MENTAL OR PSYCHICAL SYMPTOMS.
The third class of results which are found after electrical shocks from high-tension currents are the mental or psychical. By the use of these terms we do not wish to imply that they are voluntary. They are, however, so far as our present knowledge of pathology reaches, largely functional. This is precisely the class of cases which, when resulting from railway accidents, are placed under the head of railway-brain or railway-spine. They may be considered in the present state of our knowledge as traumatic functional neuroses, though it is probable that when our means of examination and investigation are more complete we may succeed in discovering a visible or perceptible lesion. The symptoms affecting motion and sensation in these cases are frequently accompanied by others of an emotional character, and in many cases there seem to be partially or wholly voluntary conditions and symptoms with the involuntary. There is in many cases a characteristic loss or diminution of the force and power of volition, but in others this is not perceptible.
These conditions are so well known when produced by other causes that we do not consider it proper to enter into a full consideration of them here, but we cannot leave this important subject without a few general remarks.
No form of affection or disease has caused more discussion among the medical profession or figured more prominently in the courts than this, and even now there are many questions in relation to these conditions still under dispute. Our own view, confirmed both by observation and experience, is that the tendency in New England, at least, has been on the whole to underrate the severity, the duration, and the amount of suffering caused by these conditions. That because there have been cases of malingering, of deception, and of rapid cure after the receipt of damages, and because in addition to this a certain visible emotional and at times apparently controllable element exists, the profession, and above all the laity, are led to conclude that this forms the essential condition and basis of the disease. On the contrary, in a very large proportion of cases the symptoms are such as cannot possibly be voluntarily assumed; they produce extreme discomfort and often much suffering for the patient, and frequently last for years, rendering their victims incapable of carrying on their former occupations.
Fortunately in the patients suffering from electric shock the severer forms of these affections are not so common. In most of the cases reported recovery has been more or less rapid. Cases in which previous hysteria or neurasthenia have existed are more liable to these manifestations than persons of a previously equable nervous constitution, but these latter are by no means wholly exempt. To consider these conditions, as is sometimes done, as the fault of the patient seems to us both unwarrantable and unjust.