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Shell-shock and other neuropsychiatric problems

Chapter 118: Case 104. (Kastan, January, 1916.)
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About This Book

The work assembles nearly six hundred clinical case histories drawn from wartime medical literature to document combat-related neuropsychiatric disorders. It presents concise case protocols illustrating varied symptom patterns, diagnostic dilemmas, malingering and simulation, therapeutic interventions, and treatment outcomes, and includes bibliographic references and introductory commentary. Sections juxtapose cases to illuminate contested diagnoses and to inform postwar rehabilitation and mental-hygiene efforts, aiming to provide clinicians and reconstruction workers with detailed clinical material for recognizing, classifying, and managing neuropsychiatric consequences of war.

Gunshot wound of head; alcoholism: Amnesia.

Case 104. (Kastan, January, 1916.)

A German soldier had a bullet pass through his right eye and lower jaw, leaving a fistulous opening from the mouth. He said that he was completely blind, but ophthalmological examination cast doubt upon the blindness. There had been immediately after the injury a number of severe attacks of dizziness, which lasted several hours; and another attack developed after he had come back from hospital, to which he had gone by reason of his pains.

He was to be arrested on account of a disciplinary crime and had ostensibly gone to his mother’s house, there to await arrest. The non-commissioned officer found him in a saloon. As soon as the phrase, “You are my prisoner!” was said, the soldier lost track of his surroundings. He had drunk a few glasses of beer but did not himself think he was drunk at the time. He was insulting and violent when asked to proceed with the officer, and a policeman was called in to take charge. He then lay down in the street and had to be put upon a wagon, still firing abusive phrases at his captors.

Upon examination, aside from the effects of the gunshot, excessive knee-jerks and tremors of the body were found. The eyebrows met but there was no other sign of bodily stigmata. There seems to have been no hereditary disease, or any history of severe alcoholism, though the man had been convicted previously of violence and theft. The amnesia is to be ascribed to effects of the head injury.