Maguire Case

Early in February 1932 a young woman named Patricia Maguire who lived in suburban Oak Park, Ill. and worked as a secretary on the Chicago Herald & Examiner went to see her family physician, complained of being extraordinarily drowsy all day long. Dr. Eugene Fagan Traut gave her a thorough examination, could ind nothing wrong with her. Within a fortnight the attack of epidemic encephalitis (sleeping sickness) from which Patricia Maguire suffered put her into a stupor from which she has not yet recovered. Her case attracted widespread newspaper attention. On the anniversary of her first symptoms, on her birthday, at every change in her condition, the Press retold the strange case of Patricia Maguire (TIME, Dec. 17, et ante). Not until last week, however, did her case achieve the dignity of a full-length professional report in the Journal of the American Medical Association. Then & there Dr. Traut wrote of his best-known patient:

''Her sleepiness consisted of inability to stay awake on elevated trains and drowsiness at work. . . . The tendency to sleep increased. She complained of forgetfulness. . . . She was sent to bed. . . ."

Examination of her blood and spinal fluid, a fever (104-o)spasms and other signs convinced Dr. Traut and consultants that Patricia Maguire suffered from sleeping sickness. Her "convulsive movements were often marked enough to throw her out of bed. She yawned a great deal and grimaced, holding her mouth pulled up at either side. She would not answer but would draw away from painful stimuli. Convulsive movements of the jaws required the insertion of a gag to protect her tongue and cheeks. She lay for hours with the neck, arms and legs acutely and rigidly flexed. . . .

"A liquid diet was administered through a nasal catheter for two months. It consisted of four coddled eggs, one pint of milk, one pint of cream, the juice of six oranges, cooked cereal, thin custard, vegetable soup and brewers' yeast. After the fever subsided, one-half ounce of cod liver oil was added. She gained weight so rapidly that the caloric value had to be reduced. When swallowing returned, the catheter was placed in her mouth. She still drinks in this manner, lying on her back with her head turned to the side."

In February 1933, stuporous Patricia Maguire developed pneumonia. An oxygen tent, adrenalin and antipneumococcus serum preserved her deathlike life.

Dr. Traut and consultants tried this & that to bring her out of the stupor--blood transfusions, serums, iodine injections, typhoid vaccine, colloidal sulphur, neoarsphenamine, artificial fevers. All without real success.

"During the last 17 months," continued Dr. Traut, "there have been signs of returning intelligence. For over a year she has grunted and rolled about when she desires to void. She has been in stupor about 80% of the time from 5 a. m. to 8 p. m. During the 'night she is apparently in a deep natural sleep. During the day she lies for the most of the time with tensely flexed arms and closed eyes, with her head turned to the side. She drools. If aroused by the entrance of some one she may look at the person and then more firmly flex her arms, make athetoid movements with the thumbs and fingers, hyperextend the left great toe and grimace. The grimace consists of pulling the right corner of her mouth up and pulling the left corner down. Meanwhile she focuses the right eye. The left eye is everted. She rolls about, groaning. The pupils are equal, regular, moderately contracted and respond in accommodation. They do not respond to light. The wrists are flexed and the fingers clench the flexed thumbs. She has recently been awake for eight or ten hours of the day with the eyes open and an alert expression. . . .

"She will protrude her tongue and follow a finger with her eyes. She will blink her eyes if a finger is thrust at them. If her arm or leg is rotated and she is directed to hold the extremity still after 20 rotations, she will stiffen the arm or leg at the proper time. She will grasp a finger or, at times, raise her hand or smile on demand. She will read and follow these commands if written on a slate. When asked how many children various families had when she became ill. she designates the correct number by raised fingers. When told of additions to these families within the last three years, she will give the correct new number if asked several days following the time she was informed. She also signaled that her uncle had died two years ago. She has recently held her head up while sitting. She watches people working in her room. She will stop eating to investigate the actions of another person in the room. She nods the head to answer a question in the affirmative. When asked how many of five apples remained after selling two, she raises three fingers. She responds best to her mother's request. She apparently distinguishes her mother from the others."

Last week Patricia Maguire's family celebrated her 30th birthday. Said Dr. Traut: "The patient is very well nourished and has good color. Her muscles are large and strong. She has not spoken or made any purposeful movements except those of defense. She lies inattentive with shut eyes most of the time.''

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