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
This condition is a form of trunk contracture in the nature of a
kyphosis (scoliotic and lordotic forms of contracture are also found
in the hysterical group), for which the terms _plicature_ of trunk,
traumatic kyphosis, pseudo-spondylitis, and camptocormia have been
in use. The term camptocormia has been proposed by Souques and
Rosanoff-Saloff. The _poilus_ speak of the condition as _cintrage_
(arching). In these cases the trunk is held almost horizontally,
with the head in hypertension and neck muscles and thyroid cartilage
jutting. The patient looks fixedly straight forward, with eyes wide
open, and carries his legs extended or half flexed. The normal folds
of the abdominal wall are very deeply marked, and at the level of the
groins, the epigastrium and the pubis, there are deep folds. Viewed
from behind, the median lumbar fold has disappeared or is faintly
marked, as are the sacro-lumbar and other masses of spinal muscles.
The whole lumbar region is elongated and flattened. The dorsal spines
of the back are accentuated; the buttocks are flattened and broadened
transversely. The back of the neck is marked by deep transverse
folds, and the seventh spine does not stand out. The patient can walk
perfectly, though sometimes there is a pseudocoxalgia and lameness.
Attempts to straighten the body lead to visible forcible contractions
of various muscles, but the kyphosis remains persistent. There is a
sense of active resistance on the part of the patient, which can be
demonstrated by palpation. If an active attempt at straightening is
made, lumbar or sacral pain develops, followed by a very lively and
emotional state of anxiety on the part of the patient, with interrupted
and accelerated breathing, an expression of terror in the face, and a
rapid pulse. The patient then subsides into his earlier attitude, and
his anxiety disappears in a few seconds. It is much easier in many
subjects to reduce the camptocormia in the position of dorsal decubitus
than upright.
Burial after shell explosion; lumbar ecchymoses; regionary pains;
camptocormia, 5½ months. Cure by three months’ plaster cast about trunk.
=Case 244.= (ROUSSY and LHERMITTE, 1917.)
An infantryman was buried after shell explosion August 25, 1914, but
he sustained no wound or bone injury. There was, however, a large
ecchymosis of the lumbar region, and he had felt violent lumbar pains.
The trunk was carried flexed, symmetrically bent over and quite
incapable of being straightened completely. A plaster corset was
applied March 16 by Souques. Three months of this was followed by a
complete straightening, which lasted after the corset was removed. The
patient was discharged well.
Public-domain text, read in full here on John Shaqi.
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