Neuropsychiatric Disturbances, Self-Mutilation and Malingering in the French Armies during World War I: War Strain or Cowardice?

Between 1914 and 1918, war strain appeared under a number of guises and affected, to varying extents, the majority of French soldiers. The most frequent form of war strain was war psychoneurosis, but war strain also induced more paroxystic disorders, such as acute episodes of terror, self-mutilation, induced illnesses and even suicide. Fear was the constant companion of soldiers of the Great War: soldiers were either able to tame it or overwhelmed by an uncontrollable fear. Nonetheless, over the course of the war, some aspects of fear were recognised as syndromes. The French health service poorly anticipated the major consequences of war strain, as with many other types of injuries. After the establishment of wartime neuropsychiatric centres, two main medical stances emerged: listening to soldiers empathetically on the one hand and applying more repressive management on the other. For many physicians, the psychological consequences of this first modern war were synonymous with malingering or cowardice in the face of duty. The stance of French military physicians in relation to their command was not unequivocal and remained ambivalent, swaying between medico-military collusion and empathy towards soldiers experiencing psychological distress. The ubiquity of suspected malingering modified the already porous borders between neuropsychiatric disorders and disobedience. Several war psychoneurotic soldiers were sentenced by councils of war for deserting their posts in the face of the enemy and were shot. Many soldiers suspected of self-mutilation or suffering from induced illnesses were also sentenced and executed without an expert assessment of their wound or their psychological state.

How new is self-harm?

"Self-harm" is now proposed as a full-fledged diagnostic category for DSM-5. The existing literature of the topic posits that it is a transhistorical psychiatric category and that examples of self-harm can be found from the earliest written records, which is part of the underlying argument for its inclusion in DSM-5. However, how old is self-harm and, indeed, what defines self-harm historically and culturally?

Craniometric measurements of artificial cranial deformations in Eastern European skulls.

Standardized lateral cephalograms of eleven skulls with artificial cranial deformations from Eastern Europe and twenty normal skulls from the same population were made, digitized and imported into the AutoCAD 2005 computer program. The x- and y-coordinates of defined measuring points were determined and angle measurements were made. The form difference of the skulls was tested with the Euclidean Distance Matrix Analysis (EDMA) and the difference of the angle measurements were compared statistically using the non-parametric Mann-Whitney test. All deformed skulls belonged to the tabular fronto-occipital type of deformation. The results of the EDMA and the angle measurements indicated significant differences for the neurocranium and the facial cranium in height between the normal and the deformed skulls, but not in the cranial length. It can be concluded that in Eastern Europe one method of cranial molding was used. The deformation of the neurocranium also affected the development of the facial cranium regarding facial height. This may indicate a dependency of the developmental fields of the neurocranium and facial cranium.

Psychocutaneous syndromes: a call for revised nomenclature.

We propose abandoning three outdated, pejorative diagnostic terms: 'trichotillomania', 'delusions of parasitosis', and 'neurotic excoriation'. These insensitive terms are offensive to patients and become a barrier to treatment. We suggest the following alternative patient-centred nomenclature: 'neuromechanical alopecia', 'pseudoparasitic dysaesthesia', and (simply) 'excoriation'. We briefly review clinical and historical aspects of these disorders.

The Amazons and an analysis of breast mutilation from a plastic surgeon's perspective.

BACKGROUND: The Amazon philosophy has been increasing in popularity because of the evolving status of women in society. Many references point to Themiscrya on the southern coast of the Black Sea in Anatolia as the Amazon homeland. The primary objective of this article is to discuss the different femininity of the Amazons and their breast mutilation from the perspective of a plastic surgeon who has been living in this region that the Amazons inhabited. METHODS: Findings from archaeology, linguistics, anthropology, medicine, history, psychology, and the fine arts were integrated. RESULTS: The hypotheses that have been proposed to explain the method of breast mutilation include amputation, cauterization, breast searing, and breast pinching. It is generally believed that the primary purpose was to facilitate the efficient use of a bow. Another explanation would be that breast mutilation was performed for medical reasons, including the prevention of breast pain, the development of a tender lump, or cancer. There is another school of thought on this involving religious and sociological reasons that breast mutilation was a badge of honor for warrior women and a sign that a woman had become a real warrior and a sacrifice to Artemis as a sign of service. CONCLUSIONS: Much indirect proof and archaeological evidence point to their historical existence. The Amazons, who lived in an autonomous and original social model, changed their image and function to suit the needs of the society and the times.

Artificial deformation of the human skull: a review.

Early examples of intentional human cranial deformation predate written history. Intentional cranial deformation as an extreme has seemingly not persisted into this century. However, mild forms of this manipulation are still practiced by various groups worldwide. Accidental cranial deformation or mild forms of intentional cranial deformation may be encountered by the clinician or anatomist. We review the literature regarding intentional manipulation of the human cranium.

[The male genital in legal medicine]. / Das männliche Genitale in der gerichtlichen Medizin.

Pathomorphological findings for the male genital are an exception among forensic cases. In earlier publications they were usually published as individual cases. A significant percentage are the so-called fertility- and potency medical certificates, which are usually commissioned for doubtful paternity cases. Old forensic writings about genital injuries distinguish--apart from the necessity of a complete dissection--between "deadly as such" and "accidentally deadly" injuries. Another group consists of reports about self-inflicted genital mutilation, e.g. among prison inmates or soldiers of the last world wars to become an invalid. When it was necessary to identify a corpse, e.g. in cases of progressive decomposition, Merkel recommended in 1945 the representation of the so-called "Schnepfenkopf" (snipe head; colliculus seminalis) in the lesser pelvis. In this article a medical and forensic review of forensically relevant findings of the male genital is presented and illustrated with historical cases.

["Oto" -- the episode in the strange world of Vincent van Gogh]. / "Oto"--epizod w dziwnym swiecie Vincenta van Gogha.

The author described briefly life of Vincent van Gogh, particularly performed episode of ear's cutting.

Dental mutilation in southern African history and prehistory with special reference to the "Cape Flats Smile".

Southern Africa has a long history of dental mutilation in the form of dental chipping and of intentional removal of anterior teeth. The first evidence is found in the skeletons of Early Iron Age populations (ca. 1500 years before present), but the incidence decreases in archaeological sites of more recent origin. In modern times, dental mutilation appears to have been limited to the people of the countries further north in Africa, but the one exception is the presence of deliberate incisor removal amongst the communities of the Western Cape. It is hypothesised in this paper that the modern practice in the Cape is associated with youthful gangs in the poorer communities, and acts as part of a rite of passage into adulthood. The "socio-sexual" theory, as reflected in such names as the "passion gap", is shown to be both wrong and insulting. The name "Cape Flats Smile" is recommended as a more appropriate and respectful term for the phenomenon.