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
In fact, Mendelssohn found a complete flaccid paraplegia with urinary
retention, without fever or pain. Knee-jerks and Achilles jerks were
absent, and there was a slight extension of the great toe on plantar
stimulation. There was disorder of sensation, with heat sensibility
abolished, painful points poorly localized, and position sense poor.
Electric reactions normal. Pain on pressure in and about the lumbar
vertebral region. Cerebrospinal fluid showed lymphocytosis and an
excessive albuminosis.
This paraplegia lasted six weeks. At the end of May, the patient began
to be able to move his toes and to lift his heel. Improvement was
gradual and progressive. Early in June he could walk if supported.
The weak knee-jerk then began to reappear and the urinary retention
gradually disappeared.
This patient was not hysterical, although a bit emotional. Perhaps,
according to Mendelssohn, an organic lesion was grafted on a neurosis.
Perhaps the spinal lesion was infectious. At any rate, a presumably
organic paraplegia had recovered in two months and a half.
Shell-explosion: Meningeal hemorrhage: Pneumococcus meningitis.
=Case 112.= (GUILLAIN AND BARRÉ, August, 1917.)
An infantryman, 20, came to the Sixth Army Neurological Center, October
13, 1916, as a case of “choluria, due to shell explosion; epistaxis
needs watching.” He was somnolent, had waked vomiting, pulse 108.
Kernig’s sign, defensive movements of the legs on stimulation, with
flexion of leg on thigh and of thigh on pelvis, plantar reflexes
flexor. Puncture showed typical meningeal hemorrhage. Two days later,
temperature 40, pulse 70, that is to say, a bradycardia in proportion
to the fever. Vomiting, pulse persisted. Next day the patient was
moaning and semi-delirious and showed stiff neck, Kernig’s sign,
accentuation of vasomotor disorder, plantar response flexor with leg
retracted, thigh flexion both homolateral and contralateral. The
spinal fluid upon the next day, that is, four days after his arrival
at the clinic, showed a purulent fluid in which there was an excess of
albumin, no sugar, diplococci extracellular (proving on culture to be
pneumococci and able to kill a mouse in twenty-four hours).
As a rule such hemorrhages remain aseptic, and in fact meningeal
hemorrhage is said by Guillain and Barré to have, as a rule, a
favorable prognosis. The above described case was the only one of
infected meningeal hemorrhage that had occurred in the Sixth Army
Neurological Center.
ANTEBELLUM cortex lesion: right hemiplegia; recovery. Struck by
shrapnel on right shoulder: Athetosis.
=Case 113.= (BATTEN, January, 1916.)
Public-domain text, read in full here on John Shaqi.
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