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Shell-shock and other neuropsychiatric problems

Chapter 589: Case 556. (Proctor, October, 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.

Shell-shock; unconsciousness: Mutism and musical alexia. Cure by anesthesia.

Case 556. (Proctor, October, 1915.)

A private, 23, was admitted to the Duchess of Connaught’s Hospital at Taplow from Gallipoli, September 10, 1915. A shell had exploded behind this man. He had been picked up, unconscious, and remained so about a day. He recovered without the power of speech. Cerebration was slow at first but improved steadily.

The man had been a professional musician. Curiously enough, though his ability to read ordinary print was as good as ever, his reading of music was lost with the speech.

September 20, he was etherized, but being of a phlegmatic type, he was not readily excited and took the anesthesia very quietly. After perseverance, however, he was induced to talk. The ability to read music returned with the voice. He was discharged, October 4, 1915.

Re the use of anesthetics for curing deafmutism, Colin Russel rather disapproves of this method on the ground that no attempt is made to get at the genuine pathogenesis of the case and that accordingly there may be a tendency to recurrence.

Re the peculiar musical alexia, see discussion under Cases 353 and 450 of confusion and amnesia. The most highly selective amnesias have been found in confusional cases. However, Case 556 had been a professional musician and the effect may have been a highly specialized suggestion. See also Case 369 of Feiling for differentiated musical disorder. Mott has used the retained knowledge of tones as an avenue of approach in certain mute cases.