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
Friedmann states that mild emotional alterations are not infrequent in
the trenches with minds disposed thereto, although emotional shock,
especially in shell fire, is the most frequent cause. However, these
particular seizures are quite unusual. The stresses of field service
lead to a sometimes complete paralysis of mental power, interfering
transiently with service. There is no evidence of sudden circulatory
disturbances such as would bring about dizziness, pallor, nausea,
or fainting spells. According to Friedmann, the regulative brain
functions, especially those that maintain consciousness, become weak
on account of a condition which he terms _Gehirnmüdigkeit_, or, as we
should say in English, brain fag. The situation forbids due completion
of sleep. Thus, the explanation of the daytime attacks follows rather
obvious lines of brain fag. The accidental awakening it is, which at
night produces the absences; the wakenings are due to the general
restlessness of the patient. The general weakening of cerebral function
produces the disorder at the moment of wakening, since the regulative
factors of consciousness are already out of order. The condition in
the absence rather closely resembles the state of consciousness just
before going to sleep, and also perhaps the state of consciousness
during the process of awakening. It is as if the process of waking were
somehow delayed a few moments. Friedmann is interested to show the
relation of such absences to the so-called _gehäuften kleinen Anfälle_,
originally described by him in 1906 as occurring in children, and
distinguished from epileptic attacks. These attacks, after lasting for
years, finally disappeared completely. The same sort of thing in adults
was symptomatic of some other disease, such as neurasthenia, and was
not a true entity. In children these attacks failed to be attended with
any mental injury, nor were there any pronounced epileptic phenomena.
Bromides had no effect upon them, and they already showed a somewhat
striking and peculiar appearance, involving interruptions ten seconds
long of capacity to think, speak, or move, without disturbance of
consciousness or automatic movements. Sometimes the attacks occurred
from six to 100 times in the day, without in any respect interfering
with the general condition of the child. The occurrence of such series
of mild seizures is nothing but a syndrome. To be sure, some cases
turn out to be cases of genuine epilepsy with an eventual degenerative
process. Some forms belong in the spasmophilia group, and some among
the hysterias. However, according to Friedmann, there is a narcoleptic
_petit mal_ that is an entity by itself, proceeding after a period
of years to complete recovery without complications. It is this form
which may be regarded as a peculiar kind of brain fag. The case of the
soldier may be supposed to be one which will prove to have this benign
outcome.
Sham fits.
=Case 78.= (HURST, March, 1917.)
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account