Case 557. (Gradenigo, March, 1917.)

An Italian infantryman was buried under Mt. Zebio after shell explosion. After 24 hours he was found and dug out. He remained unconscious for 13 days and came out absolutely deaf and mute.

At hospital he was markedly depressed and cried very readily on being spoken to. The tympanic membrane had lost its sensitiveness to pain. As for the speech mechanism, the larynx proved negative. All the movements of the soft palate, tongue and vocal cords could be normally performed. The tongue was anesthetic to touch, but the taste function was perfectly preserved. The cheeks and various parts of the face were also anesthetic to touch, and the lobules of the ears could even be pierced with large pins without reaction by the patient.

He tried to pronounce labials, opening and closing the lips rapidly; but the expiratory movement was too weak, and not a single sound was made.

At the patient’s request, he was chloroformed. During a very violent excited phase, he did emit groaning sounds. The narcosis, however, did not put an entire stop to the mutism, since only a few inarticulate sounds could be emitted, and those only after great efforts. Curiously enough, however, the chloroform narcosis had caused the deafness to disappear entirely. Another narcosis upon the patient’s insistent request was given but remained without results, and at the time of report, the patient though cheerful and intelligent-looking, was still mute.