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
=Case J.=[30] A soldier in the reserves, 23, was, subsequently to his
being brought to hospital, described by his wife as a rather
over-sensitive fellow, who could hardly look at blood and was meticulous
about the household. He had always been subject to headaches, especially
after hard work. However, he had passed through his military training
well in 1910, not even having been _bestraft_.
He began service in October and fought at Dixmude on the 19th. On the
24th in the trench and while being carried back, he had several spells
of pallor, falling stiff, and then having convulsions. Brought finally
to the Charité in Berlin, he had more spells of sudden pallor, collapse
with brief convulsions, tossings in bed, and absences, post-convulsive
headaches, and mild bad humor.
There were numerous attacks several days apart in the first seven weeks.
The patient was not of an “epileptic” disposition, though he was rather
readily dissatisfied. Headaches also occurred without relation to
convulsions.
The serum W. R. was positive. Treatment by mercurial inunctions. No
further convulsions. Prognosis as to the possibility of a constitutional
epilepsy unknown.
=SYPHILITIC ROOT-SCIATICA (lumbosacral radiculitis) in a fireworks
man with a French artillery regiment. Case presented from Dejerine’s
clinic by Long.=
=Case K.= No direct relation of this example of root-sciatica to the war
is claimed nor was there a question of financial reparation.
There was no prior injury. At the end of March, 1915, the workman was
taken with acute pains in lumbar region and thighs, and with urgent but
retarded micturition.
Unfit for work, he remained, however, five months with the regiment, and
was then retired for two months to a hospital behind the lines. He
reached the Salpétrière October 12, 1915, with “double sciatica,
intractable.”
There was no demonstrable paralysis but the legs seemed to have “melted
away,” _fondu_, as the patient said. Pains were spontaneously felt in
the lumbar plexus and sciatic nerve regions, not passing, however,
beyond the thighs. These pains were more intense with movements of legs;
but coughing did not intensify the pains. Neuralgic points could be
demonstrated by the finger in lumbar and gluteal regions and above and
below the iliac crests (corresponding with rami of first lumbar nerves).
The inguinal region was involved and the painful zone reached the
sciatic notch and the upper part of the posterior surface of the thigh.
The sensory disorder had another distribution objectively tested. The
sacral and perineal regions were free. Anesthesia of inner surfaces of
thighs, hypesthesia of the anterior surfaces of thighs and lower legs.
The anesthesia grew more and more marked lower down and was maximal in
the feet, which were practically insensible to all tests, including
those for bone sensation. There was a longitudinal strip of skin of
lower leg which retained sensation.
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