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
Upon examination at Petrograd, the hearing was found diminished and the
eardrum was pulled in. At first the patient could not speak or open
his eyes, and made incessant lateral movements of the head, jerking
backwards and to the right. The right half of the face gave convulsive
movements, which began at the lip and spread upwards. During sleep,
there was an entire cessation of these head shakings and jerks. In
the lying posture, the head shook at a rate of 100 to 120 per minute.
The jerking movements became more marked when the patient sat up or
walked. He carried his head bent toward the right shoulder. When he sat
down, the side-shaking movements disappeared, only to reappear when he
lay down. The swallowing reflexes were absent. The sensitiveness to
touch, pain, and temperature was lost in the upper part of the trunk
including the neck, to the level of the tenth dorsal vertebra. There
was anesthesia of the arms as far as the elbow on the right, and as far
as the shoulder on the left. The mucosae of the mouth were anesthetic.
Dermatographia was strongly marked.
Shell explosion; burial: Hemiplegia, probably organic.
=Case 213.= (MARIE and LEVY, January, 1917.)
A soldier was blown up by a shell and then buried at Vaux, March 29,
1916, and entered the Salpêtrière, July, 1916, with a right-sided
hemiplegia and contracture without evidence of wound. He remembered
nothing for the first fortnight after the trauma. When he came to
himself, he was paralyzed and was unable to say more than a few words,
but at the end of a month his aphasia ceased and he began to walk.
The hemiplegia was spastic. There was pronounced contracture. The
arm was extended, hand open, fingers stretched. Finger movements
were diminished, as well as extension of the wrist, but the arm was
otherwise normal. The leg was not so stiff. The great toe was in a
state of continuous extension. The toes could not be moved, and the
foot scarcely; but the leg could be strongly flexed and extended on the
thigh. The tendon reflexes of the right side were more lively than on
the left. Cloniform movements followed tapping the patellar tendon on
the right side, and a patellar clonus and ankle clonus could also be
demonstrated. Plantar reflex, flexor on the right. Distinct adduction
of the foot. Slight disturbance of tactile sensibility in the paralyzed
limbs; marked disorder of position sense and gross disturbance of
stereognostic sense. Moderate dysarthria.
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