Shell-shock and other neuropsychiatric problems : $b Presented in five hundred and eighty-nine case histories from the war literature, 1914-1918Southard, Elmer Ernest
History
Shell-shock and other neuropsychiatric problems : $b Presented in five hundred and eighty-nine case histories from the war literature, 1914-1918
Southard, Elmer Ernest
War neuroses; World War, 1914-1918 -- Medical care; World War, 1914-1918 -- Psychological aspects
It seems as if auto- and hetero-suggestion can be eliminated from the
genesis of these attacks. Neither hysterical nor epileptic crises have
preceded or ever alternated with these seizures. Nevertheless, on the
organic side, the patient had a general increase of tendon reflexes on
the left side, most marked in the knee-jerk, and fell to the left in
voltaic vertigo. There was a left hemiparesis, apparently of organic
origin, which had been determined as far back as July, 1915.
There was no true dementia. Past memories were but slowly recalled,
and inattention interfered with the fixation of recent memory. He
complained of troubles in his sleep and dreamed of war experiences
somewhat analogous to those in his attack of amnestic delirium. After
the seizure, there was a marked hebetude and mental inactivity, torpor,
and a severe headache. The case was presented to a special commission
as one of epilepsia larvata in a person hereditarily predisposed who
had never before presented epileptic signs, suffering from a disease
characterized by frequent short attacks of hallucinatory and delirious
automatism, following shell explosion which had at the same time
produced a slight left-sided hemiparesis and mental inhibition.
To illustrate an epileptic theory of Shell-shock; three cases:
1. Fugue; minor symptoms: later, epilepsy.
2. Epileptic confusion eight months after explosion.
3. Mine explosion: stammering replaced by mutism; mutism
replaced by epilepsy.
=Case 82.= (BALLARD, 1917.)
Atmospheric concussion from shell explosion, October, 1915, was
followed by unconsciousness in a soldier described by Ballard.
Blindness for a month followed recovery of consciousness.
“Neurasthenia” (anxiety neurosis) after return of sight. Apparently
nearly complete recovery after latent period of a few weeks. Return of
blindness in one eye in December. Five days automatic wandering (the
man was found in a west country town five days after leaving home to
rejoin his dépôt and seen by a medical officer who reported that he
was dazed and amnestic for that period); admission to second Eastern
General Hospital, December 15.
On admission he proved to be suffering from minor hysterical symptoms
such as an inability to open his eyes and to see clearly when the
lids were raised. The symptoms rapidly cleared up under suggestive
conversation and did not return except for amnesia and slight emotional
depression. He remained well until December 25. On that day he began
for the first time to have definite epileptic fits and nocturnal
epileptic delirium. In January he was discharged as an epileptic. There
was no epileptic temperament or feeblemindedness. Finally, there had
never been any personal or family neuropathic or psychopathic history.
=Case 83.= (BALLARD, 1917.)
A soldier was blown up, April, 1915, and had a spell of
unconsciousness. Later, pains in the head, slight amnesia and a
condition of asthenia developed.
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