Shell-shock and other neuropsychiatric problems

An Italian soldier of the Class of 1895, a peasant (family healthy; non-alcoholic; good scholar) was, July 19, 1915, helping drag a heavy cannon up hill. The big gun slid, hit several men, and grazed the patient, making a slight abrasion on his leg. He immediately lost consciousness, and arrived at the camp hospital in a stupor, which lasted so long that catheterization was necessary.

A week later he was observed in hospital, immobile and non-reactive, with a swollen abdomen and fecal impaction. The pupils were widely dilated and reacted poorly to light. The corneal reflexes were absent, and the nasal mucosa was anesthetic. Pulse 50. The patient failed to eat. Next day there was no change in his condition. He was quiet throughout the night.

On the morning of July 29, a number of answers were obtained to questions put in a loud voice, though he was unaware of much more than his name, being ignorant of the name of his country, his age, his division, where he had come from, what had happened to him, or where he was. He had now begun to eat spontaneously.

During the following days, up to August 4, the amnesia gradually dissolved for the facts before the trauma. He remembered having been greatly frightened at the time of the accident but could not remember the accident itself, and the gap for subsequent events was still complete. The pharyngeal reflex was still poor. August 5, he began to remember the details concerning the accident. About the middle of August there was no longer any diminution of hearing and ideation became more free and rapid.