Cure of self-accusatory (“started retreat from Mons”) and other delusions by “autognosis.”
Case 496. (Brown, January, 1916.)
Capt. William Brown, in the discussion at the Section of Psychiatry of the Royal Society of Medicine, January 25, 1916, speaks of a method of treatment which he calls autognosis—a method of giving the patient self-knowledge, by revealing to the patient through his own confessions the cause of mental change leading to his symptoms. One of Brown’s examples is that of a sergeant in the firing-line during the retreat from Mons. He was admitted to Maghull with the delusion that people thought he had given the signal for the retreat from Mons on a silver whistle, a shooting prize of his. German officers used silver whistles that made a note like his own. In fact, he had other like delusions, such as that people thought him responsible for an Edinburgh railroad accident in connection with his troop-train. A German spy might have heard this.
In the process of procuring autognosis, Capt. Brown found that at the age of 12 this man had been falsely accused of stealing pork pies from a shop, and had been brought before a magistrate. In point of fact, he proved an alibi, but he was greatly worried by the charge. According to Capt. Brown, this incident of the insistence of the false accusation was the beginning of his tendency to delusions. In two months’ time there was a remarkable improvement.
Re psychoanalysis, autognosis and various modifications, Forsyth remarks that when the acute stage is passed, the Shell-shock case becomes an everyday neurosis in which war experiences are merely the latest phases in the patient’s life, and that psychoanalysis may then become necessary. Eder regards the “mechanisms” of what he terms “war shock” as the Freudian mechanisms of hysteria, and has commended psychoanalysis for a few cases, preferring hypnotism for acute cases. Adrian and Yealland decry psychoanalysis on the score of time limitations.
Deafmutism in three men shell-shocked at one time.
Cases 497, 498, 499. (Roussy, April, 1915.)
There were three Zouaves in a first-line trench north of Arras, January 14, 1915, who were blown up by a bomb thrown from the enemy trench some hundreds of meters away, by a mortar, a crapouillaud. This projectile burst with a great noise, louder than that of a bomb, and made a very strong windage. A dozen men were blown under the trench wall, just after entering the trench; two were killed; and the others, most of whom had been buried to the neck, were pulled out and carried, trembling, to the nearest relief post. Two of the three Zouaves were bleeding at nose and ears, and all three were absolutely deaf and mute. Evacuated to an ambulance, and thence to Paris, they arrived at Val-de-Grâce, January 17, that is to say, three days after the shell burst. They communicated with the attendants by signs; one got hold of paper and wrote several hours in the day rapid notes about the accident. However, hysteria or pure simulation was suspected in these three Zouaves, and they were placed in small separate rooms. They were informed through the physician’s remarks to his staff that these were cases of nothing but simple nervous shock such as we had often observed, and the claim was made that they would be completely well either on the morrow or the day after.