File:Nervous and mental diseases (1908) (14776160924).jpg

Identifier: nervousmentald00chu (find matches)
Title: Nervous and mental diseases
Year: 1908 (1900s)
Authors: Church, Archibald, b. 1861 Peterson, Frederick, 1859-1938
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Publisher: Philadelphia : Saunders
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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the paretic dement, but usuallythe mind becomes completely vacu-ous ; the patient speechless, filthyin his habits, bedridden, and morehelpless than an infant. He lies inbed, either motionless or restlesslymoving his limbs and grinding histeeth. He can scarcely swallow his food, and often requires to be fedto prevent strangling. He wets and soils himself, and bed-sores andcontractures develop. Finally, death by inhalation-pneumonia, septi-cemia (from the bed-sores), cystitis, marasmus, intestinal catarrh, or ex-haustion steps in to draw the curtain on the distressing picture. Not afew die at an earlier period in an epileptiform or apoplectiform crisis. Duration and Prognosis.—Paralytic dementia runs its course inthree to five years, on an average. There are more cases which termi-nate under three years than over five, but cases lasting five years arenot infrequent. A duration of ten years is among the greatestrarities. The prognosis is practically always death within a short term of
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Fig. 312.—A noted actor who recently diedof paresis. Taken to show the expression ofparalytic dementia in an unusually expressiveface (loaned by Dr. Atwood). PARALYTIC DEMENTIA. 839 years. The author has never known personally of a case recovering.In our whole literature there are, according to Ziehen, but a dozencases of recovery on record. It is probably questionable if even thesewere genuine cases of paresis, since an error in diagnosis is not at alluncommon. Diagnosis.—The chief disorders which may be confused withparalytic dementia during the various stages of its evolution areneurasthenia, alcoholism, syphilis of the central nervous system, acutemania, epileptic dementia, paranoia, or secondary paranoia with delusionsof grandeur, multiple sclerosis, and mental conditions associated withcommon organic lesions of the brain (tumor, hemorrhage, embolism,thrombosis). In atypical cases the diagnosis is often difficult andsometimes even impossible. As regards neurasthenia, it is on

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