WeRead Powered by ReaderPub
Shell-shock and other neuropsychiatric problems cover

Shell-shock and other neuropsychiatric problems

Chapter 548: Case 515. (O’Malley, May, 1916.)
Open in WeRead

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.

Deafness: cure by stimulating vestibular apparatus.

Case 515. (O’Malley, May, 1916.)

A private, 20 years of age, lost speech and hearing after the battle of Neuve Chapelle. Eight days later he came under the care of the laryngologist in a very excited state, pointing to lips and ears and carrying a note with information concerning his deafmutism.

Dr. O’Malley wrote on a piece of paper that he would restore the patient’s speech and hearing. Dr. O’Malley then used the mirror until the point of retching, and wrote, “You can speak now; count up to ten loudly.” He did.

Dr. O’Malley next used the cold water douche to the right ear to the point of giddiness, then shouting through a speaking-tube (see description below). The patient then found he could hear and the tears streamed down his face. Thereafter he was able to converse freely. Dr. O’Malley writes:

The treatment of functional deafness consists in exciting the vestibular apparatus as follows. Cold or hot water is allowed to flow in a steady stream into and out of the external auditory meatus by means of a tube attached to a receptacle placed about one and a half to two feet above the patient’s head and continued until he becomes very giddy and an active nystagmus is produced. A speaking-tube three feet long is then used by placing the ear-piece in the ear so treated, and the surgeon shouts into the mouth-piece the assertion, “You hear now,” and the answer, “Yes” comes promptly. The tube is now dropped and a conversation held as if no deafness ever existed. So far I have found the treatment of one ear sufficient. The patient is usually very emotional, as the disturbed vestibular function, which in these cases responds easily and markedly, causes him to feel as uncomfortable as a bad sailor on a stormy voyage. This feeling, however, rapidly gives way to one of pleasure at the return of his hearing. Where functional deafness and mutism co-exist it does not appear to be material which is treated first. In two cases of this kind under my care I treated the loss of voice first.