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
=Physical Examination.= Patient is a well developed and nourished man
thirty-two years of age. Head is normal as to size and shape; there are
no scars or marks of injury. Hair and skin not remarkable in any way.
Ears negative to external examination. Teeth well kept; two missing,
several gold fillings. Tongue very slightly coated. Throat negative.
Tonsils easily visible without evidence of inflammation or exudation.
Neck, no thyroid enlargement, no abnormal pulsations, no adenopathy.
Chest, symmetrical, expansion good, resonant throughout. Breath sounds
transmitted normally. No râles or rubs heard. Heart, no enlargement or
cardiac dulness. Sounds of good quality, no murmurs heard. Rate regular.
Pulses equal, regular and synchronous, and of good volume and tension.
Systolic blood pressure 130, diastolic 65. Abdomen, flat, soft and
tympanitic throughout; no masses; no tenderness. Liver edge not felt,
below costal margin. Spleen not palpable. Extremities negative, except
for incised wound on left wrist.
=Neuromuscular Examination.= Pupils are large, round, regular, equal and
react readily to light and accommodation. No nystagmus, strabismus or
ptosis. No weaknesses or paresis of facial muscles. The tongue projects
medially and shows no tremor. The triceps and biceps reflexes are
readily elicited, and are quite active, as are the knee-jerks and
ankle-jerks. On one occasion it was thought that the tendon reflexes
were slightly more active on the left than on the right. This was never
confirmed; always afterwards found equal. There was no tremor of
extended hands. Abdominal reflexes not elicited. Cremasteric present on
both sides. The plantar response is flexor. There is no Babinski, Gordon
or Oppenheim. No Romberg. Coördination tests well performed. No speech
defect. No sensory disturbances. Urine examination negative.
Wassermann reaction in the serum: Positive, with cholesterinized
antigen; negative, with syphilitic fetal liver antigen.
Wassermann reaction in fluid positive on two occasions. Examination of
spinal fluid, November 4: globulin +++, albumin ++, 100 cells per cubic
millimeter; large lymphocytes, 8 per cent; small lymphocytes, 90 per
cent; plasma cells, 0.7 per cent; endothelial cells, 1.3 per cent.
November 11, globulin +++, albumin +++, cells 18 per cubic millimeter.
November 26, globulin ++, albumin ++, cells 92 per cubic millimeter;
large lymphocytes, 13.1 per cent; small lymphocytes, 82.1 per cent;
plasma, 1.2 per cent; endothelial, 3.6 per cent.
Gold sol, November 4, 5555432100.
Gold sol, November 26, 3332100000.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account