GASSING: Mutism, tremors, depression, battle dreams.
Case 216. (Wiltshire, June, 1916.)
An infantryman, aged 27, had been at the front for three months. He was wounded a month before coming to hospital; but when the wound healed he went back to the front, quite mute but intelligent and able to write the following:
“We were on our way to the trenches, and as we were going through the railway cutting they started to shell us, with gas shells mostly, and we had not been there more than quarter of an hour when I was compelled to lie down from temporary blindness and weakness through getting a dose of gas through my mouth and eyes. I was lying down for about ten minutes when a shell came somewhere near, and was struck by something in the face and on my left knee and I remembered no more until I found myself in hospital. I was all of a shake and while lying down would frequently jump up and wonder where I was.”
The patient had been mute thereafter, depressed, and given to dreams about fighting and shells. There was a fine tremor controllable by the will; the knee-jerks were increased. On lateral deviation, there was difficulty in fixing the eyes. There was a slight deafness due to an old discharging left ear. According to Wiltshire, Shell-shock is only exceptionally caused by chemical poisoning from gas.
Re poisoning by certain German asphyxiating gases, Sereysky reports in 1917 that these gases contained, among other poisons, a nerve poison. He found that poor heredity was a favorable soil for the action of this nerve poison. The clinical pictures in the gassed soldiers rather suggested cerebral arteriosclerosis. He remarks that the logical distance between the “exogenous” and “endogenous” is greatly reduced in these gassed cases, as the syndrome of “exogenous” gassing closely approximates that of various “endogenous” disorders.