Chapter III: Introduction

The duties of an introducer, whether of a platform speaker to an audience, or of a writer to his anticipated readers, are not always clearly defined. It has been sometimes said that the critic or reviewer may meet with better success if he has not acquainted himself too thoroughly with the contents of the book about which he writes, as in that case he will have a larger opportunity to indulge his imagination, but a critique thus produced may have the disadvantage of possible shortcoming or unfairness. In the case of this volume, however, I have felt it worth while to acquaint myself with its contents, no light task when one is confronted with a thousand pages.

The great war just closing has done much to enlighten us as to the causes, nature, outcome, and treatment of injuries and diseases to which its victims have been subjected. The object of this book is to present both the data and the principles involved in certain neuropsychiatry problems of the war. These are presented in a wealth of detail through an extraordinary series of case records (589 in all) drawn from current medical literature, during the first three years of the conflict. Case reporting is here seen at its best, and the experiences recorded are largely allowed to speak for themselves, although comments are not wanting and are often illuminating.

Many criticisms have been heard on the use of the term _Shell-shock_ as applied to some of the most important psychiatric and neurological problems of the recent war; but that the designation has meaning will be evident if Dr. Southard’s book is not simply skimmed over by the reader, but is studied in its entirety. The symptoms of a very large number, if not the majority, of the cases recorded, had for their initiating influence the psychic and physical horrors of life among exploding shells. As the author and those from whom he has received his clinical supply not infrequently point out, in many cases it would appear that purely psychic influences have played the chief rôle, but in others physical injuries have not been lacking. Much more than this is true: in many instances the soil was prepared by previous defect, disease, or injury, or to use one of Dr. Southard’s favorite expressions, “weak spots” were present before martial causes became operative.

While the contributions to the medical and surgical history of the war have been somewhat numerous in current medical journals and in monographs, few comprehensive volumes have appeared. The reasons for this are not far to seek. The conflict has been of such magnitude, and the demands on the bodily and mental activity of the medical profession have been so intense and continuous, that time and opportunity for the careful and complete recording of experiences have not been often available; but works are beginning to appear in the languages of all the belligerent countries and these will increase in number and value during the next lustrum and decade, although it may be that some of the most important contributions will come after a decade or more is past. The great work before me is one that will leave its lasting impress, not only upon military but on civil medicine, for the lessons to be drawn from its pages are in large part as applicable to the one as to the other.

Looking backward to our Civil War, one is strongly impressed with the fact that the present volume, one of the earliest works of its kind to appear in book form, deals largely with psychiatry and functional nervous diseases, whereas during and after the American conflict the most important contributions to neurology related to organic disease, especially as illustrated by the work of Weir Mitchell and his collaborators on injuries of nerves. This is the more interesting when it is remembered that Mitchell not very long after the close of the Civil War became the most prominent exponent of functional neurology, from the diagnostic and therapeutic sides. To him the profession the world over has been indebted for the development of new views as to the nature of neurasthenia and hysteria and new methods for combating these disorders. In this fact is to be found matter for thought. Those who handled best the neuropsychiatric problems of the present war were in large part qualified not merely by a knowledge of psychology and psychiatry, but far more by a thorough training in organic neurology. The problems of psychiatry can be grasped fully only by those who have a fundamental knowledge of the anatomy, physiology, and diseases of the nervous system.

Dr. Southard, preëminently a neuropathologist, is well grounded in organic neurology, and shows at every turn his capabilities for considering the neuroses, psychoses, and insanities from the standpoint of the neurologist. Moreover, he clearly shows training and insight into the problems of non-neurological internal medicine.

The ideal method of training a student for neuropsychiatric work--if one had the opportunity of directing his course from the time of his entry into medicine--would be to see to it, after a good grounding in the fundamental sciences like anatomy, physiology, and chemistry, that medicine and surgery in their broadest phases first received school and hospital attention; that the fields of neurology, pure and applied, were then fully explored; and that psychology and psychiatry received late but thorough consideration. When after America’s entrance into the world war the writer assisted in preparing medical reserve officers for neuropsychiatric service, those men did best both during their postgraduate work and in base hospitals and in the field, who had built from the bottom after the manner indicated.

At the outset of Dr. Southard’s book, for more than two hundred and fifty pages, the author considers under ten subdivisions the acquired diseases and constitutional defects which may predispose the soldier to functional and reflex nervous disease. Neurosyphilis, on which Dr. Southard and Dr. Solomon have already given us a valuable treatise, the pharmacopsychoses, especially alcoholism, and the somatopsychoses covering fevers like typhoid and paratyphoid, are considered in numerous carefully chosen case reports. The reader needs only to look closely into the case records of the first quarter of the volume to get a knowledge of the affections chiefly predisposing the soldier or civilian to functional and reflex nervous diseases. To those familiar with the medical history of the war it is well known that one of the reasons for the efficiency of the American Expeditionary Force resided in the fact that the preliminary examinations of the recruits received the fullest attention not only from the points of view of acquired and inherited disease, but also from those of special psychiatric and even psychological deficiencies. Our country, however, had for its guidance the experience of nations which were fighting for three years before we entered the arena and in addition had a large surplus of material from which to cull out the weaklings.

Among the predispositional affections considered--besides syphilis, alcohol, and other drug habits, and the somatopsychoses--are the feeble-mindednesses or hypophrenoses, the epilepsies, the psychoses due to focal brain lesions, the presenile and senile disorders, the schizophrenoses including dementia præcox and allied affections, the cyclothymoses like manic depressive insanity, the psychoneuroses, and the psychopathoses. The last two subjects indicated, considered in special chapters, seem to some extent to be receptacles for affections which cannot well be otherwise placed,--hallucinoses, hysteria, neurasthenia, and psychasthenia,--and under the psychopathoses, pathological lying, Bolshevism, delinquencies of various sorts, homosexuality, suicide and self-mutilation, nosophobia, and even claustrophobia with its exemplar who preferred exposure to shell-fire to remaining in a tunnel.

Under the encephalopsychoses are found interesting illustrations of focal lesions and the general effects of infection and toxemia. Cases of brain abscess, of spinal focal lesions, and meningeal hemorrhage are in evidence, aphasias, monoplegias, Jacksonian spasm, and thalamic disease receiving consideration.

All neurologists know the difficulties in diagnosticating epilepsy in the absence of opportunities to see attacks and to receive the carefully analyzed statement of the observers of the patient. All this and much more is well brought out in the chapter on the epileptoses. Many epileptics found their way into the armies either through the carelessness of examiners or by suppression of the facts on the part of those who desired to serve.

The fact that an imbecile can shoot straight and face fire comes out in one or two places, but this does not seem to prove that a good rifleman is necessarily an all-round good soldier.

A book like Dr. Southard’s could be made of much use in teaching students, especially postgraduates, by having them, when a particular subject like epilepsy or schizophrenia, for instance, is under discussion, use as collateral reading the case reports of this work.

Dr. Southard’s book will prove useful to many workers--to the medical officer whose duty it is to examine recruits for the service or to pass upon and treat them while in service; almost equally to the medical officer in time of peace; to authors of textbooks and treatises and to contributors to neurological and psychiatric journals; to lecturers and clinical demonstrators; to the examiner for the juvenile courts; and to members of the psychopathic, psychiatric, and neurological staffs of our hospitals.

One is not called upon in an introduction to review at length the contents of the volume, but it may prove of value to the reader to dip here and there into the pages of the work to which his attention is being invited.

It will be remembered that fifty years ago and much later, down to the time of Babinski’s active propaganda in favor of the theories of suggestion, counter-suggestion, and persuasion in hysteria, various affections of a vasomotor and thermic type were included in the list of hysterical phenomena. These and some other phenomena sometimes classed as hysterical, Babinski and those who accord with him now find it necessary to sweep entirely from the domain of hysteria, which being produced by suggestion and cured by counter-suggestion or persuasion cannot include symptoms which are beyond the control of the will and intellect of the patient.

According to the new or rather revived pronouncement, these must be due either to definite organic lesion, or to a disorder of reflex origin, connoting the occurrence of changes in the nervous centers as long ago taught by Vulpian and Charcot. In the records of cases and in the discussions thereon this differentiation receives much consideration.

It is held that the paralysis in the reflex cases is more limited, more persistent, and assumes special forms not observable in hysteria. The attitudes in hysterical palsies conform more to the natural positions of the limbs than do those observed in reflex paralysis. Probably the presence of marked amyotrophies in the reflex nervous disorders is the most convincing factor in separating these from pithiatic affections. These atrophies correspond to the arthritic muscular atrophies of Vulpian, Charcot, Gowers, and others, and cannot for a moment be regarded as caused by suggestion or as removable by counter-suggestion or persuasion. They are influenced, discounting the effect of time and natural recuperation, only by methods of treatment designed to improve the peripheral and central nutrition of the patient. Pithiatic atrophies are slight and probably always to be accounted for by disuse or the association of some peripheral neural disorder with the hysteria. Affections of the sudatory and pilatory systems are more definitely pronounced in reflex cases than in those of a strictly hysterical character.

Some of the facts brought forward by Babinski and Froment to demonstrate the differentiation of reflex paralyses from pithiatic disorders of motion are challenged in the records of this volume by others, as for instance, by Dejerine, Roussy, Marie, and Guillain. Babinski tells us that in pithiatism, properly so designated, the tendon reflexes are not affected. He believes that even in pronounced anesthesia of the lower extremities the plantar reflexes can always be elicited and are not abnormal in exhibition. Dejerine, however, produces cases to illustrate the fact that in marked hysterical anesthesia of the feet plantar responses cannot be produced. I have personally studied cases which lend some strength to either contention. In some of these I was not able to conclude that either the use of the will or the presence of contractions in extension was sufficient to exclude the normal responses.

Differences in muscle tonicity, in mechanical irritability of the muscles, and the presence or absence of fibrotendinous contractions are indications of a separation between the reflex and purely functional cases, as apparently demonstrated in some of the case records. True trophic disorders of the skin, hair, and bones observed in the reflex cases are also said to have no place in the illustrations of pithiatism.

The delver into the case histories of this volume will find numerous instructive combinations of hystero-reflex and organo-hysterical associations which are not to be enumerated in an introduction. The great importance of what all recognize as pathognomonic signs of organic disease--Babinski extensor toe response, persistent foot clonus, reactions of degeneration, marked atrophy, lost tendon jerks, etc.--is, of course, continuously in evidence. Extraordinary associations of hysterical, organic, and reflex disorders with other affections due to direct involvement of bone, muscle, and vessels and with the secondary effects of cicatrization and immobilization are brought out on many pages. In quitting this branch of our subject it might be remarked that considerable changes must be made in our textbook descriptions of nervous diseases in the light of the contributions to the neurology of the present war.

One is reminded in the details of some of the cases of the discussions some decades since on the subject of spinal traumatisms; of the work of Erichsen which resulted in giving his name and that of “railway spine” to many of the cases now commonly spoken of as traumatic hysteria and traumatic neurasthenia; of the rejoinders of Page and his views regarding spinal traumatisms; and of Oppenheim’s development of the symptom complex of what he prefers to term the traumatic neurosis. One who has taken part in much court work cannot but read these case records with interest, for the neurology of the war as presented in this volume and in numerous monographs which are now appearing, throws much light upon many often mooted medicolegal problems. I recall how many able and honest neurological observers have changed their points of view since the early days of Erichsen’s “railway spine,” a pathological suggestion which is said to have cost the corporations of England an almost fabulous sum during a score of years. I recall also that a certain Court of Appeals in one of our states even felt itself called upon to promulgate an opinion intended to exorcise entirely the plea for damages for alleged injuries if it could be shown that these were due to fright. The data of this book do not put weapons entirely into the hands of the attorney and the expert for either the plaintiff or the defendant.

Some of the French writers on the neurology of the war, as illustrated in the records collected by Dr. Southard, have brought to our attention distinctions which they draw between _états commotionnels_ and _états émotionnels_--happy terms, and yet not sufficient in their invention or in the explanations which accompany them, fully to satisfy the requirements of the facts presented. These writers seem to think of the commotional states as denoting some real disease or condition of the brain, and yet one which is really curable and reversible. They explicitly tell us, however, that these commotions fall short of being _lésionnel_. After all, is this not somewhat obscure? Is it not something of a return to the period of “railway spine” when one of the comparisons sometimes made was that the injury suffered by the nervous tissues produced in them a state comparable to that of a magnet which had been subjected to a severe blow? At any rate, in commotion thus discussed the nervous structures are supposed to sustain some real injury of a physiochemical character, whereas in the emotional states the neurones are, as Southard puts it, affected somewhat after the manner of normal emotional functioning, except perhaps that they are called upon to deliver an excessive stream of impulses. The latter would be classed among the psychopathic, the former among the physiopathic affections, and yet the distinction between the two is not always quite clear.

In not a few instances of Shell-shock--although these are not numerous, so far as records have been obtained--actual structural lesions have been recorded even in cases in which no direct external injury of a material kind was experienced as a result of the explosion of shells. In others the evidences of external injury were relatively unimportant. Various lesions, in some cases recognizable even by the naked eye, were present. Mott, for example, found not only minute hemorrhages, but in one instance a bulbar extravasation of moderate massiveness, the patient not showing external signs of injury. Cases are also recorded of hematomyelia; others with edematous or necrotic areas in the cord; and still others with lesions of the ependyma or even with splitting of the spinal canal, reminding one of the classical experiments of Duret on cerebral and cerebrospinal traumatisms.

It has been argued that too much stress should not be laid on a few cases of this sort--but are they as few as they seem to be? The fact is that necropsical opportunities are not often afforded. May not such scattered lesions often be present without resulting in death or even in long continued disturbance? There is no essential reason why minute hemorrhages into the brain and spinal cord, and especially into their membranes, may not undergo rapid absorption or even remain unchanged for some time without dire results.

One of the reported cases in which lung splitting occurred from severe concussion without external injury is not without interest in this connection, reminding one, as the commentator says, of those cases of severe concussion in which the interior of a building is injured while the exterior escapes. In the same connection also the cited experiments of Mairet and Durante on rabbits are not without instructiveness. As a result of explosives set off close to these animals, pulmonary apoplexy, spinal cord and root hemorrhages, and extravasations, perivascular and ependymal, and into the cortical and bulbar gray were found. Russca obtained direct and _contrecoup_ brain lesions, etc., in a similar way.

Here and there throughout the book will be found references to symptoms and syndromes which will have a particular interest for the reader--soldier’s heart, trench foot, congealed hand, tics, tremors, convulsions, sensory areas variously mapped, and forms of local tetanus, the last being distinctly to be differentiated from pithiatic contractures and those due to organic lesions of the nervous system. Cases of an affection described by Souques as camptocormia, from Greek words meaning to bend the trunk, were shown to the Neurological Society of Paris in 1914 and later, the main features of this affection being pronounced incurvation forward of the trunk from the dorsolumbar region, with extreme abduction and outward rotation of the lower limbs, pain in the back, and difficult and tremulous walking. In some of these cases, organic lesions of the trunkal tissues were present, but in addition psychic elements played a not unimportant part, and the cases were restored to health by a combination of physical measures with psychotherapy, enforced by electrical applications.

The part of this book given over to the discussion of treatment will doubtless to some prove the most interesting section. The presentation of the subject of therapeutics is in some degree a discussion also of diagnosis and prognosis; and so it happens in various parts of the volume that the particular subject under consideration is more or less a reaffirmation or anticipation of remarks under other headings.

Similar results are brought about by various therapeutic procedures. Nonne, Myers, and a few others bring hypnosis into the foreground, although non-hypnotic suggestion plays a larger rôle by far.

Miracle cures are wrought through many pages. Mutism, deafness and blindness, palsies, contractures, and tics disappear at times as if by magic under various forms of suggestion. Ether or chloroform narcosis drives out the malady at the moment when it reveals its true nature. Verbal suggestion has many adjuvants and collaborators--electricity, sometimes severely administered, lumbar puncture, injections of stovaine into the cerebrospinal fluid, injections of saline solution, colored lights, vibrations, active mechanotherapy, hydrotherapy, hot air baths and blasts, massage, etc. Painful and punitive measures have their place--one is inclined to think a less valuable place than is given them by some of the recorders. In some instances the element of suggestion, while doubtless present, is overshadowed by the material methods employed. Persuasion and actual physical improvement are in these cases highly important. Reëducation is not infrequently in evidence. The patient in one way or another is taught how to do things which he had lost the way of doing.

It is interesting to American neurologists to note how frequently in the reports, especially of French observers, the “Weir Mitchell treatment” was the method employed, including isolation, the faradic current, massage, and Swedish movements, hydrotherapy, dietetic measures, reëducative processes, and powerful suggestion variously exhibited, especially through the mastery of the physician over the patient. It is rather striking that few records of Freudian psychoanalytic therapy are presented.

When all is said, however, counter-suggestion and persuasion, in whatever guise made use of, were not always sufficient and this not only in the clearly organic cases, but in those which are ranked under the head of reflex nervous disorders. In these the long-continued use of physical agencies was found necessary to supplement the purely psychic procedures, these facts sometimes giving rise in the Paris Society of Neurology and elsewhere to animated discussion as to the real nature of the cases. The pithiatic features of the case at times disappear, but leave behind much to be explained and more to be accomplished. The cures wrought are not always permanent and in some cases post-bellum experiences may be required to prove the real value of the measures advocated. The reader must study well the detailed records in order to arrive at just conclusions; nevertheless, the tremendous efficacy of suggestion and persuasion stands out in many of the recitals.

Perhaps the author may permit the introducer a little liberty of comment. His non-English interpellations, especially Latin and French, may be regarded by some as overdone or perhaps pedantic, but are rather piquant, giving zest to the text. _Diagnosis per exclusionem in ordine_ is sonorous and has a scholarly flavor, but does not prevent the reader who lives beyond the faubourgs of Boston from understanding that the author is speaking of an ancient and well-tried method of differential diagnosis. _Passim_ may be more impressive or thought-fixing than its English translation, but this to the reader will simply prove a matter of individual opinion. _Psychopathia martialis_ is not only mouth-filling like _Senegambia_ or _Mesopotamia_, but really has a claim to appreciation through its evident applicability. It is agreeable to note that the book seems nowhere to indicate that _psychopathia sexualis_ and _psychopathia martialis_ are convertible terms.

The bibliography of the volume challenges admiration because of its magnitude and thoroughness and is largely to be credited, as the author indicates, to the energy and efficiency of Sergeant Norman Fenton, who did the work in connection with the Neuropsychiatric Training School at Boston, resorting first-hand to the Boston Medical Library and the Library of the New York Academy of Medicine. After Sergeant Fenton joined the American Expeditionary Force, Dr. Southard greatly increased the value of the bibliography by his personal efforts.

This bibliography covers not only the 589 case histories of the book, but it goes beyond this, especially in the presentation of references for 1917, 1918, and even 1919. Owing to the time when our country entered the war, American references are, in the main, of later date than the case histories. They will be found none the less of value to the student of neuropsychiatric problems.

The references in the bibliography number in all more than two thousand, distributed so far as nationalities are concerned about as given below, although some mistakes may have crept into this enumeration for various reasons, like the publication of the same articles in the journals of different countries. The list of references includes French, 895; British (English and Colonial), 396; Italian, 77; Russian, 100; American, 253; Spanish, 5; Dutch, 5; Scandinavian, 5; and Austrian and German, 476. It will be seen, therefore, that the bibliography covers in number nearly four times the collected case studies, most of these records being from reports made during the first three years of the war. The author has wisely made an effort to bring the bibliographic work up to and partially including 1919.

The manner in which the French neurologists and alienists continued their work during the strenuous days of the terrible conflict is worthy of all praise. The labors of the Society of Neurology of Paris never flagged, its contributions in current medical journals having become familiar to neurologists who have followed closely the trend of medical events during the war. Cases and subjects were also frequently presented and discussed at the neurological centers connected with the French and allied armies in France.

It may be almost invidious to specify names, the work done by many was of so much interest and value. Dejerine in the early days of the war, before his untimely sickness and death, contributed his part. Marie from the beginning to the end of the conflict continued to make the neurological world his debtor. The name of Babinski stands out in striking relief. Other names frequently appearing among the French contributors are those of Froment, Clovis Vincent, Roussy and Lhermitte, Léri, Guillain, Souques, Laignel-Lavastine, Courbon, Grasset, Claude, Barre, Benisty, Foix, Chavigny, Charpentier, Meige, Thomas, and Sollier.

For a work of this character not only as complete a bibliography as possible, but a thorough index is absolutely necessary, and this has been supplied. The author has not made the index too full, but with enough cross-references to enable those in all lines of medical work interested to cull out the cases and comments which most concern them.

My prologue finished, I step aside for the play and the player, with the recommendation to the reader that he give close heed to the performance--to the recital of the cases, the comments thereon, and the general discussion of subjects--knowing that such attention will be fully rewarded, for in this wonderful collection of Dr. Southard is to be seen an epitome of war neurology not elsewhere to be found.

CHARLES K. MILLS.

_Philadelphia_, May, 1919.

TABLE OF CONTENTS

SECTION A. PSYCHOSES INCIDENTAL IN THE WAR

I. THE SYPHILITIC GROUP (_Syphilopsychoses_)

CASE PAGE

1. Desertion of an officer _Briand_, 1915 8

2. Visions of a naval officer _Carlill_, _Fildes_, _Baker_, 1917 9

3. Aggravation of neurosyphilis by war _Weygandt_, 1915 10

4. Same _Hurst_, 1917 10

5. Same _Beaton_, 1915 10

6. Same _Boucherot_, 1915 11

7. Same _Todd_, 1917 12

8. Same _Farrar_, 1917 13

9. Same _Marie_, _Chatelin_, _Patrikios_, 1917 14

10. Root-sciatica _Long_, 1916 15

11. Disciplinary _Kastan_, 1916 17

12. Same _Kastan_, 1916 18

13. Same? _Kastan_, 1916 19

14. Hysterical chorea _versus_ neurosyphilis
_de Massary_, _du Sonich_, 1917 20

15. Traumatic general paresis _Hurst_, 1917 22

16. Head trauma; shell-shock; mania; W. R. positive
_Babonneix_, _David_, 1917 23

17. Head trauma in a syphilitic _Babonneix_, _David_, 1917 24

18. Shell wound: general paresis _Boucherot_, 1915 25

19. “Shell-shock” ocular palsy: syphilitic _Schuster_, 1915 26

20. Shell-shock: general paresis _Donath_, 1915 27

21. Shell-shock: tabes _Logre_, 1917 28

22. Same _Duco_, _Blum_, 1917 28

23. Pseudotabes (Shell-shock) _Pitres_, _Marchand_, 1916 29

24. Shell-shock neurosyphilis _Hurst_, 1917 30

25. Shell-shock neurosyphilis _Hurst_, 1917 31

26. Pseudoparesis (Shell-shock) _Pitres_, _Marchand_, 1916 32

27. War strain and Shell-shock in a syphilitic _Karplus_, 1915 34

28. Shell-shock recurrence of syphilitic hemiplegia
_Mairet_, _Piéron_, 1915 36

29. Shell-shock (functional!) amaurosis in a neurosyphilitic
_Laignel-Lavastine_, _Courbon_, 1916 37

30. Shell-shock (functional) phenomena in a neurosyphilitic
_Babonneix_, _David_, 1917 39

31. Vestibular symptoms in a neurosyphilitic
_Guillain_, _Barré_, 1916 40

32. Syphilophobic suicidal attempts _Colin_, _Lautier_, 1917 41

33. Simulated chancre _Pick_, 1916 42

34. Exaggeration _Buscaino_, _Coppola_, 1916 43

II. THE FEEBLE-MINDED GROUP (_Hypophrenoses_)

35. A feeble-minded person fit for service _Pruvost_, 1915 44

36. An imbecile superbrave _Pruvost_, 1915 45

37. An imbecile fit for barracks work _Pruvost_, 1915 45

38. A feeble-minded inventor _Laignel-Lavastine_, _Ballet_, 1917 47

39. A feeble-minded simulator _Pruvost_, 1915 49

40. Enlistment for amelioration of character _Briand_, 1915 49

41. An imbecile fit for service at the front _Pruvost_, 1915 50

42. An imbecile with sudden initiative _Lautier_, 1915 51

43. Emotional fugue in subnormal subject _Briand_, 1915 52

44. Regimental surgeon _versus_ alienist _re_ feeble-mindedness
_Kastan_, 1916 53

45. An imbecile rifleman _Kastan_, 1916 55

46. An imbecile hypomaniacal _Haury_, 1915 57

47. Feeble-minded desire to remain at the front _Kastan_, 1916 58

48. An imbecile sent back by Germans _Lautier_, 1915 60

49. Unfit for service: feeble-mindedness? _Kastan_, 1916 61

50. Oniric delirium in a feeble-minded subject _Soukhanoff_, 1915 62

51. Shell-shock and burial: situation not rationalized
_Duprat_, 1917 63

52. Shell-shock in weak-minded subject; fear, fugues
_Pactet_, _Bonhomme_, 1917 64

III. THE EPILEPTIC GROUP (_Epileptoses_)

53. Epilepsy: neurosyphilis _Hewat_, 1917 65

54. Epilepsy brought out by syphilis _Bonhoeffer_, 1915 66

55. Syphilis in a psychopathic subject _Bonhoeffer_, 1915 67

56. Epileptic imbecile court-martialed _Lautier_, 1916 68

57. Psychogenic seizures in feeble-minded subject
_Bonhoeffer_, 1915 69

58. Drunken epileptic: responsibility? _Juquelier_, 1917 71

59. Epilepsy: disciplinary case _Pellacani_, 1917 74

60. Same _Pellacani_, 1917 76

61. Desertion: epileptic fugue _Verger_, 1916 78

62. Specialist in escapes _Logre_, 1917 80

63. Epilepsy and other factors: disciplinary case
_Consiglio_, 1917 82

64. Strange conduct and amnesia in epileptic _Hurst_, 1917 83

65. Epilepsy after antityphoid inoculation _Bonhoeffer_, 1915 84

66. Shell-shock: Jacksonian seizures--decompression
_Leriche_, 1915 86

67. Blow on head: hysterical convulsions--cure by neglect
_Clarke_, 1916 87

68. Epilepsy with superposed hysteria _Bonhoeffer_, 1915 88

69. Musculocutaneous neuritis: Brown-Séquard’s epilepsy
_Mairet_, _Piéron_, 1916 89

70. Bullet wound: reactive epilepsy? _Bonhoeffer_, 1915 92

71. _Epilepsia tarda_ _Bonhoeffer_, 1915 93

72. Convulsions by auto-suggestion _Hurst_, 1916 95

73. Epilepsy, emotional _Westphal_, _Hübner_, 1915 97

74. Hysterical convulsions _Laignel-Lavastine_, _Fay_, 1917 98

75. Desertion: fugue, probably not epileptic _Barat_, 1914 100

76. Epileptic episode _Bonhoeffer_, 1915 102

77. Narcoleptic seizures _Friedmann_, 1915 103

78. Sham fits _Hurst_, 1917 106

79. Epileptoid attacks controllable by will _Russel_, 1917 106

80. Epileptic taint brought out at last by shell-shock
_Hurst_, 1917 107

81. Shell-shock _epilepsia larvata_ _Juquelier_, _Quellien_, 1917 108

82. To illustrate a theory of Shell-shock as epileptic
_Ballard_, 1915 110

83. Same _Ballard_, 1917 110

84. Same _Ballard_, 1917 111

85. Epileptic equivalents _Mott_, 1916 112

IV. THE ALCOHOL-DRUG-POISON GROUP (_Pharmacopsychoses_)

86. Pathological intoxication _Boucherot_, 1915 113

87. Same _Loewy_, 1915 116

88. Desertion in alcoholism: fugue _Logre_, 1916 117

89. Alcoholic amnesia experimentally reproduced _Kastan_, 1915 118

90. Desertion and drunkenness _Kastan_, 1915 119

91. Desertion by alcoholic dement _Kastan_, 1915 121

92. Desertion by alcoholic with other factors _Kastan_, 1915 124

93. Alcoholism: disciplinary case _Kastan_, 1915 126

94. Atrocity, alcoholism _Kastan_, 1915 127

95. Atrocity, alcoholic _Kastan_, 1915 128

96. Alcoholism and amnesia: disciplinary case _Kastan_, 1915 129

97. Post-traumatic intolerance of alcohol _Kastan_, 1915 130

98. Adventure with Parisian stranger _Briand_, _Haury_, 1915 131

99. Morphinism: tetanus _Briand_, 1914 131

100. Morphinism: medicolegal question _Briand_, 1914 132

101.} Two morphinists _Briand_, 1914 132
102.}

V. THE FOCAL BRAIN LESION GROUP (_Encephalopsychoses_)

103. Aphasia and left hemiplegia: local and
_contrecoup_ lesions _L’Hermitte_, 1916 133

104. Gunshot head wound and alcohol: amnesia _Kastan_, 1916 135

105. Bullet in brain: cortical blindness and hallucinations
_Lereboullet_, _Mouzon_, 1917 136

106. Content of existent psychosis changed by
head trauma _Laignel-Lavastine_, _Courbon_, 1917 139

107. Meningococcus meningitis; apparent recovery:
dementing psychosis _Maixandeau_, 1915 141

108. Meningococcus meningitis _Eschbach and Lacaze_, 1915 143

109. Shell-shock: meningitic syndrome _Pitres and Marchand_, 1916 145

110. Brain abscess in a syphilitic: matutinal loss of
knee-jerks _Dumolard_, _Rebierre_, _Quellien_, 1915 147

111. Spinal cord lesion: early recovery _Mendelssohn_, 1916 149

112. Shell explosion and meningeal hemorrhage:
pneumococcus meningitis _Guillain_, _Barré_, 1917 150

113. _Ante bellum_ cortex lesion: shrapnel wound determines
athetosis _Batten_, 1916 151

114. Hysterical _versus_ thalamic hemianesthesia _Léri_, 1916 152

115. Shell-shock: multiple sclerosis syndrome
_Pitres_, _Marchand_, 1916 154

116. Mine explosion: hysterical and organic symptoms _Smyly_, 1917 156

117. Same _Smyly_, 1917 156

VI. THE SYMPTOMATIC GROUP (_Somatopsychoses_)

118. Rabies: neuropsychiatric phenomena
_Grenier de Cardenal_, _Legrand_, _Benoit_, 1917 162

119. Tetanus, psychotic _Lumière_, _Astier_, 1917 164

120. Tetanus _fruste_ _versus_ hysteria
_Claude_, _L’Hermitte_, 1915 165

121. British officer’s letter concerning local tetanus
_Turrell_, 1917 166

122. Dysentery: psychosis _Loewy_, 1915 168

123. Typhoid fever: hysteria _Sterz_, 1914 169

124. Dementia praecox _versus_ posttyphoid encephalitis
_Nordmann_, 1916 170

125. Paratyphoid fever: psychosis outlasting fever _Merklen_, 1915 171

126. Paratyphoid fever: psychopathic taint brought out
_Merklen_, 1915 172

127. Diphtheria: post diphtheritic symptoms _Marchand_, 1916 173

128. Diphtheria: hysterical paraparesis _Marchand_, 1915 174

129. Malaria: amnesia _De Brun_, 1917 175

130. Malaria: Korsakow’s syndrome _Carlill_, 1917 176

131. Malaria: ventral horn symptoms _Blin_, 1916 178

132. Trench foot; acroparesthesia _Cottet_, 1917 180

133. Bullet injury of spine; bronchopneumonia:
_état criblé_ of spinal cord _Roussy_, 1916 181

134. Shell-shock (shell not seen); sensory and motor
symptoms: decubitus; recovery _Heitz_, 1915 183

135. Shell-shock; later typhoid fever: neuritis
(_ante bellum_ hysteria) _Roussy_, 1915 185

136. Bullet wound of pleura: hemiplegia and ulnar syndrome
_Phocas_, _Gutmann_, 1915 186

137. Tachypnoea, hysterical _Gaillard_, 1915 188

138. Soldiers’ heart _Parkinson_, 1916 190

139. Soldiers’ heart? _Parkinson_, 1916 191

140. War strain and shell wound: diabetes mellitus _Karplus_, 1915 192

141. Dercum’s disease _Hollande_, _Marchand_, 1917 193

142. Hyperthyroidism _Tombleson_, 1917 195

143. Hyperthyroidism?, neurasthenia _Dejerine_, _Gascuel_, 1914 196

144. Hyperthyroidism _Rothacker_, 1916 197

145. Graves’ disease, _forme fruste_ _Babonneix_, _Célos_, 1917 198

146. Shell-shock hysteria: surgical complications _Oppenheim_, 1915 199

VII. THE PRESENILE AND SENILE GROUP (_Geriopsychoses_)--No cases.

VIII. THE DEMENTIA PRAECOX GROUP (_Schizophrenoses_)

147. Hatred of Prussia: diagnosis, dementia praecox
_Bonhoeffer_, 1916 200

148. Dementia praecox: arrest as spy _Kastan_, 1915 201

149. Fugue, catatonic _Boucherot_, 1915 203

150. Desertion: schizophrenic? _Consiglio_, 1916 204

151. Schizophrenia; alcoholism: disciplinary case _Kastan_, 1915 206

152. Schizophrenia aggravated by service _de la Motte_, 1915 208

153. Shot himself in hand: delusions _Rouge_, 1915 209

154. Dementia praecox volunteer _Haury_, 1915 210

155. Hysteria _versus_ catatonia _Bonhoeffer_, 1916 211

156. “Hysteria” actually dementia praecox _Hoven_, 1915 213

157. Hallucinatory and delusional contents influenced
by war experiences _Gerver_, 1915 214

158. Iron cross winner, hebephrenic _Bonhoeffer_, 1915 215

159. Occipital trauma; visual hallucinations
_Claude_, _L’Hermitte_, 1915 217

160. Shell-shock: Dementia praecox _Weygandt_, 1915 219

161. Same _Dupuoy_, 1915 220

162. Shell-shock; fatigue; fugue; delusions _Rouge_, 1915 221

IX. THE MANIC-DEPRESSIVE GROUP (_Cyclothymoses_)

163. A maniacal volunteer _Boucherot_, 1915 222

164. Fugue, melancholic _Logre_, 1917 223

165. Apples in No-man’s-land _Weygandt_, 1914 224

166. Trench life: depression; hallucinations;
arteriosclerosis; age, 38 _Gerver_, 1915 225

167. War stress: manic depressive psychosis _Dumesnil_, 1915 226

168. Predisposition; war stress: melancholia _Dumesnil_, 1915 227

169. Depression; low blood pressure; pituitrin _Green_, 1916 228

X. THE PSYCHONEUROTIC GROUP (_Psychoneuroses_)

170. Three phases in a psychopath
_Laignel-Lavastine_, _Courbon_, 1917 229

171. Fugue, probably hysterical _Milian_, 1915 232

172. Hysterical Adventist _de la Motte_, 1915 234

173. Fugue, psychoneurotic _Logre_, ---- 235

174. Shell-shy; war bride pregnant: fugue with amnesia
and mutism _Myers_, 1916 236

175. A neurasthenic volunteer _E. Smith_, 1916 237

176. War stress: neurasthenia in subject without
heredity or soil _Jolly_, 1916 238

177. Arterial hypotension in psychasthenia _Crouzon_, 1915 239

178. War stress: psychasthenia _Eder_, 1916 240

179. _Ante bellum_ attacks: neurasthenia _Binswanger_, 1915 241

180. Antityphoid inoculation: neurasthenia _Consiglio_, 1917 244

181. Neurasthenia (one symptom: sympathy with the enemy)
_Steiner_, 1915 245

XI. THE PSYCHOPATHIC GROUP (_Psychopathoses_)

182. Claustrophobia: shells preferred to tunnel _Steiner_, 1915 246

183. Pathological liar _Henderson_, 1917 247

184. Psychopath almost Bolshevik _Hoven_, 1917 249

185. Hysterical mutism: persistent delusional psychosis
_Dumesnil_, 1915 250

186. Psychopathic inferiority brought out by the war
_Bennati_, 1916 251

187. Psychopathic episodes _Pellacani_, 1917 252

188. Maniacal and hysterical delinquent _Buscaino_, _Coppola_, 1916 253

189. Psychopathic delinquent _Buscaino_, _Coppola_, 1916 254

190. Psychopathic excitement _Buscaino_, _Coppola_, 1916 255

191. Desertion: dromomania _Consiglio_, 1917 256

192. Suppressed homosexuality _R. P. Smith_, 1916 257

193. Psychopathic: at first suicidal, then self-mutilative
_MacCurdy_, 1917 258

194. Bombardment: psychasthenia
_Laignel-Lavastine_, _Courbon_, 1917 259

195. Nosophobia _Colin_, _Lautier_, 1917 261

196. Psychopath: Attacks of disgust and terror
_Lattes_, _Goria_, 1915 262

SECTION B. SHELL-SHOCK: NATURE AND CAUSES

197. Shell explosion: Autopsy--hemorrhages;
vagoaccessorius chromatolysis _Mott_, 1917 265

198. Mine explosion: Autopsy--hemorrhages _Chavigny_, 1916 270

199. Mine explosion: Autopsy--hemorrhages
_Roussy_, _Boisseau_, 1916 271

200. Shell fragment in back: Autopsy--softenings in
spinal cord _Claude_, _L’Hermitte_, 1915 272

201. Shell explosion: Autopsy--lungs burst! _Sencert_, 1915 274

202. Shell explosion: Hemorrhage in spinal canal and bladder
_Ravaut_, 1915 276

203. Shell explosion: Hemorrhage and pleocytosis of
spinal fluid _Froment_, 1915 277

204. Shell explosion: Pleocytosis of spinal fluid _Guillain_, 1915 279

205. Shell explosion: Pleocytosis of spinal fluid
as late as a month after explosion _Souques_, _Donnet_, 1915 280

206. Burial: Thecal hemorrhage _Leriche_, 1915 282

207. Shell explosion: Hypertensive spinal fluid _Leriche_, 1915 283

208. Bullet wound: Hematomyelia; partial recovery
_Mendelssohn_, 1916 284

209. Shell explosion, subject prone: Hematomyelia _Babinski_, 1915 286

210. Struck by missile: Hysterical paraplegia? Herpes;
segmentary symptoms _Elliot_, 1914 288

211. Mine explosion: Head bruises, labyrinth lesions,
canities unilateral _Lebar_, 1915 291

212. Shrapnel wounds: Focal canities; hysterical symptoms
_Arinstein_, 1915 292

213. Burial: Organic (?) hemiplegia _Marie_, _Lévy_, 1917 293

214. Shell explosion; no wound: Organic and functional symptoms
_Claude_, _L’Hermitte_, 1915 294

215. Gassing: Organic symptoms _Neiding_, 1917 296

216. Gassing: Mutism, battle dreams _Wiltshire_, 1916 297

217. Shell explosion: Organic deafness; hysterical
speech disorder _Binswanger_, 1915 298

218. Distant shell explosion not seen or heard: Tympanic
rupture, cerebellar symptoms _Pitres_, _Marchand_, 1916 300

219. Mine explosion: Organic and functional symptoms _Smyly_, 1917 302

220. Shrapnel skull wound: Differential recovery from
functional symptoms _Binswanger_, 1917 303

221. Shell explosion shrapnel wound: Battle memories,
scar hyperesthetic _Bennati_, 1916 305

222. Shrapnel wounds, operation: Hysterical facial spasm
_Batten_, 1917 306

223. Shell explosion: Tremors and emotional crises _Myers_, 1916 307

224. Shell explosion, comrades killed: Tremors, crises
_Meige_, 1916 308

225. Under fire: Tremophobia: French artist’s description
_Meige_, 1916 310

226. Shell explosion: German soldier’s account of
Shell-shock symptoms _Gaupp_, 1915 312

227. A British soldier’s account of shell-shock _Batten_, 1916 315

228. Blown up by shell: Crural monoplegia; hysterical
four days later _Léri_, 1915 317

229. Shell explosion nearby: Description of treatment to
demonstrate hysterical nature of characteristic
symptoms _Binswanger_, 1915 318

230. Leg wound: Pseudocoxalgic monoplegia and anesthesia
_Roussy_, _L’Hermitte_, 1917 323

231. Leg contusion: Crural monoplegia, hysterical;
later crutch paralysis, organic _Babinski_, 1917 324

232. War strain: Arthritis; crural monoplegia and
anesthesia; hysterical “conversion hysteria” _MacCurdy_, 1917 325

233. Lance thrust in back; Crural monoplegia _Binswanger_, 1915 326

234. Shell explosion: After six days, crural monoplegia
(“metatraumatic” suggesting persisting hypersensitive
phase after shell-shock) _Schuster_, 1916 329

235. Wound of foot: Acrocontracture, seven months’
duration; psycho-electric cure at one sitting
_Roussy_, _L’Hermitte_, 1917 330

236. Shell explosion: Trauma; emotion; hysterical
paraplegia _Abrahams_, 1915 332

237. Shell explosion: Burial; paraplegia _Elliot_, 1914 334

238. Shell explosion: Paraplegia and sensory symptoms,
organic? _Hurst_, 1915 335

239. War strain and rheumatism; no emotional factors:
Paraplegia, later brachial tremor _Binswanger_, 1915 336

240. Emotion in fever patient from watching barrage
creep up: Paraplegia _Mann_, 1915 338

241. Incentives, domestic and medical, to paraplegia _Russel_, 1917 338

242. Bullet in back: Hysterical bent back; “camptocormia”
_Souques_, 1915 339

243. Shell explosion: Camptocormia _Roussy_, _L’Hermitte_, 1917 340

244. Shell explosion; burial: camptocormia
_Roussy_, _L’Hermitte_, 1917 342

245. Shell explosion; burial; Paraplegia, later camptocormia
_Joltrain_, 1917 344

246. Bullet in thigh: Astasia-abasia. Wound of neck:
Again astasia-abasia _Roussy_, _L’Hermitte_, 1917 346

247. Shell explosion: Wound of thorax; astasia-abasia
_Roussy_, _L’Hermitte_, 1917 346

248. War strain and fall in trench without trauma: Dysbasia
_Nonne_, 1915 347

249. Shell explosion: Partial burial; hysterical
symptoms in parts buried _Arinstein_, 1916 349

250. Wound of hand: Acroparalysis _Roussy_, _L’Hermitte_, 1917 350

251. Wound of arm: Hysterical paralysis _Chartier_, 1915 351

252. Wound in brachial plexus region: Supinator
longus contracture _Léri_, _Roger_, 1915 353

253. Contusion of muscle with “stupefactive” paralysis
of biceps (supinator longus still functioning) _Tinel_, 1917 355

254. Wound of arm: Blockage of impulses to hand movements
_Tubby_, 1915 356

255. Shell explosion: Bilateral symmetrical phenomena
_Gerver_, 1915 357

256. Shell explosion: Paralytic symptoms on side exposed:
Contralateral irritative symptoms _Oppenheim_, 1915 359

257. Shell explosion: Bilateral asymmetrical symptoms
_Gerver_, 1915 360

258. Shell explosion: Sensory disorder on side exposed
_Gerver_, 1915 362

259. Shell explosion: Hysterical deafness and other
symptoms; relapse _Gaupp_, 1915 363

260. Shell explosion: Deafness _Marriage_, 1917 365

261. Mine explosion: Deafmutism; recovery on epistaxis
and fever _Liébault_, 1916 366

262. Shell explosion: Deafmutism _Mott_, 1916 367

263. Shell explosion: Deafmutism and convulsions _Myers_, 1916 368

264. Gunfire: Aphonia _Blässig_, 1915 370

265. Shell-shock mutism: (_a_), observed, (_b_) dreamed
of, (_c_), developed by victim of shell explosion _Mann_, 1915 370

266. Mortar explosion: Deafness _Lattes_, _Goria_, 1917 371

267. Shell-explosion: onomatopœic noises _Ballet_, 1914 371

268. Shell explosion: Gravel in eyes; eye and face symptoms
_Ginestous_, 1916 372

269. Shell explosion; burial; blow on occiput; Blindness
_Greenlees_, 1916 373

270. Shell-shock amblyopia: Composite data _Parsons_, 1915 374

271. Factors in shell-shock amblyopia: Excitement,
blinding flashes, fear, disgust, fatigue _Pemberton_, 1915 375

272. Shell explosion amblyopia _Myers_, 1915 376

273. Shell windage without explosion: Cranial nerve disorder
_Pachantoni_, 1917 378

274. Initial case in Babinski’s series to show chloroform
elective exaggeration of reflexes _Babinski_, _Froment_, 1917 380

275. Wound of ankle: Contracture, chloroform effect
_Babinski_, _Froment_, 1917 383

276. “Reflex” disorder of right leg: Chloroform effect
_Babinski_, _Froment_, 1917 384

277. Bullet in calf: Hysterical lameness cured--reflex disorder
associated therewith _not_ cured _Vincent_, 1916 385

278. Trauma of foot: Hysterical dysbasia and reflex
disorders; differential disappearance of
hysterical symptoms _Vincent_, 1917 386

279. Shell-shock and paraplegia: Vasomotor and secretory
disorder twenty months later _Roussy_, 1917 387

280. Tetanus clinically cured: Phenomena reproduced under
chloroform anesthesia _Monier-Vinard_, 1917 388

281. Example of a “reflex” disorder after shell
explosion at great distance _Ferrand_, 1917 390

282. Shell fire: Shell-shock symptoms delayed _McWalter_, 1916 391

283. Shell-shock symptoms early and late _Smyly_, 1917 392

284. Wounds: Gassing; burial; collapse on home leave
_Elliot Smith_, 1916 393

285. Late sympathetic nerve effect after bullet wound of neck
_Tubby_, 1915 394

286. Hysterical crural monoplegia after fall from
horse under fire (reminiscence of similar
_ante bellum_ accident) _Forsyth_, 1915 395

287. Shell explosion, cave-in: Right leg symptoms
(_ante bellum_ experiences) _Myers_, 1916 396

288. Shell explosion, wound of back: Paraparesis (subject
always weak in legs) _Dejerine_, 1915 397

289. Wound near heart: Fear; paraparesis (subject always
weak in legs) _Dejerine_, 1915 399

290. Wounds: Tic on walking and recovery except frontalis tic
(emphasis of _ante bellum_ habit) _Westphal_, _Hübner_, 1915 401

291. Fatigue and emotion: Hysterical hemiplegia (similar
hemiplegia _ante bellum_) _Roussy_, _L’Hermitte_, 1917 402

292. War strain: Hemiplegia (similar hemiplegia _ante bellum_,
subject’s father hemiplegic) _Duprés_, _Rist_, 1914 403

293. Shell explosion and burial: Deafmutism (speech
difficulty _ante bellum_) _MacCurdy_, 1917 405

294. War strain: Shell-shock and psychotic symptoms
determined to parts _ante bellum_ _Zanger_, 1915 406

295. Mine explosion: Emotion; delirium (previous head
trauma without unconsciousness) _Lattes_, _Goria_, 1917 407

296. Sniper stricken blind in shooting eye _Eder_, 1916 408

297. Anticipation of warfare: Fall while mounting sentry;
hysterical blindness _Forsyth_, 1915 408

298. Spasmodic neurosis from bareback riding (similar
episode _ante bellum_) _Schuster_, 1914 409

299. _Ante bellum_ spasm of hands _Hewat_, 1917 409

300. Quarrel: Hysterical chorea, reminiscent of former
attack and itself reminiscent of organic chorea
in subject’s mother _Dupuoy_, 1915 411

301. Hallucinations and delusions of _ante bellum_ origin:
Treatment by explanation _Rows_, 1916 412

302. Tremors and convulsive crises in a poor risk
_Rogues de Fursac_, 1915 413

303. Emotionality and tachycardia in a martial misfit
_Bennati_, 1916 415

304. Hereditary instability _Wolfsohn_, 1918 416

305. Genealogical tree of a shoemaker _Wolfsohn_, 1918 417

306. Traumatic hysteria without hereditary or acquired
psychopathic tendency _Donath_, 1915 418

307. Mine explosion, burial: Neurosis in perfectly
normal soldier _MacCurdy_, 1917 419

308. Shell explosion: Tremophobia _Meige_, 1916 421

309. Frozen in bog: Glossolabial hemispasm _Binswanger_, 1915 424

310. Bruise by horse: Invincible pain--subject cured
by performing heroic feat _Loewy_, 1915 426

311. Kick by horse: Hysterical symptoms including
monocular diplopia _Oppenheim_, 1915 427

312. Windage from non-exploding shell: Emotion;
homonymous hemianopsia _Steiner_, 1915 428

313. Shell-shock psoriasis _Gaucher_, _Klein_, 1916 429

314. _Croix de guerre_ and Shell-shock got simultaneously:
Hallucinatory bell-ringing reminiscent of civilian
work _Laignel-Lavastine_, _Courbon_, 1916 430

315. Waked by shell explosion: Nystagmiform tremor
(occupational reminiscence in cinema worker) and
tachycardia _Tinel_, 1915 432

316. Synesthesialgia: Foot pain on rubbing dry hands
_Lortat-Jacob_, _Sézary_, 1915 433

317. Shell-shock and burial: Clonic spasms, later stupor
_Gaupp_, 1915 435

318. War stress (liquid fire) and shell-shock: Puerilism
_Charon_, _Halberstadt_, 1916 437

319. Bombed from aeroplane: Battle dreams; dizziness; fugue
_Lattes_, _Goria_, 1917 439

320. Hyperthyroidism after box drops from aeroplane _Bennati_, 1916 440

321. Shell dropped without bursting: Stupor and delirium
_Lattes_, _Goria_, 1917 441

322. Subject carrying explosives is jostled: Unconsciousness,
deafmutism, later camptocormia _Lattes_, _Goria_, 1917 443

323. Grazed by sliding cannon: Stupor and amnesia
_Lattes_, _Goria_, 1917 444

324. Shell explosions nearby: Emotion and insomnia
_Wiltshire_, 1916 445

325. Shell explosion: symptoms after hearing artillery
twelve days later _Wiltshire_, 1916 446

326. Exhaustion (heat?): Hyperthyroidism, hemiplegia
_Oppenheim_, 1915 447

327. War strain and rheumatism: tremors _Binswanger_, 1915 448

328. Shell explosion; emotion: Fear and dreams _Mott_, 1916 451

329. Under fire; barbed wire work: tremors and sensory symptoms
_Myers_, 1916 452

330. Shell explosion: Emotional crises; twice recurrent mutism
_Mairet_, _Piéron_, _Bouzansky_, 1915 453

331. Shell explosion: Emotional crises (fright at a frog)
_Claude_, _Dide_, _Lejonne_, 1916 455

332. War strain; wound; burials; shell-shock: neurosis
with anxiety and dreams: Relapse _MacCurdy_, 1917 457

333. Bombed by airplane: Suicidal thoughts; oniric delirium;
“moving picture in the head” _Hoven_, 1917 460

334. Shell explosion; emotion at death of best friend:
Stupor and amnesia _Gaupp_, 1915 462

335. Emotional shock from shooting comrade: Horror,
sweat, stammer, nightmare _Rows_, 1916 463

336. Emotion at death of comrade: Phobias _Bennati_, 1916 464

337. Shell explosion: Fright; delayed loss of consciousness
_Wiltshire_, 1916 465

338. Shell explosion; burial work: amnesia; unpleasant ideas
reflexly conditioned by shell whistling _Wiltshire_, 1916 467

339. Comrade’s death witnessed: Suicidal depression _Steiner_, 1915 468

340. Marching and battles: Neurasthenia? _Bonhoeffer_, 1915 469

341. English schoolmaster’s account of dreams _Mott_, 1918 470

342. War dreams shifting to sex dreams _Rows_, 1916 472

343. Shock at death of comrade: War and peace dreams _Rows_, 1916 474

344. War dreams including hunger and thirst _Mott_, 1918 475

345. Burial work: Olfactory dreams and vomiting _Wiltshire_, 1916 476

346. War dreams: Phobia conditioned on postoniric suggestion
_Duprat_, 1917 477

347. Service in rear: War dreams not based on actual experiences
_Gerver_, 1915 478

348. Hysterical astasia-abasia: Heterosuggestive “big belly”
_Roussy_, _Boisseau_, _Cornil_, 1917 479

349. Collapse going over the top: Neurasthenia _Jolly_, 1916 481

350. Battles: Mania and confusion _Gerver_, 1915 483

351. Machine-gun battle: Mania and hallucinations _Gerver_, 1915 484

352. Attacks and counter-attacks: Incoherence and quick
development of scenic war hallucinations _Gerver_, 1915 485

353. Hysterical stupor under shell fire after 2 days
in the trenches _Gaupp_, 1915 486

354. Monosymptomatic amnesia _Mallet_, 1917 488

355. Aviator shot down: Mental symptoms, organic _MacCurdy_, 1917 489

356. Shell fire and corpse work: Daze with relapse; mutism
_Mann_, 1915 491

357. Mine explosion: Confusion _Wiltshire_, 1916 492

358. Shell explosion: Alternation of personality _Gaupp_, 1915 493

359. “A Horse in the Unconscious” _Eder_, 1916 497

360. Shell explosion, gassing, fatigue: Anesthesia _Myers_, 1916 498

361. Shell explosion and burial: Somnambulism;
dissolution of amnesia under hypnosis _Myers_, 1915 499

362. Shell explosion with injuries: Somnambulism _Donath_, 1915 502

363. Shock: Stupor as if dead _Régis_, 1915 503

364. Emotions over battle scenes: Twenty-four days’ somnambulism
_Milian_, 1915 504

365. Putative loss of brother in battle: Somnambulism
and mutism twenty-seven days _Milian_, 1915 506

366. Shell explosion: Trauma, windage: Somnambulism four days
_Milian_, 1915 508

367. Burial, head trauma; gassing: Tremors, convulsions,
confusion, fugue _Consiglio_, 1916 509

368. Shell explosion: Hysterical symptoms and
tendency to fugue _Binswanger_, 1915 510

369. Burial: Dissociation of personality _Feiling_, 1915 512

370. Ear Complications and hysteria _Buscaino_, _Coppola_, 1916 516