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 soldier in the Territorial Infantry, 42, a gardener who went to
taverns, as he said, “like everybody else,” a widower with two
children, a good worker though irascible, had had syphilis as a youth.
He was called to the colors at the outbreak of the war and got on well
despite tremendous strain. March 9, 1915, he was in a bayonet charge
with his regiment and was bowled over by a shell of which a fragment
wounded him above the knee and several fragments in the thorax. All
these fragments were extracted at a temporary hospital, March 11.
The man now became strange, refused to obey orders and did a number
of peculiar things so that he was sent to Orléans temporary hospital
whence he was evacuated to Fleury Asylum, March 19. He refused to give
up his things because he was the master. He did not want to go to bed
and wanted to keep on walking constantly. He was without sense of
shame, satisfied with himself, grandiose as to his millions in bank and
the thirty-six decorations he believed had been awarded him. He mistook
the identity of the landscape and of the people about him.
Tongue tremulous; pupils unequal; knee-jerks exaggerated; dysarthria;
gaps in memory. In May occurred a number of violent reactions.
In June, however, there was a remission; the ideas of grandeur
disappeared first, then the tremors and reflex disorder and finally the
speech disorder. There was a slight seizure at this point and the man
said he had had another such just before he came to the army. July 20
he was invalided out much improved.
In this case of general paresis there is, besides the syphilis, also
alcoholism to consider, so that it is not entirely plain that the
exertions of campaign liberated the paresis.
_Re_ wounds and paresis, see also Case 5 (Beaton), in which
neurosyphilis advanced rapidly from the time of a trivial injury.
Shell-explosion: Syphilitic ocular palsy.
=Case 19.= (SCHUSTER, November, 1915.)
Schuster notes briefly a curious result of the explosion of a shell,
which caused the patient in question to lose consciousness. Shortly
after the explosion, the patient came to his senses again, but a
surprising paresis of the eye muscles had developed. This paresis
looked precisely like a syphilitic paresis clinically.
Examination of the blood serum yielded a strongly positive Wassermann
reaction.
According to Schuster, the explosion of the shell had brought about
hemorrhage in vessels supplying the region of the eye muscle nerves or
nuclei. The reason for the selection of these vessels for rupture due
to shell explosion is, according to Schuster, that the vessels were
probably already syphilitically diseased.
Public-domain text, read in full here on John Shaqi.
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