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Shell-shock and other neuropsychiatric problems

Chapter 182: Case 165. (Weygandt, 1915.)
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About This Book

The work assembles nearly six hundred clinical case histories drawn from wartime medical literature to document combat-related neuropsychiatric disorders. It presents concise case protocols illustrating varied symptom patterns, diagnostic dilemmas, malingering and simulation, therapeutic interventions, and treatment outcomes, and includes bibliographic references and introductory commentary. Sections juxtapose cases to illuminate contested diagnoses and to inform postwar rehabilitation and mental-hygiene efforts, aiming to provide clinicians and reconstruction workers with detailed clinical material for recognizing, classifying, and managing neuropsychiatric consequences of war.

Apples in No-Man’s-Land.

Case 165. (Weygandt, 1915.)

A soldier in November, 1914, suddenly climbed out of the trench and began to pick apples from an apple-tree between the firing lines. The idea was to get a bag of apples for his comrades, but he began to pelt the French trenches with apples. He was called back and on account of his strange conduct sent to hospital. Here he was at times given to pressure of speech and restlessness; he would climb the posts of the sleeping room and then loudly declare he wanted to get back to the trenches; he did not want to go back to Germany alive; did not want to live over to-morrow; was guilty of a sin; had a spot of sin, Schand, on his heart. Sometimes he refused food and said anything else tasted better. It seemed he had formerly talked about the Iron Cross.

After being transported to Germany, he was at first a little negativistic and apparently blocked. He talked about his experiences and said he wanted to go to Russia. He explained the episode of the apples on the basis that they were all really hungry and that he had sought to encourage his comrades who were unused to war. He had noticed the French all shot too high.

Physically there was a somewhat uneven innervation of the face, unilateral epicanthus and an areflexia of pharynx. Now and then the man was very irritable, but in general he was in an elevated frame of mind.

Weygandt interprets this case as one of hypomania, remarking that war influences may serve to bring out preëxisting manic depressive tendencies.

Re differential development of mania and depression, see remarks under Cases 163 (Boucherot) and 164 (Logre).