The clinical aspects of 'juvenile general paralysis' : with an account of a case treated with '606,' and observations on prophylaxis / by J. Johnston Abraham.

  • Abraham, James Johnston, 1876-1963.
Date:
[1911]
Catalogue details

Licence: In copyright

Credit: The clinical aspects of 'juvenile general paralysis' : with an account of a case treated with '606,' and observations on prophylaxis / by J. Johnston Abraham. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    (> Two mental and two physical types are found amongst these children. Mentally they may be defective from birth, ranging from idiots to high-grade imbeciles, or they may be bright and highly intelligent until the commencement of their illness. Physically they may show all the stigmata of congenital syphilis, or, as has been pointed out by Mott (20), may have absolutely no signs of syphilis whatever, whereas brother and sisters, not sufVering from general paralysis, often have well- marked signs, as though the disease had spent itself on the cutaneous and bone lesions, and allowed the central nervous system to escape. It would seem, then, that it is more often in the mild or cryptic forms, those least likely to have had an adequate course of treatment, that the disease is more likely to show itself, and it is probable if it were not for the number of abortions, miscarriages, stillbirths, and deaths in early infancy, directly attributable to syphilis, the number of cases of juvenile general paralysis would be very much greater than has been found to be the case. Assuming, then, that any congenital syphilitic may be a potential juvenile general paralytic, it becomes a vastly impor- tant matter, as pointed out by McOowall (27), to determine at what age we can safely assume that the children of known syphilitic parents are free from the risk of developing general paralysis. The average ago of onset from Mott’s statistics works out at 17, but he has had two cases occurring at the age of 28, and another at the same age is recorded by Purzio (2H). Judging from statistics, then, the risk of a congenital syphilitic developing general paralysis after 25 years of age is very small, unless, indeed, as Mott suggests, it is possible for the adult type to occur as the result of the congenital as well as the acquired variety (29). Turning now to individual details, it will perhaps be more interesting to describe the symptoms in the case recently under my care, comp aring and contrasting them at the same lime with those of the recorded cases and with the adult type. The patient was a boy who was admitted to the East Sussex County Asylum as an imbecile. He was a good-looking, bright- eyed lad of apparently H years of age, though he was in reality 18, could answer simple questions, write his name rather badly.