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Shell-shock and other neuropsychiatric problems

Chapter 559: Case 526. (Hurst, 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.

Mutism: Recovery by hypnosis.

Case 526. (Hurst, 1917.)

A transport driver, 31, was run over by a loaded wagon at Gallipoli in May, 1915, and fractured his pelvis. He remained perfectly conscious but unable to speak for three days. At the beginning of August, when he was admitted to the war hospital, he still spoke with great difficulty and with contortions of his face. Even when he did not speak, he had facial contortions and that mental condition characteristic of tic, namely: although he was able to control the contortions by will, he felt uncomfortable during the control and finally gave way to the irresistible impulse.

Under hypnotism, it was suggested to him that he would be able to speak without difficulty and would no longer have the contractions of the face. When he came out of hypnosis he was able to talk quite normally, sang next evening at a concert, and a few days later he took part in a play. The facial contortions persisted in hypnosis and even afterwards, but vanished after a second hypnosis.

Re hypnosis as treatment of mutism, Ballard remarks that a genuine return of speech and a merely hypnotic speech must be distinguished.

Nonne is the great exponent of the use of hypnotism in treatment of the war hysterias. He got as good results from high as from lower classes of men. He remarks that the hypnosis does not protect against recurrence if the patient again falls under the original conditions that brought about the first attack. Hypnosis may be used also as a diagnostic measure between functional and organic cases. Even tics and tremors have been at times cured.

Re employment of hypnotism, Hurst suggests that it may well be used, not only in mutism, but in hysterical deafness, blindness, and occasionally in psychasthenia. It is not a cure-all for the war hysterias, but is to be used as a not infrequent form of treatment. Nonne claims cures of 51 out of 63 cases of hysteria major (28 rapidly, 23 more gradually). Ten of his 63 proved refractory to hypnosis altogether.