Re mutism spontaneously or non-medically cured, see also cases 476, 480, 481, 482. For various medical methods of treatment, see, e.g., cases 516, 518, 520, 526, 544, 579.
Mott had a case which had been mute more than six months, unable to whistle, phonate in coughing, or blow out a candle, though heard to shout in his sleep: This patient recovered his speech when pitched out of a punt on New Year’s Eve. The condition was in one sense physical enough, as the X-ray showed that the man’s diaphragm hardly moved even with the greatest effort. Mott regarded the inhibition of the breathing movements, especially the phonation, as caused by fear. Mott speaks of a case that recovered on being told by a comrade that he had talked in his sleep. The man was so astonished by this statement that he said, “I don’t believe it.” Other instances of cure under quasi natural conditions are related by Mott: In the presence of a functional mute, Mott speaks loudly to the patient’s sister so that the patient may hear: “This man must be kept on a No. 1 diet, and when he can ask loud enough for you to hear, he can have a bottle of stout and a mutton-chop.” Several mutes are reported to have gotten well the next day under this treatment.
These effects shade imperceptibly over into the manifestly suggestive, and probably no sharp line can be drawn between the effects of medical suggestion, non-medical heterosuggestion, and even autosuggestion. Adrian and Yealland rather decry the Micawber line of waiting for something to turn up. Zeehandelaar, a Dutch professor, studied Berlin methods (Lewandowsky), and found numerous cases (both of mutism and of deafness, paralyses, contractures, and tremors) lying about without special treatment. According to this observer, the expectant treatment was sometimes successful, and sometimes not; if unsuccessful, the soldier was sent home, and re-examined a year later; whereupon he might be found to have profited by this long waiting and to have gotten well enough to return to army duty.
A decorated officer, evacuated for Shell-shock on the third day of the Aisne, after four days returns to the front. Evacuated a second time, after weeks returns to the front without relapse.
Case 474. (Gilles, 1916.)
A young officer, with many decorations for brilliant Colonial service, was in the battle of the Marne, under six consecutive days’ shell fire, smoked phlegmatically a cigarette no matter whether walls were crashing or horses disemboweled beside him, and was uniformly able to stimulate his men to the heavy work by humor or heroic phrases.
A week later, on the third day of the Aisne, he had to be evacuated. He was another man—wild-eyed, shivering, jumping at the least noise, unable to eat or sleep, given to battle dreams. He had to be carried away from the battle zone and put in a bed in a town in the rear and given chloral. The nightmares continued. On being awakened he would ask where he was. He was kept in bed, given strychnine cacodylate, and dieted. He went back to the front in four days. Two days later he had to be evacuated a second time. After some weeks more in the rear, however, he went back to the front, and thereafter had not relapsed (April, 1916.)
Re relapses, Wiltshire thinks their causes and frequency prove the psychogenic nature of Shell-shock. Ballard states that a severe case lasting six months does not recover in the army. Many that are said to recover in hospital break down at dépôts, often with symptoms quite unlike those which they originally presented, and it will be remembered that Ballard has an epileptic theory of the nature of Shell-shock. See Cases 82, 83, and 84 in [Section A], III, Epileptoses. But another portion of Ballard’s contentions relates to a causation through fear suppressions released by perturbing events. According to Ballard, if the man endeavors to re-suppress the released fear, the fits occur. Ballet and DeFursac note the frequency of relapses—fewer after treatment at the front.