Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories — John Shaqi
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
arm was rather more impaired than that of the right arm, while on the
contrary the sensibility of the left leg was better than that of the
right leg, though the difference between them was not great. These
statements apply to sensory tests by contact, heat, cold, and pricking.
Knee-jerks were highly exaggerated, and likewise the wrist-jerks. All
forced attempts at movements were attended by a high degree of muscular
tremor, especially when the patient was fatigued or under emotional
strain. The fingers especially were the seat of coarse tremor.
The remainder of this clinical description (courteously supplied us by
Dr. Putnam) may be quoted. A second examination which included also a
few facts not given in the first examination was made on the following
March 28, 1905. This report says “the ends of the fingers became numb
about June 1, 1904. Work was given up on July 3, and at that time the
patient was walking very badly. No treatment was used and no
satisfactory diagnosis made. In the course of July he improved somewhat,
and during August he was able to ride out a little (these spontaneous
improvements are of interest for the diagnosis). He went away from home
for a short time, but from the time of his return, about the last of
September, he grew worse rapidly, and fell into the condition above
described, in which he was wholly unable to help himself, even to
turning in bed. At times he had a great deal of pain in the neck and
forehead. Antisyphilitic treatment was recommended, and for a time
potassium iodid and other iodid preparations were given, but at first in
relatively small doses (grs. 75 daily). Under this treatment the
excretion of urine rose to four quarts daily as a maximum though
sometimes the quantity was not so great.”
Under this treatment the patient began soon to improve, and continued
doing somewhat better till about five months later. He became able to
walk downstairs and out of doors, and regained considerable use of his
hands. The quantity of urine passed became greatly increased by the use
of the iodid.
About the middle of March he became worse again. A careful examination
of the sensibility showed that in general the condition was much the
same as that previously reported. The iodid treatment, with perhaps some
mercurial, was resumed; the potassium iodid was given in doses which
were increased up to 850 grains daily, although this maximum dose was
taken only for about one week. This large quantity gradually impaired
the sense of taste for the time being, and blurred his vision, but
otherwise did him no harm. Under this he improved, so that he became
able to run more or less, and went about freely, and attended to his
business, though still retaining some stiffness in his movements.
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