Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Penicillin Treatment of General Paresis (Dementia Paralytica): Results of Treatment in 1,086 Patients the Majority of Whom Were Followed for More Than Five Years

Penicillin Treatment of General Paresis (Dementia Paralytica): Results of Treatment in 1,086... Abstract Introduction This paper is a cooperative report of the clinical, spinal fluid, and serologic findings in a group of 1,086 patients with general paresis (dementia paralytica) treated with penicillin with or without fever therapy at eight different hospitals. A detailed account of the formation and function of this cooperative clinical study has been given previously as an introduction to the presentation of the group experience in treatment of asymptomatic central nervous system syphilis.1Shortly after the effectiveness of penicillin in the treatment of early syphilis was reported, various investigators began to study the efficacy of this new antibiotic in the treatment of central nervous system syphilis. These investigations were supported in part by grants from the Office of Scientific Research and Development, the National Institutes of Health, and the Division of Venereal Disease, U. S. Public Health Service. The findings of the individual investigators have provided much of the References 1. Dr. Moore died Dec. 6, 1957. 2. Dr. Richard D. Hahn, The Johns Hopkins Hospital, Baltimore; Dr. John C. Cutler and Mrs. Geraldine Gleeson, U. S. Public Health Service. 3. The reason for decrease in work capacity as compared with usual work capacity at time of study treatment was known in 802 patients. In 776 (97%) of these patients the decrease was due to paretic neurosyphilis and in 26 (3%), to extraneous factors. 4. The actual life tables are on file in the Office of Statistics, Venereal Disease Branch, Communicable Disease Center, Public Health Service, U. S. Department of Health, Education, and Welfare, Atlanta, Ga. 5. For these mild cases "unchanged" status constituted a good clinical result. 6. Pretreatment cell count and protein level were found to have a close inverse relationship to duration of symptoms at time of study treatment. Median duration of symptoms was 22.9 months for patients with 0-4 cells, 11.2 months for patients with 5-10 cells, 10.0 months for patients with 11-30 cells, and 9.1 months for patients with 31 cells or more. Median duration of symptoms was 22.1 months for patients with protein of less than 40 mg. %; 11.5 months, with protein of 40-50 mg. %; 10.6 months, with protein of 51-98 mg. %, and 9.2 months, with protein of 99 mg. % or more. 7. Hahn, R. D., and others: Penicillin Treatment of Asymptomatic Central Nervous System Syphilis: I. Probability of Progression to Symptomatic Neurosyphilis A. M. A. Arch. Dermat. 76:355-366 8. II. Results of Therapy as Measured by Laboratory Findings , Hahn A. M. A. Arch. Dermat. Dermat. 74:367-377 ( (Oct.) ) 1956.Crossref 9. Stokes, J. H.: Modern Clinical Syphilology , Ed. 3, Philadelphia, W. B. Saunders Company, 1944, pp. 1002-1003. 10. Moore, J. E.: Modern Treatment of Syphilis , Ed. 2, Springfield, Ill., Charles C Thomas, Publisher, 1941, p. 366. 11. Dattner, B.: The Management of Neurosyphilis , New York, Grune & Stratton, Inc., 1944, p. 187. 12. Hahn, R. D.: The Treatment of Neurosyphilis with Penicillin and with Penicillin plus Malaria , Am. J. Syph. 35:433-470 ( (Sept.) ) 1951. 13. Moore, J. E.: Personal communication. 14. Lewis, N. D. C.; Hubbard, L. D., and Dyar, E. C.: Malarial Treatment of Paretic Neurosyphilis , Am. J. Psychiat. 4:175-225, 1924. 15. Woodman, R.: Normal Course and Expectation of Life in General Paralysis , State Hosp. Quart. 11:644-650, 1926. 16. Briner, O.: Über den Verlauf der progressiven Paralyse ohne und mit Fieberbehandlung , Ztschr. ges. Neurol. u. Psychiat. 128:792-816, 1930.Crossref 17. Derby, I. M.: Life Expectancy in General Paresis , Psychiat. Quart. 9:458-466, 1935.Crossref 18. Cheney, C. O.: Clinical Data on General Paresis , Psychiat. Quart. 9:467-485, 1935.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

Penicillin Treatment of General Paresis (Dementia Paralytica): Results of Treatment in 1,086 Patients the Majority of Whom Were Followed for More Than Five Years

Loading next page...
 
/lp/american-medical-association/penicillin-treatment-of-general-paresis-dementia-paralytica-results-of-mN0iqYgGwW
Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6886
DOI
10.1001/archneurpsyc.1959.02340170023003
Publisher site
See Article on Publisher Site

Abstract

Abstract Introduction This paper is a cooperative report of the clinical, spinal fluid, and serologic findings in a group of 1,086 patients with general paresis (dementia paralytica) treated with penicillin with or without fever therapy at eight different hospitals. A detailed account of the formation and function of this cooperative clinical study has been given previously as an introduction to the presentation of the group experience in treatment of asymptomatic central nervous system syphilis.1Shortly after the effectiveness of penicillin in the treatment of early syphilis was reported, various investigators began to study the efficacy of this new antibiotic in the treatment of central nervous system syphilis. These investigations were supported in part by grants from the Office of Scientific Research and Development, the National Institutes of Health, and the Division of Venereal Disease, U. S. Public Health Service. The findings of the individual investigators have provided much of the References 1. Dr. Moore died Dec. 6, 1957. 2. Dr. Richard D. Hahn, The Johns Hopkins Hospital, Baltimore; Dr. John C. Cutler and Mrs. Geraldine Gleeson, U. S. Public Health Service. 3. The reason for decrease in work capacity as compared with usual work capacity at time of study treatment was known in 802 patients. In 776 (97%) of these patients the decrease was due to paretic neurosyphilis and in 26 (3%), to extraneous factors. 4. The actual life tables are on file in the Office of Statistics, Venereal Disease Branch, Communicable Disease Center, Public Health Service, U. S. Department of Health, Education, and Welfare, Atlanta, Ga. 5. For these mild cases "unchanged" status constituted a good clinical result. 6. Pretreatment cell count and protein level were found to have a close inverse relationship to duration of symptoms at time of study treatment. Median duration of symptoms was 22.9 months for patients with 0-4 cells, 11.2 months for patients with 5-10 cells, 10.0 months for patients with 11-30 cells, and 9.1 months for patients with 31 cells or more. Median duration of symptoms was 22.1 months for patients with protein of less than 40 mg. %; 11.5 months, with protein of 40-50 mg. %; 10.6 months, with protein of 51-98 mg. %, and 9.2 months, with protein of 99 mg. % or more. 7. Hahn, R. D., and others: Penicillin Treatment of Asymptomatic Central Nervous System Syphilis: I. Probability of Progression to Symptomatic Neurosyphilis A. M. A. Arch. Dermat. 76:355-366 8. II. Results of Therapy as Measured by Laboratory Findings , Hahn A. M. A. Arch. Dermat. Dermat. 74:367-377 ( (Oct.) ) 1956.Crossref 9. Stokes, J. H.: Modern Clinical Syphilology , Ed. 3, Philadelphia, W. B. Saunders Company, 1944, pp. 1002-1003. 10. Moore, J. E.: Modern Treatment of Syphilis , Ed. 2, Springfield, Ill., Charles C Thomas, Publisher, 1941, p. 366. 11. Dattner, B.: The Management of Neurosyphilis , New York, Grune & Stratton, Inc., 1944, p. 187. 12. Hahn, R. D.: The Treatment of Neurosyphilis with Penicillin and with Penicillin plus Malaria , Am. J. Syph. 35:433-470 ( (Sept.) ) 1951. 13. Moore, J. E.: Personal communication. 14. Lewis, N. D. C.; Hubbard, L. D., and Dyar, E. C.: Malarial Treatment of Paretic Neurosyphilis , Am. J. Psychiat. 4:175-225, 1924. 15. Woodman, R.: Normal Course and Expectation of Life in General Paralysis , State Hosp. Quart. 11:644-650, 1926. 16. Briner, O.: Über den Verlauf der progressiven Paralyse ohne und mit Fieberbehandlung , Ztschr. ges. Neurol. u. Psychiat. 128:792-816, 1930.Crossref 17. Derby, I. M.: Life Expectancy in General Paresis , Psychiat. Quart. 9:458-466, 1935.Crossref 18. Cheney, C. O.: Clinical Data on General Paresis , Psychiat. Quart. 9:467-485, 1935.Crossref

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: May 1, 1959

References