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Shell-shock and other neuropsychiatric problems

Chapter 494: Case 465. (Gradenigo, March, 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.

Simulation of deafmutism.

Case 465. (Gradenigo, March, 1917.)

A soldier in the mountain artillery acted like a deafmute. He was unable to read or write. It was reported that he had been wounded, but no evidence of wound could be found. The man had a low forehead and a furtive glance, his whole impression being that of a criminal.

The only evidence of disease found was inflammation with perforation of the tympanic membrane of the left ear. Deep in the left auditory meatus was found a grain of crushed oats! The man’s speech difficulty was of a stuttering nature, but he stuttered in a different way at every test. He was unwilling to be narcotized. Finally by a process of scolding and cajoling, the man was made to confess that he could both hear and speak well. The peculiar stuttering early led to the diagnosis of simulation, but the fact that the tympanic membrane was not anesthetic, and that there was no anesthetic zone in the body strengthened the suspicion—to say nothing of the refusal of narcosis and the general behavior of the somewhat criminal-looking soldier.