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War Surgery and Medicine

Pacific Experience

page 645

Pacific Experience

Of 1272 medical cases evacuated to the 2 NZ Casualty Clearing Station from 3 NZ Division in the Solomons over a period of eight months, 10.4 per cent were cases of psychoneurosis. The diagnoses of these cases were as follows:

Anxiety neurosis 89
Neurasthenia 18
Headaches 9
Effort syndrome 7
Conversion hysteria 7
Vaso-vagal attacks 3

Of these 133 cases, 85 were evacuated from 2 NZ Clearing Station to 4 NZ General Hospital.

Broadly speaking, two types of psychoneurotic reaction were seen—the anxiety state and conversion hysteria. Mixed reactions were common.

Of the 133 psychoneurotics seen at 2 NZ Casualty Clearing Station in Guadalcanal, only seven could be classified as battle casualties, and six of these were youthful soldiers between the ages of twenty and twenty-five. In the Pacific the hospital admission rate for psychoneurotics fell abruptly as soon as rumours of impending military action began to circulate throughout the force. The incidence of neurosis in 3 NZ Division decreased when the division moved from New Caledonia to the forward area in the Solomon Islands during August and September 1943. It had been doing garrison duty in New Caledonia for seven to eight months—a duty in which boredom was inevitable. In September and October came the attacks on Vella Lavella and Treasury Islands, and in these two months only 13 cases, including the 7 battle casualties, were evacuated from the division. From November 1943 until the beginning of February 1944 service in these islands amounted to garrison duty only, and during this time twenty to twenty-four cases were evacuated each month. In the middle of February 1944 came the attack on Nissan Island, and in March it was known to the troops—although no official statement was made at that time—that many of them were likely to return to New Zealand in the near future. During the months of March, April, and May 1944 the monthly rate of evacuation for neurosis rapidly fell.

Experience in hospitals, which served large numbers of base troops in addition to divisional troops, suggested that the incidence of neurosis was just as high amongst men who had seen no action as it was amongst fighting troops.

page 646

The wastage of manpower due to psychoneurosis is shown by the following figures. Twenty-six unselected cases of anxiety neurosis that were evacuated from 2 NZ Casualty Clearing Station in Guadalcanal to 4 NZ General Hospital were followed in their subsequent army career:

Number of cases who eventually returned to their units Nil
Number of cases regraded II for base duties 8
Number of cases regraded III for return to New Zealand 18
Average length of time spent in medical units 46.5 days

The actual number of days spent in medical units varied from 17 to 130. Most of this time was spent in a General Hospital.

In the Pacific area during the eighteen months' campaign 26 per 1000 became unfit for Grade A1 duties because of psychoneurosis and 10 per 1000 were sent back to New Zealand.

Forty per cent of anxiety cases unassociated with battle stress were fit to resume Grade A1 duties.