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
A Russian Captain, 45 (heredity good; non-alcoholic, non-syphilitic;
always in good health) sustained shell-shock in a battle in
southeastern Prussia, August 13, 1914, and was unconscious for two
days. He was carried to one of the provisional field hospitals, and
then evacuated to Petrograd, where during a period of four months, he
was given electricity, suggestion, and baths. He was feeling so much
better in December, 1914, that he went back to the front and headed his
company in the trenches. He stood only five days of trench work, and
was sent for mental examination December 29, 1914.
The captain was of middle height, well developed but poorly nourished,
of a dejected and preoccupied appearance, looking to one side in
conversation, and finding difficulty in the expression of his thoughts.
He talked almost exclusively of his illness. He found difficulty in
adding or subtracting 2-digit figures. He seemed to have amentia,
frequently being mistaken as to the most important dates in his life.
He complained of general weakness and inability to work. Any endeavor
to concentrate caused vertigo, irritation, and pains in the head.
Day and night he was troubled about his health, his future, and his
family’s future. He was going to become an invalid and a burden. He
was tormented with the idea that people thought him a simulator. He
complained of lumbar pains. It seems that the explosion had affected
the left side of the body more than the right and he complained more
of pains upon that side. In the dark his gait was unsteady, and he
often had marked tremors of feet and hands. In excitement the tremor
would increase uncontrollably. The patient thought that his hearing
was diminished, especially upon the left side, and that his left ear
was weaker than the right. He slept poorly and had many nightmares;
his appetite was poor, and he was constipated. There was difficulty in
respiration; the pupils were slightly dilated and sluggish in their
responses. There was a marked tendency to Rombergism; dermatographia
marked; the skull and especially the lumbar spine was painful on
tapping; hyperesthesia of the lumbar skin; paresis of left hand and
left foot. The tendon reflexes were more marked on the right side than
on the left, and there was even a slight ankle and patellar clonus.
The Babinski sign was present on the right side. There were frequent
fibrillary contractions of the muscles of the trunk and back.
Objectively the hearing was somewhat decreased in the left ear, and the
vision of the left eye appeared to be somewhat impaired also. If the
eyes had been held closed for a time, there was difficulty in opening
them quickly. Aside from a somewhat elevated pulse and slight cardiac
arrhythmia, there was no disorder of the internal organs.
This patient remarkably improved but was not absolutely well at the
date of the report.
Public-domain text, read in full here on John Shaqi.
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