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114
Patient in a comatose condition, moaning slightly on being
moved. Reflexes diminished or abolished, but extensor plantar
reflex was present. Head somewhat thrown back but no real retraction.
Muscular twitchings of the limbs, and also more or less
continuous purposeless movements of the fingers. Pupils equally
dilated, no reaction to light. Ptosis. There were no reflex signs
present suggestive of Cerebro-Spinal Meningitis. Incontinence of
urine and faeces.
Next day there was considerable difficulty in taking food.
Lumbar puncture performed—no abnormal intraspinal pressure,
fluid clear from the first drop. The report from the Lister Institute
was as follows:—
"On microscopic examination no Tubercle Bacilli or other
organisms were found The only cells seen were a few red blood
cells. On culture only one or two colonies of non-pathogenic cocci
have been found. The result of this examination does not exclude
the diagnosis of Encephalitis lethargica as increase in the number
of lymphocytes, which may be transitory, is the only abnormal
feature shown on microscopic or cultural examination of the fluid
in this disease."
23/12/24—Pupils less dilated and reacted slightly to light.
Slightly less comatose.
25/12/24—Restless and incoherently talkative.
26/12/24—Slightly more drowsy during latter part of the da".
29/12/24—Getting weaker, quieter.
30/12/24—Died.
The highest temperature recorded in Hospital was 101.8.
Dropped to normal on the 27th, and then below normal till the end.
Case No. 40.
M. 11. Onset 21/11/24.
Was taken ill in school with sickness and headache. Slept
all night, and the next day was kept in bed. Seemed fairly