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139
6th.—Doctor was called in again. Patient was then in a very
lethargic condition, lying all day with eyes closed. Rambling towards
night, answered quite intelligently when spoken to. No
incontinence. Remained much the same as this until April 9th.
Complete constipation for six days.
10th April.—Bowels moved. Got out of bed herself whilst
the mother was downstairs. Had apparently soiled herself considerably
and was found getting into bed in a clean nightdress, and
had no knowledge of what she had done. From thence onwards she
was quite helpless, took food fairly well until April 12th, when
she had to be fed. Became more and more lethargic and could not
answer questions intelligently.
16/4/26—I saw the patient on this day at the request of the
medical attendant as a possible case of Encephalitis Lethargica.
She had obvious squint (commenced on 13th April), incontinence
from the 15th April, opened her eyes and looked around but could
not recognise anyone. She was gradually getting more and more
drowsy. The condition seemed very serious and I advised her
removal to the West Middlesex Hospital, the condition appearing
to be one of Encephalitis. She was removed to the Hospital and
died the next day. In view of the injury and long protracted
sepsis one ought to bear in mind such conditions. The Medical
Superintendent at the Hospital considered after careful consultation
with his colleague that there was no doubt that this patient
was suffering from encephalitis.
Case No. 74.
F. 17. Onset 11/1/26.
During the middle of December, 1925. this patient complained
of being cold and sleepy.