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Shell-shock and other neuropsychiatric problems

Chapter 208: Case 189. (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.

Psychopathic delinquent.

Case 189. (Buscaino and Coppola, January, 1916.)

An Italian, 20 (family history negative), was described by officers as of an odd disposition, at times thoughtful and again chattering and presumptuous, and often very vulgar in talk and manner. He had tried several trades, with little success.

While in the army he discharged his gun three times, claiming to have heard noises in a nearby field. On account of the inopportune repeated discharges, he was condemned to the barracks for ten days. The following day, instead of returning to the barracks, he abandoned his musket, cartridge box and uniform, and, returning to town, left for Leghorn. Being sent to prison, he began to scream that he was thirsty. He tore his jacket into strips with his teeth, and making a noose of it, attempted to hang himself.

On being transferred to the military hospital, he was often very restless, screaming and making a great uproar. On being questioned, he answered indifferently and had a vacant stare. During his stay at the clinic, patient was always quiet. Once, however, he had a spell of intense psycho-motor agitation, brought on without any known cause and followed by a short period of bewilderment, lasting altogether half an hour.

Patient had insomnia and his visual fields showed concentric contraction for white. He was sent to a military convalescent hospital.