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
To sum up, cases with central lesions (precentral and postcentral
gyrus) have hemiplegia and a Broca aphasia without much tendency to
cure. Cases with lesions anterior to the central convolutions have a
transient anarthria and their recovery is ordinarily complete. Cases
with retrocentral lesions have an aphasia suggestive of Wernicke’s
aphasia, and ordinarily leave behind them extensive defects in
intelligence and language. These cases should be taken account of
from the standpoint of compensation, since they are much worse off
for work than many cases with amputations; and though their disorder
looks slight, it quite interferes with working at a trade. From the
point of view of military effectiveness, the retrocentral cases are not
very good soldiers, and especially not good officers, as they do not
understand commands completely.
Neuropsychiatric phenomena in rabies.
=Case 118.= (GRENIER DE CARDENAL, LEGRAND, BENOIT, September, 1917.)
A farmer, 34, mobilized in veterinary work, fell sick at a station
for sick horses, April 25, 1917. He breakfasted well, drank coffee,
and went to the _abreuvoir_ at eleven o’clock. He told his mates that
he felt bad in his head. He fainted over a table at the eating house,
refused to eat or drink. At noon he went out into the court, vomited
and went to lie down. A physician thought he was suffering from angina
because of the pronounced dysphagia. He entered the hospital at eleven
o’clock at night on the 25th. He was found next morning on his back,
with a fixed and haggard look, crimson face, masseter and phalangeal
spasm at times. Respiration irregular, interrupted by moans. The pulse
would go up to 120 during agitation and then go down to 50 as soon as
the patient lay down again. Pupils slightly dilated and unequal. As
the patient came from a sick horse dépôt, the first question was that
of tetanus, suggested somewhat by the jactitation of the limbs and
the trismus. A violent headache began and the patient cried out, “My
head! My head!” Painful vomiting movements, with very slight bilious
material. Convulsive movements increased. The pulse was slow. The
diagnosis “meningitis” was suggested, despite the absence of fever
and the absence of Kernig’s sign. Lumbar puncture gave limpid fluid
with a normal lymphocytosis, without increase of albumin or reducing
substance. The bacteriological smear and culture were negative.
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