The somatic group of psychoses, sometimes termed symptomatic, is illustrated in 29 cases ([Cases 118-146]), and comprises cases ranging all the way from rabic phenomena to those of hyperthyroidism. Possibly the first two cases (Cases [118] and [119]) might better be placed among the encephalopsychoses. [Case 118], one of rabies, was that of a farmer without history of having been bitten by a dog, who eventually came to autopsy and received the Pasteur Institute diagnosis of rabies. A diagnosis of angina was at first made. When the symptoms became more serious and masseter spasm developed, a question of tetanus arose. Later the diagnosis of meningitis was suggested. At this point, the symptoms became predominantly psychotic.
[Case 119] was one of seven cases reported by Lumière and Astier, in which delirium and hallucinations appeared as a complication of tetanus. The case in question had been given anti-tetanic serum. (Another case showed identical symptoms without having been given anti-tetanic serum.)
That a local tetanus could be mistaken for hysteria might seem à priori unlikely, but Cases [120] and [121] indicate as much; and [Case 121] is interesting on account of the officer’s own description of his local tetanus and its treatment. A psychosis apparently related with dysentery occurred in [Case 122]. Hysteria followed typhoid fever in [Case 123]. Another form of typhoid fever complication is perhaps shown in [Case 124], wherein the diagnostic question lay between dementia praecox and a post-typhoid encephalitis.
Paratyphoid fever has diagnostic complications, as shown in Cases [125] and [126], wherein the mental symptoms outlasted the fever ([Case 125]), and psychopathic taint was brought out ([Case 126]).
Diphtheria was also represented in the matter of nervous and mental symptoms in Cases [127] and [128]. In [Case 127] the nervous symptoms appeared eight days after evacuation for diphtheria. There were a few sensory symptoms (hypalgesia, hypoacusia, and peculiar bone sensations) in this subject. The phenomenon in [Case 128] was apparently one of hysterical paraparesis; nor does it appear in this case that the hysterical paralysis was preceded by polyneuritis.
Malarial effects are present in three cases ([Cases 129-131]), of which [Case 129] showed an amnesia, [Case 130] a Korsakow syndrome, and [Case 131] anterior horn symptoms. [Case 132] exemplifies 15 instances of acroparesthetic disorders in so-called trench foot. This case, like several others, is inserted in this group, not because the symptoms are psychotic, but because they might cause diagnostic difficulty as against hysterical phenomena.
[Case 133] is an autopsied case of bronchopneumonia following bullet injury of the spine. Microscopic examination of the spinal cord showed small cavities in the first and fourth dorsal segments. This myelomalacia was doubtless related with the bullet injury of the spine, although the spinal cord was not itself directly touched by the bullet. [Case 134] might be regarded perhaps as one of Shell-shock and should be considered in relation with [the cases at the head of Section B (Cases 197-209)]. The case might be regarded as functional, except for a decubitus that developed. Despite this decubitus, there was recovery. The case is placed in the somatic group on account of pulmonary phenomena which it seemed well to relate with those of [Case 133]. Compare also [Case 136], in which reflex phenomena are associated with a bullet wound of the pleura. [Case 135] is a many-sided case, with ante-bellum hysteria and certain Shell-shock phenomena. While under observation, the patient caught typhoid fever and then developed neuritis. This neuritis was very probably not post-typhoidal so much as hysterical. Accordingly, the case should be considered in connection with the ante-bellum weak spot series, [Section B (Cases 286-301)]. There was in this case a cure by reëducation.
The reflex hemiplegia with double ulnar syndrome in [Case 136] seemed to have followed a bullet wound of the pleura. According to the authors, Phocas and Gutmann, there is considerable literature upon nerve complications of pleura trauma, including syncope, epilepsy, and (more rarely) hemiplegia.
Heart cases are illustrated by [Cases 137-139]: the first one of hysterical tachypnoea, and the others of the so-called soldiers’ heart.
Diabetes mellitus seems to have followed war strain and shell wound in [Case 140].