ture. This is the type of psychiatric, often psychotic, reaction to poisoning
or infectious disease. It is called exogenic symptomatic psychosis and, in
the Soviet view, is clearly based in the disrupted physiology of the patient.
Soviet military psychiatrists identify five basic types of symptomatic psy-
chosis: delirium, epileptic excitation, twilight states, confusion, and hallu-
cinations. Given that armies throughout history have almost always suf-
fered more casualties from disease than from enemy fire, the focus on mental
aberrations caused by disease processes probably has a long history in So-
viet military medicine. Moreover, it is the kind of problem that would find
a ready audience within Soviet psychiatry given its biological assumptions
about human behavior. Since organic patterns may be disrupted not only
by battle shock but by disease, fever, and viruses, the Soviet military psy-
chiatrist is comfortable in dealing with the psychiatric effects of infectious
diseases.

One is struck in reading Soviet military medical literature by the empha-
sis it places upon the treatment of mental disruptions caused by the exter-
nal environment. The impact of such hostile climates of extreme heat and
cold on the ability of the soldier to maintain the mental strength to con-
tinue the battle have been closely studied. This is a direction of study that
is only moderately evident in American military psychiatry and, where it
appears, is not reflected in the research of psychiatrists as much as in the
work of battle surgeons. In the Soviet case, one again encounters the ten-
dency to join the medical doctor and the psychiatrist at the point of com-
mon origin, where the physiological disruption of the brain produces be-
havioral aberrations.

Although it is clear that the Soviet theory and practice of battlefield
psychiatry is strongly rooted in both Marxist dogma regarding the mate-
rialist neurophysiology of man and Soviet combat experience in World
War II, the fact is that Soviet practice in military psychiatry remains far
more a prisoner of dogma than a practical art based in experience. The
result is that when compared to the armies of the West, particularly the
American and Israeli armies, Soviet battlefield psychiatry is neither well
articulated in its casualty servicing structure or willing to face the practical
realities that a future conventional war will present. The conclusion seems
warranted that when compared to the state of affairs in the U.S. Army,
the Soviets are not nearly as well prepared to deal with the levels of psy-
chiatric casualties projected for a future war as they could be if only they
could free themselves from the self-imposed imprisonment of Marxist-Len-
inist dogma.

-114-