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
One morning in April, 1916, his old memories came back all of a sudden
on waking. The gap was filled up to the moment of the shock. There was
no gap left except for a period of about 25 days following the shock.
He now found that he knew a little English but that he had lost his
stenography as well as his professional skill at typewriting.
_Re_ French statistics for the occurrence of general paresis, Lautier
found 27 cases in 426. Early in the war, Boucherot at Fleury received
four cases of paresis among 107 cases; the majority of these, however,
had not left the interior. Consiglio in Italy received two cases out of
270.
_Re_ hemiplegia in this case, it may be inquired whether the hemiplegia
which developed after the shell explosion on the same side of the body
on which the patient had a true syphilitic hemiplegia, was really
syphilitic or not. Was it not, perhaps, in some sense psychogenic? A
similar question may be raised concerning cases in which the _locus
minoris resistentiae_ becomes the site of symptoms. See Cases 409-414.
Shell-shock: Hysterical blindness. Signs of cerebrospinal syphilis:
Nevertheless, amaurosis functional.
=Case 29.= (LAIGNEL-LAVASTINE and COURBON, March, 1916.)
A soldier of the class of 1906 underwent shell-shock August 13, 1914,
regaining consciousness 20 days later, but blind. The light of the
shellburst, he said, was the last thing he had seen.
For sixteen months, he was transferred from hospital to hospital,
looked on sometimes as blinded; sometimes as feigning. Finally, on the
isolation service of Maison-Blanche, December 15, 1915, he received
an ophthalmologist’s diagnosis namely, hysterical amaurosis. At this
time there were found: stereotyped winking, with slight lachrymation,
a slight left external strabismus, limitation in movement of all
the extrinsic muscles of both eyes, especially to the right and in
convergence and elevation; pupils slightly smaller than normal--and
the general impression of a genuinely blinded or amblyopic subject. He
seemed to be able to distinguish faint whitish spots, without contour
or color, in objects brought to a distance of at least 40 cm.
He also complained of bad feelings inside his head on the left side,
and he proved to have a left-sided hemianesthesia of hysterical nature.
There were no other sensory disorders and no reflex disorders.
The nasolabial fold on the left side was flattened out, and there
was also on the same side a slight diminution in the lower abdominal
skin reflexes, and no response to plantar stimulation. Examination
of the mouth showed leucoplakia, and the history showed that the
man’s fifth child was born before term and died at two months. Lumbar
puncture yielded lymphocytosis (55 cells) and an excess of albumin. The
fundus examination showed a slight papillary disorder, suggesting a
retrobulbar affection of the optic nerves.
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