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117
Case No. 47.
F. 63. Married. Onset 13/4/25.
The patient had had paroxysmal albuminuria for some considerable
period. This illness began on 13th April 1925. In the
middle of the night the patient had a bad rigor which lasted about
an hour. On the following morning was very drowsy, and complained
of headaches and feeling of sickness. Had difficulty in
passing water—very scanty, and on examination it was found to be
loaded with albumen. Patient became more drowsy—comatose.
Towards the end of the week she was practically unconscious.
Patellar reflexes were absent. She had plantar flexion of the toes.
She was seen by a consultant who thought the condition was one
of uraemia, and the outlook quite hopeless. About the following
week the patient began to improve, the renal symptoms cleared up,
the albumen disappeared, and she then began to complain of her
sight—objects became indefinite and seemed to be much larger than
natural. This condition continued, and she daily became more drowsy.
She took her food very badly. About the end of the third week
she began to suffer from hallucinations and delusions. These took
took the form of seeing animals coming out of the pictures, particularly
elephants, and animals feeding on the plants in the window.
She had a persistent delusion that she was living on the other
side of the road, and that people were attempting to steal the things
from the house. She was seen by another consultant who diagnosed
the condition as encephalitis. Later during the period of hallucinations
she was seen by a third specialist as to her mental condition,
which was such that he advised that she should be certified and
placed in an asylum. Further delusions were that) the germs of
sleepy sickness when she woke up had come out on her skin and
could be seen all over body. For three months her mental condition
was entirely unbalanced. She was sent away in August with a
Nurse, and at the end of the month returned home, her mental
condition being practically normal.
No after effects.