Distribution of Epidemic Keratoconjunctivitis in the United States

Abstract

to decide this problem. For instance, it is generally known that uncertainty may be more disturbing to a patient than final knowledge of the loss. Therefore, anxious questions should be answered truthfully and sympathetically.On the other hand, one would refrain from adding another burden such as a death notice to a patient at a time when his physical condition is precarious. Table 6 allows a comparison of numbers of patients with and without psychiatric complications in relation to the severity of burns and respiratory involvement.0 It shows that there is an about equal distribution of severely affected patients among the two groups. Actu¬ ally there are relatively fewer patients severely burned and with severe respiratory damage in the group with psychiatric complications than among the patients with no post-traumatic changes. However, the difference is too small to allow any conclusions other than that the occurrence of psychiatric complications did not bear any direct relationship to the severity of burns or respiratory damage.Twenty patients with whom personal interviews were not obtainable are not included in the statistical analysis of psychiatric observations. In answer to a psychiatric questionnaire (table 1) 9 reported mental difficulties which consisted of nervousness, insomnia, fears and anxiety, whereas 11 of them stated that they had not noticed any psychiatric changes after the disaster. SUMMARYOf the 131 patients brought to the Boston City Hos¬ pital during the night of Boston's Cocoanut Grove fire, neuropsychiatrie examinations in the hospital and later interviews were carried out on 46 patients. Of the remaining 85 patients, 39 died. Twenty answered through written questionnaires, whereas of 26 patients no follow-up was obtainable.Of the 46 patients 20 did not manifest psychiatric complications at any time afterward, whereas 25 pre¬ sented symptoms of general nervousness and anxiety neuroses lasting at least three months. Nine months after the disaster 32 of the 46 patients did not show any aberration from their pretraumatic personality, whereas 13 still suffered from general nervousness and anxiety neuroses.One patient has a lasting brain lesion with the symptoms of visual agnosia. This lesion of the occipital lobe was probably caused by exposure to car¬ bon monoxide fumes but may also have been caused by other noxious gases or lack of sufficient oxygen supply.Twenty-nine of the patients had become unconscious during the fire as against 17 who did not lose con¬ sciousness. The loss of consciousness was less than one hour in 13 instances and lasted from one to several hours or days in the remaining 16.Of the 20 patients who did not develop psychiatric complications 15 had lost consciousness, which with 12 of the 15 was prolonged beyond one hour. Of the 25 patients with psychiatric complications 13 had lost consciousness. This, however, was short, below one hour, in 10 of the 13 cases. Therefore unconsciousness, and in particular prolonged unconsciousness, prevailed in patients who had stayed fre...