Shell wound and burial: Camptocormia (psychoelectric treatment successful in one séance) and lameness (long reëducative treatment successful).
Case 584. (Roussy and Lhermitte, 1917.)
At a Neuropsychiatric Center, September 2, 1916, arrived a chasseur, 29, showing lameness of a pseudocoxalgic type on the left side, combined with an anterior camptocormia. The whole situation had lasted a year. The chasseur had been wounded by shell explosion on the left side and was buried on July 29, 1915. He lost consciousness and had respiratory trouble and mutism. His arched walk and lameness began August 20, 1915.
He had a number of terms in hospital and six months at the dépôt. He was sent back to the front, June 20, 1916, being proposed for auxiliary work. There was some mental weakness. After one séance of electric treatment, the improper attitude of the trunk was corrected. The lameness, however, persisted and required long daily reëducation.
The patient was discharged cured, October 20, 1916, without lameness or camptocormia. There were a few persistent lumbar pains.
Re treatment of war psychoneuroses, Roussy and Lhermitte recommend rational and persuasive psychotherapy after the manner of Dejerine, Dubois, Babinski, and others. Hypnosis, they say, should definitely be rejected. Mental contagion must be staved off, and Roussy and Lhermitte believe that almost all cases are curable and should be sent back as competents.
They maintain that the medical officer himself plays the leading part. Many patients are “cured” when they find “good masters”; this mastery of the combined confessor and educator is greatly aided by prestige. He must speak with authority, with “iron in the velvet glove”; but with patience and persistence. If a long sitting fails, postpone work on the pretext of resting the patient. The patient must not be early threatened with discipline. Even exaggerators and malingerers must be talked to as if neuropathic.
A careful medical examination, besides correcting false diagnoses and demonstrating hystero-organic associations, will give the patient confidence in his physician.
A new patient is more easily cured than an old one. In general, patients should be treated as soon as possible after the shock. Contractures are habitually more persistent than paralysis; tremors and tic are more pertinacious than deafmutism; ante-bellum psychoneuroses are less easy to treat than cases developed by the war alone.