General paralysis : a critical review of the literature of the subject, to which is appended an analysis of the case of John S. Blackburn, in which insanity was alleged as a means of defense / by D.A. Morse.
- Morse, D. A. (David Appleton), 1840-1891
- Date:
- [1874]
Licence: Public Domain Mark
Credit: General paralysis : a critical review of the literature of the subject, to which is appended an analysis of the case of John S. Blackburn, in which insanity was alleged as a means of defense / by D.A. Morse. 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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![tlier to the subject. The above consideration of the prodromic period, together with what we shall present upon diagnosis, will enable any one to recognize the disease and will convey an idea of all we desire to express upon the subject of diagnosis. V. Diagnosis; Course; Duration axd Termination; Prognosis. We present the subject of diagnosis as follows: 1. Physical. 1st the Speech; 2nd Pupils, vision; 3d Muscular action: walk, co-ordination; the paralysis general or partial, complete or incomplete; 4th Sensation; oth Physical symptoms not always present, less frequently observed than the ]n'eceding; 6th Congestions, effusions of blood. 2. Intelleetual phenomena: Delirium, general or partial. Is there a specific delirium■? Two varieties: Expansive; depress- ive. PHYSICAL phenomena. 1. Speech, articulation. Writers mention, with scarce an ex- ception, a change of i-peech, a difficulty in the articulation of sounds, as one of the earliest manifestations of phvsical distur- bance characterizing the early derangement preceding the de- velopment of general paralysis. The speech is said to be brusque, a sudden stoppage, stuttering or stammering, or hesi- tation. It is described also as being like that of a drunken man. Tlie tongue seems thick, unmanageable—co-ordination of muscles so essential to perfect articulation seems impossible. At the same time this difficulty of speech is observed other mus- cles of the body may be affi3cted, but as the muscular action of the tongue must be more jjcrfect to produce distinct sounds, those may escape notice. This is not always present in the «ame case with the same degree; it may be observed at one time](https://iiif.wellcomecollection.org/image/b22279167_0043.jp2/full/800%2C/0/default.jpg)
