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
Six days later, on August 19, he was released from hospital, still
free from paralysis. On the railway journey he met some people of his
district by whom he sent greetings to his wife, meanwhile becoming
greatly excited. When he tried to get out of the train he noted a
weakness of the left arm and left leg; this weakness somewhat quickly
grew into a severe paralysis, so that when observed in Berlin the left
leg was entirely paralyzed, not a single muscle of which could be
moved when the patient was examined by Schuster one month after the
accident. There was also a hypesthesia on the left side with total
anesthesia of the left leg, which anesthesia was related stocking-wise
to the hypesthesia of the trunk. There was tremor of the hands as well
as generalized increase of reflexes. The plantar reflex, though weak,
was flexor. The pulse rapidly ran up under excitement. In short, the
patient seemed to be suffering from hysterical palsy. Waking suggestion
did so well with the man that after three weeks normal sensibility was
restored to the leg, and he could walk tolerably well without a cane.
The point of interest in this case is that the symptom of greatest
importance, namely paralysis of the left leg, did not arise until six
days after the shell explosion and then only after the man became
excited by thoughts of his home and family through meeting his town
people. The term _metatraumatic_ is suggested by Schuster for cases
of this sort. The emotions and stresses of war may be regarded as
_labilizing_ and _sensibilizing_ the nervous system sometimes for
months.
Wound of left foot: ACROCONTRACTURE. Psychoelectric cure, about seven
months later, at one sitting, except for some residuals that cleared
shortly afterwards.
=Case 235.= (ROUSSY and LHERMITTE, 1917.)
A soldier, 21 years, was observed at the Centre Neuropsychiatrique,
August 30, 1916. He had been wounded in battle, March 16, 1916, near
the left internal malleolus. Infection followed and inguinal adenitis,
for which he was in hospital a month.
Even before the abscess began, the foot had begun to twist inward.
After the abscess had been cured, a contracture set in permanently, and
at entrance to hospital was irreducible. The knee-jerk and Achilles
jerk were more active on the side of the equinovarus contracture. There
was even a slight amyotrophy of the calf. There was no appreciable
vasomotor disorder. The foot and lower part of the leg were a little
warmer on the left side.
Cure followed a single sitting with psychoelectric treatment, at least
so far as the contracture went. Pain and swelling remained in the
evening, followed by fatigue. The patient was discharged cured, October
12, 1916.
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