Shell-shock and other neuropsychiatric problems

A corporal, 20, was exposed to the shock of an aerial torpedo, January 18, 1916, at Souchez. The torpedo fell a meter away. There was no loss of consciousness, but the patient was agitated for several hours, not knowing what he was doing. Evacuated to hospital, he remained several days in a stupid state. He was completely deaf and remembered poorly what had happened. He made every effort to speak, but could not. His head felt on fire. He could not open his mouth well and his lower jaw was almost in a state of contracture. He felt that his tongue could not move easily. In this status he remained until February, always trying to talk, but not succeeding.

He then arrived at Hôtel-Dieu. The mouth was now opening better and he was in a better general status, though always feeling fatigued. Vibratory massage was given to the laryngeal region. He was gradually got to emit a few sounds in a low voice. He was sent, April 26, to Prés-à-goutrière. He was now somewhat vocal, but at times would become completely aphonic once more. The voice during the first few weeks of treatment became better, and the respiratory capacity was increased from 450 the first week to 460 and 500 in the next two weeks.

May 12, he suddenly lost his voice again and wanted to commit suicide. However, in three more days he was able to speak normally again and has had no relapse. He was then put under auditory reëducation and at the time of report his hearing had slightly improved.

Liébault remarks that during the time when the patient could not speak his jaw muscles were contracted and his tongue could not mobilize well. He could think words but could not articulate them. It was accordingly important to cultivate the normal functioning of these muscles.