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 man was slenderly built, of medium height, in moderate
nutrition; pale of face and mucosae; pulse small, regular, and 114.
Neurologically, the deep reflexes were generally increased, and the
skin reflexes decreased. Percussion on the back of the head elicited
marked pain. There were no pressure points. The movements of the arms
were free; there was a marked tremor of both hands, more marked on the
right. The left grasp was 45, the right, 20, by the dynamometer.
When lying upon his back, the patient could move his legs, but he
moved them only slowly and with tremor. The heel-to-knee test was
successfully executed despite the tremor; nor could it be demonstrated
that there was a genuine ataxia. Placed upon his feet, he would
collapse, nor could he be made to walk at all. With trunk supported,
he was able to make only a few unsuccessful attempts to drag the feet
forward.
Associated with this apparent paralysis, the sensitiveness to touch
had entirely ceased in the legs, as well as sensitiveness to pain. The
zone of analgesia, however, was more extensive than the anesthesia,
spreading upwards three or four cm. farther in front. Ticking of the
watch could not be heard even at the meatus of the right ear, although
hearing of the left ear was entirely normal; bone transmission on the
left side. Whispers could be heard close to the meatus. On speaking,
the patient stammered in starting sentences.
He looked extremely anxious during the first few days in the Jena
wards, claiming that he could not raise himself. When his trunk was
raised, he would let himself sink feebly back into dorsal decubitus.
However, when believing himself unobserved, he was found to be able
to move himself in bed somewhat quickly. He was able to get a box
from beneath the bed, to open the drawer of the night-stand, and to
take remarkable care of his moustachios. He complained more and more
of headache, though his appetite and sleep were good. He was often
irritable.
Treatment at first consisted of cold packs of the legs twice a day,
salt-water baths, active and passive exercises of the legs in the
position of dorsal decubitus. The patient declaimed against this
treatment. There was slight improvement after a week of treatment. He
was then able to raise himself in bed, seat himself on the edge of
the bed, and stand without support, all the time, however, groaning
and moaning. After a few moments, he would fall back on the bed,
complaining of violent headache and dizziness. While standing, both
legs trembled.
Antityphoid inoculation: Neurasthenia.
=Case 180.= (CONSIGLIO, 1917.)
Public-domain text, read in full here on John Shaqi.
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