“You may be a little surprised to hear that I am in the Hos. suffering from shell-shock, which has taken away my speech and hearing. It is some sixteen days now since it happened.… We were in the trenches and going for dear life, when two of us spotted a German machine gunner in a hole, so we made up our minds to have him. We made a charge at him, and I just remember getting to him when a high-explosive shell burst at my head; it seemed as if it burst inside my head; everything went black. I tried to call out and couldn’t, and I could not hear my mates—only just a terrible bursting in my head all the time. I never remembered anything more until I came to on the boat. The Drs. have told me that I will get alright in time. I saw a good deal of France.… There is not a young man there who is not in the Army. The girls and women work in the fie——”
The abrupt ending of the letter was due to the entrance of Major Hurst. The patient had been hypnotized but his deafness had persisted during the hypnotic sleep, so that suggestions could not be effectively taken. He heard nothing whatever during a very heavy thunderstorm, was unable to make any sign whatever, and could not even cough.
He was now told in writing that his speech and hearing would be restored when ether was given. After a few whiffs, he struggled and before he was under began to repeat the word “Mother.” Etherization was discontinued before his limbs had even become relaxed. As he was coming to, he was requested to repeat various words, and when the anesthetic had passed, he was talking normally and had completely recovered hearing.
Now, however, his memory had become a complete blank. From a short time before his shell-shock up to the moment of his regaining consciousness after etherization, he remembered nothing of his loss of speech or hearing, nothing about the events in his letter, and nothing about Major Hurst, whom he felt he had not previously seen. According to Hurst, this patient had become (a) speechless from fright at the time of the shell explosion, (b) deaf from the noise of the explosion, and (c) unconscious from the windage. After he came to at the time of the explosion, an autosuggestion to the effect that he had lost his power of speech and hearing occurred. Ether broke down this inhibition of speech and hearing by interfering with the control of the high over lower cerebral centers.
Re emotional stammering, Chavigny treats by voice gymnastics, rhythmical breathing movements, sounds spoken by metronome with simultaneous movements of arms or trunk, and by singing. Re hysterical stuttering, Roussy and Lhermitte remark that the symptoms are always very pronounced, come on suddenly, and cease just as suddenly under the influence of electrical treatment. The history will differentiate hysterical stuttering. The effects of treatment will also help. Genuine non-hysterical stammering may, of course, be increased through emotion or shock. Dundas Grant aids the stutterer by having him twist a button or carry out some other muscular movement simultaneously with the attempt to speak. He also has the patient endeavor to expand the lower part of his chest during the effort.
MacMahon notes that Shell-shock stammering is chiefly a difficulty with vowel sounds and voiced consonants, and amounts to a speech inhibition, accompanied sometimes by amnesia for words and suggesting a form of aphasia. Mild cases of such stammering are cured simultaneously. MacMahon relies in part upon especially regulated breathing movements and the attendant sense of repose. The cases of old cured stammering that have come back under Shell-shock are harder to treat.
Two burials; shell-shock: Mutism and amnesia. Recovery aided by hypnosis.
Case 528. (Myers, January, 1916.)
Major C. S. Myers recites hypnotic cure in a case of mutism. He remarks that malingering is sometimes suspected in these cases. There was, however, in this case a severe constipation which lasted five days from the shock, and a retention of urine with catheterization during the same period. This private, 32 years, came to a base hospital, mute but able to read and write as follows: