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
On recovering his senses, he could not get about, as he had lost his
memory, having to write down his room number and be warned of meal
times. He was led about like a child. He had a continuous headache on
the right side and pains in the occiput and along the spinal column,
as well as in the right leg as far as the heel. These leg pains were
lightning pains. Walking was difficult, staggering, leaning to left.
Weakness of right arm and leg; right-sided hemianalgesia. Complete
insomnia. During November there were frequent urgent desires to urinate
day or night. Evacuated to the oto-rhino-laryngological center in
Bordeaux, December 13, for examination of ears. The right ear was
found normal, but there was a rupture of the left tympanum. There was
at this time a trismus. The jaws were opened with the dilator and the
man had a syncope during this operation. The question of surgical
intervention for a cerebral lesion was raised, but he was first sent to
the neurologists at Bordeaux. There, December 31, he was found with a
facies of anguish, unstable gait, inclination to the left in walking;
no Rombergism; occasional dizzy spells. In walking, the right foot was
pointed outward and on request to direct it forward he complained of
pain in the loins, reaching as far as the scapula. Walking with eyes
closed, he leaned to the left and lost balance. With eyes open, no
disorder of balance. With eyes closed, the body leaned backward. If
requested to go back, he failed to flex his legs to keep balance. If he
was asked to put a foot upon the chair in front of him, he immediately
fell backwards. He could not support his body on the right leg more
than a few moments. He had difficulty in raising both legs from the bed
at one time and he could lift the right leg not so high as the left.
Movements of the legs were performed hesitatingly and slowly and with
greater difficulty with eyes closed.
He could not thread a needle and could hardly dress himself. Eyes
closed, he could with difficulty perform the finger to nose test; eyes
open, with much less difficulty. Adiadochokinesis; muscular strength
less in right than left; plantar reflexes absent; knee-jerks lively;
hemianalgesia, right side. Loss of deep and bony sensibility on right
side and diminution of testicular sensibility. Retraction of visual
field, right; diminution of smell and loss of hearing, right; position
sense absent on this side; stereognostic sense preserved. Mentally,
memory was poor; he was unable to read or do mental work. He slept
little and had bad battle dreams. He was very impressionable and
emotional and constantly complained of occipital pain. He had lost 8
kilos weight.
He grew gradually better. In May he could go out alone. The muscular
strength increased. The adiadochokinesis and synergic disturbances
lessened; the hemianesthesia persisted. In June there was greater
improvement; in fact, there was no sign of disorder left except
irregular sleep.
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