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War eunuchs..

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BerichtGeplaatst: 19 Nov 2006 10:31    Onderwerp: War eunuchs.. Reageer met quote


Gun Wounds in the Testicles—The Eunuchs of the World War—Steinach's Experiments to Restore Virility —Transplanting of Testicles—Literary Use of Such Material—Woman's Relation to War Cripples—Sexual Pathology—Disappearance of Libido, Erection and Ejaculation—Examples of War Perversion—Sexual Regression and Infantilism—War Neurosis and Sexuality—Sadistic Methods of Treatment—Kaufmann's Shock Cure—Its Terrible Tortures—Cruelty in Psychiatric Wards—Soldiers Deliberately Wound Themselves—Venereal Diseases Self-Inflicted—The Shadow of Death

FOR four and a half long years the war machine whirred and whirled, constantly demanding more human flesh to stuff into its insatiable, cruel maw. Those who fell into its merciless wheels came out, if not dead, at least crippled or undone. It was given to only a few to remain in the "steel bath" for any length of time without sustaining injury of body or soul. A Sittengeschichte of the World War cannot omit these victims of war for the problem of war injuries and war cripplings has numerous connections with questions of sexual life as will appear presently. We shall confine ourselves to an investigation of the problem: how far sexual life was influenced by physical and psychical wounds.
Above all, it was shot wounds in the testicles and also injuries to the spinal marrow which induced a complete disappearance of the sexual functions. Injuries of this sort were not uncommon during the war which explains their frequent occurrence in literature. Yet it appears that poetry gave much more attention to this problem of emasculation during the war than did science. One of these cases became famous in medical literature because the patient became a subject for transplantation experiments. The following report was given by Dr. Robert Lichtenstern: "On June 13, 1915, a twenty-nine-year-old soldier sustained a gun wound on the left thigh which inflicted grave injuries upon the scrotum, both testicles and the urethra. When the patient was brought to the hospital, he noticed that in urinating most of the urine ran out through the wound in the scrotum, only a small portion being voided in the natural way. He was suffering from gangrene of both testicles and serious wounds in the urethra. The next day both gangrened testicles were excised because there was danger of a generalized infection. A few days after this operation, the fever declined and the suppuration as well. The patient voided most of his urine through the perineal wound. As a result of his injuries, the patient's libido had declined tremendously, but in the first two weeks dur ing erotic conversations, he had erections on two occasions.
"On July 7, 1915, he was admitted to the surgical department of the Vienna Hospital and submitted to another examination. He was a large, powerful man with normal internal organs. His whole conduct was distinguished by an indifference to the outside world. There was no trace of testicles and on both sides of the wound there were the granulated stumps of both ligated seminal vesicles, in the middle of which the urethra lay free. The prostate showed, upon rectal examination, a normal size and consistency; the bladder emptied by a catheter was clear. In order to close his urethral wound, a temporary catheter was introduced; in the course of the next fourteen days, his wound became perfectly clear and began to form scar tissue. The opening of the fistula closed so that the catheter could be removed; the patient got up and urinated in the normal way. But he still showed a complete indifference toward everything that happened in the hospital and towards his comrades; he read nothing and manifested no interest whatever in the war. In answer to questions he replied that he had absolutely no libido and no erections. Close observation showed that for practically six weeks until the last day of August, he had no erections at all and that, despite various devices calculated to arouse him, he felt no libido whatever. For the most part the patient sat near his bed or at the window, ate voraciously, slept a lot, and busied himself with absolutely nothing at all. The loss of both testicles resulted in a remarkable increase of adipose trsue, especially around the neck which gave the patient a peculiarly stupid appearance. His facial hair, especially his mustache, fell out completely, and his bodily hair decreased too, especially at the linea alba which became almost hairless so that the pubic hairs were set off horizontally from the abdominal epidermis."
As has been mentioned, this case became famous because, as a result of certain experiments that Steinach had made upon animals, an attempt was made to transplant upon this patient a testicle which had been removed from a case of cryptorchism that had been operated upon for this ailment. The result of the transplantation aroused considerable attention in medical circles for the patient showed marked improvement. Various castration symptoms, such as adiposity, altered trichosis, loss of libido and psychic indifferentism, all receded temporarily so that the patient actually entertained the idea of marrying.
Other organic injuries also induced a whole series of grave disturbances of the sexual function. Thus Boenheim has described a case where as a result of a gun wound in the vicinity of the second lumbar vertibræ, there supervened the loss of ejaculation, orgasm and libido.
As has been said, the psychological side of this problem was seized upon by literature and treated by many writers. The sensations of the unfortunate eunuchs of the World War and their conduct of life which entailed a total reorganization of their life pattern, offered poets and writers elaborate material for literary treatment. One of the most moving representations of this sort we quote from Bruno Vogel's magnificent war book:
"Pushing myself along the ground with my arms and my right foot, I crawled over on my belly. I drank greedily and wanted to finish the whole bottle. I crawled further, making my way slowly over limbs writhing in their death agony and flaming fever, beyond large heaps of charred coal in the form of human beings, gazed into eyes torn wide open as though they could not realize that they were already dead, fell over wounded men who were groaning as loudly as though they were lying with a woman in passion. Soon both of my canteens were empty. I saw Sczepczyk again. With amazing precision his generative organs had been shot from his body. 'Herr Leutenant,' he whispered, a little bit ashamed and in deep confidence, 'Herr Leutenant, and I have never yet had a girl.' He gladly accepted the cigarette I gave him and I softly stroked his hair and forehead. Finally I slipped my hand over his eyes and, as a little smile of pleasure curled over his mouth, I pushed my mercifully brutal sword into his side. There passed over him a movement as though he wanted to sneeze, and that was all. He was saved. I had committed a murder."
The devastating reaction which occurs when one realizes that for the rest of one's life one will be unable to enjoy the highest pleasure of this mortal life, has been well depicted for us in the famous Siberian diary of Edwin Erich Dwinger entitled, The Army Behind Barbed Wire. The young author lay in a Russian hospital for prisoners-of-war with an abdominal wound. One evening, after supper, where they had again been served black kascha, a heavy groat which none of them was able to accommodate in his weak stomach, he saw that the man who had sustained an injury of the testicles was getting up from his bed for the first time. This man came right up to the author and looked at him as though he had just awakened from a frightful dream.
"I say," he began, "please tell me—you are an educated man and must know it—will it go without?"
"What do you mean, comrade?" Dwinger asked dismayed.
Thereupon he opened his drawers and made a short cutting movement and said painfully, "They cut it off for me. It isn't there any more. Isn't that so?" Dwinger didn't know whether to tell the truth or not. He really wasn't able to do it. So he muttered something to the effect that he believed that it was possible. . . only that . . . there wouldn't be any children.
"So," mumbled the unfortunate man, "so there won't be any children." He was silent for a moment, breathed with difficulty and then drew a picture from his shirt which he held before my eyes. It showed a broad, buxom girl, a perfect child-bearing machine. "My wife," he said briefly. "Until now we weren't able to have any children because there wasn't any money for them." However, it was his wife's fondest wish to have at least six children, for she held that without children life was nothing. Having said this he turned around slowly and walked to his bed, stretched himself out painfully and never spoke to anyone else until they sent him to Siberia. It is significant that we meet the tragic figure of this emasculated man further on in the novel, but at this later stage, he rejoices that he does not have to suffer the sexual hunger which the others are being plagued by.
Finally, let us cite for the reader a similar incident found in the war book, Nothing New on the Eastern Front, by Carl Agiotto. A certain Schwarz, who had been in the hospital for some time, was now cured and sent home on furlough. His young wife—this was one of those war marriages—could hardly wait for his return. "Kurt never wrote what sort of wound he sustained," she once said to a friend of hers. "He never told me more in his letters than that it was a light gun wound. You can scarcely believe how happy I am that he is coming home. I've been yearning for him so." Two days later Kurt was welcomed home by his wife in the most hearty fashion. They kissed and embraced each other as warmly as though they had just fallen in love. The young wife whispered to her husband, "Tonight I shall fix everything for you." As she said this he looked at her very curiously but kissed her on the mouth quickly and intensely. "What is it?" she asked. He merely said that it was nothing and stroked her forehead. Evening came and the young wife prepared the sleeping chamber for their night of love. Her heart danced with glee in anticipation of the happiness that would be theirs. Suddenly she fell upon her husband's neck and whispered passionately, "You've gotten so sunburnt and you look so vigorous. Have you any notion how supremely glad I am that you've come home? I love you so much." With that she sat down on the edge of the bed. Kurt suddenly became very red in the face. His wife noticed his apparent help lessness, a condition she had never before seen in him.
"What is the matter with you?" she inquired. "What makes you so very droll?
He replied that he was going out for a moment and that, upon his return, they would make a night of it. In the meantime, he urged her to get undressed so that she would be completely ready when he came back. She undressed and stretched out luxuriously over the bed in delirious expectation of the joy about to be shared with her loved one. In the meantime, he sat in the adjoining room, beating his head with his fists and drawing his breath in pain. She called out suddenly, "Kurt, Kurt, where are you? I'm ready for you and I've warmed the bed too."
He heard the call of his wife and breathing even harder than before, muttered out in great agony that he would be in presently.
"I don't understand what's the matter with you. You've never been this way before." But not a word of answer came. For a while there was a painful stillness from both sides. Finally she called out with a sob in her voice, "If you don't come in right away, I'm going to be very angry with you.
He arose and began to pace to and fro. Then muttering, "Well, it has to be some time or other," he made his way into the bed room.
"But you're still dressed," his wife called out in astonishment.
He came close, fell on his knees before her and, burying his head in her lap, sobbed out inarticulately, "I can no longer come to you for I am not a man any longer....The enemy...A bomb! "
She looked at him with terror for she now saw the meaning of it all.
This marriage was broken by the war, as were innumerable others. How many marriages did the war destroy in this fashion? Were there hundreds, were there thousands?
Before we turn to view the panorama of these most pitiful victims of the war, we must cast a glance at the women who were tied to such men and who indirectly were the victims of the mass insanity of war. It is the special merit of the poet, Ernst Toller, to have illuminated the tragedy of these women in their relations to their castrated husbands. Toller's Hinkemann may be regarded as the final literary formula of the emasculated soldier who returns home from the wars, and the inability of his wife to continue a veritably inhuman sacrifice in his behalf. In many cases, the wife of the war eunuch was animated by the best and most noble motives, just like Hinkemann's wife; but all of these pathetically noble resolves were shipwrecked on the rocks of our workaday, all-too-human life. If we are going to lend our pity to any of the marriages ruined by the war, we certainly should expend it here, for in this case we are dealing with a group of men who will never be able to find their lost happiness by the side of a woman. From every outcry of Toller's hero, we hear the whole dismal and appalling tragedy of a creature who has gone through the vast hell of war, and it is a cry which can never be silenced. How brutal is the reply to Hinkemann by his wife's seducer, Paul Grosshahn, who rebukes the cripple for seeking to keep his wife a nun. Hinkemann is informed by the seducer that he is in reality nothing more to his wife now than a ground for divorce!
How little the war mentality was able to take cognizance of the actual needs of human beings, appears from the demands made upon women in connection with the invalidism of their husbands. It was held to be quite natural that women should remain chained for the rest of their lives to crippled men, and that they should be willing to live this sort of sacrificial existence. In regard to this class of human beings, it was expected that not only would the spirit be willing, but also that the flesh would be free of all weakness. For a little while, it appeared that all the evils of war would be abolished if only there were the certainty that the cripples and invalids who returned from the battlefield would not have to remain without their wives or live unmarried. In this sacrifice of her own happiness, the preachers of this gospel saw the essential patriotic duty of every woman—and, of course, no further ground was necessary than this. From every newspaper and pulpit this message was shouted at women. The Hungarian archbishop, Johann Csernoch, preached in this fashion as early as the second month of the war. This vogue waned, however, as early as the end of the very first year of the war. It turned out that the solicitude of those responsible for the war toward the welfare of the victims of the war, was only a part of war propaganda. Even in England, where this artificial ideology could show its greatest triumphs and where this vogue went so far that parents and wives looked with pride at their sons and husbands who returned from the battlefield crippled, the propaganda nature of this whole ideology was just as apparent.
In a German essay of that time dealing with this question we read the following: "Many people will honestly desire an answer to the question of how anyone can propose to a normal woman that she marry a cripple. The answer is not very easy, but none the less science has given it. Our orthopedic surgery has gotten to the point today where it can take a man who has lost his arms or legs and render him capable of earning his own living; by teaching him proper exercises and giving him proper appliances, modern science can actually fit this man to do the most varied kinds of work....
“All that is necessary is that women and girls should learn to take the proper attitude to our honored war heroes. For this spirit must be learnt. In this new attitude to cripples the great power of love will be able to accomplish tremendous things; but the first thing that is necessary is to put oneself into the new relationship and to become accustomed to the fact that this or that man has no arm or leg."
Pious counsels such as these might have been taken to heart at a time when patriotic vanity spoke in favor of the invalids. But very soon, in this respect also, life demanded its own, and true to itself but merciless to its victims, it did not permit itself to be violated so that the crime of those who had demanded war would appear less grave because the consequences of the war were being glozed over in this fashion. And if even after the cult of the wounded ebbed, certain women in the early period of the war still continued to feel attracted to wounded men this was, to a large extent, due to a pathological condition. Sexual pathology has taught us that there is scarcely a single bodily deformity or abnormality which will definitely deprive its possessor of every possibility of woman's love, for disgusting as it may seem to the normal person, it is these very abnormalities which act as erotic attractions upon certain members of the opposite sex (varieties of fetishism and masochism). A short time ago the Berlin Institut fur Sexualförschung received a long communication from a man who lived in a rural German community, describing this kind of relationship between his own wife and a war cripple. The unhappy husband recognized and described very accurately the uncanny charm exercised by his rival upon his wife who had formerly been an exemplary partner. This case was typical of many others.
Let us now return to our original theme. We have already seen that injuries to the testicles and genitals resulted in the extinction of the sexual function, and insofar as they led to castration, resulted in all the sequelæ of eunuchism. But there was a whole series of other injuries which were also connected with grave disturbances of the sexual function. To this category of war injuries belonged all injuries to the head where the brain was affected, various contusions of the spinal marrow and similar wounds which resulted in a complete extinction of the sexual function.
Even without these injuries, many wounded men complained of disturbed sex function and there are statistics to bear out these complaints. Thus, Dr. F. Pick found among twenty-five officers and seventy-five soldiers who were in his service that ten of the former and seven of the latter complained of high grade disturbances of this sort. In more than half of these cases, libido, erection and ejaculation had completely disappeared and in the others, while the libido had not been extinguished, the erections were meager and unsatisfactory and the ejaculations completely absent. While in the majority of cases, sexual disturbances disappeared by the side of other symptoms of the disease, in the case of two convalescents ill from jaundice and arthritis, these erotic symptoms were regarded as the cause of their nervousness, and in one case led to ideas of inferiority and attempts at suicide. Pick saw the origin of this impotence primarily in the so-called "commotion neurosis" which induces changes in the lumbro-sacral marrow with consequent injury to the centrum genitospinale, and also in the enforced abstinence at the front. That the sexual hunger of the soldiers was in all respects calculated to produce these results, we have seen in our consideration of eroticism in the trenches.
In general, the purely psychic disturbances of the war could exercise a considerable influence not only on the intensity but also on the direction of the sexual impulse. This is a question concerning which there is a considerable difference of opinion. That perversions arose among soldiers, that there was a definite shunting of the erotic impulse to another direction, cannot be maintained in the strict sense of the terms. Wherever there were generated new sexual needs which tended in a direction different from the norm of sexual activity, we may see the coming to power of erotic notions which were present before, but which came to dominance only during the war, whereas previously they had been kept under strong control. We know that the soldier's manner of life, especially the atmosphere of the trenches, was all too prone to throw off inhibitions which had been accumulated in the course of human history and in the development of the individual. All this belongs to the phenomena which we shall consider in the chapter on Bestialization. Nothing is clearer than that, as a result of this process which was undergone by every soldier to a greater or less degree, unconscious motives of an animal-infantile-primitive sort were freed from their former subservience to the censorship of consciousness and civilization, and were given a tremendous opportunity for fulfillment.
Wulffen has brought to our attention the following case which illustrates the general set-up in cases of reversion. A certain officer who returned home from the war made the following strange request of his wife: That she put a dog's collar around his neck and then whip him with a dog-whip as he crawled around the room on all fours. It is obvious that this is a case of zoo-masochism, the roots of which extended into this man's past and all that the war did was to liberate the abnormal impulse from its inhibitions. It may be remarked in passing that Wulffen has also expressed an opinion shared by many others, that the impotence of many men who returned home on a furlough was attributable to unconscious homosexual components which had become strengthened on the battlefield and which now on their return home expressed themselves in an aversion to woman. This was certainly true of a number of such cases.
We wish to cite another case of "war perversion" which has been investigated by Dr. Magnus Hirschfeld. This case is especially interesting as an illustration of the aberration of infantilism which was especially favored by the whole environment of the war and came to expression in such phenomena as the aversion to work and dreaminess of many soldiers insofar as these conditions were expressions of the pathological state of infantilism. This case concerned a young officer who had been wounded in a bomb explosion. He had been left with a very active tic convulsif. The patient admitted that, long before this time, he had had numerous sexual compulsive notions but he had always been able to exorcise them. However, after his war experiences, he was completely dominated by these painful sexual imaginings which had a very strongly infantile character. The strongest erotic feelings were aroused in him when he saw little children, especially little boys, chastized and beaten on their bare posteriors and it gave him the greatest pleasure to imagine himself in the place of the punished child. He was also excited when he saw children attending to their natural needs but he could never become active with them; the very thought made him feel disgusted. At the sight of such spectacles he would feel sexual excitation and then when he got home he would recall the whole situation and satisfy himself. The patient, who was twenty-five years old, admitted that various childish phrases continually ran through his mind and that he preferred to wear boys' clothing.
In any consideration of the relation between war injuries and sexuality, we must not fail to make some reference to the various types of war neurosis. In these cases we are dealing with the psychological reactions of a fairly large number of soldiers to the experiences of war. That neuroses did not occur more frequently is really a token of the capacity for adaptation to be found in the kulturmensch an adaptation that would have been utterly impossible for the man of former times. Inasmuch as all forms of war neuroses were, without exception, accompanied by light disturbances of sexual life, we are obliged to consider this question more closely.
During the war, the question of war neuroses was discussed with a great deal of bitterness. Everybody knows the type of man afflicted with war-palsy or tremors induced by the war. Those living documents of the criminal insanity of war can still be found on the street corners, particularly of the Central European cities. Through the incessant trembling of their hands or their bodies, they hope to find in the pity of passersby a substitute for the gratitude their fatherland owes them but has never paid. They constitute the group of war neurotics. During the war, there were whole masses of them to be seen. The fully developed illness showed generalized tremors, inability to walk or stand, combined with very strong feelings of dread when movement was forcibly imposed upon them. Another group showed remarkable anomalies of posture, compulsive attitudes or various paralyses. The majority of these illnesses arose as a result of shock, especially in bomb shocks It appeared to some, as to the leading German neurologist, H. Oppenheim, that all these phenomena were to be regarded as organic disturbances. It was his opinion that these conditions were based on changes induced in the central nervous system by the shock which consisted in a loosening of the extraordinarily fine textures of the tissues and in the breaking up of the paths which the impulses of innervation had formerly traversed.
Contrasted with this, were many cases in which there were no organic changes, that the morbid condition had arisen in the absence of any injury and, finally, that the majority of cases could be helped by psychological influences like hypnosis or suggestion. Others sought to explain the cause of the morbid condition by a spiritual experience attributable to fright. As a matter of fact, it had very frequently been observed that at great natural catastrophes like earthquakes, or accidents like railway collisions, the people involved reacted with attitudes that are well known as biological fundamental types of conduct among the lower forms of life such as insects. These are elementary reactions like the "opossum reflex" in which the animal becomes immobile, or the "storm of movements" which is a tendency to flee from danger through incessant and apparently undirected motion. Before we consider the attempt which psychoanalysis has made to answer the question as to the origin of war neuroses and to bridge over the two theories.of shock and fear, we wish to say something concerning the classification of these diseases which we also owe to psycho analysis. According to this division, there are two types: conversion hysteria and fear neurosis.
In the work of Bartlett, entitled Psychology in the Soldier, we find a serviceable and popular description of the genesis of the first type, conversion hysteria, whose symptoms were the paralysis and compulsive postures already mentioned.
"The soldier became hysterical not because he got something queer into his head, but because in the totality of interests which normally constituted his personality, there was no place for war or, in general, anything which threatened to destroy the plan of his life. All through his life he had been accustomed to react, simply and immediately, to situations as they arose but now this was impossible for him. Were he now to react in accordance with his past custom, the first thing he would do would be to desert, but this would draw upon him serious punishment whereas if he remained in the army the chances were at least uncertain. Hence he continually lived in the situation which contained the strongest provocation to flight, but which, at the same time, offered him no simple method for realizing his desire. However, a day would come when suddenly, as the result of the explosion of a bomb or the violent death of a friend, or occasionally without any cause at all, he would sustain a wound which would solve his conflict. This was no physical injury. It did assume physical form but the body of this soldier was sufficiently healthy. Only he had become hysterical. We call this man a 'conversion hysteric' because he has converted the psychological inclination to flight into the physical symptom in which it comes to expression."
Another example of conversion hysteria is the case mentioned by Ferenczi of the soldier with chronic cramp of the left leg. This man had once been climbing down very cautiously from a steep mountain in Serbia and had just put his left foot forward to seek some support when suddenly there was a tremendous explosion which sent him rolling down the mountain. The symptom of the conversion hysteria is in this case, as in every other, a compulsive attitude which, so to speak, maintains the nerve impulse dominant at the moment of the shock or accident.
The second group of war neuroses, or fear hysteria, was characterized by generalized tremor and disturbances of walking. This tremor set in when the patient made his first attempts to walk after a long rest cure which was presumed to have cured him of the complete paralysis he had had before. In all these cases it was a question of an overwhelming experience, a so-called psychic trauma, against the repetition of which the patient unconsciously sought to shield himself by manifesting terrific anxiety each time there seemed to be any danger of a recurrence of that painful experience. The inability to stand and walk was a certain method of preventing such experiences from recurring inasmuch as it made impossible any sort of movement. This anxiety, which came to expression also in nightmares, had even earlier come to be regarded as a typical symptom of "anxiety neuroses" in which group we must classify the second type of war neuroses.
While an attempt was made to deduce both types of war neuroses, on the one hand from mechanical injury or shock, and on the other from the experience of terror, the psychoanalysts and many physicians who were not members of this school, such as Nonne, Liepmann and Schuster, maintained the psychogenetic standpoint, according to which it was the psychological working over of affective experiences which induced the mental illness. This conception was the only one that could answer the question why only some of the men who had all undergone the same experiences and the same terrors would show neurotic reactions. According to this theory, neither the physical nor the spiritual trauma was decisive but only the personal and individual reaction. The psychoanalytic school attempted, therefore, to answer the question as to what sort of reaction was necessary in order to produce the morbid mental condition. The war neuroses were designated as typically narcissistic experiences. That is, the assumption was made that in all the psychopaths under consideration there was some injury to the ego, some wounding of self-love (of narcissism). The natural consequence of this injury to the ego was the cessation of the ability to love anyone else than oneself, or, more technically, the diminution of the object-relationship of the libido. These students could point to cases in which the narcissistic retrogression had gone so far that patients behaved like little children; they prattled, desired to be caressed, etc. K. Abraham had a case where the patient behaved like a two-year-old child and con tinually muttered, "Mine, bums." This is obviously a reversion to infantilism, which, in the language of psychoanalysis, was termed "regression."
These preliminary remarks were necessary in order to understand what follows concerning the relation between war neuroses and sexuality. Even though the narcissistic origin of war neuroses was not doubted by any of the psychoanalysts, they, neverthe less, emphasized the strong participation of the sexual factor. Ferenczi has called our attention to the fact that many a shock, which in itself had nothing to do with the realm of the sexual, resulted in diminished sexual libido and even in impotence. It was not at all impossible that normal shocks should lead to neuroses by the way of sexual disturbances. Impotence, which seemed a trivial symptom of traumatic neuroses, not infrequently turned out to be important when a fuller explanation of the patho-genesis of the malady had been revealed.
Abraham has emphasized the fact that war neuroses generally overtook men who in peace times were labile and uncertain in their sexual relationships with women, that is, men with diminished libido and potency. Among such men, who from youth have strong narcissistic components and libido fixation, (that is they love themselves so much that it is impossible for them to achieve other than temporary relations with the opposite sex) traumatic— in the psychoanalytic jargon, narcissistic—neuroses occur quite easily.
The unconscious psychological process, which was reflected in the rise of neurotic disturbances duling the war, leads us to the problem of stimulation. No matter how little doubt there was about the unconscious character of these processes, there were, nevertheless, physicians in every land who held that the patient, especially the neurotic ones, were personally responsible for their diseases. There was a shocking underestimation of the devastating psychological effects of the war. The attitude of many patriotic physicians to the hospital inmates and, especially to the unfortunates afflicted with tremors, forms another dark chapter in the history of the World War. The adage that "only a good man can be a good physician" was not always applicable during the war, for, very frequently, both at the conscription of the soldier and at his discharge from the hospital, the physician was frequently tied hand and foot by rules based entirely on military necessity. So in recruiting men for the army, the physician was required to declare a definite percentage of the applicants fit for war service; and similarly he was required to send back to the battlefield a certain definite proportion of patients under his care in the hospital. These abuses became chronic in the last years of the war because of the great dearth of soldiers among the Central powers. These conditions became so bad that German statistics for 1915 showed the following figures: Of all the soldiers treated in the hospital of the German home territories, 90.2 per cent were declared fit for continued service, 1.4 per cent died and 8.4 per cent remained unfit for service or were furloughed. Now it would be a very happy sign of the progress of medicine in Germany were these figures true, but, alas, the situation was quite otherwise.
These abuses, inhumanly dictated by the necessities of warfare, were fulfilled by the physicians assigned to the performance of these duties by the military authorities, and in many cases the brutality of the medical men exceeded that of the military leaders. We might mention, as an example of this, the famous Kaufmann method, a sad remembrance of those dismal times, a consideration of which will round out our account of war neuroses. Since the ultimate ground for war neuroses is, as we have seen, to be sought in the individual psychological working over of experiences, it seemed natural to assume that these maladies could be dealt with by psychical methods of therapy. Thus Simmel solved the question of treatment in these cases by the use of psycho-catharsis or hypnosis, through which the patient was made aware of the circumstances which had caused his difficulties. As opposed to this, the Kaufmann method was, as its inventor himself designated it, a "surprise method" and proceeded in the following manner: Starting from the experience that very frequently innervations which had been torn from their proper paths by fright were frequently restored by renewed psychic fright, Kaufmann sug gested the following elements of treatment: 1. suggestive preparations—emphasis of the fact that the treatment would be painful but that a complete cure would ensue as a result of the one sitting, and would remain permanent; 2. the use of strong alternating current accompanied by verbal suggestion; 3. strict maintenance of the military form, the use of the relation of subordination, and the issuing of suggestions in the form of commands as sharp and crisp as though they were being called out in a military camp; 4. the consequent forcing of the cure in one sitting.
It is well known how faithfully these rules were obeyed. Characteristic of the whole procedure is a case studied by Dr. Hirschfeld in which a soldier with a strong sadistic inclination greedily seized every opportunity to be present at such a seance. Although, in general, the relations between physician and patient were the same in all armies, Kaufmann's suggestions somehow found a greater number of admirers in the Austrian army than elsewhere. The psychoanalytic writer, Fritz Wittels, has given us a very clear picture of the brutality of these Austrian medicos who were adidicted to the "Kaufmann technique," in his humorous war novel, Zacharias Pamperl:
"These gentry of the Vienna military hospitals used electrical machines of the sort that are used in America for murderers, and they tickled the defenders of the fatherland so long and so violently until they had no choice other than suicide or return to the battlefield. In addition, they injected emetics into these patients so that these poor creatures spewed their very souls out of their body and preferred rather to die for their fatherland than live that nauseated torturous existence. Maria Theresa abolished tortures, but the nerve doctors reintroduced them during the World War." In the Austrian army, military and medical authorities were especially prone to see in every psychopath, especially such as had gotten into the hospitals, malingerers. In his great drama of the war, Karl Krauss has depicted a scene in the hospital which may seem exaggerated to us today but was certainly the brutal truth at that time. A group of men, including wounded and dying together with a military physician, are gathered in one of the hospital wards. One of the chief physicians of the general staff suddenly enters and, with the utmost brusqueness and bluster, shouts out that now that all the malingerers are together he will be able to give them a piece of his mind. At these words a number of the patients manifest grave nervous symptoms. After bidding them remain quiet and make no demonstrations, he orders the younger physician to bring out the electrical apparatus, the better to detect the simulators. As the physician approaches some of the beds with the apparatus, a number of the patients get convulsions. The brutal physician-in chief turns to one corner of the room and gives expression to the feeling that a particularly miserable patient Iying there is guilty of lack of patriotism. This poor man, terrified out of his wits, there upon begins to shriek. At this the chief inquisitor remarks that for creatures of this sort, there is only one cure, to put them all into a caisson and expose them to an unceasing rain of the enemy's fire. That, he opines, would put an end to their tremors, and with that he stalks out of the room, banging the door after him At this last report one patient dies.
In view of these practices, it is not difficult to understand the horror with which the public reacted to the reports of the torture chambers of the psychiatric wards of the Viennese hospitals, which came to public expression in Vienna despite the vigilance of the military authorities. In a lecture on the subject of war neuroses to the public, Professor Schuller expressed the opinion that whenever a physician used active methods and exercised pressure upon a patient to elicit from him a statement relative to his readiness to return to the front, such action proceeded from the mistaken view that the goal of treatment was in every case the restoration of fitness for military service. The primary duty of physicians, Pro fessor Schuller reminded his audience, was the restoration to the neurotic of such a degree of health as would enable him to make his way about in the world and also to return to military service Schuller denied, however, that there was any truth in the accusation that neurologists were always seeing illustrations of soldiering and asserted that the best proof of the innocence of the physicians in these matters was the small number of court cases for malingering; moreover, he insisted that if neurologists were so bent on finding malingerers everywhere they wouldn't have had to resort to the use of the Kaufmann method. At the same time he strongly condemned the Kaufmann method as a fake device which did not cure but rather substituted one disease for another. Dr. Kurt Mendel was much more courageous and wrote that sick soldiers were not to be treated like uncouth children, since physicians were not officers and hospitals not garrisons. It is interesting to relate that the worthy psychiatrist later regretted his very righteous indignation on this matter and stated literally Pater, peccavi.
There were two other treatments available for war neuroses The first, introduced by O. Muck, was scarcely more gentle than that of Kaufmann. Those patients who had fallen a prey to ophonia, that is, who had lost their voices as a result of a nervous disturbance, had inserted into their larynx a metal ball about one centimeter in diameter. This had the effect of bringing out the patient's cry of terror before it was smothered within him. The second method employed the device of making the patient think he was going to be operated on and actually administering an anasthetic to him, but, of course, no operation was performed. It appeared that this last method, which was comparatively humane, did achieve a considerable measure of success with its suggestive methods. But the most radical cure for these victims of the war was brought by peace. In an essay concerning the ending of the war and the general question of neuroses, K. Singer remarked that as soon as peace came, the tremendous tension of these patients was ended. The reaction was a violent one and had the effect of an emotional shock. Peace became the best Kaufmannizing of the soul without any electricity, and was the most brilliant solution by a quasi-suggestive method without any real suggestion. It seems unbelievable that voices were raised against the giving to neurotics of certificates indicating that they had been wounded; and B. C. Loewy even stated that such a procedure would not be justified morally.
To conclude this whole question of malingering, let us state that the search for shirkers was not altogether unjustified, despite the fact that there seemed to be few cases of actual simulation during the war. Only rarely did the soldier rely upon his own ability to simulate. Much more frequently, however, he took definite steps to acquire a disease or to injure himself in one way or another. More often than was known, suicide made its appearance as a welcome salvation from a hero's death, and it appears to have been particularly widespread in the English army. Yet cases of this sort were not unknown in the Austrian army. One, reported in a Vienna medical weekly, told of a twenty-seven-year-old soldier who had swallowed a key and a spoon with suicidal intent. To this group also belonged those men who refused to be operated upon, individuals who, as Finsterer demonstrated, achieved the same results by their inactivity as those who inflicted injuries upon themselves—the possibility of escaping service at the front. It is noteworthy, however, that while those who inflicted actual injuries on themselves were punishable, sometimes by death, a man's refusal to give his permission for an operation that was necessary was not punishable, and was even justified by the law. But, as a matter of fact, this rule stating that a man could be operated on only after he had given his consent, (such consent was also necessary for the amputation of a limb) was sometimes violated, especially in the case of common soldiers.
The practice of inflicting injuries upon oneself was common in every army. Egon Erwin Kisch has preserved for us one such incident where three men who had injured themselves were led into a division court trembling with cold and pain. One of them had shattered his left wrist, a second had shot off two fingers, and the third had shot his left shoulder. All three were bleeding profusely through the crude bandages which they had applied themselves. There was no defense that these men could make before the court inasmuch as the shots were all on the left side of the body and hence accessible to their own firearms; furthermore, the wounds showed powder-burns, typical in cases where the shot has been fired at close range. In Serbia it was much easier, for there one had only to lift a hand out of the trench for when one sustained an injury to the fingers, it was considered an honorable wound. When these people wished to inflict gun wounds upon themselves, they carefully placed a handkerchief dipped in wine over the area they were going to shoot. This precaution conceals all powder-burns.
Often these self- injuries consisted in willingly exposing oneself to a contagious disease. Even English girls who had been driven across the channel by the patriotism of their parents and had discovered, when they arrived at the front and begun to serve as nurses and chauffeurs and auxiliaries, that war was not the delightful game it had been cracked up to be, resorted to such practices. Thus Helen Zenna Smith informed us that one of the girl drivers of her company was suddenly stricken with a dangerous form of measles. She had acquired this disease in some mysterious way. Four of her comrades, who knew very well what was the trouble with their friend, crept into her flea sack before it had been disinfected, in the hope of getting the infection which would mean hospitalization and a chance to sleep and rest for a few weeks
To the thoroughness of Professor Exner's investigation we owe a detailed list of the forms of self-injury common in the Austrian army, a list which is a tragic reflection on the inhumanity of war. The following are some of the injuries inflicted by the soldiers upon themselves to escape military service: artificially produced hernia, irritations and inflammations of the skin, scalding, with resulting inflammation, artificially produced eczema, jaundice (through picric acid), inflammation of the eyes, inflammation and infection of the external ear and of the urethra (through foreign bodies), naive simulation of gonorrhea through soapsuds, purposeful transfer to oneself of trachoma and gonorrhea, inflammations of the kidney and bladder, frostbites and freezing, swelling of limbs (through tight lacing or ligation) insertion of needles into limbs, hemorrhoids (through drastic purgatives and local irritants), and by preventing the healing process through irritation of the sick area.
In these tables of Dr. Exner, concerning the self-infliction of wounds or diseases, an inordinately large part is played by venereal diseases. In view of the relations which existed everywhere behind the front and at.the halting-stations, it was comparatively easy to obtain an infection of this sort and very frequent use was made of this opportunity. It need not be emphasized that this type of self injury was dangerous, as has been shown in the chapter on venereal diseases, Among every army, but particularly among the Austrians, this conduct was punished whenever it was discovered and, from the point of view of the military authorities, not unjustifiably However, these penalties did not accomplish their purpose and as the war was prolonged the number of cases of self-inflicted venereal diseases increased rather than diminished. It was a matter of indifference in these cases whether the infection had been derived from a woman or from a comrade. In Koppen's Army Report we find a very amusing description of the trial of a soldier who had sinned in this regard. Major Klemper was chairman of the court and the accused was Rodnick, a cannoneer. The follow ing conversation ensued: Major K.: "Tell us just what happened." The accused remained silent.
Major K.: "Well, then are we to assume that you cohabited with this woman in spite of the fact that you knew she was venereally diseased."
Rod.: "If you please, Herr Major, no."
Major K.: "What do you mean, no, you didnt do it or you didn't know? "
Rod.: "I wasn't acquainted with the girl."
Gen. S.: "Rodnick, if you are going to lie I'm going to incarcerate you at once. Here, Major, is a report from the division physician certifying that this man has a severe gonorrhea."
Major K.: "Do you want me to believe, you rascal, that you got all this from playing with that girl? If you don't tell me the truth you're going to prison at once. Now where did you get that gonorrhea? "
Rod.: "In a hospital."
Gen. S.: "That's a lie! You were never there."
Rod.: "No, general—but here—from that place."
Gen. S.: "Now, Rodnick, don't talk nonsense. You know me well enough to talk to me. I will not be deceived, so, in your own interest, tell me the story."
Rod.: "I bought it...."
Major K.: "Bought what? The girl?"
Rod.: "No, Herr Major, gonorrhea. From an infantryman. But others did it, too. This fellow was sick with gonorrhea—and if you gave him a mark he would sell you a little bit—a little bit of pus. And if you smeared this on at once . . ."
Gen. S.: "You say others did this, too? How many more in your battery? "
Rod.: "When I was there, there were five more."
In conclusion we quote a small selection from one of the best German war books, Frey's Plasterboxes:
"That fellow Kobisch had a perfect case of gonorrhea and had to go to the hospital. Where had he got it? It was necessary to know this in order to stamp out the infection. Kobisch had too little imagination to invent a momentary embrace in some hidden corner. What is more, such a yarn would have been impossible for the regiment had not been anywhere near women for a long time. Hence, driven into a tight place, the poor fellow had to admit that he had gotten it from another chap who had returned from a furlough the previous week. Before this furloughed soldier, laden with all the toxins of the big city, had been assigned to a hospital, he had given Kobisch, in return for two marks, a bit of his gonorrheal flux wherewith the latter had anointed his organ.... A very popular procedure was the production of a physical condition which would cause the physician to suspect the existence of a fresh lues. In some way this information had leaked out to the troops from a hospital and many men knew how to induce the irritation that looked like a fresh lues. A pastille of corrosive sublimate was placed under the prepuce. This caused terrific pain and in a very short time a strong inflammation appeared which caused the physician to send back to the hinterland these men whose genitals appeared syphilitic. The terrific pains were worth it, because as a result, one was able to have a few weeks of rest and leisure and to escape the dangers of war. There was a very lively traffic carried on with these pills and men tried to obtain them in any way possible—by stealing, buying or having them sent from home.
In this connection something should be said concerning life in the hospital. We have already considered this question, insofar as it is related to the history of morals, in the chapter on nurses. Certainly the inmates of the hospitals, even in those cases where they achieved some measure of healing, were not the most enviable of the creatures who stood behind the battle lines. Behind the romanticism of hospital loves and marriages with nurses (which were frequently due to a far from romantic cause, inasmuch as unmarried patients were much more likely to be sent back to the battlefield than married ones), behind this whole deceptive facade there were concealed the most terrible pains which human beings had inflicted upon each other. Added to that, there was the special martyrdom of the military haspital where the inmate, despite the fact that he was sick or wounded, did not cease to be a soldier. The military division of rank was maintained in the hospital ward and even came to expression in the matter of treatment. The common soldier was, in this regard also, merely one of the mass whose treatment was just as unvarying as the uniform that he wore. So, for example, among the Americans, morphine was given to soldiers who complained of pains and after the patient had gotten his injection there was painted upon his forehead "M" (morphine) to insure that he would not receive more than the dose assigned for the common soldier. In the Austrian hospitals, only the officers were entitled to have their pains eased by the application of morphine. There was also the uniform use of the cheap surgical panacea, iodine.
The whole hospital, with all the romanticism that has been conjured up about it and the real misery contained within, was continually shadowed by death. From it a way generally led directly, or indirectly through the return to the battlefield, to the cemetery. The hospital returned to life only such people who had left their limbs or their health behind its walls.
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BerichtGeplaatst: 19 Nov 2006 12:06    Onderwerp: Reageer met quote

Cool very interesting stuff indeed! maar moeilijk leesbaar zo van je scherm... om e.e.a telkens te printen vind ik ook niks, het zou al veel schelen indien de teksten niet zo breed waren en eventueel een corpsje groter! Cool

greetz ferd. Wink
make love not war
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BerichtGeplaatst: 19 Nov 2006 12:18    Onderwerp: Reageer met quote

Ik zie nu pas wat een lap tekst het geworden is, volgende keer verdeel ik het weer over meerdere pagina's Smile
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BerichtGeplaatst: 17 Apr 2010 22:36    Onderwerp: Reageer met quote

Het opgefriste artikel:
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