Martial misfit, dwelling on horrors of war at home; exposure; shell fire: Mental exhaustion with depression, emotionality, tachycardia.
Case 303. (Bennati, October, 1916.)
An Italian corporal, in civil life a writer (mother very nervous; patient himself rickety, unmarried; relatives well off), was in front line trenches for some fifty days. He was repeatedly excused from service on account of fatigue, distress, poor appetite, insomnia, depression and even confusion (aimless shots fired off in the night). It turned out that he had been in just this state of mind when he left home and family and that the very thought of war had seemed dreadful to him. He did not at all enjoy leaves at night, as he stumbled and fell about in the darkness and had shells burst near by. He lived immersed in mud. He reacted unfavorably to antityphoid injection.
The very day he went on winter furlough he greatly improved, but then suddenly relapsed into depression, emotionality, inattentiveness, sluggishness of mind, and exhaustion. The tendon reflexes were lively, the abdominal reflexes sluggish. There was tachycardia (120), the Mannkopf-Thomayer tests were positive at 76 and 80, oculocardiac reflexes 84 and vagotonic. Stellwag and v. Graefe symptoms.