Internal means on the inside and external means on the outside.
When he says he is alone, he means that he is abandoned by God. He is in a concentration camp, where he is forced to witness death almost every day, and he cannot do anything about it. However, nobody even tries to do anything - there is no sense of solidarity and fighting for freedom; there is no friendship in the camp; there is no sense of community, so even though he is surrounded by many people, he is ultimately alone given that he doesn't care about them and in turn they don't care about him. Also, he believes God has 'left the Earth' given that he doesn't even try to help his creations.
underlined, in the center of the page
Answer:
The principal scattered the prizes
Periodically throughout recorded history, puzzling instances of psychiatric and neurologic symptoms have presented en mass<span>: outbursts of thrashing and screaming, or je rky spasms and abrupt vocal tics affecting a group of individuals at once and often attributed to causes like possession, witchcraft, and malingering. Such occurrences of so-called "mass hysteria" continue to confound the medical community, but growing experience has improved the understanding and approach to these seemingly contagious psychogenic events. </span>
