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
The Neurological Society of Paris held a conference December 15,
1916, with the chiefs of the neurological and psychiatric military
centres of France, and discussed a variety of questions concerning
invaliding, incapacity, and compensation in neuroses and psychoses
of war. Dupré dealt especially with the psychoses of war as caused
by trauma, strain, infection, and intoxication. General paresis is
regarded by Dupré as the most important of the dementias found in
the army. The medicolegal point of view is, of course, that
general paresis is necessarily related to an old syphilis, but its
late development leads to misinterpretations as to its probable
cause, both by the family and friends and even by magistrates. The
war acts in the French nomenclature as an _agent revélateur_ or as
an _agent accélérateur_. Although its cause is prior and exterior
to the war, general paresis in a majority of cases is brought out
(_revélé_) by the lack of adaptability of the general paretic to
the novelty and difficulties of his surroundings and duties in
war. Trauma, strain, and alcohol in a certain number of cases
accelerate the progress of a general paresis. The aggravation of
paresis is produced by these same factors, but especially by
violent cerebral trauma. According to Dupré, the Val-de-Grace
statistics show that the number of paretics has not been increased
by the war. Medicolegally, the victim of general paresis, like the
victim of traumatic or infectious chronic mental disorder, may be
assigned an incapacity of from 50 to 100%, and these patients are
invalided under _Réforme No. 1_,—a permanent invaliding.
Lépine of Lyons also discusses the compensation question in
general paresis. Lépine thinks that, although syphilis is
indispensable in paresis, yet the truth is that syphilis plus
something else unknown to us is responsible for general paresis.
This something else is neither a special kind of virus nor is it a
particular kind of prepared soil alone. Trauma, physical,
intellectual, and moral strain, and insomnia are the factors to
which he calls special attention as adjuncts in the production of
general paresis. As to the responsibility of the State for the
production of general paresis, according to Lépine, the maximal
responsibility should be 40% on account of the very considerable
predisposition to paresis created by pre-existent syphilis.
Public-domain text, read in full here on John Shaqi.
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