Shell wound: Hysterical dysbasia from contracture. Many methods of treatment fail. Success with “a new measure,” e.g. stovaine.
Case 560. (Claude, March, 1917.)
A sergeant was struck in the suprapubic region, December 15, 1915, by a shell fragment and got a large hematoma in the perineal region (shell fragment visible on X-ray). The man was treated a year in a center for physiotherapy and was then treated in a neurological center, where a faulty position of the right thigh maintained in extensor rotation and abduction was found. The patient walked on crutches, legs wide apart, balancing with body.
Upon transfer to Bourges, an intraspinal injection of stovaine (after withdrawal of 2-3 cc. fluid, 1 cc. stovaine, 0.07 to the cc., mixed with cerebrospinal fluid) was made. This reduced the contracture and permitted the patient to place his legs parallel. They were then bandaged in the parallel position. The bandages were removed two days later and the limbs did not reassume their faulty position. The man was shortly able to walk with a cane; progress was rapid. This man was very desirous of cure and refused to be invalided, believing he was to be cured, and had received medal and war cross. Simple motor reëducation in competent hands had been without effect. A new kind of measure, such as stovaine, proved successful.
Re “new measures” for hysteria, see items under Case 516. See also remarks upon cures by lumbar puncture under Case 488.