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Shell-shock and other neuropsychiatric problems

Chapter 196: Case 178. (Eder, March, 1916.)
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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.

Service in France and Salonica: Psychasthenia.

Case 178. (Eder, March, 1916.)

A man, 29, after some months’ service (three months in France and later in Salonica) was invalided for backache, insomnia, and enuresis. It seems that this married man had never done any work after leaving school at 18, having substantial private means. He had been married for 3½ years, had a son, and was, according to Eder, perhaps morbidly attached to his wife and child. He had been a sportsman and was selected for sniping work in France. The son of a shipbuilder, he had always planned all kinds of ships and engines, never to be used. After seeing the world, he was about to enter his father’s business when he had to take care of his father in a nervous breakdown. After a second attack, the man never entered business.

February 6, 1916, wide-spread patchy analgesia and lumbar hyperesthesia were found. He thought sluggishly, being restless and holding attention poorly. He began twenty letters, destroying each after finishing a few lines. He was shy and felt that everybody was looking at him. He became speechless if he had to address his commanding officer. He had an obsession to mark each flagstone and touch each post, and various counting and arranging obsessions.

The Horme (Jung) was elusive. A dream: “I was in a cargo boat in the river; we were steering straight into ferry and harbor. The pilot rang down ‘Full speed to stern’; I pushed him out of the way, and rang down ‘Full speed ahead, two points to starboard.’ We went straight past ferry and harbor without accident.” Again, a few days later, “In a motor car, came to some rocks which sprang up in front of me. The machine broke down. I abandoned it and clambered over the rocks. It was tough work. My object was a ship. I got to the ship, took hold of the wrench, and signalled ‘Let go.’” Herein, according to Eder, are certain obvious symbolic conversions.