Shell-shock and other neuropsychiatric problems

An Italian peasant began to feel sick on being called to arms. Antebellum he had been an even-tempered, good-natured man, according to his own story, satisfied even with stale food, and always enjoying his sleep. He had been in the war about a month, doing construction work, sentry duty, and chores. Though he lived in the trenches under damp conditions, there had really not been much excessive war strain. He shortly developed migraine and war-weariness, as well as middle-ear disease.

A number of times he heard shooting nearby, and was subject in his sentry duty to a good deal of anxiety and painful associations. On sentry duty he had digestive disorder, vomited, and became intolerably weary; in point of fact, a fever, regarded as malarial, then developed, together with diarrhea.

Upon hospital observation, he was found fatigued, given to terrible dreams, tremulous in the fingers, with skin reflexes a little excessive, and the Moebius phenomenon. The thyroid was somewhat swollen. The pulse stood at 80. The Mannkopf sign was well marked, as well as that of Thomayer (80-120), and Erben (120-87). The oculocardiac reflex was prominent.