But parts of the book look ahead to Reconstruction. Surely occupation-workers, vocationalists, war risk insurance experts, and in fact all reconstructionists, medical and lay, must find much to their advantage in the data of [Section D (Treatment and Results)]. Had time permitted, the whole old story of “Railway Spine”—Shell-shock’s congener—might have been covered in a series of cases from last century’s literature, together with others illustrating the effects of suggestion and psychotherapy; but this must be a post-bellum task.
The compiler, who has personally dictated (and as a rule redictated and twice condensed) all the cases from the originals (or in a few instances, e.g., Russian, from translations), hopes he has not added anything new to the accounts. The cases are drawn from the literature of the belligerents, 1914-1917, English, French, Italian, Russian, and—so far as available here—German and Austrian.
I would call the collection not so much a posey of other men’s flowers as a handful of their seeds. For I have constantly not so much transcribed men’s general conclusions as borrowed their specific fine-print and footnotes. The lure of the 100 per cent has been very strong in many authors; but the test of fine-print, viz., of the actual case-protocols, saves us from premature conclusions, and the plan of the book allows us to confront actualities with actualities. One gets the impression of a dignified debate from the way in which case-histories automatically confront each other, say in [Section C (Diagnosis)].
Obligations to the books of Babinski and Froment, Eder, Hurst, Mott (Lettsomian Lectures), Roussy and Lhermitte, Elliot Smith and Pear, and others are obvious. Yealland’s book came too late for sampling its miracles, though cases of his in the periodical literature had already been incorporated in my selection.
Some of the cases in [Section A, I], had already been abstracted in Neurosyphilis: Modern Systematic Diagnosis and Treatment (Southard and Solomon, 1917).
What we actually have made is a case-history book in the newly combined fields now collectively termed neuropsychiatry. The more general the good general practitioner of medicine, the more of a neuropsychiatrist! And this is no pious wish or counsel of perfection. Neuropsychiatry, mental hygiene, psychotherapy and somatotherapy—all these will flourish intra-bellum and post-bellum, in days of destruction and in days of reconstruction. And who amongst us, medical or lay, will not have to deal in reconstruction days with cases like some here compiled? A minor blessing of the war will be the incorporation of mental hygiene in general medical practice and in auxiliary fields of applied sociology, e.g., medico-social work.
Subsidies aiding publication are due to the National Committee for Mental Hygiene; the Permanent Charity Foundation (Boston Safe Deposit and Trust Company); Mrs. Zoe D. Underhill of New York; Mr. H. T. White of New York; and Dr. W. N. Bullard of Boston—to all of these the various military recipients of the book will be under obligations, as well as others who would otherwise have had to pay the great majoration de prix due to war times.
Of those great dead contributors to neurology laid (in the [Epicrisis]) at the feet of the neo-Attila, perhaps only Sir Victor was in a narrow sense the Kaiser’s victim: still, but for the war, they might all remain to us.
By the way, just as I found John Milton had said things that fitted neurosyphilis, so also Dante is observed in the chosen mottoes to have had inklings even of Shell-shock. To the Inferno it was natural to turn for fitting mottoes (Carlyle’s renderings mainly used). The pages might have been strewn with them. A glint of too great optimism might seem to shine—in the pre-Epicrisis motto—from the lance of Achilles with its “sad yet healing gift;” but out of Shell-shock Man may get to know his own mind a little better, how under stress and strain the mind lags, blocks, twists, shrinks, and even splits, but on the whole is afterwards made good again.
E. E. Southard.