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 the practically negative tests in
this case without clinical improvement? One must believe that the
tests became negative as the result of treatment, and that this
change in the tests was due to the clearing up of some
inflammatory reactions which were present. This may mean that the
syphilis had been reduced to inactivity or latency if not cured,
or at least that there was no activity sufficient to cause a
positive W. R. in the blood serum, whereas whatever activity was
present in the brain was in such a region that it did not cause
any reacting substances to be cast into the spinal fluid. This
would not mean that there would necessarily be any return of
function already lost, because this may be considered as a
permanent loss which cannot be compensated for. As to these tests,
we now feel that the case should remain stationary; that is, that
no new symptoms will be added. However, we believe that it is
somewhat premature with our present knowledge to make this claim
very forcibly, and would rather suggest that this case be
considered as demonstrating an interesting fact, the meaning of
which can be learned only after a period of years.
2. Why does the gold sol reaction remain strongly positive when all
the other tests become negative? As already pointed out, above
(Case Martin (117)) there is no known rule about the disappearance
of one or other of the abnormal findings in spinal fluid under
treatment, and we can at present offer no explanation of this
phenomenon. It does, however, illustrate how careful we must be in
drawing any conclusions from tests in cases that are being
treated.
=Diminution in the spinal fluid tests may occur in treated cases of
neurosyphilis without clinical improvement.=
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