Original Clinical Description of Alzheimer's Disease "Perplexed Woman"
An excerpt taken from a medical book by Dr. Alois Alzheimer describing a patient in 1907 who had the disease. A woman, 51-years-old, showed jealously toward her husband as the first notable sign of the disease. Soon, a rapidly increasing loss of memory could be noticed. She could not find her way around in her own apartment. She carried objects back and forth and hid them. At times, she would think that someone wanted to kill her, and would begin shrieking loudly.
In the institution, her entire behavior bore the stamp of utter perplexity. She was totally disoriented to time and place. Occasionally, she stated that she could not understand and did not know her way around. At times she greeted the doctor like a visitor, and excused herself for not having finished her work; at times, she shrieked loudly that he wanted to cut her, or she repulsed him with indignation, saying that she feared from him something against her chastity. Periodically, she was totally delirious, dragged her bedding around, called her husband and her daughter, and seemed to have auditory hallucinations. Frequently, she shrieked with a dreadful voice for many hours.
Because of her inability to comprehend the situation, she always cried out loudly as soon as someone tried to examine her. Only through repeated attempts was it possible finally to ascertain anything. Her ability to remember was severely disturbed. If one pointed to objects, she named most of them correctly, but immediately afterwards, she would forget everything again. When reading, she went from one line into another, reading the letters or reading with senseless emphases. When writing, she repeated individual syllables several times, left out others, and quickly became stranded. When talking, she frequently used perplexing phrases and some periphrastic expressions (milk-pourer instead of cup). Sometimes one noticed her getting stuck. Some questions she obviously did not comprehend. She seemed no longer to understand the use of some objects. Her gait was not impaired. She could use both hands equally well. Her patellar reflexes were present. Her pupils reacted. Somewhat rigid radial arteries; no enlargement of cardiac dullness; no albumin. During her subsequent course, the phenomena that were interpreted as focal symptoms were at times more noticeable and at times less noticeable, but always they were only slight. At the end, the patient was completely stuporous; she lay in her bed with her legs drawn up under her body; and in spite of all precautions, she acquired decubitus ulcers.
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Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.