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

  • Myers, Charles S. (Charles Samuel), 1873-1946.
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.

    5/16 (page 5)
    &c.) have not disappeared pari passu with the regain of normal voluntary movement. Chief Topics for Investigation. There are, then, three main topics for investigation : (1) the existence of distinct commotional and emotional syndromes ; (2) the justification for limiting the effects of suggestion to volitionally imitable phenomena; (3) the sufficiency of suggestion as an explanation of all functional dissociation. Of these the first merely requires the collection of observa¬ tions. My own experience is that in patients who have been exposed to physical violence (i.e., having been buried, knocked over, or lifted in the air), stupor, hyperassthesia, and spasmodic movements are commoner than in those whose disorder has a purely mental origin. If these differ¬ ences are confirmed by others their explanation would not be difficult, but at the present moment would be out of place. So, too, it would be inopportune here to consider whether a special kind of commotion—e.g., a fine “molecular ” com¬ motion, such as might be produced by moderately short waves of the disturbed air—may ever be directly responsible for functional disorder, producing dissociation through its exhaustive effect on the higher “intellectual” regions or through its excessively stimulant effect on the lower ‘ ‘ emotional ” regions. In passing, we may note that emotion alone can give rise to increase of pressure and of albumin content, and even, according to some, to leuco- cytosis in the cerebro-spinal fluid. But fuller observations are needed on this matter. The second topic suggests a variety of investigations. Can suggestion produce local pallor or blushing ? Most experts in hypnosis maintain that local disturbances in blood-supply can be induced by hypnotic suggestion. Some claim even to have produced blisters, but further work under the careful conditions adopted by Captain J. A. Hadfield, R.A.M.C. (then a naval surgeon4) is urgently needed. Similarly in regard to local sweating, &c. The third topic involves the consideration of the other causes, besides suggestion, which have been advanced as responsible for functional dissociation. Some have thought that an excessive emotional experience may suffice to bring it about. Others have laid stress on the repression of an emotion or instinctive action arising from its conflict with other antagonistic processes, especially with the higher motives of conscience, social sanction, &c. Particular stress has been laid on the conflict of “ wishes,” on mal- adaptation to environment, on the fear of death, and on defence mechanisms before an intolerable situation; the