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
Pain sense was normal, or possibly slightly in excess. There were
painful points on pressure on the lower part of the os sacrum and
coccyx and over the right sciatic and tibial nerves. Intelligence
examination showed school knowledge to be extremely poor and
calculation ability poor. Critical judgment and reasoning power were
deficient. Memory and perception were without marked disturbance.
The patient was dull and without interest in his surroundings. He
complained that his right leg was as if dead and that he felt great
pain in any attempt to move it. He also complained of pains at night
in the region of the right shoulder and neck. His nerves, he said, had
been very weak since his trip back from the front, during which trip he
had been very cold and poorly cared for.
Treatment consisted of rest in bed, application of moist packs to
the right leg, active and passive exercises of the right leg. After
ten days he made his first independent attempts to walk, and active
movements of the right leg in dorsal decubitus became unrestricted and
painless. He remained somewhat unsteady in station, showing bilateral
twitchings and movements of the right leg muscles. In walking the right
leg was dragged behind in a spastic-paretic fashion. Appetite improved;
spasms decreased; but at the end of December foot clonus was still
persistent.
Upon January 10 there was an odd mental change. He became seclusive and
suspicious. January 15 he expressed ideas of poisoning; his sister, he
said, wanted to poison him, and others were watching him suspiciously;
his room-mates were talking about him; in fact, he thought one comrade
was an Englishman. Sleep was poor. At the end of January, after a short
period of improvement, he again had ideas of being poisoned, and had
dream-like, unclear thoughts. His actions became incoherent: he would
undress suddenly in the daytime and go to bed, getting up five minutes
later and dressing. Senseless postcards were written.
This condition lasted a few days only, whereupon the mental and bodily
condition greatly improved. Daily walks were then taken in the garden
and in the city without exertion. The ankle-clonus on the right side
was now decidedly weaker but did not entirely disappear. The muscle
power on the right side was somewhat less than on the left.
The patient was very homesick, and on March 14 was sent home.
Shell-shock--six days later, crural monoplegia, cured by suggestion.
“Metatraumatic” hysteria. HYPERSENSITIVE PHASE AFTER SHELL-SHOCK.
=Case 234.= (SCHUSTER, January, 1916.)
On August 13, 1915, a soldier was knocked unconscious by the explosion
of a shell nearby. He woke up several hours later with headache, noises
in the ears, itching, but no trace of paralysis.
Public-domain text, read in full here on John Shaqi.
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