Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case historiesSouthard, Elmer Ernest
Science
Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories
Southard, Elmer Ernest
Neurosyphilis
1. What is the significance of Mary’s trauma at three years? So far
as we are aware, none.
2. What light could be thrown by a W. R. study of the family? In
some instances, much light is thrown; in the present case all
three living sisters of the patient have been examined and their
serum W. R.’s have been found negative.
3. What is the prognosis of juvenile general paresis? Death within a
few years, as in general paresis in adults. The patients live
rarely more than four or five years after the onset of symptoms.
Mary Coughlin died a year and a half after the above examination,
namely, in her eighteenth year, some seven years after the onset
of symptoms.
4. What can be said of treatment? A few favorable results have been
reported after intraspinous therapy (Swift-Ellis). Too little work
has been done with systematic treatment of juvenile neurosyphilis,
both paretic and non-paretic, to permit important conclusions at
this time.
5. How can we explain the infection of this sibling whereas the
others, both younger and older, escaped? It would seem that we
would have to discard the hypothesis of a congenital infection and
consider that it was acquired accidentally during the lifetime of
the patient. Considering the prevalence of syphilis it is rather
to be wondered that more such cases of “innocent” infection do not
occur in children. We may recall how many instances of juvenile
gonorrhea occur. In a case as this where the symptoms calling
attention to syphilis necessarily occur so long after the original
infection it is practically impossible to trace the origin of the
infection.
=The diagnosis of JUVENILE PARESIS is often easy.=
=Case 36.= Theresa Mullen, an under-sized girl of 12 years, presented a
remarkable appearance due to congenital amputations of the fingers and
toes. She lay in bed, drivelling and making unintelligible cries. It
appeared that the patient weighed about 12 pounds at birth and was very
fat; that she had been fed on condensed milk, had survived cholera
infantum, whooping cough, and, as the parents said, “two kinds of
measles.”
Theresa had gone to school at 5 years, reaching the third grade at the
age of 9; but at this time, she began to lose ground and was put in a
class for backward children. Moreover, at about this time, the teachers
noticed spells of causeless laughter and meaningless twisting back and
forth. Theresa would also scream at night, looking about the room; once,
rising and crying, “Take him away, that black thing,” though no
appropriate object was present. There had been little or no complaint of
headache. Theresa had been deteriorating for some time, and for a year
past had been having increased difficulty in walking. For two months the
child had not spoken intelligible words; for the last week, she had been
incontinent.
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