“SHELL-SHOCK”

New Zealand Times, Volume XLII, Issue 9632, 12 April 1917, Page 3

“SHELL-SHOCK”

NEURASTHENIC CASES HYPNOTIC TREATMENT EFFECTIVE. According; to a writer in a recent exchange, neurasthenia —a common form of mental disorder and often referred to nowadays under the name of “shell-shock”—is causing many soldiers to be transferred from tlie firo trenches to the base hospital in tho war area, or to tho military neurological hospitals at Liverpool and other centres, where special treatment is given with conspicuous success.

The greatly increased violence of war as it is known to-day is such as seriously to disturb the mental balance of many young men who for height, weight, chest dimensions, and sight may be fitted for service, hut mentally are quite unfitted to bear tho stress and strain which modern fighting involves. Consequently the transference of men from the field of peace to the field of war has brought about a perplexing variety of nervous manifestations—neurasthenia and functional disease —requiring the immediate attention of men who have specialised in tho study of such affections. NEUROLOGICAL HOSPITALS. Acting on the advice of SurgeonGeneral Sir Alfred Keogh, tho Imperial Government approved the establishment of neurological hospitals for the special care and treatment of nerveshaken men. and the Mental Treatment Bill was passed “to facilitate the early treatment of mental disorder of recent origin arising from wound% shock, or other causes.” This Act made the law less rigid for the treatment of such cases by removing the necessity of formal certification in the case of soldiers suffering from, mental breakdown produced by loss of control of higher nerve centres over the lower nerve centres.

Medical men are agreed that remedial measures must be taken immediaately if success is to bo gained in restoring the mental balance of the affleted soldier. In tho earlier fighting many of our soldiers with, shattered nerves were not placed under the special treatment necessary to effect an early cure. They were admitted to general military hospitals in this country, where they did not respond to the treatment, and the tendency for their disability to develop if left alone was soon apparent. Latterly, every effort has been made to bring these men under special treatment at the neurological hospitals.

Generally speaking, the symptoms of the disease are exaggerations of instinctive emotional reactions due to tho unduly excitable condition, of the nervous system—a morbid sensitiveness and unreasonable apprehension brought about by a temporarily distorted mental vision. An excessive fear attaches to some of them which is partly attributable to tho patient’s apprehension in face of the unknown and the incomprehensible, and much of tho curative work consists in reassuring the patient. To enable this to be done satisfactorily a knowledge of the factors which cause the disordered state of mind is imperatively necessary. The patient must be himself convinced that he will recover, and not allowed to brood over his ailment. SYMPATHETIC AIDS.

Several kinds of, treatment are practised. The therapeutic use of sympathy has greatly assisted to bring about some remarkable recoveries. Some patients need isolation; others firmness. The utility of hypnotic suggestion has also been demonstrated, although a certain amount of prejudice is displayed against this form of treatment both by members of the medical profession and by a comparatively small proportion of their patients. It is claimed for hypnotic suggestion that almost ali cases of war neurasthenia and psychasthenia can be permanently cured if it be used in reasonable time. Hypnotism has only recently received the sanction of the medical profession in this country, and since the war it is said to have rendered great aid as a therapeutic agent in treating nervous tremors, insomnia, bad dreams, hallucinations, stammering, and anaesthesia. But hypnotism cannot bo universally employed as a therapeutic agent, because only a certain proportion of men are susceptible to its power. It ia on tho knowledge that the mind influences tho body that the hypnotist bases his practice. Sometimes tho nerve disturbance is accompanied by loss of speech and of memory, and slowness of ideation and “disorientation” (general mental confusion in regard to time and space) prevail. A soldier who had fought in Gallipoli could recall to mind only one incident in that strenuous campaign. The fighting in which ho had been engaged was a complete blank. He denied having gone to Gallipoli; the place was not to be found in his geography. Neither did ho know the regiment to which he belonged. But tho officer in whose charge he had been placed had learned something of his recent history. He knew the man to he suffering from a rather severe form of neurasthenia—that the violent concussion of explosions had produced partial paralysis of the central nervous system. REMOVING OBSESSIONS.

The work of the specialist is sympathetically to treat such disabilities, and, by interesting himself in individual cases and noting the peculiarities of each, to get the patient bank to a normal state of mind. In the cases of lost memory the specialist sometimes finds a man who is obsessed with some incident relating to his • earlier life. The symptoms of this obsession declare themselves under the influence of a variety of emotions, of which anger, jealousy, and grief for some alleged wrongdoing are most common. This disturbing element distresses the soldier at all times. He can think of nothing else; his talk centres round it; his dreams are confined to it. Asleep or awake, some incident of his younger days haunts him." A case of this character demands extreme patience and sympathetic attention if the functional departures from normal stability are to be corrected. An attempt is made to get at the root of the disturbing influence and to eradicate it by gaining the man’s interest in his achievements on the battlefield. He is taken by stages through his military career, beginning with his enlistment. He is taken back to the trenches, reminded of the life he lived there; how he and his comrades checked the enemy in one of the battles, .together with other prominent incidents of the war. At first this process of “jnemory recovery”- bores