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
How could the man have established the synchronism of pulse and
respiration and synchronous tachypnoea and tachycardia? Why should he
persist in this form of sport, since he had already been invalided?
The family history was not especially suggestive (father albuminuric,
died at 59; mother well, probably tuberculous). Scarlet fever at eight;
occupation, tourneur. After four months of service there was gastric
disorder followed by typhoid fever (despite vaccination, according to
the patient). Convalescent leave at Paris, during which leave he had
swollen legs and albuminuria. May, 1915, gastric difficulty; valvular
lesion determined; examination; invalided. At home, a variety of
complaints, for which treatment was unsuccessful.
During further examination it was noted that in auscultation the head
of the examiner was lifted, as if there were hypertrophy of the heart
or an aortic aneurysm. The synchronism was less exact on December 2;
112 beats to 128 respiration. Was this man a simulator? Had he become
the victim of his own enterprise? There was no evidence of simulation.
It was a question of a monosymptomatic hysteria. Gaillard discontinued
the _manière forte_ and undertook a softer treatment, but the _manière
forte_ had caused the family to want to take him away. Perhaps they
feared a too efficacious treatment. He then escaped observation. It is
probable that the tachypnoea ceased during sleep. It was not so marked
after the medical visit was over.
Soldier’s heart.
=Case 138.= (PARKINSON, July, 1916.)
A corporal, 21, who had been a miner and entirely well up to enlistment
in August, 1914, went to France in 1915. In June, came shortness of
breath and palpitation on exertion; later, precordial pain (fifth
space, between nipple and median line) and giddiness on walking. Like
all cases of true so-called “soldier’s heart,” this soldier had no
physical signs indicative of heart disease, yet reported sick for
cardiac symptoms on exertion. In this particular case, as in about half
of forty cases reported by Parkinson, there had been no disability in
civil life.
August, 1915, the soldier was admitted to the casualty clearing
station, where the apex beat was found in fifth intercostal space
internal to the left nipple line. The first sound was duplicated in all
areas. The second sound was duplicated, though not loudly, at the base.
After nine months’ treatment, this man went back to light duty with
slight symptoms.
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