4o6 DISEASES OF UNCERTAIN ETIOLOGY 



(2) ENDEMIC PARALYTIC VERTIGO. 



This is seen in France, Switzerland, Shiivoku, Japan. 



The aetiology is unknown. 



An attack begins with the blurring of objects, ptosis, paralysis of 

 the internal rectus causing diplopia, photophobia, affection of colour 

 vision, hyper^eniia of the optic disc. 



vSpeech is disturbed, mastication difficult through paresis, and later 

 paralysis of the muscles that operate those functions. 



The head falls forward as the neck and shoulder muscles are 

 affected. The posture may be stooping. 



Weakness of arms, hands and legs is not uncommonly seen. 



The attack usuallv lasts ten to fifteen minutes. 



Between attacks the patient may be perfectly well. 



The disease is never fatal. 



Iodides and arsenic should be given. 



Remove the patient to a healthy climate and district. 



(3) ENDEMIC PERIPHERAL NEURITIS. 



This is seen upon the Central African plateau, 5,000 to 6,000 feet 

 high. 



It is said to affect 3 per cent, to 5 per cent, of the Bantu people. 



There are shooting or pricking pains in the forearms and legs., 

 accompanied by numbness, with an erythematous rash and local swell- 

 ing of the affected area. 



Cold and damp increase the symptoms. 



Heat and dryness diminish them. 



The gait is peculiar, the patient having the appearance of walking 

 upon his toes and heels. 



The whole body may be affected. 



The disease may spontaneously clear up or it may last for years. 



(i) LATAH. 



This is seen in the Malay Peninsula, Java, Sumatra, Siam, 

 Burmah, Philippines, Siberia and North America. 



ETIOLOGY (Abraham). 



Auditory, an unexpected noise behind a person. 

 Visual, some unlooked-for movement. 

 Tactile, an unexpected sudden touch. 



SYMPTOMATOLOGY. 



The action seen, noise heard or words uttered may be repeated, 

 with the addition often of foul language. 



