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
Small injections of diarsenol at intervals of a month were continued,
and Bright remained perfectly well for four months, when a peculiar
seizure developed and lasted for several hours. This seizure consisted
in a sort of somnambulism in which Bright stood up at a table, making
marks on paper, and could not be persuaded to desist. After this
seizure, Bright re-entered the hospital, again showed no mental or
physical symptoms and no abnormalities of blood or spinal fluid.
3. What is the explanation of this seizure? It is possibly due to a
small vascular insult, for which potassium iodid may be suggested
with precautions as to hygiene and continued observation. He has
since remained entirely well.
=Another example where MILD MEASURES (though conceived to be
“adequate”) SEEMED TO BE LEADING TO FAILURE; INTENSIVE THERAPY
SUCCESSFUL.=
=Case 122.= Levi Morovitz, a waiter, 39 years of age, came to the
hospital with evidences of an old left hemiplegia, including the left
side of the face (there was a left-sided Babinski, Gordon, and
Oppenheim, and all the reflexes were fairly active; sluggish pupil
reactions, Rombergism, and speech defect). Morovitz was much depressed,
very slow in thinking processes, had a marked memory disturbance in
general and apparently much deterioration mentally.
A history was obtained to the effect that Morovitz had acquired syphilis
at about 33, but that he had received practically continuous treatment
ever since at a dispensary. He had, in fact, received four injections of
salvarsan a year before coming to the hospital. Of late, Morovitz had
become much more cheerful and talkative, imagining he could do great
things if he had money. He had begun to eat very rapidly and to be very
nervous. His feet had begun to drag; a distinct speech defect developed,
but from this he had recovered. About six weeks before entrance,
Morovitz had a shock, which left him with the left hemiplegia above
mentioned and with considerable headache.
Even while the preliminary examination was being performed, Morovitz
developed a minor seizure without loss of consciousness. First came
severe pain over the frontal region, which grew in severity so that the
patient held his head in his hands. A bit later, twitching movements
began in the thumb and in the fingers of the left hand, and the small
muscles of the extensor group of the thumb and third finger showed
contractions. These contractions grew more general and the excursions of
the fingers greater, until finally every finger of the left hand became
involved, whereupon movements of the same sort, though of smaller
amplitude, began in the other hand. Finally the left arm began to jerk
with alternate contractions of the biceps and triceps. The whole seizure
lasted more than five minutes. During the seizure there was dizziness
and pain in the head, chiefly on the right side.
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