Shell-shock and other neuropsychiatric problems

A young officer, with many decorations for brilliant Colonial service, was in the battle of the Marne, under six consecutive days’ shell fire, smoked phlegmatically a cigarette no matter whether walls were crashing or horses disemboweled beside him, and was uniformly able to stimulate his men to the heavy work by humor or heroic phrases.

A week later, on the third day of the Aisne, he had to be evacuated. He was another man—wild-eyed, shivering, jumping at the least noise, unable to eat or sleep, given to battle dreams. He had to be carried away from the battle zone and put in a bed in a town in the rear and given chloral. The nightmares continued. On being awakened he would ask where he was. He was kept in bed, given strychnine cacodylate, and dieted. He went back to the front in four days. Two days later he had to be evacuated a second time. After some weeks more in the rear, however, he went back to the front, and thereafter had not relapsed (April, 1916.)

Re relapses, Wiltshire thinks their causes and frequency prove the psychogenic nature of Shell-shock. Ballard states that a severe case lasting six months does not recover in the army. Many that are said to recover in hospital break down at dépôts, often with symptoms quite unlike those which they originally presented, and it will be remembered that Ballard has an epileptic theory of the nature of Shell-shock. See Cases 82, 83, and 84 in Section A, III, Epileptoses. But another portion of Ballard’s contentions relates to a causation through fear suppressions released by perturbing events. According to Ballard, if the man endeavors to re-suppress the released fear, the fits occur. Ballet and DeFursac note the frequency of relapses—fewer after treatment at the front.