Evening star. [volume] (Washington, D.C.) 1854-1972, 1927-08-20
BACKGROUND OF EVENTS
BY PAUL Y. COLLINS.

The above indicates the high quail.
! flcations of DIR. Salmon az an author
| 1ty on shell shock and other forms of
mental disease. In his official report.
| in 1917, after his investigations in the
| British Army, he said:
There is statistical evidence which
indicates that the insanity rate in the
| British Army is less at the present
| time than it was in the first year of
the war, and that it has not reached
the high rates reported in recent
wars. The high and constantly in.
creasing rate for the war neuroseS
suggests that the latter disorders are
taking the place of psychoses in mod
ern war. How much this phenome-
non is due to an actual change in in
cidence and how much to former err
rors In diagnoses cannot be stated ac-
curately
There IS a high suspicion that the
high insanity rate in the Spanish
American and the Boer Wars was due,
In part at least, to failure to recog-
nlze the real nature of the severe neu.
roses which are grouped under the
term shell shock in this war. This
may account for the remarkable re.
covery for insane soldiers in other
wars. 1t is certain that in the early
months of the present war many sol.
dlers suffering from war neuroses
were regarded as insane and disposed
OF accordingly. When one remem.
bers that the striking manifestations
seen in these cases were unfamiliar
in men, to physicians in general prac-
tlce, it is not surprising that some Of
the severe disturbances should have
been interpreted as signs of insanity"
SO DIR. Salmon clearly differentiated
between insanity and "war neuroses."
or shell Shock" which, it is stated.
is not done by the medical staff of the
Veterans Bureau, nor of ST. Eliza.
beth's Hospital
In another report by DR.. Salmon.
quoted by DR.. Fenton, is this encour-
aging word:
Few more hopeful cases exist in
the medical services of the countries
at war than those suffering from war
neuroses grouped under the term
shell shock when treated in special
hospitals by physicians and nurses ia.
mlllar with the nature of the func-
tlonal nervous diseases and with their
management.
How important is this question of
shell shock or war neuroses" in the
present-day conditions among the
veterans in the Government HOSPITALS
must be judged in the light of the fact
that mental patients exceed in mum
Der all other cases combined. Yet
they are all carried as IN. p" cases
snort for insanity cases. The Vet
Grams Bureau reports the three divi.
slons OF cases in bureau hospitals each
year as follows June 80 each year ex.
cept 1927 and August 20 for 1920:
Eqesrcuosis $3.50 1898 7 7?SS 1885 1885 a 5s4
(mehtaD -. L. 100 Il. ss7 2 74s s.7ao
General medical. 1882 5000 1914 5.76:i
Totals 500. 26.631 25 .611 25.31S 25.354
Only part of the mental cases" IN.
P.'o are actually insane, but DIR. Sal
mon alleged that most physicians fail
to note the difference.
"A technical book, entitled 'FShell
Shock: Commotional and Emotional
Aspects" written by DR.. Andre Leri.
professor to the Faculte de Paris.
confirms DR.. Salmon's general diagno-
SEES. The book is translated into Eng
llsh by Sir Alfred Keogh and Lieut..
Gen. Sir Thomas Goodwin. and pub
Ilshed as one of the Military Medical
MANUALS OF the British Army. In
PREDATORY note it is said:
defective attention to the difference
between conditions which though APP
parently similar are essentially differ.
emit, and call for Numerically opposite
treatment, has been the snare which
mas led to many mistakes"
A book. "Shell Shock and It's
Lessons" by DR.. G. Elliot Smith. Dean
or the Faculty of Medicine and Pro
lessor of Anatomy. and DR.. T. Fl.
FEAR, b. Sc.-both of oxford, England
contains this:
"A common way Of describing the
condition of a man sent back with
shock is to say that he has lost his
reason or lost his senses. AS rule.
this is singularly inept expression.
Whatever may be the state of mind
or the patient Immediately after the
mine explosion, the burial in the dug
out, the sight and. sound of his lac
Grated comrades, or other appalling eX-
periences which finally incapacitatc
him for service in the. firing line. it is
true to say that by the time Of his
arrival in a hospital in England his
reason and senses are not lost but
functioning with painful deficiency.
In a word. it is not in the in
tellectual but in the emotional sphere
that we must look for terms to de-
scribe these conditions"
Not "insanity'-shell shock is dis
tinctive. Not necessarily immediate
deferred" And now-in
our hospitals. exceeding all other
"a cac Cnp,hinoA