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
From hospital he was evacuated three weeks later with a diagnosis of
radial paralysis, coming on service September 11. Examination showed
a slight paralysis of the extensors and flexors of hand and fingers,
and of the hand muscles. There was also a slight contracture of these
muscles, more marked in the flexors. There was pain upon reduction,
with some jerking of the muscles. Electrical reactions proved normal
in nerves and muscles. There was a segmentary anesthesia to pin prick,
reaching to the level of the elbow; deep hyperesthesia of the finger
joints. There was no trophic or vasomotor disorder.
In short, here was a case of functional paralysis with contracture of
the right hand, to be regarded as hysterical in the classical sense
of the term, both by reason of the anesthesia and absence of trophic
disorder, and on account of the hysterical history of the patient.
Functional reëducative treatment quickly improved the paralysis, so
that two weeks later the patient was able to extend fingers and hand.
His total recovery was hoped for, when, September 26, wishing to get
out of the hospital without leave, the patient jumped from a window and
broke his right leg. The functional paralysis of the hand persisted and
even grew more marked.
The interesting point in this case is that despite the powerful nature
of instinctive efforts with drowning persons, this patient, subject
to an hysterical arm paralysis, did _not_ make defensive movements
with the paralyzed arm; yet this paralysis was such as to be greatly
improved by psychotherapy.
Bullet wound in brachial plexus region: SUPINATOR LONGUS CONTRACTURE,
hysterical-looking. Callus of fractured rib probably at fault:
Treatment surgical.
=Case 252.= (LÉRI and ROGER, October, 1915.)
A man was wounded, December 21, 1914, by a bullet which entered about
the middle of the spinous process of the left scapula and was extracted
a few days later from the posterior border of the sternocleidomastoid
muscle, two finger-breadths from the left clavicle, that is, at about
Erb’s point. The left upper extremity was inert for ten days, but then
began to move again, although extension and flexion of the fingers did
not begin at once.
October, 1915, movements were normal, except those of extension of
the forearm, due to contracture of the supinator longus muscle, a
contracture that had developed about three weeks after the wound and
stood out along the external border of the forearm, almost suggesting
a musculotendinous retraction. There was a palpable, hard callus of a
fractured rib, presumably a cause of the permanent irritation of the
supinator longus, being precisely at the point where lesions usually
produce superior brachial plexus palsy.
Why should the supinator longus alone of the Duchenne-Erb group
be affected? Perhaps a single root was involved in the irritative
lesion. The biceps showed also a partial R. D. The deltoid was normal
electrically and in contraction.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account