Hysterical men: War, neurosis and German mental medicine, 1914-1921.

摘要

This dissertation investigates the response of German psychiatrists and neurologists to the epidemic of male hysteria during and after the First World War. Based on clinical records, military, university and state archives and a survey of the contemporary medical literature, it tells the story of the hysteria diagnosis, the doctors who diagnosed it and the soldier-patients whom they examined and treated.;German psychiatrists celebrated war as a healthful antidote to the perceived crises of Wilhelmine society (chapter 1). Among these crises, alleged outbreaks of "pension hysteria" surrounding railroad and factory accidents brought the idea of male hysteria into German mental medicine. The context of rapid industrialization, accident insurance legislation and medical critiques of social welfare (chapter 2) forged an environment that made hysteria an acceptable--indeed the preferred--diagnosis for male sufferers of work-place and war-time trauma.;Just as the pathologies of industrialization shaped doctors' diagnostic approach to war neurotics, treatment and administration were in turn influenced by techniques of industrial management. The concerns of speed and efficiency (chapter 3) dominated discussions of war-time therapy, as new "miracle cures", capable of removing long-standing symptoms in minutes, were celebrated and promoted.;Efforts to reorganize neuropsychiatric services, I argue (chapter 4), mirrored the concurrent centralization and standardization of German industry. Indeed, doctors aimed to channel neurotics through a "rationalized" system that stretched from the battlefield through the specialized clinic and into the labor force. Resorting the ability to work, i.e. to serve in the production of war materials, became, as the war progressed, the primary goal of neuropsychiatric care. For doctors, reestablishing hysterics' control over their own bodies meant increasing medical control over hysterical patients.;Medical opposition to rationalized care was limited (chapter 5), but patient resistance grew steadily (chapter 6), culminating in the hospital mutinies of November 1918. After the war, psychiatric power was reestablished and contested with the reemergence of hysteria during the inflationary crisis (chapter 7).;The male hysteria diagnosis, I conclude, furthered neuropsychiatry's professional claims, simultaneously subordinating patients to the logic of industrial rationalization, and freeing them from the dangers of combat and the threat of military punishment.