SOME INTERESTING FACTS

Nelson Evening Mail, Volume LIII, Issue 124, 27 May 1919, Page 4

SOME INTERESTING FACTS

SYMPTOMS OF THE SICKNESS,

A pamphlet prepared by the Health Department gives some interesting facts about the occurence and forms of the new sickness. In Vienna in April, 1917, attention was drawn to the disease, and the following month the same disorder w a « dismissed by the Pans Academy of 'ted’eine.

“Professor Net-tor there expressed the ■'■n’nion that the disea-le was not a form of acute polimyhtis. He also quoted *ome ev’dence in support of the view Mint the disease occurred at the end ot the 17th and beginning of the 18th cen f my ii Germany, and more definite evidence that it occurred in Upper Italy and Hungary in 1890. Very suggestive case=) occurred in nearly ail the countries of Europe andi in the United States in the spring of 1895. From the data presented by Von Economo (Vienna) it is evident that the disease occurred in Vienna in the winter of 1916-17. “The first case noted in England occurred 11th February. 1918, in Bermondsey, and the largest number of canes i;n one week was 18, in the last week of April. The number of cases declined thereafter, and the epidemie., which never attained large proportions, came, at least temporarily, to an end : n June. The disease has been made notifiable in England and Wales under the name of ‘lethargic enoephaahtis.’ Earlv last year the local government board, with the assistance of the Medical Research Committee, "instituted clini. cal and pathological investigations. ■The following data are abstracted from a review of the Government report published in a recent number of the Rrit : sh Medical Journal; The disease is an acute affection due to a specific virus, which, like that of acute anterior poliomyelitis, probably finds en. trance through’ the naso-pharynx. and wlvch. like it, has a special affinity for tlie nervous system, though for different areas and elements. Pathologically, lethargic encephalitis belongs to the class of polio-encephalitic diseases winch are inanimately in nature, Bacteriologi. cal investigations did not yield any positive results. Clinically the disease is a general infectious disease, characterised by manifestations originating in the central nervous system, of which the most frequem and' characteristic are progressive lethargy or stupor and lesion in or about the nuclei of the th'rd pair of cranial nerves. There «eems to he little doubt that there is always a certain amount of fever in an early stage, although occasionally it may not be observed for several days after the onset of symptoms. Usually ■the first symptom is simple catarrhal conjunctivitis, and in a smaller number of cases tonsilitis, simple sore throat, and bronchial catarrhs were observed, but the salient symptom observed in BO per cent of 'the cases a f this stage was progressive lethargy. It might he ushered in suddenly by a fainting attack or fit, but the onset was more often gradual. The patient became dazed or «tupid, slept a great deal, and was drowsy fav day. In marked oases the lethargy' was accompanied 1 by heaviness of the ‘eyelids, pain in the eyes, blurred vision, and photophobia, and, in. a well-marked case, gradually passed, into stunor. Headache was common, add giddiness was a highly characteristic ear'v symptom, and in some ■i,rrompanied by diphopia. Mental libhl tude was often associated with the highly emotional state, and the patient might exhibit, without apparent cause, svmptoms, which might be labelled hysterical. In. other instances the mental depression was so great that melancholia was suspected. . , . After this prodromal period, m ,i* occura, the symptoms of a general infectious disease become mamlest; the febrile reaction has already been m«n tinned. The patient lies in bed on tfie back, often unable to make any tary movement on account of great muscular weakness; the face is quit? expressionless and maek-liko. and ihei Jv be definite double facial paralysis. The severest cases he hke a log on tn bed, resembling a waxen image m tn lark of expression and mobility, and this may be accompanied by The patient is m a condition of stu hour, although true sleep is aften not obtained. Delirium. usually is nob uncommon, and m addition the muscular trouble there is distinct rigidity in a considerable proportion o ST'S, voice monotonous, sentences are I? slowly and words slurred mtd one an othey Occasionally, however, once started to speak the pat'ent sentences with so grea rapidity that he is often unintelligible. Among 168 cases 37 deaths were recorded. Tim duration of the -f u P° v . 1 very variable; occasionally it lasts two to three days, more often two to' A weeks, and in one case, winch ly recovered, it continued for eigmweeks. It is too soon to speak positrveTV of after effects, hut certain manifefta, Jons have persisted alter the emotion of. three months from the date ot onset; these are an alternation the mental condition, percent nerve palsy, the appearance of pmaiysis Separately of spinal cord ongm) and athetosis. ■ . ■With regard to no specific method has been devised, and the best that oa-ri be ’done id » .P°»- “R® patient to bed and prbvi«te him with good* nursing ; cold springing tap He* beneficial during - The f*?™’ and tends to diminish the qeMTfum. }» many : instances transient or rohef. with diminution of stupor; followed the xyithdrawal of oelrobrosmm*. ffuid t; by Jumarb; puncture, •v-hen the fluid waa under pressure. For the pain, numbness, arid tingling, of the fimb# warmth via the ( be9t remedy, and fiie.Bedclothes should be raised on frames. Constitution >i a obstinate, and often difficult' to overcome, * except by 'OL.U - , •

enemata, followed by such drugs as liquid paraffin or pheuolphthalein, No Uvpnotics, and no morphine or other preparation of opium should be given, and ]>r MacNalty deprecates the administration of hex amnio in large and repeated doses; if it is.prescribed the urine should be carefully watched for albumin. Daily cleansing of the mouth and antiseptic treatment of the nose and mouth should be carried out, and respiratory complications systematically looked for. Finally, the patient should he given to understand that his convalescence will last for at least six months after the beginning of the illness.