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
He carried on there for a fortnight, always trembling, but not eating
and no longer able to handle a gun. He was evacuated a month later
and sent successively to Villers-Cotterets, to Meaux, to Courneuve
(a month), again to Meaux, and finally to the neurological center at
Villers-Cotterets, where he remained for two months (April 13 to June
15, 1915). Here he was given the diagnosis of hysterical chorea by
Guillain, and showed lively knee-jerks and Achilles jerks and great
emotionality. The tremors were greatly increased when the cannon grew
loud or bombs burst nearby. Lumbar puncture here showed a perfectly
normal spinal fluid. He was then sent to the Salpêtrière, June 19,
1915, and was evacuated July 13 to a civil hospital until September 24,
whence he was sent for convalescence to his home village, October 6 to
December 15, from which he was returned to the Salpêtrière.
Throughout these transfers there had been no change whatever in his
status. For almost a year, as the result of a shell explosion, he had
been trembling in precisely the same way. All four extremities trembled
equally, unless the right arm and the left leg might be thought to
tremble a bit more. The tremor was equally pronounced in dorsal
decubitus as in the sitting or upright postures, but ceased during
sleep. The tremors were worse in the evening and it was hard for the
man to get to sleep. The eyelids and tongue showed a few irregular,
jerking movements, not synchronous with the tremor of the extremities.
The head showed few tremors. The patient was able to diminish the
trembling of the arms somewhat by keeping the elbows flexed at a right
angle and held firmly to his body. If the tremor of the legs got more
energetic, the patient would get up and take a few steps. Any movement,
such as laying hold of an object, carrying a spoon or a glass to the
mouth, led to an exaggeration of the tremors in such wise that the
tremor of multiple sclerosis in its most extreme form was recalled.
It was very hard for the man to eat. If the eyes were closed, the
tremors grew more marked. The emotion caused by sudden noise or sharp
command or memory of his trench life caused motor crises, with coarse,
generalized movements, and even loss of balance. This agitation grew
gradually less marked, but the tremors persisted. An attempt to test
reflexes led to violent generalized contractions. There was no sensory
disorder. The pulse was variable; at rest it stood at 60; if a table
near by was struck suddenly, the pulse would go up to 120.
Sharp gunfire: TREMORS; TREMOPHOBIA. A patient’s (an artist)
description of his feelings.
=Case 225.= (MEIGE, February, 1916.)
Public-domain text, read in full here on John Shaqi.
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