A little later, on a hot day in the trench, while working, the sapper turned to a comrade and saw a great black spot on his face. He turned toward another and saw another great black spot on this face also. He was frightened, felt strange sensations, fell, and had a third convulsive crisis. The black spots that he saw were due to a scotoma, the result of a transient glance at the sun.

After this scotomatous episode, his crises always had a visual aura. He would feel rather uncomfortable, leave the supper table, feel a gastric sensation, warmth in the face, and oppression. He would go out in the cold for the air, look about for something, appear frightened, fix his gaze upon a certain point, and cease to reply to questions. His head would jerk back suddenly, and he would utter strangled cries of fear. He was now evidently prey to a terrifying hallucination. In ten minutes, everything had gone again, leaving him trembling with emotion. He would then relate how, after the epigastric sensation had begun, he tried to see if he could make out something abnormal; whereupon a little fiery wheel would appear and roll up nearer and nearer, so as to almost touch his eyelids. He could see his comrades to the right and to the left of the wheel; he could hear questions but could not answer. Just as the fire wheel was about to blast him, consciousness was lost and the fits came on.

War strain; anxiety; confusion; fugue. Demotion and detail to the interior.

Case 75. (Barat, November, 1914.)

A lieutenant, 25, an officer in a regiment on active duty near the front, was called before a special board charged with desertion in the face of the enemy. He had been assigned to a certain position but not only had not complied with the order, but had wandered off to the British sector and been arrested there as a spy.

The prisoner was well developed, without stigmata; heredity, negative. His career in the army had been courageous and he had been advanced several ranks and was about to be given a medal for bravery. He said that he had been under a severe strain for several days.

One evening he had been given the order to attack. The artillery opened fire. He found that the Germans had erected barbed wire defences. The loss of men was terrific. His order was to shoot all who held back. A poor territorial crouched down and would not go forward—supplicating the prisoner not to shoot him. The prisoner spared him.

The next night the order to attack the German trenches was again given. This time he was overcome with anxiety and discouragement. The last he remembers was the order to attack. Next day he felt sick and his mind was foggy. He remembered leaving his regiment and wandering round for several days until he fell into the hands of the British and was arrested. Then he understood what he had done.

The prisoner asked to be allowed to return to the front. The testimony of one of the lieutenant’s men verified his statements. On the day before he left the front he had been anxious, had cried often, and would speak to no one. On the day he left the trenches without permission, he was nervous and disoriented.