A sergeant, accountant in civil life (father insane, mother pulmonary, grandfather alcoholic, cousin insane; patient himself anemic as a boy, victim of chronic gastritis and gonorrhea), was evacuated from the front to Chateaugiron in March, 1916. It appeared that instead of watching over his men as a sergeant should, he gave utterance to baroque theories of the divine right, the influence of the grace of God on man, and the end of the war. He went so far as to ask leave to transmit to the Inventions Bureau of the War Ministry an invention with respect to the problem of locomotion, and he sent to the King of Belgium a manuscript to the effect that he had received from heaven a mission to reëstablish the world’s balance. He was, in fact, the victim of delusions of a mystical nature with visual hallucinations. To explain his mission, he wrote, “It was my duty to take supreme command of war operations.… I have the power, the right and the duty to give the following order … general armistice … peace will be symbolized by the house undivided and will be constituted by general Christian religious unity … as a consequence of what we shall say they will give up our territory to us of their own accord.”
This case of paranoia apparently took its coloring in part from the war situation itself.
Hysterical mutism: Persistent delusional psychosis.
Case 185. (Dumesnil, 1915.)
A sergeant, aged 23, evacuated from the front to a hospital for the insane, had been mute, though not deaf, since February 28, 1915. If asked to cry out he grew black in the face and could utter only a raucous scream which made everyone jump. He wrote very frequently, stating in February that as he was still a sergeant and had no hope of advancement, he cared nothing more for life. “The idea of death got anchored in my head.” In this state of mind, on the afternoon of the 27th two bombs came. “I saw the first one coming and cried out a warning. Coming back I saw the second one. The bombs were coming rather softly. From this moment on and up to the time when they burst, I thought I had gone, that I had been carried off and crushed. I was quite astounded at finding myself covered with earth and stones … but I could not talk any more, I could just say in a low voice ‘Papa,’ and the next day in an ambulance I could not talk at all.”
There was complete pharyngeal anesthesia. The man had been a foundling and was clearly a degenerate. He had always been of a depressed disposition and given to thoughts about his misfortunes. Over and above the mutism gradually ideas of persecution and revindication developed (such as that he merited adjutant’s rank and was being mocked and treated as a simulator). He drew up a long letter to the War Ministry in which he stated his desire to be sent back to the front. He complained to the police about a hospital sergeant and offered a duel in an elaborate and inflammatory style, “with whatever weapons shall please you, either sabre of 1845, revolver of 1902 or bayonet of 1886 or the chassepot. One of us two must disappear.” He had become dangerous enough to be interned and in hospital remained mute with the same ideas of persecution and revindication, the same alternate phases of calmness and excitation. According to Dumesnil: hysterical mutism with persecutory delusional psychosis.
A peasant’s psychopathic inferiority brought out by the war.