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
The speech in 1904 had been somewhat defective (“truly rural” rendered
as “tooly lualal,” “sifted soft thistles” as “thoft thsistles”), and
there had been little further development of the speech defect. The
handwriting had lost appreciably in legibility and had become much more
tremulous. During the first period of hospital observation Morrill had
what might possibly have been visual hallucinations, but it was
impossible to tell whether his story of seeing his wife and children
trying to get in through the window was hallucinatory or a matter of
fabrication. Memory was decidedly imperfect and few details of recent
events could be produced. The association of ideas was almost a
so-called “flight” of apprehensive, fearful ideas, loosely connected,
incoherently expressed, and dealing chiefly with his work and his
children. Judgment was imperfect; the height of the room was estimated
as 24 feet, but the height and weight of persons were estimated with
fair accuracy, and also the length of small objects, whose lengths were
doubtless remembered rather than estimated. The estimate of time
elapsing during a medical examination was accurate, but the estimate of
longer durations involving over-night memories was hopelessly imperfect.
Emotionally, there was a dulling of sensibility, an appearance of
suspicion and apprehensiveness; the patient fancied himself to be in a
hopeless condition as a result of syphilis, but at the same time
accompanied his statement of his hopelessness with laughter. A sample of
his hypochondriacal ideas: “I am all gone; I am good for nothing; I am
all gone now; I can’t drink now; can’t write or talk at all; worse than
when you saw me first; nothing in my inside; all wrong through me again;
I aint got no swallow now; I can’t die even; my heart aint much good; I
can’t hear it beat; I don’t think it flutters; no life in these hands;
they are all cold and dead” (pointing to his arms and moving them
about). During such a portrayal the patient laughed in a silly way.
During the second hospital stay, Morrill was at first restless,
sleepless, profane, imperfectly oriented for time, possibly for place,
and also for the attendants. A few weeks later he became stuporous and
confused, and his feebleness and physical exhaustion were finally ended
by death, March 21, 1906. Death was preceded by a semi-comatose
condition; a left otitis media had developed.
Public-domain text, read in full here on John Shaqi.
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