2. On entry HESS manifested a spotty amnesia. The British psychiatrist accompanying him stated that from 4 October 43 to 4 February 45 HESS presented symptoms of total amnesia. From 4 February 45 to 12 July 45 he recovered, and is said to have made a statement that his previous amnesia was simulated. On 12 July 45 he again developed amnesia which has lasted to the present. Also while in England HESS claimed he was being poisoned and sealed up numerous samples of food, chocolate, medicine, etc. as “evidence” to be analyzed prior to his trials. Such behavior could be either simulated or a true paranoid reaction.

3. Present examination reveals a normal mental status with the exception of the amnesia. Attitude and general behavior are normal, mood and affect, while slightly depressed, are intact and normal. Sensorium is intact and insight is good. Content reveals vague paranoid trends, but there is no evidence of any actual psychosis. His reactions to his suspicions are not fixed—and delusioned trends—are distinctly spotty and disconnected. His reactions are those of an individual who has given up a simulated behavior pattern rather than those of the psychotic. Oddly enough his memory for this phase of behavior is excellent.

4. Special examinations with Rorschach cards indicate some neurotic patterns. They point to a highly schizoid personality with hysterical and obsessive components. Such findings are confirmed in the patient’s present reactions. He complains bitterly of “stomach cramps” which are obviously neurotic manifestations. He is over-dramatic in his actions presenting typical hysterical gestures, complaints and symptoms. His amnesia is at present limited to personal events concerning his history after joining the party. The amnesia however shifts in a highly suspicious fashion. Such amnesias may be hysterical in nature but in such cases do not change in depth from day to day and facts recently learned are not lost as with Hess.

5. In HESS’ case there is also the factor of his long amnesia in England. It is quite possible that he has suggested an amnesia to himself for so long that he partially believes in it. In a person of hysterical make-up such auto suggestion could readily produce an amnesic state. Also the “gain” or protection found in amnesia, fancied or real, would be a bar to its easy clearance. Finally a large conscious element may well be present.

6. In this case I believe all those factors are present. Treatment will have to be formulated along lines attacking the suggestive factors and overcoming conscious restraints. Hypnosis would be a value but probably chemical hypnosis will be required. Such narco-hypnosis and analysis require the use of intra venous drugs of the barbitol series, either sodium amytol or sodium pentothal. Such treatment is in general innocuous if proper precautions are taken. It must be borne in mind, however, that occasional accidents happen in any intravenous technique. With the drugs mentioned above rare fatalities have been reported although in more than 1000 such cases personally treated, I have never seen one.

7. Essentially the present situation is as follows:

a. Internee HESS is sane and responsible.

b. Internee HESS is a profound neurotic of the hysterical type.

c. His amnesia is of mixed etiology, stemming from auto suggestions and conscious malingering in a hysterical personality.

d. Treatment will be required if it is felt desirable to remove this amnesia.