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JAMA. 2004;292:636.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Warfare has lost its personal character, and is now merely wholesale butchery. This fact is impressively demonstrated by a letter from Dr. Paul Jacoby¹ of Orel, Russia, whose experience at the seat of war has shown that the battles and mine explosions affect men like great cosmic phenomena, in which the personal element is entirely lacking. Danger, death itself, present themselves under new and strange forms, altogether different from the ideas of war to which we have been accustomed since the days when knighthood was in flower.

Our psychology has not adapted itself yet to the new aspect of warfare. A cruiser which in less than two minutes sinks with 800 men on board; a skirmish in which 104 out of 107 of the horses are killed; an assault in which every assailant drops to the very last man; an assault over a surface known to be undermined by fifteen . . . [Full Text of this Article]