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 treatment was by quinin and potassium iodide, with massage. The
patient was apparently on the highroad to complete recovery, and left
for France March 21, weighing 63 kilos.
Trench-foot: Acroparesthesia.
=Case 132.= (COTTET, September, 1917.)
A fantassin, 36, carpenter by trade, went into the trenches October,
1914, and had two attacks of trench-foot, first in January, 1915, when
there was a painful swelling of the foot and secondly in July, 1916,
when there were some bullae on the dorsal aspect of the feet. These
were not serious and the fantassin did not report sick.
He was wounded, August 27, 1916, by shell fragment on the right elbow,
was evacuated to the ambulance where the fragment was extracted and
then to a hospital which he left cured with a seven days’ leave.
Although he had not suffered in any way from his feet while in
hospital, and had not been exposed to cold, the bullae reappeared on
the feet just as they had been in July. They in fact now formed a sort
of exanthem occupying symmetrically the dorsal surfaces of the toes.
The bullae contained serum. They were confluent, varying from pin head
to a nut in size, were as a rule round, but sometimes irregular. The
eruption went on to a cure rapidly and on the twelfth day the bullae
had dried up. This patient had hypesthesia up to the knees, hypesthesia
of the dorsal surfaces of the feet, hyperesthesia of the plantar
surfaces and ankles, hypesthesia of the forearm and the elbow and of
the dorsal surfaces of the hands with possibly exaggerated sensibility
of the palma surfaces. Hypesthesia of the face was limited to a small
part of the right ear. The reflexes were normal and there was no
atrophy. The name “paresthetic trench acrotrophodynia” was given to it.
In a service of eighty beds Cottet found within two months fifteen
instances of these acroparesthetic disorders regarded as neuritic
changes in trench-foot of a latent and lasting character which would
have remained unobserved unless there were disorders of sensibility. In
fact similar disorders of sensibility may be found without any history
of _gelure des pieds_, forming a latent type of neuritic alteration
hardly noticed by the patient himself. In twenty-six cases Cottet found
sixteen with hypesthesia of the ears and of the nose.
Bullet injury of spine; bronchopneumonia: état criblé of spinal cord.
=Case 133.= (ROUSSY, June, 1916.)
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