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
A man in service ten months, under strong excitement and at times under
protracted shell fire, complained of palpitation, insomnia, dizziness,
and dyspnoea. Hospital notes showed that the left lobe of the thyroid
was somewhat enlarged. Before the war his neck could not have been
very thick; he had served his year out without difficulty. His mother
is said to have suffered at one time from thick neck. According to the
patient, he had never suffered with heart trouble. Heart not enlarged;
blowing first sound over the apex. Graefe, Stellwag and Möbius signs
negative. Heart rapid, not irregular; pulse strong. There was fine
tremor of the hands, as well as a tremor of the tongue. Knee-jerks
increased.
The patient was at first sleepless and excited, but after three weeks
in bed the heart murmur had disappeared. After three months, he was
ordered to _Ersatz_ with the left side of the neck measuring 20 as
against 18 cm. on the right. There was a soft pulsating swelling of the
thyroid. First sound over apex still impure; heart action now regular;
pulse 64; blood pressure 120 Riva-Rocci; after test exercises, slight
dyspnoea. No cyanosis. The outstretched hands were no longer very
tremulous. The knee-jerks were still increased. The man had begun to
sleep well. His neck was apparently much diminished in girth.
Here then was a case of Graves’ disease of acute development, brought
out by nervous stress and excitement as well as by 10 months of war
work and exposure to shell fire,--with approximate recovery after three
months of rest.
Graves’ disease, forme fruste.
=Case 145.= (BABONNEIX AND CÉLOS, June, 1917.)
Public-domain text, read in full here on John Shaqi.
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