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Shell-shock and other neuropsychiatric problems

Chapter 248: Case 223. (Myers, March, 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.

Shell-shock: Hyperesthesia and over-reaction.

Case 223. (Myers, March, 1916.)

A stretcher-bearer, 19, who had had 18 months’ service and 6 months’ service in France, sent to Lieut-Col. Myers the day after admission to a base hospital, showed a remarkable condition of hyperesthesia and over-reaction.

It appears that four days before, he had been blown up three times by aero torpedo mortar shells while attending the wounded. One had blown him into the air, another had blown him into a dug-out, and a third had knocked him down. Two or three hours later, having finished the job of carrying wounded to the dressing station, everything seemed to “go black” in the dug-out where he was resting, and from that time on he had been shaky. It seemed that he had hardly slept for several days before he finally gave in.

There were irregular spasmodic movements of the head, arms (especially the right), and legs (especially the left). There were coarse tremors and incoördination in moving the arms. With eyes closed, he touched his nose with uncertainty. Cotton-wool touch on arms or head provoked lively movements. “I was always ticklish,” he explained, “but never like this; I can’t stand it, Sir.” Pinpricks produced almost convulsions. There was perspiration, rigidity of legs, and spasm such that knee-jerks were unobtainable. Plantar reaction, flexor. There were also visual hallucinations of bursting shells, and these were also heard when dozing.

Improvement followed with rest, but about two weeks later, on waking to find himself being carried back to his tent to avoid a shower, he was so terrified that a special nurse became necessary. He was still jumpy the next day, alarmed at footsteps, and afflicted with headache. He improved further in three days; remained two months in hospital in England, had one month’s leave, and then returned to light duty.