An officer, mute for five months following shell-shock, had been for four months treated in a succession of hospitals—field hospital, war hospital, two reserve hospitals.
He had no acquired or hereditary neuropathic taint, but even in the period before the critical shock he had been under tremendous physical and mental strain. The explosion produced a total anesthesia of the skin of the head, face, neck and shoulder region—in short, what Charcot called the “doll’s head” form of sensory disorder. Moreover, there was a marked contraction of the visual fields.
The patient, when treatment was given, fell at once into a deep hypnosis and began to intone, and then to speak isolated words, and finally to speak complete sentences. All that was left of his mutism was a slight over-fatiguability of the speech organs. This also cleared up in the next few days. He was discharged well, and had already been—December, 1915—some months in the field.
[Case 531], though an officer, responded to hypnosis well, and Nonne remarks that hypnotizability is independent of the presence of any neuropathic tendencies, or of any loss of resistance through exhaustion. One trouble with the hypnotic method, according to Nonne, is the fatigue of the hypnotizer and his inability to rely upon assistants.
Re Charcot, Nonne remarks that the work of Charcot on hysteria is not sufficiently well-known, especially as civilian practitioners in peace times had few cases. Re taint, Nonne found such tendencies absent in more than half of his cases with careful anamneses. The absence of adequate psychogenic cause is a not uncommon experience according to Nonne. Nonne, finding 26 cases of pure neurosis amongst 1800 cases of war injury, had a considerable number of odd erroneous diagnoses in the group. Not only were cerebrospinal paralyses wrongly diagnosticated, but ischemic paralysis, plexus paralysis, arthritis deformans and synovitis.
A soldier is put in the Landsturm at 22 and later called “unfit” by reason of tremors after mine-explosion (history of tremors at 14 after a fall), but is cured by hypnosis.
Case 532. (Grünbaum, November, 1916.)
A Landsturm soldier, 22 (father excitable, family otherwise normal), had a history of being the best scholar in the class and well up to his fourteenth year. At 16 he fell from a tree and though he apparently sustained no injury his head and arm began to tremble. He became unable to learn and gave up his preparations to be a teacher. The tremor, however, disappeared in six months and he went into some technical work. At 16½ years he went as cabin-boy, but in a fortnight he was sent home by the physician. He then began to breed carrier pigeons and got first prizes at international exhibitions. He also went into foundry work and did well as an apprentice. He worked well at home and busied himself with setting up small electrical and other machines. He had never been interested in women and loved his pigeons best, and therefore was regarded by people who knew him as not quite right. He was also non-alcoholic.
After mobilization he was sent back twice but finally was put into a Jäger Battalion. After reaching the front he had to have a hernia operation and on getting well went back to his place and a few days later a mine exploded near him. He was much frightened and fell down unconscious. On regaining consciousness he felt a “running” in the legs and tremors in the hands. The latter grew stronger and began to affect the arms.