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
=Past History.= Medical history is unimportant. He denies syphilis. His
early childhood is of little significance. He was somewhat dull in
school. At about the age of twelve he began to lie and steal, and has
continued this ever since. His attempts have all been very crude, it is
said, and when confronted he would strenuously deny his deeds, even when
the evidence was overwhelming. He forged checks, borrowed money from all
his friends, and charged things at stores to the family. The family paid
the bills for a time, and then later had him sent to a reform school. He
was married at nineteen, but wife has left him and obtained a divorce.
He has been excessively alcoholic for years, and is suspected also of
taking drugs. He was discharged from the navy dishonorably. He later
joined the army and was discharged therefrom on account of “rheumatism,”
according to his account, but in reality deserted. He had finished a
jail sentence of thirteen months for forgery a little over a year before
entrance.
=Physical examination= shows a well developed and nourished man. The
general physical examination is negative. The lungs show nothing
abnormal. The heart is not enlarged, there are no murmurs or
irregularities; blood pressure, 145 systolic. The alimentary system is
negative. No palpable lymph glands. =Neurological examination=: pupils
equal and react to light and accommodation. Extraocular movements well
performed. Tongue projects in the median line, with no tremor. There is
no evidence of facial paresis or weakness of the muscles. The biceps,
triceps, knee-jerks and ankle-jerks are present and equal on the two
sides. There is no Gordon, Babinski or Oppenheim; no ankle clonus. There
is no tremor of the extended hands. No Romberg sign. There is a little
difficulty in the finger-to-finger test. There is no sensory disturbance
either subjective or objective. No tenderness over nerve trunks.
=Mental examination= shows nothing of a psychotic nature. Patient is
well oriented; memory for remote and recent events is well preserved,
school knowledge well retained, grasp on current events good; no
delusions or hallucinations elicited. Patient is not feebleminded,
according to the intelligence tests of Binet and Simon and
Yerkes-Bridges, but shows poor attention and gives evidence of weakness
in volitional spheres; is very suggestible.
To summarize the case, then, we have a man of thirty years of age who
has shown criminalistic and anti-social tendencies since childhood,
whose general physical and neurological examination is negative
(excepting the laboratory tests), whose mental examination shows no
psychotic symptoms, and who seems not feebleminded. In other words, with
the exception of the serological and chemical findings in the blood and
cerebrospinal fluid, there is nothing to suggest that he is more than a
“criminal type.”
Wassermann reaction in blood serum positive.
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