Shell-shock and other neuropsychiatric problems

by Elmer Ernest Southard

He was sent home from service in 1913, with ulcers of hand.

At the beginning of the war he was found to have ulcers on the knee, legs, and mouth, and was sent home for six months.

Again called up in 1915, the ulcers were still in evidence; he got inunctions in a military hospital four months.

He was sent to his corps in July and had no relapse until July, 1916, when he was detailed for active service. Thereupon, ulcers began on the left hand and right leg. He reported sick, but was sent nevertheless to the front. In hospital he was found to have several scars about one inch across on each leg, on the dorsum of the left hand, at the right of the left index finger, and elsewhere. These scars were deeply pigmented. One of them was square! There were other recent ulcers that closely resembled tertiary ulcers. The most recent of these ulcers was angular, intensely red, and showed remains of a collapsed vesicle. There was a deep dark scab on the mucous membrane of the left cheek.

There is no doubt that these ulcers were produced by some caustic, the nature of which remains unknown. The patient had, however, been able to evade military obligation during peace time and for two years during war time.

Re simulation, according to Pick, some 5 to 7 per cent venereal diseases in the German army have been simulations. Gonorrhoea is simulated by soap, balanitis by cantharides, soft chancre by soap and mercuric or mercurous chloride mixed, hard chancre by a fluid or powder containing NaOH, Na₂CO, and NaCl. Secondary syphilitic signs are imitated by cantharides or garlic, producing scrotal dermatitis. Tertiaries are imitated with caustics.

Ramón to Rosina: a soldier’s letter to his fiancée.

Case 34. (Buscaino and Coppola, January, 1916.)

“I am here to stay a month. Believe me, it is better here than in the army. There is a rule that we may eat as much as we can and everything is of the very best. The servants treat us like brothers. Do not think it is a nuisance to be inside four walls with a wee bit of a garden. No, indeed! But I have got to act the fool and from the very first day I began to play and act crazy with a kitten, so that if you had seen me you would say: “Ramón is really crazy.” Rosina, dear, to avoid paying taxes you have got to be a smuggler. And now that I am at the ball I have got to dance. I want to see if after all the suffering I cannot get something better. I am better off here than at the regiment. I sleep in a fine warm bed, and they have only cold straw; I have good food and drink and plenty of milk, and they have poor food and drink and so little.