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
The patient said that he heard less well on the left side. There was
also a slight contraction of the left visual field. The reflexes
were lively, but equal on both sides. A diagnosis of hysterical
hemianesthesia was apparently called for, but psychoelectric treatment
failed. The plantar reflex was, in fact, completely absent on the left
side, as well as the corneal reflex. The faradic current failed to
produce as marked a dilatation of the pupil on the left side as on the
right. The forehead wrinkles were less marked on the left side. The
mouth deviated slightly to the right. The left nasolabial fold was a
little less marked. The tongue did not deviate, but was a little narrow
on the left side. The palate deviated a little to the left. The left
side of the trunk seemed a little less developed than the right, and
the scapula stuck a little less closely to the body on the left side,
when the arms were raised. The left buttock was a little narrower than
the right and the left gluteal fold was less marked. In combined
flexion of thigh and trunk the left foot readily left the floor. There
was a left-sided hypotonia in forced flexion of the forearm. There were
no tremors of the limbs in repose, except a few contractions of the
left lower extremity. In movement, however, there was a marked tremor
and in coördination the finger to nose test could not be performed.
Speech was slow and hesitant, sometimes stuttering. Food was sometimes
taken into the air passages. Headaches were localized on the right
side. They had begun when the first symptoms began. There was mental
disorder, with gaps in memory. In short, the case is probably one of
thalamic disease, though there were no pains except a few in the left
side of the trunk at the beginning of the disease. The diagnosis of
hysteria was at first made in this case, but the rule that hysterical
hemianesthesia is never found without auto- or hetero-suggestion caused
the alteration of diagnosis to thalamic.
Shell-explosion: Syndrome suggesting multiple sclerosis.
=Case 115.= (PITRES AND MARCHAND, November, 1916.)
A soldier, 40, carriage painter, underwent shell-shock at Voquois,
May 2, 1915, following ten hours’ bombardment. At the time he felt
tinglings. The bombardment had just ceased when he fainted suddenly
while repairing a telegraph line. There was no loss of consciousness.
He could not move his arms or legs, was able to spit, and did not
suffer at all except for the tingling. He was evacuated to the
interior, where the diagnosis of psychopathic double paraplegia,
Kernig’s sign, zones of anesthesia in the legs, was made. He
was immediately treated with gray oil, and got an injection of
neosalvarsan, and iodides. He grew slowly better. He could lift a
leg from the bed, but then both legs began to tremble. The arms had
recovered their movement, before the legs, but always trembled in
movement.
November, 1915, he was able to get up; two months later, he walked
alone.
Public-domain text, read in full here on John Shaqi.
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