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
=REMISSIONS of identical appearance occur in PARETIC and in DIFFUSE
(non-paretic meningovascular) NEUROSYPHILIS.=
=Case 23.= Thomas Donovan, a merchant 44 years of age, acquired syphilis
according to his own story at the age of 31, and he was at that time
treated at a well-known watering-place with mercurial injections. Later
he continued treatment under his family physician, and at 34 was
pronounced cured. However, four years later—that is seven years after
his initial infection and in his 38th year—he had his blood examined and
it proved positive. He was accordingly treated by salvarsan and his W.
R. became negative. The story did not end there, however, for at 43,
mental symptoms appeared of the nature of depression and a diagnosis of
paresis was made. He was released from the institution against advice at
that time, and without treatment, made a partial recovery.
A sudden outburst of violence brought Mr. Donovan to the Psychopathic
Hospital; he was very surly, combative, and difficult to manage,
standing 6′ 2″, and weighing 210 pounds. He was oriented only fairly
well and his surliness was streaked with humor. He facetiously said that
the Psychopathic Hospital was the largest hospital in the country, and
that it was, in fact, a horse hospital; that he had come because he
liked the surroundings, not to make money; that he was the healthiest
man in the world, never having been sick; that the Psychopathic Hospital
was a club, for which you have to get somebody to propose your name.
There was amnesia and no knowledge of current events. He regarded the
food as poisoned, refused to eat, and was very irritable and untidy.
=Physically=, there were few abnormalities, but the pupils failed to
react either to light or accommodation, and the knee-jerks and
ankle-jerks were absent. There was a slight Rombergism. There was a
marked speech defect to test phrases. Both serum and spinal fluid W.
R.’s were positive; the fluid showed 41 cells per cmm., there were large
amounts of globulin and albumin, and the gold sol reaction was of the
“paretic” type.
=ATAXIA OR INCOÖRDINATION=
NEUROSYPHILIS
LESION OF PERIPHERAL SENSORY NERVES
DIVISION OF POSTERIOR ROOTS
TUMORS OR CHRONIC SCLEROSIS OF POSTERIOR COLUMNS
SUBACUTE COMBINED DEGENERATION
VESTIBULAR ATAXIA
FRIEDREICH’S ATAXIA
FAMILY PROGRESSIVE HYPERTROPHIC NEURITIS
THROMBOSIS POSTERIOR INFERIOR CEREBELLAR ARTERY
MARIE’S HEREDITARY CEREBELLAR ATAXIA
LESIONS OF CEREBELLUM, TUMORS, ETC.
WRITERS’ CRAMP
PREHEMIPLEGIA
MULTIPLE SCLEROSIS
PSEUDO-SCLEROSIS
HYSTERIA
CHART 18
=CONDITIONS IN WHICH VERTIGO IS FOUND=
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