At the end of [Section A], accordingly, we shall be left with two more formulae for discussion in Sections [B], [C], and [D], viz:
(5) Cases without physical shell-shock but with symptoms of pathological Shell-shock (-+-).
(6) Cases with physical shell-shock and pathological Shell-shock (++-).
The data of [Section A] will solidly prove that Shell-shock, however picturesque the term for laymen or in the argot of the clinic, is medically most intriguing. As we cannot get rid of the term (even by suppressing it in parentheses or by condemning it to the limbo of the so-called), we must make the best of it by calling Shell-shock just the ore in the clinical mine. To say the least, the term is harmless: it merely stimulates the lay hearer to questions. These questions he must ask of the expert. But every time that the expert suavely states that Shell-shock is nothing but psychoneurosis, that expert runs the risk of hurting some patient who may or not have a psychoneurosis but has been called psychoneurotic. All the while, of course, the suave expert is perfectly right—statistically. In fine, the man you have called a victim of Shell-shock is probably a victim of psychoneurosis, but only probably!
[Section A] shows how he may—not probably, but possibly—be a victim of say ten other things. But it is not that he has an even chance of being one of these ten other things. As the reader watches the procession of cases in [Section A], he will perceive that, amongst the ten major groups there studied, some have far greater diagnostic likelihood than others. Thus, syphilis, epilepsy, and somatic diseases will in the sequel prove more dangerous to our success as diagnosticians than, e. g., feeblemindedness or even perhaps alcoholism. But now let us look at these cases systematically, just as if we dealt with so many cases of Railway-spine or any other “incipient, acute, and curable” cases.
Chart 2
PSYCHOPATHIA MARTIALIS
| ⎧‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾⎫ | |||
|---|---|---|---|
| ⎧‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾‾⎫ | |||
| SHELL-SHOCK (THE PHYSICAL FACTOR) | SHELL-SHOCK (NEUROTIC SYMPTOMS) | PSYCHOSIS (SYMPTOMS NON-NEUROTIC) | |
| Absent | Absent | INCIDENTAL | |
| Present | Absent | LIBERATED, AGGRAVATED, ACCELERATED PSYCHOSES | |
| Absent | COMBINED NEUROSES AND PSYCHOSES [2](Formula -++) | ||
| Present | COMBINED NEUROSES AND PSYCHOSES (Formula +++) | ||
| Absent | NEUROSES (Quasi Shell-shock) | Absent | |
| Present | NEUROSES (True Shell-shock) | Absent | |