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103
After that he had a series of attacks when he seemed to "lose
himself" for a minute or so. These attacks, were said by his
Medical Advisor, to be Syncopic in origin.
In April, 1923, he was sent for to return to the office temporarily,
and remained at work until the onset of the present illness,
March, 1924.
During August, 1923, his wife fractured her patella and was in
Hospital for two months. She limped for some time after, which
upset the patient considerably.
The illness commenced with vomiting and lasted for two days,
leaving the patient very limp. Vomiting subsided for 10 days,
then recurred with severe headaches and pain in left arm.
Diplopia and great drowsiness commenced—commenced two weeks
after the second attack of vomitting—at times delirious.
Would fall off to sleep whilst talking (drowsiness marked for
one week). Very weak and tottering. Diplopia lasted for 2—3
weeks. Memory got very bad. Previous to onset very irritable,
now extremely docile. During attack could not write, illegible,
could not form letters. Intense pain down left side of head and
extending down left arm, lasting for five days. Patellar reflexes
present. Plantar reflexes, extensor. Pupil equal and active.
After prolonged convalescence, seemed to improve up to
October, 1924, then he got more lethargic, and would sit or stand
about in one position without speaking. The picture, expression,
and general posture are those of a typical case of Parkinsonism.
His memory is getting worse and he is duite incapable of
any sustained effort. Very emotional. Writing is now perfectly
good. He is unable to express his thoughts in a letter. Apart
from the condition left by his encephalitis, the patient's health is
quite good.