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
It seems that four months before going to the police station, she
developed a chancre, which was locally treated. A careful physical
examination showed a fine red macular eruption which was without much
question a syphilitic roseola. The spinal fluid yielded a positive W. R.
although other tests of the fluid were negative. Curiously enough, no
physical sign of involvement of the nervous system could be discovered.
We were inclined to regard the mental symptoms as partly due to the
syphilitic intoxication, and partly due to a psychic reaction of the
nature of defense. As for the positive W. R. in the spinal fluid, in
early secondaries various observers differ as to the frequency both of
the W. R. and of other changes, percentages being given that range from
25 to 90%. See case Caperson (45). It is of note that clinically there
were symptoms referable to a syphilitic involvement of the nervous
system; namely, marked headache and malaise. The headaches of the
secondary period are frequently the result of meningeal involvement.
=TABOPARETIC NEUROSYPHILIS (“taboparesis”); death from TYPHOID
MENINGITIS. Autopsy.=
=Case 82.= Frederick Estabrook was a salesman, who, be it noted, had
never had typhoid fever or any disease remotely resembling typhoid
fever. He had acquired syphilis at 19; had married at 22; was the father
of two healthy children (no miscarriages); had had a certain disturbance
of bladder and rectum, but remained a successful salesman to the age of
28, when advancing tabes confined him to bed for a time. At 30, mental
signs of PARETIC NEUROSYPHILIS developed, and death followed at 32,
after an acute illness of a week.
The details of the history after the first symptoms at 28 are as
follows:
At twenty-eight patient lost control of limbs and was confined to the
house about two months, under medical care. Three months later he had
regained partial control of his limbs but had lost all control of his
sphincters. After another month he had returned to work, but did not
work steadily and seemed to have lost ambition. In the summer of 1905,
his mind became obviously altered. He grew indolent and extravagant and
given to buying expensive and useless articles. Loss of interest in
things followed, together with loss of memory for recent events, lack of
insight into illness, delusions of persecution by wife, irascibility
followed quickly by crying. Before admission to hospital, he was
euphoric, drawling and tremulous in speech, sprawling in penmanship,
alternately depressed and exalted in manner. Knee-jerks were absent,
gait ataxic, pupils stiff to light.
The family history was negative with respect to insanity. All the family
were reported as nervous. A brother died of peritonitis at twenty-eight,
a sister of pneumonia under twenty. Another brother and sister are
living. Father and mother died of heart trouble at about sixty-seven and
sixty respectively.
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