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 private, 31, was in the retreat from Mons, was blown up by a shell
and buried in May, 1915, went back to the front after two months leave,
was knocked unconscious by a shell December, 1916. He came to himself
two days later in the hospital, but remained confused and lethargic.
In England, December 21, his legs were still weak and walking was
unsteady. The right pupil reacted neither to light nor to accommodation
and was irregular, eccentric, and dilated. The left pupil showed the
Argyll-Robertson reaction. There was early primary optic atrophy.
The right knee-jerk was slightly exaggerated. The vibration sense
was reduced over sacrum and malleoli. At this time the man’s mental
condition was practically normal.
The Wassermann reaction of the serum and spinal fluid proved positive.
Improvement followed rest, iodide, mercury, and seven injections of
salvarsan. By the middle of February he was able to walk well. The
right pupil regained its power to react to accommodation, but remained
inactive to light. Meanwhile, the left pupil had regained a slight
power to react to light.
_Re_ treatment of syphilis, both Thibierge and Lépine give warning
of some bad results with arsenobenzol treatment, though Thibierge
states that the number of serious accidents and especially of deaths
has diminished more and more now that no arsenobenzol (drug No.
914) is given. Encephalitis is the gravest of the untoward results
of injection, sometimes appearing in young and vigorous subjects.
Hemorrhagic encephalitis appears to occur more frequently after the
second injection than after the first, and according to Thibierge may
be especially suspected in subjects who after the first injection
present much fever, congestion of face, and cutaneous eruptions.
Treatment in these cases should be suspended or given in moderate
doses.
Shell-explosion: Neurosyphilis. Fit for light duty.
=Case 25.= (HURST, April, 1917.)
A corporal, 26, blown up by a shell December 7, 1916, was admitted
to the hospital on the 13th, dazed and with symptoms of a left-sided
hemiplegia of organic origin. The right pupil was larger than the left.
There was a bruise of the scalp in the right parietal region. The
man had had syphilis at 16. The Wassermann reaction of the serum was
strongly positive. Rest, salvarsan, mercury, and iodides were given,
and the general symptoms and hemiplegia gradually disappeared, until
on December 12 there was only a moderate weakness of the left side,
with knee-jerks in excess, abdominal reflexes absent, and the Babinski
reaction.
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