Contributions to the study of shell shock : being an account of certain disorders of cutaneous sensibility / by Charles S. Myers.

  • Myers, Charles S. (Charles Samuel), 1873-1946.
Date:
1916?]
Catalogue details

Licence: In copyright

Credit: Contributions to the study of shell shock : being an account of certain disorders of cutaneous sensibility / by Charles S. Myers. Source: Wellcome Collection.

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    has burst near to him, horribly mutilating several of his com¬ rades. Henceforth I shall, for brevity’s sake, allude to cases of mutism by the letters A or B, according to their apparent origin. The relative frequency of the A and B cases is difficult to determine. Histories are not always easy to obtain; and some cases may belong to both groups, or apparently to A, though really to B. But my general impression is that the two groups occur with equal frequency. Predisposing conditions. — In about one-third of the cases of mutism various predisposing affections may be demon¬ strated, e.g., “nervousness,” “fits,” stuttering, wounds, or exposure to the enemy’s gas. These predisposing affections occur as often in the cases of group A as in those of group B. Mutism is not restricted to any one age. I have met with cases in men of 30, 40, and even 50 years. The average age of the cases of mutism I have seen is about 25 years. Mutism is extremely rare among commissioned officers. I have heard of one or two cases ; but among the many officers I have seen I have not met with one so affected. Immediate effeots.—The usual direct result of the shock, as described to me by mute patients, is “lossof consciousness ” or “ loss of memory.” I have seen only three cases in which complete preservation of memory was claimed ; two of these were highly “ nervous ” subjects, of whom one had stammered formerly and the other had been subject to fits in childhood. It was, of course, difficult to decide whether a given patient had suffered from unconsciousness or merely from amnesia when I saw him after he had “ come to himself ”; but where, on the one hand, his condition appeared to have resulted from physical violence, or where, on the other hand, he had been able to walk down with assistance from the trenches, or had been affected with automatism (fugues), or was still preoccupied with the visual or auditory hallucinations of coming shells, a tolerably reliable decision seemed possible. Both loss of consciousness and loss of memory occur alike in groups A and B ; but, as we should expect, unconsciousness appears to be commoner in group A, and amnesia in group B. I have little doubt that the amnesia complained of is almost always due to the onset of a semi-stuporose state, and that most cases of initial loss of consciousness are really the expression of, or, at all events subsequently pass into, a condition of confusion or stupor. Stupor.- Indeed, a definite history of stupor is obtainable in a very large number of mute patients. Others were still in that condition at the time of my examination of them, staring vacantly into space and taking no notice of their surroundings. Stupor is apparently commoner in the B than in the A cases, but it does not seem specially prone