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Chadwick Lecture (April 26th, 1917): Mental Hygiene in Shell-shock, during and after the War

Published online by Cambridge University Press:  19 February 2018

Extract

Mr. President, Ladies and Gentlemen,—A new epoch in military and medical science has arisen in consequence of the employment of high explosives, combined with prolonged trench warfare, in this terrible war.

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1917 

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References

(1) Since this lecture was delivered I have had the opportunity of examining the brain of a man who died suddenly the day after he had been brought from the clearing station. He had been exposed to heavy shell fire; there was no history of gas or burial. There was no visible external injury, and Capt. Stokes, who made the post-mortem examination, from his findings came to the conclusion that the man had died of shell-shock. Microscopic examination showed no punctate haemorrhages in the white matter which I have described as characteristic of gas poisoning, and which I have demonstrated as being due to thrombosis or embolism of terminal arterioles or venules. Nevertheless there were ruptured vessels in the medulla oblongata, the pons and the corpus callosum, and the condition of the heart and lungs showed that arrest of the cerebro-respiratory centres might have been the immediate cause of death. The full account of this case and another of death from the explosion of a large amount of cordite will be published shortly in the Journal of the Army Medical Service. The reader is also referred to a communication read before the Pathological Section of the Royal Society of Medicine entitled “Punctate Hæmorrhages of the Brain in Gas Poisoning,” Proc. Roy, Soc. Med., vol. x, Pathological Section.Google Scholar

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