107. It is beyond the scope of this book to deal systematically with the hospital and administrative side of these questions. Especially the zone question is of practical importance, that is, the question of arrangements at the front, on evacuation lines, and in the interior. Roussy and Lhermitte have particularly discussed these matters.
After thirty months’ experience in the psychiatric centers of two armies, Damaye suggested an organization of psychiatric centers in two parts,—First, a service draining patients from the firing line, rapidly give them first care and evacuate them, in charge of special attendants, to: Second, a psychiatric or neurological center in the communication zone (étapes) without danger of bombardment and at a distance from the guns. The more serious cases will then be evacuated, thirdly, into the interior from these centers along communication lines. But most will have gotten well at the front.
108. By orthopedists and mechanotherapeutists too much stress may indeed be laid on non-psychiatric measures, as Duprat hints. Yet perhaps neuropsychiatrists may need as much coaching in the opposite direction. One must remember the non-psychopathic fraction of these Shell-shock disorders and their need of diathermy (Babinski). Duprat says that the centers for physiotherapy cannot effectively do the work of all Shell-shock therapy, as the physiotherapists have their aims fixed on nerves and muscles rather than the mind. Each case requiring psychotherapy ought to be studied in an experimental psychological laboratory from a number of points of view such as mechano-motor capacity, the sensibility, emotional and intellectual sides, memory, impulses and the like. Testing apparatus should be available together with dynamometers, sphygmometers, chronoscopes, ergographs, pneumographs, cardiographs and recording apparatus.
Chart 19
PSYCHOELECTRIC AND REËDUCATIVE TREATMENT
| Phase | I. | PERSUASIVE TALK IN CONSULTING ROOM |
| Phase | II. | ISOLATION, REST IN BED, MILK DIET (a few days) |
| Phase | III. | FARADIZATION |
| Phase | IV. | REËDUCATION (Physiotherapy and Psychotherapy) |
| Phase | V. | AFTER-CARE |
Curing a psychoneuropath means victory in a moral battle!
After Roussy and Lhermitte