Evening public ledger. [volume] (Philadelphia [Pa.]) 1914-1942, 1919-01-04
Our Shell.Shocked Heroes

To the Editor Of the Evening Public Ledoey.
Sir-We have at last reached the dawn Of
peace on earth and goodwill among man
kind; our boys are coming home. and soon
everything will again assume a normal pic.
ture. Though some of our boys will not
return, having given their lives that democ-
racy might live, the vast majority will como
home again. a certain percentage, to be
sure. will be physically manned to variable
degree; most. however, will return improv-
ed In body and spirit But we must not fail
TO take into account those men who. appar-
emily sound In body. have been ailng with
that peculiar malady which has occupied the
minds OF military surgeons in all belligerent
countries. that strange disease called shell
shock" the symptoms of which II not skill
fully treated are apt to become chronic and
endanger life
Shell shock is not a new disease DR.. II.
Brooks In the American Journal Of Medical
Sciences for November. 1918. has just pub
lished an article in which. after an elaborate
study of shell shock among soldiers, no
concludes that this disease is merely a form
of hyperthyroldsm, otherwise known az
Gravess disease. exophthalmc goitre.
This opinion l have voiced for over two
years, and In frequently appearing articles 1
have pointed out that the manifestations
of the symptoms of shell shock" l. e.,
excitability. restessness. rapid heart palpitA-
ton, staring eyes, tremor Of the outstretched
fingers. and usually a goitre. are nothing
more than the symptoms of the disease
known in peace times exophthalmic goitre.
The definite cause Of this malady is un-
known but 1t Is very likely engendered by
the sudden change from an accustomed en-
vironment to an atmosphere of unyiedng
subordination in the presence Of intense
apprehension and danger to life and limb
experienced In trench life. OF course, this
presupposes in addition. a peculiar suscep-
tbility of the recruit to the disease.
What shall we do for these boys? The
profession is divided regarding what mode Of
treatment TO adopt in exophthalmic goitre
Heretofore. surgery has claimed the disease
as its own, and operation upon the thyroid
gland thyrodectomy) was considered the
cure. Though this opinion still prevails In
many medical circles. the truth of the matter
is that surgeons and nonsurgeons have been
too hasty In their generalizations In this re-
spect-surgeons. by considering as cured"
merely those patients presenting surgical
recovery though the disease returns in aggra-
waited form sooner or later; nonsurgeons. in
concluding that If the patient is not cured
by medicinal measures within several weeks,
operation should be performed.
The fact of the matter is that medical
men who have given a great deal OF the
time to diseases of the thyroid gland (tt
point of origin Of the dsease) know that the
malady is not durable by the knife; that
nonsurgical means. embracing dietetic hygi.
enic and medicinal measures when prop
erly persisted in, can cure every early case
and the vast majority of even advanced cases
of hyperthyroidism exophthalmic goitre
This is attested by the presence of many
cured in our midst, which were not
operated upon.
In conclusion, I would remark that all
cases Of so-called Shell shock" IL properly
managed nonsurgcally, may be restored to
health. happiness, and utility. none the worse
for their experiences within few months.
ISRAEL BRAN, NJ. d.
Philadelphia, January l.