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
II. INTRAMUSCULAR INJECTIONS
1. MERCURY
2. SALVARSAN, NEOSALVARSAN, OTHER ARSENIC PREPARATIONS
3. SODIUM NUCLEINATE
4. ANTIMONY
III. INTRAVENOUS
1. MERCURY
2. MERCURIALIZED SERUM
3. SALVARSAN, NEOSALVARSAN, ARSENIC
4. IODIDES
IV. SPINAL INTRADURAL
1. SALVARSANIZED SERUM (IN VIVO—SWIFT-ELLIS)
2. SALVARSANIZED SERUM (IN VITRO—MARINESCO-OGILVIE)
3. MERCURIALIZED SERUM (BYRNES)
V. CEREBRAL SUBDURAL AND INTRAVENTRICULAR
1. SALVARSANIZED SERUM (IN VIVO)
2. SALVARSANIZED SERUM (IN VITRO)
3. MERCURIALIZED SERUM
CHART 26
=Physically=, the patient showed a right-sided hemiplegia with excessive
right knee-jerk, but without Babinski or other abnormal reflex
phenomena. The extraocular movements were somewhat restricted in range
but there was neither strabismus nor nystagmus.
The question arose whether the hemiplegia was of hemorrhagic or
thrombotic origin. After all, at 51 years, hemiplegia is rather unlikely
to be of a non-syphilitic arteriosclerotic origin; moreover, we had a
clear history of syphilis. The serum W. R. proved positive as well as
the spinal fluid W. R. The finding of 77 cells per cmm., excess albumin,
and positive globulin test, taken in connection with the entire picture
seems to warrant a diagnosis of CEREBROSPINAL SYPHILIS. If we proceed on
statistical grounds, it might be regarded as more probable that the
hemiplegia is THROMBOTIC in origin rather than hemorrhagic. It appears
that syphilitic cerebral thrombosis rather characteristically occurs
without preliminary symptoms, despite the fact that many cases do show
headache, dizziness, and restlessness as prodromal symptoms.
1. What is the treatment indicated in the case of Mrs. Meyer?
It would appear that little or nothing can be done for the
hemiplegia unless the claims of Franz with respect to
reëstablishment of a degree of function in certain hemiplegics are
substantiated. However, the indication of meningitic process as
shown by the spinal fluid, suggests that the case is not a purely
vascular one but may be regarded as meningovascular. (Possibly,
also, we should regard the left frontal depression and scar as
indicative of a non-parenchymatous and non-vascular process.)
Accordingly, antisyphilitic treatment should be theoretically of
some value.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account