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
[Illustration: FIG. 2.--Section of medulla oblongata from case
of gas poisoning, stained by Nissl method, showing the swollen
cells of the nucleus ambiguus. Observe the enlarged, clear,
eccentric nucleus; the surrounding cytoplasm shows an absence
of Nissl granules. In not a single cell is the nucleus seen in
the centre as it should be. (Magnification 450.)]
[Illustration: FIG. 3.--Section of medulla oblongata from
case of shell-shock with burial, stained by Nissl method,
showing the swollen cells of the nucleus ambiguus. Observe the
enlarged, clear, eccentric nucleus; the surrounding cytoplasm
shows an absence of Nissl granules. In not a single cell is
the nucleus seen in the centre as it should be. (Magnification
450.)]
[Illustration: FIG. 4.--Section of third cervical segment of
spinal cord from case of concussion, stained by Nissl method,
showing the medium group of anterior horn cells corresponding
to the nucleus diaphragmaticus. They show certain amount of
perinuclear chromatolysis. But all the cells exhibit the Nissl
granules. Even at the seat of concussion, the fourth segment,
an external group of cells remains showing Nissl granules.
Concussion therefore does not destroy the Nissl granules.
Probably the cells of the nucleus diaphragmaticus show a
certain amount of chromatolysis because they were continually
discharging impulses along the phrenic nerves, and the few
cells that were left of the nucleus had therefore much more
work to do. (Magnification 300.)]
Mott suggests that the sudden death of the case may be due to a
hemorrhage into a sheath of a fair-sized vessel in the median raphe
of the bulb; the general venous congestion; and the almost complete
chromatolysis of the vago-accessorius nucleus (adjacent hypoglossal
nucleus normal).
According to Mott, also, many Shell-shock symptoms, _e.g._, headache,
giddiness, amnesia (anterograde and retrograde), dizzy feelings, lack
of power of attention, and fatigue, stupor, inertia, mental confusion,
terrifying dreams, are to be explained on the basis of capillary anemia
and chromatolytic changes.
Mine explosion. Ecchymoses; no bone or visceral consequences seen at
AUTOPSY (third day after explosion) except SUBDURAL HEMORRHAGE and
PUNCTATE HEMORRHAGES OF BRAIN.
=Case 198.= (CHAVIGNY, January, 1916.)
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