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Shell-shock and other neuropsychiatric problems

Chapter 597: Case 565. (Harris, 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.

Exposure in the retreat from Mons: Persistent hysterical sciatica. Treatment by faradism and verbal suggestion.

Case 565. (Harris, 1915.)

A soldier developed pains about the hips and down the right thigh after getting wet through in the retreat from Mons, August, 1914. He was treated for a period of nine months in various convalescent homes and military hospitals, incidentally receiving forty baths at Droitwich. He hobbled on a stick, leaning upon the left leg and dragging the right stiffly. The thigh was tender and hyperesthetic.

The proper treatment of cases of hysteria, according to Harris, is strong faradism, applied by a small electrode or wire brush to the moistened skin. The stimulus is made powerful enough to force the patient to admit that he feels. The theory is that the powerful stimulation “breaks down the psychical auto-inhibition which produces the hysterical anesthesia.”

Faradism is only the first phase of the treatment. Verbal suggestion follows. Building on the basis of the feeling produced by the faradism or on the basis of the ocular evidence of motion in the hitherto paralyzed muscles, the patient is informed that the electricity will now be more and more strongly felt and that he will be cured in a few minutes.

The two elements in the therapy, then, are: encouraging verbal suggestion and the suggestion afforded by the paraphernalia of a complex looking, noisy machine. The knowledge on the part of the patient that a powerful and mysterious stimulus, namely, electricity, is being employed is a third element of suggestion.

Persistent hysterical sciatica, such as that of the present case, may require prolonged treatment. In this instance, the man was completely cured in five minutes, so that he was made able to run across the room. He said he would now be able to go back to the front, and wondered why he could not have been cured before.