Plexus of War

My grandfather's old encyclopedia stated that the events from the 24th to the 30th of July 1914 was the week “researched with greater care than any other time period in history”. And although an encyclopedia is a product of its own time, and although this world has seen many eventful weeks after 1914, it is probably still true. The crisis leading to the First World War is a subject of great importance to historians, politicians and any one with an urge to understand our own time.
No other event has shaped the world of today as the First World War and its aftermath. Europe was set ablaze and traumatized for generations. The United States abandoned isolationism, the Russian tsarist regime was overthrown by communism, The Ottoman Empire was dissolved. Lines were drawn in the sands of The Middle East, carving out states still in conflict with each other. Germany was left  destroyed and impoverished, planting the seeds for populism, national socialism and another war. 
And I would have liked this post to be about Gavrilo Princip, the man who fired the shot in Sarajevo. Or about Field Marshal Alfred von Schlieffen, the man with the master plan who did not live to see it fail. But this is a blog about medical factors forming history, so this post will have to be about the German Kaiser Wilhelm II and his birth injury. The small nerve entrapped in his arm will serve as the justification for writing what I really want; the exact introduction to the July Crisis, that I myself would have liked to read.

We will get to all of these men shortly. And to the nerves of the brachial plexus. 

Recently, I was with my family in a mountain cabin during a rain shower. My eight year old son was organizing his collection of football cards, and my ten year old asked about the outbreak of the First World War. I told him it was complicated, which only increased his curiosity.

I realized that the most accessible explanation was by introducing the alliances. The cabin held no encyclopedia or atlas, so I borrowed some of the football cards from the youngest and laid them on the table as a representation of the European states. Kylian Mpappé as France, Toni Kroos as Germany, Wayne Rooney as England. The collection held no Austro-Hungarian players, but another red-and-white player filled in. At some point my wife placed a plate of biscuits in the middle of Russia, then ate most of Vladivostok.

The Alliances
Prior to the war, Europe had experienced something extraordinary; a long period of peace. The last major conflict on European soil had ended in 1871 with a French defeat to a united German Empire. With 25 smaller German states unified under the Prussian Emperor Wilhelm I, this ‘Second Reich’ was politically led by chancellor Otto von Bismarck. He built a strong Germany of industry and infrastructure, he initiated German imperialism in Africa, and he secured peace by a number of international alliances.
But the peace was fragile. By the end of the Franco-Prussian war of 1870, the French had suffered the loss of the region Alsace-Lorraine, and this led to national bitterness and hatred towards Germany. The question of Alsace-Lorraine and the demand for revenge was the main factor in French foreign policy for more than forty years. French infantry captains would lead young recruits through the hills near the border to look down upon the lost region. The French army planned for an offensive across the Rhine to reclaim the lost region. France and Germany were arch-enemies, and another war between them was considered inevitable. 
The alliance between Germany and Austria-Hungary of 1879 was a serious threat to France. It was countered by a Franco-Russian alliance in 1892. This latter alliance was somewhat peculiar, as France had been the birthplace of democracy in Europe, while Russia was a tsarist autocracy. However, the common fear of a powerful Germany was the main pillar of the Franco-Russian coalition.

In the Balkans, the two provinces of Bosnia and Herzegovina had been occupied by Austria since 1878. But in the neighbouring state of Serbia, the wish for a unified Yugoslavia was growing. As Bosnia held a large population of ethnic Serbs, it was Serbian policy that a unified Yugoslavia would have to include Bosnia. The Austrian occupation of Bosnia was a major obstacle to the Serbian ambition. In 1908, Austria proclaimed the annexation of Bosnia and Herzegovina, consolidating Bosnia as Austrian territory. This led to a diplomatic crisis, and Austria was met by anger and protests from most of Europe. The neighbouring state of Serbia now mobilized her army. Russia had economic and religious ties to Serbia, and protested bitterly against the Austrian involvement in the Balkans. But met with the threat of war from a united Germany and Austria-Hungary, Russia and Serbia backed down and recognized the annexation.
The Balkans remained a stage of political chaos, uprisings and insurgents. In the following years, Russia and France strengthened their relations, and Russia increased her army.

The Plan
With the Franco-Russian alliance, Germany knew well enough that in the case of war, she would have to fight on two fronts; against France in the West and against Russia in the East. This was an unfavorable situation.
The solution was conceived by Alfred von Schlieffen, chief of the German General Staff, and the plan came to bear his name. Simply stated, the plan was to defeat France quickly, then turn German troops around to focus on the Russian forces. Schooled in the principles of Clausewitz, Schlieffen realized that an invasion of Paris would force France to capitulate. It was the general opinion that the vast army of Russia scattered out across the enormous country would need six weeks to mobilize. Consequently, it was imperative to defeat France in that short amount of time. And to reach Paris in just six weeks, Schlieffen realized, German troops could not waste time crossing the hills and woodlands of the Ardennes on the French-German border. Instead, they would have to move quickly across the open and easily traversable plains of Belgium. The Schlieffen Plan had several advantages; Paris would be reached in a few weeks, and the French forces attacking through Alsace-Lorraine would be enveloped by the German troops coming in from the north through Belgium.

At this point in time, Belgium was a young country. Claiming independence in post-Napoleonic Europe, Belgium had been guaranteed the status of an independent and neutral state in a treaty of 1839, signed by England, France, Russia, Prussia and Austria. Seventy years later, Schlieffen decided that this treaty was an unimportant obstacle. Germany believed that Belgian neutrality could be disregarded without armed opposition, and that her English guarantor would not come to her defence. England was expected not to go to war over the ‘scrap of paper’ that was the treaty of 1839.

That assumption was proved wrong with the outbreak of war. But Schlieffen had died in 1913 and never saw his plan come into action - and fail.

The Deadlock
To sum up (and you may need the help of football cards to illustrate this): Germany was allied with Austria-Hungary. Austria-Hungary had occupied Bosnia-Herzegovina and in effect caused opposition from Serbia. Serbia wanted a united Yugoslavia including ethnic Serbs in Bosnia-Herzegovina. Serbia had close relations to Russia, and Russia was allied with France. France was under threat from Germany, but in the case of war, the Schlieffen Plan necessitated the moving of German troops through Belgium. And the neutrality of Belgium was guaranteed by England.

The Kaiser - and The Plexus, for Those Who Care
So the long lasting peace was a fragile one. Everybody lived in peace, but talked about war constantly. Europe was a barrel of dynamite ready to explode. All it needed was a little instability. And the German Emperor Wilhelm II was just that; unstable.
Born in 1859, Wilhelm was the eldest grandchild of Queen Victoria and the cousin of the British King George V. His father was Frederick III of Prussia, and young Wilhelm travelled the European courts with familiarity and confidence. He did, however, often leave a bad impression. He was described as pretentious and arrogant, childish and pathetic, vulgar in speech and manners. He was bossy towards ministers, and he interfered in international affairs with overconfidence and little insight into his own poor diplomatic abilities. He was ill tolerated by the family members in the English and the Russian courts. His uncle, the English King Edward VII, characterized him as emotionally unstable, vain and cowardly, and wrote about him that “it is not by his will that he will unleash a war, but by his weakness”.
Wilhelm’s unpleasant personality and obvious narcissism has often been ascribed to an inferiority complex founded in his childhood.
He was born by a traumatic breech birth leaving him with a withered left arm due to Erb’s palsy.
Every midwife fears a breech birth, as complications are common. And every medical student fears to be questioned about Erb’s palsy, as it requires insight into the nerves of the brachial plexus. Nerve roots leaving the spinal cord of the neck travel through this network, first merging into three trunks, then dividing and leaving the plexus as the peripheral nerves of the arm. Consequently, damage to one trunk within the plexus can cause severe damage on several peripheral nerves leaving the plexus.

The Brachial Plexus

There is some speculation as to the nature of the birth defect suffered by Wilhelm, especially since it was not noticed until three days after his birth. The most probable cause of the defect seems to be pressure damage to the nerves of the neck caused by the forceps that dragged him out during the prolonged breech birth. Whatever the cause, the palsy left Wilhelm with a withered left arm about 15cm shorter than his right arm.

This was an obvious disability for a man destined to rule a military state. Doctors tried to cure the defect, for instance by strapping his functioning right arm to his body, thus forcing him to use his left arm. His mother insisted that he learned to ride, and riding lessons from the age of eight left the prince in tears. He fell off the pony over and over again, but after weeks of endurance, he was able to maintain his balance. Later, the useless arm proved a handicap on hunting trips with other royalties.
His mother blamed herself for the birth defect. And so did Wilhelm. He developed a strained relationship with his mother. And throughout his life, Wilhelm tried to conceal his withered arm.

Wilhelm with his father, 1862.

His obvious inferiority complex was compensated by a disinhibited and pretentious confidence. He had megalomaniac ideas about his state and his own abilities. He would proclaim himself the sole ruler of Germany, disregarding the chancellor. Disagreements led to Bismarck's resignation, and his successors were insufficient opponents to Wilhelm’s rule. His narcissism was easily exploited by sycophants in the court. For instance, Admiral Tirpitz convinced the Kaiser to invest in the navy, in effect creating an arms race with England.

But worst of all; his feeling of inadequacy among the family members in the royal houses of England and Russia was compensated by an aggressive behaviour towards these nations. And his strained relationship to his English-born mother probably evolved to a similarly strained relationship to England.

The Spark
Sarajevo, 28th of June 1914. Gavrilo Princip, a 19 year old Bosnian Serb, was standing outside a food shop in the Bosnian capital, and he was disappointed. Hours earlier he and his comrades had failed in their attempt to kill the Austrian Archduke Franz Ferdinand, nephew of the Austro-Hungarian Kaiser Franz Joseph and heir to the Austro-Hungarian throne.
Princip was organised in The Black Hand, a secret military society backed by Serbian Army officers, whose goal was the unification of all South Slavic territories. Princip would later state that he was a Yugoslav nationalist aiming for the unification of all Yugoslavs freed from Austria.
The royal visit of the Archduke to the Bosnian capital had provided an obvious opportunity to strike a blow against the sworn enemy. Earlier that morning, Princip and five other conspirators had hurled a hand grenade at the Archdukes motorcade, but had missed, only wounding an officer. Princip managed to escape, as did the Archduke. But after the planned speech at the Sarajevo Town Hall, Franz Ferdinand decided to visit the victim of the assault.

Gavrilo Princip arrested after
assassinating Austro-Hungarian
Archduke Franz Ferdinand.

On the way to the hospital, his driver took a wrong turn and had to brake the car at the exact spot where Princip had positioned himself. As the car stalled, Princip stepped to the footboard of the car and shot Franz Ferdinand and his wife Sophie at point-blank range. Sophie died immediately, Franz Ferdinand a few minutes later.

Gavrilo Princip was arrested, as were his comrades involved in the plot.

The Crisis
The following month saw the fiercest diplomatic negotiations in history. Known as The July Crisis, it would all turn out in vain.
The assassins were all Serbs, and it was an obvious assumption that Serbian military officers had been involved in the planning of the attack. It was even speculated that Serbian government officials had had knowledge of the plot. Austria would have to react with determination against Serbia. Foreign Minister Leopold Berchtold argued that the assassination had to be avenged, and he considered a small scale war against Serbia. Chief of the Austro-Hungarian General Staff Conrad von Hötzendorf saw this as an opportunity to destroy Serbia’s abilities to interfere in Bosnia once and for all. But first, they would need the approval of their ally. A dispatch was sent to Kaiser Wilhelm II, bearing a memorandum from Berchtold and a personal letter from Austrian Kaiser Franz Joseph, the uncle of the assassinated Archduke Franz Ferdinand. On the 5th of July, the German Kaiser gave his Austrian friend his full support; in the event of war, Austria-Hungary could count on the Germans. Russia’s attitude would be hostile, but Wilhelm considered her unprepared for war.
Not only did Wilhelm give Austria a blank cheque to interfere in Serbia, he encouraged it; actions should not be delayed, and Wilhelm apparently told the Austrian ambassador that Franz Joseph “would regret it if we did not make use of the present moment, which is all in our favour.” Having no illusions of the consequences, Kaiser Wilhelm urged Austria to invade Serbia, and he promised to defend her against Russia. He knew well enough that the defence against Russia would necessitate German invasion of France. He also knew that this invasion would move through Belgium, violating her neutrality.
The crippled and belittled child in Wilhelm had finally been given the opportunity to assert himself. And he would take it out on all of Europe.

The Ultimatum
Beograd, 23th of July 1914. Serbia was presented with an Austro-Hungarian ultimatum to be answered within 48 hours. Disguised as diplomacy, the ultimatum was devised to trigger a war. It demanded that Serbia formally and publicly condemned all propaganda against Austria-Hungary and dissolved Serbian national organisations. It also demanded the arrest of named Serbs assumed involved in the assassination. But most importantly, it demanded that Austro-Hungarian delegates were allowed to take part in the investigations and trials against the perpetrators of the assassination of the Austro-Hungarian Archduke. This latter point was deliberately designed to provoke a rejection; allowing foreign representatives to interfere in the legal processes of a sovereign state could not possibly be accepted.
The Austro-Hungarian ultimatum to Serbia was soon known throughout Europe, causing shock and fear. Winston Churchill called it “the most insolent document of its kind ever devised,” and British Foreign Secretary Edward Grey declared that he had "never before seen one state address to another independent state a document of so formidable a character." Grey urged Austria to extend its deadline and offered to mediate in the conflict. France, Italy and Russia agreed to participate in a British organized international conference to solve the diplomatic crisis. But Germany refused.
On 25th of July 1914, Serbia replied just before the deadline, meeting all the demands except one; she would not allow the presence of Austro-Hungarian police and legal representatives in Serbia.
Although celebrated throughout Europe as a masterwork of diplomacy, it did not satisfy the Austro-Hungarian government. And Serbia had already seen through the Austrian bluff, recognizing the ultimatum for what it was; an alibi to go to war. Even before the answer was delivered, Serbia had mobilized her troops.

The Outbreak
The chain of events that followed were as foreseeable as a house of cards falling apart:
On receiving the Serbian reply, the Austro-Hungarian government dismissed it as unsatisfactory and severed diplomatic ties with Serbia.
On 28th of July, Austria-Hungary declared war on Serbia.
On 30th of July, Austrian warships bombarded the Serbian capital of Belgrade.
On 31st of July, reacting to the Austrian bombardment, Russia mobilized against Austria-Hungary.
On 1st of August, the mobilization against Austria-Hungary was countered by her ally, as Germany declared war on Russia. Obligated by the alliance with Russia, France now mobilized against Germany. For Germany, the war on two fronts was a reality. It was clear that the Schlieffen Plan would have to come into effect.
On 2nd of August, the German diplomat in Brussels delivered a document to Belgian Minister of Foreign Affairs Julien Davignon, asking for free passage of German troops through the neutral country. Germany explained the need as a means of self preservation against an expected French aggression. German troops were “compelled by necessity” to enter Belgium. If Belgium would allow this, she would be guaranteed “sovereign rights and independence [...] at the conclusion of peace.” Should she refuse the entrance of German soldiers on Belgian soil, it would regrettably be considered an act of hostility. The Belgian government had anticipated this, and although outnumbered and outgunned, mobilization had already begun. “If we are to be crushed,” Under-Secretary of the Belgian Foreign Office Bassompierre recorded, “let us be crushed gloriously.” The German request had to be refused.
On 3rd of August, Germany declared war on France. On the following morning, German units crossed into Belgium with the purpose of securing the bridges across the river Meuse. They were soon followed by vast numbers of German soldiers, marching in accordance with an invasion plan outlined several years earlier. Troops, guns, ammunition and horses moved across the plains with clockwork precision. Trains and cannons were transported in accordance with detailed time tables. Every gun in every carriage on every railway station had been scheduled in advance, just waiting for the outbreak of the inevitable war with France. 
The Germans were expected to sweep through Belgium as easily as drawing an arrow across a map. When met with Belgian opposition, German soldiers reacted with astonishment and frustration. The thousands of casualties suffered at Liege on the first days of the war was a small suggestion of the brutalities to come.

The Complex
During The July Crisis, the conflict had included Germany and Austria-Hungary on the one side and Serbia, Russia and France on the other. Diplomatic efforts to negotiate peace had been futile. However devastating a war between these nations might have turned out, it could have been restricted to European soil. The burst into World War was sparked by the German violation of Belgium neutrality.
On 3rd of August, British Foreign Secretary Edward Grey spoke to the British Parliament on the subject of British involvement in the war. The reason was the German request for passage of troops through Belgium. “If, in a crisis like this, we run away from these obligations of honor and interest as regards the Belgian Treaty [...] we should, I believe, sacrifice our respect and good name and reputation before the world.” The House replied with overwhelming applause. Standing in his office that evening, Edward Grey told his friend that "the lamps are going out all over Europe, we shall not see them lit again in our life-time," encapsulating the situation precisely.

On the following day, The British Empire declared war on Germany. With her vast empire stretched across the world, the conflict was now global. Eventually, British colonies and commonwealth countries would join.

On 6th of August, British and French troops invaded the German colony of Togo in Africa, spreading the war outside Europe.
On 7th of August, the British Expeditionary Force landed 120,000 soldiers in France to oppose the German assault. A month later, British and French troops were able to save Paris from the German advance, effectively hindering the Schlieffen plan. Within months, the Western front was locked in a war of attrition.

The German battleship Breslau

On 10th of August, the two German battleships Goeben and Breslau entered the Dardanelles on course to Constantinoble. Though The Ottoman Empire stayed neutral for another three months, the presence of German battleships in the Black Sea would eventually drag the Ottomans into war against Russia.
On 17th of August, Russia invaded East Prussia, opening the Eastern Front in Europe. While the Western Front remained essentially frozen for the next four years, the Eastern Front proved a theatre of mobility, large scale operations and movements of troops. Stretching from the Baltic to the Black Sea, the Eastern Front would see heavy fighting until the Bolshevik revolution in Octobre 1917 drew Russia out of the war.
Although initially a member of The Triple Alliance with Germany and Austria, Italy remained neutral in the first part of the war. The alliance was a defensive alliance, and with Austria and Germany as the aggressors declaring war against Serbia and Russia respectively, Italy was not obliged to enter on their side. In 1915, however, negotiations with London convinced Italy to turn against her former allies.
In 1917 after years of exhaustion on all fronts, the United States gave up isolationism and entered the war. It would be another long year before fighting came to an end.

The Aftermath
The First World War ended on November 11th 1918. At that time, military casualties had reached more than nine million deaths, while 13 million civilians had died as a direct result of the war.
Gavrilo Princip had died from tuberculosis in prison in April 1918.
Kaiser Wilhelm II abdicated in 1918, dissolving the Second Reich. He died in exile in 1941 and was buried in Doorn in the Netherlands. He never acknowledges his responsibility in the initiation of the Great War.
No one ever did. In the words of Winston Churchill:

Whole libraries have been written about the coming of the war. Every Government involved has laboured to prove its guiltlessness. Every people casts the odium upon some other. Every statesman has been at pains to show how he toiled for peace, but was nevertheless a man of action whom no fears could turn from the path of duty. Every soldier has found it necessary to explain how much he loved peace, but of course neglected no preparations for war. [...] 

Then came a few short sharp individual acts, and swiftly the final explosion. [...]

There was the man who fired the shots that killed the Archduke and his wife in Sarajevo. There was the man who, deliberately accepting the risk of a world war, told the Austrian Emperor that Germany would give him a free hand against Serbia and urged him to use it. There was the man who framed and launched the ultimatum to Serbia. These men took the fatal decisive steps. [...] no-one except the doers of these particular deeds bears the direct concrete responsibility for the loosing upon mankind of incomparably its most frightful misfortune since the collapse of the Roman Empire before the Barbarians. [...]

Such were the plans and compacts which underlay the civilization of Europe. All had been worked out to the minutest detail. They involved the marshalling for immediate battle of nearly twelve million men. For each of these there was a place reserved. For each there was a summons by name. The depots from which he would draw his uniform and weapons, the time-tables of the railways by which he would travel, the roads by which he would march, the proclamations which would inflame or inspire him, the food and munitions he would require, the hospitals which would receive his torn or shattered body - all were ready. Only his grave was lacking; but graves do not take long to dig.

__________________

Tuchman B: The Guns of August. Macmillan. 1962.
Churchill WS: The Great War. George Newnes Limited. 1933.
Carter M: What Happens When a Bad-Tempered, Distractible Doofus Runs an Empire? The New Yorker. 2018.
Grimberg C: Verdenshistorien. Politikens Forlag. 1968.
Hansen AP, Budtz-Jørgensen J, Steinmetz E: Vor Tids Leksikon. Aschehoug Dansk Forlag. 1951.

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