The Bradshaw lecture on prognosis in relation to disease of the nervous system / by Judson S. Bury.

  • Judson Sykes Bury
Date:
1901
Catalogue details

Licence: In copyright

Credit: The Bradshaw lecture on prognosis in relation to disease of the nervous system / by Judson S. Bury. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    Iii the case of disseminated sclerosis, infantile paralysis, myelitis, and many other nervous affections, we assume that they, too, may he set up by poisons, some of which might he derived from the products of over-fatigue or of abnormal digestion in the alimentary canal, or from the perverted function of some other organ or tissue. Two striking features may be noted regarding the effects of poisons—namely, their selective action and the immunity which is the direct result of their action. Immunity, however, is not known to occur in the case of poisons which arc not of bacterial origin, with the exception of opium and tobacco. In the case of toxins, both selective action and immunity play an important part in the prognosis of disease, and may now he briefly illus- trated by reference to the nervous diseases produced by syphilis. The poison of syphilis shows a preference for the vascular struc- tures at the base of the brain, for branches of the cerebral and spinal vessels, for the afferent conducting paths of the spinal cord, and for the cortical cells in the anterior part of the brain. ]Now it is often stated that organic affections of the nervous system run a more favourable course when due to syphilis than when they are started by other agencies. The statement, if true, must be taken with considerable qualifications. When brain tissue is destroyed by the blocking of an artery, it matters not whether the clot be of syphilitic or other origin; the result is permanent impairment of function. If brain tissue is damaged but not destroyed, then as much recovery may take place when the arterial obstruction is due to embolism from heart disease as when it is due to thrombosis from syphilitic endarteritis. But if there is only a narrowing of vessels, there is reason to believe that the thickening is more amenable to treatment if syphilitic than if due to other forms of arterial sclerosis. Exudation from syphilitic vessels may be removed by treat- ment, but it is impossible to say to what extent this will occur in any individual case. Moreover, there can be no doubt that absorption of exudations occurs in other specific infections, as,
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