Postencephalitic respiratory disorders : review of syndromy, case reports, physiopathology, psychopathology and therapy / by Smith Ely Jelliffe.

  • Smith Ely Jelliffe
Date:
1927
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Licence: In copyright

Credit: Postencephalitic respiratory disorders : review of syndromy, case reports, physiopathology, psychopathology and therapy / by Smith Ely Jelliffe. Source: Wellcome Collection.

    19/152 (page 7)
    sense of being ill, has salivation, with attacks of dyspnea, whenever he sees the physician, or is under observation. Case 4: Forty-eight years of age. These dyspneic attacks are reported as conditioned by the physician or by general emotional conditions. “ Encephalitis, with its imperceptible transitions from distinctly or¬ ganic to distinctly functional disturbances, cuts in my opinion the Gordian knot of the problem, reducing the two terms to their true value, namely, that of being opposite and yet complementary viewpoints, of which our mind cannot rid itself in the study of the actual biological unit.” This is his concluding remark. Among the cases reported by Kennedy, Davis and Hyslop 8 before the Research Society of Nervous and Mental Disease in December, 1921, published in July, 1922, they speak of the disturbed breathing in two and mention briefly a third. Case H. G. Ill in December, 1918, with influenza (?). Severe headache and intense sleepiness day and night with reversal of sleep mechanism after three or four weeks. Seen in the spring of 1921 he had some parkinsonism, great inability to do things. Great anxiety on effort, shivering attacks and respiratory disturbances. These attacks lasted from 15 to 30 minutes. During them he felt as though he could not fill his lungs with air, and he breathed with all of his accessory respiratory muscles from 56 to 64 times a minute. At other times he experienced what seemed like a spasm of the laryngeal muscles and breathed more and more stertorously and ineffectively so that the lips were cyanosed and the eyes protruded. Phenomena such as these have appeared at times in hysteria, and various physicians have considered them as hysterical in this case. This explanation would not account for the patient’s abnormal thirst for ice water. He consumed for a period of 18 months, between 30 and 40 quarts of water every day and had proportionate polyuria. [Compare with Case I of Jelliffe.] Case 2. (p. 42) A boy of fourteen had his acute attack of encephalitis in January, 1920. There was an apparent recovery for many months. He then developed polydipsia and polyuria with tremors in the upper extremities, excessive salivation and distressing paroxysmal attacks in which breathing was exceedingly rapid, labored and difficult, quite similar to the preceding patient. In the discussion the authors note: “ Breathing spasms were seen twice. One patient, E. P., just mentioned, had had from the beginning very irregular breathing—both in depth and rate—accompanied by curi¬ ous noises which occurred during sleep. Case 3. S. J., fifteen months after 8 Kennedy, F., Davis, T. K., and Hyslop, G. H. An Additional Con¬ tribution to the Symptomatology of Epidemic Encephalitis. Am. Archives of Neur. & Psychiatry, VIII, 1922, 40, July.