AMAarchives of neurology & psychiatry . ve. The urine was normal, except for a faint trace ofalbumin. The temperature, from the day of admission to the day of death, rosegradually from 99 to F. The spinal fluid was clear, under normal pres-sure, with 80 lymphocytes per cubic millimeter. CLOBrS-STRAiSS—EPIDEMIC EXCEPHALITIS 129 Course of Illness.—On the day after admission the patient remained comatose;there was no definite ocular palsy but a limitation of eye movements to theextreme right and left. The left pupil was larger than the right, and did notrespond to light; the right responded
AMAarchives of neurology & psychiatry . ve. The urine was normal, except for a faint trace ofalbumin. The temperature, from the day of admission to the day of death, rosegradually from 99 to F. The spinal fluid was clear, under normal pres-sure, with 80 lymphocytes per cubic millimeter. CLOBrS-STRAiSS—EPIDEMIC EXCEPHALITIS 129 Course of Illness.—On the day after admission the patient remained comatose;there was no definite ocular palsy but a limitation of eye movements to theextreme right and left. The left pupil was larger than the right, and did notrespond to light; the right responded only slightly. The fundi were was noted, also slight flattening of the lower part of the left side of theface, but no paralysis of the tongue or palate and no rigidity of the neck. Theknee and Achilles jerks were not very active. A bilateral Kernig sign andoccasional myoclonic movement were noted. On the following day the comapersisted. Cheyne-Stokes respiration developed and death occurred fromrespiratory Fig. 4.—Small capillaries: type of veisel found most frequently but notexclusively in the midbrain. About a definitely thickened capillary there is agroup of apparently newly formed, patent blood vessels. Case 4.—History.—-S. B., a woman 33 years of age, married, was admittedto the hospital on Sept. 10, 1921, complaining of frequent vomiting for oversix weeks and cough of one weeks duration. The family and previous medicalhistories were unimportant. Four years before she had been treated for threeweeks at the Manhattan State Hospital for neurosis, and a year before hadhad pneumonia with uneventful recovery. 130 ikciiiriis or .ixn Isvciii.\try The repeated vomitin^ made her tliiiik tliat she was preRiiaiit. The vomituswas occasionally greenish, hut never hloody. After two weeks a curettage wasperformed with no relief. She was ahle to retain only small amounts of was neither jaundice nor hearthurn. .\ week before admiss
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