An Iron Cross winner had a hysterical-looking attack (reminiscence of a bayoneted Gurkha). Later he begins to talk of “this damned war that is so vulgar” and of “atrocities, concrete and abstract”: Shortly the diagnosis, hebephrenia, had to be made.
Case 158. (Bonhoeffer, 1915.)
An Iron Cross winner, 21, in the field from August, 1914, to the middle of March, 1915, at first in France, later in Russia, finally went to hospital for rheumatism and sciatica. Three months later he had to be transferred to the Charité in a state of delirious excitement.
The attack began suddenly. He thought he was in the field telephoning with his captain, trembled, threatened to injure people about him, said he could not hold the position with the few men he had, and the like. Next day he quieted down and became oriented for time and place. He explained that he had seen a Gurkha coming upon him with a mallet, by way of revenge upon him because he had stuck his bayonet in the Gurkha’s breast. Behind a little hill he had seen Frenchmen and Englishmen, from which he drew the conclusion there was going to be an attack that night. A little cloud of dust he thought was enemy cavalry. In point of fact, he said he had once on patrol stuck a Gurkha through and the Gurkha’s eyes had since followed him in his mind. He had seen him crawling along the ground one evening and heard his step. The patient had imperfect insight into these hallucinations when questioned about them during the daytime, and still talked somewhat as if the experience was a real one.
At first the situation seemed probably one of hysterical delusion, for which the Gurkha experience served as material. In point of fact, further observation in the clinic showed that the diagnosis of hysteria was wrong. He was induced to write out his experience in a style quite like his conversation; and there was a queer tendency in his writing to the use of foreign words, somewhat improperly used. After a time he began to sit about dully and at times to run about and throw himself into and out of bed, or strike rhythmically with his shoes on the floor, or draw his shoulders together, making grimaces, rolling his eyes and breathing deeply. He said he had to make these movements involuntarily if he were in some way excited. But the peculiar conduct also often occurred without any emotional prod. His emotions were variable, but on the whole indifferent and not always quite suitable.
He frequently said he wanted to get into the field again, giving vent to superficial phrases, such as “atrocities, concrete and abstract,” and “this damned war that is so vulgar.” Yet a few minutes later he would say he wanted to go to war at Amsterdam as Amsterdam had pleased him very much. He said he now had a good many thoughts and ideas which formerly he had not had. He had not been promoted, he said, because he had once angered an officer in another company.
His field hospital history told of certain oddities, such as his lying stiffly in bed heedless of what was going on about him, falling into causeless depression, failing to sleep, and wandering about.
As to previous life, only his own data were available. He had been a moderate scholar, had been rather irritable and thought a peculiar character. In the ward, he showed baseless antipathy to certain patients and said they were well. He seemed to have no insight into his condition, yet wrote in a letter that the insane state in which he was had very much “augmented his mental organism.” The diagnosis of early hebephrenic disorder could now be considered established.