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
Soon another sort of symptoms appeared. The patient would rise, cry
out, threaten his neighbors. He was calmed with morphine. There were
periods of excitement alternating with periods of calmness, during
which he would reply sharply but accurately, being somewhat vexed by
the questions, and would walk up and down without offering a word. When
a glass of water was offered to him, as soon as his glance met the
glass his eyes expressed fear. He drew back in repulsion and cried out
in terror. When the liquid was out of his sight the hydrophobic spasm
ceased. This hyperesthesia of the sensorium was so intense that the
mere sight of the shining glassware of the laboratory brought out a
sharp crisis.
He was sent that evening to the neuropsychiatry center, walking jerkily
and as if slightly drunk, with a number of small gesticulations and
murmurings. He was immediately isolated, undressed himself and went
to bed. He did not move in his bed, and seemed to sleep. The next day
he got up, dressed and had a small spell of excitement, but was quiet
enough on the medical visit, though the floor was soiled with urine
and vomitus and the clothing was in disorder. He now had a pronounced
phase, deep sunk eyes, drawn features and anxious look; dilated pupils
and an expression of mixed fear and anger. His breathing was hard and
he kept his hand on his heart. He was oriented. He suddenly rose and
said, “I am thirsty.” A glass of milk was given him. He hesitated a
moment, plunged his mouth and hands into it and aspirated the drink
without making any swallowing movements. He pushed away the glass, spat
a little, and vomited a small quantity of a black liquid. Then followed
an anxious crisis, and he fell upon his side, absolutely immobile,
without breathing for a few seconds. Again in the sitting posture, he
was taken with contractions of the limbs and face. The tendon reflexes
were at this time normal.
A quarter of an hour later the attendant found him dead, in the sitting
posture, leaning against the wall, mouth open, arms dependent, hands
extended, pupils dilated--a death in syncope. The brain was found
congested. There was a slight effusion of blood over the posterior
aspect of the brain. There were no hemorrhages or softenings in the
brain substance. The muscles were of a dark red to black. The adherent
lungs were very slightly congested at the base. The stomach contained
a quarter of a liter of black, inodorous fluid in which there was
much bile and little blood. There were numerous small hemorrhages of
the mucosa near the great curvature. The spleen was large, the liver
congested. The Pasteur Institute confirmed the diagnosis of rabies.
There is no history of the man’s having been bitten by a dog.
Tetanus: Psychosis.
=Case 119.= (LUMIÈRE AND ASTIER, 1917.)
Public-domain text, read in full here on John Shaqi.
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