Chart 9
CAUSES OF SHELL-SHOCK

After Ballard

As against the diagnosis of hysteria, three herpetic clusters appeared on the skin of the left thigh, from three to six inches above the knee. Elliot regards it as certain that the posterior root ganglia were injured. He regards the case as one of injury to the spinal nerve roots. The hyperalgesia about the body of course suggested damage to the spinal cord. According to Elliot, therefore, this case is one of organic disease; whether of the roots or of the cord was uncertain. At any rate the cases of this type, though not functional, recovered.

Mine-explosion; burial; labyrinthine lesions and head bruises, more marked on left side: Focal canities (WHITE HAIR developing OVERNIGHT) on left side.

Case 211. (Lebar, June, 1915.)

A soldier, 23, in the Argonne was blown up by a mine in a trench, fell, and was covered by a mass of earth, from which he extricated himself. He immediately became deaf from what was medically determined to be a double hemorrhagic labyrinthitis. There were also superficial powder burns of the face, as well as several bruises on the head, especially on the left side.

The next day, at the English hospital at Arc-en-Barrois, the patient noticed tufts of white hair on the left side of the head. There were four islets of gray hair in the left fronto-parieto-occipital region, separated from one another by normal hairs. The gray hairs were gray completely from the roots to the ends of the hair. The longest hairs were as white as the shortest. There was not a brown hair amongst them. The gray hairs were solidly implanted, and could be pulled out only by strong traction. There was a discoloration also of the bulbar swelling of the hair. The rest of the head hair was dark brown. His hair was described in the military description: “deep chestnut brown.” There was no other symptom aside from an incessant twitching of the left eyelids. The place of whitening was apparently determined by the region of the scalp injured. Not only were the bruises on the left side of the head and face, but the labyrinthine lesions were more marked on this side and the twitching of the eye-lids was confined to the left side.