A perfect soldier type. Mine explosion; burial; superficial wounds: War neurosis.

Case 307. (MacCurdy, July, 1917.)

A lieutenant, 29, had been a regular soldier for eight years before the war and was made a non-commissioned officer almost at once after enlisting. He went out as a sergeant with the original expeditionary force and got through the retreat from Mons and the first battle of Ypres intact. He enjoyed the fighting hugely and even got indifferent to the burial work. The death of chums saddened him, but he carried on and soon forgot about the incidents. He might be regarded as a perfect soldier.

In August, 1915, there was a slight touch of rheumatism. Two or three months later the Germans exploded a mine immediately in front of the trench where he was. He went pale for the first time in his life, but kept his men “standing to.” Thereafter he began to think for the first time about danger. Mining was hereabouts the chief form of attack, and he frequently heard Germans digging beneath a dug-out. He slept well in billets, but was too restless for sleep on active duty.

He got more and more on edge during the next weeks. Six weeks after the mine explosion he was buried in a dug-out. Though he did not lose consciousness, he was dazed and had to lie down for two hours. Nervousness, chronic headache and insomnia, even in billets, followed. His imagination played upon the blowing out of dug-outs and the bowling over of men by shells. He had become company sergeant-major and the responsibility made him grow worse and worse. At times he tended to jump when the shells came, but was outwardly perfectly calm. He began to take morphia, though with little result. He had suicidal thoughts.

After two months of these symptoms he was sent to England. He began to sleep fairly well and three months later applied for light duty; was greatly bored by the company accountant work given him; got a commission and was sent back to the front nine months later, January, 1917. He got on with the active fighting very well, sleeping four or five hours a night. In April he was sent to Arras. He had had a dream that he was going to be bowled over, buried and wounded in the neck. Sleep got poorer. In April he led his men in an advance and actually was bowled over, buried and hit in the neck as well as in the knee and the hand, though all the wounds were superficial. He was carried back, dazed, to hospital, where he grew fairly comfortable in ten days and even undertook a journey down to the base.

He arrived in collapse, remained in camp at the base three weeks, getting steadily worse. Something, he could not tell what, was going to happen and kill him. He could not concentrate, even to read. He thought of suicide. He slept practically not at all, waking from a doze with a start, feeling that something had hit him. He had dreams of being taken prisoner and on waking would in fancy start a fight to escape from imagined imprisonment back to the British lines. After two weeks in various hospitals he spent ten days in a hospital for nervous cases and grew better. Riding on trains he was terrorized in every tunnel lest he should be crushed.

According to MacCurdy, an anxiety neurosis would have developed had not his superiors sent the lieutenant back to hospital after the final burial in April. As this perfect soldier said:There is no man on earth who can stick this thing forever.”

Shell-shock; thrown against a wall: Tremors—TREMOPHOBIA.

Case 308. (Meige, February, 1916.)