Case 226. (Gaupp, April, 1915.)
A volunteer, 21, who had been in civil life a lackey, wrote as follows upon arrival in Gaupp’s clinic:
“On account of our privations and the various terrible scenes that you have to see, my nerves went back on me. Like the rest of the front, we too had to suffer terribly heavy artillery fire from December 20 onwards. December 29 at eight o’clock in the evening, when I was about to mount guard at the camp, I was thrown down by a shell that unexpectedly struck near me across the earth pushed out into a trench. I ran at once to cover as some more shots followed directly. I couldn’t be made to do anything on the thirtieth nor can I very clearly remember the events of that day. There was a terrific cannonade again, then cries of the wounded and the sight of the dead, etc. I was told afterwards that I fell down, cried, struck about me, and remained lying, dazed. The first that I can remember was that I was lying on a floor. I was then carried into another house, into a better room. Then I regained consciousness and could hear again after the noise in the ears had stopped, but I could not talk or walk. I was unconscious for two days. I got into the hospital train at R. the next day but had to be carried in as I could not walk. Travelling in the train made me quite foolish in my head and gave me bad headaches; I could not form any clear thoughts.”
It seems that this volunteer had not been quite up to the hardships of the war from the beginning; always a weakling, he had to be spared on the marches. In fact, he had been refused by the army at the first examination as unfit. He had been a nervous, tender, somewhat anxious fellow since childhood.
At the clinic there was an astasia and an abasia without any signs of organic disease. The striking feature was mutism. He could understand things spoken and written, but he was entirely mute, nodding and shaking his head properly for affirmatives and negatives. He carried with him a few slips of paper with written requests, like: “Please, can I have salt; otherwise I can’t eat the soup;” “Are we going to ride farther, I have such a bad headache. The doctor must not come. The one who wanted to shoot me if I couldn’t speak. They are all bad.”
Treatment by suggestion (laryngeal faradization, lively verbal suggestion to pronounce single vowels, syllables, and whole words and sentences with enunciation of them) removed the mutism in a few days. At first the man’s speech was low and somewhat retarded, but later it became entirely normal. Within ten days the abasia cleared up and the patient became lively and cheerful. He was depressed on finding that he had lice, but after losing them became happy and childlike again.
February 1, however, on learning that he would be able to do garrison duty again, he took the news very soberly, and grew more quiet, trembled and seemed anxious.
February 7, he was sent to the garrison, increasingly excited. His own account of it in a letter written to a hospital nurse, runs as follows:
“As you will see, I did not reach Dn. but only got as far as here [Another hospital]. I will tell you how it happened. Probably I ought to have remained in Tübingen for a while longer and perhaps then nothing would have happened to me. You will remember that I was more nervous and excited the last days than I had been before, and the cause was also known to you. I wanted to get home in some way and so I pretended to be as well as possible. That crying attack, or whatever it was [an outcry in a frightful dream] had not been thought of by the physician any further, you know, and so I didn’t think anything about it either. Then the head doctor asked me once if I had any trouble left. Well, I spoke out everything I had to say, but no further attention was paid to that either. Then when I took a walk and after walking slowly two hours could hardly stand, was trembling all over and had a high pulse and also a violent acute pain in the region of the heart, that wasn’t of any importance either. Well, then I just got better from day to day and so I got what I wanted only too easily because they wanted the space and I certainly would have gone home and not to Dn. as I should have. [His reserve battalion was at Dn.] I got into the wrong train at St. so as to go home. I kept saying to myself, ‘You can’t do that, it will be punished.’ Nevertheless I couldn’t act any other way because I was really sick from longing for home.”