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PSYCHIC EPILEPSY OCCURRING WITHOUT OTHER EPILEPTIC PHENOMENA.
259 and attenuation of the doubt as to the diagnosis of tetanus and suggested urmia. Urine obtained by the catheter contained a large quantity of albumin and no sugar. Lumbar puncture yielded a clear f1 uid which was not under increased pressure and did not contain excess of albumin or leucocytes. It contained 3 grammes per litre of urea. Death occurred in the evening. At the necropsy no cerebral lesion was found. There was oedematous congestion of the lungs. The heart weighed 270 grammes and there was no notable hypertrophy of the left ventricle. The kidneys were small and atrophic and their capsules were adherent. The left weighed 95 and the right 98 grammes. The surface was granular. On microscopic examination they showed advanced atrophic sclerotic nephritis. The medulla of the patient was emulsified and injected into guinea-pigs, which did not react in any way. In this case the simulation of tetanus was complete ; only the absence of pyrexia could have raised any doubts as to the diagnosis. The only alternative to attributing the symptoms to uraemia is to suppose that tetanus coexisted with the nephritis, but this is excluded by the apyrexia and the negative result of the injection of the guinea-pigs.
Cheyne-Stokes respiration,
contractures-raised
a
THE FOURTH CONGRESS OF THE INTERNATIONAL SOCIETY OF SURGERY.
15th, and from the 16th to the 28th excursions Philadelphia, Baltimore, Washington, Chicago, Rochester, Buffalo, Niagara Falls, and Boston. The
to
departure for Europe is April 28th. particulars can be obtained by those interested on application to the Secretariat General, 78, rue dc ]a Loi, Brussels.
probable
PSYCHIC
EPILEPSY OCCURRING WITHOUT OTHER EPILEPTIC PHENOMENA.
IN the Journal of Nc°vo2cs and Mental Disease for September, 1913, Dr. George E. Price, of Philadelphia, describes the case of a man, aged 42, in whose family history nothing of significance had occurred beyond the insanity of a maternal grandfather, whose symptoms came on after a period of very hard mental and physical work. He was heard by his wife one evening to be snapping an empty revolver in an adjoining room, and when she entered it she found him confused and under the delusion there was a man in the room whom he was trying to shoot. In less than an hour the symptoms disappeared, to be followed, however, by severe headache and sleepiness. During the next month some seven similar attacks occurred, some lasting not much longer than 15 minutes, in all of which the patient was confused and suffered from a vague delusion that there was The attacks were a strange man in the room. alwayss followed by headache, and he had no subsequent recollection of them. As the attacks were becoming more frequent the patient was removed to the Jefferson Hospital and subjected to a full course of bromides. Great improvement resulted, and the " fits " entirely disappeared. In all of them which were observed in hospital it was remarked that the patient’s face was suffused. The essential features of the attacks were clouding of
THE Fourth International Congress of Surgery, which will be held in New York from April 13th to 16th, will miss the stimulating presence of Dr. Lucas-Cbampionniere, who presided at the Third Congress held in Brussels in 1911. Doubtless, however, Professor Depage, of Brussels, to whose energetic work as secretary the undoubted success of the last Congress was largely due, will adequately replace that distinguished surgeon whose loss the surgical world has so recently had to mourn. It is shall leave arranged that the steamer at on Hamburg April 2nd, calling Southampton and en 1’oute for New York, while the Cherbourg Rotte1’dam will leave Rotterdam on April 4th, calling at Boulogne. The steamers aretimed to arrive in New York on April 9th and 12th respectively. The Congress will be opened on April 13th at 11.30 A.M. in the Hotel Astor by the President of the United States. The scientific proceedings will begin at 2.30 that afternoon with the discussion on the Surgery of Gastric and Duodenal Ulcer. On the 14th the reports on Grafting and Transplantation, and on the 15th those on Amputations will be read and discussed. During the Congress operative demonstrations will be given in the different hospitals. Only members of the society, which now numbers some 600 of the world’s leading surgeons, can take part in the discussions, but the meetings are open to non-members, and it has been decided that foreign surgeons who are not members shall be permitted, on the recommendation of the delegates of their respective countries, to share in the special arrangements made for the journey. In commenting on the last Congress in THE LANCET of Oct. 21st, 1911, p. 1148, regret was
7Kp’or
date of
Further
consciousness, disorientation, delusions, absolute amnesia, a certain amount of sameness and automatism in the phenomena, and the subsequent headache and somnolence. From a consideration of the facts Dr. Price regards the symptoms as those of a true psychical equivalent of epilepsy, although there is no history of convulsive seizures in the patient or in his family. If the mental disorder occurs as the sole manifestation of epilepsy, obviously the diagnosis may be attended with some difficulty. In the present instance, however, there seems no good reason to doubt the accuracy of Dr. Price’s view of the case, which is of some medico-legal importance, even though the patient did not actually come in contact with the law. A number of instances of pure psychic epilepsy have already been recorded in the literature.
severe
TREATMENT OF ANKYLOSTOMIASIS. ANKYLOSTOMIASIS
causes
the
world
enormous
economic loss. Not so immediately and obviously fatal as plague or sleeping sickness, it yet accounts for much of the unsatisfactory work which is proverbially all that is achieved by many natives in the tropics, and beyond. It attacks expressed that there was not a much larger attend- myriads of bare-footed labourers in the Southern ance in the British section, only 24 being present. States of the Union, in Brazil, West and East Africa, We hope that British surgery will be more India, the Straits Settlements, and in the islands adequately represented this year. Among the of the South Seas. We recently mentioned that of entertainments provided are a special (invitation) 127 bodies serially examined post mortem in luncheon, tea, and dinner on the opening day, a German West Africa 114 (93 per cent.) showed ankyluncheon given by Mrs. Mayo for the ladies and a lostoma infection. Besides, as we know, the disease soiree on the 14th, a subscription banquet on the occurs in Europe, even in England. Not only is
Cheyne-Stokes respiration,
contractures-raised
a
THE FOURTH CONGRESS OF THE INTERNATIONAL SOCIETY OF SURGERY.
15th, and from the 16th to the 28th excursions Philadelphia, Baltimore, Washington, Chicago, Rochester, Buffalo, Niagara Falls, and Boston. The
to
departure for Europe is April 28th. particulars can be obtained by those interested on application to the Secretariat General, 78, rue dc ]a Loi, Brussels.
probable
PSYCHIC
EPILEPSY OCCURRING WITHOUT OTHER EPILEPTIC PHENOMENA.
IN the Journal of Nc°vo2cs and Mental Disease for September, 1913, Dr. George E. Price, of Philadelphia, describes the case of a man, aged 42, in whose family history nothing of significance had occurred beyond the insanity of a maternal grandfather, whose symptoms came on after a period of very hard mental and physical work. He was heard by his wife one evening to be snapping an empty revolver in an adjoining room, and when she entered it she found him confused and under the delusion there was a man in the room whom he was trying to shoot. In less than an hour the symptoms disappeared, to be followed, however, by severe headache and sleepiness. During the next month some seven similar attacks occurred, some lasting not much longer than 15 minutes, in all of which the patient was confused and suffered from a vague delusion that there was The attacks were a strange man in the room. alwayss followed by headache, and he had no subsequent recollection of them. As the attacks were becoming more frequent the patient was removed to the Jefferson Hospital and subjected to a full course of bromides. Great improvement resulted, and the " fits " entirely disappeared. In all of them which were observed in hospital it was remarked that the patient’s face was suffused. The essential features of the attacks were clouding of
THE Fourth International Congress of Surgery, which will be held in New York from April 13th to 16th, will miss the stimulating presence of Dr. Lucas-Cbampionniere, who presided at the Third Congress held in Brussels in 1911. Doubtless, however, Professor Depage, of Brussels, to whose energetic work as secretary the undoubted success of the last Congress was largely due, will adequately replace that distinguished surgeon whose loss the surgical world has so recently had to mourn. It is shall leave arranged that the steamer at on Hamburg April 2nd, calling Southampton and en 1’oute for New York, while the Cherbourg Rotte1’dam will leave Rotterdam on April 4th, calling at Boulogne. The steamers aretimed to arrive in New York on April 9th and 12th respectively. The Congress will be opened on April 13th at 11.30 A.M. in the Hotel Astor by the President of the United States. The scientific proceedings will begin at 2.30 that afternoon with the discussion on the Surgery of Gastric and Duodenal Ulcer. On the 14th the reports on Grafting and Transplantation, and on the 15th those on Amputations will be read and discussed. During the Congress operative demonstrations will be given in the different hospitals. Only members of the society, which now numbers some 600 of the world’s leading surgeons, can take part in the discussions, but the meetings are open to non-members, and it has been decided that foreign surgeons who are not members shall be permitted, on the recommendation of the delegates of their respective countries, to share in the special arrangements made for the journey. In commenting on the last Congress in THE LANCET of Oct. 21st, 1911, p. 1148, regret was
7Kp’or
date of
Further
consciousness, disorientation, delusions, absolute amnesia, a certain amount of sameness and automatism in the phenomena, and the subsequent headache and somnolence. From a consideration of the facts Dr. Price regards the symptoms as those of a true psychical equivalent of epilepsy, although there is no history of convulsive seizures in the patient or in his family. If the mental disorder occurs as the sole manifestation of epilepsy, obviously the diagnosis may be attended with some difficulty. In the present instance, however, there seems no good reason to doubt the accuracy of Dr. Price’s view of the case, which is of some medico-legal importance, even though the patient did not actually come in contact with the law. A number of instances of pure psychic epilepsy have already been recorded in the literature.
severe
TREATMENT OF ANKYLOSTOMIASIS. ANKYLOSTOMIASIS
causes
the
world
enormous
economic loss. Not so immediately and obviously fatal as plague or sleeping sickness, it yet accounts for much of the unsatisfactory work which is proverbially all that is achieved by many natives in the tropics, and beyond. It attacks expressed that there was not a much larger attend- myriads of bare-footed labourers in the Southern ance in the British section, only 24 being present. States of the Union, in Brazil, West and East Africa, We hope that British surgery will be more India, the Straits Settlements, and in the islands adequately represented this year. Among the of the South Seas. We recently mentioned that of entertainments provided are a special (invitation) 127 bodies serially examined post mortem in luncheon, tea, and dinner on the opening day, a German West Africa 114 (93 per cent.) showed ankyluncheon given by Mrs. Mayo for the ladies and a lostoma infection. Besides, as we know, the disease soiree on the 14th, a subscription banquet on the occurs in Europe, even in England. Not only is