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New Zealand Medical Services in Middle East and Italy

Exhaustion Cases

Exhaustion Cases

Arrangements were made during the Cassino operations for exhaustion cases to be sent to 5 MDS, which was open for the sick casualties of the Division. An endeavour was made to retain the lighter cases in the divisional area and save the serious loss of manpower resulting from evacuation to the Base. At that time, the physical exhaustion cases had been reclassified as ‘sick’ instead of as ‘battle casualties’. During March 158 exhaustion cases, including two officers, were admitted to the sick MDS. Of these, 104 were evacuated, but more could have been retained at the MDS if more accommodation had been available. At first the men were returned to their units in twenty-four to forty-eight hours, but this proved unsatisfactory and they were held longer, some up to five days, and were much benefited by the rest.

Of fifty-two men returned to their units, eight and the two officers were re-admitted and evacuated. The majority of the cases were from the more recent reinforcements, particularly the 10th Reinforcements. Most of them were from three battalions, but there were men also from the artillery and engineers. Some concern was caused as the majority were very recent arrivals in the Division, and quite page 561 obviously in many cases had neither the wish nor the mental outlook to try to make themselves useful members of their units.

In drawing particular attention to this in March 1944, the Consultant Physician stated that men who manifested psychoneurotic tendencies in civil life still managed to find their way overseas, and their breakdown was seldom surprising. Apart from the exclusion of that type of case, the most important factor in prevention, or in reduction of incidence of these breakdowns, was the inculcation of sound discipline, which could only derive from a proper military training. Medical officers often remarked upon the almost complete lack of training many of the men appeared to have had in New Zealand. Some of the ‘breakdowns’ asserted that they had attended practically no parades, had done no rifle drill, had never seen a machine gun and had not even done a route march. When such men joined a line battalion it was only natural that they should develop acute feelings of inadequacy and inferiority, especially in times of stress. These feelings bred various phobias, anxieties, insomnia, and depression, and the first step towards functional nervous disorder was well established before the man had any chance of adjusting himself to his completely new and strange environment.