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Shell-shock and other neuropsychiatric problems

Chapter 385: Case 360. (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; gassing; fatigue: Anesthesias.

Case 360. (Myers, March, 1916.)

A stretcher-bearer, 44, eleven years in the service and two months on French service, was seen by Lt. Col. Myers eight days after reporting sick and admission to a base hospital.

While he was under cover in a cellar, three days before reporting sick, a shell had jammed the door and the fumes came in. Later in the day, in another cellar, he had been blown off his seat by a shell and six other men had been laid out. The shelling continued that day and two following days. He had worked on the wounded without any rest.

On lying down he found his left arm numb and cold. The numbness then spread to the legs, especially to the left leg. There was continual tingling in terminal joints of fingers of left hand; hypalgesia over both forearms and hands, especially on left side; total analgesia over left dorsum.

Two days later, the patient could feel articles and reported that the numbness occurred only in the early morning and was followed by a tingling as the numbness passed off. On the same day, the hands and forearms showed a total loss of sensibility to pain, except for a small area on the flexor surface below the elbow joint.

Re spread of anesthesia and alternation of sensory symptoms in this case. Babinski, of course, believes, that the majority of these conditions are the product of medical suggestion, but Babinski meets any critique by pointing out that any other sort of suggestion may produce such results. The heterosuggestion need not be medical. Thus, the sight of a comrade with paralysis or anesthesia, organic or hysterical, may suggest such to the soldier. Léri remarks that these may also be produced by autosuggestion alone. “From a tired feeling in a limb to a loss of power in it, there is but a small step. Another step leads to paralysis and anesthesia. The neuropathic temperament takes these small steps in perfectly good faith.” Léri has found no case in which he could exclude the influence of auto- or heterosuggestion.