SHELL SHOCK.•
Dn. Ltni has made an important contribution to a subject not only of interest just after the war, when there are so many sufferers from shell shock in its various forms, but during the piping times of peace, for the symptoms are produced by many industrial accidents and in the emotional form by railway disasters, and its study throws much light on the causa- tion and development of neurasthenia, a condition all too prevalent at the present time.
Shell shock I How frequently do we hear and make use of the words without framing in our minds any very clear picture of what we mean by the term, which has been by some people so extended as to embrace all cases of neurasthenia resulting from the strain of battle. On the other hand, Dr. Leri very wisely does not limit the description " shell shock " to the group of symptoms resulting from the cerebral concussion consequent on the explosion of a shell, the commotional cases, but considers under this term the symptoms arising from the explosion of a shell without evidence being obtainable of such concussion, the emotional cases. Nevertheless, the distinction between these two types is very important, for only by distinguishing them can appropriate treatment be given. The difficulties of making a correct diagnosis are increased the further back from the firing-line the patient comes under treatment, since an Intimate knowledge of the incidents accompanying the shock is so essential, a statement which applies also to treatment. Dr. lAri's book owes much of its value and freshness to the fact that most of the work on which it was based was carried out in the forward zone.
One of the surprises of the war has been the way in which the soldiers have withstood the nervous strain, which would pre- viously have seemed beyond human strength. It is stated drat cases of insanity have not exceeded the normal proportion, • Shell Shock. By Andre Uri. Edited by Sir John Oollle. London: University of London Press. (7e. ed. net.] and in this volume it appears to be maintained that the majority of shell shock patients had either in their families or themselves exhibited some degree of nervous instability. It is a hard question to decide, but we can at Mast insist that no considera- tions of this kind should be allowed any weight in the awarding of pensions.
The translation has been well done, and conveys the clearness associated with French writings ; but one wonders whether the formidable array of technical terms, formidable not only to the public but to all except the medical specialist, is to be found in the French edition. Three excellent photographs of patients help one to visualize the facial changes, but the word-pictures are even more satisfactory.
Previous page
