3. Clinical Psychiatry

Abstract

A married woman, æt. 40, began to have difficulty in doing her work, complaining of headaches, which gradually became more severe. Her memory gradually failed for both recent and remote events. After about seven years walking became difficult, and finally she was bedridden, being unable to stand. A tremor of the hands developed, and it was necessary to feed, dress, and care for her. No syphilitic evidences; Wassermann negative in blood and spinal fluid. No sclerosis of peripheral arteries. Blood-pressure 160–80. Pupils irregular, the right dilated; reaction to light slow, to accommodation nil. Tactile appreciation slightly impaired; inability to localise readily for touch or space; wincing to pin-pricks. Knee-jerks exaggerated. Right ankle clonus. No Babinski. Marked tremor of hands, tongue and lips. Speech retarded and slurring. The clinical condition much resembled general paralysis, except for its protracted course and the negative Wassermann. Diagnosis, “cerebral tumour?” Died comatose at the age of 48.