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
2. What is the duty of the military authorities relative to so
called traumatic paresis? Medicolegally speaking, Froissart,
quoted by Rayneau, states that a victim of traumatic paresis _may
or may not_ have presented mental disorders before the accident,
that is, that the paretic symptoms may develop out of a clear sky
as a result of the accident. The accident itself must be of a
serious nature. The accident must be followed by phenomena
pointing to brain injury of traumatic nature. These phenomena need
not be characteristic symptoms of general paresis at the outset.
The period elapsing between the trauma and the supervening
condition of paresis must be occupied without notable
interruption, at first by phenomena of a purely traumatic nature,
later by signs indicating the onset and evolution of general
paresis.
The French invaliding process called _Réforme No. 1_ with pension
is granted according to the governmental instructions only to
officers, subalterns, and soldiers whose disease is due to trauma.
In view of this governmental regulation, the military surgeon must
write out certificates describing every cranial trauma, however
slight, which might have a bearing on the development of paresis.
However, he should not too readily admit trauma as a cause of
paresis. If a long period of quietude, a period in which the
trauma itself seems to have undergone a complete recovery,
supervenes, then general paresis should not be reported by the
surgeon.
Lépine has recently noted the following features as desirable in
board reports concerning paretics: nature of trauma, length of
service, fatigue endured, insomnia, date of infection, treatment,
W. R.
=Can “gassing” light up a paresis? Example from de Massary of
Issy-les-Moulineaux.=
=Case H.= A soldier, 35, was sent to the _Centre Neurologique_ with a
hospital ticket reading:
“Neurasthenia, general weakness following intoxication by gas.”
The soldier was thought at first to be a neurasthenic. But he soon
showed signs of more pronounced mental trouble. The voice was
suspicious. There was a slight irregularity of pupils.
An epileptiform attack occurred, followed by aggravation of symptoms.
Lumbar puncture showed pleocytosis. The W. R. of the serum proved
positive.
Yet the evident =neurosyphilis=, possibly =paretic= (de Massary’s
diagnosis), was preceded by a neurasthenia and the neurasthenia was
preceded by “gassing.”
De Massary believes the patient _and his family_ would perhaps be
justified in believing the condition produced by the injury. De Massary
is not clear as to the financial deserts of the patient. It is not a
manifest case of aggravation of antebellum symptoms, even if it be
neuropathologically an instance of acquired loss of resistance to
pre-existent spirochetes in body or brain.
Public-domain text, read in full here on John Shaqi.
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