Shell-shock paraplegia: Treatment by bed, cigarettes and chocolates altered to isolation, no tobacco, no visitors, faradization. Recovery.
Early in the war, a lad, 19, was blown up by a shell. He was sent home paralyzed from waist down, and was seen by Capt. Buzzard after he had spent ten months in various hospitals, “carefully nursed, on the water bed, constantly using a bed urinal, smoking innumerable cigarettes, and eating countless chocolates.” He could not move his legs. They were wasted and flaccid. The knee-jerks could be got with difficulty. Plantar reflexes flexor. Complete anesthesia from umbilicus downwards, but preservation of abdominal reflexes. The navel did not shift downwards when the patient attempted to sit up. The incontinence was not real; urine was passed into the urinal at appropriate intervals.
Buzzard directed treatment “not to his spinal cord but to his mind; isolation; the stoppage of tobacco and all visits; the assurance that he would rapidly get well, together with some suggestive faradization of his legs.” This brought about a cure in a very short period. The atrophied legs eventually grew strong enough to walk.
Re cigarettes in Shell-shock, Mott decries the over-liberal gifts of cigarettes that induced cigarette habits in both officers and men. Of course, the cigarettes are still more detrimental to cases of soldier’s heart than to other cases of neurosis. Mott remarks how over-frequent are the social tea-parties, joy rides and drives given by well-meaning ladies for the “poor dears,” actually perpetuating neuroses.
Re atrophy, Babinski and Froment again bring up the question whether muscular atrophy can be brought about by a hysterical motor disorder. In point of fact, Charcot and Babinski were the first to describe the true hysterical amyotrophy, but this hysterical amyotrophy is exceptional in hysterical paralysis, and is slight when it occurs.