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Shell-shock and other neuropsychiatric problems

Chapter 206: Case 187. (Pellacani, April, 1917.)
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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.

Psychopathic episodes.

Case 187. (Pellacani, April, 1917.)

A Neapolitan, 26 (neuropathic stock: mother epileptic, brother psychopathic; patient had previous criminal record; married and then appeared to behave himself for several years; had always been excitable and of violent temper), after but one severe day in the trenches, woke and found his night clothes soaked in urine. Another time, his comrade had awakened him because he was gnashing his teeth in his sleep. Again, his grief became very violent at learning of his wife’s infidelity, and during the night he bit his finger. He thereafter suffered from severe headaches, dizziness and vertigo though without falling. He was granted a furlough, but the condition was aggravated on account of his wife’s abandonment of him, and one day, finding her with her lover, he threw himself at them, wounding her severely in the face: he did not remember this impulse later. Many hours later, on awakening in prison with his wounded hand, he recalled the entire episode. He showed a confused and excited condition, which, however, quickly diminished. He became lucid and tranquil, though easily aroused. He cried at the thought of his daughter, whom he wanted to save. Insomnia, instability of reaction, habitual migraine, and dizziness. Tremors of the fingers and of the eyelids. Exaggerated reflexes. Very striking cutaneous analgesia.