University of Virginia Library

DES TROUBLES PSYCHIQUES ET NEVROSIQUES POST-TRAUMATIQUES, Par R. Benon. Ancien interne de la Clinique des Maladies Mentales et de l'Encephale à la Faculté de Paris, Médecin de l'Hospice Général de Nantes (Quartiers d'Hospice). G. Steinheil, éditeur, Paris, 1913; pp. x-449.

The author in this volume has written a clinical and medico-legal treatise on traumatic nervous affections from a broad and philosophical standpoint. The subject is treated under the following headings: "Generalities," in which is discussed the historical development of our knowledge of the effects of traumatism, the etiology, the evolution of the various disturbances, and the legal side of the questions at issue.

Following this introduction, under Chapter I, the general

topic of what the writer terms the traumatic dysthenias or the traumatic sthenopathies is discussed under the following subheadings: (a) Simple post-traumatic asthenia; (b) Post-traumatic astheno-mania; (c) Prolonged asthenia and chronic traumatic asthenia, under which he includes traumatic neurasthenia, traumatic hystero-neurasthenia, traumatic neurosis, and traumatic psychoneurosis; (d) Chronic post-traumatic mania; (e) Periodic post-traumatic dysthenias; (f) Asthenic mania and pathological anatomy. Chapter II, under the general heading, "Traumatic Dysthymias: (a) Anxiety post-traumatic hyperthymia; (b) Traumatic hypochondriasis and traumatic hysteria; (c) Special hyperthymia of accidents; (d) Hysterical and traumatic crises; (e) Prolonged or permanent post-traumatic disturbances of character in children and adults. Chapter III, under the general heading, "Traumatic Dysthymias": (a) Traumatic amnesia; (b) Post-traumatic Korsakoff syndrome; (c) Traumatic mental confusion; (d) Post-traumatic agnosia; (e) Post-traumatic dementias; (f) Systematized chronic post-traumatic deliriums. Chapter IV, under the general heading, "Psychic states and Diverse Post-Traumatic Neuroses": (a) Post-traumatic epilepsy; (b) Traumatic aphasia; (c) Alcoholism, traumatism and hallucinatory conditions; (d) Post-traumatic sensual perversions; (e) Pains, vertigos, deafness, etc., following trauma; (f) Distant post-traumatic psychic disorders with cerebral lesions; (g) Unclassifiable observations. To this comprehensive material is added an appendix on the topic of psychic and neurotic disturbances as indications for trephining.

This outline of the contents of the book, which contains in addition many subheadings, gives a sufficiently clear idea of its scope and of the pains which the author has taken to subdivide his subject matter to the last possible degree. Whether such a detailed classification has merit sufficient to justify its complexity must be left to the individual reader to determine. It may, however, with justice be said that the author has spared no pains to illustrate by case reports the various phases of traumatic disorder which he enumerates. He has a keen sense of the significance of psychiatric knowledge in a proper understanding of the various results of trauma, and lays special stress upon the breadth of the psychiatric field, under which he properly enough includes the various so-called psychoneuroses as well as epilepsy, tics and aphasia. He believes that one may only arrive at a diagnostic criterion of such affections through the sensations and emotions expressed by the patients. The somatic phenomena he regards as always subordinate and accessory. Under this point of view,

he attacks his problem, and with considerable success An admirable brief historical review of traumatism in relation to the nervous system constitutes a valuable section of the book, in which he brings out the conflicting views which have prevailed since the earlier work of Erichsen down through the fundamental investigations of Westphal, Charcot, Knapp, Oppenheim and others.

The author finds fault with the common use of the word traumatism in the sense of trauma, and correctly draws attention to the fact that traumatism should express a general condition, whereas, trauma should be used as indicative of a local lesion. This distinction has been too often overlooked, with resulting confusion.

In general, the book represents a vast amount of painstaking thought and an earnest but somewhat confusing attempt to bring light into the somewhat dark places of a much-discussed subject, which has frequently been the source of more or less acrimonious discussion. Not the least significant part of the volume is the constant reference to the legal implications of the traumatic affections. It should therefore be useful, not only to the physician, but also to the legal profession. It will doubtless be used rather as a book of reference than as a readable treatise.

E. W. TAYLOR.