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

Shell-shock and other neuropsychiatric problems

Chapter 620: Case 588. (Arinstein, September, 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.

Shell-shock with loss of consciousness: Deafmutism, rhythmic head movements, anesthesia, asymmetrical areflexia. Recovery by suggestion with faradism, massage and reëducation.

Case 588. (Arinstein, September, 1916.)

A Russian private, 30, literate, lost consciousness upon the explosion of a large shell, November 10, 1915. He was brought to hospital, November 14, completely deaf and dumb, and with his head rhythmically swaying sidewise 60 to 70 times per minute. The swaying ceased during sleep. The head was carried inclined to the right; there was complaint of headache. The left leg, the trunk and the hairy part of the head were anesthetic. The knee-jerks were obtained with difficulty, the Achilles jerks were lively; the throat and conjunctival reflexes were absent; the abdominal and cremasteric reflexes were lively. The right plantar reflex was absent; the left normal. The vision of the right eye was impaired, and there was a monocular diplopia of this eye. The drum membranes were pulled in, and the disorder of hearing was explained on the basis of labyrinthine shock.

After a séance of written suggestion with faradism to neck and small palate and vibratory massage to throat, speech returned. November 26, the patient read in a loud voice a written phrase. He did not speak again independently until early in December, when he read aloud written matter. The return of spontaneous speech was gradual. Hearing returned December 5, when he was able to hear in the right ear by means of a tube. In the sitting posture there was less swaying of the head. If the patient lay down, rhythmic movements of the head became stronger and more rapid (120).