Shell-shock; burial: Coma and semicoma; BLOOD-STAINED SPINAL FLUID. Improvement on puncture. Persistent astasia abasia with spasticity.
Case 206. (Leriche, September, 1915.)
A man was buried March 15, 1915, following the bursting of a large calibre shell. He is said to have had hemoptysis and arrived at hospital March 17 in coma. He kept moaning while asleep. March 18, he was still stupid and as if stunned. He did not talk or understand what was said, but was able to write a few words. The knee-jerks were a little exaggerated. There was a slight spasticity of the limbs, which was exaggerated on emotion into a sort of spasmodic crisis.
Lumbar puncture gave a reddish fluid under strong tension. After lumbar puncture the man came out of coma and the next day, after another puncture (fluid slightly yellowish), there was further improvement and the patient spoke. The third puncture, March 20, yielded yellow fluid. The spastic phenomena still persisted, however. The patient could not walk or stand. Every time he touched the ground he had a clonic crisis. He was evacuated to a neurological center.
Re astasia-abasia, Nonne found these cases heading a group of 63 cases of war hysteria treated in a twelvemonth. Figures as follows:
| Astasia-abasia | 14 |
| Generalized tremor | 12 |
| Brachial monoplegia | 11 |
| Isolated contracture | 6 |
| Crural paraplegia | 5 |
| Mutism | 5 |
| Isolated tic | 4 |
| Hemiplegia | 3 |
| Isolated respiratory convulsions | 2 |
| Isolated sensory disorder | 1 |
Fifty-one of the 63 cases were freed by therapy from their main symptoms (twenty-eight cases cured in one or two hypnotic sittings).
Prolonged bombardment; shell explosion (nearby?): Depression; suicidal attempt; hypertensive spinal fluid.