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Contents

Preface

An official compilation of the History of Neuropsychiatry in World War II was anticipated long before the termination of hostilities. Army Regulations No. 345-105 (30 June 1928) provided for the continuous recording of military history, and subsequent changes thereto, from 1940 to 1943, stressed the inclusion of wartime activities. Therefore, with this task in mind, during and for some time after World War II, related materials and documents were accumulated and stored by responsible members of the Surgeon General's Office and the staff of the Neuropsychiatry Consultants Division. Key personnel and many of the assigned consultants were periodically brought into the division to record their experiences before they were deployed elsewhere, or released from the Army. Their contributions form much of the basic material from which this volume has evolved. In June 1945, Brig. Gen. William C. Menninger, MC, developed an original outline for this history. A few months later, after several revisions and changes in format, Lt. Col. Malcolm J. Farrell, MC, produced the outline which was generally accepted at the time and followed, but with little success, for attempts to complete the work failed, until 1957 when the project was again resumed.

The reason for the failure was an assumption that such a history could be written with part-time leadership. While an individual author could take time out of a busy schedule to write a particular chapter, the coordination and completion of the entire task required the continuous effort, organization, and single-minded dedication by some one person or agency. Even attempts to engage an individual for 3 months or even a year had been unsuccessful.

Upon viewing the inaction of previous years, Col. Albert J. Glass, MC, one of the editors of this volume, upon assuming the position of Chief Neuropsychiatric Consultant to The Surgeon General, in the latter part of 1956, met with Col. John Boyd Coates, Jr., MC, then Director, The Historical Unit, U.S. Army Medical Service, and both reached the decision that it was necessary to assign a full-time project officer to The Historical Unit for at least 3 years. This plan was broached to The Surgeon General and was accepted. Lt. Col. Robert J. Bernucci, MC, the other editor of this volume, was selected and assigned as the Project Officer, in February 1957. An Advisory Editorial Board for Neuropsychiatry was appointed on 5 August 1957 and met for the first time on 27 September 1957. Authors were selected, a new outline for an administrative and clinical presentation of neuropsychiatry was prepared, available manuscripts were reviewed, and slowly but steadily the history began to take form.

It soon became apparent, however, that there could be no realistic separation between administrative and clinical aspects of wartime psychi?


atry. Therefore, discarding this approach, the old history outline of Menninger and his associates was resurrected. Other relevant data which had been accumulated in the previous decade were incorporated and a revised outline format was produced and accepted by the Advisory Editorial Board.

The Advisory Editorial Board selected 35 major authors, who were involved in World War II neuropsychiatry, and The Surgeon General invited them to participate in the writing of the history. All but one, who was ill in a hospital at the time, accepted. This group included members of the Advisory Editorial Board who assumed the duties of key authors or monitors for the various sections of the history. Since then, the list has been expanded to approximately 70 authors, coauthors, collaborators, and monitors. Several hundred World War II psychiatrists and neurologists in response to personal requests contributed anecdotes and experiences, reference material, reprints, and photographs. Every effort toward proper attribution for the material used has been made in this volume.

As this history is a product of many authors, some duplication was inevitable. It was necessary for each author to establish a background to relate the events of World War II as it concerned his particular area of endeavor. To have ruthlessly removed all such duplication would have made unintelligible many of the chapters as individual accounts of a particular sphere in World War II neuropsychiatry.

Another important consideration must be noted. The authors, as persons who participated in World War II, having their own viewpoints and judgments of events, were given considerable freedom in their viewpoint but at the same time assumed responsibility for their work. Many controversial areas, therefore, are presented in which judgments of individual authors may be contrary to other opinions. From an editorial standpoint, it was not deemed necessary to point out each and every possible area of controversy and difference, then and now. Some brief editorial comments, pointing out inconsistencies and contradictions have been made, but this was by no means done in all instances. Undoubtedly, readers will find many statements with which they take an opposite view. However, history is not designed to settle issues but rather to present adequate data of past events and permit readers to draw their own conclusions.

After review of the collected manuscripts, the Advisory Editorial Board found variable uses of the words 'neuropsychiatry' and 'psychiatry' by different authors. They decided that the word 'neuropsychiatry' should be used where it was demanded by historical necessity, as in formal titles and official designations of units and their functions, and where this word most accurately fitted into the general or historical context of a passage. However, the word 'psychiatry' was favored when the specific context called for this more restrictive term which was less ambiguous and more in keeping with current usage at the time of this writing.


From the many authors involved, it was possible to cover every facet of the history by those who actually experienced it. At first, some found it difficult after a lapse of years to stimulate old memories, to revise their old manuscripts, or to write anew; some even may have preferred not to reactivate painful experiences; some verbalized freely; others may have found it tedious; some wrote in one style and some in another. To keep continuous contact with all authors, to provide them with source material, and to prod and encourage some writers who were understandably engaged in full-time civilian pursuits were some of the tasks of the Project Officer. All finished manuscripts were eventually assembled and presented insofar as possible within the limits of space imposed by the publication which was authorized. Unfortunately, much had to be deleted from almost every manuscript. However, every effort was made to retain the major topics stressed by each author. The editors can only express their regrets that the full manuscripts could not be reproduced.

There were many other factors involved in the production of this historical account. The Project Officer became the central or pivotal point for all contributors. Correspondence was voluminous. Thousands of pages of reference material had to be unearthed, reviewed, reduplicated, and shipped to the many writers, and thousands of photographs were screened to uncover a few suitable prints for this volume.

It cannot be denied that there were marked differences between World War I and World War II. During the interval between the wars, our youth was impressed with the theme that war was wrong. With the declaration of World War II, there were no spontaneous rallies, enthusiastic war slogans, or new martial songs to stimulate the will to fight, as there had been in World War I. In World War II, environmental pressures, both in the United States and abroad, were multiplied and stresses increased in an army so vast and widely distributed. The increased efficiency and lethality of newer weapons surpassed that of the First World War. World War I lasted 1? years and was fought in only one theater. World War II lasted 4 years and was fought in many theaters all over the globe.

In World War I, psychiatry seemed better organized at the outset and was able to progress to maximum efficiency more quickly. In World War II, psychiatry started more slowly, progressed more slowly, and yet, despite many problems and wider coverage, it actually accomplished more than could be claimed for World War I, although admittedly more time was required. Millions more people were in the service during the Second World War and they required many more medical personnel, including neuropsychiatrist who were always in short supply. Although it took 10 years to publish the neuropsychiatric history of World War I, it should be recognized that the wider scope, the longer duration, and the multiple theaters of operations required more time to be expended in the production of the neurospsychiatric history of World War II. It must be remembered that we fought the Korean War in the interim, which also contributed to the delay.


The editors wish to express their sincere thanks to the medical officers who made the material for these chapters available and to the distinguished authors who have written them. In addition, thanks are due to the entire Advisory Editorial Board for its constant support.

Grateful appreciation is due Col. Arnold Lorentz Ahnfeldt, MC, who succeeded Col. John Boyd Coates, Jr., MC, as Director and Editor in Chief, The Historical Unit, U.S. Army Medical Service, and who continued, in the manner of Colonel Coates, to guide this project and give frequent encouragement and experienced advice when it was needed.

In particular, the editors and authors are greatly indebted to a number of persons whose contributions made possible this final product:

To Mr. E. L. Hamilton, Chief, Medical Statistics Division (now Agency), Office of The Surgeon General, and particularly to Dr. Bernard D. Karpinos, Special Assistant for Manpower Studies, in the Medical Statistics Agency. The basic medical statistical data relating to the various phases of the neuropsychiatric problem, presented in the various chapters of this volume, unless otherwise indicated, were provided or reviewed by these members of the Agency, especially by Dr. Karpinos who also provided other essential data for inclusion in this volume. The data furnished by the Medical Statistics Agency are based on tabulations of the individual medical records, except for those in which the source is otherwise specified.

To Mrs. Genevieve Comeau, General Reference and Research Branch, The Historical Unit, who devoted many hours and days, in that branch and in other archival repositories, searching for material requested or otherwise needed by the many authors. Unfortunately, ill health necessitated Mrs. Comeau's resignation; her work was most ably continued by Mrs. Claire M. Sorrell.

To Mrs. Hazel G. Hine, Chief, Administrative Branch, The Historical Unit, and her competent staff in both the Administrative Branch and the Reproduction Section of that branch, who patiently cooperated with the many tedious tasks involved in the typing and reduplication of old tattered and frayed documents, scattered bits of information, manuscript drafts, and finally, the finished manuscripts.

To Mrs. Elaine R. Stevenson, Editor (Printed Media), of the Editorial Branch, The Historical Unit, who ably assisted in the publications editing and indexing for the volume.

And finally, to Miss Rebecca L. Duberstein, Chief, Editorial Section, Editorial Branch, The Historical Unit, who, by her knowledgeable comments and suggested text revisions for correction and clarification, enhanced the presentation of many of these chapters.

ROBERT J. BERNUCCI                                                                       ALBERT J. GLASS,

Lieutenant Colonel, MC, USA (Ret.),                                              Colonel, MC, USA (Ret.),

Editor for Neuropsychiatry.                                                              Editor for Neuropsychiatry.

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