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Case I In our first study we found that the persons were religious minded having a past record of taking ‘sanyas' in the early ages. Later on he lived in the family on the advice of his ‘Guru' and subsequently worked in a central government office till his retirement from service living in a middle class family he had a much regulated life. Although he had chronic piles and bloods discharged frequently, he had no other physical problems. The attack was first noticed from the stiffness of the writing fingers at the age of about 74 years. Gradually the disease spread and the patient's movements were slow. Legs became stiff and toe walking was difficult. Tremor, weakness and numbness leading to distortion of words showed progressive increase.
History of the patient shows no abnormalcy in regard to biological order of the body. Sense perception and power to recollect old memories were vibrant. After retirement from service the patient remained extremely busy with reading and writing. A couple of books written were published. A book on the ‘Gita' was written and the patient despite illness showed sign of satisfaction when it was handed over to him. The patient had undergone surgery for the enlargement of prostate gland during the early stage of Parkinsonism. He was resolute and determined in his decision in spite of other problems of health. However, the death occurred due to cerebral attack at the age of 79 years.
Case II The patient had a long history of hypertension and was a regular taker of such drugs to cause less tension and arrest of blood pressure. Features of Parkinsonism were profoundly visible during the age of 70 years. Some peculiar childish behavior such as sitting alone and writing illegible words, smiling with skeptical expression or forced imitation, closing of the eyes and telling of ghosts moving round the house to the grandchildren was noticed at the early stage of the disease. With the progress of Parkinsonism walking was very slow and the limbs were stiff and had little strength. Voice was almost feeble and not understandable. Listeners could not respond appropriately to his absurd queries and the patient became angry. This could be seen from the facial expression. Curiously, however the patient showed no sign of response during the time of taking snaps by the photographer. Without realizing the gravity of the situation the patient often stared at the visitors and kept silent. During the last stage, severe lung congestion resulting in bronchopneumonia was detected by the attending physician and the treatment was done accordingly. Finally, at the age of about 76 years the patient died at home.
Case III In our case study we have the third sample which is distinctly different from the previous two cases. The patient was relatively a rich person having his own business. During the early years of life the patient was under the shelter of parents and elder brother. Later on he stayed in the same building separately with his wife and daughter. Being the owner of a Chemical factory under the SSI Scheme, he had to take, sometimes, a long drive to go to the remote places of West Bengal and even adjacent Bihar .
Case history of the patient shows no major illness was reported. At about 64 years the first symptom of nervous disorder was noticed by the relatives. Gradually the tremor on the neck and shoulders spread over and the limbs were affected. The patient, however, did not have any complain with regard to memory. Communication with the office staff or the relatives was unabated. The business was carried on despite gradual increase of the difficulties of the movement of the limbs and the body. Movement was restricted and the patient had to take a driver for his car to attend to the factory only. Visit to the house of the relatives was infrequent due to the inability to remain in the same posture for quite a long time. The shaking of the neck, shoulder and the limb was so frequent as to cause extreme difficulty to perform day to day work. As the illness progressed the patient had distortion in speech and ultimately had to be shifted at the Nursing Home for the treatment of bronchopneumonia developed subsequently. Severe pulmonary disorder as a result of acute bronchitis was the ultimate cause of death of the patient at the age of about 69 years. In chart I the details of Parkinsonism as revealed in three cases have been shown.
In observed samples we have all the male patients living in Kolkata and its suburbs. It is found that the average survival rate after the attack of Parkinson's disease was about 5 years and there has been no transmission of the disease to any person of their family members since the death of the patients. Care and nursing was mainly done by the members of the family. The ultimate cause of death was bronchopneumonia with cardiac failure.
In our study of the disease of the degeneration of body, brain and physic of a particular age group, we now make out a brief description of Alzheimerism which is regarded as the worst neuropsychiatric disorder of human body.
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