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Shell-shock and other neuropsychiatric problems

Chapter 579: Case 546. (Tombleson, September, 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.

Neurotic symptoms: Improvement under repeated hypnosis.

Case 546. (Tombleson, September, 1917.)

A private, 32, was admitted, April 15, 1916, to Tombleson’s ward from the Cottonera Mental Ward with the diagnosis: psychasthenia with paresis of right arm. The man was very suspicious of the medical profession, melancholy, morose and prone to tears. He had been kicked by a horse four years before and showed a depressed and very tender scar in the right parietal region. The right side of the body since that injury had been getting weaker, but the arm was much weaker than the leg. Anesthesia was practically complete on the right side. There was a wasting of the muscles of the right arm and the skin of the hand and fingers was thin and shiny.

Before his transfer the man was placed in the somnambulistic state, with suggestions of happiness and confidence in the coming cure. He arrived at Valletta, April 16, in a cheerful frame of mind, stating that there was nothing now the matter but weakness. Under somnambulism the loss of symptoms was suggested and, April 17, the patient was well except for the loss of power in the arm and leg. Daily training under somnambulism was given for a period of seven days, with suggestions especially leveled at the paretic muscles. He was then so far recovered that hypnotic treatment was stopped. The patient went to England, May 12, 1916, well.