Re reëducation of cutaneous sensations, Chavigny recommends the faradic current in successive applications, marking the extent of the zone of anesthesia with ink upon the skin. Each time the current is applied, the inked limits of the area are lessened. By this form of suggestion, not only does the anesthesia disappear, but very often the accompanying paralysis also.
Hysterical contracture, edema and vasomotor disorder.
Case 407. (Ballet, July, 1915.)
For some unknown reason, a soldier developed a contracture of the right upper and lower extremities at a time when a basin of water was offered to him for toilet purposes. Three days later, this contracture disappeared in the leg but persisted in the arm at the radiocarpal joint and in the finger joints. There was also an anesthesia to touch and pain and temperature which ran up the arm to the shoulder. The tendon reflexes were normal. On the whole, there seemed to be no doubt that the case was one of hysterical arm contracture. Associated with this contracture was a white edema of the hand. On account of the chances of simulation, the hand was done up and sealed in such wise that the seals would have been broken if the splint had been lifted down during the night. The bandage was in place from June 25 to June 29. Upon its removal, there was no edema, but the contracture was still there. The arm was put up upon a cushion so that the hand would drain to the forearm. The edema was found capable of returning when the hand was placed below the level of the shoulder, disappearing when the hand was raised. The contractured hand was warmer than its fellow. According to Ballet, we here have an anesthetic instance of contracture associated with edema and vasomotor disorder.
Re edema, Babinski states that no case of hysterical edema has stood the test of scientific critique. Sometimes a case turns out one of tuberculous synovitis. Sometimes the patient is shown artificially to have brought about the edema. The hysterical “blue edema” of Charcot has not been proved to exist. Some during the war have been found due to voluntary constriction. Some of these constriction edemas even become relatively permanent. Babinski regards the above case of Ballet, as well as cases of Lebar and of Raynaud, as not true cases. Raynaud’s case was probably vascular.
Re vasomotor disorders in Ballet’s case, the Babinski school, of course, holds that hysteria cannot cause such disorders.
Hemiparesis with syringomyelic dissociation of sensations.