(n) We studied the localization (traumatotropic) group.
(o) We arrived, with the aid of Babinski, at the necessity of splitting functional cases into psychopathic and physiopathic.
73. Summary of general considerations: continued.
We found ourselves looking on the Shell-shock neuroses as, like other functional neuroses, in a sense mental diseases. Perhaps we would better say (to get rid of all suspicion of medicolegal “insanity”) that the Shell-shock neuroses seemed to us in some sense psychopathic. But, though the Shell-shock neuroses looked psychopathic and were presumably more functional than organic in nature, it was a curious thing that, practically speaking, the Shell-shock neuroses proved to be farther away from the more functional of the psychoses than from certain organic psychosis.
In particular, we found reliable authors insisting on the practical diagnostic necessity of excluding syphilis, epilepsy, somatic disease—whereas the nature and causes of the Shell-shock neurosis seemed theoretically to withdraw them most remotely from that triad of mainly organic disorders. By the same token, theoretically one might have supposed these Shell-shock neuroses to draw very near to those far less organic disorders (schizophrenia, cyclothymia, feeble-mindedness (i.e., the slighter degrees likely to be found in military service, alcoholism))—yet practically few large diagnostic problems came to light as between the Shell-shock neuroses and the tetrad of dynamic or lightly organic diseases above listed.
74. Diagrammatically this situation is presented in [Chart 17].
But why should the Shell-shock neuroses seem so “organic”? Partly, it is probable, because the term “organic” is too often used to mean “subcortical.” In another diagram the truer relations are depicted, with four classes of phenomena ([Chart 18]).
(a) Organic mental (cortical), e.g., general paresis.
(b) Functional mental (cortical), e.g., hysteria.
(c) Organic neural (subcortical), e.g., tabes dorsalis.