nor for a tongue that cries mamma and papa.
Inferno, Canto XXXII, 7-9.
In the course of our study of psychoses incidental in the war ([Section A]) and especially of Shell-shock’s nature and causes ([Section B]), we have naturally met most if not all of the major diagnostic difficulties. In the present Section we shall study cases for the light they may throw on the more technical troubles of the diagnostician. Who would à priori have felt that such diseases as tetanus, rabies, malaria, would produce practical difficulties in clinical diagnosis in the field of Shell-shock?
Mayhap there was no need to emphasize further the values of lumbar puncture fluid examination. Yet the admixture of “functional” and “organic” symptoms in numerous puzzling cases can hardly be over-emphasized.
But the interpolation, through the ingenious inquiries of Babinski, of a new or but vaguely suspected series of “reflex” (“physiopathic”) troubles between the organic neuropathic disorders on the one hand and the hysterical psychopathic disorders on the other—the result of these observations, sampled only in [Section B], is given more in detail in the present Section. What a split in therapeutic method a recognition of this new group of “physiopathic” disorders might entail is seen also in further cases in the Section that follows this ([Section D on Treatment and Results]).
A number of simulation cases has been added.
Chart 11
ETIOLOGICAL GROUPING OF WAR PSYCHONEUROSES
| I. | NEUROSO-ORGANIC ASSOCIATION (NO CAUSAL NEXUS) |
| II. | REFLEX NEUROSES (LESION DISPROPORTIONATELY SLIGHT BY COMPARISON WITH PSYCHONEUROSIS) |
| III. | NEUROSO-SOMATIC ASSOCIATION (Trench Foot, Neuritis, Radiculitis) |
| IV. | FATIGUE OR EMOTIONAL PSYCHONEUROSES (CONSIDER EFFECTS OF PSYCHIC CONTAGION, EDUCATION) |
| V. | PSYCHONEUROSES ON ANTEBELLUM BASIS |
After Grasset