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
Ten months after the traumatism, the hemiplegia and spastic walk
remained. The upper limb was now carried in extension back of the
body, with hand supinated, fingers sometimes in extension, sometimes
in flexion, index finger separately from the others. Finger movements
difficult and shoulder movements limited. The leg, however, was almost
normal except that the toes could not be moved. The tendon reflexes
were more lively and cloniform on the right, but there was no longer
patellar or ankle clonus. Stereognosis slow, but finger movements were
naturally difficult. W. R. of blood, negative. Probably this is an
organic case.
Blown up by a shell; no skin or bone lesion: Mixture of organic
(_e.g._, lost knee-jerks) and functional (_e.g._, urinary retention)
disorders.
=Case 214.= (CLAUDE and LHERMITTE, October, 1915.)
A man, 38, was blown up in a trench without sustaining skin or skeletal
lesions, April 5, 1915. He lost consciousness for a half hour and,
coming to, found a crural paraplegia and urinary retention. Examined
July 24, in addition to the paraplegia were found tactile and algesic
hypesthesia of the legs with preservation of deep sensibility. Pains
were felt in the legs, especially in the hips. The knee-jerks were
abolished; the Achilles jerks were preserved, as well as the flexor
plantar reflexes and somewhat weakened cremasteric and abdominal
reflexes. Micturition was difficult. Constipation. Slight paresis of
left arm. Lumbar puncture, July 28, yielded a clear fluid of normal
tension without chemical or cytological changes.
The sphincter disorders gradually disappeared. The knee-jerks
reappeared in a weakened form August 31. The legs could, at the time of
report, be moved somewhat, though not above the level of the bed.
We here deal, presumably, with a mild form of concussion of the spinal
cord, in which, however, some of the transient symptoms are very
possibly merely functional in origin.
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