COMPLETE SITUS TRANSVERSUS

Willard J. Stone
1913 Journal of the American Medical Association (JAMA)  
The rapid and complete recovery in this case after the use of salvarsan seemed sufficiently unique to make the case worthy of record. Patient.\p=m-\F.M., aged 34, married, laborer, was admitted to the hospital Dec. 28, 1912. The family history was of no importance. The patient was moderately alcoholic and had been drinking tather heavily just before the onset of the present illness. He had a severe syphilitic infection in 1903 for which he was treated in hospital one year and discharged as
more » ... discharged as cured. There were no further symptoms until the present time. Present Trouble.\p=m-\DuringDecember 1912, the patient had several of what he calls weak spells in which he became dizzy and confused, but did not fall or lose consciousness. Shortly after a hearty dinner, about 2 p. m. Dec. 28, 1912, without prodromes, he suddenly fell to the floor in a general convulsion lasting several minutes, which was followed by complete unconsciousness. Examination.\p=m-\Onadmission to the hospital, about 5 p. m. of the same day, the patient was in coma from which ho could be partially roused with difficulty. He showed conjugate deviation to the left with nystagmus, small equal inactive pupils, and periodic winking. The respirations were of the Cheyne-Stokes type. The heart, lungs and abdomen were neg¬ ative, 'liiere was a moderate amount of arterial thickening, hut the pulse tension was not high. The patient had a flaccid paralysis of the left side with lost reflexes. On the right side the reflexes were normal. Projectile vomiting occurred with incontinence of urine and feces. Course.-During the night the coma cleared up. After 3 a. m. the patient was restless and irrational a part of the time with periods of seiuistupor. The pupils were now unequal, the right being larger and reacting sluggishly, the left still small and inactive, with no deviation or nystagmus. All the
doi:10.1001/jama.1913.04340170024016 fatcat:6fcurlez4nawjevpzugzjcyeny