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War Surgery and Medicine



Medical officers, partly through a relative ignorance of psychiatry, were often unable to agree as to the appropriate diagnosis in nervous disorders not necessarily associated with battle stress. At page 638 first diagnoses were made by the RMOs and by forward units, but it was later decided that the diagnosis be left to medical officers at the base hospitals when the patients were sent there. Fewer people were responsible, and the diagnoses they commonly used were: dullness and backwardness (to describe those with low intellectual capacity); psychopathic personality (to designate those who were potentially unstable); hysteria (for those showing physical manifestations); anxiety neurosis (to describe the commonest type); and psychoses.

Nervous disorders associated with battle stress created other difficulties in nomenclature. These were at first differentiated into ‘battle casualties’ and ‘sick’, depending on the patient's personal experience, but after June 1943 all cases breaking down through battle stress were called ‘sick’. At that time too it was realised that the diagnoses ‘physical exhaustion’ and ‘nervous exhaustion’ were the most suitable ones for many of these cases, and they became established in the nomenclature, though they were not listed in the official Nomenclature of Diseases.