Conference of Officers in Charge of Government Hospitals Serving Veterans of the World War
History
Conference of Officers in Charge of Government Hospitals Serving Veterans of the World War
Medicine, Military; Military hospitals; World War, 1914-1918 -- Veterans -- Medical care -- United States
DR. KOLB: In relation to the examinations made of these neuro-psychiatric
cases which were sent to us, I want to outline the procedure we use at
Waukesha in arriving at correct diagnosis and methods of treatment. The
patient is given to one special doctor. This doctor is supposed to make
the first preliminary examination, which included a complete physical,
neurological and psychiatric examination, and do all the work in
connection with these patients while in hospital. In making this
examination we have on our staff a number of very competent attending
specialists in order that we can obviate the mistake General Sawyer has
mentioned of assuming that these men are simply neurotics and passing
over important physical conditions. By this method we have caught a
number of cases which have been passed over as cases of neurasthenia.
For instance, I have in mind a case diagnosed neurasthenia which was
treated six months ago, which was a case of brain tumor.
After we have made the first preliminary examination the man is
carefully observed in hospital, not only by his own officer but by the
clinical director, and notes are made from time to time. Examinations
are also made by the dentist, x-ray examinations and various laboratory
examinations, including serological and base metabolism. In the end,
after all the data is assembled and written up, he is brought to the
staff and there his case is thoroughly discussed by all the members of
the staff; a diagnosis is arrived at, methods of treatment discussed and
afterwards put into effect.
Now as to the organic conditions with which our neurotics suffer. It is
true a large proportion of them do have organic disorders in connection
with their neuroses. We find that most of them do have functional
disorders originating purely in their mind, or because of some
constitutional nervous defect and that the real fundamental condition
from which they are suffering is not an organic condition but is nervous
or mental and must be approached along lines of psycho-therapy.
Now I will not go into the subject of psycho-therapy. We pay special
attention to mental questions but we do not neglect the physical by any
means. Every physical disorder which is found is corrected, if
correction is possible. We have complete physio-therapy and occupational
therapy and all other facilities for treating nervous cases. We are
careful never to stress too much on the physical treatment we give these
patients, because by so doing we suggest to them conditions they really
do not have and by that means prolong their functional disorders.
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