A case of syphilitic encephalopathy
Transactions of the Royal Academy of Medicine in Ireland
Cf. Discussion opened by Binswanger at the Twelf 91 International Congress, ~oscow. A Case of Syphilitic EncephaIoTathy. system. Ir is mail~ly as a case in point that I have tlmught ir worth while to bring the following uu(ler )-our notice, ~~lthough there a~'e not wantiag, as I think, other points of i~~terest in it: CASE. A gentleman, furty-five year.~ of a~e, married, was admitted to Farnham House on February 23rd i 1897. His history, ascertained at various times subsequentLy, is as fol[ows
... tLy, is as fol[ows :--tte comes (,f an aristocratic family, more tlian one member of which has li,en to eminence his grandfather, for example, held a very ILigh ecclesiastica[ posiLion 4hough he llimself was merely a minlor ~~tticial in a small provincial town. itis mother's sister w~~s insane, and both paren.ts hnd been addicted, to aleolkol. Ti,e lmtient is state4 to have been very clevev and illtelligent, witlL ah excellent memory and a taste for reading, and o~~e of tlle best ot¡ his class in Irehmd. He had, however, always beca l,eculiar, and was boastf, zl, exaggerative, headstrong, and given to extravagance in money matters, believing thut he was destined one day to become rich. He never ~orked hard. 'rlmre is a tradition that he suffered from sunstroke in boyhood, and he bears the marks of various acci,tents in the forro of scars and tiro like. He himself admitted having had syphilis many years ago, though his relatives l~elieved hito to have lived a most inoral life. TlJis was, however, (l,)ltbtless true since bis marriage~ abollt twenty years back, of which tl~ere are several living cimi]dre~, the e]dest about seventeen. For tlle past fifteen years he has been a i~eavy drinker, except at interwtis, and his alcoholism cuhninated a fe~v years ago ia ah attack of delirium tremens, sin(.e wllen ir is stated that lm '~ has never beell tlle same man." Fits and paralysis are denied by the relative from whom most of the history was obtained, but the patient stated tl~at he had had some sort of " stroke" about six years ago, followed by right-sided paresis, includingright ptosis. ([ gire this for what i~ may be worth.) He w~ls, however, undoubtedly under treatmei~t in January, 18~ 1, at the National Eye and Ear Infirmary for ptosis and paralysis of accommodation of the right eye only, at whicll time he was also suffering from general tremor. The symptorJ~.~ were ascribed to alcohol and tobaceo, in both of which he i~ad been indu]ging to excess, and after three weeks' treatment with iodi,ie of potassium~ combined with abs~inlence from alcr and nicotil~e, his eye was nearly well, and his general state much improved.