Contributions to the study of shell shock : being an account of certain disorders of cutaneous sensibility / by Charles S. Myers.

  • Charles Samuel Myers
Date:
1916?]
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Licence: In copyright

Credit: Contributions to the study of shell shock : being an account of certain disorders of cutaneous sensibility / by Charles S. Myers. Source: Wellcome Collection.

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    to occur among those predisposed to shock. Of the varieties of stupor a detailed description may be deferred until I come to deal with this condition at some later date. But I may note that in this communication I have not classed a man as mute until his stuporose state has so far passed off that he is clearly capable of observing and reacting to his environment ; being able to write or at least to gesticulate. Onset of mutism. —As regards the speed and mode of the onset of mutism my records are unsatisfactory, no reliable information being usually obtainable on these points from the patients or from the medical officers of regiments or field ambulances. Most of the patients claim to have found themselves mute on ‘‘coming to.” That is to say, their functional condition is “ of unconscious origin whereas in the cases of mutism in which no loss of memory occurs it is probably often ‘ ‘ of conscious origin. ” The following is a typical history given in writing, but otherwise unsupported, by an A case. “A shell burst about two yards away ; it lifted me up in the air. I don’t know what happened afterwards. [When I came to myself] I was watching the trench mortars coming over and killing my mates, and I could not tell them [what was the matter], because I couldn’t speak.” The following is an equally typical history of a B case, obtained from the patient’s regimental medical officer. “ It appears that he was in the trenches at -, where he was subjected to heavy shelling one day. Several burst near him, one blowing in the dug-out and wounding several men. They were relieved two nights or so later and went into billets at-. Whilst in a courtyard outside his billet a shell exploded in the yard and wounded several men, but he was not blown up in any way. He then cleared out to the billet of the other company. Here he was quite dazed, would answer no questions, and if any one came near him he would either jump at them or draw away.” In only a few cases was the onset late or gradual (see, for example, Cases 17 and 18, described below). I have had opportunities of seeing cases of mutism at field ambulances and clearing stations—that is, within a very short time after the occurrence of the shock. They differ usually from those which I have seen (in greater numbers) at the base hospitals (a) in being more completely mute, (b) in being more intensely pre-occupied and more intolerant of suggestion. For example, one man, admitted as deaf- mute into a field ambulance, could be induced, when hypnotised, to react to my spoken order (viz., to put out his tongue), but thereupon he awoke and seemed as deaf and as “stupid” as before. Another mute, seen at a clearing station, could be made by post-hypnotic suggestion to pronounce his regimental number, but was found an hour