The psychic effects of accidents / by Tom A. Williams.

  • Williams, Tom A. (Tom Alfred), 1870-
Date:
1912
Catalogue details

Licence: In copyright

Credit: The psychic effects of accidents / by Tom A. Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    6/16 (page 6)
    Sensibility was normal. Psychic Examination.—This showed the iJathogenesis. He was particular to old- maidislmess, and dyspeptic all his life. He was subject to petty worries and easily annoyed. Lately, he had feared losing his position to a pushing subordinate, and little family worries had occurred. A son had studied medicine, and he himself had often gone to the lectures, by wliich knowledge he understood the mechanism of his allection to be “a failure of the will to connect with what moves the arm.” He defied me to make him move the arm by suggestion. Treatment.—Entirely acquiescing, 1 explained that the fault was not in the con- nection, but in the controller himself, and admitted my inability to make his arm move, but declared that he could by practice. Having disarmed him thus, I easily inaugurated movements on the spot by suggestion, and he Hexed and rotated the forearm and moved the lingers. Then his wife and doctor were called and shown the improvement. An encouraging prognosis was given, and a week’s horseback tour advised. The iron was not struck while hot, so he did not recover for some time; but he is now well. II. IlYSTERiCiVii Prurigo.—A girl aged t) came to the dispensary on account of itch- ing of the right side of the face. Her frequent scratching had kept up a pityriasis. This had begun two years before, after her father had for some weeks suffered niueh from furuncle, when he had itched all over, scratched much, and spoken of it a great deal. He still does so when he eats pork, thinking that it makes him itch. The little girl had only one boil on the right heel, and this she feared to scratch. It did not appear that the child’s face had really been diseased; but I believed that the eruption was kept up by a morbid impulsion to scratch, and therefore prescribed sulphur ointment with the object of inculcating belief, and impressed upon mother and child the need of never touching the face, and assured them that the itching would totally disappear in two weeks, which prediction was verified by the result. III. Hysteric.;VU Typhlitis After Appendectomy.—A girl of 20 was seen with Drs. Watkins and Stavely because of recurrences of right iliac pain with nausea and vomiting, but with normal temperature and pulse, since three months. Two months before, the appendix had been removed for similar symptoms, and found little changed, though containing a concretion of lime. At the time, the ovaries and gall-bladder were found normal. The pains recurred every few days, lasted some hours, and were relieved by morphine or the ycotch douche. Examination showed only a psychogenic hyperesthesia in the right iliac fossa, controllable by indirect suggestion. Some sacral atonia, a slight retroversion, and intestinal sand could not explain a manifestly psj-chogenic tenderness. After being convinced that a determination to conquer a longing for the comfort and anodynes which sickness brings would cure her, she went back to her home and remains nell. Litigation Not Itself the Cause. It has been stated that a lawsuit is necessary to create traumatic liysteria. That this is not so is shown by the following case, where the idea of entire disability was created by the presence of a partial disability due to an accident and was very simply removed by psychotherapy without question of in- demnity :— Incapacitating Hysteria Engrafted upon Hejiatomyelia of the Right Hand AND Arm Segments.—A man of 20, apprenticed mechanic since the age of Iff, was seen with Drs. Conklin and Lewis Taylor in June, 1911. Two years before, he had dived to the bottom of a creek. Tbe concussion which ensued kept him in bed with severe headache and unable to move for three days. Urinaiy incontinence lasted one day. He vomited at first. For nearly a year he was unable to walk without severe staggering; his speech had been very dillicult, and still remained slow. He complained also of great sleepiness and difliculty in holding his water; so that he was quite unable to go