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July 19, 1913


Author Affiliations


JAMA. 1913;61(3):191-192. doi:10.1001/jama.1913.04350030031011

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History.  —H. D. V., aged 24, American, clerk, Coalinga, San Joaquin Valley, California, was admitted to Southern Pacific Hospital Feb. 17, 1913. Family history was negative. Patient had had measles and typhoid (?) when a child. Denied venereal infection. He was in hospital from Aug. 16 to 20, 1912, for laryngitis, which was suspected of being tuberculous. The present illness apparently began two months before admission with "a cold." the laryngeal condition having subsided shortly after the previous discharge. Four days before readmission trifacial neuralgia together with severe frontal and occipital headache developed. Patient lost 20 pounds in weight in two weeks. No cough; no thoracic pains.

Examination.  —Poorly nourished young man. Pulse rapid and weak; respirations normal; temperature 97.6 F. (a. m.). Pupils react well to light but poorly to accommodation. Tongue coated. Lungs and heart negative. Very slight abdominal tenderness. Spleen negative. No rose-spots. No tremors. Urinalysis: clear, amber,

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