This remarkable picture captures the closure of the first great chapter in the history of British military psychiatry. Taken in December 1918, it shows a group of Army doctors photographed in front of the main entrance to the Maudsley Hospital. The Maudsley, constructed in 1915 to treat civilian psychiatric disorders, was actually opened in January 1916 as a specialist treatment and research hospital for ‘shell shock’. Seated, front left and front right, are two luminaries of the time: William Rivers and Frederick Mott.

Mott, the leading neuropathologist of his age, was biologically minded. He believed that the clinical manifestations of shell shock were brought about by small, pathological changes in the central nervous system, caused by close proximity to explosions or toxins. His subsequent experiences led him to modify these views and recognise a psychological component.

Rivers had been a lecturer at Cambridge in medical psychology; he was also a renowned anthropologist. He believed Freud's ideas could be used to understand war neuroses. Famously, in 1917, he treated the war poet Siegfried Sassoon at the Craiglockhart Hospital near Edinburgh. As a result, Sassoon returned to active duty as an infantry officer in France.

Lessons learnt in military psychiatry are often forgotten once the conflict has been resolved. One wonders what Mott and Rivers would have thought of the current phenomenon of ‘minor traumatic brain injury’ currently described in American veterans of Iraq and Afghanistan.

Photograph courtesy of the Bethelm Royal Archives and Museum.