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Shell-shock and other neuropsychiatric problems

Chapter 331: Case 306. (Donath, 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.

Fall from horse in battle; fear of being crushed: Hysterical crises. Case offered as showing TRAUMATIC HYSTERIA in a young physician WITHOUT HEREDITARY OR ACQUIRED PSYCHOPATHIC TENDENCY.

Case 306. (Donath, 1915.)

A physician of twenty went into the war as a volunteer Hussar. During an attack, he fell from his horse without losing consciousness, though he was at the time much afraid of being crushed. The attack ceased and he returned to the lines on horseback.

Immediately there developed an emotional crisis, and thereafter he broke into weeping on the slightest occasion. He was afraid he was going to lose his reason; that some spiritual power was going to suppress his ego and madden him. He wept as he was going under narcosis to be operated upon for an intercurrent appendicitis. He became so sensitive to noise that he wanted to choke the offender. One day he bit himself on the arm in his excitement. Sensory tests could not be executed on account of his fear of the brush. Reflexes were normal.

It took four hypnotic seances to get him in proper rapport with his physician for psychotherapy.

This case is cited by Donath as one in which traumatic hysteria has been proven to exist in a man without any sign of neuropathic or psychopathic taint, either in his previous history or in his relatives.