Shell-shock, explosion on left side: Sensory disorders especially on left side; ecchymosis of right (uninjured) leg, possibly conditioned upon shock of left hemisphere.
Case 258. (Gerver, 1915.)
An artillery officer had had a shell burst to the left side of his horse, which veered to the right but did not fall. The officer’s left hand immediately became so numb and weak that he could not hold his reins with it; it shortly became more painful. The left foot showed a tendency to the same anesthesia and paresis.
Curiously enough, a number of punctate hemorrhages appeared on the right thigh and lower leg, upon the outer aspect. According to Gerver, these hemorrhages into the skin of the right leg may have something to do with a disturbance of circulation related with effects wrought upon the left hemisphere. During the course of the disease, pains occurred not only in the left arm and leg but also in the right leg.
Re brain injuries produced by shell explosions without external wound, Roussy and Boisseau have not found a single clinical instance amongst 133 cases observed, which suggested cerebral softening, or even hemorrhage into the brain substance, the cord substance, or the meninges. These 133 cases were observed in army neurological centres and contained instances of (a) mental disease (confusion, delirium, amnesia), (b) nervous disease (astasia-abasia, tremors, paralyses, contracture), and (c) an intermediary group (either mental confusion with stupor, or hysterical deafmutism).