Not fit for purpose

Records of those not fit to serve in the First World War

Application form for reassessment of Charles Townsend

Have you ever heard of prosopography? I must admit, it was a new one for me as well. The basic meaning of the word is a study into the common characteristics of a historical group whose lives otherwise may have little recorded. These studies often use statistics gleamed from data which can sometimes have seemingly little relevance.

You may be surprised to hear, for example, that you can utilise our collection of Middlesex County appeals against conscription (from record series MH 47) to investigate the health of First World War London.

MH 47 contains over 11,000 records relating to people from Middlesex who were appealing against their conscription into the army. The men could appeal on one of seven different grounds and it is the men who applied under code E, ‘On grounds of ill-health or infirmity’, which interests me the most.

It is very rare to have a collection of papers from one specific demographic which give detailed medical histories. There are three pieces in MH 47 which contain these medical applications, numbering over 1,100 case papers in total. I have thoroughly investigated the largest of the three pieces in order to produce some initial statistics. ¹

The papers themselves are remarkably interesting. From January 1916 (when conscription came into effect), until November 1917, medical examinations would take place under the control of the military. The Appeal Tribunals came to recognise that increasing numbers of medically unsuitable men were being passed fit for service by examiners trying to meet the pressures of replenishing front-line forces; this included passing men who had previously been medically discharged from the Army.

In November 1917 the examinations passed to civilian control where each man was given a numbered grade depending on their suitability for service ranging from 1 (fit for service) to 4 (totally unfit for service). ²

Complaint by Herbert Burgess about his examination (catalogue ref: MH 47/115)

Following the change to civilian control there was a flood of applications for medical reassessment by people who judged that they had been unfairly graded by the military assessors. Many complained about their initial assessment such as Herbert Burgess (inset) who writes:

“I was placed in grade 2 after an examination by one Doctor lasting not five minutes. My answers to questions put to me were ridiculed openly and in one case I was actually told I was prevaricating”. ³

From looking at the records, the complaints that they describe and the results of the re-evaluations you can start to pull out some interesting points:

• 303 of the 442 case papers (or 68.5%) were aged between 40 and 50
• 223 (or 50.45%) had their grading lowered on reassessment
• 190 (or 43%) were graded the same on reassessment
• 11 (or 2.5%) had their grading raised (from grade 2 to 1)

We can also learn something of the condition of those men who were assessed as not being fit to serve:

• 54 people (or 12.75%) were reassessed grade 4, completely unfit for service
• Of those 54, 17 had originally been assessed grade 1 (fit for service)
• 10 of those assessed as grade 4 had previously been rejected as unfit for service

I wanted to know whether, by looking at the reasons given by those assessed as grade 4, we could learn anything about the health of Londoners at the time:

• 11 men complained of a heart defect or heart disease
• nine complained of either partial or total blindness or deafness
• six complained of hernia and 5 of chronic bronchitis

Six people assessed as grade 4 complained of some form of psychological issue. Three of these used the term ‘Neurasthenia’, a psychopathological term used to cover symptoms such as fatigue, anxiety, neuralgia and depression. This surprised me given the stigma associated with so called ‘shirking’ and conscientious objectors. On further examination I discovered that 33 people in piece MH 47/115 had complained of some measure of nervous debility. The majority of these, 13 in all, were placed in grade 2 as ‘those who, while not attaining the standard of grade 1 … are likely to improve if trained’. ⁴

These papers deserve a fuller and more frank assessment as they may be invaluable in painting a picture of the health of wartime Middlesex, especially Greater London.