Chart 12
WAR PSYCHONEUROSES
SYMPTOMATIC GROUPS

I.EMOTIONAL (Hyper- Hypo- Para-)
II.CONFUSIONAL (Attention and Memory Disorder, Dream States; Deliria)
III.CONVULSIVE AND PITHIATIC (Hysterical)
IV.NEURASTHENIC AND PSYCHASTHENIC
V.SENSITIVOMOTOR AND SENSORIMOTOR—e.g., Limited Paralyses, Contractures, Deaf-mutism
VI.COMPLEX
VII.PHYSIOPATHIC (Babinski)

After Grasset

Value of lumbar puncture.

Case 371. (Souques and Donnet, October, 1915.)

A colonial soldier arrived at Paul-Brousse Hospital with a hospital ticket showing that ten days before he had had commotio cerebri. He was dull, had a fixed stare, held his head in his hands, was disoriented for time and place, and had lost memory for everything that had happened for eighteen months. There was no sign of wound. There was no motor disorder save that walking was a bit slow and uncertain. Perhaps the right knee-jerk was stronger than the left. Percussion of the right Achilles tendon produced tremor. The plantar reflexes were flexor on both sides; flexion lasted longer right than left. The cremasteric and abdominal reflexes were a little weaker on the right. Arm reflexes were lively. Sensations proved normal. Complaint of headache, frontal and vertical.

Lumbar puncture October 7, that is, on the thirteenth day after the shell-shock, yielded a transparent, slightly greenish fluid, with 92 cells per cm. (lymphocytes with one or two large mononuclear cells and a few sometimes degenerated endothelial cells) and hyperalbuminosis.

October 9, the clouding of consciousness was less marked. The headaches and amnesia were constantly complained of; the reflexes were normal. October 12, there was less headache. October 25, another lumbar puncture showed but 14 or 15 lymphocytes per cm. and hyperalbuminosis. There was now no longer any clouding of consciousness. The amnesia, retrograde and anterograde back to May 9, 1914 (date of his daughter’s birth), and up to September 25, 1915, persisted. The man did not remember the declaration of war, or the mobilization, or his regiment, and the like. Meantime, the man’s judgment and reasoning powers were normal.