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89
9/9/22. Very drowsy. Doubly incontinent. Loss of
facial expression. Patient remained semi-conscious—lying in bed
without movement although there was no paralysis until he died
14/9/22. Temperature rose to 102.4 on 13/9/22.
Result of exam. of C.S.fluid. Physical—clear, no deposit.
Chemical—1 per cent. albumen. Globulin nil. Dextrose trace.
Microscopical—V. few white cells—no more than in normal. No
micro organisms. Wasserman re-action negative.
At P.M. examination. Brain excess C.S.F. congested—
nothing else abnormal. Kidneys—early interstitial nephritis.
Stomach walls much thickened. Ch. Gastritis—old healed pyloric
ulcer with stenosis of pylorus.
Case No. 5.
F. 38. Onset ?. Notified 29/11/22.
The case was admitted to the West Middlesex Hospital. No
records available-
Case No. 6.
F. 22. Milliner. Onset 20/11/22. Notified 13/12/22
The illness commenced with a headache, pain in the back of
neck, general malaise and lethargy, becoming more and more
drowsy each day. She saw the doctor at the surgery on 21/11/22.
Later went to bed and the doctor was called in on 25/11/22.
Fever—3 days duration. Highest temperature 102 degrees.
For about 3 days speech became unintelligible. She afterwards
stated that she knew everything that was going on but could
not make any attempt at speech. The lethargy, which was quite
definite for the first week gradually improved. There was slight
double ptosis. No diplopia or nystagmus. The discs were normal
with the exception of a slight retinal hæmorrage in the upper
quadrant on the right side. Pupils reacted to light and accommodation.
Corneal reflex normal.