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
Ordinarily, one might content himself regarding the case of John Doran
as one of idiopathic epilepsy with mental defect or deterioration.
However, the frontal bosses, suggestive teeth, the flattened bridge of
the nose, the roughened tibiae, and the old scars, though singly not of
great significance, collectively make one suspicious. Despite the family
physician’s belief that John could not have acquired syphilis from the
parents, the infection seems entirely possible despite the fact that no
symptoms developed early thereafter.
The W. R. in this case proved positive in both blood serum and spinal
fluid.
1. What is the relation of trauma to this case of JUVENILE
NEUROSYPHILIS? Probably none.
2. What would be the effect of treatment? For a number of years John
Doran was lost sight of. He was, however, treated, according to
our information, with intraspinous injections of salvarsanized
serum, whereupon his convulsions shortly ceased. He has been
recently examined mentally once more, and still grades as
feebleminded. He still has violent outbreaks of temper.
3. Is such a case as Doran typical? Shanahan has investigated
conditions at Craig Colony. There were 22 out of 886 epileptics
(at Craig Colony) or 2½%, who showed a positive W. R. Nine of
these cases were regarded by Shanahan as cases of epilepsy
actually caused by syphilis. Viet had found 7%, and Bratz and Lüth
5% of constitutional epileptics to be syphilitic, but the data of
these German authors were obtained before the era of Wassermann
tests.
=Adrenal tuberculosis complicating juvenile paretic neurosyphilis
(“juvenile paresis”). Autopsy.=
=Case 80.= When James Arnold appeared at the Danvers Hospital in his 22d
year, he looked as if he were but 12 or 14 years of age. He was
excessively fat but of fair muscular development. The left eye diverged
outward, and the left pupil was smaller than the right. An odd feature
was a high degree of pigmentation of the skin of the genitalia and the
groins (the axilla, the mammillary areas, and the oral mucosæ were free
from pigmentation). =Physically= speaking, the patient was practically
normal. =Neurologically=, however, there was much of interest, in the
light of which the clinical history was of value.
It seems that after an apparently normal early childhood, the boy had
begun, at the age of 11, to experience difficulty in carrying out
every-day school tasks; and after this his mental capacity had slowly
but progressively deteriorated. The deterioration was not merely
intellectual, but the boy became dishonest and untrustworthy and
developed a number of untidy and uncleanly habits, behaving at the age
of 16, as the parents stated, like a child of six.
Public-domain text, read in full here on John Shaqi.
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