A final contribution to the study of shell shock : being a consideration of unsettled points needing investigation / by Charles S. Myers.

  • Charles Samuel Myers
Date:
1919?]
Catalogue details

Licence: In copyright

Credit: A final contribution to the study of shell shock : being a consideration of unsettled points needing investigation / by Charles S. Myers. Source: Wellcome Collection.

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    object being to bring all the war neuroses under two heads—the “conversion hysterias” and the “anxiety neuroses.” Classification of Main Types of War Neuroses. With a view to determining the sufficiency of suggesti¬ bility as a cause of functional nervous disorders, let us endeavour to classify the main types of the war neuroses, beginning with obviously hysterical, “suggested,” cases and passing to those which show more and more clearly the need for other explanations. 1. A highly “nervous” soldier is hit on the forearm by a piece of shell. His arm drops to his side, and the thought at once occurs to him that he has lost the use of it. The entire limb becomes functionally paralysed. Here we have a clear case of suggestion acting under the influence of fear. 2. After an accident in civil life a man had long ago suffered pain or impaired mobility. A slight bruise in the same region on the battle-field produces functional hyper¬ esthesia or paralysis. The hyperesthesia gives place to anesthesia, or with recovery of movement a condition of extreme incoordination ensues. The influence of suggestion is here fairly obvious. The soldier may even admit that the bruise revived the memory of his former accident. But is it necessarily and always true that hypersesthesia has been converted into anaesthesia by suggestion or that the in¬ coordination can be imitated volitionally ? 3. In childhood certain spasmodic movements were temporarily induced by a severe fright. Of this the soldier has lost all memory. Sudden fear in the trenches revives this disordered movement, which persists for many weeks. The influence of suggestion is here less sure. But even if suggestion can explain the origin it cannot account for the long persistence of the movement, which may even con¬ tinue during sleep. But if (as is usual) it ceases during sleep can it be supposed that each morning on waking the patient receives a fresh suggestion ? Do we not gain a clearer insight into the condition by regarding the move¬ ment as a dissociated emotional expression inherent in the waking personality of the patient, especially when this view leads us to cure the disorder by reviving in the patient the memory of the original trouble, and thus helping to restore his normal personality ? 4. A soldier in previous good health is buried owing to a shell explosion. After a period of stupor or confusion