Epidemic Encephalitis: Some Psychical Sequeló

Extract

Numerous observations have lately been recorded in medical literature on the acute manifestations of epidemic encephalitis; but the late after-effects, especially those of a psychotic nature, have been seldom described. Kirby and Davis (1) have emphasized this, and have recorded 18 cases in their early and later stages. They remark that “a satisfactory solution of certain of the psychiatric problems presented by this disease will require a longer period for clinical observation of cases than has elapsed since the appearance of the epidemic of 1918–19.” The following series of 10 cases is offered as a contribution to the clinical records of the sequelae of the disease, especially from the psychiatric point of view. Eight of them originated in connection with the epidemic of 1918–20. The remaining two are of remoter origin, and are admitted on account of their close resemblance to the others, and of their special interest from the point of view of classification and prognosis. Five of them (3, 5, 6, 9 and 10) are, or have been, in mental hospitals. In this connection the only statistics available to me are those quoted by Kirby and Davis (loc. cit.) for the New York State Hospitals in the hospital year from July 1, 1919, to June 30, 1920, when, out of 6,500 admissions, only 20 were considered to be probably cases of epidemic encephalitis. (But the epidemic was subsiding at that time.) The 5 cases mentioned should therefore be of considerable interest; and it is one of the purposes of this paper to show that a more thorough knowledge of the results of this protean disease would lead to its being diagnosed more frequently among the cases, even those of very long residence, in mental hospitals.