Deafness, cured by suggestion in writing.
Case 522. (Buscaino and Coppola, 1916.)
L. G., 20 years old; fusileer. (Mother of neuropathic constitution. Father died in 50th year of heart disease. One brother had hemiparesis from infantile cerebropathia.) The patient suffered from infantile otitis media bilateralis, which was followed by abundant chronic otorrhea from his fifteenth year. He relates that for a long time he was obliged to wear a very large handkerchief on his shoulders to receive the pus, which came from an ear. No sex disease. Nothing of importance in the physical anamnesis.
Patient entered the army, Jan. 15, 1915. In May, he was sent to the front (Basso Isonzo). Towards the end of July, while he was in the trench, a grenade exploded a short distance from him, causing slight abrasions at the nape of the neck and in the fleshy part of the left calf. He was picked up in an unconscious state, and taken to the hospital at Cervignano, where he was admitted as a deafmute and was given electric treatments. After 18 days or so, first stammering and then pronouncing with difficulty a few words, he finally regained his speech entirely. Deafness continued, however.
Being transported to a special hospital in Florence, he was in a state of psychic excitement for several days, showing also visual hallucinations—saw “many soldiers,” saw “many soldiers all about him.” He was treated with chloral and bromide. The suspicions of several physicians were aroused by the obstinate declaration by the patient that he was incurably deaf.
On being admitted to the clinic on August 22, he showed complete deafness in addition to a slight degree of stupor; he remained impassive to the glance of his questioner without showing signs of worry about his condition, nor did he make any effort to make himself understood by making lip-movements (which is in contrast to another patient affected by organic deafness, who on the contrary made great efforts to understand anything said to him, clearly showing his great grief over his incapacity).
He failed to respond to auditory stimuli either by air or by bone conduction. It was possible from the beginning to exclude suspicion of simulation; during the day, indeed, it was not possible by any of the repeated attempts to awaken surprise in the patient by means of an acoustic stimulus. At night, while the patient slept, it was possible, however, to awaken him by calling his name, or by making a fairly loud sound; the patient would then open his eyes but was quite unable to hear. Neither confusion nor hallucinations were in evidence.
He was able to converse very well and spontaneously (he remembers having lost consciousness at the explosion of the grenade and not coming to until after his arrival at the hospital at Cervignano); he read correctly both mentally and aloud, and answered by signs the questions put to him in writing. Being face to face with hysterical traumatic deafness, notwithstanding no other hysterical phenomena were noticed, a successful attempt was made with suggestive therapy, the patient being emphatically assured (always in writing) that the following Sunday his hearing would be restored without doubt. The following Sunday, in fact, during the visit of a lady (one of his friends), hearing in his left ear was suddenly and almost completely restored to the patient. He was in profound emotion on account of this, and upon the appearance of the physician he had a hard weeping spell. During the following day, he began slowly to hear with the right ear.
During the latter part of his stay at the clinic, however (until September 24, 1915), a slight hypo-acusia in the right ear persisted, along with severe headaches and pains in the left ear (which the patient compared to the suffering as a child with otitis).
At the otoscopic examination by a specialist, only residuals of the old catarrhal otitis with retraction of the tympanic membrane were found.