CLINICAL STUDIES ON ENCEPHALITIS LETHARGICA 
By Drs. P. LANTIN and W. ViTUG 
An unfamiliar malady was observed in the clinics of the 
Philippine General Hospital in the latter part of 1919. This 
unusual disease we refer to was the so-called encephalitis 
lethargica. 
In reviewing the available statistics about outbreaks of this 
disease we found that, as early as 1712, encephalitis lethargica 
was observed by Camerarius in Tubingen; later it was reported 
in 1890 in Austria-Hungary and in northern Italy, where it 
received the name of encephalitis lethargica nona; lastly, in 
1917, it was reported in Vienna by Von Economo. Since this 
last report, the scientific journals coming from Europe and the 
United States have brought numerous accounts concerning the 
disease. | 
Our observations on this disease have been very limited, and 
are based on only eight cases. The cases were all Filipinos, 
adults, consisting of two females and six males. Three cases 
were admitted in September, and five in October, 1919. 
Symptomatology.—Encephalitis lethargica has many varieties 
of onset; the prodromal symptoms, however, in our cases point 
to involvement of the central nervous system. Some observers 
state that in many cases the disease starts with malaise and 
catarrh, involving the nose and pharynx, accompanied by slight 
cough. Some of our cases gave similar history. Our first case 
started with pain in the eyes, and severe headache, first localized 
in the frontal region, spreading afterwards all over the head. 
The second case began with pain in the shoulder. The third 
case began with choreic movements in the muscles of the face 
and extremities. The fourth case began with pain in the molar 
teeth, radiating to the head, accompanied by difficulty in swal- 
lowing, dyspneea, palpitation, and restlessness. The remaining 
four cases began with heaviness in the head, gradually in- 
creasing, accompanied by headache, blurring of vision, vertigo, 
and general weakness. Fever and diplopia set in. 
After from one to three days of fever and diplopia, stupor 
occurred. The patients slept most of the time, and could be 
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