Shell-shock and other neuropsychiatric problems : $b Presented in five hundred and eighty-nine case histories from the war literature, 1914-1918Southard, Elmer Ernest
History
Shell-shock and other neuropsychiatric problems : $b Presented in five hundred and eighty-nine case histories from the war literature, 1914-1918
Southard, Elmer Ernest
War neuroses; World War, 1914-1918 -- Medical care; World War, 1914-1918 -- Psychological aspects
One evening he had been given the order to attack. The artillery opened
fire. He found that the Germans had erected barbed wire defences. The
loss of men was terrific. His order was to shoot all who held back. A
poor territorial crouched down and would not go forward--supplicating
the prisoner not to shoot him. The prisoner spared him.
The next night the order to attack the German trenches was again given.
This time he was overcome with anxiety and discouragement. The last
he remembers was the order to attack. Next day he felt sick and his
mind was foggy. He remembered leaving his regiment and wandering round
for several days until he fell into the hands of the British and was
arrested. Then he understood what he had done.
The prisoner asked to be allowed to return to the front. The testimony
of one of the lieutenant’s men verified his statements. On the day
before he left the front he had been anxious, had cried often, and
would speak to no one. On the day he left the trenches without
permission, he was nervous and disoriented.
There was no doubt that simulation could be ruled out; the differential
diagnosis lay between a “confused state of emotional origin” and an
“epileptic dazed state.”
For epilepsy there was a history of attacks with falling to the ground
and loss of consciousness, without involuntary micturition or biting of
tongue, during the time when he was a sergeant. Moreover, irritability
and unwarranted suspiciousness had been present at these periods.
However, there were no other epileptic symptoms; these two attacks were
isolated and of quite long duration, leaving no headache or malaise
after them. Also there was no basis for the diagnosis “epileptic
dazed state,” since there was no abrupt commencement; the loss of
consciousness was never complete (the subject was able to converse with
persons while the attacks were on); and some remembrance was present of
incidents during the attacks.
For Barat, the important points are that the attacks were preceded by
long periods of anxiety and the disturbances resulted more from moral
than physiological causes.
The importance of the psychological factors lead the author and his
colleagues to the diagnosis “Mental confusion of emotional origin.”
The board decided to return him to the interior and give him a barracks
position at the reduced rank of drill sergeant.
A solitary epileptic episode in an artillery officer (slight concussion
of the brain two years before) following extraordinary campaign stress
(38 artillery battles in two months).
=Case 76.= (BONHOEFFER, July, 1915.)
Public-domain text, read in full here on John Shaqi.
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