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
This case appears to belong to the B group of mutism cases,
according to the classification of Myers, namely, to the group
in which the effects are psychical rather than physical.
According to Myers, whether mutism occurs as an apparent result
of physicochemical or of mental causes--that is, as an A or a
B case--it is _actually_ always the result of mental--that is,
psycho-physiological shock. Mutism in the A cases of physical
nature, where the shock must have been grosser and more
profound, generally proves more severe than in the B cases.
As to the appearance of unconsciousness, apparently confirmed
by the patients’ statements that they “lost consciousness,”
it is a question whether these cases are not really cases
of deep stupor. According to Myers, the mutism is in nearly
every instance closely dependent on some form of stupor, being
generally the relic of such stupor after it has passed off.
Let the loss of consciousness be a profound stupor due to
the lifting or burial of the patient, then from this stage
there will be a transition to a state of ordinary stupor in
which intelligence is active but the patient is unresponsive
to stimuli. The patient is in a condition called by Myers
_excommunication_, in which the inhibitory process may be
regarded as protecting the individual against further shock. As
the stupor now passes away, it is natural that the inhibition
should appear lost in the case of hearing and speech, which are
two main channels of intercourse with others.
Dumbness is, by far, the commonest disorder of speech,
occurring in about ten per cent of shock cases in the first
thousand cases of shell-shock seen by Lt. Col. Myers.
Stuttering and jerky speech have occurred in about three per
cent. Loss of voice is rarer.
As against the view of Babinski, that mutism, being curable by
suggestion, must have been produced by suggestion, Lt. Col.
Myers argues that the stupor preceding mutism is the antithesis
of suggestibility and is, in fact, a condition of extreme
_autofixity_.
Naval gun-fire effects on seaman: Aphonia. Two recurrences.
=Case 264.= (BLÄSSIG, June, 1915.)
A seaman from the _Derfflinger_ was brought into a naval hospital with
loss of voice, December 22, 1914, able to speak only in a whisper. As
a child he had had diphtheria, but recovered without complication. He
had always had a very well-controlled voice. Early in December he had
had a cold owing to sentry deck duty in bad weather. Two days after
the shelling of Scarboro,--December 16,--while in the munition chamber
of the big guns, he suddenly lost his voice. He had been greatly upset
during the firing of the guns. In two weeks he recovered speech.
Public-domain text, read in full here on John Shaqi.
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