Casualties.

Privation and disease have mainly killed soldiers until very recently. Now that enemy action predominates, faster and better control of bleeding and infection before and during evacuation spares ever more lives today. This essay focuses on psychological war wounds, placing them in the context of military casualties. The surgeon's concepts of 'primary' wounds in war, and of would 'complications' and 'contamination', serve as models for psychological and moral injury in war. 'Psychological injury' is explained and preferred to 'Post-Traumatic Stress Disorder', being less stigmatizing and more faithful to the phenomenon. Primary psychological injury equates to the direct damage done by a bullet; the complications - for example, alcohol abuse - equate to hemorrhage and infection. Two current senses of 'moral injury' equate to wound contamination. As with physical wounds, it is the complications and contamination of mental wounds that most often kill service members or veterans, or blight their lives.

The cost of preventing stigma by hospitalizing soldiers in a general hospital instead of a psychiatric hospital.

Hospitalization costs are lower in psychiatric hospitals than in psychiatric departments of general hospitals. However, soldiers hospitalized in psychiatric hospitals are subject to the stigma associated with mental illness. The goal of this study was to examine the financial costs of preventing such stigma by hospitalizing soldiers in psychiatric departments of general hospitals, rather than less expensive psychiatric hospitals. Another goal was to find ways to reduce hospitalization costs, taking into consideration the consequences of the stigma for patients and their families. Costs, medical data, and demographic data were gathered from records of soldiers hospitalized for psychiatric illness. The most expensive causes of hospitalization were determined (acute psychotic state and adjustment disorders), and the characteristics of a soldier most likely to encounter psychosis were described. Recommendations include rerouting patients from hospitalization to ambulatory day care, when possible, and from general to psychiatric hospitals. We also recommend adopting a psychiatric diagnosis-related group price list to standardize sums paid per diagnosis and creating a system for considering, on a case-by-case basis, early discharge of soldiers with psychotic disorders during the stressful first half-year of military service.

French soldiers and their correspondence: towards a history of writing practices in the First World War.

The years 1914-18 engendered a "sudden and irrepressible boulimia" of letter-writing, a diluvian outpouring which defied all attempts at administrative control. The massive correspondence of French soldiers, analysed and quoted in the archives of the Commission de Contrôle Postal, has already been mined by war historians. They have normally used it to carry out a kind of historical opinion poll on the mood of the trenches. This article, however, focuses less on the content of soldiers' correspondence, and more on the nature and history of letter-writing itself. It examines letters as letters, their frequency, their destinations and all the unwritten codes to which they are subject. At a time of newly acquired mass literacy, the poilus experienced the urgent need to write. Their "laconic writing" raises important questions about historical sources, their transparency and their silences. It also offers a perspective on the much debated integration of the peasantry into national life and culture.