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
At first able only to bring himself to an upright position and to rush
a few steps, he later acquired considerable control of his feet and
legs through crutches. The insomnia persisted.
Smyly regards this case, like Case 116, as more neurological than
mental.
_Re_ organic neurology, much of great value has been reported.
Sargent and Holmes say that, contrary to expectation, there have been
few war cases of bad sequelae of cerebral injuries, such as insanity
and epilepsy. During early stages, after infection of the head wounds,
there is dulness and amnesia, irritability and childishness,--symptoms
which disappear during and after repair of the wounds. Mental disorder
requiring internment is surprisingly rare. During 12 months only eight
cases were transferred from the head hospital in a year to the Napsbury
war hospital, where cases of insanity attributable to the service are
sent; and in but two of these could the persisting mental symptoms be
attributed to head injury.
Col. F. W. Mott confirms the opinion of Col. Sargent and Col. Holmes,
remarking that from all the London County Council Asylums, only one
case of insanity associated with gunshot head wound had been admitted,
and that this was one of a Belgian who died from septic infection
of the cerebral ventricles. Yet all cases of insanity in invalided
soldiers belonging to the London County Council area (about one-seventh
of the population of the United Kingdom) are transferred to these
asylums.
Again Sargent and Holmes point out that both generalized and Jacksonian
epileptiform seizures are comparatively rare in patients suffering from
recent head wounds; even convulsions in later stages have been as yet
less common than was feared. Thus, after evacuation to England, fits
occurred in 37 (6 per cent) of 610 cases with complete notes, and in
only eleven of these 37 cases were the convulsions frequent. Sargent
and Holmes remark, however, that the practice of giving bromides
regularly to all serious cranial injuries until the wound is healed,
and for some months afterwards, seems advisable. In 33 of the 37
convulsive cases there have been severe compound fractures of the
skull, and in four of these a missile was still present in the brain.
Five secondary operations were performed with good results, after
drainage of small abscesses in two and removal of spicules of bone in
three. The In-patient and Out-patient records of the National Hospital
for the Paralyzed and Epileptic were searched for epileptics already
discharged from the army, but notes of but two patients attending this
hospital for epilepsy were found.
Public-domain text, read in full here on John Shaqi.
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