Régis, who has named the state “oniric delirium,” states that the condition never lasts more than a fortnight, is caused by emotional shock, and occurs in all cases with mental disorder following battle; but similar hallucinatory conditions have begun to appear also amongst alcoholics, in garrison or at home. There is emotional constitution in most of these cases. There is not so much evidence of heredity. Out of 50 of Régis’ cases, 22 had been wounded, and 28 not. Régis states that the psychoses are rather more apt to affect men in the reserve, and are severest in officers. These cases should not be committed to institutions, but ought to be treated in special military psychiatric wards containing separate rooms. Very fine-spun diagnosis may be necessary now and again on account of the occurrence of infectious deliria and phenomena of the banal psychoses that may closely resemble oniric deliria.
Shell-shock; emotion (best friend mangled): Stupor with amnesia.
Case 334. (Gaupp, March, 1915.)
A soldier, 23 (in civil life a turner, of Polish descent, and of a somewhat nervous and easily excitable disposition), early in August went from Strassburg into the Vosges and Lorraine. August 26 a number of shells exploded near him. The troop was excited and took refuge in a cellar. His best friend was torn to pieces by a shell. When the body was removed, the man felt sick and lost consciousness. He arrived at the clinic in Tübingen in a stuporous condition, by hospital train, August 31, 1914. He walked weakly to his bed, supported by two men, and lay in the bed, apathetic and reacting to questions only with a stare. Things put in his mouth were swallowed. He remained motionless.
Next evening he answered a low Yes to a nurse’s question about eating. A little afterwards, he said he supposed he was a prisoner in the enemy’s country. A while later he got properly oriented but still did not know how he had come. September 2, however, he was much clearer and said he had awakened out of a long dream. There was a complete amnesia, however, from the moment when he went to help remove the torn body of his friend up to September 1. Memories became clearer for the period before the shell explosion. The patient became very lively, talking vividly of war experiences, imitating the hiss of shells with an expression of intense anxiety, getting accustomed to the battle scenes, saying that he was now seeing everything again as if real. He remained anxious for some days, complaining of weight on his chest and of feelings of inner restlessness and tension.
Amnesia for the period August 26 to September 1 remained; all that he could say was that he had been thrown sidewise for some distance by the air pressure of the shell.
From September 6 onwards, he grew calmer but he was still very labile, given to lively imaginings and emotion. By mid September he could be discharged for garrison duty.
Emotional shock; shooting a comrade: Horror, sweat, stammer, recurrent nightmare. Improvement on “tracing back.” Brief recrudescence on death of child.