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

Smith Ely Jelliffe

Date:: 1927

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

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$that the family should not hear his sniffling, he would turn on the water in the basin; that at times he was very uncomfortable and on some nights unable to sleep; that at times he breathed like a patient suffering from asthma. If his attention was diverted, the attacks usually ceased. She stated that at other times he would occasionally get into a condition as though ‘ suffering from tetany ’; that his hands ‘ would get clenched.’* “ The physical examination by myself yielded little of moment. The gait and station were normal. There was no tremor, the tongue was pro¬ truded in the median line and not tremulous. The lips were protruded firmly. The angles of the mouth were retracted equally well. The pupils were of average size, well rounded, equal, reacted very promptly to light and to accommodation and convergence. The tendon reflexes were normal. There were no sensory losses. There were no functional nervous symptoms present at the time of my examination; the mental examination also was negative. Laboratory findings reported negative. “After making some suggestions to Dr. A. as to the boy’s method of living, general hygienic care, further observation, etc.., she left me with the understanding that he was to be placed under treatment, as far as the nose was concerned, by Dr. L.” History by Burr.—On December 6, 1923, another specialist [this was Dr. Burr referred to, compare with history here—B.] was consulted who has kindly sent me the following history: “ In August, 1922, patient was in an auto accident, suffered a fractured nose but was not unconscious. He entered the J. Hospital for a nose operation for obstructed breathing. Prior to accident he had a tendency to a habit spasm of forcibly expiring air through his nose. While in J. he contracted scarlet fever and was sent to a Municipal Hospital. He had a light attack and in six weeks returned for the nose operation. Following the nasal operation he went to a business college one month, was still continuing the habit of forcing air through the nose. In January he again returned to high school. But it seems he did not succeed well; the patient states he had drowsy spells, would try to concentrate, then fall asleep. The teacher remarked that he would have to remain awake, or he could not stay in the class. He did finish the year of school but failed in two subjects. He states he worried constantly over the obstruction in his nose; he lacked interest in his work.” “ In March, 1923 (this should be 1922), Easter vacation, he had an attack of sore throat, grippe, and a severe stomach upset. In about forty-eight hours this was followed by a semidelirious spell with fever; states he had a terrible dream in which he was dying and saw angels. The next day he was very much excited, seemed afraid and continually screamed, ‘ I will never be the same again.’ He seemed to be normal the next day and returned to school, but the patient states he continued to feel sleepy in school. i * Thus Dercum’s notes show he had the “ spells ” before 1923 as erroneously denied by Burr.$