PSYCHIATRY AND WAR. In harmony with the general fact that it is man's mind that receives last consideration in questions of health it has taken until the present war for any real appreciation of the incidence of mental disease in the military forces to get recogni tion. The Russians in the Russo-Japanese War had a regular organized service for caring for the mentally ill, removing them from the front and taking them back to the hospitals at Mos cow and Saint Petersburg, but it has remained for the present war to develop a real compre hensive appreciation of the nature of the prob lems involved. The first of these problems, namely the examination of recruits for the pur pose of eliminating the mentally defective or otherwise affected individuals who would prob ably not be able to stand the stresses of actual conflict, has been developed more elaborately in this country than in the European countries, probably for the obvious reason in America the man power has not been so severely taxed, for when it is experience teaches that all methods of examination which result in the elimination of recruits are looked upon with progressingly less favor.
The general plan in dealing with mental ill ness in the American army is broadly as fol lows: first, a weeding out of defective and otherwise mentally abnormal individuals in the various camps, the establishment in connection with the various hospitals, particularly the large base hospitals, of psychiatric wards in charge of a competent psychiatrist and assistants, with a detail of nurses who have had experience in institutions for the care of the mentally ill. The mental cases thus in the large base hospitals receive their proper classification and therefore treatment as do other varieties of illnesses and injuries. Coupled with this fundamental or ganization there is an effort to segregate the mental case as soon as possible back of the fir ing line and to place him under treatment at the earliest possible moment. Psychiatric de partments therefore naturally took their place alongside of other departments in the great hospitals for the American troops on the other side. In these divisions of the hospital the men tally ill received prompt treatment, the object being to deal with minor mental ailments promptly before they have become aggravated or chronic with the immediate object of getting the soldier back into service and avoiding the necessity of invaliding him home.
The present war has developed no new forms of mental disease. The particular delusions or hallucinatory experiences of the mentally ill naturally vary and take their material from the immediate surroundings. Aside from this the pictures of mental illness are the same as we are accustomed to see in civil life. The one overwhelming feature, however, which distin guishes the mental cases in this war is the prev alence of the neuroses, grouped together un der the somewhat misleading and general term '
The United States government will normally he responsible for these soldiers whole mental illness is directly traceable to the performance of their duties as soldiers. Naturally there will he a number of cases whose mental illness will he traceable to conditions which arose before they went into the service and were only dis covered by the army. For these the United States will not be responsible. For the others, however, they will be, and the treatment of their mental condition will be a part of the large problem of the rehabilitation of the sol dier when he returns shattered in mind and body from the war.