The Full Text of “Mental Cases”
1Who are these? Why sit they here in twilight?
2Wherefore rock they, purgatorial shadows,
3Drooping tongues from jaws that slob their relish,
4Baring teeth that leer like skulls’ tongues wicked?
5Stroke on stroke of pain,—but what slow panic,
6Gouged these chasms round their fretted sockets?
7Ever from their hair and through their hand palms
8Misery swelters. Surely we have perished
9Sleeping, and walk hell; but who these hellish?
10—These are men whose minds the Dead have ravished.
11Memory fingers in their hair of murders,
12Multitudinous murders they once witnessed.
13Wading sloughs of flesh these helpless wander,
14Treading blood from lungs that had loved laughter.
15Always they must see these things and hear them,
16Batter of guns and shatter of flying muscles,
17Carnage incomparable and human squander
18Rucked too thick for these men’s extrication.
19Therefore still their eyeballs shrink tormented
20Back into their brains, because on their sense
21Sunlight seems a bloodsmear; night comes blood-black;
22Dawn breaks open like a wound that bleeds afresh
23—Thus their heads wear this hilarious, hideous,
24Awful falseness of set-smiling corpses.
25—Thus their hands are plucking at each other;
26Picking at the rope-knouts of their scourging;
27Snatching after us who smote them, brother,
28Pawing us who dealt them war and madness.
The Full Text of “Mental Cases”
1Who are these? Why sit they here in twilight?
2Wherefore rock they, purgatorial shadows,
3Drooping tongues from jaws that slob their relish,
4Baring teeth that leer like skulls’ tongues wicked?
5Stroke on stroke of pain,—but what slow panic,
6Gouged these chasms round their fretted sockets?
7Ever from their hair and through their hand palms
8Misery swelters. Surely we have perished
9Sleeping, and walk hell; but who these hellish?
10—These are men whose minds the Dead have ravished.
11Memory fingers in their hair of murders,
12Multitudinous murders they once witnessed.
13Wading sloughs of flesh these helpless wander,
14Treading blood from lungs that had loved laughter.
15Always they must see these things and hear them,
16Batter of guns and shatter of flying muscles,
17Carnage incomparable and human squander
18Rucked too thick for these men’s extrication.
19Therefore still their eyeballs shrink tormented
20Back into their brains, because on their sense
21Sunlight seems a bloodsmear; night comes blood-black;
22Dawn breaks open like a wound that bleeds afresh
23—Thus their heads wear this hilarious, hideous,
24Awful falseness of set-smiling corpses.
25—Thus their hands are plucking at each other;
26Picking at the rope-knouts of their scourging;
27Snatching after us who smote them, brother,
28Pawing us who dealt them war and madness.
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“Mental Cases” Introduction
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"Mental Cases" was written by the British poet and WWI soldier Wilfred Owen, who was killed in action in November 1918. As with much of Owen's poetry, "Mental Cases" focuses on the horrors of war, and in particular the ongoing psychological effects of wartime trauma. Owen based the poem on his own experiences in Edinburgh's Craiglockhart military hospital, where soldiers were often sent for recovery from "shell-shock" (now known as post-traumatic stress disorder, or PTSD). Using grotesque, visceral imagery, "Mental Cases" builds a picture of life as a kind of living hell for soldiers returning from the battlefield, their bodies and minds irrevocably ravaged by the horrors they witnessed.
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“Mental Cases” Summary
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Who are these men, sitting in the soft light of the setting sun? Why are they rocking back and forth, shadows of their former selves stuck between heaven and hell, their tongues hanging out of their drooling mouths, grimacing menacingly like cursed skulls? Their pain strikes them again and again—but what steady anxiety has caused such intense emptiness and hollowness in their worried eyes? Misery seeps out through their hair and hands. We must have died in our sleep, and are now walking in hell—but who are these citizens of hell?
These are men whose minds have been seized and destroyed by the Dead. Their memories run their fingers through their hair, which is filled with murder—the many murders they once saw. They trudge aimlessly through swamps of flesh, and struggle to stay afloat in pools of blood from lungs that used to be full of laughter. They can never un-see or un-hear these things—the onslaught of guns and the way bodies exploded. The devastating waste of human life they've seen is packed too thickly in their minds for them to escape it.
As such, their tortured eyeballs continue to sink further back into their brains, offended by the way that sunlight looks to them like bloodstains. The night is also dark with blood, and when dawn appears it feels to them like re-opening a wound and causing it to bleed all over again. That's why they have these grotesque expressions, these horrible, fake looks like corpses that have been made to smile. That's why their hands twitch anxiously, picking at their torturous experiences like knots. They grab at us, brother, pitifully reaching for us because we are the ones who sent them to war—and condemned them to madness.
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“Mental Cases” Themes
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The Psychological Horrors of War
“Mental Cases” is one of Wilfred Owen’s most graphic war poems, and was based on his first-hand experience in Scotland’s Craiglockhart Military Hospital. The poem is deeply critical of WWI, and argues that many young men's experiences in the conflict will go on to haunt them. These men—the “mental cases” of the poem's title—are so troubled by what they’ve been through that they've essentially become the living dead. The poem argues that the effects of war stretch far beyond the battlefield, and it condemns those who bear responsibility for this suffering and dehumanization. No cause, the poem implies, justifies the “carnage” and “madness” of modern conflict.
The speaker describes the conditions inside a war hospital in gruesome detail in order to establish the horrific physical and mental consequences of war—particularly a war as deadly as WWI. The hospital is presented as a kind of "hell," the soldiers there so far removed from being their former selves that they don't even seem fully human.
This idea reflected by the poem's focus on their individual body parts. The speaker never identifies another soldier by name, instead focusing on "tongues," "jaws," "hair," "palms," "eyeballs," and so on. This dehumanization of the men speaks to the way that war itself has stripped them of their humanity. The focus on body parts also creates a shockingly horrific atmosphere, gesturing towards the gruesome injuries and deaths that were a daily fact of warfare.
But these men are not just in the hospital for bodily injuries; these are the "mental cases" who are suffering the ongoing psychological torture inflicted on them by their wartime experiences. Though they have technically escaped the battlefield, their trauma lives within them like a parasite. And this inner war—the war that never ceases—is so overwhelming that the men can no longer properly function in the world.
Instead, they sit there drooling, their eyes staring off into the distance, their hands twitching in spasms. The speaker attributes this to the way their minds have been “ravished” by “the Dead” (the word capitalized to represent them as a great, zombie-like horde). The poem implies that living after the war is perhaps a worse fate than dying during it, because the after-effects are so harrowing.
For these men, then, life will never return to normal. When dawn breaks and brings a new day, it brings for them only purgatory—the ongoing pain of psychological suffering. And in its conclusion, the poem turns to the reader—“brother”—and suggests that it was “us” who dealt the men “war and madness.” This might refer to the collective failure of humanity that leads to war, or more specifically the initial enthusiasm for the war in Britain that led so many young men to sign up, expecting more of an adventurous holiday than either death or lifetime of psychological torture.
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Line-by-Line Explanation & Analysis of “Mental Cases”
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Lines 1-5
Who are these? Why sit they here in twilight?
Wherefore rock they, purgatorial shadows,
Drooping tongues from jaws that slob their relish,
Baring teeth that leer like skulls’ tongues wicked?
Stroke on stroke of pain,The poem opens in what's implied to be a military hospital, and focuses on men suffering from shell-shock (which is now referred to as post-traumatic stress disorder, or PTSD). The poem starts with a series of rhetorical questions that ask the reader to consider both who these men are and why they sit “in twilight.” The speaker asks why (“wherefore”) these men have been reduced to “shadows” of their former selves, and now spend their days in pain, rocking back and forth and drooling from their open mouths. The grotesque imagery here gives the reader a shockingly vivid sense of the scene inside the hospital.
As literal questions, the answers are obvious: these are men trying to recover from shocking war experiences, and they are in the hospital as part of their convalescence. But these questions also gesture towards the fact that—as the rest of the poem makes clear—these men no longer seem human; language about "shadows" makes it seem as though it's they have become the suffering ghosts of their former selves. These questions thus speak more widely to the sense of the war as an incredible, unjustifiable waste of human life. That is, the speaker isn't really asking the immediate why they're sitting there in the military hospital, but why the war that led them there happened in the first place.
Diving into more specifics of those questions, the mention of “purgatorial shadows” is likely an allusion to Dante’s Inferno. There, and elsewhere in literature, the souls of the dead are known as “shades,” the implication being that they are no longer physically present in the world, and instead are mere shadows—like the negative of a photograph—cast by their former waking lives.
What’s interesting here is how the speaker conflates this with purgatory, which is an in-between place that is neither heaven nor hell. The idea is that, though the men are almost as good as dead in the sense that they can no longer function, the fact that they are still alive constitutes a kind of ongoing, undecided state. That is, they are caught between the poles of the living and the dead, not quite one or the other. Indeed, the poem subtly implies that either option—being fully alive or being fully dead—would be better than being barely alive.
Notice how the language here actually sounds gruesome too—it’s intentionally graphic, designed to shock the reader into empathizing with the wounded soldiers. The assonant /aw/ of "jaws that slob" evokes that loose-mouthed slobber, for example. The consonant /k/ and sharp /t/ sounds then make the lines sound almost like they're being spat out (the /s/ sound adds to this effect):
Wherefore rock they, purgatorial shadows,
Drooping tongues from jaws that slob their relish,
Baring teeth that leer like skulls' tongues wicked?
Stroke on stroke of pain, [...]The diacope of "Stroke on stroke" underscores the intensity of the soldiers' pain, playing on the way that “stroke” usually relates to something gentle. The men’s pain is constant and real, but it’s also a kind of phantom, something without physicality. "Stroke" can also refer to time, as in the "stroke of the clock." Immediately, then, the reader is given a powerful impression of ongoing, day-to-day, minute-to-minute torture.
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Lines 5-9
—but what slow panic,
Gouged these chasms round their fretted sockets?
Ever from their hair and through their hand palms
Misery swelters. Surely we have perished
Sleeping, and walk hell; but who these hellish? -
Lines 10-14
—These are men whose minds the Dead have ravished.
Memory fingers in their hair of murders,
Multitudinous murders they once witnessed.
Wading sloughs of flesh these helpless wander,
Treading blood from lungs that had loved laughter. -
Lines 15-18
Always they must see these things and hear them,
Batter of guns and shatter of flying muscles,
Carnage incomparable and human squander
Rucked too thick for these men’s extrication. -
Lines 19-22
Therefore still their eyeballs shrink tormented
Back into their brains, because on their sense
Sunlight seems a bloodsmear; night comes blood-black;
Dawn breaks open like a wound that bleeds afresh -
Lines 23-28
—Thus their heads wear this hilarious, hideous,
Awful falseness of set-smiling corpses.
—Thus their hands are plucking at each other;
Picking at the rope-knouts of their scourging;
Snatching after us who smote them, brother,
Pawing us who dealt them war and madness.
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“Mental Cases” Symbols
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Eyes
Part of the power of "Mental Cases" is the way that it focuses on individual body parts rather than people as a whole. This has a dehumanizing effect that, in turn, gestures toward the way that war strips soldiers of their humanity.
The poem often focuses on the soldiers' eyes in particular, which become symbolic of the men's lost humanity and individual identities. Think about the old cliché that the eyes are the window to the soul—that people can be known most intimately through their eyes. These men, however, have "chasms" in their "fretted [eye]sockets," deep (metaphorical) holes where their eyes used to be.
The implication is that they have no souls; they are but shadows of their formers selves, not fully alive yet not dead. Their "shrink[ing]" eyeballs reveal that they are disconnected from normal life, sinking further and further in a nightmarish world of memories. Eyes, then, also symbolize how their owners are, in a way, not there—they aren't fully present in the real world because they are unable to stop seeing what their eyes saw on the battlefield.
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“Mental Cases” Poetic Devices & Figurative Language
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Alliteration
The poem uses alliteration throughout. Alliteration helps to intensify the horror of the poem, with the relentlessness of the poem's sounds bombarding the reader much like the men's traumatic memories bombard them in the hospital. By essentially turning up the volume on the poem, alliteration also makes the grotesque images at hand stand out all the more starkly.
Lines 4 and 5, for example, use alliteration of sharp /t/, hissing /s/, and plosive /p/ sounds:
Baring teeth that leer like skulls’ tongues wicked?
Stroke on stroke of pain,—but what slow panic,These sounds lend the lines a popping, sickly feel (especially when also taking into account the hard /k/ consonance throughout). The sounds here help capture the poem's shocking portrayal of violence and psychological torture. It's almost as though the sounds here are attacking the reader!
In the second stanza, /m/ alliteration occurs throughout the first three lines:
—These are men whose minds the Dead have ravished.
Memory fingers in their hair of murders,
Multitudinous murders they once witnessed.These lines, not coincidentally, are about all the "murders" that replay in the men's minds. The alliteration itself—all those /m/ sounds—reflects that abundance. In the same stanza (line 14), "lungs" and "loved laughter" alliterate, connecting the men's joy to their delicate physical bodies—to those blood-leaking lungs.
In lines 20 and 21 of the final stanza, /b/ and /s/ sounds once again create an aural barrage on the listener:
Back into their brains, because on their sense
Sunlight seems a bloodsmear; night comes blood-black;As best it can, the poem tries to bombard the reader with sound in a way that gestures towards the sensory onslaught experienced by the soldiers. The /b/ sound continues in the next line, while three /h/ sounds in line 23 evoke the sound of cackling laughter—"heads," "hilarious," and "hideous" create a kind of "ha-ha-ha." In lines 25 to 27, "plucking" alliterates with "picking," while the /s/ of "scourging" echoes in "snatching" and "smote." Again, the poem creates a mixture of abrasive and threatening sounds to evoke its atmosphere of torment and horror.
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Allusion
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Apostrophe
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Assonance
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Caesura
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Consonance
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Enjambment
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Metaphor
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Oxymoron
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Repetition
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Rhetorical Question
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Simile
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Imagery
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"Mental Cases" Vocabulary
Select any word below to get its definition in the context of the poem. The words are listed in the order in which they appear in the poem.
- Twilight
- Wherefore
- Rock
- Purgatorial
- Slob
- Relish
- Leer
- Wicked
- Stroke
- Chasms
- Fretted Sockets
- Ever
- Swelter
- Perished
- Ravished
- Multitudinous
- Wading
- Sloughs
- Batter
- Carnage
- Squander.
- Rucked
- Extrication
- On their sense
- Bloodsmear
- Blood-black
- Afresh
- Thus
- Set-smiling
- Rope-knouts
- Scourging
- Smote
- Pawing
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The low light cast when the sun is below the horizon.
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Form, Meter, & Rhyme Scheme of “Mental Cases”
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Form
"Mental Cases" consists of three nine-line stanzas. The poem unfolds by first posing a set of questions, then answering them, before describing the ongoing situation in the hospital. Beyond this, there is no set poetic form. Instead, the poem relies on intense imagery and sound patterning (through devices like alliteration an assonance) to evoke a hellish atmosphere.
The poem begins with a series of questions that introduce the men and their psychological state. Line 10, which marks the start of stanza 2, then provides a definitive answer to the question of who these men are: "these are men" who are haunted by the dead. The rest of the stanza dives into the men's minds, describing their inner turmoil. The final stanza then essentially responds to the first: all that trauma, the poem says, is what makes the men appear like the living dead.
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Meter
"Mental Cases" is written in trochaic pentameter. This means that each line has five trochees, poetic feet with a stressed-unstressed syllable pattern (DUM-da).
There's something brutal about the sound of this meter. The way each line arrives with a strong stress at the start, and how these stresses tend to be on unsettling words like "Gouged" or "Misery," makes the poem feel a relentless onslaught. Line 3 provides a good example of this effect:
Drooping | tongues from | jaws that | slob their | relish,
The stresses are intentionally grating on the ear, and attempt to evoke the mental and physical exhaustion felt by the men in the hospital. Here, the falling unstressed syllable also conveys the way that the men's tongues are hanging out of their mouths. If the stress pattern was the other way round (iambic) it would be nowhere near as effective.
For another example, take lines 13 and 14, in which the trochees make the lines themselves difficult to wade through:
Wading | sloughs of | flesh these | helpless | wander,
Treading | blood from | lungs that | had loved | laughter.Notice how the stresses convey the physical effort of trench warfare, as though the reader must trudge through every heavy step. The fourth foot line 14 above has an iambic substitution ("had loved"), but it feels clumsy among such reliable trochees—again suggesting difficulty and tiredness.
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Rhyme Scheme
"Mental Cases" does not follow a rhyme scheme. The poem aims to capture the chaotic, confused, and exhausted state of mind that many of the men this hospital have to endure. To make the poem too neat and structured, then, would probably make it sound too calm.
Interestingly, though, each does stanza does feature one irregularly placed rhyming pair. In the first stanza, "relish" meets with "hellish" (lines 3 and 9 respectively). There's something unsettling to the ear about picking up on this rhyme, especially as these are so far apart as to seem more like an echo. This helps the poem build an atmosphere of paranoia and anxiety, especially amongst such an intense barrage of sound patterning (through alliteration, consonance, and assonance).
In the second stanza, "wander" rhymes with "squander" (lines 13 and 17). Notice how both of these words relate to a kind of loss, the first directional and the second relating to human life. Again, functioning as a mere echo, this rhyme provokes unease.
In the final stanza, lines 25 and 27 rhyme "other" with "brother." The "other" refers to the patients' hands, while "brother" is an address to the reader (and the general public at the time). This creates a kind of pair between "us" (the addressees of the poem) and "them" (the soldiers), linking the former with responsibility for the state of the latter.
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“Mental Cases” Speaker
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Many readers take the speaker in "Mental Cases" to be Wilfred Owen himself. Owen served in WWI, and the poem was based, at least in part, on his experiences recovering in Craiglockhart Hospital in Edinburgh. This institution was set up as a psychiatric unit for soldiers struggling with the psychological effects of the war.
That said, the speaker certainly doesn't have to be equated with the poet. All readers know from the poem itself is that the speaker has intimate knowledge of this kind of institution. The speaker makes close observations of the men in the hospital, and describes their memories of time in battle in vivid, nightmarish detail. This knowledge of both the men and the experience of war suggests that the speaker is also a soldier.
Yet at the end of the poem the speaker identifies with the reader rather than the men in the hospital ("Snatching after us who smote them, brother"); this suggests the speaker identifies with those "who smote them" and "who dealt them war and madness." Or, perhaps, everyone simply looks the same to the traumatized soldiers' eyes. In any case, it's clear that the speaker wants the reader—most likely the British public at the time of the poem's publication—to see that they, too, have played a role in the events that caused the men's suffering. In supporting the war, or not questioning some of its propaganda, responsibility is shared among the population.
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“Mental Cases” Setting
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Though the poem never mentions it explicitly, the setting is a military hospital during WWI. Specifically, it's a psychiatric hospital—an institution set up to aid "mental cases" (those with ongoing psychological problems caused by the war). Owen himself stayed in Craiglockhart Hospital in Edinburgh, which also counts Siegfried Sassoon, another famous war poet, as one if its former patents.
The hospital, of course, is not a happy place. As the speaker makes clear, it's full of pain and suffering. These men have seen such terrible things that their minds have become like "hellish" theaters, re-staging the horrors that they've seen—from daybreak to nighttime. Accordingly, the poem is as much set in the minds of the patients as it is in the hospital itself. Owen suffered from what at the time was called "shell-shock" himself, giving him insight into what it was actually like to escape the war physically but still be in its grip mentally.
The speaker plays with how the setting seems like "hell." It's as if, claims the speaker, they have all died during their sleep and are now living through eternal damnation. But, of course, the poem's power comes the fact this is not a fantasy, but a terrible reality. For the speaker, World War I has opened up a kind of portal to incredible psychological pain, and the poem presents a sense of time passing day to day and hour to hour with no respite from this suffering.
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Literary and Historical Context of “Mental Cases”
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Literary Context
Wilfred Owen served as a soldier in World War I. In late 1917, Owen was a patient at Craiglockhart Hospital in Edinburgh. He was suffering from "shell-shock"—the same condition that tortures the "mental cases" in this poem. Owen worked feverishly on his poetry during this stay, and produced not only this poem, but many others, including perhaps his two most celebrated works: "Dulce Et Decorum Est" and "Anthem for Doomed Youth." As in those two famous poems, "Mental Cases" seeks to undercut the glorification of war, instead striving to present an unflinching account of the real and terrible effects of the conflict.
While in Craiglockhart, Owen befriended another celebrated war poet, Siegfried Sassoon. Sassoon had a great impact on the poetry of his friend, suggesting revisions for a number of his poems. In his own poems like "Survivors," Sassoon, too, examined the way that soldiers often remained haunted by their wartime memories. Robert Graves, another writer who served in the war, wrote about similar experiences. An excerpt from his autobiographical account of the war is included in the Resources section of this guide.
It's worth comparing Owen's staunchly anti-war poetry with the jingoistic pro-war poems of writers like Rupert Brooke and Jessie Pope ("Who's for the Game?"). At the end of this poem, the speaker seems to have those who glorify war in mind—including those who presented a dishonest picture of wartime experience without having actually seen it first-hand.
Historical Context
WWI was a terrible conflict in which around 16 million people died. Those were just the direct deaths—famine, genocide, and the great flu outbreak of 1918-1919 killed many more people after the official end of the conflict. In a title that seems tragically ironic now, WWI was known as "the war to end all wars."
Life in the trenches of Europe was terrifying and deadly, and the poor conditions caused frequent sickness and disease. Owen fought in France, part of what was called the Western Front—the war's main combat theater.
Though "Mental Cases" makes reference to trench warfare, the real "theater" in this poem is in the patient's minds. That is, the poem is more concerned with the ongoing psychological effects of the war than the obviously horrific physical injuries typical of its battles. These men, though they have technically escaped the conflict, re-stage it daily in their imaginations.
Both Owen and Siegfried Sassoon were patients at the Craiglockhart Hospital in Edinburgh, which was dedicated to assisting those soldiers suffering from "shell-shock" (now called post-traumatic stress disorder, or PTSD). Wartime experience caused untold damage to soldiers' mental states, a problem compounded by the fact that psychological suffering was often condemned as weakness or cowardice.
Even Sassoon—who became famous for his death-defying acts of bravery—suffered from shell-shock. Some soldiers had the double misfortune of being given ineffective, even dangerous, treatments for their condition, including electroshock therapy. It was an army major, Arthur Hurst, who made great innovations for the treatment of this condition, pioneering occupational therapy techniques like giving the men simple agricultural tasks or encouraging them to use their creative talents.
It was during his hospital stay at Craiglockhart that Owen wrote some of his most enduring poetry. In a turn of fate that perhaps underscores the tragedy of war, Owen himself very nearly survived to see its end. He was killed one week before the Armistice on November 11, 1918, with news of his death reaching his parents on the same day that church bells were ringing out to signal the end of the war.
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More “Mental Cases” Resources
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External Resources
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Wilfred Owen's Biography — Read more about the poet's life and work.
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Bringing WWI to Life — Director Peter Jackson discusses his recent WWI film, They Shall Not Grow Old. Through technology, Jackson brings old war footage to vivid life.
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"Good-bye to All That" — An excerpt from wartime writer Robert Graves's memoir about his experiences in WWI.
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War Poetry Podcasts — Listen to this series of podcasts from the University of Oxford about various aspects of World War I poetry, including some excellent material about Wilfred Owen.
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Shell-Shock — An informative article about what is now commonly referred to as Post-Traumatic Stress Disorder (or PTSD).
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Poems in Response to Owen — A BBC show in which three contemporary poets respond to Wilfred Owen's poetry.
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LitCharts on Other Poems by Wilfred Owen
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