Читать книгу Shell-Shock and Other Neuropsychiatric Problems - Elmer Ernest Southard - Страница 82

Fatigue; fear; hysterical convulsions. Visual aura (approaching fire wheel) built up after the third crisis (scotoma after look at sun).

Case 74. (Laignel-Lavastine and Fay, July, 1917.)

A sapper, 23, with his company under heavy bombardment, October, 1916, was overcome by weariness and fear (he had always been of a timorous disposition). The order for the rear came, but the convoy was hardly en route when the sapper felt a griping in the pit of the stomach and the blood going to his head; whereupon he lost consciousness and went into convulsions.

This incident seems to have made a powerful impression upon the sapper. A fortnight later, while working in the trenches, he had more epigastric sensations with vague discomfort. He thought about the earlier crisis and about his wounded comrades, and again fell down and had more convulsions lasting a quarter of an hour. The tongue may have been slightly bitten in this seizure. In the genesis of this second seizure we may consider that the feeling of discomfort and the epigastric sensations served to recall the first seizure, so that the second one may be regarded as due to autosuggestion—that is, as hysterical.

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.