Shell-shock and other neuropsychiatric problems presented in five hundred and eighty-nine case histories from the War literature, 1914-1918 / by E.E. Southard ; with a bibliography by Norman Fenton ; and an introduction by Charles K. Mills.

  • Southard, Elmer Ernest, 1876-1920.
Date:
1919
Catalogue details

Licence: Public Domain Mark

Credit: Shell-shock and other neuropsychiatric problems presented in five hundred and eighty-nine case histories from the War literature, 1914-1918 / by E.E. Southard ; with a bibliography by Norman Fenton ; and an introduction by Charles K. Mills. Source: Wellcome Collection.

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    SYPHILITIC ROOT-SCIATICA (lumbosacral Case 10. (LONG (DEJERINE’S clinic), February, 1916.) No direct relation of this example of root-sciatica to the war is claimed nor was there a question of financial reparation. There was no prior injury. At the end of March, 1915, the workman was taken with acute pains in lumbar region and thighs, and with urgent but retarded micturition. Unfit for work, he remained, however, five months with the regiment, and was then retired for two months to a hospital behind the lines. He reached the Salpétriére October 12, 1915, with ‘‘double sciatica, intractable.”’ There was no demonstrable paralysis but the legs seemed to have ‘“‘melted away,’ fondu, as the patient said. Pains were spontaneously felt in the lumbar plexus and sciatic nerve regions, not passing, however, beyond the thighs. These pains were more intense with movements of legs; but coughing did not intensify the pains. Neuralgic points could be demonstrated by the finger in lumbar and gluteal regions and above and below the iliac crests (corresponding with rami of first lumbar nerves). The inguinal region was involved and the painful zone reached the sciatic notch and the upper part of the posterior surface of the thigh. The sensory disorder had another distribution, objectively tested. The sacral and perineal regions were free. Anes- thesia of inner surfaces of thighs, hypesthesia of the anterior surfaces of thighs and lower legs. The anesthesia grew more and more marked lower down and was maximal in the feet, which were practically insensible to all tests, including those for bone sensation. There was a longitudinal strip of skin of lower leg which retained sensation. Position sense of toes, except great toes, was poor. There was a slight ataxia attributable to the sensory disorder — reflexes of upper extremities, abdominal, and cremasteric preserved, knee-jerks, Achilles and plantar reactions absent.