Mine explosion; unconsciousness: Camptocormia. Hospital rounder twenty months (bedfast five months) without complete neurological examination. Cure by persuasive electrotherapy in one hour.
Case 401. (Marie, Meige, Béhagne, February, 1917; Souques and Mégevand, February, 1917.)
A man became a hospital rounder to all points of the compass in France during a period of twenty months, with such diagnoses as myelopathic disorder, complex spinal trouble, ataxic phenomena.
As a matter of fact he was a camptocormic: trunk bent, knees semi-flexed, legs in external rotation. He used two canes in locomotion, made a bowing movement with each 20 cm. step, then another bowing movement, and another little step with the other foot. Made to lie down, his legs would elongate, the right completely but the left with some difficulty, the feet going into hyperextension, with the big toe raised, others flexed; the feet externally rotating, plantae turned in. In horizontal decubitus, there was only slight lumbar discomfort, but the legs stiffened and gave quick convulsive jerks. Taking the posture several times in succession would diminish these phenomena. Kneeling, he could bring his heels within 10 cm. of the buttock, whereas in spontaneous flexion of the leg on the thigh, the knee remained a distance of 40 cm. from the buttock.
A complete examination showed no joint disorder or any diminution in muscular strength, or any reflex disorder except that all the tendon reflexes were rather powerful. There was a question of possible X-ray demonstration of lesions and ankylosis of the fourth and fifth lumbar vertebrae, and there was a question of some incontinence of urine. On the basis of these phenomena apparently, this camptocormic patient had been saddled with the diagnosis of myelopathic and ataxic disorder for a period of 16 months. A neurologist was at last consulted, and on his advice, it proved possible to get the patient evacuated to a neurological center in a period of four months. Facts of this species are unfortunately still too common, state Marie, Meige and Béhagne, February 1, 1917, despite the remarkable and rapid cures obtained in camptocormia by Souques. In point of fact, no complete neurological examination had been performed upon this man during a period of 20 months.
This particular patient was given to Souques for treatment (Souques and Mégevand). His cure was completed by persuasive electrotherapy, in an hour.
It appears that the man was buried in a mine explosion, June 5, 1915, lost consciousness and came to twenty hours later, able to rise and take a few steps, but bent in two with a sharp dorsolumbar pain. The pain grew more violent and generalized during the next few days, and he began to lose all power in his legs, so that he could walk with the greatest difficulty. He was practically bedfast for five months. He then tried to rise and walk, but suffered so much that he could not get up except in a camptocormic position. It was in fact only January 23, 1917, at the Salpêtrière, that the diagnosis of camptocormia was made. The man complained of pains at the lower dorsal and lumbar regions of the spinal column with slight irradiation sidewise. The following diagnoses had been made:
June 8, 1915. Severe contusion of chest and back.
July 9, 1915. Multiple contusions, commotio spinalis; lesions and ankylosis of the 4th and 5th lumbar vertebrae (X-ray examination).