Shell-shock and other neuropsychiatric problems

by Elmer Ernest Southard

“It’s agricultural land, ploughed fields. There were two farms in front of us. One day we saw an old cow between our trenches and the Germans, and we all had pot shots at it. Once the Germans rushed our trenches; we killed hundreds, bayoneted them mostly, and hit them over the heads with the butts of our rifles. It was hellish. The British were all shouting. I saw a German officer behind with a sword and a revolver. I saw a lot of French soldiers, too; they wore long coats with the corners turned back; some had blue and some had red trousers. The French dragoons are like Life Guards, with big steel breastplates and brass helmets with a long plume; they carried swords and rifles and a few had lances.”

He was asked to mention some of his impressions in Belgium and what he thought of the manners and customs of the French and Belgians.

“We cut off all our buttons and gave them to the French girls. The French cigarettes are muck; you buy them in little blue packets; the tobacco is rather dark and strong. When we bivouacked on the march at night we were not allowed any lights, but you could smoke by digging a hole in the ground with your bayonet and smoking into that.”

The following are some of his remarks about his stay at Gibraltar.

“Gibraltar’s like a great big rock; the steep side looks toward Spain. I was in barracks there, and used to spend a lot of time in the band-room practicing. Sometimes we bathed in the sea. I went to Spain two or three times and saw some bull-fights; they were very exciting, but rather too cruel for my taste. They used to kill six or seven bulls a day. The horses got fearfully cut about.”

This bandsman showed what Feiling calls dissociation of personality. There was an amnesia of such degree that all conscious memories of the patient’s life, as well as all memory of letters, objects, and life in general, were suppressed. The patient was brought, after the burial above noted, to the hospital for epilepsy and paralysis at Maida Vale, January 21, 1915. After his experience, he had been transferred to the Second Western General Hospital, Manchester, where he spoke sensibly, understood and was able to remember things since the burial. His mind was a complete blank for all previous experience. He was unable to recognize his own father or relatives. He was slightly deaf for a time but this defect disappeared.

At Maida Vale he showed a nervous twitching of eyelids and facial muscles; otherwise he was neurologically and physically normal, dreamless, without complaints, and straightforward about all experiences since coming to himself in the hospital at Manchester. He took his parents on trust. “I don’t know if I ever went to school.” “A bayonet is like a knife; you see soldiers with them on their rifles. I have never seen a bullet.” His memory for recent events was also not good. He once recognized a single tune played at a concert.

Suspected of malingering, he was tried out in various ways. He was told that an elephant was a little furry animal and shown a little 6 inch toy sample. On going to the zoo he was greatly astonished at seeing a real elephant. He did not know what the war was about and he had no interest therein.

March 10 he was hypnotized and proved an easy subject. Powerful suggestions that lost memories would return were unavailing. The next day, during hypnosis, it was found that his previous experience could be readily tapped, and a history of his family, schooling, running away, and eventual enlistment was told. He had been at Gibraltar when war broke out. He was at the first battle at Ypres, and was for ten days in severe trench fighting, and was finally buried in the mud and débris of a trench blown in by a high explosive shell. He had been buried for about 12 hours, was dug out at night, and (according to his father) remained unconscious 24 hours, and deaf and dumb three days. He was transferred to another hospital and then to Manchester, where he came to himself.

Only during the first few sittings did the patient lie with eyes closed. Later, during hypnosis, he behaved exactly like a normal person. The fact came to light that when hypnotized the patient returned to the personality that possessed him just before awakening in Manchester, and accordingly during hypnosis, he had to become acquainted again with his hypnotizer. Maida Vale astonished him, as it should have been Manchester. Thus there were two personalities: No. 1: The personality since the date of the Manchester awakening; No. 2: The personality containing all the memories of the past life as well as the more recent Flanders memories. In State No. 1, the manner was jaunty and cocksure. In State No. 2, the man was more modest and less loud. Moreover, though in State No. 1 he spoke with a Lancashire accent, in State No. 2 his speech was in the West Country dialect—a strange observation, confirmed by several observers. He was asked to write down the answers to questions, and on awakening from hypnosis was shown the things written; whereupon he laughed and said, “Why, that’s not my writing.” On writing out the same sentences again, various minor points of difference were apparent. Hypnotized in the presence of his father, in whom in State No. 1 he took no great interest, he showed every sign of joy, causing his father to think that in State No. 2, his son had “come all right again.” In State No. 2 he could play a euphonium better than in State No. 1; but after practicing in State No. 1 he rapidly became as expert as in the hypnotic state.