SHELL SHOCK.

Manawatu Herald, Volume XXXIX, Issue 1678, 24 February 1917, Page 4

SHELL SHOCK.

ITS CURIOUS PHASES. SOME ODD RECOVERIES. xV very considerable difference of opinion exists among army doctors as to the nature and treatment of the complaint familiarly known as ‘•shell shock.” The number of these cases is legion. Some of them are as clear as a pikestaff, but in others there is room for considerable doubt. Let us take one of the former type. A shell explodes in the vicinity of a soldier. He is unwounded, but violently shaken, perhaps knocked over or buried. He loses his senses for a varying period, and his nervous system, having suffered a violent shaking, is no longer what it was. He starts at the least sound, he cannot sleep, he has pains in the head, and his hands are slightly tremulous; all, except the last, symptoms that depend on the word of the patient and not on the observation of the doctor. A STRANGE FACT. Now. there is one remarkable fact to be noted about all these cases. These men ar unwounded. No case of “shell shock” is ever found to occur in a soldier who has a wound, no matter how trivial. It seems as if the rending of the flesh by a bullet or a fragment of shrapnel acts as a sort of safety valve against “shell shock,” localising in the injury the destructive force that otherwise is spent on the nervous system. Some men, on recovering from unconsciousness, are found to have lost the use of one of the special senses —sight or hearing or speech. This is a purely functional loss, and recovery may occur at any period, weeks or months later, in a way suggesting that the age of miracles in not yet past. The deaf hear, the blind see. the dumb speak. I saw one of these cases recover myself; a case of complete deafness, writes a physician. I had been talking to the man by means of paper and pencil, when he suddenly put his hands to his head, complained of intense pain, said his head was bursting, rolled about in agony; and it was then discovered that- he could hear us speaking to him. Recovery was perfect. Others have recovered their speech in a similarly mysterious it ml impressive way, usually its the result of a great shock. But the sad fact remains that it great many have never altered at itII; they are in exactly the same state as when they regained consciousness. Attempts have therefore been made to assist laggard nature in a cure. HYPNOTISM FAILS. Hypnotism was first of all tried, hypnotism accompanied by “suggestions.” The patients were placed in the hypnotic condition in the usual way, and then “suggestions” were made to them that they could speak. (Obviously deaf patients could not be treated in this way,) The results were not very encouraging. Then it occurred to someone that, if a patient who was dumb were simply placed under an anaesthetic (chloroform or ether) he might recover his speech during the struggling stage, when everyone gives vent to incohent and generally imprint able ejacula t ions. As the prospect of success seemed reasonably favourable, the experiment was tried. A man who had been deaf and dumb for three months was placed under light anaesthesia. During the struggling stage various incoherent sounds proceeded from his lips, and finally, to our delight, these crystallised into words; “Oh, Christ!” which is one of the favourite ejaculations of (hose under chloroform. Other words and phrases followed, of the usual unprintable nature; but the solid fact remained that he could speak, and, what is more, spoke when he came ouf of the anaesthetic sleep. Hearing, 100, was partially recovered, for whop we banged tin cans close to his ears he muttered: “Bells! Church bells!” thereby disclosing an imagination somewhat rare in the British soldier.

Quite a number of eases have now been successfully treated by the simple method of putting the patient under chloroform, the rationale of the treatment being that some great nervous shock is needed to cure the condition (hat has been originally caused by a shock, and has been kept in being by the man’s feeling of helplessness. These are all genuine, undoubted instances of “shell shock,’’ but what shall we say of those who are merely “nervy’’ and sleepless, and have headaches and obscure pains'? They have not lost speech or hearing or sight, and have never been violently “concussed.” but the strain of the trenches and the booming of the guns have proved too much for them. Such men come up month after month, and are neither better nor worse. No treatment touches them. Is the condition genuine, or arc fhey consciously or unconsciously deceiving themselves and other* / So one cap say for certain. Some sceptical physicians compare this condition to the state known as “railway spine," which is generally remarkably improved by the payment of heavy damages from the railway company. It is suggested, rather unkindly, I think, that the termination of the war, or (heir discharge from the service, would speedily cure most of them. With that 1 do not generally agree. What 1 do believe is that, in a mainly urbanised population, such as ours, many are on the verge of neurasthenia (that

is, possess a nervous system whose energy is soon exhausted), and that war acts as the immediate, prompt, exciting cause to tumble (hem over. It is a significant comment on this, that “shell shock” is not nearly so prevalent amongst the French or the Germans, whose armies are more largely composed of peasants than ours, and in the Balkans it is comparatively rare.