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Shell-shock and other neuropsychiatric problems

Chapter 526: Case 491. (Reeve, September, 1917.)
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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.

Burial and bruises of back: Hysterical cross-legs. Treatment by induced fatigue of contractured muscles.

Case 491. (Reeve, September, 1917.)

A man, 32, was buried by a shell and bruised about the back, August 2, 1916. He was bedfast until February, 1917. Every attempt to move the legs brought on tremors. He was then allowed up; but the attempt to walk caused one foot to knock the other, and his ankles became bruised, necessitating cotton wool pads for feet.

He was admitted to Maghull, June 12, with one leg crossed over the other and the thigh adductors spastic, especially on the right.

The fatigue treatment was carried out in dorsal decubitus, each leg being pulled by a man, and the separation repeated when necessary. Four hours a day for three days of this work finally reduced the spasm so that the patient was able to walk with assistance. On the sixth day he walked a mile without assistance. The spasm has not returned.

Re leg contractures, Bérard got successful results by continuous extension combined with injections of 1 per cent novocain into the sciatic nerve trunk and the contractured muscles. According to Babinski and Froment, there ought to be an almost certain cure of any genuine hysterical state. They quote the observations of Souques, Meige, Albert Charpentier, Clovis Vincent, Roussy, and Léri as proving this claim.

The Reeve method, so far as it is psychotherapeutic, bears a resemblance to Clovis Vincent’s first stage of what the poilu calls torpillage, namely, the stage of crisis and of intensive reëducation. But Clovis Vincent uses in his direct and forcible reëducation the galvanic current.