December 21, discharged well.
Re the nature of oniric delirium, see discussion under Cases [333] and [450], Chavigny had but two cases out of 260 in which a rapid curability was noted (90 per cent finally curable). Chavigny’s treatment consists of rest in bed, quiet, purgation if necessary, and warm or cold shower baths. Chavigny remarks upon the extraordinary transformation from apathy to lucidity in the course of a few minutes, brought about by arranging a slight but definite emotional shock to the patient, namely, by mentioning in his presence something about home or family. One bit of technic was to get the patient to write or dictate a letter home.
Régis remarks that battle dreams of this nature occasionally affect alcoholics in garrison or at home. The victim ought not to be hastily committed to an asylum, but should be treated in a military neuropsychiatric service with isolation chambers and open wards. Régis organized early in the war at Bordeaux a central psychiatric service along these modern lines. He remarks that the central service ought to receive not only patients from the military hospitals, but also patients from the temporary auxiliary hospitals of the city and district round about. A pooling of the military and civilian issue upon rational lines is here indicated.
Régis and others have remarked upon the necessity of differentiating these battle deliria from toxic and infectious psychoses.
Shell explosion: Deafmutism, recovery of speech with electrical treatment; deafness cured by suggestion in writing.
Case 478. (Buscaino and Coppola, January, 1916.)
A fusileer, 20 (mother neurotic, brother hemiparetic from infantile disease; patient had extreme otorrhea from an early otitis media), entered the army January 15, 1915. He was sent to the Isonzo in May and was slightly injured in the nape of the neck and the left calf by fragments of a shell that exploded near by. He was picked up unconscious and taken to the hospital at Servignano. There he was given electric treatment, and in a period of 18 days recovered his speech, passing through a phase of stammering. He was sent to a special hospital in Florence, still deaf, and passed into a state of mental excitement with visual hallucinations of soldiers. He was given chloral and bromide. He insisted that he was incurably deaf. August 22, he was admitted to Buscaino’s clinic, completely deaf, slightly stuporous, somewhat indifferent, and innocent of any effort to make himself understood (contrary to the habits of an organically deaf person). Simulation could be excluded. It was possible to awaken the patient during sleep by auditory stimuli, whereupon he opened his eyes but could not hear. He talked well and spontaneously, telling about his accident, reading and answering by signs. He was assured,—always in writing,—that upon the following Sunday his hearing would be restored. Upon that day, during the visit of a lady,—one of the patient’s friends,—hearing was suddenly and almost completely restored in the left ear. The patient was so moved by this that he cried when the physician came. Upon the following day, he gradually began to hear with his right ear. A slight diminution of hearing in the right ear persisted, however, until September 24, and was associated with headache and pains in the left ear—pains which the patient compared to his ear pains in childhood (remains of otitis with retraction of the tympanic membrane).
Paraplegia: Cured by administration of Iron Cross.