But it must not be thought that these dreads cause only the trivial instances of nervous breakdown in which people never very capable give way before the strenuous call of commercial life in the large cities of our time. Nor must it be thought that education is dispelling them. Some idea of the important role that dreads may play in the production of human ills that seem to be very serious and that often prove quite incapacitating for mental and physical work, even in men of fine abilities and proven powers, may be gathered from what happened during the recent Great War. The Allied nations had to maintain some fifty thousand beds behind the lines for the accommodation of patients suffering from functional nervous affections really founded on dreads. At the beginning these cases were misunderstood, and they were unfortunately called "shell shock" because they seemed so serious that it was thought that they were {240} due to some concussion of the nervous system, that is, some shaking up of its elements that made it impossible for it to function normally, even though there were no external signs of injury. After a time, however, it came to be appreciated that the great majority of these patients were suffering from major hysteria due to loss of control over the nervous system as a consequence of the almost inevitable dreads which developed in the awful conditions of warfare in the trenches, with its terrifying sights and sounds, and with the intense strain put upon the nervous system because of the demands made upon physical energy almost to the point of exhaustion. After loss of sleep and irregular eating, wet feet for days at a time, exposure to the inclemencies of the weather and then having to withstand an enemy attack, often at dawn after a fearsome barrage had been laid down on them for hours, it is no wonder that in many cases men's nervous control did give way. They were not cowards, they were not malingerers; on the contrary they were often brave men who had volunteered for the service, giving up important positions at home to take up the defense of their country; and yet after a time their dreads dominated them and they suffered from all sorts of symptoms. Some of them could not see, a number could not hear; some could not use their legs, and some could not employ their arms properly; some walked with a limp, some had tremor that made their usefulness as soldiers absolutely at an end. Nearly all of them had a series of complaints which they wanted to detail in all their minuteness to every physician who came near. Their stories of what had happened were mainly untrue or utter exaggerations of the actual events, and yet these men were not liars and they were not the doddering idiots that they sometimes {241} seemed to be; they were just fellow mortals who meant to do their best, and who had been affected in this way because they were asked to stand what was beyond their strength of soul to withstand.