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
After a few days of essentially suggestive treatment with continued
attempts at passive movements of the contracted joints (knee, ankle,
toe), with steady concentration of the patient’s attention upon the
joints, a slight mobility in the toe joint on passive movement was
obtained.
After a few more days, the ankle became passively mobile to some
degree; the patient exerted a certain resistance to passive flexion
of toes and ankle. A week later, reflex contractions of the toes
could be evoked by deep pin-prick. There had been an analgesia of
both lower thighs and of the soles of the feet, and this analgesia
remained unchanged. At this point, the subjective complaints of the
patient, namely, noises in the head, especially in the left ear, and
other cephalic sensations, tended to disappear and the patient felt
subjectively better; yet there was still an intolerable itching of the
head and spine.
A month after the admission of the patient to the nerve hospital of the
psychiatric clinic in Jena, there had been no essential change in the
immobility and contracture in extension in the left leg. Accordingly,
with the permission of the patient, he was placed in deep chloroform
narcosis, and the knee-joint was bent at a right angle and fixed in
approximately that position with a bandage. This experiment failed
because, while the patient was waking out of his narcosis, the leg
slipped back into extension, breaking the bandage. Accordingly, deeper
narcosis was undertaken, and the leg fixed at a right angle in a
plaster cast.
While the patient was coming out of narcosis, it was evident that he
had been dreaming of battle scenes. In fact, Binswanger remarks that
these dream pictures and the words spoken while going under and coming
out of narcosis, are curiously demonstrative of “_sympathy with the
enemy_,” for while waking out of narcosis, he cried: “Dost see, dost
see the enemy there? Has he a father and mother? Has he a wife? I’ll
not kill him.” At the same time, he cried hard and continually made
trigger-movements with his right forefinger.[6] In point of fact,
throughout his waking treatment, no one was able to learn what was
going on in his mind, his sleep was good and deep, and his emotional
state was entirely quiet and patient.
[6] Compare sentiments of a Russian in narcosis (Case 319,
Arinstein.) See also Case 181 (Steiner).
As the patient was coming out of chloroform and regaining consciousness
of his surroundings, he was repeatedly and persistently assured that
the bending of his leg was now accomplished and the cramp removed. All
that he would now have to do was to get back the strength of his leg.
Public-domain text, read in full here on John Shaqi.
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