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Shell-shock and other neuropsychiatric problems

Chapter 593: Case 561. (Claude, March, 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: Hysterical dysbasia. Treatment by stovaine anesthesia.

Case 561. (Claude, March, 1917.)

A chasseur, buried June 24, 1916, had a number of general symptoms, apparently got well and was given seven days’ leave at home. On the way he felt abdominal pain which he thought due to the jolting of the car. Suddenly he felt his legs trembling on extension. He left the train and went into a hospital where a diagnosis of radicular and spinal lesions was made. Two months later he was sent to Claude who found that he could walk only with knees flexed. If he was requested to stand up and extend his legs on the thigh, a trembling set in suggestive of an epileptoid trepidation. Even in the horizontal position the same clonic trepidation occurred which only stopped if the patient flexed his legs on the thighs.

However, no sign of organic lesion could be found. There was an analgesia limited to the ankles. Psycho-physiotherapeutic treatment was unavailing. January 28, 1917, the stovaine injection method was tried. After anesthesia had set in, it was found possible still to produce the spastic state by extending the legs; but a half hour after injection the spastic state could no longer be produced. The patient was shown that the trepidation was abolished. During the period of return of sensibility, the legs were constantly moved and the patient constantly told to make movements himself. He was convinced of his power. There was no longer any clonus. The patient remained all day in bed without epileptiform movements. Next day he complained merely of weakness in the legs and was got to walk without having convulsive tremors. During the next few days he began to walk with a cane, later without support, and there were no more contractions except transiently in the left leg if the patient walked a little too long. He left the hospital cured.