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82
ENCEPHALITIS LETHARGICA.
The problem in this case has been difficult. The number of
cases notified were as follows:—
1921 1922 1923 1924 1925
2 3 1 33 17
A batch were also notified in the early part of 1926, which
really arose in 1925.
The disease which was brought to notice in 1917, has spread
rapidly through Europe and this Country, but apart from the
Derby outbreak in 1919, has shown little inclination to spread in
houses like the commoner infectious diseases, and second cases are
rare.
Up to 1922 the mortality was put at about 50 per cent. but
the report of Dr. Parsons to the Ministry of Health stated that
"There is some reason to think however, from evidence collected
since 1920, that the disease generally is assuming a milder and less
fatal form."
The after results of the cases that recover are often extremely
grave, in fact so grave, that special legislation is being asked for
and special institutions are being provided for dealing with these
cases.
In some cases there are paralytic symptoms combined under
the appellation of Parkinsonism.
Parkinsons disease or Paralysis Agitans is characterized by a
" mask like " expressionless face, a shuffling unsteady gait and various
paralytic symptoms with tremors. In others, the after results
are entirely psychological or mental as shown by alterations of
character, instability, and often moral delinquency, these latter
causing a new and special anxiety in the Police Courts. Unfortunately
these latter symptoms may not develop for a long period,
even years after the original illness, and the original illness itself
may have been quite slight in its manifestations and have given no
indication whatever of the seriousness of the after effects. In