Case 574. (Vincent, July, 1917.)

A French private was buried in a trench upon the explosion of a large shell, November, 1914. He said he had had a “fracture of the occiput” and had fainted away without regaining consciousness for several hours.

He was evacuated to Dunkirk, then Saint Nasire, and then to Sables-d’Olonne. He showed no paralysis or paresis of limbs. During the first month, he had violent pains in the head, spells and vomiting. There was a slight aphasic disorder. He was treated by cupping upon the head and by applications of ice.

After the visit of the inspector general, he was sent to Nantes to be trephined. Dr. Mathieu regarded an operation as useless. He was treated with bromides and the faradic current by Miraillé, applied to the right arm, which had become paretic.

June, 1915, he started on a three-months convalescent leave in Paris.

From October to December, he had electric treatment at the Grand-Palais.

December, 1915, he went to the Salpêtrière under P. Marie, where he was given electric treatment.

January 1916, he went to Maison-Blanche under Laignel-Lavastine, where he was given electricity 4½ months.

April 4 he went back to his dépôt.

Presented to the invaliding board, May 11, at Decize, he was sent to the neurological center at Bourges. He was there given massage and movements. Upon entrance he had a functional inactivity of the right arm. He should have been cured a long time before by the therapeutics employed. He was then sent to Vincent at the neurological center at Tours for special motor reëducation. Vincent found almost complete functional incapacity of the right arm, without atrophy, with normal reactions, no R. D., and normal arterial pressure. June 26, 1916, the patient was able to write, although slowly. He could sign a letter, and could lift a weight of 10 kilos.

The details of Vincent’s method mentioned under Case 566 are pursued, to use his own words, with methodical ruthlessness. This form of reëducation consists in manoeuvres that make the patients yield despite themselves. The galvanic current is used to force a man to react voluntarily or automatically. See, for example, Claude’s case of a hysterical brachial monoplegic (Case 574) found able to descend a ladder with the use of his arms only. After the physician’s victory is secured, then a sort of consolidation must be obtained by means of the execution of certain movements on the part of the patient for an hour or two. As another factor in the situation set up by Clovis Vincent, is the enthusiasm generated in the moral atmosphere in which the cure takes place. Mott has also insisted upon this atmosphere of cure, which Mott believes is in part responsible for the good results of Adrian and Yealland. Roussy and Boisseau, at Salins, started out with a process similar to that of Vincent, with a preliminary period of isolation. Roussy also uses the faradic current instead of the galvanic (see remarks of Mann concerning deaths with the Kaufmann method in Germany, under Case 570). Vincent’s three stages are given in Chart 19, page 897.