On syphilitic affections of the nervous system : their diagnosis and treatment.

  • Anderson, T.M'Call.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: On syphilitic affections of the nervous system : their diagnosis and treatment. 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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    emphasized the importance of continuiDg the administration of the iodide for long periods of time. He had been much disappointed with the relapses which not infrequently occurred after a complete cure had apparently been effected. He also referred to cases such as Professor Grainger Stewart had mentioned, in which a cicatrix remained after a syphilitic lesion, and continued to act as a local source of irritation and discharge. Everyone would, he supposed, agree that, in cases of epilepsy due to such a cause, in which the cicatrix could be accurately localized, the cicatrix shoidd, if possible, be removed by operative procedure. The surgical treatment of old syphilitic deposits had recently been considered by Dr. Seguin of New York, with, whose views Dr. Bramwell agreed. Dr. Stretch Dowse (London) said—There are so many interesting points relative to this subject under discussion that it is impossible for me to deal with them seratim. I feel compelled, however, to preface my remarks by saying that in my opinion, and in my experience, the syphilis of to-day differs in many ways from the syphilis as I was first led to observe it some tlurty years ago. I now not unfrequently see large gummata existing side by side with the primary syphilitic sore, and I see also actual paralysis and other nerve troubles co-existing with the roseolar eruption upon the skin, and I cannot doubt from this evidence alone that gummata can and do exist in the early stages of syphilis, and that these changes are associated with the nerve tissues. I would say concerning the effect of syphilis upon nervous tissue, that we must consider its influence, like that of other diseased conditions, from three definite stand-points, viz., the anatomical, or the seat of lesion ; the physiological or the functional nature of the lesion; and thirdly, the pathological, the disorders resulting from derangement of the nutritive processes. The usual anatomical seats of syphilitic lesions in the brain, giving rise to objective signs and producing the varieties of paresis, are located for the most part in the cortical motor area of the cerebral convolutions, or in the membranes adjacent. Their infiaence upon these centres may be indirect by pressure upon the grey matter, or direct by actual invasion and disintegration of the cortex. Dr. Hughlings Jackson has very decided opinions relative to syphilis and nerve structures. He holds that syphilitic lesions never arise in the proper nerve substance, but that the products of syphilis arrest the function of brain areas by produc-