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
The condition in the hand suggests a radial paralysis. The patient
is unable to flex his fingers, though he probably is able to make
some movements with his thumb. Sometimes, on request to move the
hand, a series of coarse oscillations follows, somewhat like a
tremor. These oscillations are, according to Roussy and Lhermitte,
apparently pathognomonic, and depend upon the contraction of the
muscles antagonistic to those whose movement has been requested. These
antagonistic muscles, themselves entirely incapable of voluntary
movement, are seen to be contracting effectively and jerkily to meet
the action of the agonists, also seen making jerky movements. If the
forearm is moved passively and rapidly, the hand flops about inert,
like the hand of a marionette, although not to the degree of hypotonia
in organic paralysis. The hand is often cold, moist, and cyanotic, and
even possibly analgesic and hypesthetic.
Bullet wound of arm: Apparent radial paralysis, not resolved by
self-preservative swimming movements. Paralysis actually hysterical.
=Case 251.= (CHARTIER, October, 1915.)
A professional acrobat, 22, Corporal in an African Chasseur regiment,
was rather instructively tattooed and had apparently performed some
of his service in disciplinary companies. In short, one might have
a legitimate suspicion of the objective value of any manifestations
he might present. However, one of his chiefs had written a favorable
letter concerning his services. He had had various crises of a
hysterical character since adolescence, and there was alcoholism in the
family.
He was wounded May 4, 1915, by a bullet which passed through the outer
and lower part of the right upper arm, and thereafter the forearm and
hand became completely inert, both for flexion and extension. There
was a considerable hyperesthesia. The wound healed quickly, without
complications.
August 5, about 10 o’clock at night, the man--then at his dépôt--tried
to commit suicide (motive not related with the war). He threw himself
into the Rhône from a height, where the water was deep and the current
rapid. His brother and a comrade, who knew that he was going to make
the attempt, saved him. Chartier himself happened to see the whole
scene, and noted that throughout the affair the forearm and hand of the
patient remained inert. It seemed as if there was a radial paralysis.
This was the more likely as the man had been wounded in the arm. First
care was given. The man had not known of Chartier’s presence. He had
been under water about two minutes.
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