Evening star., 1929-11-17
PSYCHOSES RECOGNIZED
AS WORLD WAR WOUNDS
Veterans Bureau Strives TO Aid Those
Whose Minds Are Disabled to
Adjust Themselves.

satisfactorily. Now some people, II
they want to be sick badly enough, have
their wishes gratified. SickneSseS al
ways are coming advertently.
Functional Sickness.
This does not mean that they are
slammed" The individual really is
sick The sickness may take a form
astonishingly like that of some organic
disease. Functional sickness remains
one of the most obscure and difficult
problems the physician has to face.
This was the mechanism of some Of
the war neuroses. Many of them were
classed at the time especially If they
came under fire, as "Shell-shock." This
came to be regarded by the general
public as a specific form of nervous
malady. 1t came to include the func-
tional sickness. the abnormal fears and
obSessions, and the curious mental be-
havior which seemed to result from the
stresses of danger and action.
The term has long since been in dis.
favor with Veterans Bureau doctors. It
is believed to have no meaning, SO spe-
ciflc syndrome. 1t was supposed at first
to indicate injury to the nervous sys-
tenn by shell-f1re. The facts were that
there were about as many cases III
training camp which might have been
classified as "shell-shock" as in tie
front lines. 1t merely indicated a grea:
variety of abnormal reactions to diff
culties.
The great ma ajority of these cases
cleared up when the victims were taken
out of the circumstances which gave
rise to them and given a little treat
ment. These were the neuroses, III
which the patient never lost touch en-
tirely with the reality cf things.
But there were thousands of other
cases which, from the very nature of the
individuals, displayed extremenly abnor-
NAL adjustments which could not be
corrected. These we're the psychoses.
The victims had tendencies in that di-
rection before they entered the service.
But in familiar environments, where
they were not subject to violent strains
and stresses, the mental difficulties
might never have been precipitated or
have been delayed for years.
WarSTIastened Conditions.
The tumult of war brought to the
service these tenden les to abnormal re-
action. They might have come any
way. but the changed conditions has
tened and exaggerated them. 1t is pos
sible that fundamentally they were in
evitable from some popularity in the
structure of the individual.
It is these individuals who now con-
Stitute. IL years after the armistice, the
pathetic legion of lost minds.
The army camps took men at an age
when one of the most dreaded of
conditions. dementia, precox,
is most likely to become manifest. Con-
the great majority of the in
sane veterans now are suffering from
some form of that classification. Very
little is known about its causes or the
proper treatment. The Veterans Bu-
reau considers 1t of so much importance
that a special study of its etiology, to
continue two or three years, has been
started. This will be exhaustive. Pres
ent plans call for Several hundred diff
ferent examinations of every patient to
give complete data on heredity. physical
condition. intelligence, personality,
physical type and environmental factors
at all stages of life from infancy up
ward.
Meanwhile the dementia precox cases
are not considered entirely hopeless and
even at ST. Elizabeth's, where treatment
is handicapped by the fact that most
Of the patients are in an advanced
stage of the condition before they are
sent there, a considerable number go
out greatly improved if not entirely
cured But there is no set treatment.
Psychotherapy has accomplished Won
ders in some cases where physicians
could establish contact with the real
difficulties presumably responsible for
the condition.
Must Interest Patient.
This disease takes the form of sort
of progressive degeneration, slipping
backward to lower and lower levels with
less and less capability of adjusting to
reality. The first consideration is to
arrest this process by getting the patient
interested in something real. Much is
accomplished in the occupational ther-
apy shops where the patients work at
simple tasks which require, however,
more than automatic motions. In many
cases the deterioration can be stopped
altogether. In others it can be greatly
slowed down.
In the meantime hope is held out to
everybody No war damage Is looked
upon as irreparable. 1t Is at least pos
sible to remedy the physical condition
and every patient is given thorough
physical examination. Sometimes when
Ioci of infection are cleared up ana
the victims body restored more closely
to normal there is a decided mental i'm
provement. But the physical basis Of
the malady, if it exists, remains un-
known.
st. Elizabeths gets, for the most part.
only advanced cases which have been
classified as true psychoses. There are
a great many neuroses resulting from
the war scattered in hospitals through
out the country or at large and max
ing imperfect adjustments. Such cases
present continual difficulties. The pa
tients often are difficult to deal with, de-
manding unreasonable provisions and
misrepresenting their treatment. few
years ago short shrift might have been
made Of them.
But now no sufferers from the war
get more patient and kindly attention
even from those they abuse the worst.
For the Veterans Bureau takes the po-
sition that they are war casualties just
as much as men who lost arms or legs.
II will continue to help them to ad-
just until the adjustment is Satisfac-
torily accomplished.
South African Mines