Case 160. (Weygandt, 1915.)
A subaltern who had been in the service since 1909 was on patrol under shell fire from the enemy, but shortly thereafter came with his detachment into the zone of the German fire. Six men, two steps away from him, were killed by a shell. The officer remained stationary with the rest of his detachment until darkness set in, then returned, made his report in due order, but thereafter tremors set in over his whole body and he lost consciousness. He was carried to the hospital and on the way met his best friend whom he did not recognize. Arrived at the hospital he was unable to give answers to questions or obey requests for two or three hours. He thought he was hearing calls, commands and a dull dröhnen. If an automobile passed he was frightened and cried, “Auto! Auto!” He remained subject to inhibition, anxiety and insomnia for a long time; pulse accelerated; visual fields somewhat contracted for red. Face asymmetrically innervated and dermatographia. Sent to the reserve hospital, he was still apprehensive, especially at night, but in the course of a few days became perfectly tranquil. Only if he took part in the singing of war songs did he feel transient sensations in his knees.
Here is a case of psychic shock with many traits, such as inhibition and hallucinations, suggestive of dementia praecox. The Abderhalden reactions (cortex, white matter, testes, not thyroid) all, according to Weygandt, are suggestive also of dementia praecox.
Shell-shock dementia praecox.
Case 161. (Dupuoy, 1916.)
A machine gunner, 23, was the sole survivor, March 18, 1915, of the explosion of a large calibre shell in a block house containing ten men. He worked himself out of the débris and came to Dupuoy’s attention in September, when an extension of leave was asked for him.
There were two groups of symptoms; persistent headache, painful hyperacousia, vertigo, tremulous walk, cervical spinal column stiff and painful both spontaneously and to pressure, muscular weakness, tremor of hands, hypesthesia of extremities especially upper, exaggeration of tendon and bone reflexes with tendency to ankle clonus and patellar clonus, sterno sign lively, frequent nosebleeds (two to four times a week), profound sweating, unequal pupils.
On the mental side it was clear that the man’s character had changed, according to information supplied by the mother. Aprosexia, impairment of memory, recollective and retentive, inability to give age, birth date and similar data. Words came with difficulty. Some disorder of comprehension; stereotyped replies; negativism; indifference; he would sit hours in a chair or on a bed silent and inactive. Fixed attitudes; dull glance; eyelids half closed. In short, it seemed as if this patient was a case of catatonic dementia praecox.
Re dementia praecox and shell-shock, Stansfield remarks upon the similarity of certain symptoms found in Shell-shock to those of dementia praecox; for example, apathy, retardation, amnesia and speech defect. According to Stansfield, one often gets the impression in a Shell-shock case as though the trench and shell fire stress had merely brought out a latent dementia praecox.