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
Fourth: Lesions of the lateral-frontal region produce more or less
marked aphasic disorder, just as do those of the inferior part of the
precentral gyrus. This aphasia is more apt to occur when the wound is
deep. However, no case of permanent aphasia has been observed in cases
of lesion of the lateral-frontal region (termed in Foix’s nomenclature,
the precentral region, but referring to the tissues in front of
the precentral (or ascending frontal) gyrus of the more familiar
nomenclature). Almost absolute, or absolute, anarthria follows the
wound, and the patient is hemiplegic. This hemiplegia may last from ten
days to two or three months. After a time there is no longer more than
a slight dysarthria, and writing becomes good again; reading remains,
perhaps, a little difficult. A complete or almost complete cure is the
rule.
Fifth: When the retrocentral region is injured, various aphasic
syndromes appear. The retrocentral region is the parietal-temporal lobe
except the superior part of the parietal lobe and the anterior part
of the temporal lobe, which latter two regions when injured do not
allow any marked aphasic disorder. Lesions of the middle or posterior
temporal region are particularly important for speech, and produce more
marked disorder than lesions of the angular gyrus or the supramarginal
gyrus. At first, words cannot be spoken, for a period of a fortnight
to three months. Speech returns progressively, with an increased power
of comprehension. At the same time, the patients begin to read and
write. But there is no further spontaneous progress after a period of
six or eight months, and then special reëducation must be started.
These speech disorders of retrocentral (parietal-temporal) origin are
either aphasic syndromes or slight remains of psychical disorders,
or again, a disorder practically limited to alexia. The true aphasic
syndromes concern the spoken word, understanding the words, writing,
and calculation. The disorder is not especially dysarthric and consists
particularly in loss of vocabulary. It might be called an amnestic
aphasia (Pitres). These cases have well-marked intellectual disorder
and their power of calculation is especially poor. As to the aphasic
traces, which are more important to understand than they are extensive
in point of fact, they relate particularly to calculating power, to
vocabulary (slowness in finding words), and to reading (reading without
comprehension). As to the cases of alexia, these are cases of lesions
of the posterior part of the parietal-temporal lobe, and are usually
accompanied by a hemi- or a quadrantanopsia.
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