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Shell-shock and other neuropsychiatric problems

Chapter 601: Case 569. (Voss, November, 1916.)
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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.

A year’s field service, gunshot; typhoid fever: Astasia-abasia: Lourdes-like cure: Residual amnesia.

Case 569. (Voss, November, 1916.)

A soldier in service from the outbreak of war, shot in September, 1915, afterward suffering from fainting spells, was treated in several hospitals. He developed a typhoid fever at Lindau, which was at first taken for hysterical fever. Eventually he came to the observation of Voss, unable to stand and falling hysteria-wise if compelled to walk.

Thorough examination was made. It was emphatically explained to him that there could be no reason why he should not stand or walk.

A miracle occurred. From the second day of his hospital stay he not only walked about but began to polish doors and windows with inexhaustible strength.

But when he was about to be told that he must now be looked upon as well, the miracle was not so manifest. It now transpired that he had serious gaps of memory and disorders in recognition, a sphincter disorder and ever since his typhoid incontinence with fluid feces.

In short, waking suggestion had caused a very prominent symptom to disappear, but the total personality remained sick. According to Voss, the procedures of Kaufmann are dubious just because they cannot stand the test of time. Yet so far as the cure of this man’s astasia-abasia was concerned, it was not at all unlike the cures wrought at Lourdes.

Re miracles of this sort, see cases of Colin Russel (503 and 504) as well as those of Veale (511 and 512). Voss’ arguments run parallel with the contentions of various persons that the miracle cures (such as those by anesthesia, electric suggestion, and hypnosis), do not get sufficiently to the bottom of the affections in question. Buzzard, in the preface to Yealland’s book on the Hysterical Disorders of Warfare, remarks that the question of the ultimate prognosis in cases thus suddenly cured must be left unanswered.