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
An infantryman in the Côte du Poivre was sitting on the ground in the
opening of a dugout eating soup, when a shell burst and the roof of the
sap fell in on him. The planks and the stonework fell heavily on the
dorsolumbar region. The patient was almost bent in two, head to knees,
legs buried, hardly able to breathe. He did not lose consciousness
and cried out, feeling for a moment very anxious and fearful that his
comrades had left. Only two hours later was it possible to dig him
out. He said he had been absolutely unable to make any movement, had
kept his body bent, and felt violent pains in the back. He was carried
back twelve hours later and reached the dressing station in eight
more hours, eventually reaching the neurological service two days and
a half after the accident. On entrance he was prostrated, complained
of lumbar pains and of inability to move, and was able to make only a
few contractions on the left side when asked to try. The right leg was
flaccid. The left knee-jerk was stronger than the right. Other reflexes
normal. Hyperesthesia to pin prick on the right side. Slight saddle
hypesthesia, reaching to the iliac crests above and perineum below with
preservation of touch sensation. Slight forward posture of vertebral
column. The patient complained of pain on pressure of the spinal
processes and the lumbar spine. There was slight ecchymosis about the
left iliac crest.
Lumbar puncture showed clear fluid without hypertension, in which were
a few lymphocytes. There was a large amount of albumin. The blood
pressure was normal. There had been a slight diarrhea following the
accident which disappeared on entrance to the hospital. The question
was raised whether the case was one of slight hematomyelia or was
pithiatic.
Suggestive therapy was tried, and liquid was injected into the muscles
of the lumbar region and the posterior surfaces of the thighs. In
a quarter of an hour the patient found himself able to raise the
foot above the bed. There remained an extensor paralysis of the
right leg. When the patient was made to raise the foot he began to
show the phenomenon of Souques, called camptocormia. He could walk,
nevertheless, and took a few steps sustaining the weight of his body
by placing his arms on his thighs. Though he complained of lumbar
pain, it was finally possible for him to pick up an object from the
ground and lean sidewise. He could not, however, stand up. Yet when the
patient was made to lie down, his back was spontaneously straightened.
Treatment of the camptocormia was also successful.
Astasia-abasia: Two cases from (a) thigh wound, and (b) shell-shock and
wound of thorax. Cures by faradism.
=Case 246.= (ROUSSY and LHERMITTE, 1917.)
An infantryman was wounded September 23, 1914, by a bullet in the
anterior and middle part of the left thigh. From the moment of the
trauma, he had not been able to walk, but gradually regained his
ability to stand, and then to walk. He was returned to the front
(January, 1915).
Public-domain text, read in full here on John Shaqi.
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