Soldier’s heart, both neurotic and organic.
Case 451. (MacCurdy, July, 1917.)
A territorial, 19, who had enlisted in January 1914, reached France in September, 1916. He was of neurotic make-up (night terrors, fear of dark, giddiness in high places, fear of tunnels, enuresis until 10 years, worry about seminal emissions), and had always had a tendency to short wind. Enlisting at 16, he found it hard carrying his pack at first but soon grew stronger. The trench life was distasteful. He began to wish that he might be killed, or at all events removed from the trenches. Pains developed under the heart, with shortness of breath, palpitation, dizziness, and faint feelings. The man connected these heart symptoms with what he called his weakness of gall bladder (namely, enuresis). He was several times sent off duty for heart treatment. After three months in and out of hospital, he got trench foot, was sent to England, and transferred to a special heart hospital. Here the pulse test was positive, in that the rate did not diminish as it normally does after two minutes’ rest. After graduated exercises for several months, the pulse test had become negative and the heart had gradually improved from the organic standpoint. The patient, however, insisted that his heart trouble was as bad as ever, and was probably consciously hoping that his symptoms might persist.
Re soldier’s heart, Abrahams classifies cases that come to the military surgeon for heart symptoms as (a) functional fatigue cases; (b) nicotine and drug cases; (c) organic heart disease and Graves’ disease; (d) the true soldier’s heart, occurring in men with a neurasthenic soil that lose control of the vasomotors and inhibitors of the heart.