsley Hospital and the Rockefeller Foundation in the 1930s, London, Wellcome Trust Centre for the History of Medicine at UCL, 2003, pp. 23–37.

70 Letter from Aubrey Lewis to Alan Gregg, 28 Nov. 1940, Maudsley Hospital Psychotherapy, folder 257, box 19, series 401, RG 1.1, RAC.

71 NA, FD 1/6580, letter from Edward Mellanby to Aubrey Lewis, 8 May 1941.

72 NA, FD 1/6580, letter from Aubrey Lewis to Edward Mellanby, 12 May 1941.

73 NA, FD 1/6580, letter from Edward Mellanby to Edgar Adrian, 13 May 1941; and letter from Edgar Adrian to Edward Mellanby, 15 May 1941.

74 NRC, MS: Allied Cooperation 1940–April 1941, letter from Sanford Larkey to Edward Mellanby, 5 June 1941. This ambivalence almost certainly reflected the fact that the organization and role of the physical and biomedical sciences was being significantly changed in America at this time. The OSRD was formed later that month. See note 20 above.

75 Aubrey Lewis, ‘Incidence of neuroses in England under war conditions’, Lancet, 1942, ii: 175–83. Cf. Felix Brown, ‘Civilian psychiatric air-raid casualties’, Lancet, 1941, i: 686–91.

76 Lewis, op. cit., note 75 above.

77 There was also no mention that Whitehall had been asked to approve publication and distribution of the report. However, the text does not seem to have been censored. NA, FD 1/6580, letter from Wilson Jameson to Landsborough Thomson, 4 Sept. 1941.

78 Lewis, op. cit., note 75 above, p. 175.

79 Ibid., p. 176.

80 Ibid., pp. 176–7.

81 One of the problems of interpreting this report arises from the fact that some of the psychiatrists and general physicians Lewis interviewed used the term psychoneuroses, while others mentioned anticipation neuroses, anxiety neuroses, and depressive neuroses in their written testimonials. Lewis never clarified if these terms were synonyms or whether they indicated separate clinical entities. This problem of classifying all types of air-raid casualties had been identified by G B Shirlaw, ‘Classification of air-raid casualties’, Lancet, 1940, ii: 344–5; it was also considered by Blacker, op. cit., note 48 above, p. 47.

82 Lewis, op. cit., note 75 above, p. 177.

83 Lewis was aware of a “proposal” by Solly Zuckerman to conduct research on the question of links between civilian housing and morale. This was then being considered by the Ministry of Home Security. NA, FD 1/6580, letter from Aubrey Lewis to Edward Mellanby, 14 Aug. 1941.

84 Lewis, op. cit., note 75 above, p. 183.

85 NA, FD 1/6580, letter from Edward Mellanby to Edgar Adrian, 15 Aug. 1941.

86 NA, FD 1/6580, letter from Edgar Adrian to Edward Mellanby, 18 Aug. 1941.

87 NA, FD 1/6580, letter from Wilson Jameson to Landsborough Thomson, 4 Sept. 1941.

88 NA, FD 1/6580, letter from Edward Mellanby to Lewis Weed, 2 Oct. 1941.

89 NRC, MS: Allied Cooperation 1940–April 1941, letter from Lewis Weed to Edward Mellanby, 17 Oct. 1941.

90 Weed was more aware of the psychiatric research situation in Britain than Mellanby might have suspected. In August 1941, O'Brien had sent Weed the Maudsley Hospital's ‘Report on Research’ to the Rockefeller Foundation, “through the channel of Dr. [Pat] Cushing [nephew of Harvey Cushing] who is now here, as it contains some material on psychiatry in war-time that I thought might be of some use to the N.R.C.” Letter from Daniel O'Brien to Alan Gregg, 25 July 1941, folder 258, box 19, series 401, RG 1.1, RAC.

91 Later, the medical press would confuse the issue further. WL, GC/135/B/1 Box 2, Service Psychiatry Monographs, extract from the British Medical Journal, 1942, ii: 574–6: William Sargant, ‘Physical treatment of acute war neuroses: some clinical observations’.

92 On Wilder Penfield, see Wilder Penfield, No man alone: a neurosurgeon's life, Boston, Little, Brown, 1977.

93 Wilder Penfield, ‘Clinical notes from a trip to Great Britain’, Arch. Neurol. Psychiatry, 1942, 47: p. 1034.

94 My emphasis. Arthur Salusbury MacNalty (ed.), The civilian health and medical services, 2 vols, London, HMSO, 1953–1955, vol. 1, p. 184.

95 Further support for this view appears in wartime sources. The Maudsley Hospital, for example, had been re-located to Mill Hill and Sutton Emergency Hospitals. They reported in early 1940 that Mill Hill had 200 neuro-psychiatric beds, which were to be filled by normal civilian cases, “acute psychiatric casualties” resulting from air raids, psychiatric disorder among the fighting forces, and cases with effort syndrome and another psychiatric condition. See Memorandum on the plan of work to be undertaken at Mill Hill emergency hospital under war conditions with special reference to research investigations, 9 Feb. 1940, folder 257, box 19, series 401, RG 1.1, RAC. As late as 17 February 1941, R H Curtis of the London County Council at Mill Hill, could write: “I am afraid London just now is no place to which to invite a friend, but I am glad you are coming, all the same. I wish things were more nearly normal. It is a horrid thought that the Maudsley is still empty and that its work is all disorganized, in spite of the effort made—I think with a measure of success—to keep its spirit and research alive at Mill Hill and Sutton.” Letter from R H Curtin to Daniel O'Brien, 17 Feb. 1941, folder 258, box 19, series 401, RG 1.1, RAC; Also in this folder, see the London County Council ‘Report of air-raid damage’, pp. 1-6, attached to the Memorandum, Daniel O'Brien to Alan Gregg, 14 May 1941. This report finds that “Since 7th September 1940, 106 incidents have been reported from the mental hospitals, 4 incidents having been reported from 3 mental hospitals and one district office from 18th April to the evening of 1st May 1941”, p. 1. On p. 6, the report indicates that 279 beds were permanently removed from service because of enemy action, 951 had been removed temporarily, that eleven hospitals had sustained serious damage, and a further eleven had been slightly damaged. Included in these, were Mill Hill and Sutton Emergency Hospitals. Mill Hill had lost 40 beds, and 150 were temporarily unusable. At Sutton, 4 beds were permanently gone, and 91 temporarily. A comparable survey for hospitals in the provinces has not been located.

96 Letter from John Rees to Alan Gregg, 2 Jan. 1941, folder 347 Tavistock Clinic, box 26, series 401, RG 1.1, RAC; on Rees, see Malcolm Pines, ‘Rees, John Rawlings, 1890–1969’, ODNB, vol. 46, pp. 323–4.

97 Shephard, op. cit., note 35 above, p. 181.

98 The attitude was common. Walter Maclay (1902–1964), Medical Superintendent of the Maudsley staff and a visitor for three months in the United States in 1943, described his attitude thus: “In war time the problem of the anti-social effect of neurosis has come very much to the fore, whether the society concerned in the fighting services or the civilian community. In the last war this problem was appreciated too late and neurosis was, on the whole, considered as an excusing disability and the neurotic was accepted as a pensionable burden negative to war effort. In this war, from the outset, psychiatric method and organization was directed against neurosis as an excusing social disability: treatment was directed not only towards the individual neurotic problems but more towards social reinstatement.” Folder 259, box 19, series 401, RG 1.1, RAC. Such views make it difficult to see how the “reported” incidence of neuroses could have increased.

99 ‘Fewer suicides’, The Times, 1 Sept. 1942, p. 5.

100 Lyotard, op. cit., note 6 above, pp. 10–47.