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
This dose was repeated January 2 and January 3, on which date there was
no headache.
January 4, Kernig’s sign and neck stiffness were diminished; fine râles
at the bases without dulness. 30 cubic centimeters of electragol were
injected intravenously.
January 5, Kernig and neck stiffness slight. Meningitic tâche;
exaggerated knee-jerks; unequal pupils; temp. 36.6 morning, 39.4
afternoon; respiration 36; pulse 120; no râles; splenic enlargement.
6, no headache or photophobia; constipation; fine râles, right base;
spartein; meningococci found in hypertensive spinal fluid. 30 cc. serum.
7, more râles; exaggerated heart sounds; intestinal worms in stools.
8, temperature fell to 37; pulse to 90.
9, patient worse; involuntary stools; Kernig’s sign; stiff neck; fever.
30 cc. serum injected.
10, 20 cc. injected.
11, delirious all night; tetaniform stiffness of neck; more râles.
12, delirious, incoherent words, Cheyne-Stokes breathing.
13, less stiffness, Kernig almost absent; pupils normal; Romberg sign
slightly developed; pulse 120.
14, a few râles at right base.
15, pains in elbows, knees and hands with joint swelling; moist râles;
temp. 38.4; pulse 140. Digitalon.
16 and 17, serum erythema of thorax; edema of left knee; pulse 150;
spartein 16.
17, ice pack over heart.
18, edema of knee diminished; no headache, delirium or pupillary sign.
19, improvement. Temperature normal thereafter.
20 and 21, fine râles. Then all symptoms disappeared.
Recovery was predicted, but on January 28 it was observed that the
patient was untidy, made mistakes in dressing, such as trying to put
his legs into the armholes of his shirt, and denied the most evident
facts: His _képi_ on his head, he said it was not. Face drawn; skin
yellow. Appearance of asthenia. Deep depression and hebetude. At this
time the knee-jerks were exaggerated, pupils unequal, vermicular tremor
of tongue; the patient walked on a broad base with tremulous legs
suggesting contracture and weakness.
February 8, in a similar state the patient wandered about his room,
moving his bed and chairs about, answering questions with an absent
air. He had now been taught to be less untidy.
March 5, stiff neck and Kernig’s sign were distinct. He made believe he
was on his farm. Ecchymosis of right upper eyelid: he had fallen (his
sheep had pushed him over!). The improbability of this idea did not
persuade him to think it had not happened. He walked after the manner
of a tabetic.
In April he became bedridden, unable to walk, with marked stiffness and
Kernig’s sign. He had at this time periods of excitement in which he
would tear the bedclothes. He was invalided as demented.
Meningococcus meningitis.
=Case 108.= (ESCHBACH AND LACAZE, November, 1915.)
Public-domain text, read in full here on John Shaqi.
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