PREFACE
The subject matter of this volume is divided into twosections, the one dealing with neuropsychiatry in the United States; the other,with neuropsychiatry in the American Expeditionary Forces. This divisionnaturally follows the differences which obtained in administering theneuropsychiatric service in both places, as the class of cases, generallyspeaking, with which the neuropsychiatrists had to deal.
The section of neuropsychiatry in the United States was quitelargely prepared by Col. Pearce Bailey, M. C., who during the year preceding hisuntimely deathb gave a large proportion of his time to acareful study of the records of the division of neurology and psychiatry in theSurgeon General's Office. His material was completed and edited by Lieut. Col.Frankwood E. Williams, M. C., who was Colonel Bailey's chief assistant duringthe war, and Sergt. Paul O. Komora, M. D., who served in the offices of bothColonel Bailey in the United States and Colonel Salmon in the AmericanExpeditionary Forces.
In the preparation of Chapters V and VI, material furnishedby a number of neuropsychiatric officers was freely used. Mention isparticularly made of the reports of Maj. A. J. Rosanoff, M. C., who was chief ofneuropsychiatric service of the special hospital for war neuroses at Plattsburg,N. Y.; of Capt. Earl D. Bond, M. C., who was in charge of the neuropsychiatricactivities in connection with the embarkation and debarkation of troops atNewport News, Va.; of Capt. Sylvester R. Leahy, M. C., who assisted in similarwork at the port of Hoboken; and of Maj. Herman M. Adler, M. C., who made aspecial study of disciplinary problems in the Army in the United States.
In the preparation of Chapter IX jointly by Col. PearceBailey, M. C., and Capt. Roy Haber, S. C., who was on duty in the division ofneurology and psychiatry, Surgeon General's Office, assistance in the editingof this chapter for statistical style and accuracy was given by Dr. Horatio M.Pollock and Miss Edith M. Furbush, statisticians, respectively, of the New YorkState Department of Mental Hygiene (formerly the New York State HospitalCommission) and the National Committee for Mental Hygiene.
This is the first time in the history of the country that ithas been possible to study statistically such quantity of data in regard toneuropsychiatric disorders. Special study of neuropsychiatry had not reached anadvanced stage during the Civil War, and the medical and surgical history ofthat war contains no discussion of this class of diseases. Such medico-militarysta-
aFor the purposes of the history of the Medical Department of the United States Army in the World War, the period of war activities extends from Apr. 6, 1917, to Dec. 31, 1919. In the professional volumes, however, in which are recorded the medical and surgical aspects of the conflict as applied to the actual care of the sick and wounded, this period is extended, in some instances, to the time of the completion of the history of the given service. In this way only can the results of the methods employed be followed to their logical conclusion.
bDeceased Feb. 11, 1922.
tistics as had been compiled since that time have relatedonly to a comparatively few men who had volunteered for military service.
Previous statistical studies have necessarily been confinedto the records of various civilian institutions. These have not been possible onany large scale because of the lack of a uniform method of recording data in thevarious States and even in the several hospitals of the same State. Such studieshave also lacked completeness for the reason that no State has made adequateinstitutional provision for mental diseases and practically no provision hasbeen made at all for those who do not fall in the category of insanity.Therefore, individuals with psychoneuroses, constitutional psychopathic states,and the like have appeared only seldom in civil statistics.
The information obtained from this study will be of value tothe Medical Department of the Army, in the event of future wars, in helping tomake a correct estimate of the percentage of nervous and mental disabilitiesexisting in the group of citizens liable for military service, and in estimatingto what extent these conditions may be found among citizens of the differentStates and among people of different races and nationalities. Furthermore,authentic data will be available from which to fix definite standards ofrejection for those examined at the time of entrance to the military service,and estimates can be made as to the different types of nervous diseases whichwill develop in the Army.
The degree to which neuropsychiatric defects were shown toprevail was unexpectedly large. The great predominance of those littleunderstood conduct disorders embraced under the clinical classifications ofpsychoneuroses and constitutional psychopathic states was particularlysurprising. It had always been believed that the psychoneuroses were theimportant forms of neuropsychiatric disorder, but from a study of the Armyneuropsychiatric examinations it must be concluded that the psychoneurosesgreatly surpass them in numbers. Hitherto these conditions have not beenregarded socially as serious, but in the future it is apparent that every effortmust be made by all citizens interested in the welfare of the country to salvagethis great class of people in order that the man power of the country may bemaintained at its maximum, as well as for other economic reasons.
In the preparation of Section II of this volume, the editor,Col. Thomas W. Salmon, M. C.,c who wassenior consultant in neuropsychiatry, A. E. F., was assisted by Sergt. NormanFenton, M. D., who served during the World War as assistant in psychology atBase Hospital No. 117, A. E. F. (the special hospital for war neuroses), and whofor several years after the war was engaged in a noteworthy study of thesubsequent histories of men who had suffered with neuropsychiatric conditions inthe Army.
The effects of modern war upon the human mechanism havebearings upon problems of health nearly as important in some of their practicalaspects now that the war is over, as when the success of the war itself dependedupon the preservation of the health and morale of troops at their highestpossible level. In the belief that it might be useful and at the same time notdetract from the value of this volume as a record of events, the relation thatmethods of management of the war neuroses and of mental disorders in theAmerican
cDeceased Aug. 13, 1927.
Expeditionary Forces bear to the solution of problems ofmental health in civil populations has been commented upon from time to time.
While the actual neuropsychiatric work in the AmericanExpeditionary Forces covered many different fields, there was, in almost everyinstance, an individual officer who was more directly responsible than anyoneelse for a particular activity or more fully informed regarding it. Therefore,the main divisions of neuropsychiatric activities are dealt with in separatechapters prepared in most cases by the officer who came in most intimate contactwith the work described. As director of psychiatry and later senior consultantin neuropsychiatry, the editor of this section had an unusual opportunity toview the neuropsychiatric work as a whole. For this reason, accounts of thegeneral conceptions upon which neuropsychiatric plans were based, the generalnarrative and an account of the administrative mechanism by which the work wasconducted, as well as an evaluation of the results and the significance of whatwas accomplished have been contributed by the editor.
The account of neuropsychiatry in divisions, corps, andarmies, in Chapter II of this section, was prepared by Lieut. Col. Edwin G.Zabriskie, M. C., consultant in neuropsychiatry in the 3d Division, 3d and 5thCorps, and First Army; Lieut. Col. John H. W. Rhein, M. C.,dwho at different times was consultant in neuropsychiatry with the SecondArmy and commanding officer of Neurological Hospital No. 1; Maj. Edward A.Strecker, M. C., Maj. Samuel Leopold, M. C., Maj. Mortimer W. Raynor, M. C., andCapt. Harry A. Steckel, M. C., who served as division psychiatrists in the 28th,4th, 79th, and 26th Divisions, respectively. Chapter III, which deals with thearmy neurological hospitals. was prepared by Lieut. Col. John H. W. Rhein, M.C., and Maj. Roscoe W. Hall, M. C. Chapter IV, dealing with the special basehospital for war neuroses at La Fauche (Base Hospital No. 117), was prepared byLieut. Col. Frederick W. Parsons, M. C., commanding officer of that unit.Chapter V was prepared by Maj. Sidney I. Schwab, M. C., medical director of thishospital, and Sergt. Norman Fenton, M. D., who also prepared the bibliographyand made the study of a group of discharged men who had war neuroses. Chapter VIwas prepared by Lieut. Col. Michael W. Thornton, M. C. (section on psychiatriccollection station), and Lieut. Col. Sanger Brown, II, M. C. (history of BaseHospital No. 214). Chapter VII, dealing with neuropsychiatry in the army ofoccupation, was prepared by Maj. Samuel W. Hamilton, M. C. (who was consultantin neuropsychiatry for the Third Army).
It is impossible to give full credit for all the otherassistance given in the preparation of this volume, for many officers havecontributed their own observations and data.
dDeceased.
