Swelling of hand and forearm, seven months.
Case 468. (Léri and Roger, September, 1915.)
A soldier was wounded September 22, 1914, at Charleroi by a bullet in the forearm. He came under observation May 14, 1915, with a huge edema of forearm and hand, suddenly stopping at the elbow, an elastic edema, especially marked in the palm, which was restored to its smooth contour very quickly after being compressed by the fingers, and very like an elephantiasis. The hand was in a position of moderate extension on the forearm, with fist clenched. There was a linear ecchymotic line at the upper edge of the zone of edema, especially on the antero-internal face.
According to the soldier’s own story, the swelling had begun a fortnight after the injury. He said that a very tight moist dressing had been applied during the first few days.
The patient was cared for by massage, and then by local baths. He was anesthetized in December and several drains were inserted; no result. In January he was chloroformed again and two long incisions were made along the internal border of the supinator longus and along the ulnar border of the forearm. He was better for two weeks after this second operation, but then grew worse.
The diagnosis of syringomyelia was now made, based upon the appearance of the arm and upon some ill-defined hypesthesia. This diagnosis was not entertained by Léri and Roger who, when they obtained the patient, put him into a plaster cast up to the shoulder. The edema went down rapidly to normal. In short, it was here a question of a simulator, who was even willing to undergo surgical operations with general anesthesia.
Re evading service, Gleboff’s classification is as follows: 1. False assertion of disease of (a) internal organs, (b) vision, (c) hearing, (d) joints. 2. Simulation of temporary disease of organs. 3. Mutilation of limbs.
Re swelling of hand and forearm, see remarks on hysterical edema under Cases [407] and [456].
A German shell-shy.