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Shell-shock and other neuropsychiatric problems

Chapter 207: Case 188. (Buscaino and Coppola, January, 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.

Maniacal and hysterical delinquent.

Case 188. (Buscaino and Coppola, January, 1916.)

An Italian soldier, 25, a foundling, was always off and on in a military prison. At a tavern one night the man unsheathed his sword and threw three bottles at the host. Bystanders overpowered him and carried him to the local police station. Handcuffs were put on to stop the mania. His pupils were dilated and he was sweating profusely. Alcohol could absolutely be excluded from the history of this incident.

Observed in clinic, the patient was rather silent, but on the whole normal and without delusions or hallucinations. It seems that he had committed a number of crimes in the army that were always excused on account of his mental state. He had been strongly alcoholic, although not at the time of the incident mentioned. He was covered with tattooings of an obscene and violent nature.

He showed pharyngeal and conjunctival anesthesia and concentric limitation of the visual fields of unusual degree, and a remarkable hypalgesia. The knee-jerks were lively. The man was, in point of fact, sent back to military service, with, however, the suggestion of reform school.