Case 13. (Kastan, January, 1916.)
Kastan describes a non-commissioned officer, who came voluntarily into the clinic. It seems that he had absented himself (?) from the army in the suburbs of Königsberg, September 3, 1914. He was arrested October 7th. Once before he had been brought to Kastan’s clinic on the suspicion of general paresis, but had been dismissed as non-paretic. Brought in again in a condition of marked fear, he declared that he had to fall behind his company while he was on the march on account of a feeling of weakness. He had been taken to a hospital and then carried to the suburbs of Königsberg, examined, and found unfit for service.
He had in his 20th year become infected with syphilis, and had recently become forgetful, subject to fears, and easily excitable. He had been very unhappily married with a woman who was hysterical and threatened to shoot and poison him. He lived in a condition of continual quarrels with her. The symptoms that he felt on the march were numbness of the legs and a rush of blood to the head. In the clinic, he was subject to much dreaming and raving about the war. There was excessive perspiration.
1. As to the proper interpretation of this case, details are lacking as to the physical and laboratory side. In fact, it would appear that the suspicion of paresis at his first reception in a clinic was dismissed without resort to laboratory findings.
There are no neurological symptoms in the case clearly suggestive of neurosyphilis, except perhaps the numbness of the legs. The remainder of the picture appears to be entirely psychic. Sensory and intellectual symptoms are missing unless we count the war dreams and mania as intellectual. It appears wiser to count these as emotional in the sense that they were roused by emotion-laden memories. The fear, perspiration, and feelings of head flush are perhaps to be best interpreted as satellites about an emotional nucleus.
Hysterical chorea versus neurosyphilis.
Case 14. (De Massary and Du Sonich, April, 1917.)
There were various complications in the case of a lieutenant (nervous tic in childhood; travel 23 to 30), who was at Antwerp during the period of mobilization. He was taken there by the Germans; was a prisoner in their hands for 55 days; and succeeded under great strain in escaping.
He then entered his regiment, and, passing the examinations, was made an adjutant, and went to the front, March, 1915. He stayed ten months in the Verdun region, under heavy bombardment, and in June was bowled over and buried by a 210. He seemed to be fearless, getting no sensation from shell-bursts except a griping sensation in the bowels.