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
Fernand and Emilienne were two recidivists in morphinism. Although
neither was over 22 years of age, both had been several times convicted
of shop-lifting. They stole only if they had no money for morphine.
Prostitution served to care for Emilienne, while Fernand was at times a
cocaine seller, and at times made money in devious ways at Montmartre.
Emilienne’s patronage scattered with the war, and it was the same with
Fernand’s. Accordingly, there was no money for either morphine or
cocaine. Moreover, the shops being not crowded were easier to watch. As
Emilienne did not care to be arrested and sent off as an undesirable,
she presented herself at the hospital for the insane at Sainte-Anne.
Fernand shortly joined her there.
V. ENCEPHALOPSYCHOSES
(THE FOCAL BRAIN DISEASE GROUP.)
Left-sided hemiplegia and aphasia: Contrecoup and local lesions.
=Case 103.= (LHERMITTE, June, 1916.)
A soldier of 23 was wounded in the left parietal region and showed a
_left_-sided hemiplegia with aphasia. The speech difficulty, although
very marked, retrograded almost completely, but the hemiplegia remained
severe. This hemiplegia was a spastic one, of a classical nature, with
Babinski sign and exaggeration of tendon reflexes. Lhermitte thinks
that the left hemisphere was directly affected by the contusion, as
in point of fact there was an actual loss of bony tissue, but that it
would not be necessary to suppose the ipsilateral hemiplegia was due to
an absence of pyramidal decussation. The transient aphasia was probably
due to direct affection of the tissues on the left side of the brain;
the permanent hemiplegia was doubtless due to a lesion of the opposite
hemisphere produced by contrecoup. It appears that sometimes a surgeon
may be led to superfluous surgical intervention in a case of such
paradoxical hemiplegia, since the surgeon may believe that a bullet
or shell fragment has traversed the brain substance to the opposite
side of the skull, when as a matter of fact the brain parts have been
injured merely by contrecoup.
_Re_ such amnesia, it is of note that many head cases, even if they do
not show amnesia, show a conspicuous euphoria and lack of understanding
of the seriousness of the injury in question and of the necessary
treatment. According to E. Meyer, there are constantly to be found
in head cases disturbances of perception and lack of coördination
(especially for time), perseveration, difficulty in thinking and
calculating.
CHART 5
COMMOTIO CEREBRI
I. SENSES: Asymmetrical hyp- or anesthesia (with hyperalgesia
and osseous hyperesthesia).
II. MOTILITY: Disorder, muscular or reflex. General or
unilateral hyperexcitability.
III. VASOMOTOR CONTROL: Dermatographia. Cardiac, splanchnic
disorder; also, Headaches, Vertigo.
IV. EMOTIONS: Disorder.
V. INTAKE OF IDEAS: Disorder. Persistent lacunae of memory.
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