UR patient was a white, married woman of forty-nine; born in Maryland of an English mother (now living) and a French father (who died of cerebral hemorrhage). Her economic condition was comfortable and in an urban environment. Her religion, originally Catholic, had been changed to Protestant. The husband was so upset by his wife's illness that he was unable to give any early history of her family life. Her sister, though upset, gave a fairly clear picture of the patient's life preceding her admission to the hospital. Mrs. A had had a normal childhood. She was described as being an extremely kind-hearted and level-headed person, who always took the initiative in things. She had had childhood diseases; and she had had pneumonia at thirty-nine. Menstruation had been normal and menopause had occurred uneventfully. After graduation from high school she had worked as a milliner, a buyer, and a school teacher. She had broken an engagement during her early thirties and had married her present husband when she was forty-three. Their life has been very happy. Six weeks before admission, Mrs. A felt as though she had influenza. She had a chill, followed by several days of feeling comfortable, and then another chill. The family doctor thought she might have influenza or malaria. Chills continued and her condition grew worse. Her temperature elev ted to 104 degrees F. and with it she became irrational. She was unable to void, developed pyuria, and the bladder became markedly distended. Likewise she was unable to defecate (the doctor likened it to paralytic ileus) and there was much borborygmus. For five days she was stuporous. A consultant did two blood counts and a lumbar puncture (spinal fluid cell count was 208 lymphocytes) and made a diagnosis of encephalitis. The lumbar puncture seemed to relieve Mrs. A temporarily; she improved physically though mentally she seemed sicker. A special nurse
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