Shell-shock and other neuropsychiatric problems

A grenadier, 21, of healthy stock, physique, and habits, lost his speech, April 15, 1916, five weeks after going into the field. May 5, examination showed him a well-nourished healthy man (lively reflexes and slight dermatographia), able to communicate only by signs and writing. The laryngoscope showed almost complete immobility of the two vocal cords, which lay in the cadaveric position, as in paralysis of the recurrent nerves. In endeavoring to pronounce the vowels ā and ee the cords trembled but failed to move toward each other. The patient’s effort to speak was such that his head soon got deep red and sweat streamed from the forehead.

Speech exercises were started by passing the electric current through the larynx during the processes of laryngoscopy. The patient was meantime assured that his larynx was healthy and that he would soon learn to speak again. At the first sitting, the patient felt himself able to cough aloud.

After a few days, the patient was able to speak the separate vowels tolerably well, and was then made to go on with such words as Anna, Otto, Hurrah. The vocal cords began to move better. Fatigue was a feature of the first treatments, of such a degree that words that could be pronounced during the first part of the sitting were lost toward the close.

The grenadier assiduously set himself to say over and over again the words that he had learned, and would come to the sister radiant with joy at his success. In ten days he was able to speak again perfectly, though giving the impression of a slight stuttering. After three weeks hospital stay he was discharged cured and fit for service.