A manual of diseases of the nervous.

  • Gowers, William Richard editor, Sir.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the nervous. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    alterations, not sufficient to be seen, but still considerable, probably constitute the morbid process in many diseases that are commonly classed as “functional.” Hence we may distinguish a class of “nutri- tional diseases ” as to a large extent distinct from those that consist m a mere derangement of function. While distinguishing these two classes, we cannot entirely separate them; nutrition and function are mutually dependent, and prolonged functional disturbance must deter- mine nutritional change. Visible disease varies much in nature and degree. Some forms can always be seen with the unassisted eye; they change the shape or colour or consistence of the part. Other forms can be detected only with the aid of the microscope; while many may be seen with the unassisted eye when their degree is considerable, and only by means of the microscope in their early stage or when in slight degree. It is convenient to term such alterations, the visibility of which is alto- gether a matter of degree, “ structural diseases.” Thus we may dis- tinguish four pathological classes of disease of the nervous system : 1. Organic disease (or “ coarse ” organic disease); such as tumour, haemorrhage, softening. 2. Structural disease; such as most forms of sclerosis. 3. Nutritional disease; such as general paralysis of the insane, paralysis agitans. 4. Functional disease; such as reflex convulsions, and many forms of hysteria. In the first class the morbid process always begins outside the nerve-elements themselves. In the second class it may begin in them or outside them. In the third and fourth classes these elements are probably always primarily affected. Such a classification helps us to obtain clearer views of the primary relations of disease, but is not convenient for systematic description. For this a hybrid svstem is necessary, in which organic and structural diseases are classified according to their seat,—in the nerves, spinal cord, or brain. With each group maj be placed some nutritional or functional maladies of local incidence. The bulk of these diseases are, however, best considered separately, after the organic diseases have been described, since many of them are of wide distribution or uncertain seat. Classification has two purposes to serve. It serves to bring out the differences in the nature of disease, and thus to define our conceptions and make clear our distinctions. But this purpose is less obtrusive than the second,—to furnish us, as it were, with shelves on which to place our conceptions, and labels with which to ticket them, so that we may find them when we need them and study them in a useful order with the least loss of time. Even if our knowledge were perfect, it is not likely that any scientific