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 adjuvant factors have been recognized in military paresis?
Aside from syphilis, Rayneau finds that alcoholism, malaria,
sunstroke and various intoxications serve as causes for paresis.
Rayneau points out that the apparent integrity of the mind in
general paresis may be such that they last in the army some time
and have their oddities ascribed to misconduct or breaches of
discipline. In fact the Legrande du Saulle called this early
period in general paresis the _medicolegal period_, showing, as it
so often does, thefts, outrages against decency, frauds, assaults,
exhibitionism and the like. To be sure these acts are absurd and
infantile and not difficult to recognize as of psychotic origin.
=Syphilis may bring out epilepsy in a subject having taint. Case
from Bonhoeffer, 1915.=
=Case I.=[28] A man of 35 in the _Landwehr_ acquired syphilis some time
in the summer of 1914. He was a good soldier, passed through several
clashes, and was promoted to _Unteroffizier_.
To understand what followed it must be stated that he had been a
bed-wetter to 11, had been practically a teetotaler (Bonhoeffer’s point
is perhaps that otherwise epilepsy might have developed sooner?), and,
when he did drink, vomited almost at once, and had amnesia for the
period of drunkenness. His father had been somewhat of a drinker. His
sister had suffered from convulsions as a child.
February, 1915, the _Unteroffizier_ lost appetite, got headaches, and
went to hospital for a time. Upon getting better, he was sent on service
to Berlin. In a Berlin hotel he had his first convulsions and
unconsciousness, biting his tongue. He was confused for several days,
and, when he had become clear, had a pronounced retrograde amnesia
together with a tendency to fabricate a filling for the lost period.
This retrograde amnesia is uncommon in epilepsy and suggests organic
disease. No sign of organic disease was found on neurological
examination. The patient had no signs of the epileptic make-up. The
serum W. R. was negative. On the whole, Bonhoeffer regards the epilepsy
as “reactive” to the syphilis, as a syphilogenic epilepsy.
As to the amnesia, it is of interest that alcohol should long before
have been able to cause amnesia in this man in the same way as does now
the syphilitic epilepsy.
Public-domain text, read in full here on John Shaqi.
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