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Syphilis in a psychopathic subject. Convulsions 5 days after Dixmude.

Case 55. (Bonhoeffer, July, 1915.)

A soldier in the reserves, 23, was, subsequently to his being brought to hospital, described by his wife as a rather over-sensitive fellow, who could hardly look at blood and was meticulous about the household. He had always been subject to headaches, especially after hard work. However, he had passed through his military training well in 1910, not even having been bestraft.

He began service in October and fought at Dixmude on the 19th. On the 24th in the trench and while being carried back, he had several spells of pallor, falling stiff, and then having convulsions. Brought finally to the Charité in Berlin, he had more spells of sudden pallor, collapse with brief convulsions, tossings in bed, as well as absences, post-convulsive headaches, and mild bad humor.

There were numerous attacks several days apart in the first seven weeks. The patient was not of an “epileptic” disposition, though readily dissatisfied and headachey.

The serum W. R. was positive. Treatment by mercurial inunctions. No further convulsions. Prognosis doubtful.

Re epilepsy and the war, during the first six months Bonhoeffer observed 33 cases in the Charité Clinic in Berlin. Twenty of these 33 cases, unlike Case 55, had attacks before the war, although ten of these had become epileptic rather late, namely, after the period of active military service, at ages from 22 to 27. The development of epilepsy like Case 55’s is not without frequent precedent.

Bonhoeffer states that aside from epilepsy directly due to brain injury by shells, there has been no certain case in which we have the right to regard the war itself as the total cause of the epilepsy. Some, like Case 55, are of syphilitic origin. No subject with a severe long-standing epilepsy has been able to get into the field, according to Bonhoeffer; when they do, they prove constitutional subjects.