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
3. Is there any significance in the story, if true, that Phillips
acquired his syphilis from a Mongolian? It seems to be fairly well
established that syphilis of the nervous system is extremely rare
in China and Japan, whereas bone syphilis is very frequent there.
It has been held that this has to do (_a_) with strains of
spirochetes, (_b_) with the state of civilization, or (_c_) with
the degree of “syphilization.” Apparently when a race is first
infected with syphilis the lesions are chiefly of the cutaneous
and osseous systems; only in later generations the vascular and
nervous systems suffer. However, involvement of the nervous
systems of Mongolians resident in this country is no rarity, a
point possibly in favor of the theory of special strains affecting
the nervous system as prevalent in western countries. Little or
nothing is known as to the effect of transmission from one race to
another, as from Mongolian to Caucasian in Phillips’ story.
=NEUROSYPHILIS is NOT to be entirely ruled out by a negative serum
Wassermann Reaction; for the fluid Wassermann Reaction may be
positive.=
=Case 13.= William Twist is a case of note in the matter of the
so-called preparetic period (the idea of Charles L. Dana which was
scoffed at when first proposed by him in 1910). The patient, a very
successful traveling salesman, 35 years of age, was admitted to the
Psychopathic Hospital showing a typical picture of general paresis.
Thus, =mentally=, the patient showed elation, grandiosity (millions of
dollars to give away), intellectual weakness, disorder of memory, lack
of judgment, rambling talk, speech defect, omission of letters in
writing and spelling.
=Neurologically=, there was tremor of the lips, slight irregularity of
the pupils, which however reacted well, and lively knee-jerks.
Mr. Twist had sought advice at our out-patient department in his
thirty-third year. The records show that at that time he was somewhat
depressed, and his speech was even then, according to his own statement,
stammering. However, we found the W. R. at that time to be negative in
the blood serum. It appeared that his mother had died of consumption;
his father was said to have committed suicide. A brother had once
recovered from an attack of depression, presumably an attack of
manic-depressive psychosis. Accordingly, we thought at the time that the
case was probably one of manic-depressive psychosis. Moreover, our
routine serum W. R. failed to indicate any syphilitic process. As for
the so-called stammering of speech, this appeared to be a matter of the
patient’s own recollection rather than of our observation. In any event,
the patient had gone into the country and appears to have entirely
recovered; falling, again, however, into mental difficulties after a
short period, and finally arriving at the hospital in the
above-mentioned classical condition.
Public-domain text, read in full here on John Shaqi.
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