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
However, according to his wife, Crane had acquired chancre at about 26
years, was treated mercurially for about three years and declared well.
He had remained well up to about 18 months before entrance, when,
without previous warning, the patient had a convulsion with the
continuous movements for about half an hour. He was semi-conscious for
about 18 hours and vomited continuously. There was amnesia for the whole
affair on regaining consciousness. In a week’s time, Crane was entirely
well. But six weeks later there was another convulsion. Upon removal to
a hospital, the diagnosis of general paresis was made, and the patient
was given the Swift-Ellis intraspinous treatment. This seemed to be very
successful, and the patient discontinued treatment after 14 weeks
(during which time there had been seven treatments) on the ground that
he was entirely well.
However, after discontinuing treatment, there was another convulsion in
about a month, and further convulsions occurred once a month. For six
months, however, the patient took no treatment, but finally returned to
the hospital and was given mercury. This treatment appeared to suspend
convulsions again for three months, but at the expiration of six months,
the patient had three convulsions in one day, and several more during
the following days. After the last of these convulsions, there had been
numbness on the right side of the body and considerable headache.
The diagnosis of PARETIC NEUROSYPHILIS (“general paresis”) is borne out
by the laboratory tests. The W. R. of the blood serum was, to be sure,
negative, but the W. R. of the spinal fluid was positive, and there was
a “paretic” type of gold reaction, together with other laboratory signs.
The case well demonstrates that group of paretic cases in which
convulsions periodically occur, leaving the patient worse after each
convulsion. Treatment with salvarsan was instituted, and mercury and
iodid was given by mouth. During the period of eight months which have
now elapsed since the beginning of this treatment, there have been no
convulsions; there has been a great improvement in the memory, the
hearing has improved, the W. R. in the spinal fluid is much less
intense, the gold sol test has become negative, and the other tests are
all less intense.
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