BIOLOGY LIBRARY
REVIEW OF
NEUROLOGY AND PSYCHIATRY
REVIEW
OF
NEUROLOGY and PSYCHIATRY
(Founded by the Late Dr ALEXANDER BRUCE)
Editor
A. NINIAN BRUCE
M.D., D.Sc., M.R.C.P.E., F.R.S.E.
Assistant Editors
CHAS. MACFIE CAMPBELL S. A. KINNIER WILSON
M.D., B.Sc., M.R.C.P E. M.D., B.So., M.R.C.P. (Lord.)
J. D. ROLLESTON
M.A., M.D.
Supported by
F. W. MOTT, London
RI8IEN RUSSELL, London
Sir E. A. SCHAFER, Edinburgh
J. SHAW BOLTON, Wakefield
J. MICHELL CLARKE, Bristol
Sir THOMAS CLOUSTON, Edinburgh
C. C. EASTERBROOK, Dumfries
Sib DAVID FKRRIER, London
HENRY HEAD, London
WALTER K. HUNTER, Glasgow
JOHN MACPHERSON, Edinburgh
HAMILTON C. MARR, Edinburgh
C. S. SHERRINGTON, Liverpool
G. ELLIOT SMITH, Manchester
PURVES STEWART, London
ALDREN TURNER, London
W. B. WARRINGTON. Liverpool
K. T. WILLIAMSON, Manchester
VOLUME XI.
EDINBURGH
OTTO SCHULZE & COMPANY
20 SOUTH FREDERICK STREET
19 13
PRINTED AT
THE DARIEN PRESS
EDINBURGH
Contents
ORIGINAL ARTICLES
The Pineal Body: A Review. Leonard J. Kidd, M.D.
A Case op Combined Degeneration op the Spinal Cord
with Amyotrophy. Gordon Holmes, M.D.
Multiple Neuromata op the Central Nervous System :
Their Structure and Histogenesis. The late Alex¬
ander Brace, M.D., LL.D., F.R.C.P.E., and James W.
Dawson, M.D. ------
The Dipprrsxtiation op Cells in the Cbrbbro-Spinal Fluid
by Alzheimer’s Method. D. K. Henderson, M.B.,
Ch.B., and Winifred Muirhead, L.R.C.P. (Edin.)
A Case or Cerebral Syphilis occurring Six Months apter
the Initial Lesion. Menas 8 . Gregory, M.D., and
Morris J. Karpas, M.D. -
The Sprbad op Inpection by the Ascending Lymph Stream
op Nerves from Peripheral Inflammatory Foci to
the Central Nervous System. Drs Orr, Rows, and
Stephenson ......
Clixioo-Pathological Findings in Syphilis op the Central
Nervous System. William H. Hough, M.D. -
A Case with Transient Attacks op Paralysis : Autopsy.
Walter K. Hunter, M.D.,D.Sc., and Madge E. Robertson,
M.B., Ch.B. - - - -
Rmarm upon the Irregular and Unusual Types op
Familial Periodic Paralysis and Conditions simu-
uting thk Same, with a Preliminary Report upon
a New Sub-Type op this Palsy. L. Pierce Clark, M.D.
Myasthenia Gravis with Exophthalmic Goitre. George E.
Rennie, M.D., F.R.C.P..
PACIK
1
76
117
195
257
349
411
419
459
475
380734
VI
CONTENTS
Direct Trochlear and Crossed Oculomotor Fibres. Leonard
J. Kidd, M.D..
A Case op Toxic Exhaustive Insanity, associated with
Chronic Suppurative Otitis Media, Labyrinthitis,
and Extra-Dural Abscess. D. K. Henderson, M.D.,
Winifred Muirhead, L.R.C.P. (Edin.), and J. S. Fraser,
M.B., F.R.C.S..
A Guide to the Descriptive Study op the Personality.
With Special Reperence to the Taking of An¬
amneses of Cases with Psychoses. Dr August Hoch
and Dr George S. Amsden -
The Direct Ventro-lateral Pyramidal Tract. William G.
Spiller, M.D. ......
PAGE
507
565
677
615
f
IRevnew
of
IReuroloap an6 fltescbiatcp
Original Hcticles
THE PINEAL BODY: A REVIEW.
By LEONARD J. KIDD, M.D.
Introduction; 1. Ancient Vietos of the Pineal Body; 2. Comparative
Anatomy and Development; 3. Comparative Histology; 4. Clinico-
Pathological; 5. Experimental; 6. General Discussion; 7. Con¬
clusions ; 8. References.
Introduction.
There appears to be no really satisfactory review in the
English language dealing with all aspects of the pineal body.
Histological, experimental, and clinico-pathological evidence has
been accumulating during the past few years—and even months—
which suggests that the question is no longer, “ Has the mammalian
pineal body any functions ? ” but rather, “ What are its functions,
and how does it functionate ? ”
In this review my object is to so present the subject that we may
learn by it the extent and the limitations of our present knowledge
of pineal physiology, and may also learn in what directions this
may be increased. In the clinico-pathological section I am not
at all concerned with the purely intracranial signs and symptoms
of pineal tumours, but only with the metabolic symptoms shown
by about 10 per cent, of the recorded 65 cases.
1. Ancient Views of the Pineal Body.
The mammalian epiphysis was known at any rate in pre-
Galenic ages; and Studnicka 5 mentions that Faivre 2 (1857)
i
LEONARD J. KIDD
.2
claims that Galen 1 and also Oribas knew of the existence of
brain-sand in the human pineal body. The pre-Galenic teaching
was that the pineal body acts towards the fourth ventricle in the
same sort of way in which the pylorus acts towards the stomach,
viz., that its function is to allow only the proper amount of the
vital spirits to pass from the third to the fourth ventricle. Galen 1
refuted this ancient teaching: he writes of the pineal as a gland,
similar to the other glands of the body. The statement is made
by Paul Seigneur, 6 in his recent thesis, that Galen looked on the
pineal as a gland which furnishes a secretion. I have failed to
verify the latter part of this statement from a study of any of the
three editions of Galen to which I have had access.* But if
Galen really did teach this, his foresight was truly remarkable.
Seigneur states that Magendie revived the pre-Galenic teaching,
and held that the pineal acts as a pad whose function is to open
and close the Sylvian aqueduct. There is no need to refer in
detail to the fanciful guesswork of Descartes (1649). It is stated
by Faivre 2 (1854) that in 1680 Duverney announced to the
Academy of Sciences that the dog has no pineal: this teaching
was accepted by Samuel Collins in his “ System of Anatomy,” and
also by Camper, but was refuted by Soemmering, Gisbert, and
Jacob Wolfif.
We can conveniently divide the history of the study of the
pineal body into the following eras: (1) the pre-Galenic; (2) the
Galenic; (3) the period of the dark ages ending about a.d. 1824;
(4) an era of twilight, beginning in 1824, when the epiphysis of
Petromyzonts was studied more or less by Serres (1824), Schlemm
and D’Alton (1838), Johannes Muller (1839), Siebold and Stannius
(1854), and Mayer (1864); and, finally (5) the modern era which
began with the careful comparative histological studies by Faivre 2
(1854) of the mammalian, avian, and reptilian epiphysis.
It is said that the early history of the epiphysis is given by
(1) Longet (1847), (2) Faivre 2 (1857 paper), (3) Legros 3 (1873),
(4) Peytoureau 4 (1886-87), and (5) by Duval (1888). The
references to Longet and Duval are given by Studnicka. 6
* Apparently Seigneur relies here on the thesis of Peytoureau ; 4 for in his
bibliography he gives two references to Galen, and in each case adds “ cit. par
Peytoureau.” I have to thank Mr Victor Plarr, the Librarian of the Royal
College of Surgeons, London, for his kind help in translating passages from
Galen.
THE PINEAL BODY: A REVIEW
3
2. Comparative Anatomy and Development.
Although several observers studied the comparative anatomy of the
epiphysis of lower vertebrates during the second and third quarters of
the nineteenth century, the first really notable discovery appears to
have been made by Leydig 7 in 1872: he then described a parietal
sense-organ in Anguis and Lacerta, which he called “the frontal
organ " : he stated that there was no evidence as to its function. In
1*82 Ahlborn 9 suggested that the parietal organ of Leydig is to he
compared with the unpaired eye of Amphioxus and of Tunicata. In
the same year Rabl-Ruckhard 8 suggested the homology of this organ
with the median eye of Arthropoda ; and in 1884 he drew attention to
the parietal foramen of fossil reptiles. These researches were soon
followed by numerous studies of the development of the epiphysis,
viz., those of de Graaf 10 (1886), Baldwin Spencer 11 (1886), Beard 12
(1888), Francotte 13 (1888), Beraneck 14 (1892,’93), C. Hill 13 (1891,
'34 ), Bendy 16 (1899, 1907, 1911), and others. The most recent studies
are those of Terry 17 (1910) in Teleosts, and J. Warren 18 (1911) in
Reptiles.
So far as is at present known, an epiphysis is present in all verte¬
brates, with the exception of Myxinoids (Studnidka), Torpedo oceUata
(B'Erchia 19 ), and T. marmorata (Studnidka 6 ), and all the Crocodilia
(Sorenson,- 0 Voeltzkow 21 ). Not only is this true for the adults of
these forms, but even in their ontogeny no trace of an epiphysis has
been found—at any rate in the Crocodilia. In mammals the epiphysis
appears as a single outgrowth or evagination of the hinder* end of the
roof-plate of the diencephalon. In lower vertebrates usually two
epiphyses are seen at a very early stage of development: these are
usually strictly median in position: the anterior one is developed in
the anterior part of the diencephalic roof, and the hinder one in its
posterior part. In most forms the anterior (epiphysis 1) becomes the
pineal “eye” of those few forms which possess a recognisable one,
whereas the hinder (epiphysis 2) becomes the pineal body. In other
forms, the anterior either disappears or becomes fused with the hinder.
It was formerly taught that the pineal eye is formed from the distal
end of the epiphysis, from which it is constricted off; but few modern
writers accept this view. Most authorities hold that two epiphysial
evaginations occur: of these, the anterior is the future pineal sense-
organ or eye, the posterior the “ epiphysis.” But some observers argue
for a primitive bilateral origin of the pineal eye and epiphysis (pineal
organ), so that they were originally paired structures. Thus, Gaskell 22
maintained that the pineal sense-organs of the Ammoccetes of Petromyzon
were paired organs. Dendy 16 states that in Petromyzonts the hinder
epiphysis is much more developed than the anterior, and is actually
median in position; he found that in Geotria australis (the New
Zealand fresh-water lamprey) the anterior organ lies a little to the
left of the median line: the posterior becomes the pineal eye and is
connected by the “pineal nerve” with the right habenular ganglion.
Locy 23 (1893, ’94) described in the Selachian Acanthias vulgaris
4
LEONARD J. KIDD
two pairs of symmetrically developed “ accessory optic vesicles,” behind
the optic vesicles, on the open neural plate. He held that these are
serially homologous with the optic vesicles: he derives the pineal pair
from the more anterior pair of these accessory vesicles. His observa¬
tions have, however, never been confirmed on embryos of this easily
accessible Selachian. In 1891 C. Hill 15 found in Teleosts and in the
Ganoid Amia right and left primary epiphysial outgrowths. Dendy 16
found (1899) that, in that very primitive type of reptiles Sphenodon,
the left epiphysial vesicle becomes the parietal eye. B^raneck 14
described right and left epiphysial outgrowths in Lacertilia , and
strenuously maintained the doctrine of the individuality of the pineal
eye. John Cameron 24 showed that, in the chick, at about the fiftieth
hour of incubation the epiphyses appear as bilateral outgrowths from
the roof of the diencephalon, the left being the larger: by the sixtieth
hour the two outgrowths have coalesced to form the single unpaired
outgrowth. He points out that the transitory appearance of the
bilateral condition explains why it had been previously overlooked.
He found the same state of afiairs in Amphibia. I note, however, that
in very early stages in reptiles Warren 18 found the two epiphyses
strictly median in position from the first. It is only right to mention
here that Cameron, 24 who strongly champions the “ primitively bilateral
origin ” hypothesis, has shown in Teleosts , Amphibia , Birds , and Man,
nerve-fibres passing from the ganglion habenulae of one side to epiphysial
elements on the opposite side, forming a true decussation in the superior
(habenular) commissure. Dendy 16 admitted candidly in 1899 that at
present it is not possible to explain why these two organs (epiphysial
vesicles) should so persistently tend to alter their positions from the
primitive transverse to the sagittal plane. He draws attention to the
fact that in the Devonian fossil fish Titanichthys there are paired para¬
sagittal parietal foramina present.
The variations of the vertebrate epiphysis are very great. For the
following compilation I am indebted especially to StudniSka’s monu¬
mental paper, 5 and to Dendy’s excellent one 16 on the pineal gland in
“ Science Progress.”
1. Adult Elasmobranchs. —In Spinax niger the epiphysis is a
median, unpaired body in the form of a long slender tube which
passes forwards and ends in a terminal enlargement lodged in the
cartilaginous roof of the cranium. Studniftka describes its walls as
containing numerous modified columnar ependymal cells whose free
extremities project slightly into the lumen of the organ.
2. Ganoids .—In Acipenser (sturgeon) the structure resembles that
of Elasmobranchs.
3. Teleosts. —The same thing is true here also; but the proximal
part is much shorter, and its terminal vesicle is usually larger, and
may have its wall much folded. C. Hill 15 describes, in the Salmon,
numerous cells, resembling ganglion cells, in the wall of the vesicle.
4. Amphibia. — (a) Urodela — have a single pineal organ: it
apparently represents the proximal part of the stalk of a more fully
developed pineal organ, such as occurs in fishes. (6) Anura—the
THE PINEAL BODY: A REVIEW
5
f
l
f
I
Vw
!
f
(
i
f
f
\
f'
l
r
t
*
I
f
!
V
(
\
(
(
{
pineal organ is single, but has both a proximal and a distal vesicular
part. The former contains the usual modified ependymal cells with
their free ends projecting into its cavity.
5. Reptilia .—Of existing forms, only Sphenodon and Lacertilia
have a pineal eye: but a parietal foramen was present in many extinct
forms. In Ophidia the pineal organ is a solid, very vascular body,
and resembles that of birds and mammals.
6. Aves .—The epiphysis may be tubular, follicular, or solid; and
it is usually connected with the brain by a hollow or a solid stalk. In
Meleagris there are vast numbers of small follicles, lined by ependymal
epithelium, and separated from one another by vascular connective-
tissue ; and Studntfka has demonstrated the presence of ependymal
cells with their free extremities projecting into the cavities of the
follicles.
7. Mammalia. —The pineal body usually resembles that of birds,
and is very vascular; but there are great variations, sometimes even
in closely related forms: the recent studies 44 of Cutore (1912) show
this well: thus, he finds great macroscopic differences between the
pineals of Macacos and Cercopilhecus. Again, the study by Jordan 27
(1911) of the epiphysis of the Virginian Opossum shows a very
primitive type quite reptilian in character.
In summing up this section, we may say that it is clear that the
morphology of the epiphysial organs is not yet fully understood, and
that it presents problems of great difficulty.
3. Comparative Histology.
[I have made free use of the monographs of Mdlle. Dimitrova 00 and
of Studni£ka 5 in the following section: to several papers I have not
had access, but in these instances I have been at pains to compare
as many abstracts of these as I could find. Dimitrova gives an
excellent historical summary up to 1901; and Studni£ka summarises
the literature of the histology of the mammalian pineal under six
headings, viz.: (1) Connective-tissue framework; (2) Ependyma; (3)
Parenchyma—neuroglia; (4) Nerve-bundles in the epiphysis; (5)
Ganglion-cells (?); (6) Figment in the epiphysis.]
v. Kollikbr 25 (1850) described small round cells, multipolar
nerve-cella, compact bundles of cells, and a few nerve-fibres.
Faivre 2 (1854) was apparently the first observer who made a
careful comparative histological study of the pineal body. [Curiously,
this paper is not mentioned by Dimitrova, though she quotes Faivre’s
later paper of 1857—a paper to which I have not had access.] Faivre
studied the pineal of Man, horse, guinea-pig, dog, ox, rabbit, pig, the
hen, turkey, turtle-dove, and the tortoise; unfortunately he gives no
figures. He refutes the teaching that the parenchyma is composed of
grey matter analogous to the cortical substance: superficial examination,
even, shows the error of this; he quotes Valentin (“Neurologie,”
p. 222) that the pineal has a striking histological resemblance to the
pituitary. Faivre describes the pineal of Man as formed of three
6
LEONARD J. KIDD
elements, viz., (1) the fibro-vascular envelope, which sends many
prolongations into the interior, (2) the globular or nuclear parenchyma,
(3) the brain-sand or inorganic material. Of these, the parenchyma is
the most important. The parenchyma is formed essentially of a large
quantity of “ globules ”; these, full of grains (“ grenus ”) in their
interior, are generally elliptical with irregular borders; their diameter
averages *015 mm. He says that these globules do not call to mind
the structure of the histological elements of the nervous system, and
that comparative histology shows that the “ globules ” are the nuclei of
the cells. I interpret these descriptions to mean that Faivre recog¬
nised that the nuclei of the parenchymal pineal cells of Man contain
granules; if this be correct, he was the first observer to make this
discovery. [I find that practically all modem writers appear to have
overlooked this earlier paper of Faivre, probably because Dimitrova
has no mention of it; and it is certain that everyone who wishes to
learn about pineal histology consults her paper’s historical summary.]
It is of interest to note that Faivre found the “ globules ” were smaller
in a girl of 3 years than in a woman of 60. In the horse he found
throughout the parenchyma a large number of small black granules
(“grains”) endowed with remarkable Brownian movement. Its
globules are much larger than Man’s, viz., *02 mm.; some differences
between the pineals of the horse and of Man are mentioned.
He notes that the guinea-pig’s pineal is easily missed; it is very
small (2 mm. length), slender, and easily torn out in preparation; its
ovoid granules are *012 to *006 mm. in diameter, i.e., slightly smaller
than in Man, and are full of blackish “ granulations ”: Faivre found
also small grains of calcium phosphate, and of concretions whose nature
he failed to determine. The dog’s pineal resembles Man’s; its globules
are very small ( 004 to *006 mm. in diameter). The hen’s pineal has
the ordinary globular structure: the small “ grains ” are rounded, and
are from *001 to *002 mm. in diameter: their contents are sometimes
granular, but more often they appear to be surrounded by a whitish
zone which seems to be the cell of which they are the nucleus. Other
birds resemble the hen, both as to the position and structure of the
pineal. At the end of his paper Faivre states that in all the animals
which he examined, viz., mammals, birds, and reptiles, he got the same
results. He appears, then, to have been the first to establish two facts
which are now recognised by modern histologists, viz., (1) that the
nuclei of the parenchymal pineal cells contain granules, and (2) that
there are certain histological differences in the pineals of the child and
of the adult.
In his second paper (1857) he is stated by Dimitrova 60 to have
“described round the gland a connective-tissue sheath coming from
the choroid plexus, and fibro-vascular septa which penetrate into its
thickness and divide it into a large number of cavities. These are
occupied by the special elements, which are distinct from those which
enter into the composition of the nervous system but approach the
nerve-elements of invertebrata and of embryos. In Man and the horse
Faivre has found nerve-elements in the pineal peduncles; he finds also
THE PINEAL BODY: A REVIEW 7
concretions, which are, he thinks, due to the rich vascularity of the
organ.”
Lockhart Clark 86 (1861) found nerve-fibres, nuclei, and brain-
sand, but no nerve-cells. He writes: “ Its reticular structure bears
s decided resemblance to the epithelium of the olfactory mucous
membrane and still more to what I have described elsewhere as the
fourth layer of the olfactory bulb in the sheep, and particularly in
the cat.”
Luts 27 (1865) looked on the pineal as formed of grey matter and
of nerve-fibres which are connected with various regions of the brain.
Leydig 7 (1866) says that the structure of the mammalian pineal,
especially of the mouse, resembles that of the pituitary body of reptiles,
with certain small differences, however.
Krause 28 (1868) described nerve-fibres with a double contour.
Sti£da 29 (1869) studied the pineal of birds and mammals, and
described an anastomosis of the processes of the pineal cells; and he
found nuclei in the reticulum.
Bizzozkro 30 (1871) described two sorts of cells; and he appears to
have been one of the first to discover—as many observers have since
found—that there are certain differences between the cells of the pineal
of newly-born animals and those of adults. He found often a yellowish
or brownish pigment in the connective-tissue cellB; he found no true
septa, but only irregular trabeculse.
Meyhert 31 (1871) looked on the pineal as a nerve-ganglion.
Hagemann 32 (1871-72) studied fishes, birds, and mammals; he
described two kinds of epithelial cells, viz., round and fusiform; also
bipolar and multipolar nerve-cells. Thus he regarded the pineal body
as composed of a mixture of epithelial cells and nerve-elements.
Cruvejlhier 33 (1877) found (1) pale rounded cells without processes,
(2) multipolar cells, (3) a small number of nerve-cells, and (4) a
multitude of calcareous concretions.
Mihalkovicz 34 (1877) says that developmental studies show that
the pineal cells are not lymphatic corpuscles; they are in their origin
homologous with the epithelial elements of the cerebral ventricles.
Schwalbe 35 (1881) held that there is a striking resemblance
between the pineal cells and those of lymphatic corpuscles; but he
regarded them as, developmentally, modified epithelial cells.
Ciowini 36 (1885-86) demonstrated—apparently for the first time—
the presence of neuroglial elements; the few nerve-fibres met with
belong to the vessels.
Darkschewitsch 87 (1886), who studied the frog, rabbit, dog, ape,
and human fcetus, describes and figures in the dog medullated fibres
connecting the pineal and the posterior commissure. He describes
great abundance of nerve-fibres. He used Weigert’s hsematoxylin
method.
Henle 38 (1887) looked on the pineal as a lymphatic ganglion: he
described its parenchyma as containing two kinds of cells, viz., (1) round
cells which resemble lymph corpuscles or leucocytes (but are a little
larger), and (2) angular cells provided with points.
8
LEONARD ,T. KIDD
Ellenberger 89 (1887) describes the horse’s pineal as very vascular;
under a low power it resembles in structure a lymphatic gland. Only
rarely did he find nerve-fibres in the pineal: they are continued into
its stalk, but he failed to trace them to their termination.
Flesch 40 (1888) studied the pineal of horse, sheep, pig, dog, bat,
and Man; he found brain-sand only in Man. He denied that the
pineal of mammals is a rudimentary organ, and regarded it as an
epithelial organ: he found nerve-fibres. He points out that the size
of the pineal bears no relationship to the size of the brain; thus the
small-brained sheep has a relatively large pineal. He argued that the
mammalian pineal is physiologically active, because (1) it contains
nerves, (2) is very vascular, (3) its specific cells contain pigment-
granules. He held that it was probably a secretory organ. He
suggests that it may also contain a heat-regulating centre.
Edinger 41 (1889) says that in higher mammals the pineal is formed
of neuroglial cells, and that nerve-elements are absent.
Chauveau 42 (1889) finds in the connective-tissue, vesicles filled
with polyhedral cells.
Mingazzini 48 (1889) claimed that the pineal elements resemble
lymphatic corpuscles.
Soury 44 (1889) found a substance, resembling adenoid tissue,
packing the spaces of the fine network and cellular elements.
Weigert 45 (1895), working by his own method, described the
pineal cells as bound together by an abundant, but loose, network of
large neuroglial fibres.
Cajal 48 (1895) found sympathetic nerves penetrating the pineal
body with its vessels : their axons form a rich interstitial plexus: the
terminal nerve-twigs are situated on the external side of the glandular
cells, but do not penetrate into their protoplasm ; this relationship is
like that found by several authors for other secreting glands.
Galeotti 47 (1896-97) argues for a secretory function of the pineal;
and he appears to have been the first to attempt to show how this
secretory process is carried out. He worked on the adult rabbit, also
on an embryo white rat, of 14 mm. length, and on lower vertebrates.
In the rabbit he described the parenchymal cells as irregularly disposed:
their nucleus is oval, and is surrounded by a little granular protoplasm:
pigment is often contained in the cells. Pigment-granules are found
in both the cytoplasm and the nucleus of the cells: sometimes they
are accumulated in the cytoplasm in notable quantity. Galeotti held
that not only do the pineal cells elaborate pigment, but also, by
different mechanisms, a product of secretion in whose formation the
nucleus and nucleolus participate. Dimitrova 50 (to whose account
chiefly I have had to trust) holds that these conclusions are unwarranted
by Galeotti’s observations. I find the statement is made by Fok 81 (1912)
that Galeotti, applying his own elective coloration method, found abun¬
dance of “ secretory ” granules in the epiphysis of Scyllium canicula,
Leuciscus cephalus, Rana esculenla, and in a nine days’ embryo of Gallus;
whereas he failed to find them in Anguilla vulgaris, Spelerpes fuscus,
Triton crislatus, and Proteus anguineus,
THE PINEAL BODY: A REVIEW
9
Lord 48 (1899) described the parenchyma of the human pineal as
formed of small stellate cells resembling those of adenoid tissue, and
of pale elements of variable shape.
Nicolas 4a (1900) found striped muscle-fibres in the pineal of the
ox and calf, chiefly in the distal part: they may be superficial or
deep, are very few in number, and easily found when large. Their
sue varies from 66 to 100 /x in length by 4 to 6 /* in breadth : they are
accompanied by neuroglial fibres: and Nicolas never saw any con¬
nection of these muscle-fibres with vessels. His pupil, Mdlle. Dimitrova,
confirmed his results, in the following year, in all the six pineals of
ox and calf which she examined. But no one else has since that time
found striped muscle-fibres in any normal mammal.
Dimitrova 40 (1901) studied the pineals of many mammals, young
and old, by many methods; these included Man, ox, calf, sheep, horse,
dog. and cat: all her observations were made on fresh glands: even her
human material was never more than five hours old. She is the great
champion of the essentially neuroglial nature of the mammalian pineal.
She discusses the meaning of the intra-protoplasmic granules and
the intra-nuclear droplets which she found. She writes: “ If the
presence of granules is sufficient to prove a glandular function, then
the pineal cells are in the highest degree glandular.” But she admits
that her observations do not admit of a definite answer to the question
of an internal secretion. She found that calcareous concretions were
common and large in Man and the ox; pigment was specially frequent
in the horse: it is found in the parenchymal cells and, more often,
in the connective-tissue cells. Her conclusions may be summarised
thus: (1) The pineal is composed essentially of neuroglial elements;
(2) cavities exist in the pineals of ox, calf, sheep, and dog: they
resemble thyroid vesicles, or the vesicles in the anterior lobe of the
pituitary (she suggests that they represent vestiges of the primitive
budding); (3) she found, in young cats only, some cells which are
independent of the neuroglial cells: their significance is doubtful, but
they resemble those which Cajal and Retzius have described as
“sympathetic”: she suggests that they are developing neuroglial
elements; (4) she has never seen fibrils, of clearly nervous appearance,
except in young animals: they could not be recognised in adults in
the midst of the innumerable fibrils impregnated by the chromate of
silver.
Angladb and Duclos 61 (1908-09) found neuroglia constantly in
the human pineal: sometimes it appears to form an accessory support
by connection with the connective-tissue: sometimes the septa are
formed in great part by neuroglial elements: in the alveoli there are
always neuroglial cells and fibres, but there are also probably cellular
elements of another nature.
Sartrschi 54 (1910), whose very important paper I know only by
several abstracts, studied the pineal of birds and mammals (guinea-pig,
rabbit, sheep, pig, cat, dog, ox, horse, and Man) both young and old.
The pineal of the newly-born child differs from that of the adult. A
pronounced glandular structure exists especially in birds; but only
10
LEONARD J. KIDD
in certain very young mammals—rabbit and guinea-pig—is it very
definite: in the sheep, ox, horse, dog, and cat, secretory processes are
not so evident, but Sarteschi holds that they cannot be denied. In
the course of growth regressive changes occur, and these can be
demonstrated histologically. The pineal of birds differs from that of
mammals, and has a characteristic aspect. In Galina glandular and
neuroglial elements are found: the nuclei of the glandular cells are
rich in fuchsinophile granules. The organ is divided by the connective-
tissue septa into a large number of multilocular cavities, often irregular,
in the central part of which is often seen a clear lacunar space, more
or less large, in relation to which the glandular cells frequently take
a radial disposition. In the interior of this space one sees numerous
transparent spherules whose limiting membrane alone stands out
prominently. Sometimes between the spherules there are irregular
granular masses, at other times groups of elements exactly like
glandular elements; the cell-body of these glandular elements has a
spongy structure. The neuroglial elements appear specially evident
about the capsule, and sometimes along the septa. In the pineal of
the guinea-pig and rabbit most of the cells are polygonal, and have a
spongy protoplasm; other cells, which present similar characteristics,
are distinguished by their swollen appearance: and a clear space, full
of liquid, is formed in the cell-body. One often sees spheres of various
sizes, either isolated or grouped. In very young rabbits the pineal
cells have abundant protoplasm, with a nucleus rich in fuchsinophile
granules; in adult rabbits, these cells are rather scarce, the
fuchsinophile granules are heaped up irregularly, and the nucleus is
sometimes wanting. In adults the granules appear to undergo
regressive changes; the protoplasm seems to be arranged in irregular
granules, but little distinct: also the gland preserves its epithelial
aspect in some parts only: usually large numbers of Cerletti’s
“ perivascular corpuscles ” are seen. The pineals of the sheep, young
and old, ox and calf, and pig contain many neuroglial cells with long
interlacing processes terminating among them: many typically
glandular elements are also found. After a period of rapid evolution,
their pineals undergo a regressive change in the adult.
CosTANTija 63 (1910) studied the pineal of ox, horse, and Man:
he notes that the pineal of the ox and horse is twice as large as Man’s,
though their brain is much smaller. He finds the organ is very
vascular; he describes two sorts of cells, viz., acidophile and basophile;
he lays great stress on the granular nature of the pineal cells, and
concludes that the mammalian pineal is an organ with an internal
secretion.
Cutore 64 (1910) is stated to have found, in many mammals, in
addition to neuroglial elements, cells of epithelial character, and also
lymphatic elements. In Macacus he found abundant medullated
nerve-fibres, which form a plexus: but he failed to find this in other
mammals. The pineal of Cercopithecns shows an evidently glandular
structure.
Galasescu and Urechia 63 (1910) describe by the name of
THE PINEAL BODY: A REVIEW
11
t
I “ paravascular acidophile” cells which they find round some of the
«, vessels of the pineal: these cells are round or oval, with well-coloured
nuclei, situated in the midst of a protoplasm which stains vividly with
cosine, van Gieson’s fuchsine, <fcc. The protoplasm, which is clearly
delimited, contains sometimes fine granules; and sometimes it is so
packed that the nucleus is indistinguishable. These cells resemble
those of the parathyroids. The two writers suggest that these cells
in the neighbourhood of the vessels may play a part in an internal
secretion of the pineal body.
Krabbe 5 * (1911) studied 100 human pineals, male and female:
the ages of the subjects varied between 14 and 92 years: also
some pineals from newly-born children, and some from children up to 7
years of age; but unfortunately he was not able to study any between the
ages of 7 and 14 years. He found two types of cells in the parenchyma,
viz., (1) special “ pineal ” cells, and (2) neuroglial cells. The former
are much the more numerous: their nucleus is large and usually oval:
there is but little chromatine, and that chiefly at the periphery : there
is usually a nucleolus. The protoplasm is relatively slight in amount:
the position of the nucleus varies. He thinks that granules leave the
cell-protoplasm to traverse the intercellular spaces and enter finally the
blood, or lymph, or cerebro-spinal fluid. On one point he feels certain,
viz., that the nuclear products are not gathered by the paravascular
granules, because these cells appear to be commoner in cases in which
the parenchyma has been destroyed and consequently cannot be the
path of nuclear secretion. Some of the nuclei are hollowed out; he
supposes that the nucleus is regenerated after evacuation. In young
subjects he sometimes found small groups of cells differing from the
“ pineal cells ” in that the nuclei are very small and very rich in
chromatine, the chromatic granules are very fine, and the cells are
situated more deeply. These cells resemble those of the newly-born;
and Krabbe looks on them as pineal cells which have retained their
infantile characters. With regard to the neuroglial cells, he thinks
that Dimitrova’s interpretation of her own figures is not exact, for “ it
is not enough to say that a cell is neuroglial merely because it is in
contact with neuroglial fibres.” He gives reasons (p. 263) for his
doubt. He goes on : “ One must modify Dimitrova’s teaching that
the pineal is formed essentially of neuroglial elements, and say that its
parenchyma consists of non-neuroglial cells between which there are a
smaller number of cells (neuroglial) which give off a very large number
of fibres which intersect the other cells.” Krabbe describes also other
cells, and certain variations of the connective-tissue of the pineal: he
says there is no doubt that augmentation of this tissue is a process of
involution, such as exists in the whole gland. He failed to find any
relationship between the secretory process of the nuclei of the “ pineal ”
cells and the augmentation of this tissue. He found, by the Kulschitzky-
Wolters method, medullated nerve-fibres, not, however, in the par¬
enchyma nor connective-tissue; but only at the base of the gland a
small nerve-bundle, coming from the posterior commissure, possibly
aberrant. He found calcifications, usually in the parenchyma, in a
12
LEONARD J. KIDD
few cases in the septa (small and elongated); pigment (lipochrome)
in the connective-tissue, parenchyma, and in the cells whose nucleus
is divided; fat, but never much, in the septa sometimes: it plays a
less important part than the lipoid substances. He never found
muscle-fibres; he often found, but not constantly, the neuroglial
plaques described by Marburg 68 in 1909. Small cysts are common :
only once were they as large as a pea : most were scarcely larger than
a pin's head : they are always of the type described by Marburg as the
result of central softening of the neuroglial plaques. Krabbe concludes
that the pineal of Man shows signs of involution. To the signs described
by previous writers, viz., concretions, proliferation of connective-tissue,
and neuroglial plaques with their cysts, he would add a fourth, viz., the
presence of cells of disintegration. The various forms of cells he found
in the septa have certainly no productive function, they are rather the
expression of involution of the pineal. On the other hand, he finds
evidences which suggest that the adult human pineal has a function.
He has been struck by the integrity which the pineal of Man shows
from early adult life to extreme old age. Ordinarily, involution begins
towards the age of 7 years: but even at 92 years Krabbe found no
greater changes than at the age of 14 years, with the exception of
sclerosis of vessels. While it is true that degenerative processes are
seen in the young, it is also true that the pineal even of the old shows
signs of a function. In only one case did he find total degeneration.
If the pineal has a function, it lies in its parenchymal “ pineal ” cells.
Krabbe gives reasons why the evacuation of nuclear granules into the
cell-protoplasm is not the expression of a degenerative process, thus :
(1) the nucleus regenerates after evacuating its droplets; (2) other
organs— e.g., epididymis, pancreas of salamander—have similar pro¬
cesses of evacuation of products of secretion of the nucleus into the
'protoplasm; (3) these processes occur throughout life without the
disappearance of pineal cells. He adds significantly that, if they
represent a process of annihilation of the gland, it is surprising that
the gland, after seventy years of annihilation, preserves almost the same
appearance as that of one from a child of 14 years! He is rather
sceptical on the subject of pineal syndromes: he thinks that pineal
tumours may possibly have an action (1 trophic) on nerve-centres
situated near the pineal gland. He tried—in a single rabbit—the
effect of an injection of pilocarpine on the pineal, which was
subsequently examined histologically; but he was not able to draw
any conclusions from his findings.
Jordan 67 (1911) gave an excellent description of the microscopic
anatomy of the epiphysis of the Virginian Opossum, both male and
female adults. Microscopically, it is a simple tubular evagination
of the roof of the third ventricle; it thus recalls the embryonic form
of the epiphysis of lower vertebrates, and appears to represent a
condition of primitive or arrested development. Jordan finds two
types of epiphysis in the opossum, viz., (1) the short tubular or cup-like
type, such as is seen in lower mammals and carnivora especially, and
(2) the long tubular type of birds and reptiles. These types are
THE PINEAL BODY: A REVIEW
13
illustrated. The opossum’s epiphysis is much less vascular than the
pineals of sheep and higher mammals. Delicate bundles of medulla ted
nerve-fibres are discernible throughout the entire inter-commissural
portion of the epiphysial region. The epiphysis proper shows a few
small tubules or alveoli: in no case could they be traced into the lumen
of the epiphysis. Neuroglial fibres are chiefly coarse or fine, but some
are of intermediate grades: neuroglial cells are also found. On the
question of a possible secretion, Jordan thinks that observations
on the opossum’s epiphysis indicate that the mammalian pineal is
unimportant for body metabolism. He writes: “This is not
necessarily an admission that it elaborates no secretion which may
even exert specific effects, but only that it is not essential either
directly or indirectly for the normal conduct of the vegetative functions,
as are the secretions of other of the better understood ductless glands.”
In November 1911 Jordan 57 followed up his paper on the opossum
by a very suggestive study of the histogenesis of the pineal body of
the sheep. He studied six stages in all, from that of a 5 cm. embryo
(about the second week) to the 21 cm. stage (about months, t.«.,
half way through gestation). He studied also the pineals of the
animals at term, of lambs aged about 8 months, of yearling sheep, and
of old sheep. The pineal at term is exactly like that at 8 months,
except that the latter is larger. At half way through gestation the
alveoli and melanic granules are most abundant. At term the sheep’s
pineal is very vascular. At 8 months of age it attains its maximum
size (about 8x5 mm.). Jordan writes: “The greatest increase in
bulk (approximately five-fold) during the first year indicates that,
if the pineal body has a specific function, this is most active in the
young; and the suggestion frequently made that the body is a gland
which elaborates an internal secretion which has to do with the normal
growth or the appearance of maturity (sheep mate at from 6 to 8
months) receives support from anatomical facts.” He found increase
of size in the pineals of young children, i.e., in an infant of 5 days it
was 3x2x1 mm.; in youth it is largest, about 7x5 mm.; in old
age considerably smaller. The abundance of melanic granules found
half way through gestation “indicates that the secretory activity of
the ‘gland’ may be greatest at this stage of development.” Jordan
failed to find chromaffin cells, which some authors describe, in the
pineal; most workers (according to my own reading) agree with
Jordan on this point. He could not find any striped muscle-fibres.
“ Nor do the trabeculae here contain smooth muscle-fibres as noted by
some investigators for certain forms (e.g., ox; Illing, 59 1910).” He
failed also to find nerve-cells; and pigment-clumps occurred only in
old sheep. Contrary to Dimitrova’s negative findings, be found brain-
sand in the proximal portion of the pineals of yearling sheep, and a
large amount in old sheep. After the first year the sheep’s pineal
becomes slightly smaller (6 x 4£ mm.); this lessening in size is
accompanied by a decrease in the parenchymal cells and an increase
in the connective-tissue and neuroglial elements. In old sheep there
are evidences of several degenerative changes. Jordan has a long
14
LEONARD J. KIDD
description and discussion of the cytoplasmic granules: the nucleus
contains only chromatic granules, the cytoplasm only melanic granules.
He concludes that there is no cytologic evidence in favour of a
secretory function of the sheep’s pineal; but he is careful to point out
that “ its general structure (i.e., lobulation, connective-tissue framework,
arrangement of parenchyma into follicles, presence of blind alveoli,
large perivascular lymph-spaces, great vascularity, and presence of
granules in the cytoplasm) indicates a glandular function of the
nature of elaborating an internal secretion. The parenchyma! cells are
all of one type: more or less highly differentiated ependymal cells,
giving origin to neuroglia cells and fibres, and inter-neuroglia cells.”
He interprets the cysts and the melanic cytoplasmic granules as having
probably only an ancestral significance. The importance of his paper
is very great.
Biondi 58 (1912), whose work I know of merely by a single brief
abstract, studied the avian pineal, chiefly (I believe) that of the adult
hen, by Golgi’s arsenious acid method; the parenchymal cells were
studied by another method for the demonstration of mitochondria.
He appears to describe granules in the parenchymal cells of the hen’s
pineal which he is inclined to look on as mitochondrial formations;
but he seems to admit that the matter is not yet quite settled. One
may recall here the fact that P. Mulon has described ( Compt . Rend. d.
1. Soc. d. Biol., 1911, i., p. 652) in the cortex of the adrenal of many
mammals an internal secretory process in which mitochondria elaborate
a complex lecithalbumen which is discharged from the cells into the
blood-stream. This is of special interest because there is some evidence
in favour of the view that the cortical adrenals are connected with the
sex-functions and probably bodily growth also; a relationship with
the pineal body is thus suggested, but its exact nature is at present
unknown.
I have not attempted to give any detailed account of the important
1909 paper of Marburg, 08 as I know of it only by scattered and
fragmentary references by other writers; but some of his findings
are noticed in my account of Krabbe’s paper 56 (1911), and MUnzer 87
seems to rely largely on Marburg’s paper in his own general survey
of the pineal body.
After this histological section was written, an important paper by
Funkquist 60 appeared on the morphogeny and histogenesis of the
pineal organ in birds and mammals. He worked by numerous methods :
and his technique is fully described. His studies included the hen,
duck, diver, canary, and sparrow; the ox, pig, rabbit, rat, hedgehog,
and cat. The turkey-cock is also mentioned once. The valuations in
both classes are considerable. In birds and mammals the epiphysis is
developed as a pocket-shaped outgrowth from the roof of the pars
parencephalica (v. Kupfl’er) diencephali, which later is changed into
a tubular structure of vafying length. In certain birds (diver) this
separates often from its connection with the brain. In both classes
two types of epiphysis are found, viz., (1) a simple tubular one: its
growth is by enlargement of its circumference and thickening of its
THE PINEAL BODY: A REVIEW
15
walls: it is found in sparrow, canary, opossum, and ox; (2) a budding
tubular form : in many instances the tubules are detached from the
pineal pocket ; this type is found in diver, duck, hen, rat, hedgehog, cat.
Originally, the embryonic epiphysis has an epithelial character : later
its character is transforms! into a neuroglial tissue. Two types of
ceils are described, viz., ependymal cells, and astrocytes. The author
never found brain-sand in avian or mammalian embryos, but only in
adult mammals : he found plenty in a 3-year-old mare, in older oxen,
cows, and sheep. He never found true nerve-cells or fibres, nor muscle-
cells. He suggests th^t what some authors have taken for muscle-cells
may really have been a “ myoid ” development of neuroglial cells.
4. Clinico-Pathological.
Out of about sixty-five recorded cases of tumours of the pineal
lody metabolic symptoms and signs have been present in about
10 per cent. To these metabolic cases I shall refer, and also to
two cases recorded by Pellizzi, 71 and to one of the two cases of
sexual precocity recorded by Machell. 72 Among other lesions
which occasionally involve the pineal body, either primarily or
secondarily, are, according to Seigneur, 6 (1) hypertrophy (Virchow,
Meckel, (Esterlen, Lieutaud, Morgagni, Blanquinque, and Marburg;
other ancient cases are said to be given by Legros 3 ); (2) atrophy
(Morgagni, Laignel-Lavastine—an unpublished case); (3) cysts, of
which Marburg 68 recognises two varieties: Virchow and older
writers also record cases); (4) haemorrhages (Ziegler, Simon); (5)
syphilis (Lord, 48 possibly Pontoppidan); (6) abscess (Birsch-
Hirschfeld).
The cases of pineal tumours with metabolic symptoms may be
classified as (1) cases occurring in very young male children
associated with bodily, sexual, mental, and vocal precocity; (2)
cases associated with obesity; (3) mixed cases. But needless
repetition would be necessary if the cases were detailed according
to such a grouping. I propose, therefore, to give the cases in
chronological order.
Gutzeit’s Case 61 (1896).
A boy of years, strongly built and well developed, showed abund¬
ance of pubic hair during the last eight months of his life when intra¬
cranial signs were present. Pappenheimer 64 states—without giving
any particulars—that other marked signs of precocity were present. [I
have not had access to Gutzeit’s paper ; and all the many abstracts of
it, which I know, are very meagre.] Autopsy showed a teratoma of
the pineal, which had compressed the corpora quadrigemina.
16
LEONARD J. KIDD
? Heubner’s Case 82 (1898-99).
I have not had access to the publication in which Heubner records
this case. There are great discrepancies between various writers
about the case; thus, Bailey and Jelliffe 68 describe it as a separate
case from that of CEstreich and Slawyk (see below) : whereas Seigneur 6
describes the case as the case of Heubner and of CEstreich and Slawyk.
The similarity in the autopsy findings in the (two?) cases suggests
that Seigneur is right. Heubner’s case is generally described as being
in 1898 a 4 ^-year-old boy: yet he seems to become in 1899 a 4-year-
old boy! I find in CEstreich and Slawyk’s paper no mention of
Heubner’s name. But v. Frankl-Hochwart 69 writes of Heubner’s
case as “published by CEstreich and Slawyk”—“a 4-year-old boy.”
Marburg 68 (1908) has no mention of Heubner’s case, but he refers to
the case of O. and S. as a 4^-year-old boy. Raymond and Claude 70
say the boy was 4 ; they too ignore Heubner’s name in connection with
the matter.
It is stated by Pappenheimer 64 that in 1898 Heubner reported,
before a German Society in Diisseldorff, the case of a boy of 4 J years,
who in his last illness showed a marked development of pubic hair and
growth of the genitals. From other abstracts I gather that the large
size of the penis and testes, and the pubic hair, appeared with the
intracranial symptoms. It is said that Heubner showed a photograph
of the patient. It is also said that the case was later examined by
CEstreich and Slawyk. Autopsy: a cystic psammo-sarcoma of the
pineal.
CEstreich and Slawyk’s Case 65 (1899).
A boy of 4 years of age. Birth with forceps: was a long time
asphyxiated: laryngismus at 3 months. He developed normally
during his first year. When 1 year old, had convulsive attacks.
When he was 3 years old, the formerly bright boy showed a strikingly
quiet and shy disposition : he sat in the corner most of the time, and
cried much. At this time he began to grow quickly and vigorously,
and his bodily overgrowth was excessive. His penis developed
enormously: this was attributed by the parents to masturbation,
but there was no proof of this. When 4 years old, the boy looked
7 or 8, was very bony and muscular, and had plenty of fat: his skin
was of natural colour. Height 108 cm. (3 ft. 6£ in.), i.e., about
61 in. too tall for his age. Weight 20 kilos, i.e., 4 too much.
Mammary glands hypertrophic, contained colostrum, and measured
2 cm. (| in.) in height. The flaccid penis measured 9 cm. (3 T 9 ff in.)
in length. Testes as large as a pigeon’s egg. Abundance of dark
pubic hair, 1 cm. (| in.) long. Extremities of natural length, and no
thickening of phalanges. Mentally, he was quiet but not sad, and
somewhat precocious (“ altklug ”). Towards the end of his illness his
weight rose to 2 2'3 kilos, and then slowly sank to 19-5 kilos. Definite
intracranial symptoms appeared during the last four weeks of life.
[This statement differs from Pappenlieimer’s account 64 of the so-called
THE PINEAL BODY: A REVIEW
17
“ Heubner’s case ”: according to 0. and S., genito-somatic overgrowth
began at 3 years, and lasted for twelve months: then appeared signs
of intracranial disease : the importance of these points is very great.]
Autopsy: a cystic psammo-sarcoma of the pineal. The pituitary,
thyroid, adrenals, and pancreas were normal, both macroscopically and
microscopically. The thymus showed no visible pathological changes :
it was 7 cm. long, 3§ wide, and 1 cm. thick.
C. Ogle’s Case* (1899).
His case 2 was a boy of 6 years, who had been strange in his
manner for the last few months, had masturbated, and had slept
much. His penis was the size of that of a boy of 16 or 17: pubic
hair fairly plentiful: testes “ did not seem enlarged.” Autopsy: an
alveolar sarcoma of the pineal, with hemorrhages: the pituitary was
normal microscopically.
M. Neumann’s Case 2 67 (1901).
A boy of 11 years had acute symptoms like those of tuberculous
meningitis only ten days before his death. There was slight develop¬
ment of the external genitals. Autopsy: a cystic sarcoma of the
pineal.
Marburg’s Case® 8 (1908).
A girl of 9 years began to grow fat about one year after the earliest
intracranial symptoms appeared. The adiposity was great on the chest
and abdomen: the fat was more than 5 cm. thick (2 in.): no other
anomalies of growth were present, and there were no genital or sexual
changes. Measurements of height and weight are given. Death .
followed on operation. Autopsy: a mixed glio-sarcoma of pineal.
The pituitary and all the other endocrine glands were normal.
Marburg concluded that, as he found all these glands normal, and
the pineal showed a multiplication of its glandular elements as well
as of its neuroglial tissue, the adiposity was to be attributed to a
hyperpinealismus. And he enunciated the following three pineal
syndromes: (1) hypopinealismus (in early life) gives premature
development, genital, sexual, somatic; (2) hyperpinealismus gives
adiposity; (3) A-pinealismus, cachexia.
von Frankl-Hochwart’s Case 69 (1909).
A boy of years with marked genito-somatic, psychical, and vocal
precocity. His father and two paternal uncles had persistent branchial
clefts: a sister a hsemangeioma of the labium: a younger brother a
nsevus on leg. When the patient was 3 years old he began to grow
rapidly and excessively, and showed mental precocity. When 6 years
old he was heavy and stout, and looked 7 years old: at this time his
mental precocity reached a truly astonishing degree; thus, he spent
much time in discussing the question of the immortality of the soul,
and the life after death: those ideas and subjects were not suggested
a
18
LEONARD J. KIDD
to him by his relatives or friends. He was sensitive and good-hearted.
It was at this time (5 years 1 month) that he showed his first signs of
intracranial disease (August 1908). Early in December 1908 he
showed great development of the penis, strong erections, marked growth
of pubic hair, and moderate growth on tibiae: his voice was extra¬
ordinarily deep, and resembled that of a boy’s breaking voice at puberty.
He was seen by v. Frankl-Hochwart on 13th January 1909, i.e., nine days
before death. He then showed subcutaneous fat, and strong bony
development: height 123 cm. (4 ft. £ in.), i.e., that of a boy of 9 years:
penis 7 cm. long (2$ in.): pubic hair equal to that of a boy of 15:
testes the size of a hazel-nut: no axillary hair. The diagnosis was
“ tumor cerebri destroying the pineal.” Autopsy: a pineal teratoma,
composed of neuroglial elements, papillary granulations, epidermic
globes, and hyaline cartilage. Pituitary microscopically normal.
Raymond and Claude’s Cask 70 (1910).
A boy aged 10 years : birth normal: family history good. At the
age of 7 years he was rather large, and his intelligence was very much
developed. At age of 8 his stature was above the average, and his
size was rather big. He then became fat and weak: the adiposity
continued for a year or more. When examined at the age of 10 by
the authors, his figure was a little swollen and bloated (“bouffie”),
and his colour slightly pale. Height 138 cm. (4 ft. 6£ in.), i.e., that
of a boy of 13 or 14. Weight 39 kilos (average is 25 or 26): and
the parents affirmed that he had been for six months losing flesh.
There was adiposity of abdomen, thighs, and lumbar region: his
cheeks were chubby. Mental apathy: but he answers questions well,
perhaps slightly better than most boys of his age: memory good:
slight depression: but otherwise his psychical state was good. He
had pubic hair, equal to that of a boy of 14 or 15 : and slight down
on cheeks and upper lip. But the penis was very short and small, and
the testes very small. The diagnosis of pineal tumour was made.
Autopsy: a glioma of the pineaL Pituitary small: its glandular
elements, however, were normal in appearance: “ still its glandular
functions were certainly impeded ”: the diminution of its size was
attributed to mechanical compression. The testes measured 10x8
mm.; they showed no evidence of spermatogenesis: their interstitial
tissue was over-developed. The testes were microscopically abnormal
for his age and for the general degree of good bodily development.
The adrenals showed changes:—the cortex contained nodules like
hypernephroma, viz., groups of cells forming a rounded nodule, and
containing fat; the medullary substance was also very well developed,
and contained very many more eosinophile cells than normal. These
changes pointed to a general hyperfunction of the adrenals. The
pancreas was normal, with well-developed islets of Langerhans. The
thyroid body was rather small, but showed no other obvious changes.
The authors discuss the question of pineal syndromes, and conclude
that adiposity and genital troubles are really due to a pluriglandular
syndrome,
PINEAL BODY: A REVIEW
19
Thera several recorded cases of pineal tumours, verified by
autopsy, in some degree of adiposity has been noted: but I
think no good purpose would be served by further reference to
them. In my opinion, it is not yet proved that adiposity is ever
of purely pineal origin. Incidentally, this point will be referred
to in the section on experimental procedures.
There are, however, still three cases which deserve mention
here, though it is true that the existence of any pineal lesion,
gross or functional, in them is unproved.
Prllizzi’s Precocious Grotto-Somatic Pineal Syndrome (1910).
Under this title Pellizzi 71 has described two cases in young boys.
[I greatly regret that I have not had access to his paper ; and in the
only abstract of it, known to me, no statement is made whether intra¬
cranial disease was found: for aught I know to the contrary, both
children may be still alive.l
Pellizzi’8 Case 1.—In the abstract there is no mention of the boy’s
general health : this may mean that it was quite good. Marked bodily
overgrowth began at the age of 7 months: at age of 2 years penile
erections and seminal emissions: the semen was proved to contain
spermatozoa : no sexual libido accompanied the emissions : no onanism.
The genitals resembled those of a man: the pubes was moderately
covered with hair : there was a suggestion of a moustache. Psychical
condition good, corresponded with that of an older child. Radiography
showed a condition as of a youth of 16 or 17 : but the dentition showed
the true age. The abstract contains no further particulars.
Pellizzi's Case 2.—The abstract says that the history was less
reliable than in case 1. In this boy bodily overgrowth began at the
age of 2 years. He was hydrocephalic, and his mental capacity was
very limited. The genital development corresponded approximately to
that of case 1. (This last sentence is not exactly satisfying, and no
further particulars of the case are given in the abstract.) The
presence of hydrocephalus of course makes us think here of a tumour
of, or involving, the pineal. But in case 1 there is an alternative
possibility which will be referred to in the section of this paper on the
“ General Discussion.”
Machell’s Case 2 72 (Bov) op Sexual Precocity (1911).
In January 1912 I abstracted this case in The Review of
Neurology and Psychiatry , and suggested that a pineal lesion was
probably present: this I will discuss in my general discussion.
A boy showed pubic hair at the age of 5 months: erections one
year later: emissions when 2£ years old. His father, aged 33, weighed
12 lbs. at birth, and developed early: he is now, however, only 5 ft.
high, and weighs in clothes only 103 lbs.: he is the small one of the
family: he has three brothers of normal size, the youngest of whom
20
LEONARD J. KIDD
developed early: he has also two sisters, who menstruated at the usual
age and are of average height and weight. A photograph of the
patient shows pubic hair and great penile development, and a very
finely built sturdy frame of good proportions. His weight at 4 months
of age was about 7£ lbs. too great: at 8 months 12 lbs. too great: at
12 months 13 lbs. too much: at 3 years 20 lbs. too much. At the
age of 44 months his height was 3 ft. in. (8£ in. too much). At
age of 4 years his head was 2*3 in. too large in circumference: his
chest nearly 5 in. too large in girth: his penis measured 2£ in. when
lax: it was very large when erect: emissions, both spontaneous and
on manipulation. Mental precocity very marked: disdains toys of
tiny tots: habits those of much older boys: manner independent: he
is perfectly self-possessed with strangers even, answering questions in
a loud, bass, stentorian voice. Machell makes no mention of the boy’s
general health: it seems probable, then, that it was good. The boy
was bom in February 1906: he was therefore less than 6 years old
when Machell’s paper was published (November 1911).
Directly I read Machell’s paper I was struck by the extra¬
ordinarily close resemblance of his case 2 (boy) to v. Frankl-
Hochwart’s case, 09 so far as the bodily, genital, sexual, mental, and
vocal development was concerned. In my general discussion I
shall refer to Machell’s case again, and show that,-as in Pellizzi’s
case 1, there is one, and only one, other lesion besides a pineal
lesion that, in the present state of our knowledge, is to be
thought of.
By the kindness of the Editor of this Review I am able to
draw attention to an important case which came to my notice
after my MS. was sent in. I refer to the case recorded by E.
Cecil Williams ( Proc. Roy. Soc. of Med., section of study of Disease
in Childhood, Vol. 6, Nov. 1912, p. 24). It was one of precocious
development in a boy aged 6 years.
About November 1911 the boy began to develop quickly: he was
admitted to hospital in May 1912. At that time his weight was
4 st. 2 lbs.; height 4 ft. 2 in.; he has a slight moustache; his voice is
deep, like an adult’s; the muscles of his arms and his trunk are well
developed; he can lift heavy weights; he is slow of intellect and
movement, and cannot run as other boys of his age do; he is inclined
to knock-knee, and his tibiae are inclined to be curved. Pubic hair is
abundant, but there is none in the axillae; his external genitals are
fully developed. All these changes are shown, in a photograph. No
tumour can be felt in the abdomen, and there is no bronzing of the
skin. His blood-pressure is high (110 mm. Hg.). His urine is normal.
The head-circumference is 211 in. The boy put on 11 lbs. in weight
during his five weeks’ stay in hospital. Fresh measurements were taken
THE PINEAL BODY: A REVIEW
21
I
f
I
in October 1912; the particulars given show marked increase of weight,
I height, and of neck and chest measurements. The author discusses
f the possibility of a tumour of the cortex of the adrenal or of the
pineal body. A skiagram of the skull was thought to indicate a slight
enlargement of the sella turcica and pituitary fossa. The president of
the section thought that there was also an early development of the
sphenoidal sinuses: unfortunately, the skiagram is not given. It is
stated that in October 1912 the boy’s general health is excellent ; but
there is no mention of the reason why he was admitted to hospital in
May 1912 ; possibly the state of his lower extremities was the reason.
It is noted that the ocular fundi were normal.
The special interest of this case arises from the suggestion that
a lesion of the pituitary body, or of its neighbourhood, may be
present. If subsequent study should prove this to be the case,
then it will be the first case on record in which a pituitary lesion
has led, either directly or indirectly, to the macro-genito-somatic
precocious syndrome in a boy of the early age of six years.
Further, we should then have to modify our conceptions of this
syndrome in boys under the age of seven years, and to say that in
such cases three possible diagnoses are open, viz., (1) a lesion of
the pineal body, (2) of the adrenal cortex, (3) of the pituitary
1 lx>dy. Everyone will notice the striking difference between the
mental precocity and independent manner of Machell’s case and
the slowness of intellect of Williams’ case. It seems probable
that the inability to run in Williams’ case is duo entirely to the
state of the boy’s lower extremities.
(To be concluded.)
8. References.
1 Galen—
(a) “De usu parti urn Corporis humani,” Venice, 1562, Libr. viii., Cap. 14,
p. 252.
(b) (Also Venice, 1576, 5th ed., i., p. 170.)
(c) French translation, Paris, 1659, Ch. 14, pp. 393, 394.
(d) Works of Hippoorates and Galen, Pans, 1679 (“Galeni de Auat.
Administ.,” Libr. ix., Ch. 3, Tome iv., p. 191).
3 Faivbe, E.—
1854. Compt. Bend. d. 1. Soc. de Biol.” Ser 2, i., p. 195.
1857. Annales dee Sciences Nalur., Ser. 4, Zoologie 7-8, p. 52.
* Leobos—
1873. “ These de Paris” (a pathological study).
* Peytoobeap, S. A.—
1886-87. “Thfese de Bordeaux,” No. 95, 68 pp., 42 figs.
1887. Oaz. hebd. d. Sc. Mid. de Bordeaux, viii., 397, 406.
* StpdniCka, F. K.—
1905. “Oppel’s Lehrb. d. Vergleich. Mikr. Anat. d. Wirbeltiere,” Teil 5,
pp. 1-248, 1 Taf. and 134 text-figs., “Die Parietalorgane.”
* Seionepb, Paul-
1912. “ These de Paris,” No. 375, pp. 119 (no figures).
22
LEONARD J. KIDD
* Leydig, F.—
1868. “ Traits d’HistoL Comp, de l’Homme et des Animaux,” p. 199.
1872. “ Die in Deutschland lebenden Arten der Saurier,” p. 72, Taf. 12.
8 Rabl-Ruckhabd, H.—
1882. Arch./. Anat. u. Physiol., p. 111.
9 Ahlborn, F.—
1882. Zeilsch. f. Wis8ens. Zool., Vol. 40, p. 336.
10 de Graae, H. W.—
1886. Zool. Anzeiger, Vol. 9, p. 191.
11 Spencer, W. B.—
1886. Proc. Roy. Soc. Lond., Vol. 40, p. 559. “The Median Eye of
Sphenodon and other Lizards.”
1886. Quart. Joum. qf Micr. Set.. Vol. 27, p. 165.
13 Beard, J.—
1888. Quart. Joum. oj Micr. Sci., Vol. 29, p. 55.
13 Francotte, P.—
1888. Arch, dt Biol., Vol. 8.
14 Beraneck, E.—
1892. Anat. Anzciger, Vol. 7, p. 674.
1893. Ibid., Vol. 8, p. 669.
15 Hill, C.—
1891. Joum. of Morphol., VoL 5, p. 503.
1894. Ibid., Vol. 9, p. 237.
18 Dendy, A.—
1899. Quart. Joum. of Micr. Sci., N.S., 42, p. Ill (Sphenodon).
1907. Ibid., N.S., 51, p. 1 (Qeotria australis).
1907. Science Progress, Vol. 2, p. 284. “The Pineal Gland.”
1911. Phil. Trans. Roy. Soc. Loud., vol. B. 201, pp. 227-329, pi. 19-31,
20 text-figs. (Sphenodon).
17 Terry, R. J.—
1910. Joum. of Morphol., Vol. 21 (Teleosts).
18 Warren, J. —
1911. Amer. Joum. of Anat., Vol. 11 (Reptiles).
19 d’Erchia, F.—
1896. Monit. Zool. Ital., Vol. 7, pp. 118, 201.
70 Sorenson, A. D.—
1894. Joum. of Comparative Neurol., Vol. 4, p. 153.
21 Voeltzkow, A.—
1903. Abhandl. d. Senckenberg. Naturf. Oesellsch,, Vol. 27.
23 Gaskkll, W. H.—
1890. Quart. Joum. of Micros. Sci., Vol. 31, p. 379.
33 Locy, W. A.—
1893, 1894. Anat. Anzeiger, Vol. 9, pp. 169, 231, 486.
1893, 1894. Joum. of Morphol., Vol. 9, p. 115 ; Vol. 11, p. 497.
24 Cameron, John-
1904. Proc. Roy. Soc. Edin., Vol. 25, p. 162.
1903. Anat. Anzeiger, Vol. 23.
1904. Joum. of Anat. and Physiol,, VoL 38, p. 286.
38 v. Kollikkr, A.—
1850. Milcr. Anat. des Menschens, Band 2, Leipzig.
38 Clarke, J. Lockhart—
1861. Proc. Roy. Soc. Lond., Vol. 11, p. 365.
37 Luys—
1865. “ Systeme Nerveux Ckfrtfbro-Spinal,” Paris.
38 Krause—
1868. “ Anatomie des Kaninchens,” Leipzig.
39 Sti£da, L.—
1869. Zeitsch.f. Wissens. Zool., Vol. 19, p. 80.
30 Bizzozero, G.—
1871. Centralbl. f. d. Med. Wissensch.
1871. R. Istit. Lomb. di Sc. ct. Lett., Milan.
THE PINEAL BODY: A REVIEW
23
S £Y 5 KitT T.
1871.Strieker’s Handbook,” Cb. 31, Leipzig.
R Hagkmakk—
1872. “ Archiv von Reichert ond do Bois-Reymond.”
33 Cbuveilhieb and See —
1877. “Traits d’Anat. Descript.,” VoL 3, p. 431.
M y ^ THAT.K OVTf7 f> __
1877. “ Entwiok-Geechichte dee Gehims,” p. 98, Leipzig.
35 Schwalbe, G.—
1881. “ Nerven-Lehre.”
36 0JOKINI A
1885-86. Riv. SperimetU . di. Fren . e.d. Med . Legale ”Y ol. 11, 1885, p. 182 ;
VoL 12, 1886, p. 364.
17 Dabkschxwitsch, L.—
1886. Neurol . Cenlralbl. 9 VoL 5, p. 29.
* Hen lx, J.—
1887. “ Nerven-Lehre,” p. 322.
® Et.T
1887. “ Vergleioh. HistoL d. Haua-Saugetiere,” p. 727.
* Flesch, M.—
1888. A not. Anzeiger, VoL 3, p. 173.
41 Edlnger, L.—
1889. “ Zwolf Vorlesungen, Ac.”
43 Chauveau—
1889. “ Anat. Comparie dee Animaux Domestiques.”
a Mlngazzim—
1889. Organ* Nervosi, Rome.
44 Soury— _
1889. “ Systeme Nerveux Central,” VoL 2, p. 781, Pans.
45 Weigebt C._
1895.’ “ Beitrage z. Keimtniss d. Normalen Menschlichen Neuroglia,”
Frankfurt.
48 Cajal, R. y. —
1895. Soc. Espan. Historia Natural, Madrid.
47 Galeotti, G.—
1896-97. Riv. di Patol. Nerv. e. Mentale, VoL 2, p. 481.
* Lord, J. R.—
1899. Trans. Path. Soc. Land., VoL 60, p. 18.
* Nicolas, A. —
1900. Compt. Rend. d. 1. Soc. de Biol., VoL 62, p. 876.
** Dimitrova, Z.—
1901. Le Ndvraxe, VoL 2, p. 267.
41 Anglade and Duclos —
1908-09. “ Rapport Mid. pour l’annie 1908 de l’Asile Public d’Alienees de
Bordeaux,” 1909.
w Sabteschi XJ._
1910. Folia Neurobiologica, VoL 4, No. 6.
55 Costantiri, G.—
1910. Pathologica, VoL 2, p. 439.
44 Cutor*, G.—
1910. AreA. Ital. di Anat. e. di Embryd., Firenze, VoL 9, F. 3-4.
* GaLA 8E8CU, P., and Urechia, C. J. —
1910. Compt. Rend. d. 1. Soc. de Biol., VoL 68, i., p. 623.
54 Krabbe, K.—
1911. Nouv. Iconogr. de la SalpRriire, VoL 24, p. 267, 1 pi.
47 Jordan, H. E.—
1911. Anatomical Record, VoL 6, p. 326 (Opossum).
1911. Atner. Joum. of Anat., VoL 12, p. 249 (Sheep).
** Biondi, G.—
1912. Zeitsch. f. d. ges. Neurol, u. Psychol., VoL 9, H. 1.
Abstkacts
24
M Illing, P.—
1910. “ Vergleichend Anatomisch© und Histologische Unters. liber die
Epiphyeis cerebri einiger Siiuger,” Inaug. Diss. Leipzig.
60 Funkquist, H.—
1912. Anat . Anzeiger , Vol. 42, No. 4/5, Sept. 17, p. Ill, 15 figs.
61 Gutzeit—
1896. “Dissert. Kouigsberg.” “Ein teratom der Zirbeldriise.”
® Heubner—
1898-99. AUgem. Med. Central-Ztg ., Vol. 73, p. 89.
M Bailey, P., and Jelliffk, S. E.—
1911. Arch, of Intern. Mtd. y Vol. 8, No. 6, p. 851, “Tumours of the
Pineal Body.”
w Pappenheimkr, A. M.—
1910. Virchow's Arch. f. Path. Anat. u. Physiol., Vol. 200, p. 134.
Oestreich, R., and Slawyk—
1899. Virchow's Arch./. Path. Anat. u. Physiol. , Vol. 157, p. 475.
66 Ogle, C.—
1898-99. Trans. Path. Soc . Loud., Vol. 50, p. 6 (Date of Communication,
Dec. 6, 1898).
m Neumann, M.—
1901. Monatsch.f. Psychiat. u. Neurol. , Vol. 9, p. 337.
68 Marburg, O.—
1908. Wien. Med. Wochschr., Vol. 58, p. 2617.
1909. “ Arbeiten a. d. Neur. Inst. a. a. Wiener Univ. v. H. Obcrsteiner,”
Vol. 17, p. 217.
• v. Frankl-Hochwart, L.—
1909. Deutsch. Zeitsch. f. Nervtnhi-ilk , Vol. 37, p. 455.
1910. Wien. Med. Wochschr. , Vol. 00, p. 505.
70 Raymond, F., and Claude, H.—
1910. Bull, de UAcadem. de Med., Paris, Vol. 63, p. 265.
71 Pellizzi, G. B.—
1910. Riv. Ital. di Neuropatol. Psich. ed Elcttrotcrapia , Vol. 3, p. 193.
1910. “Lavori d. 1st. d. Clin. d. Mai. Nerv. e. Meat. d. R. Univ. d.
Pisa,” Vol. 2.
72 Machell, H. T.—
1911. The Canada Lancet , November, p. 171. “Report of Two Cases of
Sexual Precocity.”
abstracts
ANATOMY.
THE HISTOLOGY OF THE CRANIAL AUTONOMIC GANGLIA OF
(1) THE SHEEP. F. W. Carpenter, Journ. of Comp. Neurol ., VoL
xxil, October 15th, 1912, p. 447.
The chief object of this study was the peripheral endings of the
pre-ganglionic fibres. The nerve-terminations were demonstrated
by the intra-vitam staining with methylene bine. In addition,
Cajal’s silver nitrate method was used for the otic ganglion: some
of its cells arc fenestrated, resembling in this respect certain
ciliary ganglion cells of mammals and birds (Sala, von Lenhossek)
and certain spinal ganglion cells of mammals (Oajal). Conclu¬
sions :—(1) The spheno-palatinc, otic, and submaxillary ganglia of
ABSTRACTS
25
the sheep contain multipolar cells with long, slender, frequently
branched dendrites which extend for considerable distances beyond
the limits of the cell capsules: they thus resemble the ordinary
type of mammalian sympathetic cells. (2) In the ciliary ganglion
the only cells in which processes were clearly differentiated by
methylene blue possessed each a single, heavy, branched dendrite.
(3) In all the four cranial autonomic ganglia the preganglionic-
axons terminate on the cell-bodies of the post-ganglionic neurones
in sub-capsular peri-cellular end-nets of fine varicose fibrils; these
end-nets vary in complexity: a given ganglion may show both a
comparatively simple ending and complete intricate networks
(these are figured). These endings are similar to those of
pre-ganglionic fibres in the vertebral and pre-vertebral ganglia of
the sympathetic system. Leonard J. Kidd.
CONTINUITY IN THE VERTEBRATE NERVOUS SYSTEM, AND
(2) THE MUTUAL AND INTIMATE CONNECTIONS BETWEEN
NEUROGLIA AND NERVE CELLS AND FIBRES. (La
doctrine de la continuity dans l’organisation du n4vraxe chez
les vertybrls, et les mutuels et intimes rapports entre la
ndvroglie et les cellules et les fibres nerveuses.) G. Paladino,
Arch. Ital. de. Biol.., Ivi., 1911, p. 225.
Paladino, who has been studying neuroglia for twenty years, holds
that the disagreements on the mutual relationships of nerve cells
and fibres are directly due to imperfect knowledge of neuroglia
and of its intimate connections with nerve cells and fibres. In
the present study he used the iodide of palladium method chiefly.
The following is a much shortened summary of some of his twelve
conclusions: (1) Nerve cells are in continuation among themselves
by proximal and distal connections of varying degree and diverse
directions: the cell-processes divide at first into two or three
branches or into numerous brush-like ones. (2) The double
genetic origin of neuroglia (Ford Robertson) is accepted, viz.,
ectoglia from ectoderm, and mesoglia from mesoderm. (3)
Neuroglia-cells anastomose among themselves and are directly
inter-connected by their processes proximally and distally: they
are thus connected with both neighbouring and distant glia-cells.
(4) Neuroglia forms round nerve cells a peri-cellular network,
continuous with the interstitial neuroglia, and penetrates the cell-
body to form an endo-cellular network whose threads are fine
and meshes narrower than those of the pcri-cellular network.
(5) Neuroglia is applied to the cell-processes, and constitutes a
myeline framework for the medullated fibres, often to a con¬
siderable distance. (6) The nerve-cells of the electric lobes of
Torpedo show, in old age, vacuolisation of varying degrees: if
extreme, they are reduced to a thin layer of protoplasm, with
26
ABSTRACTS
excentric and finely granular nucleus without nucleolus or
chromatin network. In these cases the penetration of the
neuroglia into the cell-bodies can attain exceptional proportions
(these points are well figured). (7) The neuroglia, with its
peri-cellular and endo-cellular networks, in continuation with each
other and with the interstitial neuroglia, represents not only a
supporting and isolating mechanism, but also a nutritive apparatus
which serves, by the interstices of the endo-cellular network, for
the more intimate distribution of the plasmatic juice in the
elements of the nerve-cells. This paper has twelve figures, and
is the author’s summary of his Italian paper {Bend. d. B. Accad. d.
Set. Fis. e. Mat. di. Napoli, f. 7-9, 1911). Leonard J. Kidd.
PHYSIOLOGY.
BRONCHO-DILATOR NERVES. W. E. Dixon and F. Ransom, Joum.
(3) of Physiol., VoL xlv., No. 6, Dec. 9,1912, p. 413.
In these experiments on cats the Dixon-Brodie oncometric method
of recording the changes of lung volume during artificial re¬
spiration was used: two methods of producing anaesthesia were
adopted. In order to exaggerate the effects of vagal stimulation
and to produce a small degree of bronchial tonus, the authors
employed physostigmine in small doses: the bronchial tonus which
the physostigmine induces passes off in about an hour, and a
further dose was necessary if the experiment was not completed.
The following are their conclusions:—(1) The bronchial muscles
are supplied by powerful broncho-dilator nerves which are
sympathetic in origin. (2) The fibres proceed mainly through
the rami of the 1st, 2nd, and 3rd thoracic nerves, are connected
with nerve-cells in the ganglion stellatum, and proceed to the
lungs with the cardiac accelerators. A variable number of fibres
pass down the cervical sympathetic, and these, too, have their
cells in the ganglion stellatum. (3) Some crossing of fibres to the
bronchioles of the opposite lung is the rule. (4) Very occasionally
evidence was found of broncho-constrictor fibres in the sympathetic
of the neck, and of broncho-dilator fibres in the vagus. The
effects are always insignificant, and are held to be due to each
nerve containing some fibres arising from the other. (5) Reflex
broncho-dilatation was obtained by exciting the central end of the
vagus nerves after section of both, and of the cut central end of
the accelerator nerves, also after section of the vagi, this being a
crossed reflex. (6) The broncho-constrictor fibres in the vagus
cross to a variable extent, but some crossing is the rule. (7) Re¬
flex broncho-constriction was obtained by exciting the central
end of one vagus, the central end of the accelerators, and the
ABSTRACTS
27
central end of the anterior crural nerve. (8) Adrenalin ad¬
ministered to an animal showing bronchial tonus causes active
temporary dilatation; atropine causes passive permanent dilatation.
Leonard J. Kidd.
THE PART PLATED B7 THE 8UPRABBNALS IN THE NORMAL
(4) VASCULAR REACTIONS OF THE BODY. O. von Anbkp,
Joum. of Pkytiol., Vol. xlv., No. 5, Dec. 9,1912, p. 307.
The existence of secretory fibres to the adrenals, running in the
splanchnic nerves, has been established by Biedl, Asher, Cannon,
and Elliott. In this experimental study on dogs the author
exposed the splanchnics extra-peritoneally from the back, and a
string was passed round each adrenal in order to exclude either
or lx>th as quickly as possible from the circulation by tying the
string. Anaesthesia was by morphia and AC.E. To exclude
any possibility of reflex on the heart, all its nerves were cut.
Both vagi were divided in the neck, and the stellate ganglia
were extirpated from the back by Anderson’s method; usually
no pneumo-thorax was produced The author concludes:—
(1) Stimulation of the splanchnic nerves by any means, as
shown by Johansson and others, causes a rise of blood-pressure
which occurs in two phases. The second phase, as Lehndorff
found, is accompanied by constriction of peripheral blood-vessels
(even after denervation) and by acceleration and increased tone
and augmentation of the heart (also after denervation). (2) The
secondary rise, and all the concomitant phenomena, are due to
the discharge of adrenalin into the circulation, and are absent
after extirpation of both suprarenals. (3) Every rise of blood-
pressure, brought about by the agency of the nervous system,
thus involves the co-operation of the chemical mechanism
represented by the suprarenal glands. Leonard J. Kidd.
Note A FURTHER OBSERVATIONS ON VASOMOTOR PHENO-
(5) MENA (Observations ultorieures sur les ph&iomdnes vaso-
motours.) M. Camis, Arch. Ital. de Biol., lvi, 1911, p. 277.
In this experimental research Camis destroyed the labyrinth in
rabbits by the method of C. Winkler (“The Central Course of
the Nervus Octavus and its Influence on Motility,” Amsterdam,
1907). The motor phenomena corresponded exactly with those
described by Winkler, viz., forced positions of head and eyes—
head flexed towards operated side, eye on operated side turned
downwards and inwards, that of sound side turned upwards and
outwards, mystagmus, etc. Difficulty was experienced in keeping
the rabbits alive for more than a few days. In all his twenty-four
animals Camis found a vasodilatation of the pinna of the operated
28
ABSTKACTS
side: this usually disappeared on the third day. Since ho found
also narrowing of the palpebral fissure, paralysis of the nictitating
membrane, and myosis on the operated side, he proceeded to test
by experiment whether he had accidentally wounded the cervical
sympathetic. He refers to the findings of S. J. and Clara Meltzer
(Amer. Journ. of Physiol., ix., 1903, p. 252) that, in rabbits,
after section of the cervical sympathetic or extirpation of the
superior cervical ganglion, together with section of the third
cervical nerve of that side, hypodermic injection of adrenalin
causes a slight permanent vaso-constriction of the homolateral
ear with either no change, or slight vaso-dilatation, in the hetero¬
lateral. He therefore applied this method to labyrinthectomised
rabbits. In all cases he found that the results agreed in the
main with those found in sympathectomised rabbits. Conclusions:
—(1) Destruction of the x*abbit’s labyrinth gives rise to a vaso¬
dilatation of the homolateral pinna, of two or three days’ duration;
(2) when the two ears have regained equal conditions of vascularity
hypodermic injection of medium doses of adrenalin gives a vaso¬
constriction only in the ear of the operated side; (3) the vessels
of the ear of the operated side do not react to excitation, nor to
section, of the cervical sympathetic.
Leonard J. Kidd.
THE ACTION OF ADRENALIN ON THE PULMONARY VESSELS,
(6) AND THE VASO-MOTORS OF THE LUNG. (L’action de
1'adrenaline sur les Vaisseaux pulmonaires, et le vaso-moteurs
du poumon.) L. Plumier-Clermont {Acad, de Mid. de Belgique ,
Sept. 28,1912), La Presse Mid. Beige , No. 44, Nov. 3, 1912, p. 884.
In 1904 the author found that adrenalin has a vaso-constrictor
action on the pulmonary vessels of the dog. He has repeated his
experiments, in view of the fact that Heger and Philippson have
recently failed to confirm his conclusion ( v. Review, x., Sept. 1912,
p, 441). He confirms his own earlier work, and concludes that
a vaso-motor apparatus exists in the lungs, but is much less
developed than that of the general vascular circuit.
Leonard J. Kidd.
THE EFFECT OF ADRENALIN ON THE PULMONARY CIRCU-
(7) LATION. E. M. Tribe, Proc. Physiol. Soc., Oct. 19, 1912, p. xx.
{Joum. of Physiol., Vol. xlv., No. 5, Dec. 9,1912).
In this preliminary communication Tribe records the results of his
experiments on any possible variation in the action of adrenalin on
the lung vessels of mammals, birds, and reptiles. With Parke-
Davis’ adrenal chloride solution, 1:1000 in normal saline with 0*5
per cent, chloretone as a preservative, he obtained in all animals
a distinct, but not intense dilatation. With the crystalline
ABSTRACTS
29
adrenalin of Parke-Davis, however, he got almost always a
marked constriction, as Wiggers did previously: the exceptions
were due to failure to keep the lungs at the body temperature.
Tribe experimented further on nearly thirty cats by the method
used by Dixon and Brodie (1904). He confirmed his previous
results. He suggests that the chloretone in the “adrenalin
chloride” is probably an important factor in producing that
preparation’s dilator effect; but on this point he insists on the
need for further work. He writes:—“ In any case the main
question as to the existence of vaso-motor nerves in the lungs is
still undecided, since it is doubtful if the constriction obtained in
the lung vessels is comparable to that of organs known to possess
vaso-motor nerves, where a violent constriction is obtained with
minute amounts of even the adrenalin chloride preparation. These
investigations are being pursued.” Leonard J. Kidd.
HYPOPHYSIAL GLYCOSURIA AND ADRENALIN GLYCOSURIA.
(8) (Glycosurie hypophysaire et glycosnrie adrdnalique.) H. Claude
and A Baudoutn, Compt. Rend. Soc. de Biol., lxxiii., No. 37, Dec.
27,1912, p. 732.
The writers used exactly the same procedures, and obtained exactly
similar results, with adrenalin as they did in the same subjects
with extract of hypophysial posterior lobe (v. supra). They always
injected only 1 mg. of Parke-Davis solution of hydrochlorate ot
adrenalin (1:1000). In some of their patients the adrenalin
glycosuria was more marked than the hypophysial, in others the
opposite held good. As a rule the hypophysis extract gave a
rather larger amount of sugar, whereas adrenalin gave a rather
larger flow of urine. The writers conclude that in therapeutic
doses adrenalin glycosuria is an alimentary glycosuria, as they had
previously shown is the case with hypophysial glycosuria. And
in these doses it acts, like hypophysis extract, by hindering
fixation of glucose in the liver in the form of glycogen.
Leonard J. Kidd.
CONTRIBUTIONS TO THE PHYSIOLOGY OF THE LABYRINTH.
(Contributions h la Fhysiologie dn Labyrinthe.)
Note 1. THE ERGOGRAM OF THE LABYRINTHECTOMISED FROG.
(9) (L'Ergogramme de la grenouille privde dn labyrinthe.) M. Camis,
Arch. Ital. de Biol., lv., 1911, p. 172.
Ewald obtained an asymmetrical position in the cadavers of
labyrinthectomisfed pigeons. Emanuel found that traction on the
foot of a normal frog and of a dead frog respectively gave
characteristically different curves : further, the curve in bilaterally
labyrinthectomised frogs resembled the cadaveric, whereas after
unilateral operation both feet showed curves intermediate between
30
ABSTRACTS
the normal and the cadaveric. Camis operated on thirty frogs by
Schrader's method: he took ergograms of the gastrocnemius from
one to seventy-five days after the operation. He found peculiar
oscillations of tonus, sometimes very irregular: these occurred
only from the third to the seventh day after labyrinthectomy.
Reference is made to Gaglio’s findings that cocainisation of the
pigeon’s semicircular canals gives the same results as their section
or destruction. Camis confirms this for the frog: he also shows
that cocaine, applied through the acoustic bulla on the side of
labyrinthectomy, abolishes the oscillations of tonus. Conclu¬
sions:—(1) The labyrinthectomised frog shows irritative phenomena
as well as those of defect: the former consist of transitory oscilla¬
tions of tonus of skeletal muscles (gastrocnemius) which are
homolateral after destruction of one labyrinth, bilateral after
destruction of both labyrinths. (2) Local application of cocaine
abolishes these oscillations of tonus of labyrinthine origin.
(Several ergogram-tracings are given.) Leonard J. Kidd.
Note 2. A METHOD OF OPERATION FOR DESTRUCTION OF THE
(10) SEMICIRCULAR CANALS OF THE DOO. (Un methods opfra-
toire pour la destruction des can&ux demi-ciroulaires du chien.)
M. Camis, Arch. Ital. de Biol., lv., 1911, p. 180.
The method commonly used destroys the cochlea and the middle
ear; even the method of Fano and Masini destroys the latter, and
is difficult and uncertain in its results if one wishes to spare the
cochlea. Camis has devised an operation, based on exact ana¬
tomical studies in the dog, here fully described and illustrated, in
which the lesion is limited to the semicircular canals; it has given
him excellent results: numerous autopsies show that it effectually
destroys the labyrinth without injury to the nerve-centres. Having
found in his dogs a characteristic position of the head, viz., turned
towards, and flexed on, the operated side, he performed a control
operation:—he carried out the first part of the operation which
comprises the exposure of the neck-muscles: no asymmetry of
the poise of the dog’s head followed. The paper is essentially one
for the experimentalist. Leonard J. Kidd.
Note 3. EFFECTS OF LABYRINTHECTOMY IN THE DOO,
(11) ESPECIALLY ON THE VASOMOTOR INNERVATION.
(Effets de la labyrinthectomie chez le chien, particuli&rement
but l’innervation vaso-motrice.) M. Camis, Arch. Ital. de Biol.,
lvil, F3, Sept 16,1912, p. 439.
This note was delayed in publication for many months. The
semicircular canals were destroyed in the dog by the author’s
method (v. note 2), sometimes on one side, sometimes on both;
the bilateral operations were sometimes performed simultaneously,
ABSTRACTS
31
but sometimes one side was operated on after a certain interval
after operation on the other side. Many breeds of dogs were
used: accounts of eleven operations are given.
Section 1 deals with general observations on the consequences
of extirpation of the labyrinth in dogs: these may be summed up
as phenomena of deficiency and of irritation: these latter were
of short duration, and variable. The former, too, were transitory
on account of a compensatory mechanism. The irritative pheno¬
mena are movements of rotation round longitudinal axis, of
manege, of wheel-movement, and mystagmus. Those of deficiency,
unmodified by time, were torsion of head and difficulty of
leaping from a height. Those of deficiency, compensated in time,
were narrowing of the pupil on side of operation, exaggeration of
lateral head-movements, tendency to fall towards that side,
impossibility of standing on hind-paws, and steppage gait.
Section 2 deals with the vasomotor reflexes of labyrinth-
eetomised dogs. Camis studied the vasomotor reflexes of their
hind limbs to determine (1) if the labyrinth has any influence on
vasomotor phenomena, (2) if this influence regulates antagonistic
innervation of muscles. He concludes that (1) unilateral laby-
rinthectomy leads to inversion of the vasomotor reflexes of the
homolateral limbs, and bilateral to inversion on both sides, and
(2) these consecutive vasomotor changes consist probably in
functional abolition of the vaso-constrictor centre, for which
reason there is lack of the reciprocal innervation on which the
physiological role of vasomotor reflexes is based.
Leonard J. Kidd.
Note 6. ON THE MT08I8 AND THE PARADOXICAL MYDRIASIS
(12) IN THE LABYRINTHECTOMISED CAT. (Sur la myose et
sor la mydriase paradoxale chez le chat labyrinthectomisd.)
M. Camis, Arch.. Ital. de Biol., lvi., 1911, p. 319.
In dogs and rabbits myosis was invariably found by Camis on
the side of labyrinthectomy: its duration was approximately four
to six days in dogs, and about three days in rabbits. For the
cat, Winkler’s operative method was adopted. The cat resembles
the dog rather than the rabbit so far as the resulting motor
phenomena are concerned. The homolateral palpebral fissure was
markedly narrowed, the third lid paralysed, and the myosis very
pronounced; these phenomena were constant (in many animals),
and they resemble exactly those found in the cat after destruction
of the cervical sympathetic. Meltzer found that, while hypodermic
injection of even large doses of adrenalin has no effect on the eye
of a normal cat when the cervical sympathetic has been previously
divided on one side, or the superior cervical ganglion extirpated,
adrenalin causes a retraction of the paralysed nictitating membrane,
32
ABSTRACTS
Cami8 finds that adrenalin has a similiar action on the labyrinth-
ectomised cat’s eye: the probable mechanism is discussed. He
concludes that here the adrenalin acts directly on the muscle
of the iridic dilator.
Having reviewed here his previous experimental studies on
the labyrinth, Camis suggests that we have now a new view
of the functions of the semicircular canals. In place of the
rather nebulous and artificial concept of labyrinthine tonus, we
must conclude that they represent an organ on which, by their
functional reciprocity, the precision and proper use (l’dconomie)
of muscular movements depends. He does not, however, believe
that his researches can destroy the concept of labyrinthine tonus:
rather, they help us to understand that it is not a function
sni generis, but a special manifestation of the general functions of
the neuro-muscular system: excitation and inhibition. Further
studies are to follow, and these conclusions form a working
hypothesis which awaits the verdict of future experiments.
Leonard J. Kidd.
Note 5. THE GLYCOSURIA CONSECUTIVE TO DESTRUCTION
(13) OF THE SEMICIRCULAR CANALS IN THE DOG. (La
glycosurie consecutive k la destruction des can&ux demi-
circulaires chez le chien.) M. Camis, Arch. Ital. de Biol ., IvL, 1911,
p. 289.
Dogs of various breeds were used: the phenylhydrazine method
was applied, with microscopical examination for crystals. A full
description is given of the exact procedure, with accounts of many
experiments. Camis discusses the glycosurias which follow opera¬
tions, anaesthetics, and adrenalin-injections. He attributes great
importance to irritation of the sympathetic system. He quotes
many experimental facts which tend to show that glycosuria,
determined by the most varied interventions, is always the con¬
sequence of direct or indirect sympathetic irritation. The post-
labyrinthectomy vasomotor phenomena, previously described by
him, are probably due to central effects. He concludes that
(1) destruction of the semicircular canals in the dog determines a
glycosuria, and (2) this glycosuria lasts for at>out seven days after
operation, and the quantity of glucose seems to oscillate between
•5 and 2 per cent. Leonard J. Kidd.
PATHOLOGY.
THE NEUROFIBRILS IN PELLAGRA, ACCORDING TO URECHIA.
(14) (Des neurofibrilles dans la pellagre, d’aprds Urechia.) Millant,
Arch. Intemat. de Neurol., Nov. 1912, p. 312.
Almost the whole of this paper consists of quotations from
Urechia’s recent study (“Lesiunele Neurofibrilelor in Psichosa
ABSTRACTS
33
Pelagrosa,” 1911, Bucharest). Though many observers have
studied the nerve-cells in pellagra, the neurofibrils have been
neglected. In 1905 Marinesco described a special network in
the pigmented portions of nerve-cells in leprosy and pellagra:
it has remarkable powers of resistance to agents which are noxious
to nerve-cells. In the same year Parhon and Papinian studied by
Cajal’s method the neurofibrUs in a case of pellagra which showed
cerebro-spinal changes: these were variable in the brain, and
occurred mostly in some of the cells of Betz: neurofibrils were
almost entirely absent: the cervical spinal cord was most affected.
Ob regia and Pitulescu (1909) studied in four mental cases the
ganglia of the solar plexus by Bielchowski’s method: they found
greater changes than in G.P.I.: the fibrillar network sometimes
disappeared entirely: cell-changes were also present. Urechia col¬
lected reports of fourteen autopsies: he found the neurofibrils affected
throughout the whole extent of the nervous axis. The changes in
the neurofibrils comprised reduction to a state of fine black granu¬
lations, especially in the cell-bodies, less often in their processes;
often fragmentation, especially in Betz cells: sometimes they
stick together and give an appearance of thick fibres: fatty
degeneration is common. The fibrils are best preserved in the
peri-nuclear zone of the cells. In the brain, the small pyramidal
cells suffer most, those of Betz less, and the large pyramidal cells
least. In the cerebellum, the fibrillar network of the Purkinje
cells often shows fragmentation: the peri-nuclear zone is least
affected. In the spinal cord the lesions are slight; in the root-cells
more frequent and extensive. The spinal ganglia are little
affected: rarely their cells with the neurofibnls form a wide-
meshed network, fragmented or granular: Cajal’s fenestrated
cells are abundant: no irritative lesion is seen in their processes.
In general, Urechia found enlargement of the fibrillar network of
the cells, the fibrils granular and fragmented: in certain cells
only a homogeneous coloured mass was seen, with some non-
absorbed granulations towards the periphery. The neurofibrils
are beet preserved in the cell-processes: pigment is abundant, and
the special network of Marinesco usually shows much resistance.
Leonard J. Kidd.
GENERAL PARALYSIS IN DOGS. (Paralysie gfo&ale du chien.)
(15) L. Mabchand and G. Petit, Arch, Intemat. dc Neurol., No. 6,
Nov. 1912, p. 317.
The writers have established the existence of a general paralysis
in many dogs: it consists of a diffuse subacute meningo¬
encephalitis, often with associated cerebellar, bulbar, and spinal
lesions. It is usually the result of the not yet isolated virus of
3
34
ABSTRACTS
“ the disease of early life,” which goes on for many months before
the characteristic symptoms appear. Two types occur: (1) the
commoner dementia type, (2) the epileptic. A case of each type
is fully detailed, with the autopsy findings. Usually, the dog
shows progressive enfeeblement of intelligence, failure of memory
(he may not know his own master), weakness, or loss of perception,
indifference, automatism, dirty habits, bulimia, and loss of judgment:
thus, he attacks ferociously his fellow, separated from himself by
a partition, and violently injures himself. There may be agitation,
or stupor. The former may occur at the onset, with change of
character, surliness, and bad vision: more commonly it falls into
a hebetude which persists to the end. The dog may even mutilate
his own limbs (this occurred in a hyaena affected with meningo¬
encephalitis). The knee-jerks are exaggerated: general tremors :
static and dynamic ataxia. Twice manage movements have been
seen by the writers, due to a cerebellar hemiatrophy added to a
meningo-encephalitis. Sensibility is blunted: a prick causes
retraction without definite defensive movement. Inequality of
pupils and myosis may occur. Some dogs cease to bark, apparently
more from aphonia than from placidity of mood: others appear
to be deaf. There is no fever. An unquestionable lymphocytosis
is found. Anatomically, the nervous lesions are meningo-cortical,
cerebellar, bulbar, spinal (especially of lumbar cord). The pia
mater and the vessels are specially affected: these show subacute
inflammation. There is perivasculitis of meninges and cortex,
neuroglial sclerosis (specially in the molecular layer of cortex):
the cortical cells are chromatolysed, especially in the motor area,
and numerous lymphocytes are attached to their cell-bodies and
their processes: the meninges are infiltrated with embryonic cells.
The clinical symptoms vary according to the site, gravity, and
extent of the lesions. Thus, a virus, other than that of syphilis,
can in animals cause, by its nervous localisations, lesions and
symptoms identical with those of human general paralysis. Three
figures illustrate these changes. The paper is abstracted by the
writers from their communications made at the Paris Congress of
Comparative Pathology, October 1912. Its bearing on the “no
syphilis no 6.P. ” dogma is obvious. Leonard J. Kidd.
THE SUPRARENAL GLANDS IN ANENCEPHAL7. (Nebennieren
(16) bei Anenzephalie.) Rorkrt Meter, Virchow’s Archiv ., Bd. 210,
H. 1-2,1912, S. 161.
The author examined the suprarenals of anencephalics. In about
half of his cases either one or both adrenals were atrophied. In
all the cases the adrenals were smaller than normal, although
morphologically some of them were normal. The parts generally
affected are the inner layers of the zona fasciculata and zona
ABSTRACTS
35
reticularis, which may be absent or not properly developed, although
the zona glomernlosa and the part of the zona faaciculata adjacent
may be quite normal and fat-containing. The author concludes
from bis observations that the changes in the suprarenals are
related to the brain deformity, although what the causal factor
is, is stUl unknown. R. A. Krause.
CLINICAL NEUROLOGY.
ANATOMICAL AND CLINICAL REMARKS ON FRANKER OPERA-
(17) TION IN TABET IC GASTRIC CRISES AND IN POST¬
HERPETIC NEURALGIA (Remarques anatomiques et cliniques
nr 1’operation de Franks dans lea crises gastriqnes dn tabes et
lee allies post-zostlriennee.) Sicabd and Lbblanc, Rev. Neurol.,
August 15th, 1912, p. 157.
The authors insist on the uselessness and the danger of Franke’s
operation, which consists in the avulsion of the intercostal nerves
(usually the 5th to the 10th) as close to the vertebral column as
possible, and give the results of experiments on the cadaver
supporting their views. S. A. K. Wilson.
ON INTERMITTENT EXOPHTHALMIC GOITRE (IN TABES DOR-
(18) SALTS WITH BRONCHIAL ASTHMA). Ueber intermittierende
Basedowsymptome (bei Tabes dorsalis und Bronchialasthma).
H. Cubshmann, Zeit. f. Klin. Med., Bd. 76, Heft. 3-4,1912, S. 242.
A case of a tabetic patient who showed intermittent Basedow
symptoms (such as exophthalmos, swelling of thyroid, tachycardia,
sweating, tremors of hands, and increased blood pressure), which
coincided each time with the onset of gastric crises. In this case
the administraiion of adrenalin (3 to 10 drops of the 1:1000 sol.)
per os, was of great benefit in relieving the abdominal symptoms.
Two other cases are also described in which, besides the above
symptoms, there were also added attacks of bronchial asthma.
The author points out that those cases confirm the view that
the Basedow's symptoms got in tabetics are a result of a lesion of
the vago-sympathetic system. In the paper he discusses which
part of the system is probably effected as presented by the
patient’s symptoms. R. A. Krause.
ATROPHY OF THE MEDULLA FILLET, AND SUPERIOR CERE
(19) BELLAR PEDUNCLE IN FRIEDREICH’S DISEASE (Examen
dn nlvraxe dans un cas de maladie de Friedreich: atrophie du
bulbe, du ruban de Reil, et du pddoncule c&lbelleux sup&ieur.)
Thomas and Dubupt, Rev. Neurol., Sept 30,1912, p. 317.
In a typical case of Friedreich’s disease the lesions were by no means
so strictly limited to the spinal cord as is usually supposed to be
36
ABSTRACTS
the case. In certain systems (e.g., the pyramidal) degeneration
affects the peripheral ends of the neurones concerned, and does not
extend to the trophic centres of these neurones; this is true also
of the lower motor neurones (and possibly also of the posterior root
neurones, in some cases). In other systems (as in the case here
reported) degeneration reaches the trophic centres concerned
and the whole system disintegrates: this occurred in the median
fillet and its cells of origin, in the nucleus of Monakow, in the
direct cerebellar tracts and the columns of Clarke, and in the
dentate nuclei and the superior cerebellar peduncles.
S. A. K. Wilson.
SUB-AOUTE COMBINED DEGENERATION OF THE SPINAL
(20) CORD. Long, Rev. Neurol. t May 15,1912, p. 585.
A typical case of this disease, which is considerably less frequent
in France, apparently, than in England. According to Long,
as yet no case has occurred at the Salpetri&re. An excellent
description of the pathology of the reported case is furnished.
The author has no new hypothesis of the pathogeny of the condition.
S. A. K. Wilson.
A FRESH CASE OF TYPHOID SPINE IN THE CHILD. (Spondylite
(21) typhique, nouveau cas observe ches l’enfant.) Ardin- Delthkil,
M. Raynaud, and M. Coudray, B-ull et mfan. Soc. mid. H6p. de
Parit, 1912, xxriii., p. 900.
A boy, aged 10 years, on the twenty-seventh day of an ordinary
attack of typhoid fever, was suddenly seized with severe pain in the
lumbar region radiating into the hip and throughout the lower
limb. The pain was both constant and paroxysmal. There was
also severe pain on pressure of the spines and transverse processes
of the third to fifth lumbar vertebree, and a definite band of
hypereesthesia was found on the inner aspect of the left thigh and
leg corresponding to the distribution of the fourth lumbar root.
The X-rays showed a slight degree of spondyloarthritis. Apart
from marked hypertension and an excess of albumin, the cerebro¬
spinal fluid was normal. Considerable relief followed lumbar
puncture, and in two months from the onset recovery was
complete. J. D. Rolleston.
TWO OASES OF TYPHOID SPINE OBSERVED IN PARIS. (Deux
(22) cas de spondylite typhique observes & Paris.) J. Auclaib and R. J.
Weissenbach, Bull, et mim. Soc. mid. H6p. de Parit , 1912, xxxiv.,
p. 353.
Case 1. — Male, aged 19. Onset of symptoms on eighty-eighth
day of typhoid fever complicated by two relapses. Complete
cure in three months after immobilisation in plaster j ticket.
ABSTRACTS
37
Case 2. — Male, aged 15. Onset on fifty-third day of typhoid
after temperature had become normal. Immobilisation in plaster
jacket and recovery in five months.
The normal condition of the cerebro-spinal fluid in each case
negatived the diagnosis of meningitis or myelitis. Skiagrams of
the first case were negative, in the second they showed opacity of
the normally transparent intervertebral discs between the third and
fourth, and fourth and fifth lumbar vertebrae. These three vertebrae
appeared to be surrounded by a diffuse organised sheath which
involved the ligaments and transverse processes. As the lesions
chiefly affected the vertebral articulations the term spondyloar-
thritis or perispondylitis would be more correct anatomically
than spondylitis. J. D. Rolleston.
TWO FATAL CASES OF NON-MENTNGOCOCCAL CEREBRO-
(23) SPINAL MENINGITIS CAUSED BT A POLYMORPHOUS
COCCUS. (Deux cas mortals de mdningite cdrdbro-spin&le non-
mdmngococcique causds par un coccus polymorphe.) F. Chbvrel
and J. Boubdini&rb, Bull, et mim. Soc. mid. H6p. de Paris , 1912,
xxxiv., p. 325.
The patients were a man aged 38, and a girl of 4 months. The
organism isolated from the blood and cerebro-spinal fluid was a
diploeoccus resembling the meningococcus, but of smaller size.
In cultures it usually appeared single, but it also formed tetrads.
It was constantly associated with a polymorphous bacillus, which
was short and thick in young cultures and filamentous in old
cultures. It was impossible to determine whether this was a case
of symbiosis of two distinct germs or of a single polymorphous
organism. J. D. Rolleston.
CEREBRO-SPINAL MENINGITIS IN AN INFANT OF FIVE
(24) MONTHS. PURPURA, MENINGOCOCCAL SEPTICAEMIA,
SEROTHERAPY, RECOVERY. (Mdningite cdrdbro-spinale chez
un nourisson de cinq mois. Purpura, Septicdmie mdningococcique,
Sdrotherapie, Gudrison.) Triboulet Debb£ and Paraf. Bull, et
mim. Soc. mid. H6p. de Paris , 1912, xxiv., p. 552.
The child was admitted to hospital for febrile purpura. The only
meningeal manifestation was slight nuchal rigidity. Meningococci
were found in the turbid cerebro-spinal fluid, blood and naso¬
pharynx. It was impossible to say whether the septicaemia
preceded the meningitis or vice versa. J. D. Rolleston.
MENINGOCOCCAL SEPTICAEMIA (Les meningococcdmies (sep-
(25) ticdmiez mdningococciques).) S. Pobtrbt Theses de Paris ,
1912 -13, No. 41.
Pobtbet adopts the following classification with illustrative cases
from literature:—
38
ABSTRACTS
1. Meningococcal septicaemia without meningitis, as in cases
reported by Bovaird (v. Review 1909, vii., p. 419), Netter (ibid.
p. 741), Monziols and Loiseleur (ibid. 1910, viii., p. 304), and
Chevrel and Bourdini&re (ibid. p. 703).
2. Meningococcal septicaemia followed by cerebro-spinal menin¬
gitis, as in cases reported by Pissavy (ibid. 1912, x., p. 27), and
Lemierre, May, and Portret (ibid. p. 486).;
3. Cerebro-spinal meningitis accompanied by meningococcal
septicaemia (a) without metastases; (b) with metastases in the
joints as in Vigot’s cases (ibid. 1911, ix., p. 130), in the lungs,
heart (ibid. 1912, x. 487), or brain (ibid. 1911, ix. 31).
Meningococcal septicaemia must be distinguished from septic¬
aemia due to the parameningococcus. In the treatment intra¬
venous and subcutaneous injections must be associated with
intraspinal serotherapy. J. D. Rolleston.
RECOVERY FROM TUBERCULOUS MENINGITIS. (Mfiningite
(26) tubercnleux gudrie.) Mlle. E. Cottin, Rev. de Mid., 1912,
xxxii., p. 848.
The patient was a man, aged 21, suffering from pulmonary
tuberculosis, who recovered successively from pneumothorax,
meningitis, nephritis and anal abscess, the tuberculous nature
of each complication being confirmed by bacteriological and
experimental examination. The recovery from meningitis had
now been maintained for eight months. He still had occasional
headaches, neuralgic in character, and his sputum still tuberculised
guinea-pigs, but his general condition was excellent, and he had
gained 18 kilos in six months. J. D. Rolleston.
VERY EARLY ACUTE SYPHILITIC MENINGITIS. (Mtaingite
(27) aiguB syphilitique trto precoce.) C. Achard and Q. Desbouis,
Bull, et mint. Soc . mid. R6p. de Parte, 1912, xxxiv., p. 559.
A woman, aged 20, who had had a vulvar chancre two months
previously, was admitted to hospital with meningitis. Rapid im¬
provement followed injections of biniodide of mercury. On
re-admission some months later with cutaneous syphilides and
mucous tubercles intra-muscular injections of neo-salvarsan were
given, of which she received seven in eight weeks. The syphilides
healed rapidly, and the meningeal lymphocytosis was reduced
from fifty to three or six lymphocytes per c. mm. Wassermann’s
reaction was still positive with the blood serum and doubtful in
the cerebro-spinal fluid.
J. D. Rolleston.
ABSTRACTS
3d
ACUTE AND SUBACUTE SECONDARY SYPHILITIC MENTN-
( 28 ) Qim (M&ungites syphilitiquee aigufe et sabaignte da la
pdriode second&ire.) L. Jbassvlmb, Bull, et nUm. Soc, mid. H6p.
dc Parity 1912, xxxiv., p. 6(7.
A record of two cases.
Case 1. A woman, aged 22, who had had syphilis for three
years, and had had only a few months’ treatment, suddenly
developed acute meningitis, characterised by severe headache,
followed by delirium and coma, generalised rigidity, Kemig’s
sign, facial paralysis, and strabismus. Staining left by the roseola
was still present. The cerebro-spinal fluid showed a large quantity
of albumin, and a leucocytosis in which the lymphocytes pre¬
dominated. Wassermann’s reaction was well marked in the cerebro¬
spinal fluid, but very slight in the blood serum. Some improve¬
ment in the symptoms followed two intravenous injections of
“ 606,” and the leucocytosis diminished, but the albumin content
still remained high, and Wassermann’s reaction continued positive.
Facial erysipelas and broncho-pneumonia ensued, and death took
place.
Case 2. A woman, aged 21, six months pregnant, and present¬
ing a well-marked roseola and mucous tubercles, developed a
severe headache which was not relieved by aspirin. The cerebro¬
spinal fluid showed lymphocytosis and excess of albumin. Wasser¬
mann’s reaction was positive in the blood, but negative in the
cerebro-spinal fluid, as is the rule when the meningeal reaction
is not very intense. The headache disappeared immediately after
the first injection of “ 606,” but the cerebro-spinal fluid had not
become completely normal after six injections. An apparently
healthy child was born at full term.
J. D. Rolleston.
ON MENINGITIS DUE TO HEMOPHILIC! ORGANISMS — SO
(29) CALLED INFLUENZAL MENINGITIS. Hexbebt Henry,
Joum. Pathol, and Bact. t Yol. xvii., No. 2, Oct, p. 174.
Author gives nine cases in which influenza-like organisms were
found microscopically, and in most of them cultivated on haemoglobin
media. Six of these cases are described with some detail, and
the post-mortem findings given.
As regards the clinical features of the cases, all six were in
children under 6 years of age, three gave a history of discharge from
the ear. For the rest the symptoms appear to have been those
of an acute meningitis.
The post-mortem findings in five cases were those of widespread
purulent cerebro-spinal meningitis. In one case the inflammatory
process was localised to one hemisphere. In addition to the
40
ABSTRACTS
meningeal inflammation the ventricles were found distended with
purulent fluid. The appearances, in fact, were very similar to
what is found in cases of pneumococcal meningitis.
In the fresh cerebro-spinal fluid the organisms were found in
large numbers within the leucocytes. The organisms were, as a
rule, small, although occasional filamentous forms were met with.
The filamentous forms were much more numerous in cultures.
The various strains of the organism grew only at body
temperature, and only on haemoglobin-containing media. The
colonies showed the usual characters of those of the influenza
bacillus.
As regards pathogenicity, great variations were found in the
various strains, some producing little effect on rabbits, others
causing septicaemia. James Miller.
POST - TRAUMATIC SYNDROME RESEMBLING GENERAL
(30) PARALYSIS CAUSED BY AN ACUTE MENINGITIS OF
SLOW EVOLUTION. (Syndrome p&r&lytique post tr&um&tique
ddtermind par one mdningite aigtie k Evolution lente.) Raynkau
and Mabchand, Rev. Newrol., April 30,1912, p. 529.
A HEALTHY man of 35, with no history 4 of any previous illness,
met with a very severe accident at a level crossing, and after a
period of unconsciousness gradually developed mental symptoms
bearing a close resemblance to general paralysis. In addition,
the pupils were subsequently found to be unequal, but their
reflexes were normal The lower left face was slightly weak:
articulation was occasionally defective. The patient died in an
asylum twenty months after the accident, a diagnosis of traumatic
general paralysis having been made. At the necropsy, however,
the appearances were solely those of acute meningitis of a purulent
nature, and microscopical examination showed that it had been
of slow evolution, and had spread backward from the frontal poles.
None of the histological features of general paralysis were found.
A case of this sort indicates the desirability of caution in diagnosing
traumatic general paralysis, unless the characteristic histological
appearances of that condition are subsequently found.
S. A. K. Wilson
AN ANALYSIS OF 123 CONSECUTIVE OASES IN WHICH OPERA
(31) TIONS WERE PERFORMED FOR THE RELIEF OF THE
MASTOID, LABYRINTHINE AND INTRACRANIAL COM¬
PLICATIONS OF SUPPURATIVE OTITIS MEDIA G. S.
Fraser and J. K. Milne Dickie, Joum. Laryngol. Rhinol. and
Otol., Vol. xxvii., No. 3, 1912.
The series is divided into four groups—
A. 32 acute cases in which the Schwartze operation was
ABSTRACTS
41
performed: in 6 of these cases the radical operation was completed
Later on, while in 1 the modified radical operation was performed.
5 cases proved fatal. 3 had meningitis, in 2 combined with
labyrinthitis, 1 died of septicaemia, one death under an anaesthetic
(a diabetic case).
B. 78 chronic cases—
(1) In 11 the modified radical operation was performed.
(2) In 52 the radical operation.
(3) 4 cases of successful operation on the labyrinth.
(4) 2 cases of successful operation for venous thrombosis.
(5) 9 fatal cases (4 of purulent meningitis, combined with
labyrinthitis in 3); 1 from meningitis and sinus
thrombosis; 1 from sinus thrombosis and pyaemia;
1 from tempero-sphenoidal abscess, labyrinthitis and
meningitis; l from cerebellar abscess with early
meningitis; 1 from status lymphaticus—acute sepsis.
C. 12 tubercular cases: 1 death from miliary tuberculosis.
D. 1 malignant case. R. V£rel.
BULLET WOUND OF THE SPINAL COED BETWEEN THE FIRST
(32) AND SECOND DORSAL VERTEBRA!: LAMINECTOMY:
REMOVAL OF THE BULLET: COMPLETE RECOVERY.
William B. Colby, Annals of Surgery , Yol. lvi., No. 1, 1912, p. 60.
The author recounts the history of a girl, 14 years old, who was
shot in the back with a bullet '22 calibre: the missile entered the
spine in the middle line between the first and second dorsal
vertebrae. The girl immediately lost control of the lower ex¬
tremities. An hour later there was complete paralysis of both
legs, paralysis of both sphincters, mobility of both arms good, but
movement of the right arm caused intense pain.
An X-ray photograph showed the bullet in three fragments
lodged between the first and second dorsal vertebrae: the vertebrae
were not fractured, and whether the spinal cord had been pierced
or not it was impossible to say. An operation was performed
twenty-four hours after the accident: the bullet wound was traced
and enlarged.
The right lamina was found to have been perforated, and two
fragments of the bullet were actually removed from the substance
of the spinal cord. No attempt was made to close the dura, and
the wound was drained. There was a free discharge of cerebro¬
spinal fluid for ten days, and then it ceased.
The patient made a continuous recovery, and at the end of two
months was perfectly well except for a slight limp in the left leg.
The author reviews results of similar cases published by Pilcher,
Winslow, Fort, and others. He draws attention to the important
experimental work at present being done by Allen of Philadelphia.
42
ABSTRACTS
Allen has shown that severe concussion of the spine results in
widespread paralytic symptoms, and yet he has succeeded in
preventing and curing these symptoms by making a longitudinal
incision into the cord immediately after the concussion was
obtained: in other words by establishing drainage.
J. Fraser.
CASE OP MOLLUSOUM FIBROSUM WITH DEFINITE FAMILY
(33) HI8TORY. H. B. Steen, Ind. Med. Gaz ., 1912, xlvii., p. 400.
A record of a case in a Hindu boy, aged 12, whose grandmother,
father, uncle, and sister were similarly affected. Allusion is made
to Scott’s case (y. Review, 1912, x., p. 31). J. D. Rolleston.
A CASE OF VON RECKLINGHAUSEN'S DISEASE. M. S. Rosenthal,
(34) Amer. Joum. Derm., 1912, xvi., p. 603.
The patient was a negro with no family history of tumours and
no serious previous illnesses. No other abnormalities. Intelligence
above the average for a negro. The tumours were of two varieties:
(a) pedunculated, freely movable in all directions, with the over-
lying skin not adherent, ( b) but slightly movable and firmly
attached to the deeper structures.
Biopsy of (a) showed them to be fibromata. A few nerve
fibrils were found in (b). There was no involvement of any of
the large nerve trunks. Owing to his colour alteration in
pigment was not obvious. J. D. Rolleston.
THE ARGYLL-BOBERTSON PUPIL IN NON-SYPHILITIC AFFEC-
(35) TION8. (Le signs d’Argyll-Robertson dans les affections non
ayphilitiques.) Felix Rose, Semaine Mediccde , No. 49, Dec. 4,
1912.
This is a critical review dealing with recent literature on the
subject. The conclusions come to are those generally held. In
the immense majority of cases the presence of an Argyll-Robertson
pupil means the existence of an old syphilitic infection, and this
is practically always so when the Argyll-Robertson pupil is the
only sign of nervous system disease present. In syphilitic affec¬
tions, it occurs much more often in parasyphilitic or quaternary
lesions than in tertiary or in secondary. The condition, however,
has been reported in some, though very few, cases of undoubted
non-syphilitic affections such as some traumatic cases, some cases
of alcoholism (v. Review , 1912, x. 455), one case of diabetes, one
case of disseminated sclerosis, and some cases of syringomyelia.
The pathology of the condition is discussed briefly, and the
ABSTRACTS
43
arguments in favour of a variable location for the lesion responsible
for it.
A useful bibliography of recent literature is given.
P. W. Saundebs.
HEMIPLEGIA IN THE EARLY STAGE OF SYPHILIS. (Hemiplegie
(36) im Fnihgtadium der Syphilis.) B. Schluchtbrbb, Munch , med .
Wock . ., 1912, lix., p. 2395.
A harried woman, aged 21, developed typical right hemiplegia
six months after infection in addition to malignant syphilis.
Mercurial treatment was of no avail, but rapid improvement
followed injections of salvarsan, combined with small doses of
mercury and potassium iodide. The hemiplegia was probably due
to endarteritic thrombosis in the internal capsule.
J. D. Rolleston.
FEVER IN THE LATE STAGE OF SYPHILIS. (Zur Frags des
(37) Fiebera in sp&ten Syphilisstadien.) Bjalokur, Wien. Klin.
Woch., 1912, xxv., S. 1490.
The patient was a man, aged 53, who had led a dissolute life, but
denied syphilitic infection. For the last fifteen years he had
Buffered on and off from fever, diarrhoea, sweating, and occasional
haemoptysis. The liver and spleen were slightly enlarged. The
diagnosis oscillated between malaria and tuberculosis, but treatment
appropriate to these diseases was of no avail. That syphilis was
not suspected is shown by the fact that it was not until six years
after the introduction of Wassennann’s reaction that this test was
applied. A positive result was obtained. Potassium iodide was
exhibited combined with injections of sodium cacodylate, and a
rapid disappearance of the symptoms ensued.
J. D. Rolleston.
THE ACHILLES JERK AND REFLEX OF THE TENSOR FASOLfi
(38) FEM0RI8 IN SCIATICA FROM DISEASE OF THE NERVE
ROOT AND FROM DISEASE OF THE NERVE TRUNK. (Les
reflexes du tendon d'Achille et du tenseur du fascia lata dans
la sdatique radiculaire et dans la sdatique troncnlaire.) Bonola,
Rev. Neurol., September 30th, 1912, p. 324
In patients suffering from sciatica, with alterations in the reflexes
of the lower extremity, absence or diminution of the Achilles jerk
and of the reflex of the fascia lata is a sign that the sciatica is of
root origin: absence or diminution of the former with conservation
of the latter indicates that the trunk of the nerve is effected.
S. A. £. Wilson.
44
ABSTRACTS
DELATED TEMPORARY PARALYSIS OF THE SIXTH CRANIAL
(89) NERVE IN FRACTURES OF THE SKULL (Paralyses tardives
et passages du moteur oculaire externe dans lea fractures du
enure.) A. Broca and B. Desplas, Rev. de Chir. y Tome xlvL, No.
9, Sept 1912, p. 349.
The authors discuss the frequency with which paralysis of the
sixth cranial nerve occurs in fracture of the skull, and they point
out that frequently it may be the only existing symptom suggestive
of fracture.
The paralysis may arise from various causes—an actual rupture
of the nerve; pressure from resulting callus, and the sudden
pressure of effused blood.
Details of two cases are discussed, in which the paralysis
occurred in children secondary to fracture of the base: the par¬
alysis came on late and gradually disappeared. In one instance
the sixth nerve alone was involved; in the other both the sixth
nerve and the seventh were affected.
The condition may appear within three or four days of the
accident and within a week may have cleared up. In other
instances the recovery may not be complete until five to six
months after the injury.
The distinctive late development of the paralysis has a certain
anatomical bearing. The sixth nerve lies in intimate relationship
to the apex of the petrous portion of the temporal bone. About
2 mm. from this apex there is fixed to the upper border of the
petrous bone “ Gruber’s Ligament,” a fibrous band springing from
the posterior wall of the cavernous sinus.
The nerve passes beneath this ligament lying upon the bone,
below the inferior petrosal sinus.
In such a fixed position it is liable to compression, and it is
probable that the characteristic late paralysis is the result of a
hsematoma produced around the nerve or actually in its sheath.
J. Fraser.
OBSERVATIONS ON THE PATHOLOGY OF TEMPORARY FACIAL
(40) PARALYSIS, SECONDARY TO FRACTURES OF THE
PETROUS PORTION OF THE TEMPORAL BONE. (Note sur
la pathog4nee de la p&ralysie faciale secondaire et temporaire
dans les fractures du rocher.) H. Nimirb and A Nimieb, Rev.
de Chir., No. 7, July 1912, p. 1.
The paper is introduced by an epitome of the various theories which
are held regarding the etiology of such facial paralysis. Three
such theories are mentioned. (1) The compression of the nerve in
the aqueduct of Fallopius by effused blood (Viallo, Alt, Voran).
(2) The compression of callus resulting in the process of fracture
repair (Demoulin). (3) A post-traumatic otitis (S. Duplay).
ABSTRACTS
45
The last of these is at once ruled out of count: it is due to the
lighting up of a pre-existing inflammation, and therefore not
strictly the result of the fracture.
The authors consider the second theory is weakened by two
objections, the date at which the resulting callus would begin to
appear, and the fact that the distinctive point in fractures of the
skull is the very small amount of external callus which arises.
They reject the hypothesis that the simple effusion of blood
produces the paralysis, because it has not been verified by post¬
mortem examination.
The view which the authors support is that the paralysis
results from a condition of multiple points of haemorrhage actually
into the nerve substance: little patches of ecchymosis which
actually rupture the nerve filaments, or by pressure destroy their
power of conduction.
The recovery of such a facial paralysis, perhaps after many
months, is the outcome of a true nerve regeneration.
Their conclusions are summed up with the following words:
“Judging from post-mortem appearances, we believe that
temporary, secondary facial paralysis arising as a complication
of fracture of the petrous portion of the temporal bone, is the
result of a temporary disorganisation of the nerve trunk by blood
effused into the nerve substance as a result of the injury.”
J. Fraser.
TUMOUR OF THE CEREBELLO PONTINE ANGLE. (Tumeur de
(41) l'angle ponto-cdrdbelleux.) Geests, Jowm. de Neurol., Ann. 17,
No. 21, Nov. 5,1912, p. 409.
A well-defined case of cerebello-pontine tumour with abundance
of classical symptoms. In addition to general symptoms of com¬
pression there were localising signs which rendered a very exact
diagnosis possible. Tinnitus was present, accompanied by an
increasing deafness. Both the cochlear and vestibular roots of
the eighth nerve were affected. The seventh, fifth, fourth, ninth,
and tenth nerves were all involved to a slight extent. Cerebellar
symptoms and evidence of pressure on the motor tracts completed
the clinical picture. A decompression operation was performed,
followed later by an unsuccessful attempt at removal. The post¬
mortem revealed a glioma in the left cerebello-pontine angle.
W. Bom
DECOMPRESSION CRANIECTOMY. (La craniectomie dfeompxes-
(42) sire). E. BoucHfe, Joum. de Neurol ., Ann. 17, No. 16-20, Aug.-Oct
1912, p. 301.
This is an extremely full discussion of the question of decompres¬
sion from the physiological, pathological, and operative standpoints;
46
ABSTRACTS
so full, indeed, as to make the task of abstraction impossible.
Special attention is paid to optic neuritis, and to the question of
the best operation, that favoured by the author being the sub¬
temporal operation of Cushing. One of the features of the paper
is a most exhaustive bibliography. W. Boyd.
A CASE OF AOROMBGAL7 WITH MENTAL SYMPTOMS. E. R.
(43) East, Joum. Merit Sc., YoL lviii., Nob. 2 and 3, Oct. 1912, p. 631.
A typical case of acromegaly, but without definite signs of
pituitary enlargement, such as hemianopia. A very full list of
measurements of the head, arms, and legs is given. The mental
state was one of acute excitement with confusion and hallucinations.
W. Boyd.
EXOPHTHALMIC GOITRE WITH GENERALISED PIGMENTA-
(44) TION. (Goitre exophtalmiaue avec pigmentation gtafralisde).
A Siredey and Mllx. de Jong, Bull, et mim. Soc. mid. H6p. de
Paris, 1912, xxxiv., p. 321.
The patient was a woman, aged 65, whose condition was attributed
to a polyglandular syndrome involving both the thyroid and
suprarenals. This hypothesis was all the more probable as she
had previously shown evidence of ovarian insufficiency, viz., late
onset of puberty (at 20) and painful and scanty menstruation.
J. D. Rolleston.
SYMMETRICAL HYPERTROPHY OF THE SALIVARY GLANDS
(45) IN A CRETIN. (Sur un cas d’hypertrophie symfetrique des
gl&ndes salivaires dies un crttin.) C. Parhon and C. U rechi a,
Joum. de Neurol., Ann. 17, No. 20, Oct 20,1912, p. 381.
The patient, a man of 40, presented marked hypertrophy of the
parotid glands on both sides. The other salivary glands were not
enlarged, nor were the lachrymal glands. The thyroid was
moderately enlarged. The mononuclear elements of the blood
were increased. A lack of mental development was very evident.
The case, therefore, comes into the category of the syndrome of
Mickulicz. A full discussion is given of the cases of this con¬
dition already described in the literature, together with a very
complete bibliography. W. Boyd.
TETANY FOLLOWING EXTIRPATION OF THE THYROID.
(46) Francis J. Shepherd, Annals of Surgery , Yol. IvL, No. 5, 1912,
p. 665.
Before the function of the parathyroid glands was known,
Reverden and Kocher noticed that symptoms of tetany followed
ABSTRACTS
47
the complete removal of the thyroid gland, but that if a part of
the gland was left, the patient as a rule escaped tetany and also
cachexia strumipriva.
Gley in 1891-1897 proved for the first time by experiments on
animals that post-operative tetany was due to the removal of the
parathyroids and not to the thyroid.
Now there are two theories of the functions of the parathyroids:
(1) That an antitoxin is developed by the parathyroids which
neutralises certain waste products of tissue metabolism (Berkeley),
so that when the parathyroids are destroyed, a toxic material is
formed in the blood which causes tetany. (2) That the calcium
metabolism of the cells of the body is controlled by the parathyroids,
and that their removal causes a rapid disappearance of the soluble
salts of calcium from the blood (MacCallum).
Based upon this latter theory is the treatment of tetany by
the administration of calcium lactate.
The author describes his experiences in dealing with a case of
tetany which developed after the operation of thyroidectomy. The
patient was a woman, 34 years of age, suffering from a large cystic
goitre; the dyspnoea and dysphagia were so marked that operation
was recommended. The operation was a difficult one: with the
exception of a small piece of the lower pole, the whole gland was
removed and with it, presumably, the parathyroid.
Symptoms of tetany developed three days after operation;
they took the form of dizziness, numbness, formication, and pain at
the bases of both lungs.
Upon the fifth day these symptoms were complicated by cramps
in both hands, and severe paroxysms in both arms and legs; the
thumbs were contracted in the palms of the hands, the fingers
flexed at the metacarpo-phalangeal joint, the wrist flexed and
elbows bent. The toes were flexed and adducted, and the feet
extended. Chvostik’s sign was well marked and pressure upon a
nerve trunk produced spasms (Trousseau’s sign).
Treatment was begun with the appearance of severe symptoms
(fifth day), and consisted in drachm doses of lactate of calcium
every three hours. Two administrations of the drug caused a
disappearance of symptoms; five administrations were given.
Two days later symptoms recurred and were again relieved by
the drug. The patient exhibited an extreme dislike to calcium
lactate, but the substitution of parathyroid extract produced no
alleviation of symptoms. The patient left hospital upon the
twenty-first day, and she was then taking 30 gr. of calcium lactate
and gr. parathyroid extract every four hours. At the time of
writing the patient was perfectly well, and the administration of
calcium lactate had been diminished to 20 gr. twice a day.
48
ABSTRACTS
The case is cited as agreeing with the etiological theory
propounded by MacCallum.
The author draws attention to the difficulty there is in
recognising parathyroid tissue during operation. J. Fraser.
A OASE OF DYSPITUITABISM- Gerhardt von Bonin, Quart .
(47) Joum. Med., Vol. 6, No. 22, Jan. 1913, p. 120.
There are hardly any cases of pure hyperpituitarism or of pure
hypopituitarism, but both types are generally mixed. Sexual
infantilism and adiposity are symptoms of hypopituitarism, and
are generally, if not always, found associated with acromegaly, i.e.,
hyperpituitarism. This would be accounted for by Cushing’s
theory that one secretion enters the blood directly, whilst the
way for the other to the third ventricle is blocked by the pressure
from the tumour upon the infundibulum. The changes in the
histological appearance of the thyroid in cases of acromegaly are
probably due to the same physiological fact: a lower demand for
the thyroid products on the part of the body-cells. The changes
in the thyroid and in the testicles are due to a primary state of
hypopituitarism. The growth-changes in acromegaly are not
confined to particular parts of the body, but occur in all parts of
the skeleton. These growth-changes are, according to Keith,
explained by the assumption that the secretion of the pituitary
body acts as a hormone, which renders the osteoblasts more
sensitive to mechanical and other stimuli. A. Ninian Bruce.
A OASE OF HYPOPHYSO- GENITAL SYNDROME DUE TO
(48) SYPHILIS. (Syndrome hypophyso-gdnital d’origine syphi-
litique.) P. Carnot and J. Dumont, Bull, et M6m. d. L Soc. Mid,
dee H6p. de Parte, No. 31, Not. 14, 1912, p. 430.
The patient shown was a man of 36. A syphilitic chancre at
18, followed by secondaries. At 21 malaria. At 24 vague, fleeting
pains in lower extremities, with rather marked thirst, and some
polyuria which has persisted for these twelve years. At 29 violent
cephalalgia with rapid onset of bilateral blindness: vision im¬
proved greatly under specific treatment: meanwhile, he had
nocturnal delirium, wandered, and was violent: he went into
hospital, and came out asthenic. At this time (7 years ago)
rapid loss of hair of beard, pubes, and axillae, with testicular
atrophy and impotence: abdomen swollen, of female type. Exami¬
nation now shows only moderate fatness; a pelvis large, of female
type; no giantism or enlargement of extremities; face eunuchoid,
pale, waxy, wrinkled; eye-lashes and scalp-hair preserved; no
marked loss of extremity of eyebrows (Hertoghe’s sign of hypothy-
ABSTRACTS
49
roidism), Teetee reduced to soft, insensitive, smooth masses the
Bize of haricot beans; epididymis and cord atrophied; penis small;
prostate not obviously altered. Psychically, apathetic, calm,
mild, no volitional energy; intelligence feeble; speech drawling.
Vision now not bad. Considerable chilliness; extreme asthenia;
no skin pigmentation. Thyroid not palpable. Slight polyuria and
polydipsia, but no glycosuria or albuminuria. A lateral skull radio¬
gram shows (1) slight enlargement of posterior clinoid processes;
(2) none of sella; (3) great enlargement of frontal, maxillary, and
sphenoidal sinuses; (4) great thickening of cranial bones, especially
occipital. The writers interpret their case as one of a syphilitic
lesion in the neighbourhood of the hypophysis, causing secondarily
testicular atrophy with signs of eunuchoidism. They discuss the
question of a slight hypothyroidism, but acquit the adrenals.
Leonard J. Kidd.
NOTES ON A CASE OF PRECOCIOUS DEVELOPMENT IN A
(49) BOY AOED. 6 YEARS. E. C. Williams, Brit. Jovm. Child.
Du., 1912, ix., p. 529.
The boy had begun to develop rapidly about six months before
admission, when his condition was as follows: weight 4 st. 2 lbs.,
height 4 ft. 2 in. Slight moustache, voice deep, like an adult’s.
Abundance of pubic hair; no axillary hair. External genitals
well developed. Intelligence and movement slow.
A skiagram of the skull showed that the pituitary fossa was
enlarged in the anteto-posterior direction. The length of the
cranium was 90 mm., and the greatest breadth 145 mm. The
advanced condition of ossification in the hands corresponded to
that of a boy of 14 or 16 years.
There was no evidence of adrenal hypernephroma, which has
been found in many cases of sexual precocity, but Williams
suggests that the relatively high blood-pressure—110 mm.—was
due to an excess of suprarenal or pituitary extract in the blood.
J. D. Rolleston.
THE MECHANISM OF PITUITARY GLYCOSURIA. (La m&anisme
(50) de la glycosurie hypophysaire.) H. Claude and A Baudouin,
Compt. Bend. Soe. de Biol., Ixxiii., No. 34, Dec. 6,1912, p. 568.
The writers showed in the’ same journal (lxxii.. No. 20, June 7,
1912, p. -855) that in man this is an alimentary glycosuria: they
never obtained it in the fasting state, but only when, some minutes
after hypodermic injection of pituitary extract, a meal of milk,
bread, and sugar was taken, representing 140 to 150 g. of glucose.
They never got the glycosuria with anterior Jobe extract, not eveq
4
50
ABSTRACTS
in those patients who reacted to posterior lobe extracts. This
reaction was chiefly marked in arthritic and “ pre-diabetic ”
patients, and little or not at all in others. The extracts were
made from either the posterior lobe or from the whole gland of the
ox: the lipoids were removed from the extract by chloroform in a
Soxhlet’s apparatus. In the present paper the writers record four
experiments on an arthritic man of 45 who passed traces of sugar
after a meal rich in carbohydrates: the test meal consisted of
90 g. of glucose dissolved in 2 litres of water, 100 g. of bread, and
a little meat. They find that the glycosuria varies according to the
relation of the time of the injection and the meal To obtain the
maximum glycosuria, the sugar must be taken from half an hour
to one hour after the injection of pituitary extract: the effect of
the injection tends to become exhausted, but it lasts for several
hours and may last till the next day. But the reaction appears
also when the meal is taken 3, 4, or 6 hours after the injection, but
the glycosuria becomes progressively smaller. If, however, the
meal be taken 2£ or 3 hours before the injection, it usually happens
that no glycosuria follows: in any case it is infinitely less than by
the former plan; and, if it does so occur, it is only one or two
hours after the injection: it seems then that the injection
needs a certain time to give its effects. The most probable
explanation of pituitary glycosuria is held to be that the pituitary
extract determines an hepatic insufficiency, so that there is a failure
of fixation of glucose in the state of glycogen. As to whether this
is caused by a direct action on the liver or by the nervous system,
the writers point out that the question should be solved by showing
whether pituitary glycosuria occurs after section of the splanchnic
nerves. They think the action of the nervous system is probable,
on account of the analogy with adrenalin glycosuria. They hope
to show in an early paper that, in man, pituitary extracts act
exactly like those of the adrenals, in the same subjects and accord¬
ing to the same laws. They claim that pituitrin (as much, or even
more than adrenalin), stimulates the sympathetic; and all its
general effects, malaise, pallor of skin, and contraction of unstriped
muscle, are very well explained by excitation of the sympathetic
system. Leonard J. Kidd.
PSYCHIATRY.
AN ADDRESS ON MENTAL DISORDERS. Sir E. H. Savagb,
(51) Lancet , VoL clxxxiiL, Oct. 26,1912, p. 1134.
This is the Presidential Address delivered before the new Section
of Psychiatry of the Royal Society of Medicine. The President
first gives a review of the progress of psychiatry in England, and
ABSTRACTS
51
then goes on to point out some of the principal problems awaiting
solution at present. He dwells on the complex but vitally im¬
portant subject of bodily and mental relationships, and mentions
some interesting and perplexing cases which he has encountered
in practice. Considerable space is devoted to the question of
heredity, and the transmission of a tendency to mental disorder,
and the address concludes with a reference to internal secretions
and the central nervous system, a subject of which the possibilities
are boundless. W. Boyd.
GYNECOLOGIC DISEASE IN THE INSANE, and its BeUtion-
(52) ship to the Various Forms of Psychosis. F. J. Taussig, Jowm.
Amur. Med. Auoe., Vol. lix., No. 9, Aug. 31,1912, p. 713.
The author has examined 537 out of about 900 inmates of the
St Louis City Sanitarium, and found 252 to have some lesion in
the pelvic organs sufficient to cause symptoms at present or in the
future. These lesions are recorded: 87 suffered from retroversion
and 52 from a relaxed pelvic floor. It seems probable that
gynecological disease is only slightly more common in insane
women than in the sane.
In senile dementia, terminal dementia, and paranoia, only about
one-third was diseased, in dementia proecox about one-half; among
the imbeciles about two-thirds. In the manic depressive group
about 74 per cent, showed gynecological lesions, and a large
proportion of these showed a chronic inflammatory condition of
the genital tract The number of recoveries from this form of
insanity after gynecological operations is so large that when a
definite lesion is found it should always be corrected by local or
operative measures. A. N ini an Bruce.
DEMENTIA F&AOOX FBU8TE WITH DYSPRAXIA (Dtfmence
(53) prdcoce fruste arec phdnomftnes de dyspraxia.) Mabillk, Rev.
Neurol., June 15,1912, p. 238.
The case described is peculiarly interesting, and somewhat difficult
to class. It is also debateable whether the symptoms described
are really those of dyspraxia as commonly understood. The
patient, an intelligent student, aged 30, presents the following
symptoms: he is unable to perform any act to order until an
interval of from 20 to 60 seconds has elapsed; as a result, he takes
an unconscionable time in dressing himself, in eating, &c. Such
an action as lighting a cigarette is correctly performed, but there
are long pauses between the constituent elements in the action,
each of which, nevertheless, is performed rather suddenly and
52 ABSTRACTS
abruptly. There are numerous other examples of this aboulia
quoted, and a discussion of the diagnosis is appended.
S. A. K. Wilson.
DEMENTIA PRJEOOX IN RELATION TO APRAXIA. Robert Jones,
(54) Joum. Merit. Sc., Vol. lviil, Nos. 2 and 3, Oct. 1912, p. 697.
The text of this paper was a case described in the Presidential
Address delivered to the Congress of French-speaking Alienists at
Tunis in April 1912. The case was that of a student, set. 30, who
suffered from an affection of the will Recent memory was bad,
power of attention and of concentration were feeble, but it was in
the domain of action that there was the most marked defect.
Although not paralysed in any way, the patient was unable to
carry out the simplest movements until after an interval varying
from a few minutes to several hours. The case was not one of
true apraxia, but rather “apraxia by suspension,” or ideational
inertia, seeing that in the end the movement could be produced.
In addition to the apraxia there were apathy, loss of intellectual
activity, retarded mental reaction, and inadequate emotional tone,
all of which point towards a diagnosis of dementia prrecox. The
relation of this disease to apraxia is discussed, and a summary given
of the most recent views regarding the morbid anatomy of the two
conditions. W. Born
APPENDICITIS IN PRIVATE AND PUBLIC HOSPITALS FOR THE
(65) INSANE. J. F. Bbiskvb, Joum. Merit. Sc., Vol. lviii., Nob. 2 and 3,
Oct 1912, p. 622.
The fact is brought out that appendicitis is a very rare disease
amongst the insane. In 2000 post-mortems at Claybury Asylum,
there was only one case of appendicitis. The writer maintains
that this is due to the routine administration of purgatives to
asylum patients, thus preventing any faecal accumulation in the
caecum. W. Boyd.
THE 8YPHILITI0 PSYCHOSES. F. M. Barnes, Med. Record, 1912, ii.,
(56) p. 591.
Barnes emphasises the following points: (1) There is no mental
symptom-complex characteristic of syphilitic disease of the nervous
system. (2) Many types of psychoses may lie simulated by mental
disorders caused by syphilis. (3) Cerebral syphilis may develop
in a brain already affected with mental disorder, and may occur
in conjunction with organic disease of the brain. (4) Paralysis,
BOOKS AND PAMPHLETS RECEIVED
53
paresis and convulsive episodes may be absent when mental
disturbance i8 due to syphilis. (5) The diagnosis during life is
frequently difficult and often impossible.
J. D. Rolleston.
TREATMENT.
PROGRESS IN THE TREATMENT OF THE NEUROSES. E. W.
(57) Taylob, Boston Med. and Surg. Joum., Vol. clxvii., No. 9, Aug.
1912.
In this paper the author shows in a general way the necessity for
a fuller and more accurate appreciation of the neurasthenic state
by the general practitioner. He points out the importance of a
psycho-analysis in such cases as a basis of rational treatment.
This view is being brought about, firstly, by the workers in the
various fields of psychology, and secondly, by medical men bene¬
fiting from such knowledge, and endeavouring by individualistic
analysis and explanation to develop the patient’s capacity for
meeting his personal problem. A. Fergus Hew at.
THE ACTION OF LARGE DOSES OF SODIUM BICARBONATE
(58) IN DIABETES MELLITI8. (Uber einige Wirkungen grosser
Dosen Natrium Bicarb, bei Diabetes Mellitus.) Olav Hanssen,
Zeit.f. Klin. Med., Bd. 76, H. 3-4, S. 219.
In diabetic coma the administration of large quantities of sod.
bicarbonate, although of temporary benefit in some cases, caused
in a number of other cases tonic and clonic convulsions. The
pathological examinations showed that the cases treated with
sod. bicarb, had marked hypersemia and oedema of the lepto-
meninges, a few of the cases also had haemorrhages.
R. A. Krause.
BOOKS AND PAMPHLETS RECEIVED.
Clark, L. Pierce. “Remarks upon psychogenetic convulsions and
genuine epilepsy” {Med. Record, Oct. 5,1912).
Clark, L. Pierce. “ Remarks upon some recent studies in the patho¬
genesis of epilepsy” ( Boston Med. and Surg. Joum., VoL clxvii., No. 3,
July 18,1912, pp. 78-81).
Clark, L. Pierce, and Atwood, C. E. “ A study of the significance of the
habit-movements in mental defectives” ( Joum. Amer. Med. Assoc., Vol.
lviii, March 23,1912, pp. 838-843).
5
54
BOOKS AND PAMPHLETS RECEIVED
Fuller, S. C. “ Ein Fall der Alzheimerschen Krankheit” ( Ztschr. f. d.
get. Neurol, u. Psyehiat ., Bd. xi., H. 1/2,1911, a. 158).
Lowy, Max. “Zur Kasuistik der Brunnenkrise (des Brunnendusels,
dee Brunnen- und Baderausches).” {Zttchr. f. Balneol J. iv., Nr. 12,1912).
Lowy, Max. “ Zur Kasuistik selteuer ‘ dyshumoraler ’ (innersekretor-
ischer storungen) ” {Prog. Med. Wchntchr ., xxxvL, Nr. 34-37,1911).
Lowy, Max. “ Uber eine Unruheerscheinung: die Halluziuation des
Anrufes mit dem eigeuen Namen (ohne und mit Beachtungswahn) ” {Jahrb.
/. Ptychiat. v. Neurol ., Bd. xxxiii., 1911).
Wedensky, N. E. “Uber eiue neue eigentumliche Einwirkung des
sensiblen Nerven auf die zeutrale Innervation bei seiner andauernden
elektrischen Reizung ” {Folia Neuro-biol L, Bd. vi., Nr. 7 and 8,1912, b. 591).
White, Wm. A “ Outlines of Psychiatry " (.Nervous and Mental Disease ,
Monograph Series, No. 1, Fourth Edition. New York, 1913).
White, Wm. A. “Bulletin No. 4.” Government Hospital for the
Insane, Washington, D.C., 1912.
“Proceed, of Soc. for Psychical Research,” Yol. xxvi., Nov. 1912.
“ The Training School” YoL ix., Nos. 6, 7, and 8, Oct, Nov., and Dec.
1912.
■Review
of
IReuroloGi? an£> psychiatric?
©dginal articles
THE PINEAL BODY: A REVIEW.
By LEONARD J. KIDD, M.D.
Introduction; 1. Ancient Views of the Pineal Body; 2. Comparative
Anatomy and Development; 3. Comparative Histology; 4. Clinico-
Pathological; 6. Experimental; 6. General Discussion; 7. Con¬
clusions; 8. References.
(Continued from page 21.)
5. Experimental.
(1) Extract-Injection Method.
[I shall make use here of the term “ pinealine ”—which I
have coined—to denote an extract made from the pineal
body.]
W. H. Howell 7 ® (1898), in the course of a study of the
physiological effects of injection of extracts of the sheep’s
hypophysis and infundibular body on dogs, found that glycerine
extracts of pineal body (probably of sheep, but the source of the
pinealine is not stated) gave inconstant results on blood-pressure,
viz., sometimes a very slight fall, or none, at others a marked fall.
Unfortunately he did not pursue his pineal experimentation any
further.
E von Cyon 74 (1903) found that intravenous injection into
rabbits of pinealine of the ox and the sheep had no effect on blood-
pressure ; small doses gave a feeble and frequent pulse : large doses
6
56
LEONARD J. KIDD
a bigeminal or trigeminal pulse, which disappeared after section
of the vagi. He attributed the effects to the presence of salts in
the epiphysis, especially phosphate of calcium.
Dixon and Halliburton 76 (1909) found that sheep’s pinealine
—prepared in four distinct ways—when injected intravenously
into cats, fully anaesthetised with urethane, gave a slight fall of
blood pressure, which was transient: chemical examination showed
that it was not choline which caused this falL They concluded
that other physiological methods must be employed for the purpose
of deciding whether the mammalian pineal has any function.
In 1910 these two authors, 76 experimenting on dogs, anaesthetised
with urethane and morphine, found that, while extracts made from
the choroid plexuses of ox, sheep, and man, injected into the
sub-cerebellar cisterna, or the lumbar region, cause a flow of
cerebro-spinal fluid, pinealine has no such effect.
Ott and Scott 78 (1910-1911) reported at a meeting of the
Society of Experimental Biology and Medicine, New York, in
December 1910 (their full paper appeared in October 1911) that
intravenous injection of boiled pinealine (source not stated) had a
rapid galactagogue effect on lactating goats. Five grains of pine¬
aline were needed for this effect: one-grain doses had no such
effect. No etherisation was used, and the method of Rohrig was
applied in these experiments. They got galactagogue effects also
with thymus extract (1 gr.), corpus luteum extract (10 grs.), and
infundibulin. The galactagogue effect of pinealine was less than
that of infundibulin.
In April 1912 these two authors 78 added several new points
on the effects of intravenous injection of pinealine and of corpus
luteum extracts. The effects of both on the circulation were
nearly identical, viz., initial depression of blood-pressure, followed
by a rise above normal for a short time: the pulse-rate was not
appreciably altered. While corpus luteum had no effect on the
kidneys, pinealine caused diuresis and increase of kidney volume
due to vaso-dilatation. Application of pinealine to a uterine strip
of the rabbit in situ caused increased contraction of the pregnant
uterus but not of the non-pregnant, whereas corpus luteum extract
caused both, but only slight in the case of the non-pregnant uterus.
On an excised strip of rabbit’s intestine, pinealine gave slight
increase of contractions, while corpus luteum gave greatly increased
contractions. Finally, in rabbits whose superior cervical sym-
THE PINEAL BODY: A REVIEW
57
pathetic ganglion had been excised, local application of pinealine
gave slight pupillo-dilatation.
In May 1912 79 Ott and Scott reported that a preliminary
intravenous injection of gr. of atropine lessens the galactagogue
effects of a subsequent injection of pinealine, corpus luteum extract,
and infundibulin. They add that pinealine dilates the renal
vessels; and they suggest that, as pinealine, corpus luteum extract,
thymus extract, and infundibulin are vaso-dilators in the male
genitalia, it is probable that they are also vaso-dilators in the
mammary gland.
Jordan and Eyster 77 (1911).
[I have placed their names before those of Schafer and K.
Mackenzie, for though their full paper did not appear till
December 1911 ( i.e ., after that of S. and M.), yet it
appeared in abstract before that of S. and M., i.e., in the
Proc. Amer. Physiol. Soc. for February 1911 (Amcr.
Joum. of Physiol.).]
These two investigators performed intravenous injections of
sheep’s pinealine—but in a more concentrated form than that used
by Dixon and Halliburton 75 —into dogs, cats, a rabbit, and a sheep.
They confirm the findings of Dixon and Halliburton that the effect
on the cat’s blood-pressure is small. They found that, with a fall
of blood-pressure, there was a vaso-dilatation in the intestines, a
slight improvement in the beat of the isolated cat’s heart, and a
transitory diuresis (associated with glycosuria in about 80 per cent,
of the cases). They found also slight effects on respiration: in a
sheep there was gradual increase in depth, lasting for some time
after the injection. They note that these pinealine effects are
relatively slight when compared with those of other glands known
to furnish internal secretions.
Schafer and K. Mackenzie 78 (July 1911) failed to confirm
the earliest findings of Ott and Scott 76 (1910) on pinealine and on
thymus extract, but confirmed them on infundibulin and on corpus
luteum extract. The source of their pinealine is not stated. Their
work was performed on lactating animals—chiefly cats, but also a
few dogs.
K. Mackenzie 79 (December 1911), in a renewed study of the
subject, found that intravenous injection of boiled pinealine of
58
LEONARD J. KIDD
sheep gave a small, but distinct, stimulating effect on mammary
secretion in cats in varying stages of lactation. He thought that
the pinealine effect “might be due to the presence of a small
quantity of pituitary extract absorbed from the surrounding cerebro¬
spinal fluid, but he failed to obtain any effect from the cerebro¬
spinal fluid itself, also from extracts of brain substance.” He
suggests that, if it were sufficiently inspissated, the cerebro-spinal
fluid might possibly show the presence of the pituitary galactagogue;
but he had not had an opportunity of trying this experiment at
the time of sending in his MS.
(2) Electrical Stimulation Method.
E. von Cyon 74 (1903) appears to be the only observer who has
applied the method of electrical stimulation of the exposed pineal
body. He succeeded in doing this in the rabbit. He obtained a
lessening in size of the pineal with a slight change in its position,
but no alteration of its colour: he therefore rejects a vaso-constric-
tion as the cause of the diminution of size. It is very unlikely
that either striped or unstriped muscle-fibres are responsible for
this diminution of volume, for no one has ever found either kind
in the rabbit’s pineal. Yon Cyon admits that the pineal contrac¬
tion causes mechanically a flow and afflux of cerebro-spinal fluid.
The suggestion has been made that the lessening of size may be
due to an inhibition of pineal secretion: but we must remember
that at present we lack conclusive proof that the pineal really has
a secretion to be inhibited, though such a hypothesis will probably
prove to be correct.
(3) Destruction of the Pineal by Cautery.
Sarteschi 62 (1910), who operated on eleven rabbits, is said to
have adopted this method in some instances; but his results were
negative.
Exner and Boese 80 (1910) applied this method to young
rabbits; only six out of ninety-five animals lived to the period of
sexual maturity. Their results were negative.
We are now able to understand why the method has proved
a failure; for recently Fo& 81 has shown that it is not possible to
destroy completely the rabbit’s pineal by the cautery. He refers
to Staderini’s 82 study of the topography of the rabbit’s pineal body:
THE PINEAL BODY: A REVIEW 59
he shows that the method adopted by Exner and Boese could, in
most instances, destroy only that part of the rabbit’s pineal which
is situated between the vermis cerebelli and the cerebral hemi¬
spheres : Fo& finds that the rabbit’s pineal is 15 to 16 mm. in length,
by 5 to 6 mm. breadth in its distal portion: he found that in the
rabbit the danger of wounding venous sinuses and of damag¬
ing the vermis cerebelli or the occipital lobes is very great:
in short, it is not possible to even extirpate the rabbit’s pineal
completely.
It follows from this that the negative findings from the applica¬
tion of the cautery method are due to the fact that the destruction
of the pineal was incomplete.
(4) Extirpation of Pineal Body.
Sabteschi 62 (1910) applied this method in some of his eleven
rabbits: only two survived, both being females: in one the ex¬
tirpation was said to be complete, but the animal died, without
discoverable cause, four months after the operation; both these
female rabbits became very emaciated and had a retardation of
development; though both animals were kept with males, they
did not breed. [It seems very doubtful, from the abstracts of
Sarteschi’s paper known to me, whether this was connected with
the pineal body at all: possibly the post-operative emaciation was
responsible: in any case, in only one of the two animals was the
extirpation claimed as a complete one.]
Exner and Boese 80 (1910) attempted this method in some of
their ninety-five young rabbits; of these, twenty-two were kept for
a long time: but only six till puberty, three being males. No
difference in weight, nor in reproductive faculty was noted. But,
as I shall show presently when I come to Foa’s researches, it is
doubtful whether the extirpation was complete, or is indeed
possible in the rabbit.
Biedl 83 (1910) is reported to have performed some extirpation
experiments, with negative results. But Fok 81 says that Biedl’s
account is very short: I have failed to obtain Biedl’s important
monograph.
Foa 81 (1912) has given us far the most valuable experimental
study of the pineal body. But at the outset of his inquiry, he
came to the astonishing conclusion that the pinealine injection-
method had been worked out, and was not worthy of re-study.
60
LEONARD J. KIDD
[I pointed out in December 1910 88 that not only is this untrue, bufc
the subject had not even begun to be studied properly, because no on©
had tested the effects of pinealine taken from very young or newly-
born animals. Even now, at the end of 1912, my statement still
applies: but I have reason to believe that before long we shall have
some experimental work published—on the lines of the suggestions
made by me in 1910—by two physiologists, with whom I have been in
private correspondence on these and other points concerning the pineal
y*]
Foil began his work by a preliminary exact study of the topo¬
graphy of the rabbit’s pineal body: he performed a preliminary
series of extirpation experiments: he found that it is extremely
difficult to destroy the whole of the head of the pineal body of
the rabbit without injury to the vermis and the occipital lobes:
haemorrhage is also very great. He found that young rabbits, of
1 to 2 months, died within three days of operation. He there¬
fore examined Gallus: he found that the topography of its pineal
resembles that of the rabbit: but he was able to prove that
complete extirpation was possible in chickens. He extirpated com¬
pletely the pineal in sixty-three chickens aged from 3 to 5 weeks:
fifteen survived, three being males: at this early age he found it
impossible to decide the sex—hence the small number of cockerels
surviving. During the two or three months following the operation
the animals remained rather smaller than the controls and were
torpid and listless; after three months they began to develop vigor¬
ously, and their bodily development overtook that of the controls, and
remained within normal limits. After eight to eleven months, the
combs and the testes of the cockerels showed great hypertrophy; the
figures are very striking. One cockerel crowed thirty-six days before
the control, mated forty-seven days sooner, showed 35 gr. greater
body-weight, his testis was 9 gr. heavier, and his comb 38 gr. heavier,
at the age of 8 to 11 months the pinealectomised cockerels showed
the same degree of body-development and generative capacity as
the controls. In some of the control animals Foil had performed
a sham operation which consisted in an exact copy of the full
operation with the exception that the pineal body was left in
situ uninjured. When pinealectomised pullets, which had begun to
lay, were isolated with pinealectomised cockerels, their eggs proved
fertile on artificial incubation. Autopsy showed no appreciable
macroscopic changes when compared with the controls: the
examination included brain, pituitary, thymus, thyroid, adrenals
THE PINEAL BODY: A REVIEW
61
heart, lungs, kidneys, all the abdominal viscera, bones, and panni-
culus adiposus. Fok reserves a report of the histological findings
for a subsequent paper: he promises also a comparative study of
the pineal body at various ages. [There is one omission in his
excellent paper that disappoints me: he gives no particulars as
to the size, or generative capacity, of the progeny of (1) mated
pinealectomised cockerels and pullets; (2) pinealectomised cockerels
mated with normal pullets; (3) pinealectomised pullets with normal
cockerels. The importance of these needed experiments will be
clear when my own interpretation of Machell’s case of sexual
precocity in a boy is referred to in my general discussion.]
Fok’s list of formal conclusions is as follows :—
(1) Complete removal of the pineal of chickens, aged 20-30
days, is possible.
(2) (Refers to the early post-operative torpor, listlessness, and
retardation of growth already detailed.)
(3) In pinealectomised cockerels there is a premature develop¬
ment of the primary and secondary sexual characters (sexual
instinct, crowing, comb).
(4) At 8-11 months the operated males showed hypertrophy
of comb and testes.
(5) No macroscopic changes are found in the endocrine glands.
(6) Pullets, pinealectomised during the first month of life,
show at the end of 8 to 12 months no differences of development,
generative capacity, appearance, or size of organs, from those of
non-operated pullets.
Thus he alters Marburg’s scheme in one important particular,
viz., he points out that a-pinealismus (in cockerels) leads to the
conditions—or some of them—described by Marburg as due to
hypopinealismus. At present we know nothing of hypopinealismus
from an experimental point of view. And it is quite possible, I
think, that we never shall
(5) Effects of Castration on the Pineal Body.
Saeteschi u (1910) failed to find any changes in the pineal body
of animals castrated in early life: from the abstracts of his paper
I gather that this applies to rabbits; but, as he studied histo¬
logically so many varieties of mammals, he may have applied
the castration method in others besides rabbits.
62
LEONARD J. KIDD
Biach and Hulles u (1912) castrated fifteen kittens, aged 3 to
4 weeks: half of each litter were kept as controls: nine lived, viz.,
seven males and two females; all were kept for seven or eight
months. Their pineals were hardened; thin paraffin sections cut,
and stained with hsemoleene-eosin. Constant atrophy of the
pineal body was found in both sexes : the atrophy is described as
involving not only the whole gland but also its individual cells.
In one cat, aged 3 months, castration was performed: at this age
the cells of the cat’s testes are functionally active: exactly the
same pineal changes were found as in the castrated kittens. The
parenchymal cells of the pineal body were scattered, instead of
being compact; and the intercellular spaces were larger than
normal The authors conclude that, while their own observa¬
tions show that Marburg’s hypothesis of the functions of the
pineal goes perhaps too far, yet they bear out his assertion of
the contrast between the pineal and the pituitary, while they also
show—for the first time—that, whereas it is well known that
castration causes pituitary hypertrophy, it causes atrophy of the
pineal.
(6) Needed Experimental Procedures.
Two years ago I drew attention 88 to at least three methods of
pineal experimentation that had been neglected by all those in¬
vestigators with whose writings I was then acquainted. And even
now, towards the end of 1912, it is as true as it was in 1910, that
(1) pinealine from young animals, (2) pineal feeding, (3) pineal
grafting, have not yet been tested. Fortunately, however, this
deficiency in our present knowledge of pineal physiology will soon
probably be removed by two physiologists with whom I have been
corresponding privately on certain aspects of pineal physiology. The
best way now to deal with the subject will, I think, be to deal first
with pineal feeding, grafting, and the pinealine method, and then to
take seriatim the four other experimental methods which I have
detailed in the subsection 5 of this section of my paper.
Pineal feeding might be tried (1) on normal animals, young and
old; (2) on pinealectomised animals, young and old ; (3) on completely
hypophysectomised puppies ; (4) on castrated animals, 4c., «fcc. Pineal
grafting might be tried in the same conditions. In addition both
feeding and grafting might be tried on young and adult animals
whose thyroid, adrenals, &c., had been previously extirpated.
1. The Pinealine-Injection Method.
(4.) Pinealine from Very Young Animals .—It is to be hoped that, in
addition to mammalian and avian pinealine, we shall ha,ve tests of
THE PINEAL BODY: A REVIEW
63
pinealine from lower vertebrates, especially snakes, amphibia, and
fishes.
(1) Can we thns set up an experimental hyperpinealismus 1 In all
cases a careful histological examination should be made of all the
endocrine glands, the bones, subcutaneous fat, and mammary glands
(of both sexes); and I think we ought to include also sympathetic
ganglia, the so-called paraganglia, the carotid bodies, <fcc., Slc. ; in
short, our histological examination ought to comprise all the organs of
what some writers call “ the endocrino-sympathetic system.”
(2) Has young pinealine any effects on adult animals ?
(3) Does it prolong the duration of life in completely hypophy-
sectomised puppies ?
(4) Does it modify the known effects of thyroidectomy, adrenal¬
ectomy, Ac., in young or adult animals 1
(5) Have thyroidectomy, thymectomy, adrenalectomy, or castration
(both sexes) any modifying effects on the physiological activity of the
pinealine of young animals ?
(6) Do extracts prepared from the pituitary and other glands of
pinealectomised chickens give their usual injection effects ?
(B.) Pinealine from Adult Animals. —Undoubtedly we shall have
both a reinvestigation of some of the experimental findings of Ott and
Scott, and of K. Mackenzie, and a further and more extended new
investigation. There is one striking omission on the part of all
workers from the time of W. H. Howell (1898) up to Ott and Scott
(1912), viz., no histological examination has followed their experi¬
mental studies. In any case I fail to see how anyone, who is familiar
with the most recent work of Ott and Scott, can maintain that the
adult-pinealine method has been anything like worked out yet: we
may yet learn a good deal from it of exact pineal physiology. I may
add that it is conceivable that we may one day have a pineal medica¬
tion ; it seems to be about the only form of organo-therapy that has
not been tried ; but let us pray that it may follow, and not precede, a
careful experimental study.
2. The Electrical Stimulation Method.
Let us first have a reinvestigation of von Cyon’s solitary study of
stimulation of the exposed pineal body: but let us have, in addition,
an attempt to test the physiological effects of pinealine obtained from
a young animal immediately after such direct pineal stimulation. It
seems at least possible that some modification of the activity of the
pineal might be set up by this direct stimulation of the gland.
Another very important application of the electrical method—not
yet tried—is the following: At present we do not know whether the
sympathetic nerve-fibres, which Cajal 46 has found in the pineal body,
are secretory in function, or vasomotor, or both secretory and vasomotor.
We have at present no exact knowledge of the origin of these sympa¬
thetic fibres, of their course, nor as to how they reach the pineal blood
vessels and the external side of the glandular cells of the pineal body.
But it seems probable that (1) they rise in cells of the inferior cervical
64
LEONARD J. KIDD
sympathetic ganglion, (2) pass via the vertebral plexus along the
basilar artery, and (3) thence along the posterior cerebral and superior
quadrigeminate arteries to the pineal arteries. If this be correct, we
might expect to obtain some modification of pineal secretion by (1)
stimulation of the inferior cervical ganglion or the vertebral plexus,
or (2) extirpation of that ganglion. In addition, drugs might be
applied in combination with these methods. One would suggest too
that, after such stimulation or extirpation, pinealine should be pre¬
pared from the gland and its effects tested by injection. I think the
extirpation would, in this case, probably have to be bilateral, whereas
unilateral stimulation would suffice. But one can hardly doubt that
physiologists will, by adopting such methods, add substantially to our
knowledge of pineal physiology. We know now that secretory glands
are of two types, viz., (1) those which receive true secretory nerve-
fibres, e.g., the adrenals via the splanchnics, and (2) the mammary
gland, whose secretory function has been proved to be capable of
acting quite apart from connection with the nervous system. At
present we do not know to which category the pineal body belongs.
In concluding these remarks I may say that there should be no
difficulty in tracing degenerated nerve-fibres into the pineal body, after
extirpation of the inferior cervical ganglion, i.e., if its sympathetic
fibres have the origin and course which I have here suggested.
3. The Cautery Method.
This is a bad method; when it does not fail, it is likely to do too
much. Even if definite effects were obtained by its use, we should
he forced to discount their value, because it may be correct that
pineal syndromes may be due, in part at any rate, to damage done to
hypothetical centres, or tracts, situated near the pineal body.
4. Pineal Extirpation.
This method may well have a great future; the first thing is, of
course, to find out in what animals complete pinealectomy can be
performed, as in Foil's chickens, without damage to neighbouring
structures and without danger to life. I may just repeat the hope,
which I have expressed already, that Foa’s researches may be extended
in the following directions: What is the size, weight, appearance,
sexual activity, and generative capacity of the progeny of (1) pineal-
ectomised cockerels mated with normal pullets, (2) pinealeetomised
pullets with normal cockerels, (3) pinealeetomised cockerels with
pinealeetomised pullets ? Of course a searching histological examina¬
tion would be made of the endocrino-sympathetic system of the resulting
progeny in each category.
5. Effect of Castration on the Pineal.
The experiments of Biach and Hulles 84 should be repeated, and
should be performed in other animals besides cats. And it is to be
hoped that we shall be given a more elaborate histological examination
of the pineal body of castrated animals than that given by them.
THE PINEAL BODY: A KEYIEW
65
Further, it is of vital importance that we should learn what is the
exact histological condition of the pineals of very old animals which
had been castrated during the first few weeks of life. [My reason for
insisting on this point will be given in my general discussion.] Finally,
we want to know what effects, if any, has castration of very old
animals on their pineal body.
In concluding this section, I should like to express the hope that
both the analytical and the physiological chemist will teach us some¬
thing of value on the obscure question of pineal chemistry : one cannot
doubt that this method of inquiry has a future in front of it.
6. General Discussion.
We come now to the greatest difficulty of all—what use shall
we make of the vast mass of facts which have been accumulated,
as the results of the labours of numerous investigators in several
fields of inquiry, during the modern era, which may conveniently
be said to begin with the studies of Faivre 2 in 1854 ? First of all,
a broad survey of the pineal body from all aspects leads, in my
opinion, to one fundamental conclusion, viz., that it is probably
functional in all those vertebrates which possess one. The pineal
body is not, as so many even good authorities have assumed, a
rudimentary, functionless, degenerated, or degenerating and
disappearing organ. It is something entirely different, viz., a
metamorphosed—perhaps also a metamorphosing—organ. If the
pineal were really a degenerating and disappearing organ, Nature
has been slow indeed in getting rid of it: she has had ever since
the far-distant palaeozoic era. Let anyone just think of the fact
that modern snakes, which are practically identical with those of
the mesozoic era, have an unusually vascular pineal organ. Will
he seriously ask us to believe that Nature would send a lot of
blood to an organ that has no need for it, and thus keep a certain
amount of blood from other organs and tissues which do need
it ? Now it does not in the least follow that, even if the pineal
body be functional in all those vertebrates that possess one, its
functions are of necessity identical in all vertebrate classes. We
must here remember that we are to-day merely at the threshold of
our inquiry into comparative pineal physiology. The alleged
absence of a pineal organ in certain lower vertebrates is worthy of
a passing notice here: its absence in Myxinoids is not in the least
surprising; for this group of the Cyclostomes is known to be—in
the main—a very degenerate one. The absence of a pineal organ
66
LEONARD J. KIDD
in Crocodilia is certainly strange, but I suspect that they will yet
be found to possess one. For palaeontologists tell us that existing
Crocodilia are practically identical as to size, osteology, &c., with
those of the mesozoic era; crocodiles, like reptiles, have lived a
nice, easy, lazy life through the ages: it seems unlikely to me that
crocodiles should lack a pineal organ while snakes have a highly
vascular one. One would also expect to find a pineal organ in
Torpedo ; a reinvestigation is desirable. We see that when an animal
type is going to degenerate—as, for example, the Myxinoids —it
loses its pineal organ entirely: it does not keep one, as do its
cousins the Petromyzonts, and almost all higher vertebrates: still
less does it keep a vascular one. It seems to me that the study
of Myxinoids tends to show the absurdity of the non-functional
hypothesis of the pineal organ of vertebrates. The variations of
the vertebrate pineal body are so great that it seems probable that
its importance varies in various vertebrate classes, and even some¬
times in closely related members. When we come to comparative
histological studies, the functional activity of the pineal body is
strongly suggested by the work of many investigators, specially
Faivre 2 (1854), Leydig 7 (1866), Bizzozero 80 (1871), Hagemann 82
(1871-72), Cajal 46 (1895), Galeotti 47 (1896-97), Dimitrova 60 (1901),
Sarteschi 52 (1910), Krabbe 66 (1911), and Jordan 67 (1911).
When we study the clinico-pathological aspects of the pineal
body, we see some evidence that it has, in early childhood, probably
some relationship with body-growth and sex-characters. But it
seems to be difficult to establish very definite conclusions as to
pineal physiology from these cases, because not only do pineal
lesions fail in 90 per cent, of the recorded cases to give any
metabolic symptoms, but, of the 10 per cent, which do give such
symptoms, some give mixed symptoms and signs, as in Raymond
and Claude’s case; 70 whereas others give bodily overgrowth with
premature sexual and genital development; and yet others give
the latter without much of the former. We can no longer entirely
subscribe to Marburg’s 68 three syndromes, for Fok’s 81 experiments
on chickens teach us that a-pinealismus leads to testicular hyper¬
trophy (at a certain age), with over-development of secondary
sexual characters, but no marked bodily overgrowth, at least
nothing approaching giantism. It is, of course, true that Foil’s
conclusions on these matters are based on his findings in so small
a number as three completely pinealectomised cockerels. It seems
THE PINEAL BODY: A REVIEW
67
at least possible that the cachexia, which Marburg attributes to
a-pinealismus, may be not really of pineal origin: but here again
we must remember that Foil found in his cockerels an early period
of torpor, poor appetite, and listlessness, which passed away, how¬
ever, with the beginning of vigorous growth. As to Marburg’s
syndrome due to hyperpinealismus, at present we know nothing
whatever of such a state, so far as experiment is concerned,
the reason being that no experimentalist has yet adopted my
suggestions, 88 made in 1910, as to the application of pineal feeding
and grafting and injection of pinealine from very young animals.
But the obesity that has been found in some cases of pineal
tumours may not, after all, be of pineal origin; for even absence
of any recognisable histological changes in the pituitary or other
glands in such cases does not exclude the possibility of a dys-
pituitarismus due to subtle metabolic or chemical changes of
which at present we have no knowledge. Then, again, adiposity
occurs in so many other conditions, and its modes of production
are still so obscure that we must conclude, I think, that it
is uncertain whether hyperpinealismus in man ever causes
adiposity per se. We must wait for the verdict of properly
applied experimentation.
As to the embryonic hypothesis of the production of pineal
syndromes in some cases of pineal tumours, which was suggested
by Askanazy, cited by Pappenheimer, 6 * I think we must now
dismiss it: the experiments of Biach and Hulles, 84 and those of
Fod 81 seem to point clearly to the existence of a pineal function,
in young mammals and birds respectively, which is related to the
development of the testes: the experiments of Biach and Hulles
include also the ovaries. In connection with the embryonic
hypothesis, I may quote here a passage from the monograph of
Poppi 86 (1911)—to which I have failed to gain access. Poppi is
said to hold that an embryonic lesion of the hypophysis cerebri
can, by causing lesions of either the pineal body or the thyroid,
alter the thymus which, in its turn, causes generalised lymphatic
lesions and especially hypertrophy of the pharyngeal tonsil, which
causes a lesion of the pharyngeal hypophysis. But is it a fact that
an embryonic lesion of the hypophysis cerebri can cause a pineal
lesion?
So far as recent experiments go, we must, I think, pro¬
visionally conclude that one of the functions of the mammalian
68
LEONARD J. KIDD
and avian pineal body is to exercise an inhibitory influence on
the development of the testes in early life (prepuberal), and,
through them probably, on the appearance of the secondary
sexual characters. Its relation to the ovaries needs further
experimental study in several directions which I need not specify
here.
It might be claimed that the embryonic hypothesis may after
all be correct: but I think the utmost we can now admit in its
favour is that, if embryonic lesions do sometimes lead to definite
pineal syndromes, they probably do so by virtue of their stimu¬
lating or inhibitory effects on the specific functions of the pineal
body.
There is one matter on which most authors seem to lay in¬
sufficient stress: we are all so apt in these days to talk of states
of excess or defect of secretory processes in endocrine glands that
we are in danger of forgetting that possibly perversion of secre¬
tion, which may quite well be due to subtle chemical changes
which give no recognisable histological alteration, may really
be sometimes more important than mere excess or deficiency.
Again, it is often forgotten that states of excess and deficiency not
uncommonly occur simultaneously in a gland which is the subject
of tumour-formation, or pressure. It seems then unsafe to con¬
clude at present that a hyperpinealismus may of itself cause
adiposity; for aught we know to the contrary, a dyspinealismus
may possibly do so sometimes, and may at other times cause a
hypopinealismus or an a-pinealismus, and at still others a mixture
of excess and deficiency. If we turn for a moment to acromegaly,
we seem to get some confirmation on these points: though the
balance of opinion is now that that disease is due to hyperplasia
of the glandular lobe of the pituitary, and that Marie’s original
teaching that it is due to hypopituitarism, is in the main erroneous,
yet we know that pituitary medication, which is usually harmful
in the disease, has sometimes done some good. We can hardly
doubt, I think, that cases of acromegaly vary (as do all diseased
states): hyperpituitarism preponderates usually, but it is some¬
times accompanied by some degree of hypopituitarism: Marie was
therefore not wholly in error. So far as the pineal body is
concerned, I think the solution of these matters rests mainly in
the hands of the experimentalist and the chemical physiologist.
A reference to Machell’s 72 case 2 (boy) seems to be needed
THE PINEAL BODY: A REVIEW
69
here. When I abstracted his paper in January 1912 I drew
“ special attention to the heavy weight of the patient’s father at
birth, his early development, and ultimate small size when grown
up.” I suggested that “ this may mean that the patient’s father
showed a condition of non-fatal hypopinealismus in early life,
to which was added during adolescence a condition of hypo-
pituitarismus.” I have already indicated the experimental
methods—or some of them—by which the accuracy or the error
of this suggestion may be tested. It seems to me that we must
beware of assuming that every case of hypopituitarismus must of
necessity conform in all respects with the full adiposo-genital
syndrome of Frohlich; whereas it is rare, states of incomplete
hypopituitarismus are common—unless we are greatly mistaken.
What is going to happen to Machell’s boy, or to Pellizzi’s case 1 ?
[I assume that Pellizzi’s case 1 had no ill-health, and is presumably
still alive.] Will Machell’s boy get intracranial signs and die ?
If he has really an intracranial tumour, it is very slow in giving
any purely intracranial signs. Will this boy, who is now so big,
grow up small eventually? Are there sometimes cases of non-
fatal pineal lesions—not due to gross disease—which can give
effects such as this boy shows? Clearly, all such cases should
always, if possible, be followed up to adult life, if they reach it.
There seems to be only one known condition, besides pineal
tumours, which can for a long time give genital and sexual over¬
growth somewhat similar to that shown by Machell’s boy, or
Pellizzi’s boy (case 1), viz., tumours of the adrenal cortex. But,
whereas all those cases of pineal tumours, which were associated
with genito-somatic precocity, have occurred in boys, cortical
adrenal tumours are excessively rare in boys, and never—so far
as we know—give rise in boys to genital precocity. It is un¬
likely, therefore, that Machell’s case and Pellizzi’s case 1 are
examples of cortical adrenal tumours. Of course, if they are, we
have an easy explanation of the absence in them of intracranial
signs and symptoms. [An immensely large and valuable body
of facts will be found in Glynn’s excellent paper 86 on adrenal
tumours, &c., 1912.]
Many authors have cited the presence in the pineal body of
such a large amount of neuroglial tissue as a proof of its functional
unimportance. Now I am one of those who hold that every¬
where neuroglial cells and fibres have some function, or functions,
70
LEONARD J. KIDD
quite apart from their mere mechanical one. Even if the pineal
were composed of nothing but neuroglial tissue, we should not be
justified in stating that it is functionless. Let the adherents of
the “purely supporting nature” hypothesis of neuroglia answer
the following questions, if they can: If the pineal body be
a rudimentary, useless, disappearing organ, of what possible use
to it can a supporting tissue be ? What would the supporting
tissue support but itself? And how would the presence of a
self-supporting tissue that had no other functions benefit any
animal organism ? No, not only is neuroglia not solely a support¬
ing tissue, but I believe there is no tissue in the animal body
that has only that function: every tissue has probably more than
one function.
The crucial test whether a gland furnishes an internal secretion
consists in recovering from its efferent vein, or veins, a substance
which, on injection, gives specific effects. Now, in the case of the
pineal body, this test may prove to be difficult of performance: so
far as I know, it has not yet been tried. The pineal veins, which
enter the veins of Galen of both sides, are small, and might prove
difficult of puncture; still, I hope an attempt will be made. It is
probable that arterial changes seldom cause pineal syndromes; the
human pineal is supplied by the superior quadrigeminate branches
of both posterior cerebral arteries; bilateral disease of these trunks
must be exceedingly rare; but, since the superior quadrigeminate
artery supplies also the anterior corpus quadrigeminum, it seems
probable that a lesion of that body may affect the pineal by cutting
off some or all of its arterial supply—quite apart from pressure
effects—and may thus modify its secretory processes. We may
recall the case of Biancone, of tumour of the corpora quadrigemina,
in which masturbation was a prominent feature: this has been
connected causally with the pineal body by some writers. Be that
as it may, the pineal body deserves a much closer and more con¬
scientious histological study at the hands of neuro-pathologists than
it has yet received; it may be much more often affected secondarily
than we know at present: we may learn facts of value, if this be
done. As to the origin and course of the sympathetic fibres which
have been found by Cajal 46 and others in the pineal body, nothing
definite appears to be known; one would suppose that they come
from the inferior cervical sympathetic ganglion, by the vertebral.
plexus, along the basilar artery. There seems to be a promising
THE PINEAL BODY: A REVIEW
71
field here for research, e.g., the effect, if any, of extirpation of that
ganglion, or stimulation, on the pineal body: it is conceivable that
by such means the secretory activity of the pineal might be
modified, in the case of young animals especially: one would like
to know whether pinealine obtained after prolonged sympathetic
stimulation, or extirpation, gave more or less than its usual effects
on injection. I have dealt with the subject in section 5.
We come now to a very important subject which is a great
stumbling-block to many writers, viz., the question of the pineal
involution which occurs normally in childhood. Some writers
seem to imply that, because a partial pineal involution occurs
then, therefore the pineal has no function or functions after child¬
hood. I look on this attitude as entirely erroneous. At the
present time we have evidence which suggests that this involution
begins somewhere about the age of 7 years in man, and ends
normally at puberty. This means that there is (1) an early pineal
function (prepuberal), which is active only in the first few years
of life, in inhibiting premature sexual and genital development: a
gradual involution occurs during the second half of prepuberal
life, and by the time of puberty it is complete; those pineal
elements, then, which subserve this prepuberal sexual function
have now finished their work: they therefore undergo involution;
we find evidence, then, of degeneration and disappearance of some
pineal elements, together with a slight reduction in the size of the
pineal body which later is still further reduced; (2) the other
pineal function—which depends on those pineal elements that do
not undergo involution at puberty—is active at any rate from
puberty to extreme old age; we cannot, however, at present
decide whether it begins only at puberty, for it may really be
active from birth ; nor do we know its function or functions. We
have some evidence that pinealine from adult animals has the
property of stimulating some unstriped muscles; but we cannot
at present say anything definite about this non-sexual pineal
function. Thus, it seems probable that of the two (or more)
functions of the pineal body, one comes to an end normally at
puberty, the other (or others) exists either from birth to death, or
from puberty to death; of these the former is sexual, the latter at
any rate not primarily sexual.
It is not yet possible to admit that Biach and Hulles 84 in¬
terpreted their own experimental findings wholly correctly; for
7
72
LEONARD J. KIDD
their second figure, that of the pineal of a cat of 7 or 8 months
of age, which had been castrated during the first few weeks of life,
shows that, although many pineal elements have disappeared
and the remaining parenchymal cells are a little smaller, and
apparently less defined, than those of a normal cat’s pineal, shown
in Fig. 1, yet we are not entitled to say from this second figure
that the atrophy of the pineal is anything like complete. We are
not yet in a position to say whether, if these cats had been kept
to extreme old age before the histological examination was made,
their pineals would have shown a complete and total atrophy.
This is the reason why I have urged, in the section dealing with
needed experimental procedures, that it is essential that a histo¬
logical examination should be made of the pineals of very old
animals which had been castrated in very early life. The fact
that the human pineal body appears to lessen in size after puberty
—without disappearing—seems to point to the existence of at
least two distinct functions, of which one normally finishes its
work at puberty, and the other, whenever its work may have
begun, goes on to the end of life.
Seigneur 6 has well said, in a burst of graduation eloquence:
“ The pineal gland, having known its days of glory, has fallen into
neglect.” At the same time we see signs on all sides that numerous
active investigators are beginning to study the pineal in a more
enlightened manner. The “ rudimentary, useless ” hypothesis has
—unless I am greatly mistaken—gone for good. By the time
this paper sees the light, we may have learnt from Fok what
histological changes, if any, follow on pinealectomy in young
chickens. We have to remember that the subject of pineal
physiology is almost an untouched field of inquiry. In opening
up new fields of inquiry, as in developing new countries, men
always make some mistakes and miscalculations; and this is
especially likely to occur in such a difficult subject as pineal
physiology. In this review I have said but little on the obscure
question of interglandular relationships. The most we can at
present say, with any confidence, appears to be this: the pineal
of young mammals and birds has (1) certainly a relationship with
the development of the testes and, probably through them, with
the secondary sexual characters and bodily growth; (2) probably
a relationship with the pituitary, and the adrenal cortex; (3)
possibly with the thyroid and thymus; (4) possibly with the
THE PINEAL BODY: A REVIEW
73
ovaries: the experiments of Biach and Hulles 84 suggest it,
whereas those of Foa 81 leave us in doubt—a doubt which may
disappear when his histological studies shall be in our hands.
[We shall probably learn before long from two physiologists, who
are experimenting on certain aspects of pineal physiology which
I have privately suggested to them, whether it is possible to
induce an experimental hyperpinealismus by means of (1)
pinealine from young animals, (2) pineal feeding, (3) pineal graft¬
ing.] It may quite well happen that embryonic pineal extracts
may prove useful in teaching us more about the pineal body: the
young science of experimental embryology has already gained
many r victories—especially in the hands of the brilliant school of
American embryologists—and it undoubtedly has a future in
front of it.
[Among the most generally useful papers on the pineal body may
be mentioned: (1) “ On the symptomatology of pineal tumours,” Bailey
and Jelliffe, 63 Mllnzer, 87 and Seigneur: 6 his thesis is excellent, but is
weak on the experimental side; of these three writers, Miinzer gives
few references, whereas both Bailey and Jelliffe and also Seigneur give
full references to all the recorded cases of pineal tumours; Seigneur
gives references to as many as 65 cases in chapter 5 of his thesis ; 6 it
would be difficult to praise his industry too highly: he has even
succeeded in finding my little letter on pineal experimentation, 88 which
has naturally been overlooked by most recent writers on the pineal
body owing to the fact that it was published in the correspondence
columns of the British Medical Journal. (2) On the ancient history
of the pineal body the papers by Faivre 2 (1857), Legros, 3 and
Peytoureau. 4 (3) On the comparative anatomy and development, the
papers by Studnicka, 5 Dendy, 16 Terry, 17 and Warren : 18 the postscript
in Bendy’s 1911 paper, 16 dealing with the work of Nowikoff (1910)
in reptiles, is well worth study. (4) On the histology, the papers by
Faivre 2 (1854), Dimitrova 56 (1901), Sarteschi 52 (1910), Krabbe 56
(1911), and Jordan 57 (1911). (5) On the experimental physiology,
the papers by von Cyon 74 (1903), Dixon and Halliburton 75 (1909),
Ott and Scott 76 (1911-12), Schafer and Mackenzie 78 (1911), Sarteschi 52
(1910), Biach and Hulles 84 (1912), and, above all, Foa 81 (1912). I
may add that I have not been able to refer to the paper on pineal
cysts by F. Nassetti (Riv. speriment. di Freniat., Vol. 38, 1912, p. 291),
as it had not reached the library where I work when my MS. was
sent in.]
7 . Conclusions.
1. The facte of comparative anatomy, embryology, histology,
clinico-pathology, and experimental physiology, point to the belief
that the pineal body is functional in all those vertebrates which
!> 088 es 8 one.
74
LEONARD J. KIDD
2 . The pineal body is a metamorphosed organ; not a rudi¬
mentary, useless, degenerated, degenerating, or disappearing organ;
the phenomena, which have been urged in favour of the latter
hypothesis, have been erroneously interpreted.
3. The pineal body probably furnishes an internal secretion;
the crucial test for this may prove difficult of attainment; it has
not yet been attempted.
4. So far as our at present imperfectly applied experimental
studies have taught us, the pineal body of very young birds and
mammals has an inhibitory action on the development of the
testes and—probably through them—on bodily growth and the
appearance of the secondary sexual characters.
5. A relationship of the pineal body with the ovaries is
suggested by certain experiments, 84 but has not yet received con¬
tinuation from those of Foil 81 (1912).
6 . A relationsliip with the pituitary and the adrenal cortex is
probable, with the thyroid and thymus possible; but on these
points nothing certain is yet known.
7. Histological studies, and also the most recent experiments
of Ott and Scott 76 on adult pinealine (1912), seem to show that,
in addition to its prepuberal-sexual function, the pineal body of
man and other mammals has at least one other function; it is
not primarily, at any rate, a sexual one; and it appears to be
active either from puberty to the end of life, or from birth.
8 . A true partial pineal involution begins normally in child¬
hood at about the age of seven years, and is normally complete at
puberty; its meaning is that the prepuberal sexual function of
the pineal body has come to an end, and therefore involution
occurs of those pineal elements which subserve that function.
9. The adult mammalian pineal body seems to have definite
actions on some unstriped muscles (Ott and Scott especially), and
it is functionally active normally up to the end of life.
10. The neuroglial and connective-tissue elements of the
pineal body may have specific functions, quite apart from their
purely mechanical r61e; but nothing definite is yet known on
this matter.
11. The size of the pineal body bears no relation to the size
of the brain or the size of the body.
12. The great variations of the pineal body—sometimes even
in closely related forms—suggest that its functions vary, and
are relatively greater in some than in others.
THE PINEAL BODY: A REVIEW
75
13. We are not yet in a position to say how the pineal body
functionates.
14. The future of pineal physiology lies probably mainly in
the hands of the experimental and chemical physiologist, to a
less degree of the pathologist, and possibly to some extent of the
experimental embryologist.
15. An exhaustive study of the nnmy methods by which our
present imperfect knowledge of compa itive pineal physiology
may be increased will be found in sections ' and G of this pajtev.
8. References.
75 Howell, W. H.—
1898. Joum. qf Exptr. Med., VoL 3, p. 258.
74 von Cvon, E.—
1903. Pjluger'a Arch./. Physiol ., VoL 98, p. 327.
75 Dixon, W. E., and Halliburton, W. D.—
1909. Quart. Joum. of Exper. Physiol., Vol. 2, p. 283.
1910. Proc. Physiol. Soc. {Joum. of Physiol., Vol. 40, p. xxx).
78 Ott, L, and Scott, J. C.—
1910. Soc. Exper. Biol, and Med., New York, Deo. 21.
1911. Therapeutic Gazette (Detroit), Series 4, Vol. 27, Oct. 15, p. 68 (Full
P&pcr)
1912. Monthly Cyclop, and Med. Bull., April (Abstract in N.T. Med.
Joum., Vol, 95. June 8, p. 1242).
1912. Therapeutic Gazette, Vol. 28, May 15, p. 310.
77 Jordan, H. E., and Eystkb, J. A. E. —
1911. Amer. Joum. of Physiol., VoL 29, p. 116.
78 Schafer, E. A., and Mackenzie, K.—
1911. Proc. Roy. Soc. Lend., VoL B. 84, p. 22.
78 Mackenzie, K.—
1911. Quart. Joum. of Exper. Physiol., Vol. 4, p. 317.
• Exner, A., and Boise, J.—
1910. JDeutsch. Zeitschr.f. Chimrg., VoL 107, p. 182.
« FoA, C.—
1912. Pathologica, VoL 4, No. 90, August 1, p. 445 (in Italian).
1912. Arch. Ital. de Biol., VoL 57, F. 2, July 30, p. 233 (in French).
• Staderini, R.—
1897. Monit. Zool. Ital., Vol. 8, p. 241.
1897. Arch. Ital. de Biol., VoL 30, p. 323.
® Biedl, A. —
1910. “ Innere Secretion,” Wien.
M Biach, P., and Hclles, E.—
1912. Wien. Klin. Wochschr., VoL 25, No. 10, March 7, p. 373.
■ Poppi—
1911. “ L’lpofisi Cerebrate, faringea e la Glandula Pineale in Patologia.
Di una probabile etiologia primitiva Commune a varie forme
morboise,” Bologna.
“ Glynn, E. E.—
1912. Quart. Joum, of Med., VoL 5, January, p. 157 (on the Adrenal
Cortex, its tumours and rests, See.).
77 Munzer, A.—
1911. Berlin. Klin. Wochschr., Vol. 48, p. 1669. “ Die Zirbeldrttse.”
• Kidd, L. J.— *
1910. Brit. Med. Joum., VoL 2, Dec. 24, p. 2002. “Pineal Experi¬
mentation. ”
70
GORDON HOLMES
A CASE OF COMBINED DEGENERATION OF
THE SPINAL CORD WITH AMYOTROPHY.
By GORDON HOLMES, M.D.
True combined system degeneration of the spinal cord, excepting
certain familial forms as Friedreich’s disease, is a relatively rare con¬
dition, though pseudo-systemic degenerations, as those that occur
in subacute combined degeneration and in certain general diseases
as pernicious anaemia, are comparatively common. Though there
may be no very great or general difference in the symptoms or in
the clinical courses of the two conditions their pathological natures
are essentially unlike. For in true combined system degeneration
we have to deal with the simultaneous or successive affection, due
to the same cause or to factors arising from the same cause, of
two or more tracts or systems of fibres which are unrelated to
one another both anatomically and functionally. Further, this
degeneration is a purely primary phenomenon unconnected with any
local vascular lesions or other injurious processes, and as a rule
it attacks the peripheral portions of the longer fibres first and then
gradually extends towards their cells of origin; the neurones, in
fact, die backwards towards their cells, as an old and ill-nourished
tree on which the topmost branches first decay while the trunk
and roots preserve life longer. But even the occurrence of this
form of combined degeneration has been questioned, as by von
Leyden, for instance, who maintained that, apart from amyotrophic
lateral sclerosis and a few other diseases, the combined degenerations
must be ascribed to diffuse or local processes, such as a disseminated
myelitis.
The case recorded here, which was under my care at the
National Hospital for the Paralysed and Epileptic, undoubtedly
represents a true combined systemic degeneration of the dorsal
columns and of the pyramidal tracts of the spinal cord, but this
system degeneration was associated with a rapid and progressive
wasting of various groups of muscles owing to a primary disease
of the cells of the ventral horns.
F. H., 39 years of age, a farrier, was first seen in the out-patient
department of the hospital in August 1910. He came originally
complaining of progressive weakness of his arms and legs.
His health previous to the onset of his present illness had been
DEGENERATION OF THE SPINAL CORI)
77
excellent; he was always moderate in the use of alcohol and denied
venereal disease, though he admitted the risk of infection. He
had been married fifteen years and had a family of four children,
who, with the exception of one who died in infancy, were alive and
well; his wife had had no miscarriages. There was no history
of any similar illness in his family. He was well and regularly
at work till April 1910, when he had an attack of “influenza”;
his symptoms then were those of a cold, with aching all over, and
during it he felt hot and thirsty. By this slight illness he was
kept from work for three or four weeks; while recovering he fell
from a bicycle, but did not apparently hurt himself. He was able
to continue at work till towards the end of May, when his right
arm commenced to become weak gradually; at first there were
aching pains in the limb, but these were never a prominent
symptom. In July or the early part of August his gait was first
affected, and his left arm became weak. His wife had noticed that
his speech was indistinct for about two months.
When seen in August 1910 there was extensive atrophy of
almost all groups of muscles in the upper extremities, greatest
in the forearm and hand muscles, and more advanced in the right
than in the left limb. No fibrillation was observed. All move¬
ments of the right arm and fingers were feeble, but the left arm
though weak could be used by the patient. The muscles of the
lower limbs were also small, especially below the knees, and flexion
and extension of the ankles were very weak; he could, however,
walk alone, but he staggered and his gait was feeble and unsteady.
His tongue was at that time tremulous but not wasted, and his
pupils were small but equal; the right was almost inactive to light,
while the contraction of the left was sluggish and feeble. There
was slight diminution of sensibility to touch and pain in his
legs, but the sense of position and the appreciation of passive
movement in them was more severely disturbed.
The knee-jerks were much diminished, and the ankle-jerks
were absent, but stimulation of the soles gave extensor plantar
responses.
The patient lived out of London, and was not seen again till
he was admitted to hospital on 11th November 1910. He had
become steadily weaker, his arms had wasted more rapidly, and
for six weeks he had been unable to walk alone. For two weeks
he had some difficulty in controlling his sphincters.
78
GORDON HOLMES
He states that during the attack which he describes as
“influenza” his memory was defective—“he used to tell people
the same thing over and over again ”—but he believed this had
passed off. On examination, however, he was found to be dull
and apathetic, and his memory for even the details of his illness
was poor and unreliable.
On admission his right pupil was larger than his left, and both
were slightly excentric and irregular in outline; they reacted
sluggishly and feebly to light but briskly on accommodation. There
was no history of diplopia, and no strabismus, ptosis, or nystagmus.
The muscles of his face moved well, but his lips were tremulous,
and there was some fine tremor of his tongue when it was
protruded. His right arm could not be raised from the bed, while
the movements of the left were feeble and small in range. All
the muscles of both hands were extremely wasted, as well as
those of the forearms, and to a less degree those above the
elbows. The abdominal muscles were very spastic, the patient
was unable to sit up without support, and in the lower extremi¬
ties there was obvious wasting of the anterior groups of muscles
of the legs, and both limbs were very spastic and all their move¬
ments feeble. The patient was now unable to stand even with
assistance.
No definite anaesthesia or analgesia was made out when the
patient entered hospital, but he was now so dull and stupid that
examination was very difficult; there was, however, beyond doubt
some loss of the sense of position in his legs.
His arm-jerks, as well as his knee- and ankle-jerks, were now
absent, and the abdominal reflexes could not be obtained, while
the plantar responses were definitely of the extensor type. He
had overflow incontinence of urine necessitating the systematic
use of the catheter while he was in hospital, and he frequently
passed faeces under him, but this seemed to be in part at least
due to his mental state.
After admission to hospital his condition deteriorated rapidly.
He became duller and more listless, and spoke only in reply to
questions; his speech became more slurred and indistinct, resembling
that of bulbar palsy, and in January 1911 he developed slight
dysphagia as well. His limbs gradually wasted and contractures
developed in his legs. His pupils remained unequal and irregular,
and the reaction of the right to light was lost, while that of the
DEGENERATION OF THE SPINAL CORD 79
left was very small and sluggish. He eventually died on 10th
March 1911.
The Wassermann reaction in the blood obtained after death
was strongly positive, even though the patient had been treated
with mercury for a considerable period; unhappily the cerebro¬
spinal fluid could not be obtained for examination during life.
The autopsy was performed two hours after death by Dr Hinds
Howell, to whom I am indebted for these notes made at the time,
and for supervising the preparation of the histological sections.
The spinal cord seemed small, and the ventral roots, especially
those of the cervical enlargement, were atrophied and discoloured,
and contrasted strongly with the large, healthy-looking dorsal roots.
There was no thickening or obvious disease of the spinal meninges,
but the soft membranes over the surface of the brain were milky
and thickened, and contained an excessive amount of fluid. To
the naked eye there was no abnormality in the brain excepting
slight atrophy of the frontal lobes.
On microscopical examination the cerebral leptomeninges
were found thickened and infiltrated with small round cells of the
lymphocyte type, but larger cells with oval or spindle-shaped
nuclei and more granular chromatin were found among them;
these were evidently of adventitial or endothelial origin. This
meningeal infiltration was generally denser around the vessels;
there was, however, no tendency to gummatous concentration,
and apart from the invasion of their adventitial coats by the
infiltrating cells the vessels were normal.
In the cerebral cortex the most prominent change was due
to some of the vessels entering it from the meninges, carrying
in a perivascular infilitation in their sheaths. The extent to
which this occurred was irregular; in certain regions it was
absent, despite the presence of much round cell infiltration in the
meninges, while in other regions there was infiltration around
many of even the smaller vessels. Otherwise, the only definite
cortical change was a slight chronic atrophy of some of the larger
pyramidal cells, especially of the Betz elements.
The spinal meninges were but little thickened, and contained
only a small number of infiltrating cells. The vessel walls were
definitely thickened only in the degenerated and densely sclerosed
columns of the cord.
The lesions in the spinal cord were most easily studied in
80
GORDON HOLMES
sections stained by the Weigert-Pal method. Throughout all
regions there is degeneration in both the dorsal and the lateral
columns. In the lateral column the degeneration is strictly
limited to the area occupied by the crossed pyramidal tract. It
can be traced caudalwards as far as the second sacral segment.
Here and in the lumbar and the lower dorsal segments the
degeneration is very severe (Fig. 1), but a certain number of
normal fibres persist, though most of them appear reduced in size;
no swollen or distorted fibres, such as are common near myelitic
foci and in subacute combined degeneration of the cord, are
found among them. The proportion of fibres persisting increases
considerably in the upper dorsal and cervical segments, while
in the highest cervical segments the affection is represented only
by a general pallor, due rather to an atrophy of the fibres than
to a loss in their number, in the region of the crossed pyramidal
tracts (Fig. 3). This pallor diminishes in the medulla, and above
this level the myelinated fibres of these tracts appear practically
normal. From about the level of the tenth dorsal segment
upwards there is some degeneration in the areas of the direct
ventral pyramidal tracts; this is most marked in the upper
dorsal segments, and it diminishes again in the highest segments
of the cord (Figs. 2 and 3).
No other degeneration is visible by the medullary sheath stain
in the ventro-lateral columns of the cord; the spino-cerebellar
tracts are well myelinated and the other fibres of these columns
stain uniformly well.
The degeneration in the dorsal columns may be most easily
followed from the lumbar region. In the third lumbar segment
(Fig. 1), for instance, it occupies a triangular area, the middle root
zone, the fibres along the septum, those of the cornu-commissural
region, the root entery zone, Lissauer’s tract, and the dorsal root
area being unaffected. This description applies to all the segments
of the lumbo-sacral enlargement, but in the lower sacral region
the degeneration is more diffuse and less intense. Both the extra-
and intra-medullary portions of the dorsal roots are normal. In
the lower dorsal segments the disease is less severe, perhaps, but
it occupies the same relative position; there is in addition,
however, some degeneration of the fibres ascending from the
more caudal segments in the dorso-median column. There is no
obvious loss of myelinated fibres in the ventral horns, but both
82
GORDON HOLMES
the dorsal horns and Clarke’s column are poor in medullated
fibres.
In the upper dorsal and the cervical segments the amount of
degeneration in the ascending fibres of Goll’s column is certainly
more pronounced than in the lower regions of the cord (Figs. 2
and 3), and it increases cerebralwards to the dorsal column nuclei.
The entering dorsal roots remain unaffected and the root entery
zones contain a good number of fibres, while the part of the
dorsal columns that is most affected is the dorsal root zone and
the areas lying lateral to the paramedian septa, in the medial
portion of Burdach’s column (Fig. 2). Here there is also a certain
loss of fibres in the cornu-commissural zone, but the fine fibres of
Lissauer’s tract remain unaffected.
In the brain-stem the only change visible in sections stained
by the Weigert-Pal method is the diminishing pallor of the
pyramidal tracts already referred to.
In no region of the cord is there any tendency to diffuse or
annular degeneration such as results from meningeal or vascular
disease.
The Marchi method only confirms the facts observed by the
medullary sheath stain. The degeneration it reveals in the
ventro-lateral columns of the cord is limited to the direct and
crossed pyramidal tracts, and this seems older and more advanced
in the lower than in the higher segments. The pyramids in the
medulla contain only a few black granules, while in the pons these
tracts are normal. The Marchi changes in the dorsal columns are
identical with those described in the Weigert-Pal preparations;
the degeneration seems older—the degeneration granules are
larger, more conglomerate, and more grouped around the vessels—
in the areas occupied by the ascending fibres in the higher
cervical than in the lower segments of the cord. The extra¬
medullary portions of the dorsal roots are free from degeneration.
In addition the Marchi preparations revealed slight recent
degeneration in the entering sensory root of one trigeminus
nerve, and a few granules in the corresponding bulbo-spinai
root; in the extra-medullary portion of the root the degenera¬
tion does not extend beyond the line of the neuroglial-endoneural
junction.
In the degenerated areas of the cord there is a dense neuroglial
sclerosis, greater in the dorsal than in the lateral columns; the
DEGENERATION OF THE SPINAL CORD
83
proliferated neuroglia is dense and compact, and in no place reti¬
culated or vacuolated as it is in subacute combined degeneration
of the cord. The sclerotic areas contain here and there pale
inflated cells imbedded in them, which are evidently of neuroglial
origin.
The ventral horns, especially in the cervical enlargement,
have lost a considerable proportion of their large cells, and the
majority of those that persist are shrunken, rounded in outline,
and often contain an excess of pigment.
The histological changes in the wasted muscles are merely
those which characterise secondary atrophy of spinal origin.
Thus in a man 39 years of age, who, despite the absence of a
positive history, had almost certainly had syphilis (positive
Wassermann reaction), there developed during a period of nine
months before death a symmetrical bilateral spastic paresis
associated with extensive muscular wasting and evidence of
disease of the dorsal columns of the spinal cord—loss of the sense
of position, &c. He also presented progressive mental deteriora¬
tion, small and irregular pupils which reacted sluggishly or not
at all to light, sphincter trouble, dysarthria, and dysphagia. The
post-mortem examination of the nervous system revealed chronic
syphilitic leptomeningitis over the brain, with but little change
in the cerebral cortex, a combined degeneration of the dorsal and
lateral columns of the spinal cord, and a primary atrophy of the
motor cells of the ventral horns.
In the ventro-lateral columns the disease involved both the
crossed and direct pyramidal tracts, and presented the characters
of a true system degeneration, as it was only the fibres of these
tracts that were involved, and their distal portions were evidently
affected earliest and most severely. In the dorsal columns
the disease was also systemic; it is true it involved the cornu-
commissural zone in some regions, but as Collier and Buzzard and
others have shown, this region contains exogenous fibres. It was
not due to degeneration in bulk of the dorsal roots, but apparently
picked out certain systems of fibres contained in them, and
especially those which ascend in the dorso-median columns.
Further, the degeneration of these fibres, as that of the pyramidal
tracts, increased in the ascending direction, that is, away from
their trophic cells. The degeneration in the ventral horns was
also selective, as the cordonal and commissural fibres that spring
84
GORDON HOLMES
from them were spared, though there was severe disease of their
motor radicular cells.
The degeneration in the intra-medullary portion of one
trigeminus root was probably only a chance occurrence and
unrelated to the disease; it was slight, and was such as is known
to occur in various marasmic states. Schuster has seen it in
amyotrophic lateral sclerosis.
In attempting to determine the nature of the disease it must
be admitted, in the first place, that it was syphilitic; the positive
Wassermann reaction in the serum, the presence of small pupils
reacting poorly to light, and the histological character of the
cerebral meningitis are all strong evidence in favour of this view.
When he was first seen as an out-patient the association of
progressive muscular wasting and a spastic paresis with irregular
and sluggishly reacting pupils and mental dulness suggested the
diagnosis of a combination of amyotrophic lateral sclerosis and
general paralysis of the insane, but while he was under observation
this diagnosis became less probable. And the histological examina¬
tion of the nervous system threw further doubt upon it. It is
true the affection of the ventral horns was similar to that found
in amyotrophic lateral sclerosis, but in this disease the degenera¬
tion of the ventro-lateral columns, as I have recently emphasised,
always extends beyond the areas occupied by the cortico-spinal
fibres, and the degeneration of these can be in almost every case
traced - to the cerebral cortex. The spino-cerebellar tracts, too,
which are so frequently affected in amyotrophic lateral sclerosis,
escaped in this case. Degeneration of the dorsal column has
been described in this disease by Charcot and Marie, Oppenheim,
Schuster and others, but it has been always slight, and in no way
resembled that in my case. It may be mentioned that pupillary
disturbances are occasionally seen with other symptoms that
suggest amyotrophic lateral sclerosis, and this diagnosis has been
confirmed post-mortem in such cases by Schlesinger and Probst.
It is much more difficult to dismiss the diagnosis of general
paralysis of the insane on both clinical and pathological grounds.
The poorly reacting pupils and the tremulousness of the lips and
tongue belong to the physical symptoms of this disease, but apart
from a primary progressive dementia the case presented no
characteristic mental symptoms. On the pathological side the
relatively little disease in the cerebx-al cortex is not in favour of
DEGENERATION OF THE SPINAL CORD
85
it, and such as was present is what might be expected to result
from the syphilitic leptomeningitis. Further, the cortical disease,
or the disturbance of cortical function secondary to the lepto¬
meningitis, would account for the mental deterioration. It is
well known that such pupillary disturbances as this case presented
occur in cerebral syphilis as well as in general paralysis and tabes.
The dysarthria and dysphagia may be attributed to the bilateral
spastic state, or perhaps to early bulbar disease.
Another question to be considered is if the degeneration of the
dorsal columns is tabetic. I believe this question must be answered
in the negative, although on superficial examination the lesions
of the dorsal columns resemble those of tabes dorsalis. On the
other hand, the facts that the dorsal roots are normal or almost
so, even in regions in which the disease is most intense, and that
Lissauer’s zones escape, are strong evidence against tabes. Further,
there is not the same amount of loss of myelinated fibres in the
dorsal horns and in Clarke’s columns that would be found with
tabetic degeneration of the dorsal columns of this severity.
With the pseudo-systemic combined degenerations—subacute
combined degeneration and that form that occurs in pernicious
anaunia—the case presented neither clinical nor pathological
resemblances, as the disease, especially in the ventro-lateral columns,
was restricted to certain tracts of fibres, and was not, as it is in
these cases, irregular and diffuse.
From these facts I am inclined to regard the case as a true
combined systemic degeneration of the dorsal columns of the cord
and of the cortico-spinal and spino-muscular neurones, which
developed on a syphilitic, or more probably on a parasyphilitic
basis, and only by its aetiology related to the more common post¬
syphilitic diseases, tabes dorsalis and general paralysis of the
insane.
It will be interesting to refer now to other recorded cases in
which muscular atrophy was associated with combined degeneration
of the cord.
In 1898 Pal described an amyotrophic type of combined
degeneration (“ Amyotrophisch-paretische Forme der combinierteu
Erkrankungen von Nervenbahnen—sogennante primare com-
binierte Systemerkrankung ”), and in his own case the symptoms
resembled somewhat those of the case described above. A woman,
45 years of age, in whom there was no suspicion of syphilis, com-
86
GORDON HOLMES
plained first of weakness of the left lower limb, later of the left
arm, and within six months all limbs were weak and wasted; the
proximal muscles were more affected than the distal. The pupils
were normal, but incontinence developed, and there was some loss
of sensibility to pain. The illness lasted nine months. The
pathological changes were, however, completely different from those
in my case, as there was diffuse degeneration in the ventro-lateral
columns, greatest in the areas of the pyramidal tracts, very similar
to that which characterises amyotrophic lateral sclerosis; in the
dorsal columns there was very little disease and practically no
ascending degeneration.
Mayer has also published a case which Strumpell has referred
to as post-syphilitic system disease. About eight years after
syphilitic infection the patient complained of pains in one leg,
disturbance of gait, and sphincter trouble. Two years later there
was spastic paresis of all limbs, with exaggerated reflexes, Argyll-
Robertson pupils, and dysarthria. Next year the spasticity had
diminished, the knee-jerks were feeble, and mental deterioration
had set in. Post-mortem examination revealed systemic degenera¬
tion of the pyramidal and spino-cerebellar tracts as well as of the
dorsal columns, and extreme atrophy of the cells of the ventral
horns, of Clarke’s column, and of the bulbar motor nuclei. In
this case the spastic symptoms predominated over the atrophic
till towards the end of the illness. The chief pathological differ¬
ence from the case reported here was the degeneration of the
spino-cerebellar tracts.
Sioli reports the case of a man who in 1874 had palsy of all
four limbs and sensory disturbances following a severe spinal
injury, from which he recovered completely. Five years later
there developed gradually progressive weakness of the legs and
dementia; the lower limbs were wasted and the electrical
reactions of their muscles diminished, the arms were weak, the
knee-jerks absent, and the pupils were unequal but reacted. He
afterwards found intense degeneration of the pyramidal and
direct cerebellar tracts, but in the upper dorsal segments the
disease of the ventro-lateral columns was more extensive. The
dorsal columns were severely affected in the lumbar region, but
in the higher segments there was chiefly ascending degeneration.
The ventral horn cells were also diminished in number.
Von Leyden, in his text-book on “Diseases of the Spinal Cord,”
DEGENERATION OF THE SPINAL CORD
87
refers to a similar case in which the symptoms set in six years
after syphilitic infection. The course of the illness was irregular
and intermittent; but the patient eventually presented great
weakness and wasting of the limbs, dysarthria, and mental dis¬
turbance. There was advanced degeneration of the pyramidal
tracts and some diffuse affection of the rest of the ventro-lateral
columns, though it appears from the illustration that the direct
cerebellar tracts escaped. In the dorsal columns the degeneration
fell chiefly on the columns of GolL The ventral roots and ventral
horn cells were atrophied.
In Henneberg’s case the illness began with weakness and
pain in the lower limbs, bulbar symptoms, and general wasting of
the muscles of the legs and hands. The course was very slowly
progressive, but seven years later had advanced to almost complete
atrophic palsy of the legs; there was also weakness of the lips,
tongue, and palate, and of the external recti muscles. He had also
lancinating pains, absent knee-jerks, extensor responses, sphincter
trouble, slight anaesthesia, and much loss of the sense of position.
The pupils were normal, but the mental state had deteriorated to
a moderate dementia. Histological examination showed degenera¬
tion of the pyramidal tracts which diminished cerebralwards, and
of the direct cerebellar tracts and the dorsal columns. In the
lumbar region it was chiefly the dorso-median and middle root
zones of the latter that were affected, while in the dorsal segments
almost the whole of the columns were involved, including the
ventral zone. The extra-medullary portions of the dorsal roots
and Lissauer’s tracts were unaffected. There was also extensive
atrophy of the cells of the ventral horns, of the bulbar motor
nuclei, and of Clarke’s column.
On comparing these oases with that which I record here
it will be seen that those reported by Sioli, Mayer, Henneberg, and
perhaps von Leyden’s, offer considerable clinical and pathological
resemblances. In all there were symptoms of a combined spinal
degeneration associated with extreme muscular wasting, and in all
four there was progressive mental deterioration. In one Argyll-
Robertson’s sign was present, and in another the pupils were
unequal but they reacted to light. Further, the illness followed
syphilitic infection in Mayer’s and von Leyden’s cases, but there
was no history of it in the other two.
The spinal lesions in these cases also resembled those of my
8
88
ABSTRACTS
case, the most prominent difference being degeneration of the
direct cerebellar tracts in the cases of Mayer, Sioli, and Henne-
berg, and possibly in von Leyden’s case too. There were, how¬
ever, certain differences in the type of the disease of the dorsal
columns, which possibly depended in part at least on the stage of
the disease in which the examination was made.
References.
Charcot et Marie. “Deux nouveaux cas de sclerose lateral© amyotrophique
suivis d’autopsie,” Archiv. de Neurolog., 1885, T. x., p. 1.
Collier and Buzzard. “The degenerations resulting from lesions of the posterior
nerve roots, and from transverse lesions of the spinal oord in man,” Brain ,
1903, Vol. xxvi., p. 559.
Henneberg. “Ueber einen mit Bulb&rparalyse komplizierten Fall von kom-
binierter Systemerkrankung,” Monatsschr. f. Psychiatr. u. Neurolog .,
1904, Bd. xvi., 8. 40.
Holmes. “ The pathology of Amyotrophic Lateral Sclerosis,” Rev. of Neurolog.
and Psychiatry 1909, VoL vii., p. 693.
Von Leyden. “ Klinik der Rlickenmarks-krankheiten,” Bd. ii. Berlin, 1875.
Mayer. “ Ueber die kombinierten Systemerkrankungen der RUokenmarks-
strange.” Wien und Leipzig, 1894. (Abst. by Pal.)
Oppenheim. “ Zur Pathologic der chronischen atrophischen Spinallahmung,”
Archivf. Psychiatr. 9 1892, Bd. xxiv., 8. 758.
Pal. “ Ueber amyotrophisch-paretische Formen der oombinierten Erkrankungen
von Nervenbahnen,” Wiener Med. Wochenschr ., 1898, Bd. xlviii., 8. 280.
Probst. “ Zur Kenntniss der Amyotrophischen Lateralsklerose,” Sitzungsber.
der Ala lamie der Wissenschaften zu Wien, 1903, Bd. cxii., Abth. 3, S. 683.
Schlesinger. “ Zur Kenntniss atypischer Formen der Amyotrophischen Lateral¬
sklerose mit bulbarem Beginne,” Arb. a. d. Neurolog. Institute Wien, 1900,
Bd. vii.
Schuster. “ Poliomyelitis anterior chronica mit Betheilung der hinteren Wurzeln
und der Burdach’schen Strange,” Neurolog. Centralbl., 1897, Bd. xvi., S. 342.
Sioli. “ Ein Fall von combinierter Erkrankung der RUckenmarks- Strange mit
Erkrankung der grauen Substanz,” Archiv f. Psychiatr., 1881, Bd. xi., S. 693.
abstracts
ANATOMY.
HISTOLOGY OF THE SENSORY GANGLIA OF BIRDS. E. Victor
(59) Smith, Amer. Joum. of Anat., Vol. xiv., No. 2, Jan. 15, 1913, pp.
251-282 (40 figs.).
The material used in this important study consisted of the spinal
ganglia and the 5th, 9th, and 10th cranial ganglia of the chick,
duck, goose, and pigeon; spinal, 5th, 8th, 10th cranial of screech
ABSTRACTS
89
owl; 5th, 9th, and 10th cranial of turkey; and spinal sensory
ganglia of the sparrow. The fixatives were ammoniacal alcohol
and 5 per cent, formalin: staining was by Cajal’s silver reduction
method mainly: the ganglia of old birds stained more readily than
those of younger ones. The following is a shortened account of
the author’s long summary: (1) The sensory ganglia of birds vary
in size somewhat in proportion to size of bird. In individuals
the Gasserian is the largest, then come the brachial, vagus, lumbo¬
sacral, the other spinals, and last, the glosso-pharyngeal. The
brachial ganglia are relatively large in birds that use their wings
much. (2) In the larger ganglia the cells are most numerous
about the periphery; the smaller ganglia show no definite cell-
groupings. (3) The size of the ganglion cells is in a measure
proportional to size of bird. The cells of each ganglion usually
vary considerably in size. (4) In the brachial ganglia of owl and
mallard duck the cells form two classes, large and small: the
large are much the less numerous. (5) The larger nuclei are
usually found in the larger cells. In the small birds the nuclei
are larger in proportion to size of cells than in large birds. (6) The
cells are usually rounded or elliptical: a few are pyriform, club-
shaped, or irregular: irregularities are commoner in older birds.
Lobulated cells (well figured) are common in the 5th and 10th
cranial of owl, and less common in the same ganglia of mallard
duck. (7) In adults unipolar cells predominate: their peripheral
branch is the larger. (8) In embryos the cells are bipolar: they
begin as oppositi-polar, and show gradations up to the unipolar
condition; in chick-embryos many intermediate forms are present.
(9) Initial glomeruli and implantation cones are infrequent, except
in 5th and 10th cranial ganglia of owL (10) The Gasserian of the
chick shows a remarkable coiling of the central axis of the peripheral
process, the sheath not being affected. (11) The ganglion cells of the
old hen show many vacuoles, and a less plump condition than those
of younger fowls: they show also a larger number of protoplasmic
slings and fenestrations: the latter are complicated in old hens,
simple in younger ones. (12) Fine accessory processes, terminating
within the capsule, some with and some without end enlargements,
are present in the Gasserian of the old hen, and less frequently in
owl and other birds. (13) Pericellular networks are especially
well seen in the vagus ganglion of the old hen, and also of owl.
(14) The chick’s Gasserian cells show a close-meshed, perinuclear
network. (15) The sensory ganglion cells of birds are surrounded
by connective-tissue sheaths, in which are eliiptically-shaped
nuclei: these are specially numerous in goose and duck; the
ganglia show also very many mantle-like nuclei in the intercellular
spaces. (16) No true multipolar cells were observed in the
sensory ganglia. (17) All the ganglia studied showed non-medul—
90
ABSTRACTS
lated fibres from the sympathetic; sometimes the fibres could be
traced to pericellular networks.
The author gives brief comments on the literature of the
vertebrate sensory ganglia, and “specially considers the salient
points of eleven important publications on those of birds.” His
figures are excellent. Leonard J. Kidd.
THE DEVELOPMENT OF THE PROOTIO HEAD SOMITES AND
(60) EVE MUSCLES IN CHBLYDRA SERPENTINA. C. E.
Johnson, Artur. Joum. of Anat ., VoL 14, No. 2, Jan. 15, 1913,
pp. 119-186 (24 figs.).
Apart from its intrinsic value, this paper is of special interest in
that the only previous work on the development of the head
somites of Chelonia known to the author is that of Filatoff (1907)
on Emys lutaria. The latter paper and that of Coming (1900)
contain the most complete account previously published on the
development of the eye muscles of reptiles. The present paper
has, among its figures, many excellent drawings of wax reconstruc¬
tion models. The youngest embryo studied was one of 2 mm.
with 5 segments, but it showed no differentiation of the dorsal
mesoderm in the prootic region which might indicate a possible
somite area. But in the next stage studied, that of a 3 5 mm.
embryo (10 segments), such differentiation was evident. For the
development of the head somites the stages studied ranged from
this one up to one of 8 mm.; for the development of the eye
muscles, stages from one of 9 mm. up to one of an embryo with
a carapace length of 8 - 5 mm. The author uses the convenient
terms oculomotor, trochlear, and abducent muscles to denote the
muscles supplied by the third, fourth, and sixth nerves respectively.
A.—The Head Somites.
(1) The first (pre-mandibular) prootic head cavity or somite
arises as a lateral outgrowth from the antero-dorsal wall of the
foregut: after certain later changes, fully described, it will give
rise to the anlage of the oculomotor muscles. (2) The second
(mandibular) somite arises in the dorsal mesoderm at the side of
the neural tube, just below and slightly anterior to where the
trigeminal ganglion later appears; it forms later the anlage of
the trochlear muscles: part of this muscle-mass is closely associated
with the maxillo-mandibular musculature, and probably undergoes
regression later: the remainder becomes later the superior oblique
muscle. (3) The third (hyoid) somite arises in the dorsal mesoderm,
close to the ventro-lateral side of the hind-brain, between the
location of the facio-acoustic and the trigeminal ganglia, but nearer
the latter.
ABSTRACTS
91
B.—The Eye Muscles.
(1) The first to be laid down are the abducent muscles: but
the retractor oculi is the last eye muscle to reach its definite adult
position. The Nervus Abducens first appears in the 9 mm. stage,
but is not connected with its muscles till the 10 mm. stage.
(2) The musculus obliquus superior grows forward as a stream of
cells from the dorsal portion of the mesenchymal cell-mass which
results from the second head somite. It remains connected for
a long time with the ventral portion of that mass: later it separates
from it, and its insertion to the globe is effected soon after the
11 mm. stage. The Nervus Trochlearis reaches the muscle
relatively late, i.e., shortly after the 11 mm. stage. (3) Of the
oculomotor muscles the first to appear is the Obliquus Inferior
(9 mm. stage), but it is the last to receive its nerve supply. The
Rectus Superior arises soon after it. The Rectus Inferior and
Medialis (Internus) are the last of the eye muscles to begin their
development: they arise from a common anlage in the 10 mm.
stage, and each receives its nerve branch in the 11 mm. stage.
In connection with the origin of the sixth and third nerves,
Johnson points out that in Chelydra (the snapping turtle) the
sixth nerve does not arise in continuity with the developing
muscles as Filatoff claims for Emys: its connection with the
muscles is effected later than its origin from the brain. So, too,
the third nerve, when first found in Chelydra, has no connection
with the first head somite, but could be readily followed to the
neural tube. In the 10 mm. stage, where the ciliary ganglion
appears as an accumulation of cells at the distal end of the third
nerve, that nerve has still no connection with its muscles: but at
the 11 mm. stage it extends beyond the ciliary ganglion, and
connects with the superior, inferior, and medial recti muscles.
Later it connects with the inferior oblique muscle, and eventually
becomes separated from the ciliary ganglion except for a branch
which forms the radix brevis of that ganglion.
Leonard J. Kidd.
CHROMAFFIN ELEMENTS IN THE 0ABDIOOERVICAL REGION
(61) OF CERTAIN LIZARDS. (Elements chromafflns dans la region
cardio-cervicale de (tuelques sauriens.) L. de Gaetani, Arch.
Ital. de Biol., lviii, F. 1, Nov. 15,1912, p. 28.
Trinci has recently described a cardiac and a carotid paraganglion
in reptiles ( Monit. Zool. Ital., xx., 1909). De Gaetani has made a
careful study of the cardiac and cervical regions of Lacerta viridis
and muralis. Some of his material was fixed with absolute alcohol,
and stained with thionine; some with Wiesel’s mixture (10 parts
of KBr 5 per cent, 20 parts of formalin 10 per cent., 20 parts
92
ABSTRACTS
distilled water), and stained with toluidine blue and safranin, or
with haematoxylin Delafield and eosin. He finds in lizards a cardiac
paraganglion in the form of diffuse groups of chromaffin cells in
the intra-pericardial portion of the walls of the arteries, and
disseminated groups in the neighbouring connective tissues. The
carotid paraganglion is in the region of the bifurcation of the
common carotid artery, and clearly forms a connecting link with
the carotid gland of birds and mammals. Chromaffin elements are
also present, either isolated, or in small groups disseminated in the
cardiac and cervical regions, and are in relation with the vascular
walls and possibly with the ramifications of the sympathetic:
these chromaffin cells are of various shapes—oval, rounded, or
sometimes elongated: they are enclosed in the adventitia of the
vessels: in size they resemble erythrocytes. Phaeochrome cells
are enclosed within the intimate structure of the cardiac nerve-
ganglia. The writer points out that his observations correspond
almost entirely with the most recent work of Trinci on the cardio-
cervical chromaffin system of lizards (Arch. Ital. di Anat. e. di
Embryol., x., Feb. 15,1912). Leonard J. Kidd.
THE ARTERIAL LESION IN OASES OF "CERVICAL” RIB.
(62) T. W inoate Todd, Joum. Anat. and Physiol, Vol. xlvil, Jan. 1913,
p. 250.
The vascular symptoms occurring in cases of so-called cervical rib
are not mechanical in origin, but are trophic in character and are
caused by paralysis of the sympathetic fibres passing to the
vessels. The same nerve which supplies the skin and muscles
supplies the vessels, and hence trophic changes occur in the same
area in either vessels or muscles or skin. A. Ninian Bruce.
ABNORMAL CRANIA — ACHONDROPLASTIC AND ACRO-
(63) CEPHALIC. Arthur Keith, Joum. Anat. and Physiol ., Vol.
xlvii., Jan. 1913, p. 189.
In this paper it is pointed out that the main lesion in achondro¬
plasia, so far as pertains to the skull, is an arrested growth of the
bones entering into the formation of its posterior fossa. The
nature of the arrest is due to a passive condition of the cartilage
cells bordering the line of ossific growth. The passive behaviour
of the cartilage cells is probably due to the absence of an element
secreted by one of the ductless glands.
In contrast to the cranial form seen in achondroplasia are the
conditions desoribed here as opisthocephaly and acrocephaly. All
the facts of abnormal cranial forms cannot be satisfactorily
explained by postulating any abnormal development of the amnion
ABSTRACTS
93
or of amniotic pressure, they can only be explained by supposing
there is a disturbance of those factors which regulate growth:
so far as we know these are the internal secretions or hormones.
A Ninian Bbuce.
PHYSIOLOGY.
DEGENERATION AND REGENERATION OF NERVE FIBRES.
(64) S. Walter Hanson, Jour, of Comp. Neurol ., Vol., xxil No. 6,
Dec. 16, 1912, pp. 487-646 (29 figs.).
This paper is based on experiments in which the sciatic nerve of
adult dogs was divided in the upper part of the thigh: in some
cases the ends were allowed to retract: in others a stretch of
1 cm. was removed and retraction allowed: in others, without
resection of any of the nerve, the two ends were approximated
with sutures. The dogs were kept for from one to thirty-five
days: at autopsy a short stretch of the proximal stump, and a
longer stretch of the distal stump, together with the intervening
scar, was removed. The pyridine-silver modification of Cajal’s
method was used. Ranson gives the results in detail under the
following headings:—
A.—Early Changes in the Distal Stump.
1. Degeneration of the medullated and the non-mcdullated
fibres, and in each case formation of nucleated protoplasmic
bands; these changes were studied at a distance of at least
5 mm. from the cut surface.
2. Abortive autogenous regeneration occurs in the immediate
neighbourhood of the cut surface: both medullated and non-
medullated fibres are thus affected: it occurs very early, so that
it is well advanced in both kinds of fibres one day after operation:
but many fibres do not show regenerative changes, but undergo
an uncomplicated degeneration throughout their entire extent.
Ranson looks on these as probably the more susceptible fibres:
they are well advanced in degeneration by the fourth day: “ the
more resistant is the fibre, the greater is the reaction near the
lesion, and the slower the fragmentation of the remainder of the
distal stretch.”
B.—Early Changes in the Proximal Stump.
Changes in the axons can be noticed within twenty-four hours
after the lesion. They consist of the formation of fine branches,
and the re-arrangement of the neuro-fibrils of the old axons to
form the most complicated networks. These changes are limited
94
ABSTRACTS
to the immediate neighbourhood of the cut surface, and “are
too varied to summarise in detail.” These were also seen by
Perroncito, and confirmed by others who have used the Cajal
technique.
1. The changes in the non-medullated fibres comprise (a)
early abortive regeneration; ( b ) cellulipetal (retrograde) degenera¬
tion ; (c) formation of new axons.
2. The changes in the medullated fibres are: (a) formation
of a zone of reaction; ( b) fibrillar dissociation; (c) early branching
of the axons close to the lesion; ( d ) formation of lateral branches
at some distance above the lesion; (e) formation of fibre-bundles
and skeins.
C.—Mechanism of Regeneration of Nerve Fibres.
(1) Proliferation of axons in central stump: can be seen
within twenty-four hours after the lesion. (2) Penetration of
the new axons through the scar. (3) Utilisation of the proto¬
plasmic bands as pathways for the new axons in the distal stump.
Ranson found that while the majority of the non-medullated
fibres in the distal stump degenerate very early, a few such,
which he believes to be sympathetic fibres, may persist for two
or three weeks, but they all undergo degeneration before the end
of the fourth week. He shows that “that portion of a fibre
which is separated from its tropic centre does not die at once. It
continues to live for two or three days, and possesses sufficient
vitality to cause a re-arrangement of its fibrils into a complicated
reticulum, and to give rise to lateral branches.” He has convinced
himself that all the nerve-fibres in the scar are outgrowths of
central axons. “ No cases were studied in which sufficient time
had elapsed for complete regeneration of the nerve. He expects
to make other experiments on young dogs to determine the
structure of a fully regenerated nerve, and especially the relative
proportion of medullated and non-medullated axons which it
contains.” Leonard J. Kidd.
CONTRIBUTIONS TO THE HISTO-GHBMISTK7 OF NERVE: ON
(65) THE NATURE OF WALLERIAN DEGENERATION. Hbnry
O. Fbiss and W. Cramer, Proc. Roy. Soc. t Series B, Vol. 86,
No. 8585, Feb. 7, 1913, p. 119.
Cats’ nerves removed from the body and kept at body temperature
in Ringer’s solution or in blood serum exhibit certain changes in
the myelin sheath as studied in osmic acid preparations, which
resemble the early changes exhibited by nerves degenerated for
about equal lengths of time in the living. These changes are
slowed but not inhibited by lower temperatures. In nerves kept
ABSTRACTS
95
in liquid paraffin, the changes are not seen to occur to any great
extent. There is one difference in the appearance of nerves
degenerated in vivo from that of nerves kept in vitro : the broken-
down myelin stains less clearly in the latter condition, and thus
has a flaky appearance. This same flaky staining was noted in the
living when the circulation of a nerve was cut off locally.
Authors’ Abstract.
ON THE ACTION OF INTRAVENOUS INJECTIONS OF SALINE
(66) EXTRACT OF CHOROID PLEXUSES ON THE BLOOD-
PRESSURE AND FORMATION OF CEREBRO SPINAL FLUID.
(Sopra l’azione delie iniezioni endovenose di estratto salino di
plessi coroidei solla pressione sanguigna e sulla formazione del
liquido cefalo-rachidiano.) N. del Priobb, Riv. ital. di Neuropat.,
Ptichiatr., td Elettroter., 1912, v., p. 494.
A record of experiments on dogs, the results of which agreed with
those of Halliburton (v. Review , 1911, ix., p. 504). The injections
were not toxic for the animals and were always followed by a fall
of blood-pressure. In the dogs in which a cerebro-spinal fistula
was made, fall of blood-pressure always accompanied the first
injection and rarely the succeeding ones. J. D. Rolleston.
THE ACTION OF THE VAGUS ON THE HUMAN HEART. W. T.
(67) Ritchie, Quart. Joum. Med., 1912, vL, p. 47.
Compression of the right vagus may depress the rate and strength
of the auricular beats, may prolong auricular systole, and may
depress the conductivity of the auriculo-vontrieular bundle system.
The inhibitory effects ensue gradually, and usually pass off gradu¬
ally while compression of the nerve is still being maintained.
Compression of the right vagus did not depress the excitability
of the auricular muscle when in fibrillation or in flutter. In
cases of complete auriculo-ventricular dissociation, the vagi had
no apparent influence on the ventricles. In hearts with a normal
rhythm, however, vagus compression may depress the rate and
contractility of the ventricles, and in rare instances may prolong
the duration of ventricular systole. The depression of ventricular
rate is usually proportionate to the degree of auricular retardation.
In some instances the auricles escape from vagus inhibition
before the ventricles; in others ventricular standstill may terminate
by the occurrence of idio-ventricular beats. The inhibitory effects
of left vagus compression are usually less effective than those of
right vagus compression, and the latter are almost uniformly the
reverse of those induced by atropin. Author’s Abstract.
96
ABSTRACTS
THE ACTION OF ADRENALIN, PABAGAN G LIN, AND HYPO
(68) PHYSIN ON THE KIDNEY. (Action de l'adrtaaline, de la
paragangline, et de l’hypophysine stir le rein.) P. Pentimalu
and N. Quercia, Arch. Ital. de Biol., lviii, F. 1, Nov. 15,1912, p. 33.
These experiments were performed on the isolated kidneys of
dogs and rabbits by Sollmann’s method of artificial circulation,
which has the great advantage that a constant pressure of the
fluid circulating in the kidney is always maintained. The records
of eight experiments are given: the writers mention that they
failed to find any published work on the influence of paraganglin
on the kidneys. Conclusions —(1) Adrenalin and also paraganglin
and hypophysin have a strong vaso-constrictor action on the
kidney; in the case of adrenalin, if the dose be sufficiently large,
the circulation in the kidney is entirely arrested; the writers thus
confirm Jonescu’s opinion that it exercises almost a specific action
on the renal vessels. (2) The vaso-constriction, if it be not
excessive, begins to diminish at the end of a certain time, even
though the fluid containing the vaso-constrictor substances con¬
tinues to circulate in the kidney. The return of the vessels to the
primary condition may be interpreted as a fatigue phenomenon of
the muscle cells and fibres. (3) Glomerular filtration behaves in
a similar fashion; when vaso-constriction is marked, the fluid
ceases to traverse the glomeruli: when it diminishes, filtration is
restored. (4) Of these three substances tested, hypophysin, while
it produces vaso-constriction, seems to have the least influence on
renal secretion. (5) These three substances have no diuretic
action; if sometimes diuresis occurs, it is probably due to increase
of blood-pressure; one cannot therefore believe that they have a
stimulant action on the kidney. (6) The results obtained with
adrenalin agree with the hypothesis of Schur and Wiesel that
certain forms of nephritis depend on hyper-production of adrenalin;
one can understand that the marked and protracted renal vaso¬
constriction caused by the circulation in the blood of an excess of
adrenalin may set up grave functional and anatomical renal
changes. Leonard J. Kidd.
PATHOLOGY.
GENERAL PARALYSIS WITH AMYLOID DEGENERATION OF
(69) THE BRAIN. (Paralysie gdndr&le avec d6g6n6rescence amyloids
da cerve&u.) Mionot and Mabchand, L'Enctphale, June 10,1912,
p. 497.
Apparently this is the first case on record in which amyloid
degeneration of the brain has been recorded. It has been observed
in the ganglia of the sympathetic system. In the present instance
ABSTRACTS
97
this special form of degeneration ensued on the chronic inflamma¬
tion of a diffuse meningo-encephalitis. The change commenced
round the blood vessels, and spread through all the cortex, forming
irregular plaques. Only the grey matter was involved. There
was no neuroglial reaction in the neighbourhood of the degenerated
areas. Nerve cells and fibres atrophied and disappeared as the
process advanced. S. A. K. Wilson.
SYRINGOMYELIA WITH HYPERPLASIA OF THE CONNECTIVE
(70) TISSUE AND WITH STRIPED MUSCLE FIBRES IN THE
CORD. (Syringomyflie, hyperplasia du tiara conjonctif, fibres
musculaires strides dans la moelle.) Amdb£ Thomas and Quercy,
Nouv. Icon, de la Salpetriere, Sept.-Oct. 1912, p. 364.
This case, described in great detail, is worthy of notice for several
reasons. In the central part of the cord was a gliomatous forma¬
tion through almost the whole of its vertical extent. The glioma
was excavated, and its cavity lined by a thick carpeting of
connective tissue, which was directly continuous with the
thickened meninges along several lines. The central canal was
replaced by scattered ependymal cells, in some places massed
together. At one or two levels there was no anterior commissure,
and the cavity was directly continuous with the anterior median
fissure. Above all, scattered throughout the cavity, or embedded
in its diverticula, were unmistakable cross-striated muscle fibres,
which are well reproduced in photographs.
The authors provide an interesting discussion on the presumed
embryonic origin (from mesodermic myotomes) of these fibres
at a very early stage in foetal development. They also emphasise
the sclerotic nature of the syringomyelia, and attribute to the
gliomatous formation a secondary importance.
S. A. K. Wilson.
THE IDEAL LESION PRODUCED BY JUDICIAL HANGING.
(71 )- F. Wood-Jonbs, Lancet, Jan. 4,1913, p. 63.
From a series of five sets of cervical vertebrae the author found
that the odontoid process played no part in producing death, but
that the posterior arch of the axis was snapped clean off and
remained fixed to the third vertebra, while the atlas, odontoid
process, and anterior arch of the axis remained fixed to the skull.
This lesion is produced by the violent jerk which throws the man’s
head suddenly backwards and snaps his axis vertebra. Death is
instantaneous, as the spinal cord is completely severed by the
fracture of the neck. A. Ninian Bruce.
98
ABSTRACTS
CLINICAL NEUROLOGY.
THE MECHANISM OF KERNIG’S SIGN AND OF NHRI'S SIGN.
(72) Noica, Paullan, and Sulica, L'Enciphale , Aug. 10,1912, p. 118.
The authors conclude that N4ri’s sign and Kemig’s sign are
identical, and that the phenomenon—flexion of the knee—is a move¬
ment of defence provoked by forced extension of the tendons of
the hamstrings in patients whose sensibility to movements of
defence is pathologically increased. S. A. K. Wilson.
THE ASSOCIATIONS OF TUBERCULOSIS WITH DISORDERS OF
(73) THE NERVOUS SYSTEM. A. J. Whiting, Practitioner, Vol. xc.,
Jan. 1913, p. 269.
The author divides tuberculous disease of the nervous system
into two groups: (1) a larger, in which the mechanical factor
is predominant, and (2) a smaller, in which the toxic factor is more
important. The toxic effects may be subdivided further into
those affecting: (a) the higher brain centres, causing psychical
changes of optimism or depression, ( b) the middle level centres
producing epileptiform or tetanoid spasms, (c) the lower or bulbar
centres, leading to tachycardia, dyspnoea, and vasomotor changes,
( d ) the spinal cord, causing myoidema and muscular wasting, and
(e) the nerves, resulting in changes in motor power, sensibility,
and in the reflexes.
A brief discussion then follows, attention being specially paid
to tuberculous meningitis. A. Ninian Bruce.
INTERCOSTAL ZOSTER IN TABES. (Zona intercostal chez one
(74) taMtiq.no.) Desqueeoux, Jour, de Mid. de Bordeaux , 1912, xlii.,
p. 771.
A case of typical herpes zoster in a tabetic woman, aged 42.
Desqueroux regarded it as an instance of true zoster, and not of
a zosteriform eruption in tabes. The future history would decide
the question, the absence of any recurrence indicating true zoster.
J. D. Rolleston.
SYMMETRICAL PURPURA OF LEFT ARM AND ZOSTER OF
(75) RIGHT ARM. (Purpura radiculaire du bras gauche et zona da
bras droit symfetriques.) H. Gougerot and Thibaut, Arch. 'd.
mal. d. coeur, d. vaiss. et d. sang., 1912, v., p. 726.
The patient was a man, aged 29, with advanced pulmonary
tuberculosis, in which lesions predominated at the right apex,
ABSTRACTS
99
and commencing tuberculous peritonitis with probable hepatic
involvement. The purpuric diathesis had already been manifested
by the appearance of a few purpuric spots on the lower limbs,
when zoster of the right arm developed, occupying the area of
the fifth and sixth cervical roots. Four days after the onset of
the zoster a purpuric eruption with a few abortive herpetic lesions
appeared on the left arm, with the same distribution as the zoster
on the right arm.
The case presents the following features of interest:—
1. It illustrates the frequency of purpura in tuberculous sub¬
jects (v. Review, 1912, x., p. 232).
2. It illustrates the frequency of zoster in the tuberculous,
though it cannot be regarded as an argument in favour of the
tuberculous nature of herpes zoster. Everything, on the contrary,
proves that this is an instance of a specific infection being super¬
imposed upon tuberculosis.
3. It confirms the views of Gougerot and Jalin (v. Review,
1911, ix., p. 25) adopted by Minet (ibid., 1912, x., p. 133) on
herpetic immunisation.
4. It illustrates the relation between zoster and purpura,
purpura replacing herpes in the area affected by abortive zoster.
J. D. Rolleston.
ON THE ETIOLOGY OF TABETIC ARTHROPATHIES. (Ueber
(76) die Aetiologie der tabischen Arthropathies.) K. Stakoardt,
Arch./. Psychiat., Bd. 49, H. 3, 1912.
The author reports the clinical history and pathological examina¬
tion of a case of tabetic arthropathy which came under his own
observation. He emphasises the presence of a localised inflam¬
matory process in the synovial membrane with the presence of
plasma cells and lymphocytes. He concludes that there is a
chronic non-gummatous syphilitic process at the basis of the tabetic
arthropathies, and rejects the theories of a trophic origin.
C. Macfie Campbell.
ACUTE SYPHILITIC MENINGO ENCEPHALITIS IN TABES.
( 77 ) (La mdningo-encdphalite syphilitique aiguS des tabdtiques.)
Claude, L'Enctphale , Ann. vii., No. 12, Dec. 10,1912, p. 417.
Mental symptoms supervening in the course of tabes have not
infrequently been described. Occasionally it has been clear that
these have not been due to an incipient general paralysis, but have
been associated with a more purely syphilitic process. The effort
has also been made to differentiate the actual type of psychosis
from the ordinary type of dementia paralytica. The author
100
ABSTRACTS
reports a fresh instance, which is well worked out, both clinically
and pathologically. In a typical case of tabes, of some four years’
duration, there was an “ attack ” without loss of consciousness, in
which the patient was seized with general trembling, weakness,
giddiness, and inability to stand. Some three days later his be¬
haviour was observed to have more or less suddenly become eccentric:
he began to collect matches and wooden boxes and to glue them
together, for “inventions” which one day his family would see,
&c. This mental state lasted for, at the most, five days. About
ten months later he began to get agitated, to suffer from ideas of
culpability, persecution, &c.: he became depressed and occupied
with suicidal ideas. During the fortnight before his death there
were alternations of excitement, with agitation and polymorphic
delusions.
The cord was typical of tabes. A very minute examination of
the brain was made, and the following lesions noted:—
(1) Sclero-gummatous nodule, a single small isolated specimen,
at the posterior end of the second right frontal convolution.
(2) Old meningeal thickenings and adhesions, mostly frontal,
small in dimensions and very localised.
(3) Foci of subcortical haemorrhagic softening, in definite
association with arterial lesions and accompanied by inflammatory
reactions in the immediate neighbourhood, contrasting with the
integrity of the rest of the brain substance.
(4) Circumscribed foci of cedematous encephalitis, with inflam¬
matory reaction but no necrosis.
All these lesions were notably limited, whereas the great mass
of the encephalon showed no meningeal reaction, no defect of
cortical cells, no vascular alterations; in short, none of the signs
of general paralysis. The diagnosis was syphilitic meningo¬
encephalitis, with encephalomalacia from syphilitic endarteritis.
The clinical symptoms, mental in nature and coming in “ attacks,”
may be regarded as analogous to the motor central phenomena
seen in tabes, e.g., hemiplegia. S. A. K. Wilson.
PSBUDOMENINOOOOOOnS AND PARAMENINGOCOCCUS MENIN-
(78) GITI8. (Mdningites k pseudomdningocoques et It paramdnin-
gocoques.) A R. Dujabbio de la Rivi&be, Thtses de Paris , 1912-13,
No. 86.
A bacteriological and clinical study of pseudo-meningococcus
and parameningococcus meningitis. Under the former are included
cases due to JDiplococcus crassus, D. siccus, D. flames, gonococcus,
and the polymorphous coccus recently described by Chevrel and
Bourdini6re (v. Review, 1913, xi., p. 37). J. D. Rolleston.
ABSTRACTS
101
PURULENT TYPHOID MENINGITIS. ONSET WITH SYMPTOMS
(79) OF ACUTE OTITIS. (Mdningite pnrnlente Aerfhienne, d&rat
par symptdmes d’otite aiguB.) H. Lbmixrrk and E. Joltrain,
Bull, et mfrn.. Soc. mid. H6p. de Paris, 1912, xxxiv., p. 681.
A man, aged 47, suddenly developed symptoms of acute left otitis,
rapidly followed by meningitis. The turbid cerebro-spinal fluid
yielded a pure culture of typhoid bacilli, which were also found in
the blood. Death occurred on the seventh day. Post mortem,
suppurative meningitis and the early intestinal lesions of typhoid
fever were found.
The writers have found only six similar cases of primary typhoid
meningitis. In three (Southard and Richards, v. Review, 1909, vii.,
p. 200; Milligan, and Nieter, ibid., 1908, vi., p. 491) the diagnosis
was only made at the necropsy. In the cases of Stuhmer {ibid.,
1911, ix., p. 267), David and Speik {ibid., p. 326), and Bergd and
Weissenbach {ibid., p. 680) the diagnosis was made by lumbar
puncture, and the patients recovered. J. D. Rolleston.
GLYCOSURIA IN TUBERCULOUS MENINGITIS. R. S. Frew and
(80) A E. Gabbod, Lancet, Jan. 4,1913, p. 16.
Glycosuria occurs in about one-third of all cases of tuberculous
meningitis, and is most apt to occur during the last days of the
patient’s life. It probably owes its origin in the cerebral lesion,
and belongs to the nervous group, but the authors were not able
to determine to what special lesion or other factor its occurrence
is due. A. Ninian Bruce.
CASE OF POST-DIPHTHERITIC PARALYSIS AND HEMIPLEGIA
(81) L. Humphry, Proc. Roy. Soc. Med., 1911, iv. (Child. Sect.), p. 196.
A boy, aged 11 years, had diphtheria on December 12, 1909.
Dec. 27th, paralysis of palate, weakness of legs, and loss of
knee jerks; 29th, left hemiplegia First seen by Humphry on
February 8, 1910, when left hemiplegia of face, tongue, arm and
leg was found associated with external strabismus and defective
vision of right eye. May 18th, right pupil does not react to
light, right optic atrophy. July 1911, patient can walk, some
spasticity of left arm and leg, reflexes increased and Babinski on
left side; face normal, external strabismus right eye, defective
vision and optic atrophy.
The condition was probably due to a clot obstructing the
Sylvian artery and the ophthalmic branch. J. D. Rolleston,
102-
ABSTRACTS
HEMIPLEGIA FOLLOWING SO ABLET FEVEB IN THE PUEB-
(82) PEBIUM. (H&nipl6gie aprte scarlatine chez one femme en
conches.) Issailo vitch-Dcsciau, Prase mid., 1912, xx., p. 1025.
A woman, whose age is not stated, gave birth to a healthy child by
normal labour. She got up on the ninth day, but on the next she
became feverish, and a scarlatinal rash appeared the next day.
She had no sore throat. On the third day of disease right
hemiplegia and aphasia developed. Gradual improvement
occurred, and complete recovery took place within a few months.
(The evidence of the disease being scarlet fever is by no means
convincing, and the writer is certainly mistaken in attributing a
good prognosis to post-scarlatinal hemiplegia (v. Review, 1908, vi,
p. 530. J. D. R.).) J. D. Rolleston.
HEMIPLEGIA IN TYPHOID FEVEB. J. M. Pearson, Canad. Med.
(83) Assoc. Joum., 1912, ii., p. 1120.
A man, aged 30, on the fourteenth day of a mild attack of typhoid
fever, developed left hemiplegia, followed by some difficulty in
swallowing. Death, preceded by repeated intestinal haemorrhage,
occurred on the twenty-fourth day of illness, and on the tenth
from the onset of the paralysis.
Necropsy:—Heart normal. Area of softening involving greater
part of right second and third frontal, and ascending parietal
convolutions, part of supra-marginal and angular gyri, and upper
part of temporo-sphenoidal lobe. Thrombosis of right middle
cerebral artery. J. D. Rolleston.
PEDUNCULAR AND BULBO PONTINE 8YNDBOMES IN TYPHOID
(84) FEVEB. (Syndromes p4donculaires et bulbo-protuberantiels an
eonrs de la fldvre typholde.) M. Collet, Thesa de Paris, 1912-13,
No. 77.
Peduncular and bulbo-pontine lesions in typhoid fever are
manifested by palsies which sometimes affect isolated nerves
of the peduncles, pons, or medulla, or several of these nerves
simultaneously. The palsies may be localised to the peduncular
and bulbo-pontine regions, but very frequently the bulbo-pontine
symptoms may appear in the course of ascending paralysis (v.
Review, 1906, iv., p. 291), or the peduncles, bulbo-pontine area,
and limbs may be affected simultaneously. The pathological
anatomy varies, in some cases the nerve centres, in others the
nerves, being affected by the typhoid bacillus or its toxines.
Peduncular and bulbo-pontine palsies are rare in typhoid fever.
Those occurring in the course of the disease are chiefly found in
ABSTRACTS
103
severe attacks, and are of bad prognosis. Those occurring in
convalescence generally end in recovery.
The thesis contains the histories of fourteen cases, including
a case of bilateral ophthalmoplegia reported by Lemierre, May,
and the writer. J. D. Rolleston.
BILATERAL OPHTHALMOPLEGIA IN TYPHOID FEVER. (Ophtal-
(85) mopldgie bilaterale au cours chine fldvre typhoids.) A. Lemierre,
E. Mat, and M. Collet, Bull, et mint. Soc. mid. H6p. de Parity
1918, xxziv., p. 697.
A gibl, aged 18 , on the forty-seventh day of a severe attack of
typhoid fever, was seized with headache, photophobia, and psychical
troubles, followed by paralysis first of the right, and five days
later of the left, oculomotor nerve. Spontaneous pain was present
in the lower limbs with hyperaesthesia of the calf muscles, and loss
of knee jerks. Death took place ten days after the onset of the
symptoms, the patient having had some difficulty in deglutition
two days before death. No necropsy. J. D. Rolleston.
OSTEITIS DEFORMANS OF THE CRANIUM SIMULATING
(86) HYDROCEPHALUS. (Ostdite deformans des os du crftne
simulant une hydrocdphalie.) J. Cables and Dor 6, Gaz. held, des
Set. mid. dt Bordeaux, 1912, xxxiii., p. 597.
The cranial deformity followed some cerebral disease of uncertain
nature at the age of 8 years. No symptoms of compression
resulted, and the condition was mistaken for hydrocephalus.
Death due to rupture of an aortic aneurysm occurred at the age of
54, when the condition was found to be an osteitis deformans
invading almost all the bones of the skulL The upper part of the
orbit was affected with resulting exophthalmus.
J. D. Rolleston.
ON THE PATHOLOGY AND PATHOGENESIS OF PRIMARY
(87) CHRONIC HYDROCEPHALUS. (Pathologie und Pathogenese
des prim&ren chronischen Hydrocephalus.) M. S. Mabgulis,
Arch. f. Psychiat., Bd. 50, H. 1,1912.
The author reviews the literature and reports the results of six
cases of primary chronic internal hydrocephalus. In addition,
four cases of secondary hydrocephalus were examined, two after
cerebro-spinal meningitis and two due to pressure in the posterior
fossa. The author reports his histopathological findings in
considerable detail. The anatomical picture in primary chronic
internal hydrocephalus consists in a hyperplasia of the ependyma,
in the formation of diverticula and tufts in the ventricle and a
9
104
ABSTRACTS
proliferation of the vessel sheaths, and in the formation of a fibrous
lamella. The condition is frequently accompanied by syringomyelia
which represents merely a different localisation of the same
process. C. Macfie Campbell.
TRANSMISSION OF POLIOMYELITIS BY MEANS OF THE
(88) STABLE FLY (Stomoxys calcitrant). J. F. Anderson and
W. H. Frost, Lancet , Nov. 30,1912, p. 1502.
Two monkeys were inoculated intracerebrally with an emulsion
of the spinal cord of a monkey which had died from poliomyelitis.
These animals were then exposed until death to the bites of
several hundred stomoxys for about two hours daily, and three
fresh healthy monkeys were exposed daily for about two hours
to the bites of these same flies. These three monkeys all developed
quite typical symptoms of poliomyelitis seven, eight, and nine days
respectively from the date of their first exposure. These experi¬
ments confirm those of Rosenau that poliomyelitis may be
transmitted to monkeys by means of the stable fly.
A. Ninian Bruce.
MENTAL TORTICOLLIS. (Torticollo mentale.) C. Goria, Riv. ital.
(89) di Newropat ., PeichiaUr. ed Elettroter., 1912, v., p. 482.
A record of a typical case in a man, aged 24, with a review of the
literature. J. D. Rolleston.
THE IMPORTANCE OF GENERAL NUTRITIONAL DISTURB-
(90) ANCES IN THE DETERMINATION OF FACIAL PARALYSIS.
(Snr 1’importance des troubles de la nutrition gfo&ale dans le
determinisms de la paralysis facials.) C. Parhon, Soc. de Neurol,
de Paris , Nov. 7,1912, No. xv. ( Revue Neurol. y No. 22, Nov. 30,1912,
p. 619.)
Parhon has done good service in drawing attention to the need
for a study of patients, affected with facial palsy, from the side of
general nutritional disturbances, circulatory troubles, and exo¬
genous and endogenous intoxications. He mentions five personal
cases of facial palsy in: (1) a young pregnant woman with
albuminuria, eclampsia, and blindness; (2) an old woman, a case
of facial palsy, “ a frigore,” who had suffered for many years from
excessive anxiety and an hepatic affection; (3) a young woman
with badly compensated cardiac disease; (4) a glycosuric woman;
(5) a man who showed some signs of thyroid insufficiency (baldness
and the eyebrow sign). Parhon draws attention to the recent
finding of Marinesco aud Minca that thyroidectomy hinders nerve
regeneration: this observation has been confirmed by Walter.
ABSTRACTS
105
Parhon treated his second and his fifth cases with thyroid pastilles
and galvanism: both recovered, but case 2 showed the contracture
of the orbicularis which is so commonly met with in elderly
patients. Leonard J. Kidd.
SOME RARER MANIFESTATIONS OF PARASYPHILIS OF THE
(91) NERVOUS SYSTEM. A Rkad Wilson, Brain, Vol. xxxv.,
Part II., 1912, p. 163.
There is no doubt that the great majority of cases of tabes and
general paralysis of the insane are parasyphilitic nervous diseases.
There is evidence that at all events some cases of primary optic
atrophy, primary lateral sclerosis, and progressive muscular atrophy
are parasyphilitic too. In tabes and general paralysis there is
degeneration of certain neuronic tracts or groups; and degeneration
of precisely the same character in other neuronic groups produces
primary optic atrophy, primary lateral sclerosis, and progressive
muscular atrophy. Combinations of all three with tabes or general
paralysis of the insane, or with both, or amongst themselves, are
so frequent that it is difficult to withstand the conclusion that
their essential etiological factor is the same, more especially since
it is conceded that syphilis has a great affinity for the nervous
system. If it be allowed that the neuronic degeneration of primary
optic atrophy, primary lateral sclerosis, or progressive muscular
atrophy, when combined with that of tabes or general paralysis,
is due to syphilis, it cannot be denied that such degeneration,
occurring uncombined, may still be parasyphilitic. The Argyll-
Robertson pupil is recognised as a symptom of tabes and general
paralysis, in other words it is a parasyphilitic manifestation. It
is found also with primary optic atrophy, primary lateral sclerosis,
and progressive muscular atrophy. The author considers that, if
the question of antecedent syphilis and Wassermann’s reaction
were carefully investigated in all cases of primary optic atrophy,
primary lateral sclerosis, and progressive muscular atrophy, they
would be found to take their rightful place amongst the rarer
manifestations of parasyphilis of the nervous system (cf. Review,
1912, x., p. 491). A Ninian Bruce.
MOTOR AND SPEECH PARALYSIS DUE TO CEREBRAL ANGIO
(92) SPASM William Russbll, Lancet , Nov. 16,1912, p. 1349.
Angiospasm is a spasmodic constriction of' vascular channels, no
doubt mainly on the arterial side, and may be focal or general. It
is most common at or beyond middle life in persons with arterial
thickening or atheroma, and not necessarily showing heart feeble-
106
ABSTRACTS
ness. It usually affects the vessels in or above the internal
capsule, producing transient hemiplegia and aphasia. Several cases
of this nature are mentioned, and attention is drawn to other
similar references from the literature on the subject.
A. Ninian Bruce.
THE PATHS OF ENCEPHALIC INFECTION IN OTITIS.
(93) Christopher Tylor, Brain , VoL xxxv., Part II., 1912, p. 109.
This paper is based upon the post-mortem records of 644 cases
of intracephalic infection, including 267 of infective diseases of
the ear. Out of 49 cases the pneumococcus was present in 28
and the streptococcus in 9.
Infection through vascular channels appears to be responsible
for most cases of lateral sinus thrombosis, while vascular infection
is a cause of extradural and brain abscesses in a large number of
cases. Many cases of extradural abscess are due to disease of the
petrous bone, especially its posterior surface and tegmen; in those
cases where the bone is unaffected, the dura mater becomes
infected through a septic endophlebitis of a vein of the tympanic
mucosa extending to a vein of the dura. Cerebral and cerebellar
abscesses may be due to direct contact of the brain with diseased
dura mater: if perforation of the latter takes place, direct extension
to the'cerebral surface may occur; if no perforation occurs, the
disease may spread to the brain by infection of the veins in the
dura, with extension from them to the vessels of the pia arachnoid,
and from the latter to the interior of the brain.
Cerebellar abscess is also often secondary to infective labyrinth¬
itis, extension of the disease taking place along the nerve-sheaths,
or directly in the region of the posterior semicircular canal.
Leptomeningitis is either (a) secondary to a gross intracranial
lesion or bone disease, in which case it is due to the rupture of
an abscess into the intradural space, or to vascular infection from
the lateral sinus, abscess, or bone, as the case may be; or ( b ) to
labyrinthitis, with infection spreading along the nerve-sheaths,
or vascular infection from the middle ear direct.
Infection of the labyrinth is responsible for many cases of
cerebellar abscess and meningitis of otitic origin.
A. Ninian Bruce.
AURAL VERTIGO (NONSUPPURATIVE): A CLINICAL AND
(94) THERAPEUTICAL STUDY. R. Lake, Lancet , Dec. 14, 1912,
p. 1638.
The author classifies aural vertigo as follows :—
1. Peripheral causes: (a) chronic progressive middle-ear deaf¬
ness, ( l ) hemorrhage into labyrinth and embolism, (c) traumatism.
ABSTRACTS
107
2. Aural vertigo due to altered state of blood pressure:
(а) increased blood pressure, and ( b ) diminished blood pressure.
3. Aural vertigo due to general systemic causes: (a) leukaemia,
(б) occasional, (c) with ocular symptoms, ( d ) specific, (e) cerebral
anaemia.
He then discusses these in detail. A N ini an Bruce.
RHEUMATIC NEURITIS. (Contribution k l’<tude dec ntfvrites
(95) rhnmatismales.) R. Purest, L'icko mid. du Nord, 1912, xvi.,
p. 585.
A record of three cases. 1. A man, aged 35, developed neuritis
of the left arm six weeks after acute articular rheumatism. An
attack three years before had also been followed in convalescence
by the same sequlse. The lesion was manifested by very marked
motor and sensory disturbance. There was only slight diminution
of electrical excitability. Complete recovery took place in two
months under electrical treatment combined with salicylates.
No other cause for the neuritis could be maintained, such as
alcohol, syphilis, tubercle, or lead, and there were no stigmata of
hysteria.
2. A man, aged 58, subject to rheumatic attacks since the age
of 35, developed neuritis of the right upper limb, during an attack
of generalised articular rheumatism. In addition to motor and
sensory lesions, glossy skin was present. Complete recovery took
place in a month and a half under aspirin and galvanic currents.
3. A man, aged 55, subject to rheumatism since the age of
14, developed neuritis of the lower limbs during an attack of
rheumatism. Alcoholism in this case acted as a predisposing
cause. Rapid atrophy of the calf muscles ensued. The patient
was still under treatment. The prognosis was good, as there was
no RD. J. D. Rolleston.
GANGLIONIC GLIONEUROMA OF THE OPTIC NERVE. Q. C.
(96) Ruhland, Joum. Amer. Med. Assoc., Vol. lx., No. 5, Feb. 1, 1913,
pi 363.
The tumour was a well encapsulated semi-fluctuating mass about
3 cm. by 1*5 cm. It showed ganglionic cells, nerve fibres, and
neuroglia. There was no involvement of the eyebalL It was
considered to be congenital and was found in a girl who first
showed signs of eye trouble at the age of 6. At 8 she caught
scarlet fever and exophthalmos and complete blindness of the
affected eye followed, A- Ninian Bruce,
108
ABSTRACTS
SARCOMA OF LEFT FRONTAL LOBE OF BRAIN WITHOUT
(97) DEFINITE SYMPTOMS UNTIL SHORTLY BEFORE DEATH.
B. M. Randolph, Joum. Amer. Med. Assoc., Yol. lx., No. 1 , Jan. 4,
1913, p. 30.
The patient was a woman, aged 65, single, and of high intellectual
and social attainments. About a year before death it was noticed
that she would sometimes stop in the middle of a sentence, but
otherwise was in her usual health and remained so for the next
eleven months. She then lost interest in her friends, became hazy,
unresponsive, and apathetic. Reflexes normal, no optic neuritis
nor headache, and no paralysis. These symptoms became rapidly
more marked until a few days later when she suddenly passed into
a state of stupor, dying after a few days apparently from medullary
paralysis.
At the autopsy an ovoid tumour about the size of a small hen’s
egg was found on the lower and inner aspect of the left frontal
lobe. The margins were not clearly defined. The entire third
frontal convolution showed acute softening. The tumour proved
to be a round-celled sarcoma. A. Ninian Bruce.
TWO OASES OF COLLOID TUMOUR OF THE THIRD VENTRICLE,
(98) CAUSING DEATH. Arthur J. Hall, Lancet, Jan. 11,1913, p. 89.
Case L Man, middle-aged, was found lying in the street uncon¬
scious, and died a few hours after admission to hospital No
history could be obtained. At the necropsy a globular, semi-
translucent tumour was found lying in the anterior part of the
third ventricle. It was about the size of a small toy marble, and
was attached to the anterior part of the right choroid plexus by
a narrow band of fibrous tissue. The anterior ends of the optic
thalami were hollowed out by the convex surface of the tumour
which had pushed down the front part of the velum interpositum
Case II. Girl, aged 18, who had suffered from nocturnal
enuresis since childhood, but from no other illness except recurrent
headaches during the previous six months, was found lying dead
in bed. At the necropsy a similar tumour to that described above
was found, also attached to the anterior end of the choroid plexus,
and resting on the velum interpositum.
The two tumours were smooth, soft, and gelatinous, but on
hardening had a firm, semi-translucent, almost cartilaginous, con¬
sistence and a homogeneous structure. The bulk of the tumour
consisted of a structureless hyaline matrix, containing at wide
intervals epithelial cells in various stages of degeneration. It
was surrounded by several layers of well-formed fibrous tissue.
A short account of seven other similar cases from the literature
is given. A* Ninian Bruce,
ABSTRACTS
109
VERTEBRAL CARIES: POTTS DISEASE WITHOUT CURVA-
(99) TUBE IN THE SENTLTUM. (Cine des verttbres: mal de
Pott sans gibbosity k un age avancd.) Rotstadt, Nouv. Icon, de
la SalpStri&rt, Sept-Oct 1912, p. 391.
The author describes a case of Pott’s disease in a man of 72, who
presented symptoms of cord compression at the level of the eighth
cervical segment. The compression slowly became more and more
complete. At first there was no pain, but later pains in the limbs
developed. At no time was any bony malformation of the vertebral
column to be found, but not long before the patient’s death a cold
abscess showed itself in the neck, posteriorly. At the necropsy
the inferior cervical vertebrae were found to be completely dis¬
integrated, the dura mater thickened, while caseous masses
surrounded the membranes and distorted the cord. It is
interesting to note that while the main seat of the disease was
extradural, there was in the early stages, clinically, a dissociated
anaesthesia. S. A. K. Wilson.
CHBOMATOPTIC WORD DEAFNESS. (Note snr la surditf verbale
(100) chromatoptique.) Davidknkof, L’Encephale, Aug. 10,1912, p. 127.
By “ amnesic achromatopsia ” ( amnestische Farbcnblindhcit) is
designated inability to name colours with perfect preservation of
colour vision. Such a condition ought to be classed with the
aphasias, and Monakow gave it the name of “ achromatoptic
aphasia.” Lewandowsky supposed in such a case the representa¬
tion of the colour of an object was dissociated from the general
representation of the object, its form, &c. In most cases hitherto
recorded there has been difficulty in recalling the correct name of
the colour, a form of verbal amnesia. Davidenkof, however,
reports several cases where the defect was constituted by loss of
the comprehension of these words for colours. In them, further,
colour vision was intact, as also the representation of the colours
of objects. He proposes the term “ chromatoptic word deafness ”
to express the condition. In these cases the sole indication of
sensory aphasia was loss of the meaning of colour words. They
are interesting and well worth reading in the original.
S. A. K. Wilson.
BILATERAL MOTOR APRAXIA WITH AUTOPSY. (Apnurie
(101) motrice bilatdrale: autopsie: contribution k la localisation de
l’apraxie.) D’Hollandxr, L'Encdphale, June 10,1912, p. 606.
A female patient of 55, presenting a combination of paraphasia
and bilateral motor apraxia, with certain symptoms of delusional
insanity. She had no word deafness or blindness, no paralysis or
110
ABSTRACTS
ataxia. There was, further, no agnosia as regards objects, and no
defect of memory or attention. It seems clear that the defect
was a pure motor apraxia, and not an ideational apraxia; at the
same time the symptoms were not very severe. Automatic move¬
ments (walking, eating, swallowing, &c.) were unimpaired. There
was very little perseveration to be noted
In the left hemisphere was an area of softening involving the
limbic gyrus, the lingual and fusiform gyri, the cuneus, part of the
third temporal convolution, and the white matter underneath the
third and second temporal gyri and the angular gyrus, as well as part
of the inferior parietal lobule. In this way the left sensomotorium
must have been isolated in great part from the large posterior
associational area of Flechsig. In the right hemisphere the
posterior half of the superior frontal gyrus was softened. The
author supposes that each of the two lesions was the cause of the
apraxia in the opposite limb, although there are certain objections
to this opinion that might be offered. S. A. K. Wilson.
ON THE BE8PIRAT0B7 NEUROSES. Samuel West, Lancet, Nov.
(102) 16, 1912, p. 1352.
The neuroses of the respiratory organs fall into two groups. The
first group is associated with dyspnoea and cyanosis, and in it are
found (1) asthma, (2) laryngismus stridulus and some other
laryngeal spasms, and (3) whooping-cough. The second group
is not associated with dyspnoea or cyanosis, and contains (4)
paroxysmal tachycardia, (5) the air-hunger of diabetes mellitus
and the allied condition in uraemia, and (6) periodic respiration
in its two forms, viz., grouped respiration and Cheyne-Stokes
breathing.
A general consideration of each of these seems to lead to the
same conclusion, viz., that it is not the respiratory centre in
the medulla that is at fault, but some higher co-ordinating centres
possibly in close relation with the other centres of volitional
action, and therefore presumably in the cortex of the brain.
A. Nenian Bruce.
MYOTONIC DEFECTS IN PARALYSIS AGITANS. (Des troubles
(103) d’apparence myotonique dans la maladie de Parkinson.) O.
Maillabd, L'Enctphalc, Ann. vii., No. 12, Dec. 10,1912, p. 433.
Apart from the ordinary stiffness and slowness of movement
characteristic of Parkinson’s disease, the author has remarked a
curious inability to relax the innervation of a given muscle during
as long as from 10 to 30 seconds. In the case here described the
phenomenon was particularly well seen in the orbicularis oculi on
ABSTRACTS
111
both sides. Again, in pronouncing certain letters, the patient was
unable to arrest phonation during some seconds, so that the “ a ”
of Paris, patrie, &c., became most unduly prolonged. Other more
or less similar cases have been already published. The author
believes the phenomena bear only a superficial resemblance to the
true myotonia of Thomsen’s disease. S. A K. Wilson.
PARALYSIS AGITANS m NEGROES. C. W. Bure, Joum. Amcr.
(104) Med. Assoc., YoL lx., No. 1, Jan. 4,1913, p. 43.
A description of a case in a negro, aged 52, who presented the
typical appearance of the disease barring tremor. It is pointed
out that paralysis agitans is a very rare disease in the negro.
Idiopathic epilepsy is as common in negroes as in whites, but,
while the gross nervous syphilitic diseases are common, the so-called
parasyphilitic diseases are very rare. A Ninian Bruce.
ON THE PSYCHOPATHOLOGY OP PARALYSIS AGITANS. (Zur
(105) Psychop&thologie der Paralysis agitans.) H. Konig, Arch. /.
Psychiat., Bd. 50, H. 1, 1912.
The material consisted of twenty-three cases observed in the Kiel
clinic. In his original work Parkinson made no mention of mental
disorders in paralysis agitans, but later authorities have furnished
considerable case-material. Previous authors have agreed in the
following statements:—
1. Parkinsonians show an abnormal mood, usually a depression.
2. In the course of the disorder transitory delirious conditions
of confusion are apt to occur.
3. In some cases a definite psychosis develops, most commonly
a melancholic or paranoic picture.
4. In the absence of senile and arterio-sclerotic dementia
intelligence and memory remain intact.
Konig confirms these conclusions. C. Macfie Campbell.
A CASE OF TETANUS TREATED BY MASSIVE DOSES OF
(106) ANTITETANIC SERUM. (Un cas de t6tanos traits par les
injections massives de s£rum antitdtanique.) J. Darieb and C.
Flandin, Bull, et mim. Soc. mid H6p. de Paris, 1912, xxxiv., p.
458, J. Renault, ibid., p. 463.
A fatal case in a woman, aged 27, in whom treatment was started
less than twenty-four hours after the onset. 242 c.c. of antitetanic
serum were given, 220 intravenously, and 22 intraspinally. Death
took place in three days with symptoms of bulbar intoxication,
112
ABSTRACTS
No cerebral or meningeal lesions were found post mortem. In
the subsequent discussion Renault related the case of a boy, aged 11
years, who recovered from severe tetanus after receiving sub¬
cutaneous injections of 260 c.c. in the course of five days.
J. D. Rolleston.
THE AVENUES OF RHEUMATIC INFECTION; BASED UPON
(107) EXAMINATION OF SEVENTY-FIVE CASES OF SYDEN¬
HAM’S CHOREA W. P. S. Branson, Brit. Med. Joum., Nov.
23, 1912, p. 1429.
Sydenham’s chorea and rheumatic fever are due to one and the
same infecting agent. The action of the rheumatic poison upon
a specially predisposed nervous system produces a characteristic
nervous instability which may precede the appearance of choreic
movements by some weeks, and may in other cases itself constitute
the sole evidence of the choreic tendency, the phase of movements
never becoming developed at all. The emergence of choreic move¬
ments is determined by emotional stimuli acting upon a central
nervous system, thus previously disequilibrated.
The commonest avenue of rheumatic infection is the tonsil,
and next to it the nose. The first essential of rational treatment
of rheumatic infection is restoration of the upper air passages to a
healthy condition. It is recommended that the tonsils be removed
in all rheumatic children who exhibit chronic tonsillar enlarge¬
ment. A. Ninian Bruce.
A CASE OF ADDISON’S DISEASE TREATED WITH TUBER
(108) OULIN. J. M. H. Munbo, Brit. Med. Joum., March 23,1912, p. 665.
The patient was a lady, aged 34, who showed the usual symptoms
of Addison’s disease, including pigmentation. There was no
evidence of tubercle, but one sister, whom she had nursed, died
from phthisis. The blood pressure varied from 110 to 120 mm.
She was given mg. tuberculin, increased gradually up to
mg., and ultimately was able to resume her old life and home
duties. The pigmentation became much less. Suprarenal extract
did not seem to agree with her. Apart from one relapse five
months later, for which she received thirty-four inoculations
of -nrVrj- mg. T.R., the improvement was maintained, and she was
in good health three years later. A Ninian Bruce.
NERVOUS AND MENTAL SYMPTOMS IN A CASE OF ADDI-
(109) SON’S DI8EASR J. Q. Porter Phillips, Brit. Med. Joum.,
Dec. 21,1912, p. 1705.
The case of a man, aged 49, who became depressed and restless.
Tremors of the hands, lips, and tongue developed, and neurasthenia
ABSTRACTS
113
was diagnosed. He then became suspicious, more depressed and
lost weight. He had hallucinations of taste and smell and
delusions about his personal appearance. The knee jerks were
exaggerated, muscular tone was diminished, the pupils were unequal
and reacted sluggishly to light. His speech became slow and
sluggish, and his handwriting irregular. Incipient general
paralysis was diagnosed, and he was removed to Bethlem Royal
Hospital He became more suspicious and had to be fed by tube.
He continued to lose weight and became cachectic (non-pigmented).
Abdominal pain, diarrhoea, cachexia, and asthenia became very
marked with vertigo and syncope.
At the autopsy no evidence of general paralysis or any cerebral
condition could be .discovered, but the suprarenal glands were
enlarged, sclerosed, and haemorrhagic. No tubercle bacilli could
be found. A. Ninian Bruce.
THYRO - TESTICULO - HYPOPHYSEAL SYNDROME. Df. Castro,
(110) L’Enciphale, Nov. 10,1912, p. 329.
A male patient of 44 noticed, some five or six years ago, that his
features were changing gradually, becoming coarser and heavier.
When he came under the author’s observation, he was found to
have a typical acromegalic facies, with macroglossia and exoph¬
thalmos. The thyroid was enlarged and goitrous. The penis and
testicles were small and atrophic. Glycosuria was present. X-ray
examination revealed enlargement of the sella turcica.
It is unsatisfactory not to find any reference to a number of
important clinical points in a case of this interest.
S. A. K. Wilson.
HYPOPHYSO-GENITAL SYNDROME OF SYPHILITIC ORIGIN.
(111) (Syndrome hypophyso-g^nital d’origine syphilitique.) P. Carnot
and J. Dumont, Bull, et mim. Soc. mid. H6p. de Parit, 1912, xxxiv.,
p. 430.
The patient was a man, aged 36, who had contracted syphilis at
18. Six years later polyuria and polydipsia developed, and in
another five years progressive diminution of vision and severe
headaches occurred which yielded to syphilitic treatment. Finally
testicular atrophy and impotence supervened, though without
obesity. The pituitary lesions were of an atrophic nature, as the
X-rays showed that the sella turcica was not enlarged, but the
enlargement of the frontal, maxillary, and sphenoid sinuses and
thickening of the cranial bones indicated that the hypophysis or
j uxta-hypophyseal region was involved, J. D. Rolleston.
114
ABSTRACTS
PSYCHIATRY.
POLYNEURITIC PSYCHOSIS AFTER INDUCED ABORTION.
(112) (Polyneuritische Psy chose nach kimstlichem Abort.) R Hahn,
Arch./. Psychiat ., Bd. 60, H. 1,1912.
The report of a case of Korsakoff s psychosis after induced abortion
in a woman of 31, in whom alcoholism could be excluded.
C. Macfie Campbell.
THE SIMULATION OF INSANITY AND GANSER’S SYNDROME.
(113) (Simulation de la folio et syndrome do Ganser.) Rfcois,
L'Enciphalc , Aug. 10, 1912, p. 97.
Professor R£gis points out clearly how the symptom of “ absurd
answers,” of “ answering at random,” can no longer be held to be
of the diagnostic value for simulation that it was formerly thought
to possess, and illustrates its occurrence in certain psychoses that
may lead subsequently to dementia. S. A. K. Wilson.
ON SUICIDE. (Ueber Selbetmord.) Wassermeyer, Arch. f. Psychiat.,
(114) Bd. 60, H. 1,1912.
An analysis of 169 cases of attempted suicide, 90 men, 79 women.
Of the men 27 were insane, of the women 57. Extremely con¬
densed summaries of the cases are given. Two of the women were
diagnosed as hysterical psychoses. Of the men who were not
insane, half were chronic alcoholics. Among the women who
were not insane, the majority were hysterical. Statistics with
regard to successful suicide would naturally differ considerably
from those with regard to unsuccessful attempts.
C. Macfie Campbell.
ON THE PATHOLOGICAL ANATOMY OF KORSAKOFF'S DI8-
(116) EASE. (Zur pathologischen Anatomic des Kors&kowschen
Symptomen-Komplexes alkoholischen Ursprungs.) E. Meyer,
Arch. f. Psychiat., Bd. 49, H. 2, 1912.
The report of one case with a review of the literature. The
author concludes that some of the cortical changes are to be
referred to tne initial delirium tremens; others can be correlated
with the chronic alcoholism; while a third series are to be more
definitely referred to the Korsakoff disorder. It is doubtful
whether, with our present histopathological data, the two latter
groups of pathological changes can be separated as strictly as
is done by M,eyer in this contribution. C. Macfie Campbell,
ABSTRACTS
115
TREATMENT.
THE TREATMENT OP MUSCULAR PARESIS BY MEANS OF
(116) ECCENTRIC MOVEMENTS. JR. Abercrombie, Brit Med.
Joum., Feb. 8, 1913, p. 277.
By a “concentric movement” is meant the ordinary movement
of a muscle which does work while becoming shorter, and a muscle
is said to perform an “ eccentric movement ” when it does work
by becoming longer. The general rule for the performance of
eccentric movements is that the manipulator first puts the muscle
into its shortest position, and then gradually elongates it, while
the ^patient resists the elongation. Such movements are of more
value in the treatment of paresis than the more ordinary employed
muscular movements.
A muscle which appears functionless when overstretched can
yet exhibit contractile power when put into its shortest position,
for in the latter position the sheath of the muscle is relaxed, the
channels of the dark band do not press on one another, and
therefore their pores will be unobstructed, and the ingress of the
translucent material easy. A. Ninian Bruce.
HIGH FREQUENCY CURRENTS IN TRIGEMINAL NEURALGIA
(117) W. F. Somerville, Brit. Med. Joum., Dec. 21,1913, p. 1706.
The author emphasises very strongly the great value of high
frequency electricity in trigeminal neuralgia, even in cases of long
standing, and records a case in a lady, aged 60, who suffered from
severe pain in the right side of the face of eight years’ duration.
The attacks were frequent and severe, her general health had
suffered, and she lived in constant dread of their return.' Ionisation
had proved of no benefit. High frequency electricity was begun
on 2nd Noy., and continued daily to Christmas with great benefit.
The pain returned during the break of the Christmas holidays.
Treatment was renewed and continued until. June, when the
neuralgia had entirely disappeared and she had a general feeling of
well-being. There was no recurrence five months later.
A Ninian Bruce.
ii
116
BOOKS AND PAMPHLETS RECEIVED
meeting of Congress.
THIRD INTERNATIONAL CONGRESS OF NEUROLOGY
AND PSYCHIATRY.
The next meeting of this Congress will be held at Gand (Belgium)
on 30th August 1913, the two previous meetings having been held
at Brussels (1897) and Amsterdam (1906).
The Congress at Gand is organised under the patronage of
MM. les Ministrcs de la Justice et de VIntcrieur by the Societes de
Neurologic et de Medecinc Mentale de Belgique. Numerous supporters
have already promised their assistance: van Deventer (Amsterdam),
Marinesco (Bucharest), Parhon (Bucharest), Serieux (Paris), Ferrari
(Boulogne), Wagner (Vienna), Dustin, Menzerath, Geerts, Laruelle,
Deroitte (Brussels), Claus (Anvers), Meeus (Gheel), Willems
(Louvain), &c.
The international exhibition at Gand will form an important
attraction for members.
All inquiries should be addressed to Dr Crocq, 62 Rue Joseph
II., Brussels.
BOOKS AND PAMPHLETS RECEIVED.
Babiuski, J. “Reflexes Tendineux et Reflexes Osseux” ( Bullet. Med.,
Oct. 19 and 26, Nov. 6 and 23, 1912).
Babinski, J., Chaillous, J., and Martel, Th. de. “Stase papillaire
bilatCrale cCcit6 presque complete craniectomie decompressive sans incision
de la dure-mfere. Guerison ” ( Soc. de Newrol. de Paris, April 25, 1912).
Babinski, J., and Jumenti6, J. “ Contribution k FCtude de rh6mor-
rbagie m£ning6e” (Bull, et Mdrn. de la Soc. mdd. des H6p.de Paris, Mai 31,
1912).
Babinski, J., Martel, Th. de, and Jumentie, J. “ Tumeur mCning<?e de
la region dorsale supCrieure ; paraplegia crurale par compression de la
moelle. Extraction ae la tumeur ; Guerison ” (Soc. de Neurol, de Paris ,
Avril 25, 1912).
Briggs, L. Vernon. (< Three months without and three months with a
social service worker in the mental clinic at the Boston Dispensary ” (Amer.
Joum. Insanity, Vol. lxix., No. 2, Oct. 1912).
Cooper, J. W. Astley. “ Pathological Inebriety ; its causes and treat¬
ment.” Baillifere, Tindall & Cox, London, 1913. Pr. 3s. 6d. net.
Flexner, Simon, and Noguchi, Hideyo. “ Experiments on the Cultiva¬
tion of the Virus of Poliomyelitis,” Fifteenth note (Joum. Amer. Med.
Assoc., Vol. lx., No. 5, Feb. 1, 1913).
Ingenieros, Jos6. “Principios de Psicologia Biologies,” Daniel Jorro,
Madrid, 1913. Pr. 6 pesetas.
Kingsley, J. S. “ Comparative Anatomy of Vertebrates,” John Murray,
London, 1912. Pr. 12s. net.
The Training School, Vol. ix., No. 9, Jan. 1913. Vineland, New
Jersey, U.S.A.
IRevnew
of
WeuroloG^ ant> IPs^cbiatr^
©riginal articles
MULTIPLE NEUROMATA OF THE CENTRAL
NERVOUS SYSTEM: THEIR STRUCTURE
AND HISTOGENESIS.* t
By the late ALEXANDER BRUCE, M.D., LL.D., F.R.C.P.E. ; and
JAMES W. DAWSON, M.D. (Carnegie Research Fellow).
(From the Royal College of Physicians' Laboratory , Edinburgh .)
(With 16 Plates.)
I. Histological Study of Multiple
Neuromata of the Central
Nervous System.
1. Spinal Cord.
(1) Nodule formation
(a) Disposition of the
fibres.
(b) Structure and
mode of for¬
mation.
(c) Origin of the fibres
(d) Distribution.
(2) Fibrosis associated
with the nodules.
(3) Fibrosis of the
intra - medullary
portions of the an¬
terior and pos¬
terior roots.
(4) Sclerosis.
2. Medulla oblongata and
pons—
(1) Isolated nucleated
patches.
(2) Changes in relation
to the intra-medul-
lary course of
sensory roots.
(3) Patches composed
of interlacing nu¬
cleated fibres and
fusiform nucleated
elements.
(4) Nodule formation.
(5) Changes in relation
to the superficial
origin of motor
cranial nerves.
(6) Fibrosis.
II. Interpretation.
Conclusion.
Contents.
* [Note by Dr James Ritchie, Superintendent, Royal College of Physicians’
Laboratory.—During Dr Alexander Bruce’s lifetime a full investigation had been
made of the spinal cord of theoaee which is the subject of this paper. Thecharacters
of the neuromata and their connections with the aberrant nerve fibres present
12
118 ALEXANDER BRUCE AND JAMES W. DAWSON
Contents — continued.
III. The Genesis of Peripheral
Nerves.
(1) Embryogenesis.
Note on the genesis of
fibres in the oentral
nervous system.
(2) Histogenesis in re¬
generation.
Note on the regenera¬
tion of fibres in
the oentral nervous
system.
(3) Histogenesis in tumour
formation.
(a) G&nglio - neu -
roma.
(b) Neuroma.
(c) Neuro-fibroma.
Noteon the genesis of
fibres in tumours of
the central nervous
system.
(а) Glioma and
neuro-glioma
(б) Neuroma.
Recent investigations have profoundly modified our conception of
the value of the histological elements of the nervous system. Con¬
flicting opinions are still held on many points of primary importance,
perhaps the chief of which is the relation of the nerve fibre to
the nerve cell. The origin of the nerve fibre is a problem of
vital interest not only to the embryologist, but also to the
physiologist and the pathologist It has long been the subject of
controversy, and, in spite of numerous valuable researches, we are
still far from knowing the relation of the nerve fibre to the central
neuroblast, a relation of essential importance in the understanding
of all neuro-pathological questions.
Researches on the embryogenesis and mode of regeneration of
the peripheral nerves have led, amongst other things, to a new
interpretation of the nature and mode of development of the new
growths which arise in relation to nerves. They have given a new
significance and a new conception to the term “ neuroma,” as they
have also reaffirmed the existence of the “ true ” neuroma as a
definite group of tumours.
The term neuroma conveys to many minds no definite concep¬
tion. Odier, in 1803, suggested the name to designate “ deep-
seated tumours which are characterised by painful swelling of the
had been considered and were the subject of a preliminary communication before
the Pathological Society of Great Britain and Ireland in 1910 (see Joum. PcUh.
and Bacleriol.y Cambridge, Vol. xv. (1911), p. 127). It was not until after Dr
Bruce’s death, however, that the medulla was examined and the younger nodules
present discovered. Dr Dawson is thus responsible for that part of the paper
which deals with the bearing of these latter observations on the origin of the
tumours and on the significance of the underlying processes in relation to the
question of the embryology of nerve fibrils generally.]
+ This paper was communicated to the Royal Society of Edinburgh, and has
been published in their Transactions, Vol. xlviii., Part IIL (No. 27), 1913.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 119
nerves involved.” The term came into use to indicate any tumour
in relation to a nerve, thus indicating its most important clinical
feature, whatever its histological structure might be. Early
writers ascribed their origin to an overgrowth of the connective-
tissue sheaths of the nerve, and apparently took it for granted
that a tumour composed of nerve tissue could not exist. Virchow,
in 1863, placed the pathology of neuroma on a histological instead
of a clinical basis, when he distinguished between true neuroma
(neuroma verum) and false neuroma (pseudo-neuroma). True
neuromata arise in the nerve tissue, and nerve tissue enters into
them as an essential constituent. False neuromata arise in the
interstitial connective tissue of the nerves. True neuromata
were further divided into “ neuroma ganglio-cellulare,” containing
newly formed nerve cells; neuroma fibrillare amyelinicum, con¬
taining chiefly non-medullated nerves; and neuroma fibrillare
myelinicum, consisting chiefly of medulla ted fibres. Virchow
stated that the nervous nature of many neuromata had been
overlooked because the non-myelinated fibres had been mistaken
for connective-tissue fibres, and because many of the fibres, both
medulla ted and non-medullated, had disappeared through pressure
and had been converted into connective-tissue-like elements.
This classification was regarded as unsatisfactory, especially by
those who considered nerve fibres as the processes of ganglion cells,
and who thought, therefore, that there could be no fasciculated
neuroma without ganglion cells, because nerve fibres are elements
incapable of proliferating independently of the cell with which
they have a direct connection.*
The present paper is founded on material derived from a
patient who had suffered from spastic paraplegia, and in whose
spinal cord, medulla oblongata, and pons, multiple fasciculated
neuromata were found. In these nodules no ganglion cells could
be traced, and nerve fibres, of the structure of peripheral nerves,
were present in different stages of development. Inasmuch as
the elements of a tumour differ from the tissues in which they
take their origin, and the diversity frequently consists in a
return to the embryonal phases of the elements themselves, it
seemed necessary, in considering the case, to study the literature
bearing upon the development of peripheral nerves in order to
arrive at a true solution as to the genetic relation of the elements.
# For a further consideration of this subject, see under III. (3).
120 ALEXANDER BRUCE AND JAMES W. DAWSON
Further, as in regeneration of nerves these embryonal phases of
development are often reproduced, the literature on the regenera¬
tion of nerves after section was next investigated. And, finally,
as pathological histology has often shed light on normal tissue
development, the literature bearing on tumours related to nerves
has passed under review. Aided thus by collateral evidence
adduced from the three sources of embryogenesis, regeneration, and
tumour formation, an endeavour has been made in the following
paper to give an interpretation of the histological picture which
a study of numerous nodules revealed. The consideration of our
work will thus be carried out under the following headings:—
I. Histological Study of Multiple Neuromata of the Central
Nervous System.
II. Interpretation of Observations and Conclusions.
III. The Genesis of Peripheral Nerves:
(1) Embryogenesis: with a note on the genesis of fibres
in the central nervous system.
(2) Histogenesis in Regeneration after Section: with a
note on regeneration of fibres in the central nervous
system.
(3) Histogenesis in Tumour Formation:— (a) ganglio¬
neuroma ; ( b ) neuroma; (c) neuro-fibroma: with a
note on genesis of fibres in tumours of the central
nervous system:— (a) glioma and neuro-glioma; ( b )
neuroma.
I. HISTOLOGICAL STUDY OF MULTIPLE NEUROMATA
OF THE CENTRAL NERVOUS SYSTEM.
Introduction.
Clinical History.
We are indebted to Dr R. A. Lundie for the following clinical
notes on the case:—
The patient, H. S., died at the ago of 30 on 11th November 1909.
Her father, on that date, was alive and well, aged 46; her mother
had died at 36 during childbirth; and she has four brothers and
two sisters all alive and well.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 121
At the age of 7 she had “ water in the head.” Three years
later she began to lose power gradually in both legs, the left leg
being first affected. This gradually progressed, until at the age
of 22 she became bedridden. Urinary troubles began with in¬
continence and continued throughout life; the bowels were very
constipated, and she required aperient medicine regularly. She
complained often of headache; her sight was very dim, and she
could not see to read. No view of the fundus could be obtained
on account of a diffuse opacity of the vitreous. She had often
complained of pain in the left side, and had frequent attacks of
gastritis and stomatitis.
Post-mortem report (by Dr Harvey Pirie, about twenty-four
hours later):—
Body much emaciated; arms flexed at the elbow and wrist,
but flexion could be overcome. Left leg fully flexed at the knee,
flexed and markedly abducted at the hip (contracture). The right
leg slightly abducted at the hip; fixed in fully extended position.
Lumbar spine in position of marked lordosis.
Spinal Cord .—Dura somewhat thickened, especially in the
cervical region, the cord as a whole being very atrophied. On
the surface no obviously sclerotic patches to be seen, but on
section bluish gelatinous patches were seen to involve a large
part of the sectional area of the cord throughout its whole length.
*
Brain .—The medulla, and even more so the pons, show great
general atrophy. On section this appeared to be diffuse, there
being no appearance of any special sclerosed patches. The cere¬
bellum also appears atrophied; there is no apparent atrophy of
the cerebrum, which appears pale on section.
Abdomen .—Intestines chiefly in pelvis, as the lordosis has
almost abolished the upper part of the abdomen in its antero¬
posterior diameter. The large intestine is so shrunken that it
is smaller in diameter than the small intestine. The stomach is
•
small and contained coffee-ground-looking material; no ulceration.
Eye .—Posterior half of left globe removed.
Methods .—Portions of the cord, medulla oblongata, and pons
were fixed in Zenker’s solution and in 10 per cent, formalin solu¬
tion for the examination of cell and protoplasmic structures, in
96 per cent, alcohol for Cajal’s reduced silver method for axis-
122 ALEXANDER BRUCE AND JAMES W. DAWSON
cylinders, and in 10 per cent, formalin solution with after-hardening
in Muller’s fluid for medullated sheaths. The paraffin sections
were cut at fy, and were stained with hsematoxylin and eosin.
Van Gieson’s stain, Heidenhain’s iron-haematoxylin, and Unna’s
polychrome methylene-blue. Weigert’s elastic tissue and Mallory’s
connective-tissue stains were also used. The celloidin sections
were stained with the Kulschitzky-Pal modification of Weigert’s
medullated sheath stain, with Van Gieson’s stain, and with the
Bielschowsky-Williamson axis-cylinder method.
The following regions were examined in serial paraffin or
celloidin sections: the whole of the pons, medulla oblongata,
the 7th and 8th cervical and 1st dorsal segments, and the whole
lumbo-sacral cord. Portions from each of the remaining segments
of the cord were prepared both for paraffin and celloidin: two
segments in the upper and two in the lower dorsal regions being
cut in serial longitudinal, frontal section.
The preliminary investigation was confined entirely to the
cord. Subsequently the medulla and pons were examined, and
as the formations in these regions seemed at first sight essentially
different from those in the cord, it is natural that the subject
should be considered under the two headings: the one, the spinal
cord; the other, medulla oblongata and pons.
1. Spinal Cord.
Enormous numbers of nodules of neuroma were found dis¬
tributed in the cord substance throughout its whole length, except
in the upper five cervical and in the 2nd and 3rd dorsal segments.
In those segments cut serially (7th cervical to 1st dorsal inclusive,
and the lumbo-sacral), nodules could be traced in every prepara¬
tion, often indeed numerous nodules in each section. All the
remaining segments showed definite nodule formation or indica¬
tions that such had existed.
Throughout the whole of the spinal pia abnormal, medullated
fibres were found. In the upper cervical region these were very
scattered and cut mostly transversely, so that they appeared as
fine dots bordering especially the outer layer of the pia. In the
cervical enlargement and dorsal cord they became more numerous
and strands of fine fibres could be traced, cut longitudinally or
transversely, both in Van Gieson- and Weigert-stained prepara-
NEUROMATA OF CENTRAL NERVOUS SYSTEM 123
tions. In the 1 umbo-sacral cord the pia was infiltrated with fibres
forming strands, tufts, and nodules. These were very markedly
accumulated in the region of the anterior fissure and of the liga-
mentum denticulatum, and in the latter situation they formed
frequently a nodule as large as the cross-section of the ligament
itself. The pial fibres in the lumbo-sacral cord were so numerous
that the whole circumference of the pia was seamed with strands
of four to twelve fibres cut longitudinally, or obliquely, or trans¬
versely, and in the adventitia of the pial vessels they formed an
encircling reticulum. It was specially noted that throughout the
whole of the pia covering the posterior columns and in the
posterior median septum there was scarcely any evidence of any
abnormal fibres: the only sections noted as showing such were in
the 5th cervical segment and in the lower dorsal cord. These
were very few in number and passed through only a few sections.
Most of the previous observations on such fasciculated neuro¬
mata have been confined to abnormal fibres or small nodules in
the pia and very isolated nodules in the cord substance. Orze-
chowski has recorded the existence of very numerous nodules in
the pia and in the region of the central canal in the lumbo-sacral
cord in a case of tabes with a malformation of the lateral recess of
the 4th ventricle. In his description he remarks that it is
sufficient to give the details of one segment, as all showed similar
characters. In our sections the great variation in the histological
picture is amongst its most prominent features, for each serial
section showed successive changes, and in preparations, even six
or eight celloidin sections apart, the change was so distinct that
without the intervening sections it would have been impossible to
relate them to one another. It will be concluded from this that
the nodules were microscopic: even so large a nodule as that
represented in Fig. 29 passed, as a nodule, through at most twelve
to fifteen paraffin sections. Its formation and breaking up could
be traced in two or three sections on either side.
Other points in which the neuromata in this case differ are
that, with few exceptions, in those previously described the
neuromata, when they existed in the cord substance itself, seem
to have been defined, almost encapsuled, by dense glia tissue.
Again, many writers have spoken of having been quite unable,
even in serial sections, to trace any connection of the fibres of
the nodules with fibres of the surrounding parts. Others have
124 ALEXANDER BRUCE AND JAMES W. DAWSON
definitely traced the nodules to fibres arising in relation to anterior
nerve roots (Orzechowski), or posterior nerve roots (Raymond).
The nodules present in this case showed no encapsulation with
glia tissue, and, almost without exception, the origin of the fibres
composing them could be followed for some distance.
The neuromata were present free in the pial spaces, in the
walls of vessels of the pia, pial septa, and cord substance, forming
either a nodule at one side of the vessel or surrounding the vessel
as a more or less thick sheath; and finally, they were present
lying quite free in the white and grey matter in definite contiguity
with the nervous elements.
The term “ neuroma ” is here given to all abnormal fibres as
well as nodules, for it is evident that the difference between them
lies wholly in conditions of space and possibly of time. It is
assumed that the fibres that have plenty of lymph space show
few intertwinings, while the fibres which have met with any
obstruction in their course, e.g., from a blockage of the lymph-path,
necessarily become twisted and coiled into nodules, the most
typical form of which gives the impression of a rolled-up ball of
wool cut through the centre (Figs. 8 and 29).
It would be quite impossible to give anything like a complete
picture of the findings in the different regions. To attempt to do
so would be to lose ourselves in a maze of detail, but an effort will
be made to convey a clear conception of the chief forms with their
structure and mode of formation, the disposition and origin of the
fibres composing them, and their relation to one another and to
the tissues around. •
Before passing to this study it is necessary to refer to other
pathological processes present in the cord. The clinical features
were those of disseminated sclerosis, and at the post-mortem
examination the naked-eye appearances of the cord seemed to
confirm this diagnosis, for we have noted that on cross-section the
characteristic bluish, gelatinous patches involved a large part of
the sectional area of the cord throughout its whole length.
Weigert preparation^ at different levels showed, under low power,
areas of sclerosis, but under a higher magnification Weigert-
fuchsin preparations indicated that these were not typical patches
of disseminated sclerosis, but were rather areas of marked
fibrosis.
Within these fibrosed areas were found evidences of neuroma
NEUROMATA OF CENTRAL NERVOUS SYSTEM 125
formation, and it was assumed that the fibrosis was an accompani¬
ment or a sequel to the nodule formation. Sections of the cord
at certain levels showed a more or less normal structure, with the
exception of the presence of small neuromata, either in the vessel-
walls or in the cord substance. Such nodules seemed to be the
earliest stage of a process which ended in a complete disappear¬
ance of the nodule and a replacement, not only of the nodule, but
of the previously healthy surrounding nerve tissue by a fibrosis,
whilst in the surrounding zone there was a sclerosis comparable
to that found in disseminated sclerosis. Between this earliest
stage of a nodule in the midst of otherwise healthy tissue and the
stage of complete fibrosis of the area there existed all degrees of
transition, from a slight thickening of the wall of the vessel,
almost invariably present in some relation to every nodule, to a
further stage which showed an increasing involvement of the
intertwining nerve fibres of the nodule, so that more and more
connective tissue appeared amongst them, to a still further stage
in which the nerve fibres were compressed and separated by the
increasing fibrosis, and a yet later stage, when the fibrosis was so
intense as to have left scarcely any trace of nodule formation and
only ghost-tubes of former nerve fibres could be recognised. Such
interlacing ghost-tubes gave the impression of a fine meshwork
which, under high power, at first appeared as very fine capillaries
but could be definitely analysed as nerve fibres with scarcely a
trace left of axis-cylinder and myelin sheath and peripherally-
placed nuclei
When such a stage was reached there were added two other
elements to the picture, the one a very marked infiltration of
lymphocyte-like cells accompanying the increased condensation of
the fibrous tissue, the other, a very intense glia cell proliferation
and hyperplasia in the immediately surrounding nerve tissue.
Still later in a few sections a stage was reached in which the
fibrosis was not only the most dominant feature, but the only one,
for Van Gieson and Weigert-fuchsin preparations showed an
extensive area of dense fibrous tissue with few structural elements
recognisable except small round cells around the vessels. Even
these were frequently absent, and the vessels themselves were
completely involved in the fibrosis.
There were in addition areas of true sclerosis independent of
those associated with the fibrosis: the most constant of these
126 ALEXANDER BRUCE AND JAMES W. DAWSON
were the posterior column sclerosis and the area in the direct
cerebellar tract.
To complete the histological picture it is necessary to refer to
one very constant feature present throughout nearly the whole
cord. The intra-medullary course of the posterior roots showed
a very marked fibrosis. In Weigert preparations, the posterior root-
entry zones were definitely degenerated, and in Weigert-fuchsin
and Van Gieeon preparations it seemed as if the neurilemma
sheath in relation to the posterior roots were continued along
the fibres right into the root-entry zone for a varying distance
(Fig. 53). The anterior nerve roots in their intra-medullary course
also showed this change, but to a less extent and less constantly,
except in the lumbo-sacral cord (Fig. 54).
It will thus be seen that there were several distinct appear¬
ances present in the cord:—
(1) The neuroma nodules, and by neuroma again we refer to
all stages in the development of a nodule from a few abnormal
fibres in relation to vessels or the pial spaces to definite nodule
formations.
(2) A fibrosis, in varying degrees of extension, involving areas
in which neuromata had developed.
(3) A fibrosis of the intra-medullary portions of the anterior
and posterior roots.
(4) The sclerosis which seemed independent of the presence of
the fibrosis.
(1) Nodule Formation.
The detailed description of the nodules will be taken up in the
following order:—
(а) Disposition of the fibres forming the nodules;
(б) Structure and mode of formation;
(e) Origin of the fibres;
(d) Distribution of the nodules.
A convenient introduction to this study will be given by a brief
reference to the first microscopic preparations examined. These were
Van Qieson-stained paraffin sections from the 1st dorsal segment.
It will be remembered that the 2nd and 3rd dorsal segments were
almost typical in appearance, and in this segment the normal archi¬
tecture of the cord was retained with the exception of the presence of
two symmetrical areas on either side in the white matter immediately
NEUROMATA OF CENTRAL NERVOUS SYSTEM 127
adjoining the concave anterior and antero-lateral margins of the grey
matter.
On the right side was the isolated oval nodule represented in Fig.
19, and on the left side a larger nodule, not so defined however.
Under high power the nodule on the right side was found to be com¬
posed of nerve fibres cut transversely, obliquely, and longitudinally
(cf. Fig. 6). The fibres had the structure of a peripheral nerve with
axis-cylinder, myelin sheath, and neurilemma sheath, and had only a
small amount of connective tissue between them. The nodule was
defined from the surrounding healthy white matter by a deeply
staining layer of connective tissue, and through its centre ran a thin-
walled blood vessel.
On the left side the nodule was not defined from the surrounding
tissue, and from its outer and anterior aspects radiated fine pink lines
which, in their radiation, give off fine fibrils which enclose the adjoining
normal fibres of the white matter with a pink zone—giving the impres¬
sion that a very fine fibrillar connective tissue had in some way
secondarily involved the fibres. Under high power the nodule had the
same structure as that on the right side, and the pink lines were
found to enclose very finely-calibred nerve fibres in which the yellow-
staining myelin and central axis-cylinder could be recognised—the
deeply-staining pink contours being gained by the increase of the
connective tissue around these scattering fibres of the nodule. The
vessel, found in relation to this nodule, was situated eccentrically, but
in adjoining sections it assumed a more central position.
The very defined nature of the nodule (Fig. 19) enclosed by a dense
layer of connective tissue, staining intensely pink with the fuchsin,
gave the impression, under low power, that we were dealing with a
nodule that had arisen in relation to the vessel-wall itself, possibly of
the nature of a leio-myoma or of an endarteritic process. Higher
magnification, however, revealed the nervous nature of the fibres, and
subsequent sections stained with Cajal’s and Weigert’s methods showed
the presence of numerous similar nodules and confirmed their nervous
nature.
The first silver preparations examined were a serial set in which the
nodule represented in Figs. 8 and 29 was found. A description of the
very varied nature of the nodules will be attempted later, but mean¬
while we may note the beautiful whorl-arrangement of the fibres com¬
posing this one.
The first Weigert preparations (Figs. 26 and 27) also gave beautiful
nodules with a marked intertwining of the fibres. High-power
examination showed that the internodal segments were short and
irregular, and that the myelin sheath, though staining specifically, was
thinner and not so intensively stained as the surrounding fibres of the
white matter.
(a) Disposition of the Fibres forming the Nodules.
To recognise this it will be necessary to compare Van Gieson, silver,
and Weigert preparations. The smallest and simplest neuroma forma-
128 ALEXANDER BRUCE AND JAMES W. DAWSON
tions are mere strands of fibres running parallel to each other; not
strictly straight, but usually sinuous. Such simple strands, composed
of from six to twelve fibres, were most frequently met with in the pia
lateral to the emerging anterior roots (Fig. 39). An increasing com¬
plexity in the structure was initiated by an interlacing of the fibres as
if these sinuous parallel fibres began to wind in and out amongst each
other: such fibres were met with most frequently in the walls of
blood vessels cut longitudinally (Figs. 32 and 33). A further stage in
their evolution was reached by the convoluted course of the fibres,
which seemed to coil spirally round other parallel longitudinal fibres or
round a bundle of fibres cut transversely (Fig. 38).
From these simple formations we get all transitions to the tuft-like
nodules, in which the interlacing is so dense as to appear an almost
inextricable tangle (Fig. 30), or to the whorl-arrangement, in which the
fibres appear to have some definite plan—the most typical being the
ball-of-wool appearance already noted (Fig. 29). Sometimes the
appearance was that of a ball of wool in which several successive
threads had passed in the same direction and then suddenly the winding
had commenced in another direction, so as to cross the former in
varying degrees of obliquity; successive threads were then parallel for
a time, till that direction again gave place to another. The increase
in size of the nodule was accounted for by an agglomeration of bundles
of fibres which simply repeated the primary groupings. At other times
it seemed that each individual thread had wound in an independent
direction, as if the ball had slowly revolved during the process of wind¬
ing. On cross-section of such a ball, the fibres would then present an
appearance much more uniformly transverse, while in the former case
the fibres would be cut transversely, obliquely, and even for short
lengths, longitudinally (Fig. 8).
It is impossible to give anything like an accurate description of the
almost infinite variety in the disposition of the fibres. The fibres in
their windings could sometimes be followed for a considerable distance,
and at other times they seemed to bend at very sharp angles, often at
right angles. The ball-of-wool appearance, in some form or other, was
characteristic of the larger nodules—whether they were looked at, as it
were, from the surface or on section.
(b) Structure and Mode of Formation of the Nodules.
Structure .— Van Gieson Sections. —We have already indicated that
by simple nuclear staining and superficial examination the nodules
might have been mistaken for leio-myomatous new formations. Under
a higher magnification, the fibres composing the nodules were found to
have the structure of the peripheral nerves, differing from these only in
the closer disposition of the neurilemma nuclei and the finer structure,
in general, of the fibre. Longitudinally cut fibres were stained
yellowish-green, with a central thread—corresponding to the axis-
cylinder—taking sometimes the pink stain of the fuchsin or the dark
stain of the haematoxylin, and with a very fine pink line which at
NEUROMATA OF CENTRAL NERVOUS SYSTEM 129
frequent intervals showed an elongated nucleus in relation to it
(Fig. 6). Transversely cut fibres appear as discs with a central point
—the axis-cylinder—and an outer zone staining homogeneously
yellowish-green, and each with a pink ring which gives the disc a
very sharp contour (Fig. 6), and with an occasional nucleus applied to
it. In nodules witn fibres more closely arranged than in Fig. 6, the
cro6s-section of the fibres was angular and flattened from pressure.
Between the fibres was a varying amount, usually a very slight amount
of connective tissue.
The most striking feature of the nodules was the very character¬
istic and numerous nuclei. In some nodules they were more numerous
than in others (cf. Figs. 19 and 20). In all they were elongated on
longitudinal section, with blurred ends, and with their long axis
parallel to the long axis of the fibre. Further, the nucleus stained
intensively, and a very distinct network and membrane and closely
distributed, fine, chromatin granules could be made out, but, except
in a few, no nucleolus. The cylindrical shape of the nucleus dis¬
tinguished it from the oval nuclei of the endoneurium and of the
endothelial cells, and they were further recognised by their arrange¬
ment and relation to the fibres. Sometimes, especially in the fibres
breaking off from the nodules, long bands of fibres could be resolved
simply into long stretches of nuclei, some of which showed a constric¬
tion in the middle. The nuclei belonging to the connective tissue
stained less deeply, their longitudinal axis was not always parallel to
the fibre, but often transverse, and further, they frequently showed
nucleoli. The endothelial nuclei, which again might cause confusion,
are larger, oval, less deeply stained, usually with nucleolus, and closely
related to a lumen in which red blood cells could be recognised. It
was impossible by means of any of the stains to distinguish the nerve
fibre nuclei from the nuclei of the unstriped muscle fibres in tbe vessel-
walls.
Cajal’s Silver Stain. —The fibres stain intensely black and the longi¬
tudinal fibres show numerous irregularities and fine varicosities on
their course. From the thicker fibres branch off delicate twigs, often
at a sharp angle, and these fine twigs, twining round larger fibres,
frequently end in a homogeneous bulb—similar to Cajal’s cone de crois-
aance. In the vessel-walls, especially of the smaller vessels, the fibres
form a plexus of fine fibres with branchings ending in homogeneous
cones or rings (Figs. 10-12). Along the course of the fibres are
numerous elongated nuclei, and in relation to the transversely cut
fibres are similar nuclei showing a circular outline. Both on longi¬
tudinal and transverse sections, the nuclei show a very intimate
relation to the axis-cylinder (Fig. 8).
Weigert’s Medullated Sheath Stain. —The larger nodules under low
power stain almost as deeply as the surrounding fibres of the white
matter; under high power this is shown to be due to their very close
disposition, for the individual fibres are much more faintly stained
than normal fibres. It is thus seen that the fibres are made up of
130 ALEXANDER BRUCE AND JAMES W. DAWSON
elongated, often bulging, cylinders, with a very narrow connecting
bridge: the cylinders are longer in the darker stained fibres and
shorter in the faintly stained, and the latter are best seen in the walls
of vessels forming a reticulum (Figs. 13 and 25). When the strands
of fibres are cut transversely there are numerous fine points amongst
the larger cross-sections: these points correspond in all probability to
the connecting bridges between the cylinders. The fibres composing
the strands are in all cases much finer than the fibres of a peripheral
nerve, or even of the nerve roots.
The further structure of the nodules will be indicated in studying
their mode of formation.
Mode of Formation .—In order to study the mode of formation,
serial sections of very numerous nodules were investigated. The
Weigert preparations were the most useful for this purpose, but silver
and Van Gieson sections gave very valuable confirmatory results; the
latter being specially helpful in indicating the mode of termination of
the fibres. The method adopted was to trace such a nodule as that
represented in Fig. 35, stained with Weigert’s method, or Fig. 29,
stained with silver, both upwards and downwards as long as any trace
of it could be noted. The first nodules investigated were those in the
above figures, and it will be convenient to take them as representative
of a very large number of nodules which could with certainty be con¬
firmed to have a similar origin and extension.
The large wedge-shaped and oval nodules represented in Fig. 35,
lying in the pia opposite the ligamentum denticulatum, and extending
inwards from the periphery, when traced downwards by means of
Weigert preparations, were found to change rapidly. The fibres
diminished in the peripheral mass, and the nodule increased in sire in
the lateral vessel, and, later, was connected with the pia by means of
only a few fibres. Lower still these were absent, and the nodule, still
in relation to the vessel but diminishing in volume, was found on the
border of grey and white matter (Fig. 36). In the next sections it
was independent of the vessel (Fig. 37), and its fibres gradually un¬
weaving, as it were, from the nodule mass, became lost in the mesh-
work of fibres of the grey matter; no definite connection between them
could be traced. In the final section, only two or three strands were
present, forming a very loose network of interlacing fibres, which in
the next section could not be distinguished from the normal fibres of
the part. Throughout its course from the periphery the fibres were
found intertwined, and there were attempts at whorl-formation with
strands of six to twelve parallel fibres.
If this series is traced upwards, it is found that the nodules which
lie partly parallel to the periphery of the cord and partly at right
angles (Fig. 35) are wholly within the pia—forming one long elongated
nodule in the centre, of which at one end a vessel is cut transversely.
This elongated nodule shows many parallel strands and intertwining
fibres, and can be traced in higher sections nearer and nearer to the
anterior roots, the fibres becoming more parallel (Fig. 39) and slightly
more deeply stained as the emerging anterior root zone is reached.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 131
Here the appearance of the bundle of fibres conveys the impression
that an anterior root bundle, instead of passing directly outwards, has
curved round into the pia laterally. Going back on the former figures,
we see that it has travelled either in the pial spaces or in the vessel-
walls till it had been arrested opposite the ligamentum denticulatum,
that it there passes inwards along the lateral vessel, till it reached the
sons bordering the grey matter, into the general texture of which it
had finally unwound its fibres. The successive stages of this evolution
may be followed in Figs. 35-39.
It will be necessary later to note the exact point of origin of these
fibres, which could thus with certainty be traced into relation to the
emerging anterior root zone. Meanwhile, having indicated that bundles
of fibres have passed laterally in the pia from this region, we pass to
observe similar bundles passing ventrally in the pia, and curving round
the antero-mesial border of the white matter into the anterior fissure.
The large nodule, represented in Fig. 29, stained with Cajal’s axis-
cylinder stain, when traced downwards, showed that it retained its
whorl-arrangement and its size unreduced through several successive
sections. This seemed to indicate that it had an elongated spindle-
shape rather than a circular form. It then gradually lessened in
diameter, and almost suddenly showed a commencing cleft which, in
later sections, became almost complete. In each of the two nodules
thus formed, there was a small vessel cut obliquely, an indication
that the larger nodule had been in relation to a vessel and that this
division was due to its branching. The two smaller nodules lasted
through only two or three sections, and broke up into radiating fibres
just at the border of the grey and white matter. Some of the fibres
took the course almost exactly of fibres of the normal anterior root
bundles, but none could be traced to the periphery of the cord. These
radiating fibres are similar to those described earlier as finely calibred
fibres with a pink outline of connective tissue.
If this nodule is traced upwards, it is found that it lessened in
volume more rapidly, and in eight or ten paraffin sections had assumed
the shape of a wedge in close relation to a vessel. In successive higher
sections the commissural vessels, as they curved into the grey matter
from the base of the anterior fissure, contained very numerous strands
of fine fibres (Fig. 31). These rapidly diminished in number in the
anterior fissure, and in higher sections only two strands, composed each
of from four to six fibres, could be found, and these were followed in
the pial vessels between the anterior fissure and the converging anterior
roots. A linking with anterior roots could not be traced in this case,
but in numerous others it could with certainty be confirmed that the
fibres seemed to emerge in the immediate vicinity of the anterior roots.
These, the two first nodules which came under observation, stained
respectively for medulla ted sheath and axis-cylinder,'were typical of
large numbers of nodules in the grey and white matter.
It is necessary to supplement this description by referring to Van
Gieeon-stained preparations. These showed that the fibres, immedi¬
ately on their leaving the region of the anterior roots, had a similar
132 ALEXANDER BRUCE AND JAMES W. DAWSON
but more delicate structure and an increased number of nuclei. The
pia, especially opposite the ligamentum denticulatum, showed even
more fibres than in Weigert preparations. Fig. 22 represents the
same nodule as that just traced serially (Fig. 35), and shows the very
large number of nuclei related to the fibres. Similar nodules in rela¬
tion to a lateral vessel (Fig. 20), and to a commissural vessel (Fig. 21),
could be followed in a manner exactly comparable to those already
described, the strands of fibres in the commissural vessels in successive
sections showing the increasing intertwining and nodule formation of
Fig. 21.
The pial fibres could thus be stated to arise from the region of the
anterior roots, and most probably only from their immediate vicinity.
They then pass rapidly, laterally or medially, and during their transi¬
tion undergo a change in disposition and structure. Becoming more
closely intertwined, by the time they have reached the mid-point of
the lateral surface they have assumed a nodule formation. The fibres
passing ventrally seldom assume this compact form till they emerge
from the base of the anterior fissure, but in the region of the central
canal they often form a large, dense nodule (Fig. 44). As the fibres
pass from the region of the anterior roots they become finer, stain
less intensely, and show a very distinct segmental structure, the
segments being in the form of bulging cylinders or varicosities with
connecting bridges (Fig. 13). The very fine character of the fibres
around the vessels at the base of the anterior fissure is well brought
out in Fig. 42, where the central vessel is seen dividing, and the fibres
pass in later sections along commissural vessels into the grey matter
of either side, and along the branches to the anterior (Fig. 41) and
lateral (Fig. 43) horns as leashes of fine fibrils.
The fibres do not always pass to the base of the anterior fissure,
but sometimes inwards along the lateral branches of the anterior fissure
vessels. Fig. 40 shows a wedge-shaped mas6 of fibres passing into the
direct pyramidal tract near its anterior mesial margin. These fibres
could be traced along this vessel, ultimately to form the nodule
(Fig. 27). This nodule, when traced downwards, broke up into
strands of fibres in the meshwork of the grey matter.
The fibres passing laterally in the pia could be traced passing
inwards along almost every lateral vessel between anterior and
posterior roots. If one section were taken, and attention were con¬
centrated on a strand of pial fibres in relation to the anterior roots,
in successive sections that bundle could be followed as has been done
above. Simultaneously, moreover, new bundles rise in their place cut
transversely or longitudinally, and these, in their turn, can be followed
to lateral vessels of the cord. We thus frequently get a radiation of
the fine fibres in the peripheral vessels, or indications, marked by a
fibrosis of the vessels, that such fibres have been present. The impres¬
sion is given that if we could restore the picture to an earlier stage
intra-medullary fibres in bundles or nodules would radiate inwards
along all the lateral vessels to the circumference of the grey matter.
The pial fibres, passing inwards along peripheral vessels, result in
NEUROMATA OF CENTRAL NERVOUS SYSTEM 133
the formation, speaking generally, of nodules within the white matter,
and these, running horizontally, have their greatest diameter in trans¬
verse sections of the cord (Fig. 35). The fibres passing along central
vessels form nodules in the grey matter, and these have their long axis
more oblique or parallel to the long axis of the cord (Fig. 29). Strands
of fibres also in the pia cut longitudinally, when traced upwards, fre¬
quently become more oblique or longitudinal as they reach the anterior
roots.
The fibres of the nodules in relation to central and peripheral
vessels frequently intermingle. As a rule, by this time a very large
nodule has formed at the base of the anterior horn, and from this
nodules have branched off, with the vessel branches, to the different
areas of the grey matter. When the secondary fibrotic changes,
following the nodule formation, have not occurred to any marked
extent, a very beautiful interlacing of the fibres or intermingling of
fibres from different nodules takes place at the borders of white and
grey matter. Such appearances are best understood from Van Gieson
sections, where the fibres of each nodule, as it were, become unwound,
and the disentangled threads of each nodule intermingle to form an
inextricable maze of fibres that break up at their extremities into
whorls of individualised nucleated elements. Many of these isolated
elements in the loose mesh work are distinctly the cut portions of these
terminal strands, but many could be conclusively proved to be isolated
fusiform nucleated cells. Sometimes these fusiform elements unite
end to end to form chains of cells with imbricating processes (Figs.
45, 46).
In the terminal ramifications of the fibres of each nodule all the
transitions between nucleated fibres, chains of nucleated cells, and
nucleated fusiform cells could be followed. The calibre of the
nucleated fibres is greater than that of the fibres with which they
are in continuity (Fig. 45). In each nucleated fibre there can be
recognised a distinct axis-cylinder, a homogeneous yellowish-green
surrounding layer, with a fine pink outer border. In the fusiform
elements forming the chains are darkly stained elongated nuclei, and
a homogeneous—with polychromeme-thylene blue—slightly granular
protoplasm, and in some a faintly stained filament can be definitely
demonstrated lying along one side of the nucleus or extending from
its opposite poles. This appearance was more evident in preparations
from the medulla and pons, and its significance will be dealt with in
discussing the nodules in these regions.
In the structure of the compact nodules we noted that there was
little interstitial tissue, but here, in the breaking up of the nodules, the
fusiform elements were intermingled with an increasing fibrosis. As
these elements scatter in this fibrous tissue they become more and
more unrecognisable, *and progressively may be confounded with con¬
nective tissue elements. It is only when this fibrosis is absent or
very slight that the specific nervous nature of the nucleated chains
and fusiform cells can be recognised.
13
134 ALEXANDER BRUCE AND JAMES W. DAWSON
(o) Origin of the Fibres forming the Nodules.
The majority of the nodules, it has just been stated, can be traced
to fibres passing ventrally or laterally from the immediate vicinity of
the emerging anterior nerve roots. It will now be necessary to discuss
one or two points which are of importance in relation to the possible
precise point of origin of the pial fibres so traced.
Obersteiner thus describes the histological structure of the
posterior root where it enters the cord: “ At the point where the
posterior root pierces the pia mater it is constricted, and sometimes
to a marked extent.” “ This reduction in size takes place entirely at
the expense of the myelin sheath. Consequently, when stained by
Weigert’s method, the root at this point remains colourless, and a
bright band, usually convex on the outer side, is seen traversing the
root at the point of constriction.” Levi has shown that the posterior
root fibres lose their neurilemma sheaths and become imbedded in
neuroglia within the spinal cord in the cervical segments, just as they
enter the cord in the dorsal segments, but outside the cord in the
lumbo-sacral segments. He has further shown that the Aufhellungzone
or Abla88ungzone —the zone which stains so palely with the Weigert
method—coincides with this transition line, and that here the fibres
become narrowed to form the so-called “ constriction zone ” or ring of
Obersteiner. Levi, Orr, and Rows, and others have looked upon this
point as the “ locus minoris resistenti® ” of the fibre, and have ascribed
to it considerable importance in the pathogenesis of tabes.
A similar Ablassungzone has been scarcely recognised for the
anterior nerve roots, but Orzechowski in a case of tabes, with the
development of numerous pial neuromata, found that the abnormal
pial fibres were present only in the lumbo-sacral segments, and almost
exclusively in the neighbourhood of the anterior roots. He noted that
the position of the Ablassungzone in the anterior roots changed in
different segments, even of the lumbar and sacral cord, and that all
the abnormal pial fibres could be traced to arise from that point of the
anterior root fibres peripheral to the Ablassungzone , wherever it might
be situated. As a rule, it was in the deeper layers of the pia or just
at the boundary of pia and the glia border layer.
A very prolonged study of our preparations at all the levels of the
cord was carried out with the view of tracing, if possible, the point of
connection of the fibres, the intimate association of which with the
anterior roots at once suggested their origin from them.
In numerous segments in which the secondary fibrosis had not too
greatly involved the intra-medullary course of the fibres, it was found
that the emerging anterior nerves, before reaching the pia, show at a
definite point of their course a faintly staining zone (Fig. 48). At this
point there is a considerable attenuation, possibly even an interruption,
of the myelin sheath. That this is not due to over-differentiation is
proved by the staining of the fine abnormal fibres gathered together in
the pia. This transition zone differs from that in the posterior roots
(Fig. 47) in that it is not a constriction zone, for the fibres of each
group pass parallel through the Ablassungzone before they radiate into
NEUROMATA OF CENTRAL NERVOUS SYSTEM 135
the root handle. Further, the point where the myelin sheath becomes
attenuated is not the same for each group of fibres, so that a line
passing through the Ablassungzone of the anterior roots in any one
section is a widely-extended and undulating one.
In the upper cervical segments this Ablassungzone was almost
invariably found entirely within the glia border layer, or just on its
intra-medullary border. In the dorsal cord, in those segments
sufficiently healthy to allow it to be traced, it was found just on the
borders of glia border layer and pia. In the lumbo-sacral cord the
increasing fibrosis in the emerging root zone made it difficult to
determine with certainty any regularity in its position. But it could
be proved to be an irregular line sometimes within and sometimes
without the outer border of the glia border layer.
In consequence of the existence of this Ablassungzone the intra¬
medullary part of some anterior nerve roots is divided into a central
and peripheral part. The root bundles outside the pia are cut trans¬
versely, so that the emerging roots would seem to take very rapidly a
course in the longitudinal direction of the cord. The anterior nerve
bundles have thus a central part, an Ablassungzone , and a peripheral
part. By the varying position of the Ablassungzone the length of
these portions of the nerve is altered. If it lies within the glia border
layer, then the peripheral part is lengthened, and if it lies in the pia
the peripheral part is very short.
In Weigert-stained preparations, amongst the thick root fibres—
those immediately peripheral to the Ablassungzone —small bundles of
fine fibres could be traced, either free or disposed around the vessels.
The anterior root artery, cut transversely immediately lateral to the
nerve root, was almost invariably in the lumbar cord surrounded by a
reticulum of fine fibres (Fig. 13). A passage of fibres from anterior
roots to this vessel could never be traced, for an anterior root bundle
seemed to divide and enclose the vessel. In other preparations the
Ablassungzone of one bundle was unrecognisable and its place was
taken by a fibrosis, within which could be traced an interlacing of
fibres which were finer than the intra-medullary fibres with which they
appeared to be continuous. From this interlacing, in which fibres
were cut transversely and longitudinally, there seemed to be a definite
gathering up of fine fibres to pass into the pia A very clear picture
of such a group of fibres passing laterally is seen in Fig. 39. A careful
comparison of numerous such pictures made it not unreasonable to
assume that here the Ablassungzone had been intra-medullary, and
that from the point immediately peripheral to it the pial fibres had
arisen, the secondary fibrosis involving the intra-medullary course of
the fibres.
The direct association of the abnormal pia.1 fibres with the anterior
nerve bundles immediately peripheral to the ‘ Ablassungzone seemed to
be confirmed by further study of the preparations. The connections
were often very few, but they must often have been removed by the
increasing fibrosis.
It must further be noted that the fibres of several nodules, situated
130 ALEXANDER BRUCE AND JAMES W. DAWSON
midway between the grey matter and the periphery of the cord,
seemed as if they unwound into strands directly continuous both
centrally and peripherally with anterior root bundles. A careful ex¬
amination, however, of serial sections made it evident that such
nodules also had formed in relation to vessels passing into the cord
alongside the emerging nerve bundles, and that the nodule formation
took place just as in relation to other lateral vessels. The close
proximity of the emerging fibres to the nodule made it appear as if
they entered into and emerged from the nodule. On several occasions,
however, the emerging strands showed a definite tortuosity in their
course.
According to Nageotte, the Ausgangspunkt of tabes is formed
by an area of transverse neuritis, situated near the point where
the roots penetrate the dura. It has already been pointed out that a
retrograde degeneration may occur in the anterior roots and that from
the point where this may be arrested the anterior roots may regenerate
new fibres. If this degeneration ascend to the point where the neuri¬
lemma sheath is lost, the new fibres tend to stray into the pial spaces
and vessels and to form neuromata, instead of passing onwards in the
old sheaths of Schwann to form leashes of young fibres in the degener¬
ated tube.
A careful examination of the cord throughout its whole extent has
proved the almost entire absence of any degeneration in the extra¬
medullary portions of the anterior nerve roots. The nerve roots were
retained in most of the segments, especially in those in which the
nodules were most numerous, and the pial fibres emerging laterally
and medially from the vicinity of the emerging zone were in no way
associated with an extra-medullary retrograde degeneration arrested at
the point peripheral to the Ablassungzone. A regenerative process, in
the sense of Nageotte’s findings in tabes, can, therefore, not be assumed
as an explanation of the pial fibres.
In only one funiculus of the extra-medullary anterior roots was an
appearance noted which might be interpreted as a regeneration of new
fibres within the old sheaths of Schwann: this passed through several
successive sections. It must, however, be stated that the radicular
portion of the root was not examined, but, were a retrograde degenera¬
tion to be accepted as an explanation of the new pial fibres, it must of
necessity have extended to the Ablassungzone and been evident in the
retained roots. It must further be mentioned, ere leaving this question
of the relation of the precise point of origin of the abnormal pial fibres,
that the intra-medullary portion of the anterior roots frequently showed
a myelin degeneration. This process was secondary to the fibrosis
accompanying the nodule formation and will be referred to in a later
section.
(d) Distribution of the Neuromata.
It has already been noted that with the exception of the upper five
cervical and the 2nd and 3rd dorsal segments, no part of the cord
was free from nodule formation. The first indication of such in the
NEUROMATA OF CENTRAL NERVOUS SYSTEM 137
6th cervical segment occurred as a very small nodule in relation to a
vessel of the anterior roots. The few fibres composing this nodule
could be traced in serial sections to fibres passing in from the periphery
along this vessel, and in subsequent sections the nodule broke up into
fibres within the general substance of the grey matter. The normal
structure of the white and grey matter was retained, but at the
postero-lateral angle of the anterior horn a slight amount of fibrosis
indicated that nerve fibres had been present: under high power this
was confirmed, as ghost-tubes could be distinctly recognised as nerve
fibres. In the opposite horn, at each angle, antero-mesial, antero¬
lateral, and postero-lateral, a similar change had evidently occurred,
and the vessels leading to these points from the periphery showed a
commencing fibrosis. It was evident that fine fibres had passed, in
the adventitia of these vessels, to the angles of the grey matter and
had there broken up, to disappear finally with the onset of the fibrosis.
With the exception of this very minute nodule and the indications
that other abnormal fibres had been present, this segment was quite
normal The pia showed a few fibres cut transversely and obliquely,
and there was a certain amount of infiltration of the pia and of the
vessels of the cord, especially of the grey matter, with lymphocytic-like
cells.
In the upper part of the 7th cervical segment the nodule formation
had already become much more evident. A large pear-shaped nodule
was present in the centre of the anterior horn on one side: this ex¬
tended through nearly twenty paraffin sections, and several of the
vessels distributed in the grey matter show leashes of fine fibrils in
their walls. Throughout both this and the next segment, almost
every section showed beautifully that most of the vessels in the grey
matter contained these delicate fibres. Figs. 10-12 and 29-33 are all
taken from these two segments, in which the nodule formation had
taken place more in relation to the central than to the peripheral
vessels. In the adventitia of the vessels, silver preparations revealed
a fine plexus of fibres with numerous lateral branches and fine terminal
bulbs or clubs (Figs. 10, 12): only a few ring-forms could be traced.
These appearances must be looked upon as equivalent to Cajal’s cones
and anneaux. When a vessel bends or divides the leash of fibrils in
its walls curves round or branches off along the two divisions (Fig. 33).
In relation to many of these nodules, the secondary fibrosis had in¬
volved specially that part of the anterior horn bordering the white
matter. Weigert-stained preparations also showed that there was an
involvement of the myelin of the intra-medullary anterior roots, but
silver preparations brought out the integrity of the axis-cylinder
(Fig. 34).
In the 1st dorsal segment there was a return to the more normal
architecture of the cord, with a few more or less isolated nodules and
a commencing fibrosis involving the terminal ramifications of the fibres
of the nodules. The 2nd and 3rd dorsal segments were practically
normal with the exception of the slight sclerosis to be noted later.
The segments from the 4th dorsal to the 1st lumbar inclusive
138 ALEXANDER BRUCE AND JAMES W. DAWSON
showed a very uniform change, uniform in character though not in
degree. At numerous levels the only nodules present were found in
the centre of the grey matter in the form of an extensive plexus round
a vessel as its centre. In other sections, leashes of fibres could be
traced from such nodules along all the vessels to the circumference of
the grey matter—passing to anterior and lateral horns and to Clarke’s
column. Even where the structure of the cord was retained, there
was an indication of fibrosis in relation to the nodules, and as this
advanced the nodule gradually disappeared, leaving only a few fine
fibres around a vessel. Pial fibres are present, in limited numbers,
around the whole lateral cord : and a few nodules could be traced in
the pial septa.
The lumbo-sacral cord proved to be a perfect store-house of neuro¬
mata. Nodules could be traced in every preparation without exception,
and the histological picture, formed by the combined nodule formation,
the accompanying fibrosis, the sclerosis, and the fibrosis of the intra¬
medullary course of the anterior and posterior roots, changes not only
in every segment but in every section. Throughout this region the
pia also was perfectly black, in Weigert-stained sections, with fibres
cut longitudinally, obliquely, and transversely, and with almost every
vessel there was a radiation inwards of fibres and more or less marked
nodule formation or indications that such had existed. The anterior
fissure showed numerous strands of fibres, which were continued in
the walls of the commissural vessels to the base of the anterior horn,
where they formed a very large nodule from which several smaller
nodules branched off along the different vessels. There was frequently,
too, a coalescence, at the junction of white and grey matter, of fibres
of the nodules in relation to central and peripheral vessels.
In the 2nd sacral segment, the region of the central canal was
occupied by a large nodule composed of closely disposed fibres with
numerous nuclei (Fig. 44), and on either side the central vessels showed
small nodules in the connective tissue surrounding them. The grey
matter of the antero-mesial and antero-lateral groups of cells on one
side was also occupied by a dense, compact nodule, from which fibres
radiated to intermingle with fibres formed in relation to the peripheral
vessels. The nodule in the region of the obliterated central canal
passed through the whole of the remaining sacral cord; from it fibres
radiated in all directions into the grey matter. In the pia were
numerous strands of very delicate fibres, but no further nodules could
be traced.
(2) Fibrosis associated with the Nodules.
The neuroma formation was not the only pathological process
present in the cord, nor was it the most dominant feature. Through¬
out the pia it has been noted that there was a definite thickening and
at numerous levels a marked cell-infiltration, the whole suggesting that
at one period there had existed meningitic processes. This process had
spread along the adventitia of nearly all the vessels of the antero¬
lateral cord, and was specially marked at the base of the anterior
NEUROMATA OF CENTRAL NERVOUS SYSTEM 139
fissure. The posterior roots were similarly involved in the posterior
root-entry zone throughout almost the whole extent of the cord, and
the anterior nerves in the intra-medullary root-emergent zone at
numerous levels. The upper five cervical and 2nd and 3rd dorsal
segments were alone free from this change, and even they, in the 5th
cervical and the dorsal segments, showed the change in the posterior
root-entry zone to a slight extent.
The question of the sequence of the pathological processes naturally
at once arises in the mind. Schlesinger related the neuromata in his
cases to a proliferative process, the result of a long-continued chronic
irritation. There is abundant evidence of such a chronic irritation in
this case, but a prolonged study of individual segments confirmed the
first impression that the fibrosis was secondary to the nodule formation.
Every nodule, almost without exception, could, by means of serial
sections, be definitely related to a vessel. In segments such as the
6th cervical and 1st dorsal, where individual isolated nodules were
present and the normal structure of the cord was otherwise retained,
the nodule formation was the only abnormal appearance. Such isolated
nodules were lying within the adventitia of medium-sized vessels, the
walls of which were scarcely altered in structure (Fig. 6). Other
sections showed similar nodules, with a commencing thickening of the
vessel-wall, not only of the vessel in which the nodule was present, but
to a lesser extent of all the vessels of the cord. The lower part of the
6th cervical segment in Weigert-fuchsin preparations gives the appear¬
ance, under low power, of a normal cord with the vessels, even the
capillaries, markedly prominent, owing to the slight thickening of their
walls. At a slightly lower level, where a small nodule is evident on
one side and a few abnormal strands on the other, the angles of the
grey matter are picked out by a commencing fibrosis.
When we pass to the 7th and 8th cervical segments, where the
nodule formation in the anterior white matter is marked, this stain
shows diffuse pink areas, within which are strands of myelinated fibres,
many of which are on the point of disappearance even with the most
careful differentiation. A comparison of numerous sections shows that
these areas of fibrosis are associated with the breaking up of nodules,
and that these have been first involved in, or have at least first yielded
to, the compression of the increasing fibrosis and the influence, toxic or
otherwise, which first called it into play.
In such sections, when the fibrosis is not sufficiently dense to have
involved all the structural elements, there is present a meshwork of
fine fibres which suggests the presence of capillaries running in all
directions. These are, however, finely calibred bands, recognised as
nerve fibres by the yellowish staining of their protoplasm, the occa¬
sional faint trace of axis-cylinder, and the fact that they never contain
any red blood cells.
With the increasing fibrosis the pia, pial septa, and grey matter all
show an intense perivascular infiltration with cells, whilst in the areas
of fibrosis such cells form small accumulations and extend into the
surrounding nerve tissue. Most of these cells are of the lymphocyte
140 ALEXANDER BRUCE AND JAMES W. DAWSON
type, with a darkly staining nucleus in which no definite structure can
be recognised, and with a very narrow zone of protoplasm. Some cells,
slightly larger than these, are also present, with an oval nucleus,
placed to one side, in which the chromatin network can be recognised,
especially with polychrome methylene-blue staining. A few plasma
cells, with characteristic radkem nucleus and metachromatic-staining
protoplasm, are scattered amongst the other cells.
Glia Cells .—In the zone of extension of the fibrosis, an intense
glia-cell proliferation and hyperplasia have occurred (Figs. 7 and 49).
The cells contain oval or irregular nuclei, which are much larger than
those in normal glia cells and are situated at the periphery of the
cell. The nucleus stains darkly but the chromatin network is distinct,
with large nodule points, often a distinct nucleolus, and always a
sharply contoured membrane. The protoplasm varies in amount: in
the smaller cells it is homogeneous, of very varied shape, and with very
fine processes; in the larger cells it assumes an angular or star-like
form, and from the angles pass thick ramifying processes which form
a network enclosing in its meshes numerous lymphocyte cells. Many
of the glia cells are in close relation to vessel-walls, especially capil¬
laries. It is in this zone of advancing fibrosis that there are found
elements the interpretation of which tends to cause considerable con¬
fusion (Fig. 7). The young fibroblasts are in appearance very similar
to the fusiform cells which arise from the terminal ramifications of the
nucleated tubes, especially as the latter undergo a fibrous transforma¬
tion.
Ganglion Cells .—To a remarkable extent the ganglion cells were
preserved in the grey matter, which had not been encroached upon
by the fibrosis advancing from centre and periphery. The majority of
the cells were altered in character, but many apparently healthy cells
were present. In other sections few of the cells failed to show
changes: chromatolysis in all stages, from a slight central or peri¬
pheral removal of Nissl’s granules to their entire absence, vacuolation
of the cytoplasm (Fig. 50), eccentric position of the nucleus, and all
stages of atrophy of the cells. A few cells were found which, even
with very complete differentiation, showed a diffuse staining and
fusion of the granules.
Throughout the whole dorsal cord below the 3rd dorsal segment,
this fibrosis is present to a greater or less extent. Sections at various
levels show that the central canal is involved and that the change has
extended to the commissural vessels on either side, thence to the
centre of each grey matter, from there has passed forwards to the
anterior horn, outwards to the lateral horn, and backwards to
the posterior. When this fibrosis was very marked the grey matter
in Weigert-fuchsin sections was picked out in pink. In the adjoining
lateral and in the posterior columns there was a varying degree of
sclerosis with markedly fibrosed vessels. The posterior columns showed
also a striking degree of fibrosis in the posterior root-entry zones.
From this severe degree of involvement of the grey matter there were
NEUROMATA OF CENTRAL NERVOUS SYSTEM 141
all transitions to the sections which showed only a slight nodule
formation and only a trace of commencing fibrosis.
It is when we reach the second lumbar segment that the probable
sequence of the processes becomes evident. Weigert-fuchsin sections
at this level (Figs. 51 and 52) show on both sides finer or thicker
fibrous strands passing from the periphery of the cord to the borders
of the grey matter, there to expand into a loose meshwork of pink-
stained fibres and not involving to any marked extent the grey matter,
the cells of which stand out clearly. In the formatio reticularis, on
one side, there is a very evident area of fibrosis, with the remains of
a nodule, the connections of which with the periphery can be traced
even in the thickened lateral vessel. On the opposite side (Fig. 52),
a dense area of fibrosis occupies the base of the anterior horn, stretches
amongst the antero-mesial group of cells and laterally to the postero¬
lateral group, where the remains of a whorl of fine fibres may still be
recognised. Pial septa and vessels throughout the segment show a
very marked thickening.
Similar changes are present in relation to all the nodules through¬
out the lumbo sacral cord, the variations depending on the extent and
distribution of the fibrosis. A symmetrical involvement of the grey
matter on opposite sides is frequent, and a similar symmetry has been
noted in relation to the lateral columns, which were often mapped out
by fibrous strands. In the 3rd lumbar segment the markedly
thickened vessel represented in Fig. 16 can be traced throughout
its whole extent from the anterior fissure, curving into the grey
matter, and passing to the neck of the posterior horn. In its course
it is surrounded by dense masses of deeply-staining round cells, and
a small area of calcification was associated with this accumulation.
Below the 5th lumbar segment, the secondary involvement of the
strands and nodules was very much less marked.
(3) Fibrosis of the Intra-medullary Portions of the
Anterior and Posterior Nerve Roots.
This change in relation to the anterior nerve roots was constant
throughout the 1 umbo-sacral cord, was very irregular in the dorsal cord,
and was again present in the 7th and 8th cervical segments. In
the anterior root-emergent zone the divergence peripheralwards of
the bundles of fibres was much wider than the normal: definite bundles
seemed to pass to the antero-mesial angle of the anterior columns and
even posterior to this angle, and emerging bundles radiated outwards
to a point considerably more than half way to the ligamentum denticu-
latum. The whole of this root-emergent zone was involved at certain
levelB in a fibrosis which gave to longitudinal fibres a deeply-staining
pink outline, and to transverse fibres just within the pia a sharp pink
contour, for each individual fibre was separately enclosed. The myelin
sheath of such fibres was frequently degenerated as far as the fibrosis
extended, but silver preparations showed that the axis-cylinders were
preserved. This accounts for the absence of degeneration in the extra-
142 ALEXANDER BRUCE AND JAMES W. DAWSON
medullary portion of the anterior roots in spite of the degeneration
within the cord. Sometimes the whole anterior root-emergent zone
showed this change; at other times only individual bundles of fibres
(Fig. 54), along each of which it seemed as if the neurilemma, together
with a layer of the pia, had been continued inwards. The extra¬
medullary portion of the root did not share in this fibrosis.
The change in the posterior roots was even more striking and con¬
stant. Fig. 53, taken from the 7th cervical segment, shows that
the fibres forming the compact bundle of the posterior nerve root give
no indication of a constriction zone, but are continued within the cord
for a considerable distance, retaining their neurilemma sheath and
nucleus and, as in the anterior roots, carrying in, as it were, round
each fibre a layer of the pia, with which the neurilemma sheath usually
blends at the ring of Obersteiner. Individual fibres can be traced
through the posterior root-entry zone almost to the edge of the
posterior horn, and reflex collaterals, with this structure, as far as
the base of the anterior horn. The extra-medullary root gives the
impression of having been carried right into the cord substance and,
intra-medullary, differs only in showing an increased interfibrillar tissue
with more numerous nuclei. Between, and on either side of, the longi¬
tudinal entering strands cross-sections of fibres show an involvement in
the fibrosis, as if fine fibrils of connective tissue had enclosed them in
a reticulum. An area of the posterior columns, with nucleated fibres
mostly cut transversely, is situated almost invariably just to the inner
side of the fibrosed root-entry zone.
In longitudinal sections of the cord, the entering posterior root
fibres can be traced for fully one centimetre: the fibres show neuri¬
lemma sheath and nucleus and an increased interfibrillar tissue. The
nuclei in relation to the fibres tend to assume a position actually
within the contour of the nerve fibre, and the nucleated fibres end in
direct continuity with normal non-nucleated fibres of the posterior
columns. No definite fusiform elements could be traced in relation to
the terminations of these nucleated fibres.
Weigert-fuchsin preparations show that very many of the fibres in
the posterior root-entry zone and in the areas mesial to it are de¬
generated ; in some nerve fibres only a faint shadow of myelin is
present. That this again was not due to over-differentiation was
proved by the presence of the very fine fibres in the pia immediately
anterior to the posterior roots. Under low power, the posterior root-
entry zone stood out clearly as an area of diffuse fibrosis, continuous
with an oval area immediately internal to it, which was probably the
continuation upwards of the root-entry zone of lower levels.
The 5th cervical segment showed only a slight trace of this fibrosis
in the posterior root-entry zone, but in the area internal to it were
numerous nucleated fibres, each with a delicate pink zone. In these
nucleated patches the normally situated glia cells were very much
enlarged, and the thickened, ramifying processes formed a fine network
around the fibres, the nuclei of which could be distinguished from glia
nuclei by their intimate relation to the axis-cylinder.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 143
It is important to note that though so many of the fibres in the
intra-medullaiy portion of the posterior roots showed degeneration,
there was no attempt at a regeneration from the healthy extra¬
medullary portion. None of the fibres in the lateral pia could be
traced directly to posterior roots, nor could any definite connection be
established between posterior roots and the few pial fibres in the
posterior pia and pial septa. Nageotte, as we have seen, has described
in tabes a collateral regeneration from the preserved end of the
posterior roots, and Raymond traced the fibres of the neuromata, found
by him in the posterior pia, to a regeneration of posterior root fibres
interrupted in their intra-medullary course. An explanation of this
absence of regeneration may be found in the integrity of the axis-
cylinder as revealed by the silver method.
(4) Sclerosis.
Areas of sclerosis are here distinguished from areas of fibrosis,
though the latter frequently extended so as to involve the former.
We may here confine ourselves to a reference to those areas in which
no marked fibrosis accounted for the change, i.e., areas in which the
normal framework of the cord structure was retained. * Such areas of
sclerosis had many of the characters of areas of degeneration in dis¬
seminated sclerosis. Though the same columns were affected in nearly
all the levels of the cord, this was in such varying proportions, and
separated by intervals in which no transition could be traced, that the
significance of ascending and descending degeneration could not be
ascribed to the degeneration. A further similarity to disseminated
sclerosis existed in the presence of the thickened vessels on transverse
and longitudinal sections, and further, in the presence, in varying pro¬
portions, of naked axis-cylinders. No compound granular cells were
found in the sclerosed areas, an indication that the process of sclerosis
had run its course some time previously.
In the upper cervical segments there was slight degeneration of
the column of Burdach near the median septum—frequently lozenge
or spindle-shaped; the tracts of Gowers and of Flechsig were also
slightly sclerosed to an extent coinciding with the posterior column
degeneration, and there was distinct degeneration in the tract of
Helweg on one side. In the lower cervical segments there was a
slight tendency to degeneration in the direct pyramidal tract on one
side, and the crossed pyramidal on the other, and again slight degenera¬
tion in postero-mesial columns, tracts of Gowers and of Flechsig.
Throughout the various levels of the dorsal cord, there was a very
definite area of sclerosis between the tract of Gowers and that of
Flechsig on both sides, together with a slight degree of degeneration
in the columns of Burdach adjoining the median septum. Throughout
the lumbo sacral region, the fibrosis was so extensive in the white
matter that it was impossible to distinguish areas in which sclerosis
may have been present independent of the fibrosis, except in the
144 ALEXANDER BRUCE AND JAMES W. DAWSON
postero-mesial columns, which again showed slight degeneration near
the median septum.
In some parts of the cord in the posterior columns there was a
remarkable twisting of the fibres. The fibres seemed to twine round
upon themselves and to run, as it were, around an irregular axis
parallel to the longitudinal axis of the cord, and then in successive
serial sections the normal orientation of the fibres was re-assumed.
Such appearances were accompanied by a rarefaction of the tissue,
not amounting to even slight sclerosis. Similar appearances have
frequently been noted in the posterior columns in cases of disseminated
sclerosis.
2. Medulla Oblongata and Pons.
As a preliminary to a description of the nodules in the medulla
oblongata and pons, it is necessary to state that they were
definitely distinguished from the nodules in the spinal cord in
that the fibres composing them stained specifically neither with
silver nor with the Weigert method, and, further, that only
in one or two isolated instances did the fibres assume a whorl-
arrangement. So different were the nodules that for a time
it was assumed that a pathological process was in operation
essentially distinct from that in the spinal cord. The finding,
however, of one or two nodules with definite whorl disposition
of the fibres, presenting, as it were, a transition to the more fully
developed nodules in the cord, led to the possibility being
entertained that these formations were early stages in the
development of one process. Later findings also emphasised
the nervous nature of the constituent elements of the' early
nodules.
The examination under low power of Weigert-fuchsin and
iron-hfematoxylin-fuchsin preparations at different levels of the
medulla and pons showed that the fibre-tracts were here and there
interrupted and replaced by small patches which took a diffuse
faint connective-tissue stain to a greater or less extent; in these
areas, under a higher magnification, faint lines could be recognised
taking the myelin stain. In similar sections stained with the
Bielschowsky-Williamson silver method, the fibres were again
interrupted by faintly staining areas in which were found diffusely
staining fragments of axis-cylinders, and in adjoining sections
stained with Van Gieson’s method it was demonstrated that these
areas which had stood out so clearly under a low power as patches
NEUROMATA OF CENTRAL NERVOUS SYSTEM 145
of degeneration were in reality patches of nucleated fibres and
nucleated elements cut transversely, obliquely, or longitudinally.
The fibres, in many instances, seemed to retain the normal
arrangement of the fibre strands of the part involved (Figs. 57
and 58). In other parts the fibres terminated in a loose meshwork
of interlacing, nucleated fibres, or strands of such nucleated fibres
ended in a vortex of elongated nucleated elements which diverged
from each other to interlace with similar elements from adjoining
strands (Figs. 59-62). Such areas showing this loose structure
were in all instances closely related to the tissue around blood
vessels. The iron-haematoxylin stain very readily revealed the
existence of even the smallest nucleated patches, as it showed
the break in the continuity of the normal fibres, and, further,
the minute nuclear structure of the elements replacing them
could be ascertained in one and the same section.
In the pia a few fully stained medullated fibres around vessels
were found, but in no case did these form strands or nodules
in the vessels or pial spaces. Obersteiner has observed that the
cranial pial vessels usually contain such fibres, while the spinal
pial vessels rarely do so.
From this brief description it is seen that there are present
in the medulla and pons abnormal formations which bear a certain
structural resemblance to one another. For purposes of description
we distinguish between the following:—
(1) The simplest nucleated patches with the retention of the
normal framework of the tissue;
(2) The patches in relation to sensory nerve paths;
(3) The patches which consist of a loose meshwork of interlacing
nucleated fibres and spindle-shaped elements;
(4) The definite nodule formation;
(5) The areas in relation to the superficial origin of motor
nerve roots;
(6) The areas of pure fibrosis.
Distribution of the Patches and Nodules.
It will be convenient at this point to indicate the general
distribution of the patches and nodules at different levels. Only
146 ALEXANDER BRUCE AND JAMES W. DAWSON
these have been represented in the figures that were readily
recognisable under a low magnification in Weigert-fuchsin or iron-
hsematoxylin sections.
Lower Part of Medulla Oblongata —“A.”
Four well-marked patches are to be found on examining
sections at this level. The smallest of these is situated in the
mesial line in the centre of the space bounded posteriorly by the
two nuclei of the hypoglossal nerves and anteriorly by the two
posterior longitudinal fasciculi, between which it extends for a
short space. A second patch is situated at the lateral surface of
the medulla, just anterior to the descending root of the 5th nerve,
and appears to involve some of the fibres of the direct cerebellar
F»;. A.
tract which pass backwards into the restiform body at this level.
This patch is triangular in outline, the apex being directed inwards.
The remaining two patches lie between the pyramids and the
lower end of the inferior olivary nucleus, one lying close to the
surface of the medulla, the other about the middle of the posterior
surface of the pyramid. These two patches thus involve the fibres
of the hypoglossal nerve as they pass between the inferior olive
and the pyramids on their way to the surface of the medulla.
Middle of the Medulla Oblongata—" B.”
The number of patches has greatly increased at this level.
Two well-marked examples are to be found in each restiform body,
NEUROMATA OF CENTRAL NERVOUS SYSTEM 147
all being quite superficial in position. The remaining patches
may be considered in relation to the inferior olivary nucleus.
A narrow elongated mass is to be seen between each olive and the
corresponding pyramid, the strands of the hypoglossal nerve on
each side being thus involved, and appearing to pass through these
patches. Other two are situated at the postero-lateral angle of
.VI N
v
Fio. B.
the inferior olive, touching the grey matter itself, while two
further patches lie between the two arms of one olive just at the
hilum and directly intercepting the strands of the hypoglossal
nerve, where they pass between the mesial fillet and the olive, the
hypoglossal nerve on one side, therefore, being interrupted by
three such patches.
Middle of Pons Varolii —“C.”
The most important patches at this level lie in relation to the
fibres of the 5th nerve at their point of entry, both nerves being
148 ALEXANDER BRUCE AND JAMES W. DAWSON
Fig. C.
Fio. D.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 149
approximately equally affected. The smaller patches are also
visible in the neighbourhood of the lateral fillet upon one side,
and a number of smaller ones may be detected amongst the trans¬
verse fibres of the pons towards their more superficial bundles. A
narrow elongated patch is also to be seen amongst the deeper parts
of the fibres on one of the 5th nerves.
Upper Part of Pons Varolii—“D.”
The number of patches has increased very greatly at this level,
no fewer than twenty-one being found in one section. The largest
of these is lozenge-shaped and is situated in the middle line
anterior to the posterior longitudinal fasciculus, and midway
between it and the trapezium. Within the fibres of the trapezium
itself, three smaller patches may be detected, and still other three,
also small in size, lie in the reticular formation, just posterior to
the trapezoid fibres. Another is found at the cerebello-pontine
angle. The remainder are scattered throughout the transverse
fibres of the pons, mostly amongst the more superficial of these
fibres, but not limited to them. Their exact positions may best be
seen from the accompanying figure.
Upper Level of Mesencephalon —"E.”
The patches at this level are very few in number, and are
limited to the region of crus cerebri, only one of which is affected.
*4
Flo. E.
150 ALEXANDER BRUCE AND JAMES W. DAWSON
The largest patch implicates the fibres of the 3rd nerve just
at their point of emergence, the area affected being, however,
slight in comparison with the corresponding involvement of the
5 th nerve as already described. Several smaller and superficial
patches are situated towards the inner part of the crus, while a
single isolated one, also small in size, is to be seen at a little depth
from the surface, and probably implicating pyramidal fibres.
[(1) Isolated Nucleated Patches.
It is necessary again to emphasise that it is such patches which
show a break in the continuity of the myelin staining fibres. They
are of two kinds : (a) Those of the first are small in size, isolated, few
in number, and are in no way related to the paths of cranial nerves
within the medulla or pons ; (6) those of the second are more numerous,
often extensive, and definitely on the paths of nerves from or to their
superficial and deep origin.
(a) In the smallest patches we note that two or three normally
staining longitudinal strands, composed of a very few fibres, e.g., in
the transverse fibres of the mesial fillet, are interrupted in their course
by nucleated fibres which seem to be continuous with them. The
nuclei in these fibres are elongated, with their longitudinal axis
parallel to the long axis of the tube; they stain darkly, have no
nucleoli, and are definitely within the lumen of the tube. The trans¬
versely cut strands, between and immediately in relation to the
nucleated fibres, are also nucleated, so that under low power we have
the picture of the normal transverse and longitudinal strands of fibres
for a short part of their course showing nuclei. Under a higher
magnification it is recognised that a distinct break occurs on either
side of the nucleated fibres, between them and the normal fibres, and
that in this short interval only glia fibrils are present. These can be
definitely followed right through the patch, retaining and probably
maintaining the longitudinal direction of the fibres. A careful
analysis of sections stained with Van Gieson’s, iron-haematoxylin, and
Bielschowsky’s methods, when this last method has not stained
electively and glia fibrils take the stain, proves conclusively that the
glia fibrils in these patches are retained and serve to form channels,
as it were, for the nucleated fibres.
The elongated nuclei are definitely within the fibre contour and can
be readily distinguished from the rows of small round nuclei so fre¬
quently seen in relation to the transverse fibres of the fillet and
transverse fibres of the pons. The longitudinal fibres stained yellow-
brown with Van Gieson’s method, and no distinct central filament was
recognised. The transversely cut fibres showed a similar structure, a
faintly yellow-brown disc and a reticulum of glia fibres encircling it:
the circular nuclei in relation to the fibres showed their identity, in
structure and staining, with the elongated nuclei.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 151
Such is the stfucture of those simplest nucleated patches; they
could be recognised as retaining this structure through only a few
serial sections, and almost without exception they were in relation to
the transverse fibres of the mesial fillet or transverse fibres of the pons
near the median raphe.
(6) The nucleated patches next to be described with fibres cut
transversely (Fig. 58) and longitudinally (Fig. 57) are of an entirely
different nature. They were all found in relation to strands of the
sensory cranial nerves, and it will be convenient to describe them with
the next group of changes.
(2) Changes in Relation to the Intra-medullary Course of
Sensory Roots.
A reference to Fig. 56 shows that the entering strands of the 5th
nerve are, for a considerable part of their course within the pons,
nucleated. Symmetrical changes were found in the 5th nerve on
the opposite side and in relation to strands of the 8th and 9th
nerves, though to a less extent. A comparison with Fig. 53, showing
the posterior root-entry zone in the 7th cervical segment, reveals
the similarity of the process. The whole extra-medullary nerve root
seems carried into the pons with the fibres retaining their neurilemma
sheath and nucleus. Different strands showed this to a varying
extent of their course, and individual fibres, with the structure of the
peripheral nerve, became directly continuous with the normal non-
nucleated and sheathless medullated fibres, the nuclei in the tube
becoming more and more isolated and the transition occurring almost
imperceptibly.
This nucleation of the fibres could be traced far into the pons, and
even the deep strands of the 5th nerve showed that one-third or one-
half, or even more, of the fibres composing them were nucleated.
In these deep sensory strands the neurilemma sheath was absent, and
the nuclei were more definitely within the fibre contour than in the
more superficial fibres. If such strands were cut transversely we get
the appearance shown in Fig. 58, and, if cut longitudinally, that in
Fig. 57. This seems to us to be the meaning of many of the nucleated
patches. An explanation would thus also be found for the fact that
such transversely cut fibres could often be followed for a considerable
distance in successive sections with only a slightly varying position,
and with no very defined relation to any vessels, while the longi¬
tudinally cut fibres soon become oblique. In all of these patches the
normal framework of the tissues was preserved, with an enlargement
of the glia cells in relation to the fibres: a change similar to that
noted in relation to the nucleated patches internal to the posterior
root-entry zone in the cord. Here, also, as in the cord, the nucleated
fibres could never be, beyond doubt, found to end loosely in the tissue
or break up into fusiform elements. Weigert preparations proved a
degeneration of the fibres coincident with the nucleation, but adjoin-
152 ALEXANDER BRUCE AND JAMES W. DAWSON
ing Bielschowsky preparations proved the integrity of the axis-
cylinders.
Before leaving these changes in relation to sensory nerve paths,
which we consider quite analogous to the changes in the posterior
root-entry zone, it is necessary to add that a very exhaustive
examination of serial sections of medulla and pons was made before
the conclusion was arrived at that this change was limited to sensory
strands. The only motor nerve root which showed changes at all com¬
parable was the third. The fibres of the oculo motor nerve seemed to
have a very extensive zone of exit—passing out from the surface in
several widely separated strands, the outermost of which adjoined the
crus. Several of these strands were nucleated, but only for a short
distance, and the greater part of the change was analogous to that,
to be described under (5), in connection with the motor nerve roots.
(3) Patches composed of Interlacing Nucleated Fibres and
Fusiform Nucleated Elements.
The first impression received from a low power view of such a
patch, if the attention be confined to the loose meshwork, is that we
have a proliferation of young connective-tissue cells, for this loose
tissue is in intimate relation to dilated capillaries, which, with their
walls composed of a single layer of endothelium, are very similar to new-
formed vessels (59 and 61). A closer examination, however, shows
that these cells differ in many respects from young fibroblasts, and that
they bear a close resemblance to the spindle-shaped elements, derived
from the proliferation of the sarcolemma nuclei and the increase of
the sarcoplasm—young myoblasts—in the young granulation tissue
between the two ends of a muscle wound, before the increasing con¬
densation of the scar tissue has caused their atrophy and their trans¬
formation into connective-tissue-like elements. Such cells stain more
homogeneously than fibroblasts, have not the same branching processes,
and can for a time be readily distinguished from connective-tissue cells
and endothelial cells.
Further, it is noted that these spindle-shaped nucleated elements
link themselves on to one another in the most definite way (Figs. 59
and 60), again just as endothelial cells in granulation tissue align them¬
selves to form young capillaries. There is this difference, however,
that this alignment is seldom in two parallel rows with a lumen
between, but is an interlacing in very varied directions of linked
elements, which only later converge, as it were, into strands composed
of several nucleated cell-chains. From Figs. 59 and 60 it can be seen
that as these fusiform nucleated elements link themselves to one
another, end to end, their processes fuse in an imbricated manner,
and that by the time the cell-chain thus formed is extricating itself, as
it were, from the maze of cells and passing out from them, it has
assumed an uneven cylindrical appearance, the points of fusion being
still narrower in calibre than the parts of the cylinder which contain
NEUROMATA OF CENTRAL NERVOUS SYSTEM 153
the nuclei. Such nucleated, protoplasmic cylinders are, in future,
indicated when the term “ nucleated tube ” is used.
Several of these chains of linked cells give the appearance of a
dichotomous division (Figs. 59 and 60). This forking in some in¬
stances clearly reveals the mode of origin of the two first components
of the branches, for the first links in the respective new chains lie
very close and almost parallel to one another. The impression is re¬
ceived that a longitudinal cleavage of a terminal cell had occurred,
that the proximal portions of each resultant cell had remained attached
to the common stem, and that growth in length had continued in each
new branch till, further on, a new longitudinal cleavage had taken
place when a new dichotomous division resulted. No mitosis could
anywhere be noted.
The convergence of the nucleated tubes forms bundles which run
as parallel strands for a varying distance (Fig. 62), and then assume
a more convoluted course. Such convoluted nucleated tubes (Fig. 63)
form the transition to the definite nodules to be described below (4).
Between the parallel strands formed by the convergence of the
cell-chains are found cells and tubes cut transversely, which show
clearly their identity with the longitudinal elements.
Structure of the fusiform cells and nucleated tubes .—The earliest
stage of the cell is a very thin spindle, with an elongated nucleus and
a slight amount of protoplasm extending from its poles. As the cell
increases in size the protoplasm extends, and with Van Gieson’s stain
is homogeneous and faintly tinged pink. Larger cells, under oil
immersion, reveal the presence of a more deeply staining filament
in the protoplasm just on one side of the cell ; this filament extends,
with the growth of the cell, beyond the poles of the nucleus and
becomes more evident. In cells which show a central nucleus, their
filament can often be recognised through it and extending on either
side for a short distance. The nucleus stains always deeply, but shows
a chromatin network and membrane and fine nodal points, one or two
of which are always larger than the others. The transverse section of
such fusiform cells shows the nucleus at first occupying almost the
whole disc; later it leaves a portion of protoplasm on one side, in
which is again recognised the deeplv-staining point (Fig. 1).
As the cells become linked to form chains, the central filament
becomes more evident in each cell element, and as the fusion of the
imbricating processes becomes complete and the cell borders disappear,
the discontinuous filaments form a continuous line which may be
traced passing two, or three, and even more nuclei. The surrounding
protoplasm in these tubes is homogeneous, yellow tinged with faint
pink, and its outer border is often denser and deeper pink. The
nucleus tends to be peripheral, but is still large, and surface views
especially give the impression of its being still central or bulging into
the lumen. The examination of cross-sections gives the true relation
of the nucleus to the protoplasmic tube (Fig. 2).
A farther stage in the evolution of these nucleated tubes, which
have resulted definitely from the fusion of the fusiform cells, is reached
154 ALEXANDER BRUCE AND JAMES W. DAWSON
as the contours become cylindrical and parallel, and most of the nuclei
have taken a peripheral position and flattened appearance. The proto¬
plasm still stains homogeneously, but the condensed outer border and
the sinuously-winding filament become more marked (Fig. 3).
In the loose meshwork there is present only a slight amount of
intercellular tissue derived from the adventitia of the neighbouring
blood vessels: between the tubes, however, distinct glia fibrils, very
evident with iron-hsematoxylin, run parallel to them. Very enlarged
glia cells, with thick branching processes, are found in close relation
to the meshwork.
Preparations, stained with polychrome methylene-blue, reveal the
presence in numerous cells of very fine granules, accumulated chiefly
at the poles: similar granules are found here and there in the proto¬
plasm around the nuclei of the tubes. The metachromatic staining of
these granules indicates their relation to the granules described by
Reich and Alzheimer.
Preparations, stained with iron-haematoxylin-fuchsin, show that
these nucleated tubes or bands are in various stages of commencing
myelination (Figs. 14 and 66): some tubes show only the pink tinge
of the fuchsin (Fig. 14a), but all indicate the segmental character of
the tube in which this differentiation is taking place. The first evi¬
dence of this is noted in a darkening just within the outer border of
the segment (Fig. 146); this then shows a fine granularity (Fig. 14c)
and, later, a commencing lattice-work appearance (Fig. 14a?): on cross-
section of such tubes, this transition from a homogeneous, dark ring
or shadow, through the granular stage, to the appearance of dark
radial peripheral points is also seen, and also the relation of the
nucleus to the forming myelin (Fig. 14/).
These appearances are undoubtedly those of a commencing myelina¬
tion of these tubes, formed by the alignment and fusion of the fusiform
elements. In one strand may be recognised tubes which show varying
stages in its development (Fig. 66). Several writers have pointed out
that in its first development in the peripheral nerve the myelin is
deposited in imbricated, closely applied rings, the spaces between the
rings representing the future Lantermann incisures. On cross-section
such fibres would show radial points of myelin at the periphery, and,
on longitudinal section, the myelin would take the form of a lattice
with elongated spaces.
The appearance of the nucleated tube at this stage, in Van Gieson
preparations, is not indicative of the structure of a peripheral nerve:
the nuclei are much larger and more numerous, and the neurilemma
sheath is absent. In the stage to be next described, where the tubes
assume a convoluted disposition, they become more like the peripheral
nerve fibre in character.
We desire to draw special attention to the photographs (Figs. 59-
66) which show beautifully the fusiform nucleated elements (Figs. 69
and 60), their linking into cell-chains and the fusion of imbricated
ends (Figs. 60 and 65), the transition of the chains into nucleated
bands (Fig. 61), and the convergence of the bands into longitudinal
NEUROMATA OF CENTRAL NERVOUS SYSTEM 155
strands (Figs. 62 and 66), between which are found tubes cut
transversely.
(4) Nodule Formation with Convoluted Arrangement
of the Fibres.
Such nodules were found in very few and isolated positions. The
largest, composed of tortuous fibres with numerous nuclei, is repre¬
sented in Fig. 64, and was situated laterally and posteriorly to
the strands of the 7th nerve and close to the floor of the 4th
ventricle. It had developed in relation to one side of a medium-sized
vessel, and when traced upwards divided into strands which passed
along the two divisions of this vessel to form more or less large
nodules in relation to each branch. In serial sections both the original
nodule and the two smaller ones could be followed till the fibres
unwound themselves from their compact disposition both at the upper
and lower limits into tortuous but parallel fibres, which resolve into
nucleated tubes, and then finally break up into interlacing fusiform
nucleated elements. Within the fibres of the nodule, in iron-hsema-
toxylin-fuchsin sections there is present a distinct central filament—
the axis-cylinder, a continuous but faintly-staining myelin sheath, and,
where the fibres can be isolated, a distinct outer membrane staining
pink. A small amount of interfibrillar connective tissue is also present,
derived probably from the adventitia of the vessel. Fig. 5 shows the
fibres of this nodule cut longitudinally for a short part of their course,
with a structure very similar to that of a peripheral nerve: the nuclei,
however, are larger and more numerous.
If a dissociation of the fibres by an increase of the interfibrillar
tissue takes place, as was found in a nodule lying near one inferior
olivary nucleus, the fibres assume more the appearance of those of a
peripheral nerve. In such fibres the fact that the nucleus—though
peripheral—is still definitely within the lumen of the tube and is not
applied to it from the outside as a connective-tissue nucleus, can be
very beautifully recognised. In relation to all the nodules, similar in
structure to that just described, there were found, in the immediately
surrounding tissue, radiating lines, the structure of which was resolved
into cell-chains and isolated fusiform cells which were undergoing a
fibrous transformation.
(5) Areas in Relation to the Superficial Origin of
Motor Cranial Nerves.
The earliest indication of such change was in the form of a pro¬
liferation of cells just within the pia, accompanied by a certain amount
of fibrosis and degeneration of emerging fibres. This change was most
marked in the emerging roots of the hypoglossal on both sides. These
strands, with Weigert’s stain, show along their course a degeneration
which must be compared and related to the degeneration of the intra-
156 ALEXANDER BRUCE AND JAMES W. DAWSON
medullary anterior nerve bundles in the cord. In addition to this,
however, there was a definite proliferation of cells, many of which are
spindle-shaped elements, which again fuse to form nucleated tubes,
closely applied to one another and intertwining. Further, the fibrosis
extended to involve these new-formed elements. Such a picture re¬
quired very careful examination under oil immersion and the use of
several staining methods to interpret its constituent elements. Weigert
and Bielschowsky preparations showed a disappearance of the myelin
and a diffuse staining of the axis-cylinder of the emerging fibres, while
control preparations, stained with Van Oieson’s method, proved that
there is a dense network of new nucleated tubes and fusiform cells,
and an advancing fibrosis which is causing their atrophy and disappear¬
ance. The appearance of some of these nucleated tubes is very similar
to that which we have seen in stump-neuromata, where the increasing
condensation of the scar-tissue causes compression of many of the new
nerve tubes—the myelin of which does not yet take the specific
myelin stain and shows as a homogeneous yellow zone with central
axis-cylinder. Radiating from such areas may be found the nucleated
tubes and spindle-shaped elements undergoing a fibrous transformation.
(6) Patches of Puee Fibrosis.
This again must be brought into relation to a similar change in
the spinal cord. It has already been stated that small areas may be
recognised which, under low power, stain diffusely pink, and, under
high power, reveal few or no structural elements. These areas are
related to a thickened vessel, and in the extension of the fibrosis the
new-formed nucleated tubes are involved. Within those areas, showing
no recognisable cell elements with other stains, there may frequently
be found in Bielschowsky preparations diffusely stained axis-cylinders
which we have taken to represent the remains of axis-cylinders of the
fibres displaced by the new-formed nucleated tubes.
It is thus seen that the histological picture is an extremely complex
and varied one, that at first sight the recognition of any relation
between the different appearances is difficult, and that a prolonged
investigation of serial sections and comparison of adjoining differently
stained sections is necessary before any satisfactory conclusion as to
the nature of these nucleated patches and nodules and their relation to
one another can be reached.
We look upon the patches showing a meshwork of interlacing fusi¬
form cells, described in (3), as the first stage in a process which in the
medulla and pons evolves as far as the nodule formations described in
(4). Cells, the genesis of which cannot be traced, have proliferated,
and the proliferated cells link on to one another and form chains of
cells which converge to form parallel strands. The simpler strands, owing
to the retained glia framework, may for a time conform to the plan of
the normal strands of the part involved, but, in their further evolution,
they became tortuous and intertwined and convoluted, and form the
NEUROMATA OF CENTRAL NERVOUS SYSTEM 157
nodule* described in (4). The simplest patches described in (1) (a)
we regard as sections of the margins of a patch of nucleated strands
similar to those in (3). The nodules described in (5), in relation to the
superficial origin of the motor nerves, we also take to owe their origin
to the proliferation of spindle-shaped cells, which form nucleated tubes
and nodules. The nodules have then undergone a fibrosis, which
involves the emerging roots. The small areas of fibrosis in (6) are
areas of a fibrous transformation affecting blood vessels, nucleated
tubes, and spindle-shaped cells.
Finally, the nucleated patches described in (1) (6), cut transversely
and longitudinally, we relate to transverse and longitudinal strands of
sensory nerves in their path to their nuclei of origin. An explanation
of the areas described in (2) in relation to the sensory nerves is
extremely difficult. A comparison of their extra-medullary and intra¬
medullary course shows that within the brain the interstitial tissue
and nucleation is more evident, and the impression is confirmed that
here also not only had the neurilemma sheath been carried inwards,
but pial fibrous tissue also, and that within the brain this connective-
tissue element in relation to the fibres had increased. The change
must be related to, and have the same explanation as, the fibrosis affect¬
ing the posterior roots of the cord; but further than this it is impos¬
sible to go.
To complete this histological study it is necessary to refer
briefly to the presence of several abnormalities which can here
be grouped together.
At the level of the point of emergence of the 7th nerve,
a curious condition is to be found, possibly of the nature of a
malformation. The tissue immediately to the mesial side of the
facial nerve appears to be unusually vascular, and a cavity—small
in size and with irregular walls—is developed in relation to the
vessels. This cavity increases in size as it is traced upwards, and
involves the fibres of the trapezium. Higher still, it opens out
directly on to the surface of the pons and a large irregularly
shaped depression results, which does not involve either the facial
nucleus or the descending root of the 5th nerve, but does destroy
part of the transverse fibres of the pons and trapezium (Figs.
F, G, H, I).
Round the vessels, especially the smaller vessels, of the tissue
in close relation to this malformation, a granular deposit was
found: the dust-like particles were arranged usually in a row
in the adventitial spaces and frequently fused to assume irregularly
rounded forms. If these further coalesced, they formed wide
layers in the hyaline adventitia of the vessel. These concretions
158 ALEXANDER BRUCE AND JAMES W. DAWSON
stained with the haematoxylin very like calcareous particles, and
with polychrome methylene-blue were a diffuse green (Fig. 55).
Fio. G.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 159
In the lumbar cord, the pia structure was interrupted at one
or two levels and replaced by small nodules, staining homogeneously
yellow with Van Gieson’s method in contrast to the pink
Fio. I.
160 ALEXANDER BRUCE AND JAMES W. DAWSON
connective tissue of the *pia. These nodules were immediately
anterior to the posterior roots, and the staining gave the impression
of glia islets which had undergone a homogeneous transformation.
Finally, in a very few sections, well-stained and well-developed
ganglion cells—of the type of those in the spinal ganglia—were
found amongst the extra-medullary anterior roots immediately
outside the pia.
(To be continued.)
Description of Plates.
(Fig 8 . 1-14 are from drawings: Figs. 15-66 are micro-photographs.)
Plate L
Figs. l-o. Stages in the evolution of the nucleated nerve fibre from individualised
fusiform cells. Cf. Figs. 59-66. Van Gieson’s stain, x 1,000.
Fig. 1. Earliest stage—a thin spindle with elongated nucleus and a slight
amount of protoplasm : gradual increase in the size of the cell with a more
deeply staining filament in the protoplasm on one side of the nucleus.
Transverse sections of such cells show at first the nucleus occupying almost
the whole of the disc.
Fig. 2. Uneven cylindrical appearance of the nucleated “tube”: the cell
processes have joined in an imbricated manner and fused, and, with the
fusion, the cell outlines have become lost. The discontinuous filament in
each cell may now be traced as a continuous line. Cross-sections of such
cylinders through nucleated and non-nucleated portions.
Fig. 3. Contours of nucleated “ tubes” have now become parallel, the sinuously
winding filament more marked, and the nucleus has become slightly
peripheral and flattened, though still large and bulging into the “lumen” of
the “tube.” Cross-sections of such “ tubes.”
Figs. 4 and 5. Nucleated “tube” gradually assuming the characters of the
fibres of a peripheral nerve with central filament very distinct, nucleus
flattened and peripheral, condensed outer layer of myelin, and the appearance
of a slight amount of interfibrillar tissue.
Plate II.
Fig. 6. Isolated neuroma nodule, within the adventitia of a medium-sized vessel,
lying in the anterior column of white matter (1st dorsal segment). The
nodule is composed of interlacing fibres with neurilemma nuclei and the
fibres are cut transversely, obliquely, and longitudinally. Note the central
vessel and the outer thickened wall of the adventitia completely cutting off
the nodule from the surrounding healthy white matter. Cf. Fig. 19. van
Gieson’s stain, x 250.
Fig. 7. Glia cell proliferation and hyperplasia in an area of commencing fibrosis
in the cord. Note infiltration of lymphocyte-like cells, also the presence of
spindle-shaped elements. Van Gieson’s stain, x 350.
Plate III.
Figs. 8-12. Cajal’s reduced silver method for myelinated axis cylinders, x 250.
Fig. 8. Neuroma nodule. Whorl-arrangement of the fibres giving the typical
ball-of-wool appearance ; some of the fibres interlacing in all directions and
others passing parallel for a time.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 161
Fig. 9. Transverse section of normal small vessel in the white matter of the
oord from neuroma case.
K g . 10. 8imilar vessel with delicate fibres in the adventitia.
Figs. 11 and 12. Vessels in the grey matter of the 7th and 8th cervical segments
showing within the adventitia a plexus of fine fibres, with branchings ending
in homogeneous bulbs.
Plate IV.
Fig. 13. Anterior spinal root vessel within the pia (lumbar cord); showing very
numerous newly formed medullated fibres within the adventitia. Note the
vesicular appearance and intertwining of the new fibres, that the internodal
segments are short and irregular, the fibres being made up of elongated,
often bulging, cylinders with narrow connecting bridges, and that the myelin
stains specifically yet not so intensively as that of fully formed fibres.
Kulschitzky-Pal and picro-fuchsin. x 350.
Fig. 14. Cf Figs. 65, 66. Stages in the myelination of the nucleated “tube.”
Note the segmental character of the tube in which the differentiation is
taking plaoe (a), the darkening (6), and the granularity (c) within the outer
border of each segment; and the commencing lattice-work appearance given
by the newly formed myelin (cf, e). Cross-sections of fibres in the above
stages (/). Heidenhain’s iron-hxematoxylin stain, x 700.
Plates V., VI.
Figs . 15-18. Transverse sections at different levels of the lumbo-sacral cord.
Note (1) numerous nodules both in the grey and white matter, (2) the
unravelling of the fibres composing the nodules into the general texture of
the tissue, (3) the radiating lines of fibrosis passing inwards along pial septa
and lateral vessels, also (4) the marked fibrosis of the posterior root entry
zones. Paraffin sections. Van Gieson’s stain. Figs. 15 and 16, x 20. Figs.
17 and 18, x 10.
Plate VI.
Figs. 19 22. Different varieties of nodules to show the intertwining of the fibres
and the varying amount of neurilemma nuclei. Van Gieson’s stain.
Fig. 19. Isolated nodule in the white matter of the anterior column of the 1st
dorsal segment. Cf. Fig. 6. x 180.
Fig. 20. High-power view of the nodule in Fig. 15 seen passing inwards from the
pia in region of ligamentum denticulatum. x 200.
Plate VII.
Figs . 23-28. Kulschitzky-Pal modification of Weigert’s medullated sheath stain.
Different levels of the lumbo-sacral cord : to show the medullated character
of the fibres composing the nodules.
Fig. 23. Large nodule, with very fine intertwining fibres, at anterior mesial
angle of grey matter, x 15.
Fig. 24. Similar nodule, with slightly coarser fibres, within the mesial margin
of anterior grey matter, x 20.
Fig. 25. Nodule within a glial septum, together with a vessel in the pia showing
numerous fibres within the adventitia. Cf. Fig. 13. In successive serial
sections a connection could be traced between the fibres in the vessel-wall
and the fibres composing the nodule, x 35.
Fig. 26 ( x 100), Fig. 27 ( x 160), and Fig. 28 ( x 160) show high-power views of the
nodules in Figs. 23, 24, and 25 respectively.
Plate VIII.
Figs. 29-34. Cajal’s reduced silver method for axis-cylinders. Different levels
of lower cervical oord : to show the presence of axis-cylinders in the fibres
composing the nodules.
162 ALEXANDER BRUCE AND JAMES W. DAWSON
Fig. 29. The nodule drawn in Fig. 8. This nodule had its long axis parallel to
the long axis of the cord, x 200.
Fig. 30. Nodule, of more cylindrical shape, with its long axis at right angles
to the long axis of the cord. Note the very fine character ana intricate
intertwining of the fibres composing the nodule, x 160.
Fig. 31. Nerve fibres in the adventitial lymph spaces of the vessels at the base
of the anterior median fissure and of the commissural vessels. These fibres
in successive sections were traced to the nodule in Fig. 29. x 75.
Fig. 32. Vessels passing to the anterior horn showing numerous fine fibres in the
adventitia, x 200.
Fig. 33. Similar vessel within the grey matter showing the fibres in the
adventitia following the bending and the division of the vessel, x 160.
Fig. 34. Intra-medullary course of the anterior root artery showing very fine
fibres in the adventitia, x 250.
Plate IX.
Figs. 35-39 . Sections chosen from 3rd lumbar segment (cut serially) to trace the
mode of formation of the nodules. Kulschitzky-Pal and picro-fuchsin.
Fig. 35. Wedge-shaped nodule lying in the pia, opposite the ligamentum denti-
culatum, and extending inwards from the periphery, x 70.
Fig. 36. Shows the fibres passing from this nodule in the adventitia of the
lateral vessel to a nodule at the margin of the grey and white matter, x 50.
Fig. 37. Nodule of Fig. 36 showing the unravelling of the fibres into the general
texture of the grey matter, x 180.
Fig. 38. Fibres of nodule in Fig. 35 passing inwards from the periphery, forAiing
tuft-like nodule, and fibres in a vessel-wall in the pia. x 180.
Fig. 39. Fibres passing from nodule of Fig. 35 in parallel strands towards the
region of anterior roots, x 35.
Fig. 40. Wedge-shaped nodule, at interior mesial angle of anterior column,
formed by fibres which have passed mcsially from the anterior roots.
Kulschitzky-Pal and picro-fuchsin. \ 20.
Plate X.
Figs. 41-43. Sections from 2nd sacral segment. Kulschitzky-Pal and picro-
fuchsin.
Fig. 41. Fibres passing in commissural vessel to anterior horn, x 50.
Fig. 42. Very fine fibres, contorted irregularly, in the adventitial lymph spaces
of the anterior central vessels at base of anterior fissure. Vessel dividing :
one branch seen in Fig. 41, another in Fig. 43. x 50.
Fig. 43. Branch of the anterior central vessel seen in Fig. 42, passing to lateral
grey matter with leashes of fine fibrils in its adventitia. x 50.
Figs. 44-46. Paraffin sections from 3rd sacral segment, Van Gieson’s stain,
showing nodule in region of central canal (Fig. 44, x 160), and in successive
serial sections the unravelling of the nodule into nucleated fibres (Fig. 45,
x 160), and a meshwork of individualised nucleated elements (Fig. 46, x 160).
Plate XI.
Fig. 47. Posterior root-entry zone (3rd lumbar segment), to show the Ablassung-
zone f or constriction zone, or ring of Oberateiner. Kulschitzky-Pal. x 50.
Fig. 48. Anterior root-emergent zone (7th cervical segment), to show similar
Ablassungzone in relation to the anterior roots. Kulschitzky-Pal. x 70.
Fig. 49. Glia cell proliferation and hyperplasia. Cf. Fig. 7. Van Gieson’s stain,
x 180.
Pl-ATE 1
Plate 2.
Kir.. 12.
Plate 4.
Pit*. H.
Plate 7.
Fig. 27.
Fig. 28.
►V§v
Platk 11.
Plate 12 .
Fig. 53
Fig. 55.
Fig. 56.
Fig. 57.
Fig. 58.
Plate 13.
Fig. GO.
Pl*ATK 14.
Fig. 02.
Platk 15.
Plate If).
Fir,. (J<>.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 163
Fig. 50. Anterior horn cells, showing only slight changes. Note well-marked
vacuolation in a cell at lower border of figure. Unna’s polychrome methylene-
blue stain, x 100.
Fig. 51. Transverse section of cord at level of 2nd lumbar segment: areas of
marked fibrosis, often almost symmetrical in the anterior horns. Kulschitzky-
Pal and picro-fuohsin. x 10.
Fig. 52. Dense area of fibrosis at base of anterior horn, and stretching amongst
the antero-mesial and postero-lateral groups of cells. Kulschitzky-Pal and
picro-fuchsin. x 20.
Plate XII.
Fig. 53. Fibrosis of posterior root. Extra-medullary root gives the impression
of having been carried right into the cord substance with its extra-medullary
structure. Van Gieson’s stain. x35.
Fig. 54 Fibrosis of intra-medullary course of anterior root. The neurilemma,
together with a layer of the pia, seems as if carried inwards along individual
bundles of fibres. Van Gieson’s stain, x 160.
Fig. 55. Granular deposit, often coalescing to form concretions, found in the
adventitial spaces of the smaller vessels of the tissue, in close relation to
the malformation described on page 158. Van Gieson’s stain, x 250.
Fig. 56. Fibrosis of intra-medullary course of 5th nerve. Cf. Fig. 53. Van
Gieson's stain, x 24.
Fig. 57. Isolated nucleated patch (cut longitudinally) on the course of deep
strands of 5th nerve. The affected fibres retain the normal arrangement
of the fibre strands of the part involved. Van Gieson’s stain, x 60.
Fig. 58. Isolated nucleated patch, similar to above, but cut transversely. Van
Gieson’s stain, x 60.
Plates XIH.-XVI.
Fig*. 59-66. Paraffin sections from medulla oblongata. Cf. Figs. 1-5 and Fig. 14.
Figs. 59 and 60. Loose meshwork of interlacing nucleated fibres and elongated
nucleated elements. Fusiform cells (cf. Fig. 1) are seen linked together, by
their processes, to form cell chains, and by the fusion of the imbricated
ends there is a transition into nucleated plasmodial bands or “ tubes ” (cf
Fig. 2). Note appearances as of dichotomous division, and that the nucleus
lies definitely within the cell outline or within the “ lumen” of the “ tube.”
Fig. 59 ( x 200), Fig. 60 ( x 400). Van Gieson’s stain.
Figs. 61 and 62. Convergence of nucleated “ tubes ” to form more or less parallel
bundles or strands, between which similar elements are found cut trans¬
versely. Presence of small amount of interfibrillar connective tissue and
delicate capillaries. Fig. 61 ( x 160), Fig. 62 ( x 160.) Van Gieson’s stain.
Fig. 63. Commencing intertwining of the parallel strands. Such intertwining
forms the transition to the definite nodule in Fig. 64. Van Gieson’s stain,
x 200.
Fig. 64. Nodule on floor of 4th ventriole, situated laterally and posteriorly to
the strands of the 7th nerve—a further stage of the intertwining in Fig. 63.
Van Gieson’s stain, x 25.
Figs. 65 and 66. Commencing myelination of the nucleated “ tubes.” Note the
lattice-work appearance of the newly-formed myelin. Heidenhain’s iron-
httmatoxylin stain. Fig. 65 (x 450), cf. Fig. 14, a, 6, c. Fig. 66 (x 450),
cf Fig. 14, d, 6, f
164
ABSTRACTS
abstracts
ANATOMY.
STUDIES OF THE DEGEN ERAT ION AND REGENERATION OF
( 118 ) AYTB CYLINDERS IN VITRO. Raonvald Inoebbigtsen, Jourv.
Exper. Med., Vol. xvii., No. 2, Feb. 1 , 1913, p. 182.
The brains of chick embryos, of cats 6 weeks old, of rabbits 2
months old, and of dogs 3 weeks old, when cultivated in vitro,
develop long filaments which, according to their growth and their
anatomical and tinctorial characters, must be considered as true
axis cylinders.
Similar structures develop from spinal ganglia of rabbits 7
months old, and from the spinal cord of cats 6 weeks old, and of
rabbits 2 months old.
When severed from their origin by section, these threads
undergo degenerative changes which do not appear after nine
hours, but which are seen after twenty hours, and continue until
in the course of the following two days the thread degenerates
completely.
After twenty hours the development of new axis cylinders
from the central part of the cut fibres is observed
A. Ninian Bruce.
PHYSIOLOGY.
THE EFFECT OF THYROIDECTOMY AND CASTRATION, RE-
(119) SPECTIVELY, ON THE WEIGHT OF THE RABBIT’S
PITUITARY. L. M. Dbgenkb and A. E. Livingston ( Proc.
Amer. Physiol. Soc., Dec. 29, 1912, p. xxiv.) ; Amer. Joum. of
Physiol., Vol. 31, No. 6, Feb. 1,1913.
The authors find that while thyroidectomy in rabbits, including
the removal of the internal parathyroids, is followed by pituitary
hypertrophy, removal of their testes or ovaries has no such effect.
The latter observation supports the findings of Marrassini and
Luciani {Arch. ital. de Biol., Vol. 56, 1912, p. 395) that in rabbits
and several other animals castration has no constant effect on the
weight or histological structure of the pituitary.
Leonard J. Kidd.
ABSTRACTS
165
CLINICAL NEUROLOGY.
COMBINED LESIONS OF THE POSTEEIOE AND LATERAL
(120) COLUMNS. (Lerioni combinate dei cordon! posteriori e lateral!.)
G. Mohdio, Riv. ital. di Neuropat ., Psychiat. ed Elettroter., 1912,
v. f p. 529.
A typical case in a man, aged 32, in whom the disease had reached
the second stage described by Russell, Batten, and Collier (Brain,
1900, xxiii., pp. 39-110). The increasing paresis was being trans¬
formed into spastic paraplegia, and was accompanied by hypo-
aesthesia and hypoalgesia of the lower limbs, Babinski’s and
Romberg’s signs, and immobility of the pupils. Unlike the
previous cases, there was no evidence of grave anaemia, and the
general nutrition was good. Mondio regards a gastro-intestinal
affection, prolonged masturbation, exaggerated muscular exercise
and exposure to cold and damp as causal factors in the present
case. J. D. Rolleston.
HEAD ACHE IN ACUTE INFECTIOUS DISEASES TREATED Ain)
(121) CURED BY LUMBAR PUNCTURE. (C4phal6e dans les maladies
infectieuses aiguBs traitde et gnferie par la ponction lombaire.)
H. Roger and J. Baumel (de Montpellier), Rev. de Mid., 1913,
xxxiii., p. 40.
The writers allude to the successful results obtained by Rocaz and
Carles (v. Review, 1908, vi., p. 557) and Stein (ibid., 1910, viii.,
p. 501), in typhoid fever by this method and record fifteen
personal cases in adults. Eight had typhoid fever, two Malta
fever, one influenza, two tuberculosis, and two acute gastritis.
Relief was always obtained a few minutes after puncture. In
some cases several punctures were necessary, in others a single
one was sufficient. In almost all there were hypertension and
excess of albumen. No microbes nor cellular reaction was found
in any case. No harmful results occurred from the treatment.
J. D. Rolleston.
MENINGEAL STATE IN TYPHOID FEVER. HYPERTENSION
(122) AND TYPHOID INFECTION OF CEREBRO SPINAL FLUID
WITHOUT LEUCOCYTIC REACTION. MILD COURSE AFTER
LUMBAR PUNCTURE. (£tat m4ning4e au cours d’une fi&vre
typholde. Hypertension et infection Bberthienne du liquide
cdph&lor&chidien sans reaction leucocytaire. Evolution bBnigne
aprfts la ponction lombaire.) C. Lesieub and J. Marchand, Bull,
et Mim. Soc. mid. H6p. de Paris , 1912, xxxiv., p. 785.
A woman, aged 19, on the eighteenth day of a severe and compli¬
cated attack of typhoid fever, developed meningeal phenomena,
which subsided after lumbar puncture on the twentieth day. The
x 5
166
ABSTRACTS
fluid was clear, under hypertension, agglutinated typhoid bacilli,
and contained a pure culture of these organisms. Recovery took
place with persistence of exaggeration of the reflexes, and ankle
clonus, especially on the right side. J. D. Rolleston.
PURULENT TYPHOID MENINGITIS IN ▲ TYPHOID STATE
(123) WITHOUT INTESTINAL LESIONS. (Mfaingite purulente
Iberthienne au cours d’un 6tat typholde sans lesions intestin&les.)
C. Lesieur and J. Marchand, Bull, et mdm. Soc. mid. Hop. de
Paris, 1912, xxxiv., p. 780.
A woman, aged 41, who three years previously had had severe
headache and gummata on the cranium and limbs, was admitted
to hospital with symptoms of typhoid fever. Widal’s reaction
and the blood culture were positive. Subsequently signs of
meningitis occurred, and death took place. Lumbar puncture
yielded a purulent fluid containing typhoid bacilli. The necropsy
showed a purulent cerebro-spinal meningitis, but there were no
lesions in the intestine, spleen, or mesenteric glands. The
previous attack of syphilis was probably the cause of the menin¬
geal localisation of the typhoid infection. J. D. Rolleston.
SEROUS MENINGITIS, PAPILIXEDEMA, AND MULTIPLE POLY-
024) NEURITIS OF THE CRANIAL NERVES IN A YOUNG
ALCOHOLIC SMOKER. (Mlningite sdreuse, oeddme papillaire
et polynlvrite multiple des nerfs cr&niens chez un jeune fumeur
alcoolique.) J. N. Roy, Rev. de Lar. t 1913, i., p. 97.
The patient was a man, aged 23, who had been a heavy smoker
and drinker for four years, and had had epileptiform attacks from
time to time. One morning, after three days’ excessive indulgence,
he woke up completely blind and deaf, and presented symptoms of
meningitis, which were found to have come on three weeks
previously. Three days later, complete paralysis of the palate
and laryngeal hemiplegia developed. Lumbar puncture gave issue
to a clear fluid under hypertension, containing an excess of
lymphocytes and polymorphs, but no micro-organisms. After five
weeks’ treatment complete recovery took place.
J. D. Rolleston.
ABNORMAL FORMS OF TUBERCULOUS MENINGITIS IN THE
(125) ADULT. (Contribution h l'dtude des formes anormales de la
m4ningite tuberculeuse chez l’adulte.) S. Lutel, Theses de Paris,
1912-13, No. 149.
The writer distinguishes the following clinical types of tuber¬
culous meningitis in the adult : 1. A paralytic form is much the
most frequent. 2. A convulsive form commencing with an attack
ABSTRACTS
167
of Jacksonian epilepsy and choreo-athetotic movements. 3. A
sensorial form starting with aphasia or deafness. 4. A cerebro¬
spinal form.
The thesis contains the histories of thirty-one cases, including
four hitherto unpublished, of patients aged from 18 to 48 years.
J. D. Rolleston.
ACUTE SYPHILITIC MENINGITIS. (Contribution k l’&ude de la
(126) mftningite aiguB syphilitique.) B. Bronstein, Theses de Paris,
1912-13, No. 69.
The thesis contains the histories of twelve cases, including a
personal one, recently published by Achard and Desbouis (v. Review,
1913, xl, p. 38). J. D. Rolleston.
PROGRESSIVE LENTICULAR DEGENERATION: A FAMILIAL
(127) NERVOUS DISEASE ASSOCIATED WITH CIRRHOSIS OF
THE LTVER. S. A Kinnier Wilson, Brain, Vol. xxxiv., Part iv.,
1912, pp. 295-509.
Pbogressiye lenticular degeneration is a disease which occurs in
young people, and which is often familial but not congenital or
hereditary; it is essentially and chiefly a disease of the extra-
pyramidal motor system, and is characterised by involuntary
movements, usually of the nature of tremor, dysarthria, dysphagia,
muscular weakness, spasticity, and contractures with progressive
emaciation: with these may be associated emotionalism and
certain symptoms of a mental nature. It is progressive, and,
after a longer or shorter period, fatal. Pathologically it is
characterised predominantly by bilateral degeneration of the
lenticular nucleus, and in addition cirrhosis of the liver is
constantly found, the latter morbid condition rarely, if ever,
giving rise to symptoms during the life of the patient.
The author has collected thirteen cases of this disease, with
six of which his own name is associated. Acute cases may last
only a few months; the average duration of chronic cases is four
years; one chronic case has as a maximum continued for seven
years. The mental symptoms may be very slight and are some¬
times absent, or they may be transient and such as one sees in
a toxic psychosis, but not severe, or more chronic, consisting in a
general restriction of the mental horizon, and a certain facility
or docility without delusions or hallucinations, and not necessarily
as progressive as the somatic symptoms.
In pure cases the affection constitutes an extrapyramidal
motor disease, for the reflexes are normal from the point of view
of the function of the pyramidal tracts. The neurological
symptoms constitute a syiulrome of the corpus striatum, which
168
ABSTRACTS
has not hitherto been differentiated in this disease. The syndrome
which iB here put forward may be expressed as follows: in pure,
uncomplicated, bilateral lesions of the lenticular nucleus and more
generally of the corpus striatum, provided they are of sufficient
size and of adequate duration, the clinical symptoms are bilateral
involuntary movements, practically always of the tremor variety ;
weakness, spasticity or hypertonicity (sometimes spasmodic con¬
tractions), and eventually contracture of the skeletal musculature ;
dysarthria or anarthria and dysphagia, and a degree of emotion¬
alism; but without any sensory disturbance, without any true
paralysis, and without any alteration in the cutaneous reflexes.
If the abdominal reflexes are absent (apart from muscular rigidity)
or the plantars of extensor type, then the syndrome is no longer
pure.
The chief pathological feature of the disease is bilateral sym¬
metrical degeneration of the putamen and globus pallidus, in
particular the former. This degeneration is the sequel to the
selective operation of some morbid agent on the cells and fibres
of the putamen and lenticular nucleus generally. The caudate
nucleus is often somewhat atrophic, but never to the same extent,
while other large collections of grey matter in the immediate
neighbourhood of the lenticular nucleus— e.g. t the optic thalmus,
which has partially the same blood supply—is not affected at all
in a pure case unless it be indirectly and to a very slight
extent. The morbid agent is probably of the nature of a
toxin, not of syphilitic origin. A constant, essential, and in all
probability primary feature of the pathology of the disease is
cirrhosis of the liver, not syphilitic or alcoholic. It is probable
that the toxin is associated with the hepatic cirrhosis, and may
be generated in connection therewith. The pyramidal tracts are
intact from Betz-cells to muscles in a pure case.
The question of involuntary movements is discussed. These
are of three main varieties, athetosis, chorea, and tremor. Since a
lesion of the pyramidal system is not by itself sufficient to produce in¬
voluntary movement, and since they do not occur if the pyramidal
tracts be severely injured, it would appear that extrapyramidal
paths must be injured. The two here conceived are the cerebello-
rubro-thalamo-cortical path and the lenticulo-rubrospinal system.
The corpus striatum exercises a steadying influence on the action
of the cortico-spinal system by means of the above two paths,
and injury to it removes this steadying influence, and impairs
pyramidal function as shown by hypertonicity or rigidity as
well as in tremor on voluntary movement. It does not, however,
produce any paralysis in the strict sense. The direct connection
of the corpus striatum with the cortex is minimal. There is no
necessity to postulate articulatory “ centres ” in the putamen or
ABSTRACTS
169
globua p&llidus. Dysarthria may result without any pyramidal
involvement of genu fibres and with intact cranial nuclei, from
hypertonicity of the musculature concerned. Tremor, as in
paralysis agitans, is due to disturbance or failure of function of
the lenticulo-rubrospinal system, while hypertonicity or rigidity of
the musculature, due to defect of the “ inhibitory ” action of the
corpus striatum, is possibly associated with structural or functional
defects in the eerebello-rubro-thalamo-cortical path. The absence
of normal cortico-petal impulses travelling via this path also
allows the movements of athetosis to occur.
This paper is one of the most important of recent contributions
to clinical neurology, and should be read in the original. It is
illustrated by ninety-nine figures, and there is a very complete
bibliography. A. Ninian Bruce.
TUBERCULOUS LEPROSY, GIANTISM, AND ACROMEGALY.
(128) (Ldpre tuberculense, gig&ntisme et acromdgalie.) Ds Beurmann,
L. Ramond, and Larboqub, Bull, et mdm. Soc. mid. H6p. de Paris,
1912, xxxiv., p. 714.
A record of a case in a man, aged 32, who had the characteristic
deformities of acromegaly in the hands and feet. The X-rays
showed widening of the sella turcica, slight enlargement of the
frontal sinuses, and elongation of the bones of the hands. The
acromegaly was not due to leprosy, but to a normal evolution of a
pituitary syndrome. The patient had always been tall, if not a
giant J. D. Rolleston.
A CASE OF POSITIVE WASSERMANN’S REACTION IN SAR-
(129) COMA. (Et Tilfaelde af positiv Wassermann’s Reaction ved
Sarcom.) O. Lassen, Hospitalstidende, 1912, lv., p. 1479.
A fatal case of lymphosarcoma of the neck, with pulmonary and
mesenteric metastases, in a youth of 17, in whom there was no
history nor evidence of syphilis. The reaction was performed at
the State Serum Institute. J. D. Rolleston.
ON THE DIAGNOSIS OF TUMOURS OF THE FOURTH VENTRICLE
(130) AND OF IDIOPATHIC HYDROCEPHALUS, WITH A NOTE
ON BRAIN PUNCTURE. (Zur Diagnose der Tumoren des IV.
Ventrikels und des idiopathischen Hydrocephalus nebst einer
BemerkungzurHirnpunktion.) K. Bonhoeffer, Arch. f. Ptychiat.,
fid. 49, H. 1 , 1912.
The report of three cases of tumour of the fourth ventricle, and of two
cases of idiopathic hydrocephalus, which clinically resembled the
cases of tumour. The symptoms common to the three cases of
170
ABSTRACTS
tumour were, in addition to the general cerebral symptoms, the
attacks of tonic convulsions, sudden episodes of dullness and col¬
lapse, cerebellar ataxia, disturbance of associated eye movements,
and unilateral diminution of the corneal reflex. In one case the face
showed a somewhat coarse, bloated appearance, probably associated
with pressure on the hypophysis. An attempt was made in the
cases of tumour to prevent the development of hydrocephalus, and
to relieve the severe pain by means of puncture of the ventricle.
In one case death followed seven hours after the puncture. In
one case the ventricle was frequently punctured with some sub¬
jective improvement, but with no improvement in the choked
disc; a fistula developed after this puncture.
C. Macfie Campbell.
CEREBRAL PARALYSIS WITH INTACT PYRAMIDAL TRACT.
(131) (Zerebrale L&hmung bei intacter Pyramidenbahn. Ein Beitrag
zu den Entwickltmgskrankheiten des Qehirns.) E. Hcestkrmann,
Arch.f. Psychiat., Bd. 49, H. 1,1912.
A report of four cases of hemiplegia, without evidence of de¬
generation of the pyramidal tract, with a review of the literature
dealing with similar cases. The author concludes that in child¬
hood hemiplegia may develop with a perfectly typical clinical
picture, but without involvement of the pyramidal tract, the cause
of which is a lesion of the cortex, especially of the anterior central
convolution. In this region one finds the disappearance of cell-
layers, an atypical arrangement of the cells, and arrested develop¬
ment of some of the cells. These anomalies prevent normal im¬
pulses being carried to the motor cells, which, although anatomi¬
cally connected with their own system of fibres, are physiologically
isolated. The anatomical conditions found by various authors are
as follows:—
1. Paralysis clinically, with anatomically an absolutely intact
pyramidal tract and atrophy of one part of the cortex, with normal
giant pyramids.
2. Clinically cerebral infantile hemiplegia, with anatomically
intact pyramidal tract and an old focus in the red nucleus.
3. Paralysis with intact pyramidal tract, and an old focus in
the thalamus.
4. Paralysis with intact pyramidal tracts, but absence of the
giant pyramids.
5. A case of Friedreich 8 disease without paralysis, but with
sclerosis of the pyramidal tracts.
6. Cases of idiocy with absence of the giant pyramids, but
intact pyramidal tract and unimpaired motility.
C. Macfie Campbell.
ABSTRACTS
171
MYASTHENIA. (Die Myaethenie.) Q. J. Mabkkloff, Arch. f.
(132) Psychiat ., Bd. 49, H. 2,1912.
The author reports seven cases of myasthenia personally observed,
and reviews the literature dealing with myasthenia. He empha¬
sises the fact that the disorder was not confined to the voluntary
muscles, but that it affected the whole musculature, including the
smooth involuntary muscles; thus the accommodation was easily
fatigued, and the heart muscles affected. Disorders of the bladder
and intestines of various kinds were observed. The disorders of
the bladder are considered by the author to be due to the great
muscular fatiguability. The origin of the severe diarrhoea occa¬
sionally observed is attributed to thyroid disorder. Muscular
atrophy is more frequently present than the literature would lead
one to believe, but it is sometimes concealed by pseudohypertrophy.
The author brings myasthenia into close relation with the muscular
dystrophies. He considers that the disease is based upon a certain
diathesis associated with a disorder of the internal secretions, and
that the clinical symptoms develop when the equilibrium of the
individual is upset by toxic, auto-toxic, or psychic factors.
C. Macfie Campbell.
MALUM PBRFOBANS IN DIABETES MELLITUS. A Report of
(133) Seven Oases. J. T. Sample and W. L. Gobham, Bull. Johns
Hopkins Hosp. y 1913, xxiv., p. 28.
The patients’ ages ranged from 48 to 65. Anaesthesia of the ulcer
and surrounding tissue was not marked in any case. The knee
jerks were absent in four and present in three. The authors
reject the view that the ulcer is due to changes in the peripheral
nerves as well as the vascular and mechanical theories, and hold
that the true cause lies in a disturbance of tissue vitality due to
hyperglycaemia. J. D. Rolleston.
RELAPSING OCULO MOTOR PARALYSIS IN URKUEMIO SUB-
(134) JB0T8. (Su di una paraliai recidiv&nte dell’ oculo-motore in
soggetti uricemici.) N. Scalinci, Gazz. internal, di med. chir ., dec.,
1912, p. 1157.
A record of two cases in men, aged 34 and 35 years respectively.
Neither had had syphilis, but both were uricaemic, and one had a
gouty heredity. The latter developed right ptosis without any
previous headache and paralysis of VI on the same side. This
happened several times in the course of nine years, sometimes
alternating with a similar paralysis on the opposite side. The
paralysis lasted on the average fifteen to twenty days. Finally,
recovery took place after anti-arthritic treatment. In the other
patient right ptosis was preceded by intense pain in the temporal
172
ABSTRACTS
region, and was accompanied by paralysis of VI. In the course of
two years he had three similar attacks of diminishing intensity.
After the first attack involvement of V was shown by anaesthesia of
the skin of the cheek and buccal mucosa of the same side.
J. D. Rolleston.
RECENT SYPHILITIC HEMIPLEGIA CONSIDERABLY IMPROVED
(135) BY SALVARSAN. (H6mipl6gie syphilitique rdcente consider-
ablement ameliorfe par le salvars&n.) Pieeeet and Hanne-
DOUCHE, Echo mid. du Nord , 1913, xvii., p. 5.
A man, aged 39, who had contracted syphilis six years previously,
and had left it untreated, developed sudden right hemiplegia with
anarthria. Three intravenous injections of 0*40 gr. salvarsan were
given, and within a month the patient could walk without support
and use his right hand. Recovery would probably have been
complete but for the occurrence of colic and diarrhoea which
necessitated interruption of the treatment. J. D. Rolleston.
THE EFFECT OP SALVARSAN UPON THE AUDITORY NERVE.
(136) A. Baades, Amer. Practitioner , 1913, xlvii, p. 27.
Bardes tested the hearing of forty-seven patients who had
received salvarsan, mostly intravenously. Six, whose hearing
before treatment had been normal, became deaf within a week or
month of injection. In four the disturbance was not noticed
until after the second injection. There was no evidence of middle
ear disease, but the symptoms were those of a lesion affecting the
auditory nerve. J. D. Rolleston.
ON THE PATHOLOGICAL ANATOMY OF THE PERIPHERAL
(137) NERVES IN METASYPHILITIO DISORDERS. (Beitr&ge nr
pathologischen Anatomie der peripheren Nerven bei den meta-
syphilitiscben Erkrankungen.) Arch. f. Peychiat., Bd. 49, H. 3,
• 1912.
The author reviews the literature and records the results of the
personal examination of the peripheral nerves in six cases of general
paralysis. He concludes that in metasyphilitic disorders there are
the same mesodermal changes in the peripheral spinal nerves as
in the other parts of the central nervous system. The changes in
the mesodermal supporting tissue of the nerves do not run parallel
with those in the nerve fibres. The disorder of the nerve fibres
of the peripheral nerves is functionally and anatomically inde¬
pendent of the process in the central nervous system. The
mesodermal changes in the peripheral nerves have no importance
for the symptomatology of the metasyphilitic disorders.
C. Macfie Campbell.
ABSTRACTS
173
ADIP OSIS DOLOROSA: STRIKING BENEFIT FROM FRESH
(138) THYROID GLAND. (Adipose douloureuse avec asthdnie:
action remarkable de l’opothdrapie thyroidienne.) H. Clauds
and A S£zasy, Gaz. deg H6p., Ann. 86, No. 5, Jan. 14,1913, p. 69.
Apart from the rather early age of onset (30) of adiposa dolorosa
in the woman whose case is here reported, the absence of psychical
changes is noteworthy: in both respects it resembles the case of
Delucq and Alaux ( v . Review, Yol. 2, 1904, p. 771). After com¬
plete failure of thyroid tablets, taken for twelve days, and only
trifling benefit from adrenal and ovarian therapy, fresh thyroid
gland feeding gave striking relief, so that after three weeks’
treatment the adiposis was greatly diminished and the asthenia
also. Relapse followed cessation of this fresh gland feeding, so
that fresh tender swollen plaques appeared: these yielded on
resumption of the treatment. So long as the patient continues
it she remains well in all respects, but relapses on its stoppage.
After four months of this treatment her weight returned to her
normal or slightly below it. Leonard J. Kidd.
SUPRARENAL MUSCULAR SYNDROMES. (Lea syndromes surrdno-
(139) mnscnlaires.) A S£zary, Sem. mtd., 1913, xxxiii., p. 61.
Certain slow changes in the suprarenals causing impairment of
their function may either alone, or in association with lesions in
the other glands of internal secretion, produce a myasthenic
syndrome which it is impossible to distinguish from myasthenia
unconnected with suprarenal insufficiency. In a given case of
myasthenia, therefore, it is advisable to employ suprarenal
opotherapy. Encouraging results have been obtained by supra¬
renal opotherapy alone or in combination with pituitary
medication.
Certain amyotrophic states may also be due to chronic supra¬
renal insufficiency, and benefit may be derived in such cases from
suprarenal opotherapy. J. D. Rolleston.
A CONTRIBUTION TO THE PSYCHIATRY AND NEUROLOGY
(140) OF SLEEPING SICKNESS, BASED ON OBSERVATIONS
IN THE SLEEPING-SICKNESS CAMPS, KIGARAMA AND
USUMBURA. (Psychiatrisch-neurologischer Beitrag zur Kennt-
nis der Schlafkrankheit nach Beobachtungen in den Schlafkran-
kenlagern Kiagarama and Usumbura in Deutsch-Ost-Afrika.)
W. Vix, Arch.f. Pgychiat., Bd. 60, H. 1,1912.
In Kigarama 70 patients were observed, and the progress of the
disease was followed. In 65 out of the 70 cases trypanosomes
were found in the blood or the cerebro-spinal fluid. Out of 27
cases punctured, 21 showed trypanosomes in the cerebro-spinal
id
174
ABSTRACTS
fluid; their motility rendered them easily visible in the fresh
centrifugate. The clinical picture was dominated by the mental
symptoms, and these were demonstrated in 55 out of 70 cases.
The patients were dull, apathetic, listless, showed little initiative:
a very pronounced somnolence was comparatively rare (5 cases).
In 41 cases intelligence defects could be demonstrated. In 28
cases there were conditions of excitement of greater or less
duration, and of manic type. Hallucinations were probable in one
case. Attacks of convulsions and Iobs of consciousness were
frequent (18 cases), sometimes with residual focal symptoms. The
attacks were similar to those in general paralysis.
In the large majority of the cases neurological symptoms were
demonstrated; dizziness was a frequent symptom, the pupils rarely
showed defective reaction, the external ocular muscles were not
affected. In 16 cases exophthalmus was observed, usually associ¬
ated with tachycardia. Facial paresis was present in 16 cases,
while the innervation of the tongue was involved in 23 cases.
The speech was rarely defective. Ataxia was present in 25 cases,
usually accompanied by tremor.
In advanced cases contracture developed. No sensory defect
could be demonstrated.
The clinical picture resembled general paralysis, but the
psychotic symptoms were more episodic than in the continuously
progressive course of the latter.
Anatomical examination of 3 brains disclosed a diffuse disorder
with perivascular infiltration, chiefly involving the larger vessels
and the white matter, with progressive and regressive changes of
the glia, and Nissl’s “acute alteration” of the nerve cells. The
architectonic of the cortex was undisturbed
C. Macfie Campbell.
PSYCHIATRY.
A DEMONSTRATION OF TREPONEMA PALLIDUM IN TEX
(141) BRAIN IN OASES OF GENERAL PARALYSIS. Hicayo
Noguchi and J. W. Mooee, Jowm. Exper. Med., Vol. xvii., No. 2,
Feb. 1913, p. 232.
The author examined seventy paretic brains, and succeeded in
finding the Spirochcete pallida in twelve cases. The area chosen
for examination was usually specimens of brain tissue from the
first right frontal sphere, but occasionally from the left hemisphere.
The twelve positive cases were clinically undoubted cases of
general paresis, but of a rapid course, the longest in duration
lived only thirty months. The post-mortem appearances, both
macroscopical and histological, were the typical lesions constantly
associated with general paresis. No softening, gummata, or
marked endarteritis were found. Ten were men, two were women,
and five cases were of the tabetic type. The method used for
ABSTRACTS
175
staining was a modified Levaditi silver method, the technique of
which the authors do not give. The spirochaetes were found in
all layers of the cortex except the outer layer: occasionally they
were found subcortically, they were never demonstrated in the
vessel sheath, and did not have any particular relationship to the
vessels; in the pia no spirochaetes were found. Drs Noguchi and
Moore found no ratio between the numbers of spirochaetes and
the severity of the paresis, although in one case in which they
were most numerous the paretic changes were very marked. They
conceive it is possible that the spirochaetes will be found more
readily in cases which run a fairly rapid course.
Winifred Muiriiead.
ON THE TBATMENT OF GENERAL PARALYSIS. (Die Behand-
(142) lung der progressive Paralyse.) W. Spielmeyer, Arch.f. Psychiat.,
Bd. 50, H. l, 1912.
The author discusses the clinical and anatomical data which
suggest that general paralysis may come to a spontaneous stand¬
still, and with regard to this question he adopts a very conservative
attitude. He discusses in great detail the analogy between general
paralysis and trypanosomiasis. The further treatment of general
paralysis will be directed along the lines indicated by recent
studies of trypanosome disorders. In the trypanosome disorders
treatment is ineffectual owing to the impossibility of reaching the
cerebro-spinal fluid through the meninges, a difficulty which is
of great importance in the treatment of general paralysis. The
exact method of administration of the therapeutic agent requires
yet to be determined. C. Macfie Campbell.
THE TREATMENT OF GENERAL PARALYSIS. (Die Behandlung
(143) deer progressives Paralyse.) E. Meyer, Arch. /. Psychiat., Bd. 50,
H. 1 , 1912.
The author discusses systematically the practical side of the treat¬
ment of general paralysis. Different forms of treatment have
been tried, directed both against assumed toxic and auto-toxic
processes and against syphilis. An endeavour to establish a non¬
specific immunity by means of tuberculin, deutero-albumose,
bacterial vaccines, nucleic acid, has given very modest results, and
the reports as to the results obtained in different hands are some¬
what contradictory. With regard to the action of mercury there
is a similar difference of opinion. The reports with regard to the
influence of salvarsan are equally contradictory. The alteration
•of the reaction of the cerebro-spinal fluid does not necessarily
mean a modification of the clinical course of the disorder. Out of
286 cases of general paralysis treated with salvarsan, 266 showed
no improvement. A bibliography is appended.
C. Macfie Campbell.
176
REVIEW
MANIC-DEPRESSIVE PSYCHOSIS IN TWINS. (Frenoai maniac*
(144) depressiva in gemelle.) C. Pianktta, Riv. ital. di Neuropat. r
Psychiat. ed Elettroter., 1913, v., p. 635.
A case of two sisters, aged 38, physically closely alike, whose
mother had had some psychical disturbance. Theresa, the elder
twin, developed the symptoms in the seventh month of lactation,
a few days before her sister Maria. The symptoms were the same
in both. Both were treated in distinct private asylums, but
whereas Theresa got well in three months, Maria took nine
months to recover.
Of the twenty-three published cases of insanity in twins, all
but one have been of the same sex. Fifteen were females, seven
were males, and one brother and sister. In almost all the cases
heredity was noted among the causes. In all the cases there has
been a great resemblance in the outward appearance associated
with a uniformity of character and strong ties of affection as in
the present case.
Some degree of mental debility is not uncommon in twins,
and as a rule the mentality of twins is not above the average.
With the exception of the legendary Romulus and Remus no
twins have ever attained distinction. J. D. Rolleston.
IRevtew.
INTERNAL SECRETION AND THE DUCTLESS GLANDS. Swalk
(143) Vincent. 1912. Ed. Arnold, London.
This book, which has a preface by Professor Schafer, gives a
critical account of our present knowledge of internal secretion,
a subject to which the author has devoted his attention for many
years.
The history of the conception of internal secretion is detailed,
and the various bodies entitled to inclusion among the ductless
glands described.
The author is very successful in prescribing and summarising
the extensive literature in a clear and interesting manner. The
book is far from being a mere compilation, nor are the views
expressed always those which may be said to hold the field in the
department of physiology treated.
Professor Vincent advocates restriction of the use of the term
“internal secretion,” which, in his view, has been unjustifiably
extended to include secretions from non-glandular cells, and
defines the process as consisting in the preparation and setting
free of certain substances of physiological utility by certain cells
of a glandular type, the substances set free passing not to a free
surface but into the blood stream. The question arises as to what
cells we must regard as glandular. The medullary cells of the
REVIEW
177
adrenal body are not “epithelial,” nor are those of the nervous
portion of the pituitary body, and yet it is in these cells rather
than in the associated epithelial masses that substances are con¬
tained having pronounced pharmacological properties, and the
author believes that these groups of cells constitute internally
secreting glands. With respect to the pituitary body, however
Schafer’s view must be considered, viz., that it is the function of
the pars intermedia, an epithelial structure, to produce a colloid
material which contains active principles or hormones acting upon
the heart, blood vessels, and kidneys.
Regarding the islets of Langerhans in the pancreas, the author
is of opinion that they do not constitute an organ distinct from
the pancreas, but that they are modified portions of pancreatic
tissue, capable under certain conditions of increasing at the
expense of the latter, and of being reconverted, as the physiological
conditions change, into secreting tubules.
The conclusion that the islets are not organs sui generis is not
necessarily antagonistic to the view that they are the part of the
pancreatic tissue concerned with carbohydrate metabolism. A
temporary structural modification of alveolar into islet tissue
may or may not correspond to a specialisation of function.
The precise relation between glycosuria and disease of the
pancreas is not yet sufficiently elucidated.
In discussing mammary secretion, the author takes the view
that the mammary honnone is produced by the corpus luteum,
and that enlargement of the mamma is not dependent upon
fertilisation. With regard to the work of Lane Claypon and
Starling, who find that injections of foetus into a virgin rabbit
cause growth of the mammary glands, it is pointed out that the
foetus in its entirety cannot be regarded as a gland with an
internal secretion, and that the mammary hormone derived from
foetal tissues is not specific.
There has been a tendency recently to attribute various forms
of glycosuria to the secretion of the suprarenal bodies. The
author thinks that the final solution of the problem may be
arrived at by an accurate knowledge of the interaction between
the adrenals and the pancreas through the mediation of the
sympathetic nervous system.
The function of the cortex of the suprarenal is not known.
There are some reasons for supposing that it may yield a hormone,
derived from its lipoid granules, which influences the growth and
nutrition of certain tissues and organs, and especially the organs
of reproduction.
With regard to the thyroid and parathyroid bodies, the author
adopts the view that the fundamental histological features of the
two tissues are, if not identical, at any rate very significantly
similar. Parathyroid tissue left in situ when the thyroid is
*7
178
BOOKS AND PAMPHLETS RECEIVED
removed by operation, approximates in appearance to the latter,
so that the final product in some cases cannot in microscropic
examination be distinguished from thyroid tissue. Thyroid and
parathyroid form a single physiological apparatus, the two kinds
of tissue being intimately associated embryologically and working
together physiologically.
The pituitary body, as regards histology, probable function
and pathology, is fully discussed. Schafer’s work has demonstrated.
that, besides their action on the blood pressure, extracts of the
posterior lobe have a diuretic effect, and the author thinks it
probable that this may be of clinical value.
Wm. A. Jolly (Cape Town).
BOOKS AND PAMPHLETS RECEIVED.
Abraham, Karl. “ Dreams and Myths ” ( Nerv. and Ment. Dis. Mono¬
graph Series, No. 15, New York, 1913).
Cecikas, J. “Contribution i l’6tude de I’h6r6dit4 pathologique” (Rev.
de Mid., Ann. xxxil. No. 12, D6c. 10,1912).
Elliot, R. H. “ Sclero-corneal Trephining in the Operative Treatment
of Qlaucoma." George Pulman <fe Sons, London, 1913. Price 7s. 6d. net
Jones, Edith K. “ Library Work among the Insane ” (Bulletin Amer.
Library Assoc., Yol. 6, No. 4,1912).
Langdon, F. W. “The functional psycho-neuroses” (Lancet-Clinic,
Dec. 21,1912).
Oppenheim, Hermann. “ Uber klinische Eigentumlichkeiten kongeni-
taler Hirngeschwulste ” (Neurol. Centralbl., Nr. 1,1913).
Rivers, W. C. “Walt Whitman’s Anomaly.” Crown 8vo. George
Allen A Co., London, 1913. Price 2s. 6d. net.
Salmon, Alberto. “ Di un caso di thrombosi dell’ arteria vertebrate e
della cerebellare posteriore ed inferiore” (Arch, di Biol. norm, e patol.,
Anno Ixvi., F. iv., Lugiio-Agosto, 1912).
Salmon, Alberto. “ La nevrosi traumatica.” 1913.
Sommer, R. “Klinik f. psych, u. nerv. Krankh.” Bd. vii., H. 4,1912.
Carl Marhold, Halle a S., 1912.
Stephenson, Sidney. “ Eye-strain in everyday practice.” The Ophthal¬
moscope Press, London, 1913. Price 3s. 6d. net.
Wells, F. L. “Practice and the Work-curve” (Amer. Joum. Psychol.,
Vol. xxiv., Jan. 1913, pp. 35-51).
Wells, F. L. “ The Association Experiment ” (Psychol. Bulletin, VoL ix..
No. 11, Nov. 15, 1912, p. 435).
Wells, F. L. “ Ossip-Louri^’s ‘le Langage et la Verbomanie’” (Journ.
Phil., Psychol, and Scientific Methods, Vol. ix., No. 24, Nov. 21,1912).
Wells, F. L. “Fatigue” (Psychol. Bullet., VoL ix., No. 11, Nov. 15,
1912, pp. 416-420).
“The Training School,” Yol. ix., No. 10, Feb. 1913.
“The Hundredth Annual Report for the Year 1912 of the Royal
Edinburgh Asylum, Morningside: Craig House and the West House,” by
Dr G. M. Robertson.
IReview
of
IReurolog^ anfc Ips^cbiatr^
©dglnal Reticles
MULTIPLE NEUROMATA OF THE CENTRAL
NERVOUS SYSTEM: THEIR STRUCTURE
AND HISTOGENESIS.
By tbo late ALEXANDER BRUCE t M.D«f LL.D., F.R.C-P.E. j and
JAMES W. DAWSON, M.D. (Carnegie Research Fellow).
(Continued from page 160.)
II.— Interpretation and Conclusion.
In trying to answer the question. What conclusions may be drawn
from our observations ? or, in other words. What is their explana¬
tion? we are met at the outset by the necessity of bringing, if
possible, the various formations described into a genetic relation
to one another. In the attempt to correlate the appearances in
the cord with those in the medulla oblongata and pons the problem
in the cord is, obviously, the genesis of the nerve fibres, for these
elements are the essential constituent of the nodules, while the
problem in the medulla and pons is the genesis of the fusiform
cells, for the various formations can be related to them.
In the cord the fibres were disposed, more or less, in the form
of stTands or nodules in numerous positions. They were found
always in relation to pia, pial septa, or the adventitia of vessels,
and only in their terminal ramifications did the individual fibres
come into direct contact with the actual nerve tissue. The fibres
of the nodules could in all instances be traced to strands passing
laterally or ventrally from the immediate vicinity of the emerging
18
180 ALEXANDER BRUCE AND JAMES W. DAWSON
anterior roots. Those passing laterally in the pia entered inwards
by all the peripheral vessels of the lateral region of the cord;
they formed nodules in the vessel-walls and at the junction of
white and grey matter, where their fibres terminated by gradually
unweaving themselves from the nodule into the general texture of
the grey matter. The fibres passing ventrally curved round into
the anterior fissure, as a rule to its base, forming a large nodule
in the region of the central canal, passed along the commissural
vessels to form nodules in the centre of each grey matter, and
often leashes of fibres passed along in the vessel-walls anteriorly,
laterally, and posteriorly. The terminal fibres of these nodules
again gradually unwound into the general meshwork of the grey
matter, interlacing with fibres from the nodules which had formed
in relation to peripheral vessels.
With Weigert’s medullated sheath stain these fibres are found
to have a specifically but faintly staining myelin sheath with
short and bulging interannular segments; with Cajal’s silver
method for medullated nerves the axis-cylinder stained specifically;
and with nuclear stains the fibres gave the appearance of peripheral
nerves, with, however, a finer general structure, and more numerous
and larger nuclei. The nuclear stains revealed also—what the
myelin sheath and axis-cylinder stains had only slightly indicated
—that the fibres in their terminal ramifications were continuous
with nucleated protoplasmic tubes in which a central filament and
a homogeneous outer zone could be recognised, corresponding to
the axis-cylinder and myelin sheath, and, further, that these
nucleated tubes could be traced frequently to terminate in fusiform,
nucleated elements. Some of these were simply the sections of
the nucleated tubes cut in various directions, but others could be
satisfactorily and definitely proved to be individualised fusiform
cells. In some of these cells could be traced a fine continudus
deeply staining filament in the protoplasm on one side of the
nucleus.
In the medulla and pons the most distinctive feature of the
formations was an interlacing meshwork. When this was analysed
it was found to consist of fusiform elements and again nucleated
tubes cut in various directions. In the protoplasm of many of the
cells there was present on one side of the nucleus, or projecting
beyond its poles, a deeply staining filament which increased in size
with the size of the cell. Further, many of these fusiform cells
NEUROMATA OF CENTRAL NERVOUS SYSTEM 181
were found linked together by their adjoining processes which had
fused, and stages could be followed in the transition to cylindrical
tubes in which the fusion had become complete and the cell-
boundaries had disappeared, and protoplasmic bands or tubes had
resulted. In these nucleated tubes or protoplasmic bands there
was present a deeply staining central filament, winding in and out
amongst the nuclei, and around it a homogeneous zone, with very
numerous nuclei definitely within or projecting into the lumen of
the tube. Further, it was noted that a cell-chain, thus formed,
frequently divided into two, the first components of the chain lying
very close, almost parallel to one another. The linked cells as they
formed nucleated tubes tended to converge together to form strands,
and in these strands of nucleated tubes running parallel to one
another the central filament became gradually more distinct, the
nuclei more flattened and peripheral and with an alternating
position. Further, in such strands evidence was found of an un¬
doubted commencing myelination, the tubes showing this all
having a very definite segmental structure. Further, these parallel
strands of nucleated tubes assumed a tortuous or twining character
to form nodules, and during this further evolution the nuclei took*
a still more peripheral position and the whole tube more the
character of a peripheral nerve. This was the furthest stage in
the evolution of the nodules in the medulla and pons: the tubes
had thus three phases in their evolution—firstly, a cellular one;
secondly, that of protoplasmic bands or tubes; and thirdly, one
showing the division into interannular segments and a commencing
myelination.
In the cord, therefore, we have well-stained nerve fibres,
apparently terminating in nucleated tubes and fusiform cells ; in
the medulla and pons we have fusiform cells and nucleated tubes
apparently forming strands of nucleated fibres which have many
of the characters of the fibres forming the more fully evolved
nodules in the cord but without their specific staining; while the
constituents common to the formations in both regions are the
nucleated tubes and the fusiform cells. The position stated thus,
it is not difficult to correlate the appearances, and the conclusion
might at once be reached that in the cord we have simply a further
stage in the evolution and differentiation of the fibres.
Before, however, accepting this conclusion, it is necessary to
ascertain if no other explanation can be found. If we limit
182 ALEXANDER BRUCE AND JAMES W. DAWSON
ourselves to the cord and recall the fact that the nerve fibres
composing the nodules could in all instances be traced to the
immediate vicinity of the anterior roots, two possible explanations
at once present themselves, both of which are in agreement with
the old-established outgrowth theory. The one is, that the fibres
represent aberrant anterior nerve roots in the sense of Orzechow-
ski, and the other, that these are new-formed fibres of regeneration
from the anterior roots, in the sense of the collateral regeneration
of Nageotte in tabes.
For the first we must assume that in early foetal life a
meningeal lymphangitis had caused a diversion of the growing
axons, so that instead of passing into the spinal nerves a certain
number of them had become side-tracked into the meninges, and
thence made their way along the vessels of the cord and in the
pial spaces ventrally and laterally. The fact that in the immediate
neighbourhood of the anterior roots the fibres composing the
strands were few in number compared to the great mass of the
fibres composing the nodules, in no way tells against this view,
for the importance does not depend upon the number of the axis-
cylinders. It is well known that one axis-cylinder can furnish
a large number of fibres by breaking up into its constituent fibrils:
these, according to accessory circumstances, can twist up into
whorls and form nodules when they come even from an extremely
restricted number of fibres. Such neuromata would be analogous
to stump-neuromata. But while it is possible in Weigert- and
silver-stained preparations to explain the fibres as outgrowths
from the axis-cylinders and their divisions, it is impossible to
account for the nucleated tubes and fusiform cells with which
the nerve fibres were continuous as outgrowths from axis-cylinders.
For the second possibility it is necessary to presuppose a
degeneration, in order that a regeneration might occur from the
preserved end. Such neuromata would again be analogous to
stump-neuromata. Nageotte’s position has been already stated,
and it has also been pointed out that such an explanation cannot
be accepted for the fibres forming the neuroma, for no degenera¬
tion of extra-medullary anterior root could be traced. Further,
if evidence of such regeneration had been present, the explanation
is still awanting of the presence of the nucleated tubes and
fusiform cells with which the nerve fibres are continuous.
If, now, we turn to the medulla and pons, it is clear that
NEUROMATA OF CENTRAL NERVOUS SYSTEM 183
neither of the two possibilities that at first presented themselves
as accounting for the cord nodules need be considered There is
no question of tracing the fibres composing even the most fully
formed nodules to aberrant nerve fibres nor to a regeneration of
fibres. Further, if such connections existed it would be the con¬
nection beween fully differentiated fibres and immature fibres—a
connection inconsistent with the explanation of the axis-cylinder
as an outgrowth.
We have still to consider one further possible explanation for
the cord neuromata before we have cleared the way for attempting
a unification of the processes at work. This explanation is related
to the multicellular structure of the peripheral nerves. In stump-
neuroma, Kennedy has found that the new-formed fibres terminate
in protoplasmic tubes and fusiform cells within which axis-cylinder
and myelin-sheath differentiation is taking place. The new-formed
fibres are in direct continuity with a nerve which preserves its
connection with the centre, and, according to the cell-chain theory,
the new fibres have arisen within the proliferated cells of the
sheath of Schwann, and only later become continuous with the
fibres of the preserved end. The possibility here also is that these
are aberrant anterior nerve roots which in early foetal life have
taken this aberrant course, and that some influence has caused a
proliferation of the sheath of Schwann cells at the growing tips of
the fibres with the formation of nucleated tubes and fusiform cells;
these would therefore retain their connection with the centre just
as the new fibres in the stump-neuroma. This explanation, while
satisfactory for the cord, from the point of view of the cell-chain
structure of the nerves, prevents the unification of the processes,
for there can be no such analogous explanation of the nucleated
tubes and fusiform cells in the medulla and pons. If, now, in
our endeavour to correlate the changes, we pass from our observa¬
tions to the conceptions which they justify, it is essential to admit
that the question of the genesis of the nerve fibres is the same as
the question of the genesis of the fusiform cells.
Before entering upon the consideration of the origin and nature
of the fusiform cells, it is necessary to ask what collateral evidence
we have that such fusiform cells can thus form nerve fibres,
and we find that along three pathways research has led to the
conclusion that the peripheral nerve fibre arises as a multicellular
structure.
184 ALEXANDER BRUCE AND JAMES W. DAWSON
It is beyond the scope of this paper to deal with the general
evidence for and against the different views relating to the
development of the nerve fibre in the embryo, in regeneration, and
in tumour formation, but from this evidence we wish to take such
observations as throw light on our own.
(a) In embryonal development.—The works of Balfour, Dohrn,
Beard, Hoffman, and others have demonstrated that, in Elasmo-
branchs and Selachians, cells, migrated from the embryonic
medullary tube, form cell-chains, and that each nerve fibre pro¬
ceeds out of any single chain by a differentiation within the
protoplasm. In the higher vertebrates the conditions seem not
quite so simple. Numerous recent observations, especially those
of Bethe, have shown that the first evidence of nerves consists of
a characteristic series of cells which form a syncytical cell-chain,
and that the first fibres lie within the protoplasm of this syncytium.
Kohn, too, in rabbits, has demonstrated the gradual transformation
of the indifferent cells of the spinal ganglionic anlage into ganglion
cells and nerve fibre cells, and the development of the latter into
nucleated tubes, and finally into the fibres of the sensory nerves,
the nuclei becoming ultimately the nuclei of the sheath of Schwann.
Kohn, further, has shown that the indifferent cells of the spinal
ganglionic anlage migrate along developing nerve paths, e.g., the
visceral branches of the spinal nerves, to form the sympathetic
ganglionic anlage, that in it the indifferent cells (neurocytes of
Kohn) undergo this differentiation into ganglion cells, nerve
fibre cells, and chromotrope cells, and that only when the
nerve fibres are formed does the connection take place with the
ganglion cell.
(b) In regeneration of nerves.—Galeotti and Levi found in the
new-formed tails of lizards that the first evidence of the new nerve
fibres between the young muscle fibres was in the form of chains
of fusiform cells linked end to end. Within the protoplasm of
these cells a central granular filament—corresponding to the future
axis-cylinder—developed, and, ultimately as the processes of the
cells fused and the cell boundaries became lost, the central filaments
became continuous. In mammals the activity of the neurilemma
cells in the regeneration of nerves has never been disputed, only
its result has been questioned. According to the supporters of
the cell-chain theory, the proliferation of the neurilemma nuclei
results in the formation of elongated cells which fuse to form
NEUROMATA OF CENTRAL NERVOUS SYSTEM 185
syncytical cell-chains, and in the syncytical protoplasm an axis-
cylinder differentiation occurs.
Now, as the proliferation of the neurilemma nuclei indisputably
results in the production of a tissue, acknowledged by centralists
and peripherist8 alike to be a specific tissue, in the sense that it is
a product of the Schwann cells and differs in structure, staining,
and arrangement from ordinary connective tissue; further, as this
specific tissue has, with slight unessential differences, the characters
of embryonic nerve tissue: and, further, as the works of Durante,
Ball an ce and Stewart, and Bethe have shown that the production
of this tissue from proliferated cells leads to the formation of
nucleated tubes and fibres with axis-cylinder and commencing
myelinisation, we have distinct evidence in support of our observa¬
tions of the formation of nucleated tubes and fibres from the
alignment and fusion and evolution of fusiform cells.
(e) In tumour formation.—Weichselbaum, Verocay, Falk, and
Schmincke have all described the formation of a neurogenous
tissue composed of protoplasmic nucleated tubes or bands in the
condition of embryonic, and even more fully differentiated, nerve
fibres. They bring the tissue into relation to a proliferation of the
cells of Schwann’s sheath or the less differentiated precursors of the
.same—nerve fibre cells. The transition between fusiform cells
and nucleated tubes was followed to the increasing development
within the latter of the differentiated elements of the nerve fibres.
Verocay emphasised the statement that a tissue giving the
characters of immature or embryonic nerve fibres must in all cases
be related to a proliferation of the sheath of Schwann cells or
analogous elements.
Having received this collateral evidence that fusiform cells
in development, in regeneration, and in tumour formation, may
develop a neurogenous tissue composed of nerve fibres in the
condition of nucleated tubes with a commencing myelination, we
can now pass to consider the source and nature of the fusiform
cells.
Origin of the Celle .—Two possibilities alone can account for
their genesis. The one, that they are derived from fixed tissue
elements of the nervous tissues; the other, that they are derived
from abnormal cells enclosed in the tissues in early development
—in other words, from embryonal residues. For the first we
have no evidence. For the second it may be objected that the
186 ALEXANDER BRUCE AND JAMES W. DAWSON
terms “ embryonal residues,” “ cell-rests,” “ cell-inclusions,” convey
no concrete conception, yet it must be admitted that some such
term must be postulated, and the oncology of the cord, in the
processes related to the closure of the medullary groove, allows a
possible relationship between tumour-growth and disturbances of
development to be more clearly perceived than in most tissues.
Obviously, then, to go further in our conclusions than oui
actual observations justify, we need to start with a good deal
assumed. The one conclusion that appeared as a natural conse¬
quence of our observations—the multicellular structure of the
fibres composing the nodules—leaves much still to be explained,
and for this further explanation we must have recourse to deduc¬
tions from conclusions accepted by other workers.
Nature of the Cells .—The development of the cells thus enclosed
in the brain and spinal cord into nucleated tubes and fibres
suggeets that they were destined to form such structures in the
ordinary course of development. For collateral evidence on this
point we refer again to the development of nerve fibres in the
embryo and in tumour formation.
(а) In embryonal development.—Numerous observations point
to the possibility that the cells of the early medullary tube
differentiate along three lines to form ganglion cells, glia cells,
and nerve fibre cells—cells which migrate and form cell-chains
and are therefore peripheral neuroblasts. Other observations
point to the possibility that the indifferent cells of the spinal
ganglionic ardage differentiate into ganglion cells, capsule cells,
and nerve fibre cells. In each case the nerve fibres are only
secondarily brought into connection with the process of the
ganglion cell. The prototype of the ganglion cell (central neuro¬
blast), glia cell, and nerve fibre cell (peripheral neuroblast), is
the same mother-cell. Similarly, in the sympathetic ganglionic
anlage, indifferent cells differentiate into ganglion cells, nerve
fibre cells, and chromotrope cells.
(б) In tumour formation.—In the ganglio-neuroma, described
by Falk and Verocay, the origin of the ganglion cells and
nerve fibres has been traced to a common parent cell—the early
indifferent cell, which has remained undeveloped. The nerve
fibres found in these tumours in varying stages of development
are ascribed to these cells as nerve builders and not to the
ganglion cells, which were too immature—in many cases quite
NEUROMATA OF CENTRAL NERVOUS SYSTEM 187
a-polar—to have formed them. The importance of Kohn’s
researches on the development of the sympathetic is of special
significance in relation to the development of ganglio-neuroma.
These tumours are traced to indifferent cells which have not
achieved their differentiation and evolution, and later, fulfil their
destiny in an exaggerated degree. The presence of ganglion cells,
nerve fibre cells, and chromotrope cells has been described by
numerous writers in such tumours, especially those developing
in relation to the medulla of the adrenal.
In some of the tumours of the cranial nerves described by
Verocay, and in the tumours of the Gasserian ganglion and intra¬
cranial portions of the cranial nerves, described by Risel, ganglion
cells, glia cells, and nerve fibre cells could be traced in all stages
of transition between a common undifferentiated type to mature
ganglion and glia cells and nerve fibres in different stages of
development. Such observations are obviously difficult of objective
proof, but their importance lies in the conception of the authors
that the tumour formations must be traced to an undifferentiated
cell which realised to differing degrees the differentiating possi¬
bilities present in it in the form of all three components of the
nerve tissue. Verocay has suggested the term “neurinoma,” for
tumours of nervous nature derived from the proliferation of nerve
fibre cells or their precursors. In neuro-glioma the ganglion cells
and glia cells are both traced to the proliferation of an undiffer¬
entiated cell common to both forms, and in a case of neuro-glioma
of the temporal lobe Schmincke traced the nucleated protoplasmic
tubes present also to a common parent cell He suggests that the
production of such neuroblast chains in a tumour of the central
nervous system may throw some light on the development of the
central nerve fibres from cells. Glioma also are to be traced
back to the development of embryonic indifferent cells, without
excluding the possibility of glioma-formations in later life from
already differentiated glia tissue.
Circumscribed neuromata, including amputation neuromata, are
ascribed to the proliferation of the sheath of Schwann cells, which
thus reassume their primitive neuroblastic function, and may
develop into a-myelinated or myelinated fibres or remain at a less
differentiated cellular stage.
From these observations we conclude that there is evidence
for the view that undifferentiated nerve fibre cells, arisen either
188 ALEXANDER BRUCE AND JAMES W. DAWSON
from the early medullary tube or neural crest and remaining
undeveloped in the tissues, may develop into nerve fibres through
stages which include the fusion of the adjoining ends of linked
cells, the formation of nucleated plasmodial bands or tubes, and
the differentiation of these into segmented nerve fibres. Further,
that peripheral neuroblasts (nerve fibre cells), from the point at
which they emerge from the medullary tube, or from the point
of the medullary tube which they reach from the neural crest,
migrate outwards and proliferate to form a cell-chain, the proximal
link of which becomes connected with the process of a central
neuroblast. For the sensory cerebro-spinal nerves we would
substitute the ganglionic anlage, derived from the neural crest, as
the centre for the centripetal and centrifugal growth of the cell-
chains, and for the motor cranial nerves their superficial origin
instead of the line formed by the anterior spinal roots. Indifferent
cells (neurocytes) would thus lie in immediate relation to the
mesodermic tissue which would form the anlage of the connective
tissue elements of the cord and brain, and in this mesodermic
tissue the indifferent cells might remain undeveloped. When
the invagination of the early medullary tube takes place by the
entering vessels, some of these indifferent cells would be carried in
with the pia and, especially in the medulla and pons, where the
distribution of the nerve fibres is not so uniform as in the cord
where the anterior columns run in straight lines, would be carried
inwards in the walls of the vessels to numerous and widely
distributed areas.
The question of the unification of the processes in the cord
with those in the medulla and pons here again arises. The analogy
with the growing terminal ramifications of the new nerve fibres in
amputation neuroma, and in the regeneration of nerve fibres in the
tail of lizards, where the new fibres terminate in a brush of fusiform
cells, and the knowledge that the growing axon of a nerve is
surrounded by a capsule of such cells, would lead us to assume
that the terminal ramifications of the fibres, which break up into
those fusiform cells, are the growing points of the fibres, and that
the most fully evolved and differentiated part is the oldest part of
the fibres. In the cord this part of the fibres is in the pia, in the
immediate vicinity of the anterior roots; in the medulla and pons
the most fully-differentiated fibres are in the more central parts of
the nodule, and the winding of the fibres, as it were, has taken
NEUROMATA OF CENTRAL NERVOUS SYSTEM 189
place around the first-formed elements. The fibres in these
positions are derived, therefore, from “ rests ” of undifferentiated
cells of the value of peripheral neuroblasts, which have been
carried in to the tissue in the .walls of the ingrowing vessels, and
which go on to the production of a neurogenous tissue which
reaches the stage of embryonic fibres—the protoplasmic bands of
Durante. The fibres in the cord have arisen from “rests” of
undifferentiated cells left in the immediate vicinity of the part
where in normal development the fibres are first laid down. As
the spaces in the pia and pial septa give them a free path of
growth, they develop in parallel and intertwining strands, and only
later, when possibly they meet with some difficulty in their path,
do they assume a twisted and nodular form. The precise origin
of the fibres, from the point immediately peripheral to the
Ablamingzone of the anterior nerve roots, is explained by the
fact that here probably the nerve fibre cells, according to this
view of their development, are first likely to be deposited.
Still assuming the peripherist view of the origin of the nerve
fibre from a cell-chain, the question arises: Is it possible for such
indifferent cells of the value of peripheral neuroblasts, inde¬
pendent of any central influence and function, to differentiate to
the stage of the most fully evolved fibres in the cord ? An
answer to this question would be rendered easier if we could
indicate the period at which these nodules have arisen. Is it
that in a very early stage of development, pari passu with the
development of the blood-vessels, indifferent cells have laid down
embryonic nerve fibres? In such a case we find it easy to
understand that this abnormal cell-chain might become linked on
to the process of a central neuroblast just as the normal anterior
roots become connected. If these, then, were such aberrant
nerve roots, the incompleteness of their differentiation would be
sufficiently accounted for by the sterility of their function. In
such a case, however, we would have to admit that nodules with
fibres having no function have persisted through life in spite of
the supposed inherent weak vitality of such fibres. On the other
hand, is it possible that undifferentiated potential peripheral
neuroblasts have remained undeveloped at the point of their first
deposition, and in later life have taken on a proliferative activity
which has resulted in the formation of nerve fibres ? The most
fully evolved portions of such fibres have remained as parallel
190 ALEXANDER BRUCE AND JAMES W. DAWSON
strands near the point of their formation, because the free lymph
space in the pia and pial vessels has allowed the progression
laterally and ventrally, of the fibres.
Returning now to our question regarding the stage to which
peripheral neuroblasts alone may achieve the differentiation of
the nerve fibre, we must refer to evidence obtained from the
regeneration of nerves and from tumour formation.
(a) In Regeneration .—It has frequently been pointed out that
a neurogenous tissue, with many of the characters of embryonic
nerve tissue, arises in the distal end of a severed nerve as a result
of the activity of the cells of Schwann’s sheath. Durante,
Ballance and Stewart, and Bethe have shown that in the specific
tissue a differentiation to axis-cylinder and incomplete myelination
may take place even when the distal end is not united to the
central end. For a complete differentiation of axial fibrils and
myelin, all admit that the influence of the central neuroblast
is essential.
(b) In Tumour Formation .—The generalisation that the genesis
of nerve fibres in regeneration recapitulates the stages of its first
development has necessarily its limitations, and one of these may
be the modifications imposed on the cells derived from the
proliferation of the sheath of Schwann nuclei. It is not necessary,
then, to deny the possibility that in tumour formation peripheral
neuroblasts can form completely differentiated fibres, for here we
are dealing with cells left undeveloped in the tissue. The
evidence from the cases of ganglio-neuroma already mentioned
leads us to suppose that the nerve fibre cells or their precursors
differentiate to the development of nerve fibres which show many
of the characters of fully formed nerves, stopping short again of
the stage of complete axial fibril and myelin differentiation.
From this evidence, therefore, we gather that it is quite
conceivable that the fusiform cells in our preparations have
evolved to the formation of nucleated tubes in the condition of
the protoplasmic bands of Durante in the medulla and pons, and
in the cord to a yet completer stage of differentiation. Lenhossek,
a convinced centralist, states in his latest paper that he cannot
deny the evidence that the sheath of Schwann cells (lemnoblasts)
, may in pathological conditions, in virtue of their origin from the
neural crest, produce true nerve fibres. To Lenhossek the sheath
of Schwann cells are the glia elements of the peripheral nervous
NEUROMATA OF CENTRAL NERVOUS SYSTEM 191
system, but he thinks that, in the uncertainty of our conception
of tiie actual manner of cell differentiation, it is possible that a
mother cell which should have differentiated along one line may
in pathological conditions differentiate along another which had
the same histogenesis.
This attempt at a possible interpretation and correlation of our
observations is not regarded as in any sense a logical proof. It is
not contended that the facts prove the truth of this conception,
but it is maintained that this view, though based only on deduc¬
tions, gives clearness to an otherwise quite unintelligible process.
It is convenient at this stage to consider one or two criticisms
of the peripherist standpoint with special references to appearances
in our preparations.
The necessity of the influence of the central ganglion cell to
complete the differentiation of the new nerve fibre, arisen from
the proliferation of the sheath of Schwann cells, in regeneration
has seemed an unassailable argument in favour of the centralists’
view. To this criticism the reply has been made that if it is true
that every cell differentiates in view of a function, it is necessary
to remember that it is the functioning which determines and
perfects the cell differentiation. The nerve paths in the embryo
remain as embryonic nerves till the function of the tract is called
into play; influences which accelerate or retard the period at
which nerve fibres are brought into functional activity have also
an effect in determining the date of complete axial fibril and
myelin differentiation. Margulies has pointed out that in the
newly-born kitten, if the eyelids on one side are carefully opened,
the optic nerve on that side myelinates before that of the opposite
side excluded from the light, and numerous other instances might
be given where the completion of differentiation is related to the
completion of function. The fibres in the distal end of a non-
united nerve remain for a very considerable time as embryonic
nerve fibres, but when secondary suture is carried out they very
rapidly effect a complete differentiation—in a period of time in
which it would have been impossible for axis-cylinders to grow
out from the central to the distal end.
The differentiation proceeds, therefore, pari passu with the
functioning which is its determining cause. Ballance and Stewart
think that some stimulus, afforded by the conducting of impulses,
is necessary in order to admit of the full development of the nerve
192 ALEXANDER BRUCE AND JAMES W. DAWSON
fibres, and Graham-Kerr relates the differentiation of the neuro¬
fibrils to the repeated passage of impulses along them. To attain
its perfect structure, therefore, a nerve must be brought into
relation to its functional Inanspruchnahme. Bethe, at present the
most prominent supporter of the peripherist view, claims that it is
not necessary to have complete differentiation to have an auto¬
genous regeneration. Regeneration in the distal end of a non-
united nerve is not due to the ingrowing of axis-cylinders from
the central end, but the autogenous regeneration of the sheath of
Schwann cells forms a neurogenous tissue to which complete
differentiation comes when the nerve is brought into its Funktions-
kreis. This neurogenous tissue is the maximum of what could be
expected for the regenerative powers inherent in oells which have
been derived from highly differentiated elements, while the first
development is carried out in definite correlation with tissues all
in the act of development. Bethe in some of his interpretations
may have overstepped the mark, and some of his experiments may
not be unequivocal, yet his basal contention, maintained after long
research and in face of the severest criticism, that the new fibres
arise within the proliferated cells of the sheath of Schwann and
not as outgrowths of the central axis-cylinder, is supported by the
results of the most recent embryological researches, by a very large
number of workers on the regeneration of nerves, and by numerous
observations on the genesis of nerve fibres in tumours.
A further criticism has been raised by Cajal and Perroncito in
regard to the division of the fibres and the leashes of fine fibrils
found in the old neurilemma sheaths of a regenerated nerve.
Those writers think that it is impossible to explain such findings
except by the dissociation of the old axis-cylinder into its constit¬
uent fibrils and the terminal or collateral branching-off of these
primitive fibrils. Ballance and Stewart have noted that the
proliferated sheath of Schwann cells divide in an obliquely longi¬
tudinal plane so that the resulting daughter cells somewhat over¬
lap one another, and by successive divisions closely-set longitudinal
oolumns or chains are formed. The first threads of axis-cylinders
appear in close relation to the elongated nuclei, and each cell is
potentially capable of forming a segment of a complete nerve
fibre, so that within an old neurilemma sheath may be found
parallel axis-cylinder filaments which ultimately join with the
poles of adjoining filaments to form a leash of fibrils. Francini
NEUROMATA OF CENTRAL NERVOUS SYSTEM 193
and Durante have observed that in the proliferation of the sheath
of Schwann nuclei the division may take place in two directions,
ue., transversely to the longitudinal axis of the cell, and parallel to
it In our preparations we have drawn attention to the evidence
of the longitudinal cleavage of nucleus and cell which results in
the formation of the first links of two new chains, which thus give
the appearance of a dichotomous division and have suggested that
a further elongation of the cell-chain takes place by transverse
cleavage of nucleus and cell
Again, regarding the chemiotropic influence attributed by the
centralists to the sheath of Schwann cells, it is not easy to under¬
stand what attracting or directing or orienting influence these cell-
chains could have in the development of a nodule whose fibres
cross each other in such varying directions. There is much to
indicate that the nerve fibres take the path of least resistance, and
are guided by the more fixed structures in the line of their general
growth.
We have noted these criticisms of the peripherist view in
relation to points bearing on our preparations, and we close with a
brief statement of three criticisms of the outgrowth theory. The
supporters of the cell-chain structure of the peripheral nerves,
firstly, find it difficult to conceive of a prolongation of a cell so
disproportionate to the element which gave it birth; secondly,
believe it impossible that a differentiated substance like the axis-
cylinder can bud, as such a procedure is against the data of
general cytology which attributes to differentiated substances only
a functional r61e; and finally they attribute the absence of any
satisfactory demonstration of regeneration of fibres in the central
nervous system to the absence of the activity of the neurilemma
cells.
Conclusion .—Francini states that in the histological study of a
neuroma an intuition came to him of the constitution of the peri¬
pheral nerves. We think it right to emphasise that we began
this investigation with no preconceptions in favour of the multi¬
cellular structure of the peripheral nerve. We accepted the classical
teaching of His and Cajal that the axis-cylinder is an outgrowth
from the central cell and that its free end terminates in an incre¬
mental cone of growth. A prolonged study of our preparations
and the further light shed upon them by research into the
194 ALEXANDER BRUCE AND JAMES W. DAWSON
literature of the genesis of the nerve fibres in the embryo, in
regeneration, and in tumour formation, led us, however, to the
following conclusions: that fusiform nucleated cells linked on to
one another have formed embryonic nerve fibres; that in these
nucleated fibres, which show very distinctly in their segmental
structure their origin from individual cells, have differentiated
to a greater (in the cord) or lesser (in the medulla oblongata and
pons) degree the specific nervous elements—axis-cylinder and
myelin sheath; and that function is essential to the complete
differentiation of the nerve fibre. As the genesis of these cells
cannot be traced to any of the specific elements of the tissue, we
suggest that the fusiform nucleated cells which build up the
nucleated tubes and nerve fibres are indifferent cells of the value
of peripheral neuroblasts—according to the cell-chain conception
—which have wandered into the mesodermic tissue forming the
anlage of the vessels and of the connective-tissue constituents of
the cord, and that, later, they develop their latent activity.
The multiplicity of the nodules favours this mode of origin
and the presence of several anomalies—the malformation in the
pons, the glia islets in the spinal pia, and the heterotopia of
ganglion cells—lends countenance to the correctness of the
assumption that these, together with the neuromata, must be
regarded as developmental anomalies.
Out study, then, is a confirmation, from, the aspect of a pathological
new formation, of the multicellular structure of the peripheral nerve
fibre.
The supporters of this view claim that the neurone conception
is thus placed in its true light without necessarily destroying it:
" Elle rdduit la doctrine des neurones k sa veritable valeur. sans
l’dbranler.” The neurone would therefore no longer be looked
upon as a structural unit but its trophic autonomy is retained. Two
of our predecessors in the study of this difficult and complex
problem have taken as the motto of their work, "To travel hopefully
is a better thing than to arrive,” and, in concluding, as we recognise
the conscientiousness of the research which has led equally able
workers to take views that seem so fundamentally opposed to one
another; we must admit that there are no sufficient grounds for
stating that the old neurone theory has had its day, nor, on the
other hand, that the cell-chain theory has no foundation.
(To be continued.
CELLS IN THE CEREBRO-SPINAL FLUID 195
THE DIFFERENTIATION OF CELLS IN THE
CEREBRO-SPINAL FLUID BY ALZHEIMER'S
METHOD.
Bt 1). K. HENDERSON, M.B., Ch.B.,
Resident Physician, Phipps Psychiatric Clinic, Johns Hopkins Hospital,
Baltimore; late Assistant Physician, Royal Edinburgh Asylum,
AND
WINIFRED MUIRHEAD, L.R.C.P.Edin.,
Pathologist, Royal Edinburgh Asylum.
(With Plates 17 and 18.)
In 1907 Alzheimer (1) of Munich perfected a method for the
differential cell estimation of the cerebro-spinal fluid, which, as
far as we know, has not been employed in this country. Alzheimer
was led to introduce this method because he realised that by none
of the quantitative methods could one obtain a really accurate
cell differentiation, and because he hoped that by means of a good
cell differentiation one might obtain help in the correct diagnosis
of certain forms of obscure mental and nervous disease.
The technique is not difficult. It consists in centrifuging
3 or 4 c.c. of the cerebro-spinal fluid with double the quantity of
96 per cent, alcohol for from one half to one hour, depending on
the speed of the centrifuge, and by this means the proteid
is coagulated into a hardened plug. It is then still further
dehydrated and hardened by means of pouring on absolute
alcohol, then equal quantities of absolute alcohol and ether, and
finally ether, each for a variable number of hours, depending
upon the thickness of the plug. The plug is next loosened from
the side of the tube by a fine flattened platinum needle, embedded
in oelloidin and cut in sections of 15 m. in thickness. The cut
sections may be stained by Pappenheim’s pyronin-methyl green,
or with Unna’s polychrome methylene-blue. The procedure and
details of the staining have already been fully described by Cotton
and Ayer (2).
We have had to modify the above technique, owing to
*9
196 D. K. HENDERSON AND WINIFRED MUIRHEAD
the fact that we did not have a celloidin microtome. Dr Ford
Robertson suggested to us that equally good results might
be obtained by using dextrine as a medium for freezing the
celloidin block, and cutting the sections with an ordinary freezing
microtome.
Our procedure, therefore, was as follows: The plug of cerebro¬
spinal fluid was prepared as above and embedded in 8 per cent,
celloidin. When dry the block was immersed in dextrine made
up according to the following formula: Dissolve dextrine 1 part
in 2 parts of boiling water, filter through white cotton wool, add
1 per cent, of carbolic acid as a preservative. The block was left
in the dextrine until the following day or until required; this
prevents the celloidin from becoming too hard. The celloidin
dextrine block was then placed on the microtome surrounded by
more dextrine, and frozen by means of an ether spray. The cut
sections were immediately placed in warm water to wash out the
dextrine, and then mounted on slides. The celloidin was next
dissolved out, first by methyl alcohol, then by absolute alcohol,
lastly by 75 per cent, alcohol, and stained by pyronin-methyl
green. By this method it is impossible to obtain sections absolutely
uniform in thickness, and care must be taken to avoid cutting too
thin sections, as we have found that the stain was exceeding
easily washed out from these, and consequently the cell differentia¬
tion was poor.
Rehm (3) working in the Munich laboratory over an extensive
and varied material has demonstrated very clearly the value of
this method. Some of his most important findings may be briefly
quoted. In general paralysis he found that, in addition to an
increase in the quantitative cell count, the cell types showed more
variation than in any other form of nervous or mental disease.
He was particularly impressed by the constant appearance of
plasma cells, gitter cells, macrophages, and fibroblasts. He
went so far as to consider gitter cells almost typical for general
paralysis, although he admits that these cells are found in some
cases of brain syphilis, and of tuberculous and purulent
meningitis. On the other hand, he states that he has never
found either plasma cells or gitter cells in cases of tabes dorsalis.
This observation, if correct, would be an important point in
the differential diagnosis between general paralysis and tabes
dorsalis.
CELLS IN THE CEREBRO-SPINAL FLUID 197
It is interesting to observe that in tuberculous meningitis he
has demonstrated the occurrence of a cell type resembling the
plasma cells described by Nissl and Alzheimer, but yet has
hesitated to call such cell types plasma cells.
Cotton and Ayer point out the practical value of Alzheimer’s
method of cell differentiation for the differential diagnosis in
psychiatry. They have stated that in general paralysis the cell
picture is different from that found in any other form of insanity.
They consider an excess of lymphocytes, plasma cells, and perhaps
macrophages (phagocytic cells) are the most characteristic features
of general paralysis. They make no statement in regard to the
importance of gitter cells.
Hough (4) has found plasma cells in the cerebro-spinal fluid
in general paralysis, and in brain syphilis, but does not consider
them in any way pathognomonic, as he has found them together
with kornchen cells in the cerebro-spinal fluid in cases of acute
anterior poliomyelitis, epidemic form (5).
Our own material has been mainly limited to cases in the
Royal Edinburgh Asylum, under the charge of Dr George M.
Robertson, but through the kindness of Dr J. S. Fowler, and
Dr Edwin Bramwell, we obtained spinal fluids from three cases of
tuberculous meningitis, and one case of tabes dorsalis.
Our cases were as follows:—
General paralysis - - - 26
Tabes dorsalis 3
Cerebral syphilis - - - 4
Arterio-sclerotic brain disease - 2
Imbecility 5
Alcoholic psychosis 2
Dementia prsecox - - 11
Tuberculous meningitis 3
56
Our routine examination of this material consisted, in cases
where the quantitative cell count was increased, of a differential
count of from 400 to 500 cells, and in those cases where the
quantitative cell count was negative, from 100 to 200 cells were
198 D. K. HENDERSON AND WINIFRED MUIRHEAD
counted. The quantitative cell count was performed by the
Fuchs-Rosenthal counting chamber method.
We have differentiated the following cell typeB:—
Lymphocytes .—These cells form the largest percentage of cells
found in the normal spinal fluid. A lymphocyte is a small round
cell with a deeply staining nucleus which occupies nearly the
whole cell. The nucleus is usually fairly homogeneous, but
occasionally the chromophilic granules are arranged round the
periphery in a “ clock-face ” manner, similar to the arrangement
in plasma cells. The protoplasm is seen as a thin pink-stained
rim round the nucleus. Rehm and Cotton have described an
atypical form showing a larger amount of protoplasm which may
have a tailed appearance.
Mononuclear Cells. —This type of cell formed a fair percentage
of every spinal fluid examined, and therefore must be considered
a normal constituent. It is usually a large cell, and is characterised
by a nucleus eccentrically placed, varying considerably in Bhape
and size, and staining a lighter blue than the lymphocyte. This
nucleus is most commonly kidney-shaped, but round forms are
seen and occasionally twisted forms. The protoplasm is large in
amount and Btains a pale pink.
Macrophages or Phagocytic Cells .—These cells were present in
small numbers in practically all the fluids examined. The type
of cell which we have termed a macrophage corresponded closely
to the mononuclear cells, and have simply been differentiated on
account of the capacity they possess of ingesting other cells. Owing
to the frequency of their occurrence, we must regard them as a
type of cell which may be found in normal fluid.
Polymorphonuclear Cells .—This type of cell is one which may
be present in small numbers in normal fluid. The nucleus is
stained a dark blue, and the protoplasm may appear as a faint
grey-pink, but is usually unstained. In our experience, in general
paralysis, these cells have varied in number from 0*3 to 16 per
cent., and the case which showed this maximum count terminated
fatally in a short time. Hough considers that polymorpho¬
nuclear cells are most numerous in rapidly advancing cases, but
has demonstrated that they are usually more numerous in cases
of cerebral syphilis than in cases of general paralysis. After
CELLS IN THE CEREBRO-SPINAL FLUID 199
convulsive s e i z ur e s in either of these affections they tend to be
somewhat increased.
Endothelial Cells .—We have found these cells present particu¬
larly in cases of general paralysis, bat we have also seen them in
fluids which were negative in every respect.
The nucleus is large, oval or roundish in shape, pale blue in
colour, contains deeply-stained granules and a nucleolus, which is
usually stained a bright pink.
Tim protoplasm is small in amount, stained pink, and is some¬
times not apparent.
Plasma Cells .—Hitherto these cells have been looked upon as
almost pathognomonic for general paralysis. Undoubtedly they
constantly occur in general paralysis, probably in greater numbers
than in most other affections, but we have found them present
both in tabes dorsalis and tuberculous meningitis.
Rehm and Hough also demonstrated their occurrence in cases
of cerebral syphilis, and therefore we cannot hold them typical for
any (me condition ; we have never found them present in normal
fluid. The typical plasma cell is a larger cell than a lymphocyte,
varies considerably in shape, and often presents a tailed appear¬
ance. The protoplasm is abundant, stains deeply pink with the
pyronin stain, and has a coarsely granular appearance. Frequently
there is a clear area directly round the nucleus. The nucleus is
eccentrically placed, round in shape, and has the very character¬
istic “ dock face ” arrangement of its chromatic granules.
Turner (6) differentiates two varieties of plasma cells, one of
which he considers is derived from endothelial cells, and the other
from lymphocytes. The origin of these cells is, however, still in
doubt.
Transitional Cells .—Any cells which we have been unable to
define clearly as lymphocytes, plasma, or endothelial cells, have
been included in this group.
Gitter or Lattice Cells .—This type of cell has never been found
by us in normal fluid. We have found these cells in various
stages of development in general paralysis and in tuberculous
meningitis, and have considered the type of cell which Cotton and
Heugh designate as a Korncheuzell, as an early stage of the gitter
cell.
These gitter cells are the largest forms met with, and show the
200 D. K. HENDERSON AND WINIFRED MUIRHEAD
characteristic vacuolation and lattice-work appearance of their
protoplasm. Some were phagocytic. The nucleus was pale and
irregular, and commonly situated at the periphery.
Fibroblasts .—These cells occurred in a very small percentage of
our cases, and were most frequent in cases of general paralysis.
They have usually an elongated, spindle-shaped nucleus stained
blue, slightly granular, and commonly show faintly stained
protoplasm at each end, which may, however, be absent.
We shall now briefly discuss the groups of cases examined.
General Paralysis .—From quantitative methods it is well known
that an increased cell count is practically always obtained in this
group of cases. The qualitative examination has confirmed the
large cell count, and in addition has demonstrated the multiplicity
of the cell types; this has been particularly striking in cases with a
small total cell count. In all twenty-six cases the small lymphocyte
was the predominating cell, averaging between 52 and 84 per cent.
Macrophages or phagocytic cells were present in small numbers
in all but one case. Polymorphonuclear leucocytes were present
in all cases, and in case 25 reached the large number of 16 per
cent., although the spinal fluid was free from blood.
Plasma cells of the type described by Nissl and Alzheimer
were also present in every case, and varied between 1-5 and 16
per cent. The case (case 2) which showed the large plasma cell
count of 16 per cent, was one in the early stage of the disease
and of a florid type. Gitter cells were found in small numbers in
all but three cases.
As the result of our observations we would be inclined to agree
with Rehm in considering plasma and gitter cells as almost
characteristic for general paralysis. It is true that in tuberculous
meningitis we have found both plasma and gitter cells in the
cerebro-spinal fluid, and Hough found them in the cerebro-spinal
fluid in cases of acute anterior poliomyelitis, but these diseases
need hardly be considered in connection with the differential
diagnosis of general paralysis.
Tabes Dorsalis .—One of the cases belonging to this group has
shown no mental symptoms, but the other two presented well-
marked physical signs of tabes associated with mental symptoms
non-paralytic in nature. In addition to the usual cell types we
have found plasma cells present in two out of three cases. This
GENERAL PARALYSIS.
Plate 17.
CELLS IN THE CEREBRO-SPINAL FLUID 201
finding negatives the differential point between general paralysis
and tabes dorsalis formulated by Rehm, as he stated that he had
never found plasma cells in cases of tabes dorsalis. We recognise
that our material is scanty and not sufficient to enable us to make
any dogmatic assertion, yet we would emphasise the fact that, so
far, we have been unable to find gitter cells in tabes dorsalis, as
opposed to general paralysis.
Case 28 was particularly interesting to us, owing to the fact
that here we had a case presenting a normal cell count, and yet
showed 2 per cent5 of plasma cells in the qualitative cell count.
Case 29, which showed no plasma cells, is one non-progressive
in character, several years in duration, gives a negative blood
serum Wassermann reaction, and a negative cerebro-spinal fluid
cytologically, chemically, and serologically.
Cerebral Syphilis .—The four cases of cerebral syphilis which
we have examined are old-standing and quiescent cases, and all
gave a negative quantitative cell count.
The qualitative cell picture corresponded to that obtained with
a negative fluid. We did not observe either plasma or gitter cells.
It is well to remember, however, that Rehm and Hough have each
found both plasma and gitter cells in some cases of cerebral
syphilis. Their finding s thus render plasma and gitter cells
valueless as differential factors in the diagnosis between general
paralysis and cerebral syphilis, unless their percentage is very
high, when the diagnosis of general paralysis would be more
indicated than one of cerebral syphilis.
Imbecility .—The five cases belonging to this group showed no
outstanding features, even although one of them was a congenital
syphilitic, and gave a positive Wassermann reaction with his blood
serum.
Tuberculous Meningitis .—The three cases comprising this group
have given us cell types absolutely similar to those obtained in
general paralysis, as, in addition to the usual cells, we have found
both plasma and gitter cells. This observation again confirms
that of Rehm, who, as has been stated, was averse to classify
certain cells as plasma cells, because he found them difficult to
differentiate from certain forms of tailed lymphocytes.
As far as we are concerned, the cells which we have termed
plasma cells are identical with that type of cell found in cases of
general paralysis which are known as plasma cells.
202 D. K. HENDERSON AND WINIFRED MUIRHEAD
No.
Name.
Diagnosis.
Character of Fluid.
‘ Cell
Const.
Lympho¬
cytes.
Per c.mm.
Per cenL
1
J. A.
General ParaL
-
Clear •
7
73
2
M. M. -
99
99
8L Blood
71
55 •
3
F. G. P.
M
99
Clear
100
74
4
R. A. G.
t»
99
SL Blood
9
73
5
J. M.
Clear
16
63
6
A- F.
99
99
99
87
74
7
J. M. -
99
99
9»
127
76
8
J. L.
9 9
99
99
42
84
9
A. H. •
99
99
40
83
10
J. D. -
99
99
9*
95
78
11
M. F. -
99
99
99
15
75 1
12
R. 8. -
99
99
9 9
16
73
13
T. 8. -
99
99
99
15
78
14
F. M. -
99
99
99 " *
84
79
15
W. R. -
99
99
99
40
73
16
A. M*D.
9*
9f
tt-
103
79
17
W. 8. •
99
99
SL Blood
71
6S
18
J. 8. -
99
99
Clear
6
63
19
B. 8. -
99
99
»
28
70
20
W. W. -
9 9
99
99
90
76
21
M. A. ■
9 9
99
99
48
73
22
E. D. -
99
99
99
10
75
23
R. R. -
99
99
99
27
73
24
A. R. -
99
99
99
»
52
25
A. D. -
99
H
99
110
69
26
T. B. B.
99
99
99
10
69
27
• •• * *
Tabes Dorsal.
99 “ *
•• •
63
28
D. W. -
99
99
9 9
5
76
29
J. K. -
99
tt
SL Blood
1
63
30
L. C. -
Cerebral Syph.
Clear
3-2
61
31
J. P. -
99
99>
8L Blood
4
74
32
W. 8. -
99
99
Clear •
2-2
61
33
J. G. -
99
99
99
1
60
34
R. M. -
Arterio Solar.
99
1-5
?2
35
A. R. -
99
«>
99
1
61
36
C. F. -
Imbecility •
99
0-66
70
37
G. T. -
99
.
99 "
05
63
38
G. D. •
99
.
99
1-3
65
39
J. W. -
99
.
9t
8
67
40
J. J. -
99
.
9 9
0*8
76 ;
41
M. 0. -
Alooh. Psych.
99
0-2
68 :
42
J. M. -
99
M *
99
1*6
62 ]
43
J. R.
Dement Pr®c.
99 *
2*3
59
44
P. W. -
99
99
99
9
70 i
45
W. P. -
99
99
•9
2
62 |
46
N. R. -
99
99
99
0*6
71
47
J. M. •
99
99
99
•8
64 ;
48
J. G. - -
99
99 * *
0-8
76 |
49
J. G. -
99
99
99
0-6
74 i
50
H. P. -
99
99
99
1-8
75 j
51
W. C. -
99
99
99
1-8
78 i
52
W. P. -
99
99
99
0-6
73 i
53
W. H. -
99
99
9 9
08
68 \
54
• • • * •
TubercuL Mania.
Turbid -
...
68 j
55
|(|
99
99
99
...
68 !
56
99
99
99
...
58 '
CELLS IN THE CEREBRO-SPINAL FLUID 203
204 D. K. HENDERSON AND WINIFRED MUIRHEAD
It has always been stated that in cases of tuberculous menin¬
gitis, the lymphocyte is the markedly predominating cell. That
statement is true, but by this more exact method of cell enumera¬
tion we have found a large percentage of mononuclears present,
and in addition, in one case (case 56) actually 18 per cent,
polymorphonuclear leucocytes were present in a spinal fluid free
from blood. This case progressed extremely rapidly to a fatal
termination.
Negative Cases .—Included among those are seven cases of
arterio-sclerotic brain disease, two cases of alcoholic psychosis,
and eleven cases of dementia praecox. All these cases were
negative, both in the quantitative and qualitative cell estimation,
and corresponded to our standard of normal
Summary.
1. The qualitative method of cell examination as devised by
Alzheimer affords facilities for an accurate differentiation of the
various types of cells contained in the cerebro-spinal fluid,
and promises to be of considerable assistance in the diagnosis
of various nervous and mental diseases.
2. In general paralysis a greater variation in cell types was
seen than in any other psychosis, but a similar picture to that
of general paralysis was obtained in cases of tuberculous meningitis;
such cases, however, do not complicate the diagnosis of general
paralysis.
3. Plasma cells and gitter cells seem to be characteristic
features of general paralysis, and were found to be constantly
present; in cerebral syphilis these two types of cells have been
found by other observers, but apparently not in such large
numbers or so constantly as in general paralysis.
4. We cannot corroborate the assertion of Rehm that plasma
cells do not occur in tabes dorsalis, as we have demonstrated them
in two out of three cases; on the other hand, we did not find
gitter cells in tabes dorsalis, as opposed to general paralysis,
and this may be a point of differential value.
5. Our material is too scanty to warrant us arriving at any
definite conclusions, but further study along this line would appear
to offer a wide field for investigation.
TUBERCULOUS MENINGITIS.
Plate 18 .
CELLS IN THE CEREBRO-SPINAL FLUID 205
In conclusion we thank Dr G. M. Robertson, Physician
Superintendent of the Royal Edinburgh Asylum, for permission
to publish the result of our investigation; and we also thank Dr
J. S. Fowler and Dr Edwin Bramwell for their kindness in
supplying us with specimens of cerebro-spinal fluid.
References.
1. A, Alzheimer. Zentralb. Nervenheilk. u. Psychiatric, 1907, Nr. 239.
2. Cotton and Ayer. “ The Cytological Examination of the Cerebro-spinal
Fluid.” Review qf Neur. and Psych., April 1908.
3. 0. Rehin. “Die Zerebro-spinal Flussigkeit,” Hisiolog. u. Histopath., Arb.,
uberdie Orosshimrinde. Dritt. Band, Zw. Heft, 1909.
4. W. H. Hough. “TheCytological Examination of the Cerebro-spinal Fluid,”
Bull No. 1, Government Hospital, Washington, 1909.
5. W. H. Hough and G. R. Lafora. “ Some Findings in the Cerebro-spinal Fluid
of Acute Anterior Poliomyelitis, Epidemic Form,” Bull. No. 3, Govern¬
ment Hospital, Washington.
6. John Turner. “A Note on Plasma Cells,” Review of Neur . and Psych.,
March 1910.
Explanation op Plate XVII.
This plate shows the different types of cell in general paralysis :—
1. Plasma cells.
2. Polymorphonuclear ceil.
3. Lymphocytes.
i Mononuclear cells.
5. Macrophage.
6. Endothelial cells.
7. Gitter cells.
8. Developmental stage of gitter cell.
9. Fibroblasts.
Explanation of Plate XVIH.
This plate shows the different types of cells in tuberculous meningitis -
1. Plasma cells.
2. Polymorphonuclear cells.
3. Lymphocytes.
A Mononuclear cell.
& Macrophage.
6. Dividing cell showing rosette arrange¬
ment of nucleus.
7. Gitter ceils, one of which is phagocytic.
8. Developmental stage of gitter cell.
9. Transitional cell.
206
ABSTRACTS
abstracts
ANATOMY.
ANATOMICAL STUDY OF THE PINEAL GLAND IN MAN. (Studio
(146) anatomico della glandola pineale nmana.) F. Polvani, Rastegna
di Studi Psickiat., Vol. iii., F. 1, Geunaio-Febbraio 1913, p. 3.
A preliminary note of a paper in which the author considers that
the pineal gland of the higher mammals is homologous to the
diverticuluB epiphysarium of the fish. He also records the
presence of groups of parenchymatous cells which he proposes to
call the “parapineal nuclei” These cells have the character of
secretory cells, and he thinks that their function is to control the
secretion of the testicles and ovaries. A. Ninian Bruce.
BIOCYTONEUBOLOGY BY THE AID OF THE ULTRAMIGROSGOPE.
(147) (Essai de biocytoneurologie au moyen de rultramicroscope.)
Marin esco, Nouv. Icon, de la Salpet., May-June 1912, p. 193.
The living nerve cell can be studied either with the ultramicroscope
or by observing its reaction in a living state to various colouring
matters. It is known to be a colloidal complexus whose structure
bears a definite relation to the organisation of the colloids within
the cell. Colloidal solutions are not of the nature of a homo¬
geneous mixture, but contain in suspension particles much smaller
than those in ordinary suspensions, but larger than molecules.
With the ultramicroscope these colloidal particles can be readily
seen. Particles can be seen without difficulty whose diameter is
as low as 0 003 /*. Certain colloidal solutions contain particles
still smaller, incapable of resolution with the ultramicroscope. As
a rule a colloid is a heterogeneous solution, i.e., it contains particles
of different homogeneous systems. They can be seen to be in
constant movement, each particle moving independently of its
neighbours, like specks of dust in a ray of sunlight. Colloids are
not displaced by the passage of an electric current unless they
contain electrolyte ions.
Now the cytoplasm of the nerve cells in the root and sympathetic
ganglia of mammals and of other animals lower in the scale
contains great numbers of colloidal granules, whose volume and
density vary with the age and species. In living cells no structure
in the least resembling the tigroid substance of Nissl is to be found.
If the granules are large the general tint of the cell is bluish yellow
or yellow: if small, grey or grey-blue. In man the larger the
actual dimensions of the cell, the smaller its granules, as a rule.
ABSTRACTS
20V
Colloidal granules can easily be detected in the axone. The
cytoplasm of the living cell has a good deal of elasticity: under
slight compression the cell is for the moment deformed, but will
return to its normal state when the compression is removed. If
the compression continues the cell has a marked tendency to
become tabulated. Brownian movement is very rare in living
nerve cells: it may be assumed, therefore, that their colloidal
content is viscous, and of the nature of a jelly rather than of a
solution. Any reagent, such as distilled water, which reduces the
viscosity of the cytoplasm, will cause brownian movements of the
particles to appear.
The application of any coagulant, such as acids, metallic salts,
&c., to the living cell will at once precipitate the colloidal contents,
in a form that very closely resembles the familiar Nissl bodies.
The same result can be obtained by adding a drop of a watery
solution of methylene blue. Eosine and various other colorants do
not give rise to a Nissl formation.
A neurofibrillar structure cannot be detected in the living cell
by the ultramicroscope, but it is quite possible that the neuro-
fibrillae are constituted by a viscous homogeneous transpar ent jelly
belonging to the class of stable colloids, which are precipitated with
difficulty. S. A. K. Wilson.
PSYCHOLOGY.
ON THE PSYCHOLOGY OF JUVENILE CRIMINALS. (Zur
(148) Psychologic jugendlicher Krimineller.) G. Major, Monatsschr. f.
Psyckiat. «. Neurol., Bd. 81, Juni 1912, Erganzungsheft.
A somewhat diffuse article with brief reports of several cases.
The author attributes the increase of juvenile delinquency in
Germany to the commercial development of the country after the
war of 1870. C. Macfie Campbell.
PATHOLOGY.
IN V E ST IG ATIONS ON SENILE PLAQUES. (Ustersuchungen fiber
(149) die "senilenPlaques”) G. Marin esco and J. Minea, Monatsschr.
f. Psyckiat. u. Neurol., Bd. 81, Juni 1912, Erganzungsheft
The authors report the results of the investigation of the cerebral
cortex in two cases, one aged 54, the other 107. They conclude
that there are three phases in the development of the senile
plaques. The first phase consists in the deposit of a colloid
substance from the nutritive plasma of the nervous tissue. This
material is deposited at first in small quantities, in thin threads
208
ABSTRACTS
and rods. At a certain stage there is a reaction of the nerve fibres
in the vicinity with swelling and the formation of a central body.
The changes in the nerve fibre are compared by the authors to the
changes in the central end of the nerve in the first days after its
division, but the attempt at regeneration proceeds no further,
probably due to the absence of a positive chemiotactic secretion.
The third phase consists in the progressive deposit of the substance,
the further involvement of new fibres and cells and finally
neuroglia reaction. The authors take a somewhat conservative
attitude with regard to what is called “ Alzheimer’s disease,” and
consider the plaques the result of a process which has close
affinities with the senile involution of the cortex. It must be
emphasised that the special alteration of the neurofibrils described
by Alzheimer has not as yet been discovered in a normal brain of
an aged person. The article is illustrated by numerous coloured
plates. C. Macfie Campbell.
EPIDERMOID CHOLESTEATOMA OF THE BRAIN (Zur Kasuistik
(160) der epidermoidalen Cholesteatoma dee Oehirns.) W. R. Meyer,
Virchow's Archiv., Bd. 211, H. 2,1913, 8. 161.
Author regards this type of tumour as congenital, belonging to the
group of the so-called Choristomata. The case described by him
is that of a female, set. 20 years, who died inj hospital from
tuberculous peritonitis. There were no symptoms present during
life suggestive of brain tumour. At the base of the brain there
was found post mortem a tumour about the size of a hazel nut
situated between the pons and the left temporo-sphenoidal lobe.
The surface was irregular and had the appearance of mother-of-
pearl. On section the substance was seen to consist of white, dry,
crumbling material. Microscopically all the information given by
the author is that the tumour was a typical cholesteatoma.
James Miller.
CLINICAL NEUROLOGY.
ABSENCE OF THE KNEE AND ACHILLES JERKS WITHOUT
(151) OTHER SION OF DISEASE OF THE NERVOUS SYSTEM.
(De l’absence des reflexes acMlllens et des reflexes rotuliens «»»■
autre signe d affection du systdme nerveux.) Dupuy, Nouv. Icon,
de la Salpet., March-April 1912, p. l r >3
In a careful examination of the reflexes of 2,304 members of the
Garde r^publicain the author has occasionally found the knee jerks
or Achilles jerks absent. In some instances there have been indica*-
tions of disease of the central nervous system hitherto unsuspected.
ABSTRACTS
209
In others, however, absence of those jerks may be noted by itself
alone. In most instances it is unilateral: if bilateral, the Achilles
jerks are more frequently lost than the knee jerks. It must
always be considered pathological, and the author has found that
the commonest causes are preceding neuritis, or root involvement
from gonorrhoea, syphilis, tuberculosis or alcoholism, incipient
tabes, affections involving the intestine, and trauma of the nerves,
roots, or cord centres. S. A. K. Wilson.
OH SENSORY CONDUCTION IN THE HUMAN SPINAL CORD. (Znr
(l 52) Frage nach der sensiblen Leitung im menschlichen Rtickenmark.)
H. FABEmtJS, MonaUtchr.f. Psychiat. «. Neurol., Bd. 31, H. 2, 3, 4,
5, 6,1912.
The author reports eight cases of stab wounds of the spinal cord, one
of which ended fatally six days after the injury, and tabulates eighty-
three cases. The author concludes that hyperaesthesia is found if
the transverse lesion is abrupt and leads to a complete paralysis, and
if the pain tracts of the paralysed side are intact. If they are not
intact then there is an analgesia and no hyperaesthesia occurs even
although the sense of touch is not impaired. Hyperaesthesia is not
observed if the interruption of the paths occurs gradually or if an
acute disorder leads to an incomplete paralysis. The sensory tracts
in the intact cord, and the sensory paths after interference with
the normal tracts, must be differentiated. In the normal cord all
cutaneous sensations are conducted through contralateral tracts
which ascend in the lateral column. Sensations of touch and
pressure have in addition paths of conduction in the homolateral
posterior column while pain and thermal sensations have only
crossed tracts. If there is an interruption of these paths, of the
contralateral tracts of one side of the body, temperature and pain
sense disappear. Touch and pressure may still be perceived, but
the sensations are apt to be more dull than normal These
sensations lack completely all feeling-tone no matter what the
type of stimulus is. This is the condition for an indefinite time
after the injury. Gradually a new sensory condition develops,
touch and pressure are recognised as before, strong mechanical
st imuli and high and low thermal stimuli cause a peculiar
unfamiliar prickling feeling which radiates strongly and is accom¬
panied by lively muscular twitches. This unpleasant feeling does
not consist of pain as experienced when the normal areas are
stimulated. The discrimination of heat and cold is still lost except
for great heat. The localisation of stimuli is disturbed by the
radiation of the sensation. This type of sensibility represents an
older phylogenetic stage. The cord, therefore, is able to a large
degree to make up for defects due to interruption of the normal
210
ABSTRACTS
paths of conduction. The tracts of cutaneous sensation are
anatomically divided into two different groups; similarly the
stimuli of the outer world are of twofold nature in their
importance for the organism. On the other hand they yield
information about the outer world; on the one hand they have a
vital importance for the individual (powerful mechanical stimuli,
pain and thermal stimuli). These latter sensations are conducted
in the contralateral paths. Conditions of consciousness corre¬
sponding to them are distinguished by a more or less strong
feeling-tone. This quality is completely absent in the sensations
conducted by the posterior columns. The posterior columns and
the corresponding impressions have a more objective, the contra¬
lateral paths and their correlates in consciousness have a more
subjective, vital importance for the individual.
C. Macftk Campbell.
ON THE D I F FER ENTIAL DIAGNOSIS OF INTRA- AND EXTRA-
(153) MEDULLARY SPINAL DISORDERS. (Zur Differentialdiagnose
der intra- und extramedullflren Rdckexunarkserkrankxuigen.) H.
Fabbitius, Monattschr.f. Psychiat. u. Neurol ., Bd. 31, H. 1,1912.
The author lays great stress on the importance of a careful
examination of the thermal sense. A complete contralateral loss
of discrimination between heat and cold with only moderately
pronounced spinal symptoms points strongly in the direction of
an intramedullary process. The author reports two cases.
C. Macfie Campbell.
ANOTHER CASE OF FRIEDREICH’S DISEASE WITH AUTOPSY.
(164) (Un nouveau cas de maladie de Friedreich avec autopsie.)
Alexandek A. Lambriob, Rev. Neurol ., Ann. xxi, Jan. 30, 19111,
p. 58.
The clinical history is given, and the results of a complete and
detailed histological examination. The findings are in accord
with those generally accepted as forming the pathological basis
in Friedreich’s disease. P. W. Saundres.
HERPES ZOSTER FRONTALIS WITH BACTERIAL FINDINGS IN
(166) THE GASSERIAN GANGLION. (Herpes zoster frontalis mad
bakterienfond i ganglion Gasseri.) A. Sonde, North Mag. f.
Laegevid ., 1913, lxxiv., p. 339.
A man, aged 81, admitted to hospital for senile dementia, developed
herpes zoster of the right half of the forehead and right upper
eyelid. Death from broncho-pneumonia took place three days
later. Poet mortem the right Gasserian ganglion was found to be
ABSTRACTS
211
considerably swollen and nearly double the size of the left. In
addition to hyperaemia, haemorrhage, and round-celled infiltration,
a number of Gram-positive cocci were found. They were mostly
diplococci, and were most numerous in the haemorrhages and in and
about the small vessels.
Sunde could find no previous record of bacterial findings in the
spinal ganglia in herpes zoster. J. D. Rolleston.
REFLEX ZOSTER IN LITHIASIS. (Quelques cas de zonas reflexes
(166) dies des lithiasiques.) G. Blcus, Bull et. mbn. Soc. mtd. H6p. de
Parity 1913, xxxv., p. 333.
A RECORD of three cases of an eruption with all the characteristics
of secondary symptomatic zoster running its course apart from any
seasonal or epidemic influence, and almost without fever. The
patients had no spinal nor vertebral lesions, and were not suffering
from tuberculosis or any other infection.
In the first case, a woman aged 42, the subject of cholelithiasis,
the eruption was strictly limited to the 8th and 9th dorsal
nerves, while the neuralgic pain was less definite in its distribution,
though more intense in the course of these nerves. In the second
and third cases, men aged 58 and 53 respectively, both suffering
from renal calculus, the neuralgia and the zoster occupied the
reno-ureteral zone which is innervated by the 11th and 12th
dorsal and 1st lumbar nerves.
Other examples of reflex zoster are quoted from the literature,
including Siding’s case (v. Review, 1909, vii., p. 360).
J. D. Rolleston.
HERPES ZOSTER IN THE PUERPERIUM. (Herpes zoster im
(157) Wochenbett). H. Kunz, Zentralbl. /. Gyndk., 1913, xxxvii., p. 121.
A GIRL, aged 18, gave birth to a child by normal labour on
27th June. On 1st July herpes zoster developed in the area of
the 8th and 9th left intercostal nerves. No typical neuralgic
pains preceded or accompanied the eruption. No puerperal or
any other infection was present. J. D. Rolleston.
▲ CASE OF JUVENILE TABES. T. Gillman Moorhead, Dublin
(168) Joum. Med. Set., 1913, cxxxv., p. 167.
A RECORD of a case in a woman, aged 22, a virgin, who showed no
clinical signs of acquired or inherited syphilis. The family history,
however, was suggestive, and Wassermann’s reaction in the patient’s
blood was positive, becoming negative after an intravenous injec¬
tion of 8alvar8an. J. D. Rolleston.
212
ABSTRACTS
THE CENTRAL CONVOLUTIONS IN TABES DORSALIS. (Die
(169) Zentralwindungen bei Tabes dorsalis.) L. Selling, Monatsschr. /.
Psychiat. u. Newrol., Bd. 32, H. 2,1912.
In four cases of tabes the cerebral cortex showed no constant
changes and no deficiency in nerve cells was observed. The nerve
cells were somewhat altered and the glia showed some proliferation.
The author, therefore, disagrees with Campbell’s contention that in
the posterior central convolutions of tabetics there are characteristic
cortical changes which can be correlated with the degeneration of
the sensory tracts. C. Macfie Campbell.
TABETIC ARTHROPATHY. PHARYNGEAL CRISES. (Arthro-
(160) pathic t&bdtique. Crises pharyng&B.) R. Pierkbt and E.
Dubot, Echo mid. du Nord ., 1912, xvi., p. 666.
A woman, aged 52, who had had spontaneous fracture of the right
tibia nine years previously, presented osteo-arthropathy of the
right knee, shown by considerable enlargement of the femoral
condyles and heads of the tibia, marked laxity of the muscles and
ligaments, enormous sero-fibrinous effusion in which Wassermann’s
reaction was positive, and oedema of the neighbouring tissues.
Several times in the course of the day she had a series of degluti-
tions accompanied by a clucking noise, for which she had been,
nicknamed “ the hen.” After a fortnight’s treatment with soluble
salts of mercury, as recommended by Babinski and Baur6, the
circumference of the enlarged knee diminished by 4 cm.
J. D. Rolleston.
PURULENT PNEUMOCOCCAL MENINGITIS. ABSENCE OF
(161) CELLULAR REACTION IN CEREBRO SPINAL FLUID.
(Mdningite purulent© k pneumocoques; absence de reactions
cellulaires dans le liquide cdpbalo-rachidien.) Monikb-Vinard
and Douzelot, Bull. et. mim. Soc. mid. H6p. de Paris , 1913, xxxv.,
p. 468.
A case of fulminating cerebro-spinal meningitis, accompanied with
hepatisation of the right apex and pneumococcal septicaemia in a
bronchitic, atheromatous, and probably alcoholic man of 54. The
absence of leucocytes in the cerebro-spinal fluid, which was with¬
drawn six hours before death, is attributed to their being imprisoned
in a fibrinous network in the meninges similar to that present in
the lung.
Reference is made to six similar cases in literature, including
that reported by Castaigne and Debr^ (v. Review, 1909, vii, p. 110).
J. D. Rolleston.
ABSTRACTS
213
PARAMENINGOCOCCUS CEREBROSPINAL MENINGITIS. (UncM
(162) de mtaingite cdrdbro-spinale k paramfeningocoques.) P. Mknitrixr
and Legrain, Bull, et mSm. Soc. mid. H6p. de Paris, 1913, xxxv.,
p. 461.
A woman, aged 29, the subject of chronic alcoholism, was attacked
with symptoms of cerebro-spinal meningitis. During the first
week she received 105 c.c. of anti-meningococcic serum. As she
got worse anti-parameningococcic serum was used, and 150 c.c.
were given intraspinally and 70 intravenously in the course of
six days. The presence of the parameningococcus in the cerebro¬
spinal fluid was established by Dopter. Slight improvement
occurred, but death took place from broncho-pneumonia within a
fortnight of the onset of the disease. A better result would
probably have been obtained had the specific serum been used
earlier. In addition to the meningitis, which was principally
localised in the spinal meninges, the necropsy showed chronic
nephritis and cirrhosis of the liver, which doubtless contributed
to the fatal issue. J. D. Rolleston.
PARAMENINGOCOCCUS CEREBRO SPINAL MENINGITIS. MEN
(163) INGOCOCCIC AND PARAMENINGOCOCCIC SEROTHERAPY.
DEATH. (Mdningite cdrdbro-spinale a paramdningocoque. Sdro-
thdr&pie mdningococcique et paramdningococciaue. Mort.)
A Follbt and J. Bourdini^re, Bull, et ntim. Soc. mid. H6p. de
Paris, 1913, xxxv., p. 606.
The patient was a woman, aged 27, admitted to hospital with
symptoms of meningitis. There were no signs of alcoholism or
syphilis. After 80 c.c. of meningococcus serum had been given
without benefit, the parameningococcus was isolated from the
cerebro - spinal fluid. Anti - parameningococcus serum was then
given, but the general condition became worse, and the cerebro¬
spinal fluid more purulent. Death took place in about three
weeks from the onset. The failure of treatment may have been
due either to anaphylaxis or to a special kind of parameningococcus
which was not affected by the serum used. J. D. Rolleston.
PARAMENINGOCOCCUS MENINGITIS TREATED AND CURED
(164) BY ANTI-PARAMENINGOCOCCUS SERUM (Un cas de
mdningite k paramdningocoques traitde et gudrie par le sdram
anti-paramdningococcique.) H. M£ry, H. Salin, and A Wilborts,
Bull, et mim. Soc. med. H6p. de Paris, 1913, xxxv., p. 411.
A girl, aged 3 years, was admitted to hospital with symptoms of
cerebro-spinal meningitis. The cerebro-spinal fluid was turbid,
and showed a few intracellular organisms resembling meningococci.
214
ABSTRACTS
Numerous injections of anti-meningococcic serum were followed
by only slight and transitory improvement. The agglutination
test showed that the organism was the parameningococcus. Rapid
improvement followed injections of anti-parameningococcic serum,
and finally recovery took place, apart from deafness due to
labyrinthine involvement. J. D. Rolleston.
CACHECTIC FORM OF PARAMENINGOCOCCUS CEREBRO SPINAL
(165) MENINGITIS TREATED AND CURED B7 DOPTER'S SERUM.
(Mtaingite ckrkbro-spinale k forme cachectisante due au para-
mdningocoque traitde et gudrie par le sdrum de Dopter. H. Salin
and J. Reilly, Bull, et mim. Soc. mid. H6p. de Paris, 1913, xxxv.,
p. 423.
The patient was a boy, aged 3 years, in whom the disease ran
its course in two stages. In the first stage the symptoms
were those of ordinary cerebro-spinal meningitis. The general
symptoms improved after treatment with meningococcic serum,
but the meningeal symptoms persisted, and the cerebro-spinal
fluid was only slightly modified. In the second stage, when the
temperature was almost normal, and the meningeal symptoms less
marked, symptoms of cachexia appeared, shown by emaciation,
amyotrophy, cutaneous pigmentation, generalised adenopathy, and
torpor. The parameningococcus was then isolated from the
cerebro-spinal fluid, Dopter’s serum was used, and rapid and
complete recovery resulted. J. D. Rolleston.
FULMINATING CEREBRO-SPINAL MENINGITIS DUE TO AN
(166) UNDETERMINED GOCCO BACILLUS. (Mkningite cdrdbro-
spinale suraiguB k cocco-bacille indetennink.) R. Morichau-
Brauchant, R. Le Blaye and Delage, Progrh mid. , 1913, xli.,
p. 14.
A case of a man, aged 31, in whom sudden onset after coryza of
intense meningeal symptoms, labial herpes, and a turbid cerebro¬
spinal fluid suggested the diagnosis of meningococcic cerebro¬
spinal meningitis. No improvement, however, followed injection
of anti-meningococcic serum, and death took place in three days.
Bacteriological examination of the fluid showed a small number of
extra-cellular bacilli, not staining by Gram, and a large number
of organisms resembling pneumococci. Reference is made to the
recent case of Chevrel and Bourdini&re (v. Review, 1913, xi., p. 37).
J. D. Rolleston,
ABSTRACTS
215
ARAN - DUCHENNE TYPE OP PROGRESSIVE MUSCULAR
(167) ATROPHY OF NEURITIO NATURE: SECOND CASE WITH
AUTOPSY. (Atropine musculaire progressive type Ar&n-
Duchenne de nature ndvritique: second cas snivi d’autopsie).
Long, Nouv. Icon, de la Salpet., July-August 1912, p. 281.
Clinical. —Commencement in the muscles of the left hand at
the age of 53: three years later, beginning atrophy in the
corresponding muscles of the right hand, and at the same time in
the legs. Gradual extension of the atrophy during an evolution
of 12 years (death from cancer of the stomach at the age of 65),
there being wasting and weakness of all the muscles of the left
arm, and of those of the hand and forearm on the right; paresis
of the muscles of both leg and thigh, specially on the left, with
fibrillation and partial reaction of degeneration. Loss of tendon
reflexes. Intermittent pains in the limbs. No objective changes
in sensibility. No sphincter troubles. Pupillary reactions normal.
Pathological. —Spinal cord normal, except for slight and limited
alterations in the anterior horn cells in the cervical enlargement.
In the peripheral nerves, atrophy of a large number of nerve
fibres: hypertrophy of the sheaths of Schwann in the form of a
thick cylindrical surround: intrafascicular connective tissue very
dense, without increase in the dimensions of the nerve trunks:
hypertrophy of the coats of some of the vasa nervorum. These
nerve lesions are systematised: they affect the mixed nerves and
the anterior roots close to the posterior root ganglia: the
cutaneous nerves and posterior roots are practically normal.
Interstitial myositis of the muscles, with atrophy of the striated
muscle fibres.
The case is excellently worked out, and there is a series of
abstracts of numerous interesting cases, more or less analogous.
The author discusses the relations of the neuritic form of pro¬
gressive muscular atrophy to peroneal muscular atrophy, chronic
hypertrophic interstitial neuritis, &c. S. A. K. Wilson.
UNILATERAL PROGRESSIVE MUSCULAR DYSTROPHY: FAOIO-
(168) SOAFULO - HUMERAL TYPE. (Dystrophie musculaire pro¬
gressive hlmilat&ale: type facio-scapulo-hum&al). Mingazzini,
Nouv. Icon, de la Salpet.., July-August, 1912, p. 320.
A cask of Landouzy-Dejerine muscular atrophy in a youth of 16,
already of four years’ duration, in which the amyotrophy is strictly
confined to the right side of the body. (It is stated, however, that
the left shoulder blade has a tendency “ & prendre la forme de
l’omoplate ailde ”). The author has been unable to find a record
of any similar case. S. A. K. Wilson.
216
ABSTRACTS
ISOLATED AND STATIONARY ATROPHY OF THE SMALL
(169) MUSCLES OF THE HAND: ANTERIOR TEPHROMALAGIA.
(L'atrophie isolfo non progressive des petite muscle de 1ft main :
tdphromal&cie antdrieure.) Pierre Maris and Foix, Nouv. Icon,
de la SalpSt ., Sept-Oct 1912, p. 363, and Nov.-Dee., p. 427.
The authors describe an interesting condition, clinically and
pathologically, in which there is a unilateral atrophy (occasionally
bilateral) of the small muscles of the hand—thenor, hypothenar,
or interossei, or diffuse—an atrophy which is strictly limited and
stationary. They have been able to make three pathological
examinations in their case, and have found a curious general
shrinkage of one half of the cord, and a still more striking atrophy
of the anterior horn of grey matter, which in some instances is
reduced to a mere linear cicatrix. In most cases the prime factor
in the production of the disease has been preceding syphilis, and
the authors conclude that the pathogenesis is a chronic ischaemia
of the grey matter from partial obstruction (not thrombosis) of
the branches of the anterior spinal artery supplying the part
affected. They are unable to offer any explanation of the condition
being so very frequently unilateral, and of its being restricted to
the inferior cervical segments. S. A. K. Wilson.
A REMARKABLE CASE OF DIPHTHERITIC PARALYSIS. (Caso
(170) notable de pardlisis difterica.) A. Cubells, La medicina
valenciana, 1912, xii., p. 65.
A girl, aged 4 years, about a fortnight after an attack of
diphtheria treated with antitoxin, was seized with convulsions
and loss of consciousness. The following day she developed left
hemiplegia and palatal palsy. Three further injections of
antitoxin were given, and within a fortnight complete recovery
took place. Cubells alludes to the cases of diphtheritic pseudo¬
tetanus reported by Bitot and others (v. Review 1910, viii.,
p. 562 and 1912, x. p. 337). J. D. Rolleston.
PATHOGENY OF URJ2MI0 PARALYSIS. (Pathogdnie dee paralyses
(171) urfcniques.) H. Dcfoub, Bull. et. mim. Soc. mid. H6p. de Pari$ t
1913, xxxv., p. 449.
In cases of Bright’s disease with uraemic paralysis Dufour has
always found post mortem either areas of softening or haemorrhage
of more or less considerable extent. He records an illustrative
case in a man, aged 37, the subject of Bright’s disease, who was
admitted to hospital with left hemiplegia and Babinski’s sign.
The hemiplegia cleared up in a few weeks, but returned a month
ABSTRACTS
217
later, when death took place from septic pneumonia. Post mortem
an old haemorrhage was found in the putamen of the right
lenticular nucleus. J. D. Rolleston.
UNILATERAL ARGYLL ROBERTSON PUPIL DUE TO ORBITAL
(178) TRAUMA. (Signs d’Argyll Robertson unilateral par trauma-
time arbitaire.) E. Veltkb, Archives d Ophthalmol., YoL 33,
No. 8, Feb. 1913, p. 180.
The only previous case of this nature known to Velter is that
of Ohm (CentralbL /. prakt. Augenheilk., July 1907, p. 193), a
non-syphilitic youth of 19, who showed also a partial palsy of
the homolateral third and sixth nerves. Yelter’s case was a
neurasthenic man of 58, who, in 1900, shot himself in the right
temple with two bullets: this was followed by slight headache,
visual troubles, and diplopia, which have persisted. Patient says
that for eighteen months the right pupil was widely dilated, and
then gradually became narrowed. Examination shows a normal
left eye; the right shows slight enopthalmos and narrowing of
palpebral fissure. R. pupil myosis, L. slightly dilated. Galassi’s
palpebral sign is feebler on right. Partial atrophy of right optic
disc: no trace of neuritis: partial sixth nerve palsy. Nervous
system normal: no lymphocytosis, negative Wassermann. Radio¬
graphy locates the bullets on inner orbital wall. No evidence of
antecedent syphilis obtainable; no alcoholism, lead, diabetes, or
albuminuria. Velter admits that there may have been a complete
pupillary palsy after the trauma, and that the loss of the light
reaction may have been the only residual effect of this. The
four typical light-reactions of the unilateral A. R. pupil were
present in Yelter’s case. Leonard J. Kidd.
OXYCEPHALY AND EXOPHTHALMOS. (Oxicefalia ed esoftalmo.)
(173) Rassegna di Studi Psichiat., YoL iiL, F. 1, Gennaio-Febbraio
1913, p. 14.
The author describes two cases of marked oxycephaly, with
congenital bilateral exophthalmos and signs of rickets, but with
no disturbance of sight, and considers that “oxycephaly with
exophthalmos ” is not a clinical entity, but merely a high grade of
oxycephaly in which the projection of the eyeball results simply
from the flattening of the frontal bones and the diminution in
the depth of the orbital cavity. Rickets plays an important part
in the etiology. A. Ninian Bkuce.
218
ABSTRACTS
PARTIAL SYMMETRICAL MICROGYRIA OF THE CEREBRAL
(174) HEMISPHERES AND ITS PROBABLE COMPENSATORY
EFFECTS. (Su d’nna particolare microgiria p&rzi&le simmetrica
negli emisferi cerebral!, e sui consecutivi probabili effettd com-
pensativi.) Q. D’Abundo, Riv. ital. di Neurop., Psyekiatr. ed
Elettroter., 1913, vi., p. 1.
A record of a case in which the clinical diagnosis was infantile
spastic left hemiplegia which had developed at the age of 6
months. Death from pneumonia occurred when the patient was
aged 29 years, when the necropsy revealed symmetrical microgyria
taking the place of part of the central lobe on either side.
The right cerebral hemisphere was less developed than the left,
but a small part of the caudate nucleus and the lenticular nucleus,
especially in its posterior portion, was more developed on the
right than on the left side. The atrophy of the right cerebral
hemisphere was accompanied by atrophy of the left cerebellar
hemisphere. J. D. Rolleston.
OBSERVATIONS CONCERNING THE RELATIONS EXISTING
( 176 ) BETWEEN THE VESTIBULAR APPARATUS AND THE
CENTRAL NERVOUS SYSTEM-CEREBELLAR AND VESTI¬
BULAR SYMPTOMS CAUSED BY CEREBRAL TUMOURS
ACTING FROM A DISTANCE. (NouveUes recherches et
observations concemant les relations existant entre l'appareil
vdstibulaire et le syst&me nerveux central Symptdmes c6r6-
belleux et vestibulaires b distance provoquds par des tumours
c6r6brales.) R. Bab any, Rev. Neurol ., No. L, Jan. 16,1913, p. 1.
A case is described of a right frontal tumour in which the
localising signs were very slight, and were mainly of a cerebellar
character. There were noises in the ears, vertigo, slight nystag¬
mus, a little deviation of the head to the right and down, and
some deviation of the left arm to the right in doing prescribed
movements.
The details of caloric and rotation tests are given in lull,
and they indicated, the author thinks, that there was no actual
cerebellar lesion present.
Proceeding from this particular case the author presents briefly
conclusions based on an examination of thirty-six such cases;
twenty-nine of these were instances of tumours outside the cere¬
bellum, and mostly supratentorial, and seven were examples of
intra-cerebellar tumours. All of them manifested cerebellar
symptoms. He says, in effect, that while tumours situated in
any region of the brain may show themselves by cerebellar
symptoms on the same side, or on the other side, repeated
ABSTRACTS
219
examinations by the caloric and rotation methods afford delicate
tests for determining whether the deviations from the normal
that may be present are slight or marked, transitory or permanent,
and so give a useful indication as to whether the vestibular
centres are interfered with directly and actually, or only indirectly,
by the general increased intracranial pressure.
Amongst the tabulated conclusions there is a brief, interesting
mention of the occurrence of deafness and subjective auditory
sensations in eighth nerve and other tumours.
P. W. Saunders.
THE DIAGNOSTIC VALUE OF UNILATERAL CHOKED DISC
(176) AND UNILATERAL EXOPHTHALMUS IN BE AIN TUMOUR
(Zur Frage der diagnostischen Verwertbarkeit der einseitigen
Stauungs-papille und des einseitigen Exophthalmus bei Hira-
trnnor.) Mohr, Deut. ZUckr.f. Augenheilk., Bd. 60,1912.
This paper is a statistical inquiry directed towards the problem
of the localisation of brain tumours when choked disc occurs on
one side only, or is more prominent on one side.
The author has studied the numerous cases collected by
Uhthoff, including 800 cases with post-mortem examination, and
also material from other sources.
All unsuitable cases were oxcluded, and the remainder divided
into five groups.
1. Unilateral choked disc. Here in 41 cases the choked disc
was on the side of the tumour (ipsolateral) in 56 per cent., and
on the other side—contralateral—in 44 per cent.
2. Unilateral optic neuritis. In 10 cases the neuritis was
ipsolateral in 8, contralateral in 2.
3. Bilateral optic neuritis or choked disc more prominent on
one side. In 65 cases the more prominent disc was ipsolateral
in 72 per cent., contralateral in 27 per cent.
4. In 10 cases there was choked disc on one side, and optic
atrophy on the other. Primary and secondary atrophy were not
differentiated. In all cases the atrophy was on the side of the
tumour.
5. Retinal haemorrhages in association with choked disc. Here,
in opposition to the findings of Horsley, the haemorrhages were
more often contralateral—8 to 5 ipsolateral.
In regard to the exact locality of the tumours further details
are given which show that this has little if any influence as a
determining factor.
The author’s figures support Paton’s view that no practical
significance for purposes of localisation can be attached to changes
on the fundus oculi in cases of brain tumour.
220
ABSTRACTS
On the other hand unilateral exophthalmus, or the more
prominent eye when the condition is bilateral, excluding, of course,
cases in which the orbit is invaded by new growth, is as a rule
on the side of the tumour. In 20 cases the exophthalmus was
ipsolateral in 17, contralateral in 3. This corresponds with the
theory that the exophthalmus is due to obstruction of the orbital
veins by pressure on the cavernous sinus or otherwise.
H. M. Traquaib.
ON CARCINOMA META8TA8E8 IN THE CEREBELLUM. (Ueber
(177) Kandnommetastaaen im Kleinhim.) P. Gibardi, Monatssehr. f.
PsyehiaL u. Neurol., Bd. 31, H. 2,1912.
The report of a case illustrated by five drawings of the
microscopical appearances. 0. Macfib Campbell.
ON EXPERIMENTAL INVESTIGATIONS ON THE INFLUENCE
(178) OF CEREBRAL HEMORRHAGE, CEREBRAL EMBOLISM,
EPILEPTIC ATTACKS AND CONCUSSION ON THE CLE
OULATION IN THE BRAIN. (Experimentelle Untersuchungen
fiber die Einwirkung von Gehirnblutungen, Gehimembolien,
epileptischen AnfKllen und Gehirnerschiitterungen auf die Blut-
zirkulation im Gehim.) H. Berger, MonaUtehr. f. Psyehiat. u.
Neurol., Bd. 31, H. 5,1912.
The usual assumption has been that in the conditions referred to
in this article, the sudden loss of consciousness is due to a cortical
anaemia due to a contraction of the pial vessels. In experiments
on dogs with regard to these conditions, the author demonstrated
no general contraction of the cortical vessels, but rather a dilatation
of the vessels even of the hemisphere not operated on. The loss of
consciousness in these conditions does not appear to be due to
cortical anaemia of reflex origin. C. Macfie Campbell.
AN APPROACH TO THE HYPOPHYSIS THROUGH THE ANTERIOR
( 179 ) CRANIAL FOSSA C. H. Frazier, Annals of Surgery, Vol. lvii.,
Feb. 1913, p. 145 (3 figs.).
Frazier has applied his operative method successfully in two
cases: particulars are given of one of these, a case of pituitary
cyst. He finds the operation as easy as Gasserianectomy, though
somewhat more complicated. Although he recognises that the
transphenoidal route will be needed in some cases, he believes
that the intracranial route through the anterior fossa will be
preferred in the future.
He “ reflects an osteoplastic flap from the right frontal region,
ABSTRACTS
221
removes en bloc the supraorbital ridge with a portion of the
orbital roof, later to be replaced, and rongeurs away what remains
of the orbital roof down to the optic foramen. With the elevation
of the frontal lobe and the depression of the orbital contents, a
free and adequate exposure is secured, and there remains only
to make a short incision in the dura to lay bare the cavity of
the sella.”
Frazier’s method is a modification of M‘Arthur’s (v. Review,
x., 1912, p. 393), but admits of greater elevation of the frontal lobe
and a freer exposure of the deep-seated structures; also the portion
of bone to be resected is smaller, and necrosis is less likely to
occur. When radiography shows that the sella, whether deepened
or shallow, has an enlarged orifice, showing that its contents have
encroached on the brain and not on the sphenoidal cells, one of
the intracranial methods is indicated. The intracranial method
gives a broad avenue of approach and less risk of infection than
the transphenoidal method. Leonard J. Kidd.
NYSTAGMUS IN FEVER. (Ueber nystagmus bei Fieber.) O. Beck
(180) and P. Biach, Wien. klin. Woch. ., 1912, xxv., p. 1831.
The writers examined fifty-six cases in which fever was not due
to ear disease, such as pneumonia, acute rheumatism, tonsilitis,
pericarditis, gastro-intestinal infections, and scarlet fever. In the
majority the nystagmus appeared at the onset of the fever and
disappeared when the temperature became normal, but in a
certain number the nystagmus outlasted the fever. Strange to
say no nystagmus was seen in twelve typhoid patients who
showed more or less severe cerebral symptoms, nor in any cases
of tuberculosis except the miliary variety. The writers suggest
that the nystagmus is due to cerebral hyperaemia or oedema in
the region of the posterior cerebral fossa, and compare the pheno¬
menon to the transitory loss of knee jerks, or the presence of
Babinski’s sign in febrile disorders. J. D. Rolleston.
NYSTAGMUS IN FEBRILE DISEASES. (Ueber Nystagmus bei
(181) fleberhaften Krankheiten.) E. v. Czyhlabz, Berlin, klin. Woch.,
1913, L, p. 112.
CzYHLARZ found that nystagmus was especially frequent in diseases
whose onset was accompanied by a high temperature, such as
erysipelas, lobar pneumonia, severe rheumatism, and influenza.
His observations entirely agree with those of Beck and Biach
except as regards typhoid fever and tuberculosis.
Though nystagmus was usually absent during the first fortnight
of typhoid, Czyhlarz found that it usually appeared later and per-
222
ABSTRACTS
stated long after the temperature had become normal. He also
found nystagmus present in tuberculosis without there being any
definite evidence that it was the miliary form.
J. D. Rolleston.
ACROMEGALIC GIGANTISM WITHOUT ENLARGEMENT OF THE
(182) SELLA TURCICA: SEXUAL INVERSION AND “MENTAL
FEMINISM.” Gallain, Nouv. Icon, de la Salpet., March-April
1812, p. 124.
The patient is a young man of 25, whose height ta l - 86 metres.
Hta face is smooth and puerile; he has a wide pelvis and
convergent femora. He ta very fat, with prominent breasts. The
external genitalia are normally formed and there ta no azoospermia.
The hands and feet are definitely acromegalic, of the “type en
long ” of Pierre Marie. The sella turcica ta of normal dimensions.
Hta mental condition ta one of definite inversion, of which the
author supplies abundant evidence. S. A. K. Wilson.
PITUITARY GLYCOSURIA IN HUMAN AND ANIMAL TUBER
(183) OULOSIS. (La glycosurie hypophysaire chez rhomme et
l’animal tuberculous.) H. Claudk, A. Baudouin, and R. Porak,
Com.pt. Rend. Soc. de Biol., VoL 74, No. 10, March 14, 1913,
p. 528.
Using the technique employed by Claude and Baudouin in their
previous experimental work on pituitary glycosuria ( v. Review,
Vol. xi., January 1913, p. 49), the authors failed to obtain glycosuria
after injection of posterior pituitary lobe extract in twelve young
subjects suffering from definite pulmonary tuberculosis, although
they all showed the general symptoms of posterior lobe extract
injection, viz., cardiovascular phenomena, often intense, and in
the case of women, painful uterine contractions. The authors
found also that in six rabbits, in which in the normal state pituitary
glycosuria was produced by these injections, it could not be made
to appear after experimental tuberculisation. They conclude that
impregnation of the organism with tuberculous poison causes the
disappearance of the faculty of producing hypophysial glycosuria:
in this respect tuberculosis differs strikingly from arthrittam.
Leonard J. Kidd.
OLEIDO-ORANIAL DYSOSTOSIS. (Sur un cas de dysostose cldido
(184) cranienne.) Maldaresco and Parhon, Nouv. Icon, de la SalpSt.,
May-June, 1912, p. 251.
A typical case of this rare disease [the authors say they have
found only 33 definite cases recorded, but in their bibliography
they omit at least two, if not more, English cases], in a man of 40.
ABSTRACTS
223
It is very interesting to note that a number of the recorded cases
showed considerable obesity. For somewhat inadequate reasons
the authors are inclined to class the disease as a dystrophy of
polyglandular origin. S. A. K. Wilson.
CUBE OF TETANUS BT INTRA-SPINAL SEROTHERAPY.
(185) (Gu&ison d’un cas de tltanos traits par la s6roth6rapic intra-
rachidienne.) K Merle, Bull, et mim. Soc. mdd. H6p. de Pari a,
1913, zzzv., p. 406.
The patient was a boy, aged 14 years, who received 80 c.c. of
anti tetanic serum by intraspinous injection within five days, in
addition to two doses of 20 c.c. subcutaneously.
J. D. Rolleston.
ON THE RECURRENCE OF NERVOUS SYMPTOMS OF LUETIC
(186) ORIGIN. (Ueber die Neurorezidive der luetischen Affecktionen
des Nervensystema) A. Romagna-Manoia, Monatsachr.f. PtychiaU
u. Neurol ., Bd. 38, H. 1,1912.
The author reports very briefly the clinical history of eighty cases.
He concludes that syphilis of the nervous system is more apt to
recur in the male than in the female. The age at which lues was
acquired is of some importance in this respect. In a majority of
the cases with recurrence of nervous symptoms syphilis was
acquired between 15 and 30. In a majority of the cases the
recurrence occurred within the first year after the development of
the nervous symptoms. Gummatous meningitis has the greatest
tendency to recur; next in order come mixed forms, cerebral
endarteritis, and finally peripheral neuritis. The etiological factors
of importance are unsatisfactory treatment of the initial infection
and of the nervous symptoms, chronic alcoholism, neuropathic
heredity, and general malnutrition. C. Macfie Campbell.
remarks upon some recent studies in the patho-
(187) GENESIS OF EPILEPSY. L. Pierce Clark, Botton Med. and
Swrg. Journ., Vol. clxvii., No. 3, pp. 78-81, July 18,1912.
The writer discusses the two main theories as to the causation of
epilepsy, those, namely, of heredity and of toxic action. He is of
opinion that in most cases both of these factors come into play.
He describes recent observations on the toxicity of the blood of
epileptics, and of the urine after a fit, as shown by the effect
produced when injected into animals. He discourages the sedative
treatment of epilepsy as long as there is hope of bringing the
real causal factor of the disease under control.
W, Boyd.
224
ABSTRACTS
OR THE PRECIPITATING CAUSES OF CERTAIN NEUROSES AND
(188) PSYCHOSES (Ueber Gelegenheitaursachen gewisser Neurosen
und Pay chosen.) H. Bkrtschingeb, Allg. Zttchr.f. Ptychiat ., Bd
69, H. 6, 1912.
The author discusses in a most interesting manner the reason for
the actual manifestation of a disorder which has been latent for
many years. He does not confine himself to any one disease type
but bases his remarks on a great variety of cases, which he reports
in a very summary manner. The incident which precipitates the
psychosis may be apparently unimportant and seem an inadequate
cause, but it may be sufficient to make impossible the continuation
of the compromise of which so many lives consist. The author
cites many cases to illustrate what he means by this compromise
or life - falsehood, where beneath conventional happiness and
satisfaction there are latent strong unsatisfied longings and bitter
disappointments. When faced with serious difficulties in gaining
satisfaction from life, the individual may make use of conversion
into physical symptoms and various types of invalidism or
alcoholism or unusual application to business affairs, or affection
may become centred on some other person than the one where
satisfaction is denied. Beneath an apparently harmonious married
life residuals from a previous love affair exist and actual dis¬
harmonies are repressed. The cases cited by the author illustrate
the development of a neurosis or psychosis when the fiction on
which the individual’s life is based becomes no longer tenable.
C. Macfie Campbell.
A STUDY IN HYSTERIA AND MULTIPLE PERSONALITY, WITH
(189) REPORT OF A CASH J. W. Mitchell, Special Medical Part of
Proc. Soc. Ptychiat. Research , Vol. xxvi., Nov. 1912.
An account of an extraordinary and very carefully observed case
of hysteria and multiple personality. The case was under observa¬
tion for ten years. The illness began acutely with a moderate
temperature. There were rythmic movements, paralysis, anaes¬
thesia, photophobia, and curious speech defects, there being a
great preponderance of sibilants. For many months she was
almost totally word-blind. Eighteen months after the onset of
the illness she recovered in every respect, with the exception of
right hemianalgesia, which persisted for six years. Two years
later she had another similar attack. On this occasion there was
a sanguinous discharge from the left ear, and blood oozed from
the lower eyelid on the left side. After a year the symptoms
again completely disappeared. Three years later a third attack
developed. The author now tried the effects of hypnotism, and
succeeded in abolishing the physical symptoms. At the same
ABSTRACTS
225
time he made the discovery that he was dealing not with one
personality, but with three. Psycho-analysis was resorted to,
and revealed the fact that this disintegration of personality was
caused by certain emotional shocks which bad occurred some time
previously. By means of suggestion all of the symptoms, both
physical and mental, where finally made to disappear.
W. Boyd.
PSYCHIATRY.
ON THE PATHO-PHYSIOLOGIGAL INTERPRETATION OF THE
(190) ATTACKS AND DELIRIA IN GENERAL PARALYSIS. (Zur
pathophysiologischen Auffassung der AnfBUe and Delirien bei
Paralysis progressiva.) H. Schrottbnbach, Monatatchr.f. Psychiat.
u. Neurol., Bd. 31, H. 3, 1912.
In the paralytic attack and the paralytic delirium, leucocytosis
occurs. Apoplectiform attacks always show a higher leuoocyte
count than the epileptiform attacks. The latter show higher
counts than the mild transitory delirious attacks. The leucocytosis
goes parallel with the exacerbations or remissions of the symptom-
picture. These findings warrant the assumption of a toxic or
infectious cause of exogenous or endogenous character.
C. Macfie Campbell.
THE CONVICTION AND IMPRISONMENT OF GENERAL PARA-
(191) LYTICS. (Paralyses gdndraux cond&mnfo et incarc&es.) Alex.
PAris, Arch. Intemat. de Neurol., No. 3, March 1913, p. 137.
The author records the cases of three typical general paralytics
who were convicted of theft and other offences and served their
term in prison. He mentions also the case shown by Duprd at
a meeting of the SocidU de Psychiatrie on 24th October 1912, of a
general paralytic who was condemned to three months’ imprison¬
ment for theft, in spite of the presence of extreme defect of
articulation, an absurd degree of euphoria, and absolute uncon¬
sciousness of his situation. The author suggests a periodical
medical supervision for such cases in “ houses of arrest,” hut he
does not go very fully into particulars in this short paper.
Leonard J. Kidd.
URETHRITIS IN GENERAL PARALYSIS, WITH REMARKS ON
(192) THE EXHIBITION OF HEXAMETHYLENE-TETRAMINE.
Habvby Baird, Jowm. Ment. Sc., Vol. lix., No. 244, Jan. 1913,
p. 75.
The posterior portion of the urethra was examined histologically
in 28 cases, five were normal. Of the 23 cases which showed
226
ABSTRACTS
evidence of disease, 7 paralytics and 3 non-paralytics were slightly
involved, 6 paralytics and 3 others had well-marked lesions, and
3 paralytics and 1 non-paralytic very marked. All the paralytics
showed evidence of urethritis.
Hexamethylene-tetramine was used in the treatment of the
disease, and the author thinks that the duration of the malady
was somewhat prolonged. The number of seizures was diminished
to a slight extent. W. Bom
OEREBRAL CY8TICERCOSIS AND GENERAL PARALYSIS
(193) (Cysticercose cdrdbrale et paralysis gdndrale.) A. Vioouboux
and H£ribson-Laparu, Soc. Anat. de Parts, 7 Mara 1913. (La
Presse Mid.., No. 23, March 19,1913, p. 226.)
A man of 54 showed the syndrome of general paralysis with
numerous epileptiform attacks. Autopsy showed that numerous
cysticerci of all sizes had invaded the brain, heart, and certain
muscles: the cerebral hemispheres were most affected. The sub-
pial and the intracerebral cysticerci had caused in every instance
an intense inflammatory reaction: there was diffuse meningo¬
encephalitis. The question is left open whether this latter was
produced by the cysticerci or was present before they appeared.
Leonard J. Kidd.
ON THE HISTOPATHOLOGY OF CY8TICERCU8 IN THE BRAIN.
(194) (Zur Histopathologie der Gehirncysticerkose.) K. Krause,
Monatsschr. f. fsychiat. u. Neurol., Bd. 31, H. 6,1912.
The author reports two cases of cysticercus in the brain with very
chronic course in which there was a marked dementia. He
describes in detail diffuse cortical changes which he attributes to the
presence of the cysticerci, which maintain a chronic inflammatory
process in the membranes and the cortical vessels. In both cases
there was papilloedema, although there was no definite basal
meningitis. C. Macfie Campbell.
PLURIGLANDULAR ENDOORINIO SYNDROME AND DEMENTIA
(196) PRJ3COX. (Oonsideragbes sobre tun caso de syndromo pluri¬
glandular endocrinico e dementia precoce.) F. V. de Moraes
and P. Pernambuco, Arch. Brasil, de Med., 1912, ii., p. 671.
A record of a case in an heredo-syphilitic woman, aged 19, the
subject of dementia prsecox. Involvement of the ovaries, supra-
renals, and thyroid was shown by menstrual irregularities, pigmen¬
tation of the skin, loss of axillary and pubic hair, and a goitre.
No improvement followed two injections of salvarsan, followed by
athyroidin and ovarin. J. D. Rolleston,
ABSTRACTS
227
THE PATHOLOGICAL CHANGES OF THE BRAIN IN HORSAKOFFS
(196) FS7CHOSIS. (Der Himbeftmd bei der Korsakoffschen Psychos©.)
U. Vollrath, Monattschr. f. Psychiat. u. Neurol ., Bd. 31, H. 4,1912.
The detailed report of the cortical changes in a well-marked case
of Korsakoff's psychosis with a review of the literature.
C. Macfie Campbell.
•
CTTOLOGIOAL AND CHEMICAL RESEARCHES ON THE BLOOD
(197) IN SCORBUTIC MENTAL OASES. (Di alcune ricerche emo-
citologiche e flsico-chimiche in scorbutici alienati.) Luigi
Daneo and Manlio Ferrari, Rastegna di Studi Psickiat ., Vol. iii.,
F. 1, Gennaio-Febbraio 1913, p. 6.
From a study of ten cases of mental disease, who also suffered
from scurvy (five of which were dementia praecox), the authors
find that there is a constant diminution of the red cells, a marked
leucopenia with an increase in the number of the large mono¬
nuclear and transitional forms, a diminution in the lymphocytes
and in the graver cases an eosinophilia. The blood pressure was
greatly lowered in two severe cases. The authors consider that
these facts are in favour of a toxi-infectious origin.
A. Ninian Bruce.
THE IMPORTANCE OF SCHOPENHAUER FOR PSYCHIATRY
(198) (Die Bedeutung Schopenhauers fiir die Psychiatric.) Otto
Jultusburger, AUg. Ztschr. f. Psychiat., Bd. 69, H. 6, 1912.
An extremely interesting study of certain views of Schopenhauer
which represent in outline important modem psychiatric con¬
ceptions. Psychiatry has recently been stimulated by the work
of Freud and of Bleuler who have done much to render intelligible
the actual biological significance of the neuroses and the psychoses.
Their conclusions had, however, been largely anticipated by the
philosopher of pessimism. “ If a worry or piece of knowledge or
memory is so painful that it is actually insupportable and the
individual would succumb to it, then panic-stricken nature reaches
out to insanity as towards its final salvation. The mind thus
tortured tears as it were the thread of its memory, fills out the
gaps with fictions, and finds in insanity a refuge from the pain
which exceeds its powers to bear.” In equally clear language
Schopenhauer refers to the role of these resistances which are
so important in the Freudian psychology. If clear reason cannot
assimilate by the usual associative methods some experience
because the will refuses to accept it, the nucleus of the neurosis
or the psychosis is already there. The philosopher has equally
228
ABSTRACTS
recognised that many casual thoughts, judgments, resolves are
the product of processes which take place at tf deep level in our
mental life. Schopenhauer saw the source of the most important
intra-psychic conflicts in sexuality, in the wide acceptance of the
term. The phrases in which he expresses his views might almost
be penned by one who had reached his conclusions by means of
systematic psycho-analysis. “The sexual relation is really the
invisible centre of all doing and acting and everywhere it crops
out despite all the veils thrown over it. It is the cause of war
and the aim of peace, the basis of what is earnest and the aim of
the jest, the inexhaustible source of wit, the key to all allusions,
the meaning of all secret signs, of all unspoken offers and of all
stolen glances, the thoughts and aim of the young and often of
the old, the hourly thought of the unchaste and the constant
unconscious reverie of the chaste, the ever ready stuff for jesting
for the very reason that it is essentially so deeply earnest. The
sexual instinct is the kernel of the will to live, it is the concentra¬
tion of all will, man is concrete sexual instinct.” The sexual
instinct of the philosopher, just as the more modern libido of
Freud and Jung, is something which can only be adequately
understood in a much wider context than that of the life of
the individual. It is no mere gross somatic satisfaction; it has
deep phylogenetic roots. The metaphysical needs of man, the
creations of his religious feelings and conceptions can only be
understood when their psycho - sexual roots are traced. The
bipolarity of the sexual instinct has not been neglected by the
philosopher and in this connection he has emphasised the relation
between sexuality and crime. The influence of heredity is also
referred to in clear and trenchant terms, and he insists on the
necessity of keeping these facts in mind when framing penal
statutes. How modern is his statement, " If one wish to consider
prisons as educational institutions it is regrettable that admission
into them is only possible through crime instead of the latter
being obviated by them!” Juliusburger might well have studied
the philosopher’s views in relation to the circumstances of his
own heredity, early development, and personal difficulties. As
it is, he has contributed an extremely interesting chapter to the
history of psychiatry. C. Macfie Campbell.
A STUDY OF THE SIGNIFICANCE OF THE HABIT-MOVEMENTS
(199) IN MENTAL DEJECTIVES. L. Pierce Clark and C. E.
Atwood, Joum. Amer. Med. As$oc., Vol. lviii., March 23,1912, pp.
838-843.
This is a study of such habit-movements as finger-sucking, pelvic
rocking, palm-rubbing, &c., in a large number of idiots and
ABSTRACTS
229
imbeciles. In almost all of these cases masturbation made its
appearance at puberty. The authors hold that these habit-move¬
ments are not mere acts of automatism, as has hitherto been held,
but that they bear a very definite relation to the sexual develop¬
ment, or mal-development, of the defective. The theories of
Freud are naturally quoted in support of their argument.
W. Boyd.
THE FORMS OF MENTAL DISORDER OCCURRING IN OONNEC-
(200) TION WITH CHILD BEARING. G. Clarks, Joum. Merit . Sc.,
YoL lix., No. 244, Jan. 1913, p. 67.
The author sums up as follows:—
(1) Almost any form of mental disease may be met with during
pregnancy or lactation, but by far the commonest varieties are the
acute confusional and the manic-depressive psychoses.
(2) In these two forms of mental disease the prognosis is as a
rule good, but in other forms occurring at this time the outlook
is not nearly so hopeful.
(3) Except in some cases of acute delirium, there is no reason
to think that toxic or hsemic conditions are important factors; the
mental breakdown may be looked upon as a temporary failure
of the mind to adapt itself to physiological but unusual conditions.
W. Boyd.
ON GLYCOSURIA IN MENTAL DISORDERS. (Beitrag sur Kenntnis
(SOI) der Glykosurie bei Geisteskranken.) S. Mita, Monatsschr. f.
Ptychiat. «. Neurol., Bd. 32, H. 2,1912.
Thx material consisted of 35 patients with depressed or anxious
states and of 21 control patients. Out of the 35 patients of the
first group, 8 showed glycosuria. Of these 8, 2 had neurasthenia,
2 had a hysterical psychopathic constitution, 2 had circular
insanity, 1 patient had dipsomania, 1 melancholia (the author
uses Ziehen’s classification). In none of these cases was any of
the usual symptoms of diabetes present and the amount of sugar
in the urine was very small, varying from 1*05 per cent, to 0 01
per cent. Of the 21 patients of the second group sugar was only
found once in the urine, in the case of an alcoholic with psycho¬
pathic constitution. The author concludes that there is a certain
connection between glycosuria and a depressed affect independent
of the actual clinical type of the disorder.
C. Macfie Campbell.
230
REVIEWS
■Reviews.
DIE APHASISCHEN S7MPT0ME UNDIHBE OOETIOALE LOKAL
(202) ISATION. Von E Niessl von Mayendorf (aus der paychiatrischen
Klinik zu Leipzig). Mit 51 Figuren and VII Tafeln. Leipzig:
Verlag von Wilhelm Engelmann, 1912. Pp. 454.
Dr Niessl von Mayendorf’s previous work on aphasia and its cortical
localisation in various papers in the Monatsschrift fur Psychiatric is no
doubt familiar to most neurologists. The handsome volume under
review contains some 450 pages of clinical and pathological
observations, both personal and culled from other sources, bearing
on the question of aphasia in its differing forms, and therefrom
are deduced certain conclusions which are not by any means
always in harmony with what we are pleased to call the “ classical
theory ” of aphasia: on the other hand, they are not in agreement
with the recent pronouncements of Professor Pierre Marie.
Taking as the subdivisions of his material amnesia verbalis
kinsesthetica, amnesia verbalis acustica, and amnesia verbalis
optica, respectively, the author discusses these at great length from
the points of view of symptomatology, diagnosis, prognosis, and
cortical localisation, and incidentally indulges in various discourses
into the debatable lands of transcortical and subcortical motor
aphasia, Marie’s teaching, transcortical and subcortical sensory
aphasia, the functions of the lenticular nucleus, and so on, con¬
cluding with a chapter on certain cases of “ Inselaphasie.” He
considers that transcortical motor aphasia is the product of restitu¬
tion and though readily recognisable clinically, can scarcely be
held to have a definite localisation. There is a long dissertation
on the anatomical connections and functional significance of the
lenticular nucleus, from which no definite conclusions are drawn,
and in which certain views as to its relation with pontine nuclei
are advanced, for which, in the reviewer’s opinion, there is neither
evidence nor even hypothetical justification. The author further
states that there are important considerations militating against
the view which regards the lenticular nucleus as exclusively motor,
but it is clear that misconception exists as to the meaning of the
term “ motor,” misconceptions which the recent work of Madame
Vogt and others has to a large extent cleared away. Dr von
Mayendorf concludes against attributing finality to Marie’s opinions,
and repeats various objections which have already been brought
against them. One of the most important chapters in the book
is concerned with the cortical localisation of ordinary motor
aphasia, Broca’s aphasia, which the author places in the lower
third of the precentral gyrus and the pars opercularis. In their
REVIEWS
231
course from the cortex downwards the motor speech fibres descend
by the posterior part of the external capsule, and intermingle with
pyramidal fibres in the posterior division of the internal capsule.
A brief review such as the present does not permit of adequate
discussion or criticism of this view, which, for that matter, is not
unlike that advanced by Sir David Ferrier many years ago. It
may be said, however, that it is a view which cannot lightly be
ignored, for many data lend it support. The problematical signi¬
ficance of lesions of the cortex of the island of Reil is fully discussed,
but here also no definite conclusions are drawn. There is a fairly
large bibliography, but no index. Two charts similar to those
already published by the author, in which the cortical superficies
is mapped out and dotted with figures in colours to represent the
lesions in recorded cases, are appended. There are a number of
excellent half-tone illustrations of the sections in various cases
of the author’s reported in the text.
All students of the subject will do well to make themselves
acquainted with the contents of this monograph. It contains an
immense amount of information, handled methodically and logically.
Many useful abstracts of apposite cases from the literature will
be found scattered through its pages. Several original cases are
reported in great detail, both clinically and pathologically. Dr von
Mayendorf is to be congratulated on the scholarly fashion in which
his labours have been completed, for the book is conspicuous,
among a host of contributions to the subject, by reason both of
its completeness and the ability that characterises it. There is,
it may be remarked parenthetically, a curiously personal polemic
in the book, unfortunately allowed to protrude at unexpected
moments. The author apparently introduces all who happen to
disagree with him with the prefix “ Herr ” to their names, and
if he would be particularly scathing, this is elaborated to “ Herr
Dr-aus Berlin ”! S. A. Kinnier Wilson.
HANDBTJOH DEB NERVENKRANKHEITEN IM KINDESALTEB.
(303) Von Prof. L. Bruns, Oberarzt d. Hannoverschen Kinderheilanstalt;
Prof. A Cramer, geh. Med.-Rat., Direktor d. kgl. Univ. Klinik.
f. psych, u. Nervenkrankh. in Gottingen.; Prof. Th. Ziehen, geh.
Med.-Rat., fr. Direktor d. psych, u. Nervenklinik d. kgl. Charite
in Berlin. Mit 189 Abbildungen im Text und 3 Tafeln. Berlin,
1913: S. Karger. Pp. 980. Price M. 30.
The three distinguished German neurologists who have collaborated
in the production of this volume of practically 1,000 pages
on nervous diseases as they occur in childhood are regarded
as authorities on the subjects with which they have dealt, and
their names are guarantee of the thoroughness and comprehensive-
232
REVIEWS
ness with which their task has been accomplished. The reader
who glances through the book will readily discover that practically
the whole range of neurology has been covered by the authors,
and that there is little to distinguish it from a textbook of
neurology so called, unless it be that diseases peculiar to childhood
receive more attention than the others. We cannot help feeling,
however, that the size of the book might have been reduced
without loss of any material element. Professor Cramer devotes
40 pages to hysteria in children, 90 to epilepsy, and 40 to chorea.
There is also a long chapter on tics. In spite of the amount of
space devoted to these topics, we cannot find any adequate descrip¬
tion of spasmus nutans, myoclonus, paramyoclonus multiplex,
paramyotonus, variable chorea, and certain other allied conditions:
some of these are referred to only in the briefest manner on page
527. Dr Cramer says he has never seen the reflexes altered in
chorea minor, and does not allude to the occurrence of an extensor
response in that affection. He recommends arsenic in the treatment
of chorea, and uses aspirin, apparently, only where the heart is
affected. It is the experience of English neurologists that in
aspirin, apart altogether from cardiac complications, we have
almost a specific in the therapeutics of chorea.
To Dr Bruns has been entrusted diseases of the spine and
spinal cord, the varieties of muscular atrophy, and diseases of the
peripheral nerves and plexuses. It is curious to find reproduced
on page 261 Seiffer’s scheme of the segmental distribution of the
skin, for it has long been known to be both incomplete and
inaccurate. The chapter on poliomyelitis contains much information
and from the clinical standpoint could not be improved on: the
reference to the most recent advances in our knowledge of its
etiology and pathogenesis, on the other hand, are somewhat meagre.
Dr Bruns believes that, apart from a specific morbid agent not yet
recognised, poliomyelitis may in certain circumstances be caused*
by various other bacteria or their products, but we do not find
any evidence for this view set forth. Among the special types
of the disease there is no reference to acute cerebellar ataxia, and
in Dr Ziehen’s article on encephalitis only seven lines are given
to it. Myatonia congenita is not given a chapter or section to
itself, but is dismissed in a single paragraph on page 346, among
the conditions from which poliomyelitis is to be differentiated.
In the index the page is given as 247: the disease is again referred
to (erroneously) as “ myotonia congenita ” on page 421, and three
lines allowed for it. We mention these matters to save the reader
the trouble which the reviewer has had in finding the disease,
and to indicate the inadequacy of the space, in so large and
pretentious a volume, allotted to it.
REVIEWS
233
Dr Ziehen writes at great length on the diseases of the brain
and meninges, and covers the ground with remarkable complete¬
ness. About sixty-five pages are given to the important subject
of intracranial neoplasms, and this being so, we should have liked
to see further details in the diagnosis of tumours of the temporal
lobe; there is no description of the symptom-complex associated
with the name of Hughlings Jackson and pathognomonic of lesions
in the neighbourhood of the uncinate gyrus. There is no note
of subjective visual disturbances in tumours involving the gyrus
angularis. Disturbances of the pupillary reflexes in tumours of
the third ventricle are by no means infrequent, are often of help
in localisation, and might with advantage have been mentioned.
The discussion of tumours of the pineal and pituitary glands is
not sufficient, we think, for the importance of the subject,
especially as such conditions are met with in children.
We have not offered the above criticisms in any carping spirit,
for the volume as a whole is well calculated to take its place as
a valuable work of reference. It is inevitable where there is
collaboration that a certain amount of inequality should exist,
but apart from that the merits of the book are very considerable,
and we can recommend it to all who are concerned with or
interested in the study of nervous disease in children.
S. A. Kinnier Wilson.
EYE STRAIN IN EVERYDAY PRACTICE Sidney Stephenson.
(804) The Ophthalmoscope Press, London, 1913. Pp. 139. Price 3a. 6d.
During recent years an increasing amount of attention has been
devoted to the connection between headache and other reflex
neuroses and errors of refraction, and the present state of our
knowledge of this subject is laid before the reader in an admirably
concise and intelligible manner in this little book, which consists
of seven collected papers by Mr Stephenson.
The author’s judicious and moderate attitude is well reflected
in the prescriptions given in the numerous instances quoted, for
while stress is duly laid upon the fact that it is the cases present¬
ing a low refractive error, associated with normal or supernormal
vision, in which these neuroses are apt to occur, only a minute
proportion of the prescriptions correct errors of a total magnitude
as low as a quarter of a diopter, and nearly all of them more than
this, corrections for microscopic errors being conspicuous by their
absence. Our confidence in the author is still more firmly
established by his sceptical attitude towards the views of those
who would include affections ranging from appendicitis and
tuberculosis to crime and insanity, as conditions referable to
ocular troubles.
234
BOOKS AND PAMPHLETS RECEIVED
While one or two of the points mentioned are perhaps not
yet beyond the realm of controversy, the book is one which should
be read by all practitioners, and can be recommended with all
the more confidence as it is short, well printed, and to the point.
H. M. Traquair.
BOOKS AND PAMPHLETS RECEIVED.
Cyriax, E. F., and Cyriax, R. J. “Mechanical stimulation of the
coccygeal ganglion. A contribution to the physiology of the sympathetic
nervous system ” (Ztschr. f. allg. Physiol., Bd. xiv., H. 3 and 4,1913, p. 297).
Franz, Shepherd Ivory. “ Observations on the preferential use of the
right and left hands by monkeys ” ( Joum. Animal Behavior , Vol. 3, No. 2,
March-April 1913, pp. 140-144).
Franz, Shepherd Ivory. “ The accuracy of localization of touch stimuli
on different bodily segments” ( Psychological Review, Vol. xx., No. 2, March
1913, pp. 107-128).
Hauptmann, Alfred. “Die diagnostische Bedeutung der Lumbal -
punktion ” ( Sammliing Hoche, Bd. x., H. 1, 1913). Carl Marhold, Halle
a. S. Pr. M. 1.00.
Hom6n, E. A. “ Arbeiten aus dem Pathologischen Institut der
Univenritat Helsingfors,” Bd. 1, H. 1 and 2, 1913. Ghutav Fisher, Jena.
Pr. M. 20.
Maas, Otto. “ Messapparat fur den Extremitatenumfang ” (Dent. Med.
Wchnsehr., No. 49, 1912).
Maas, Otto. “ Storung der Schwereempfindung bei Kleinhirnerkrank-
ung” (Neurol. Centralbl., Nr. 7,1913).
Sawyer, Sir James. “Insomnia; its causes and treatment” (Second
Edition, with many revisions and additions). Cornish Bros., Birmingham,
1912.
Symington, J., and Crymble, P. T. “The central fissure of the cere¬
brum ” (Joum. Anat. and Physiol ., Vol. xlvii., April 1913, p. 321).
The Training School, Vol. x., No. 1, March 1913.
■Review
of
BeuroloGE ant) Ipsvcbiatrv
Original Hcticles
MULTIPLE NEUROMATA OF THE CENTRAL
NERVOUS SYSTEM: THEIR STRUCTURE
AND HISTOGENESIS.
By the late ALEXANDER BRUCE, M.D., LL.D., F.R.C.P.E.; and
JAMES W. DAWSON, M.D. (Carnegie Research Fellow).
(Continued from page 194.)
III. —The Genesis of Peripheral Nerves.
General Remarks on the Structure of the Peripheral
Nervous System. 1
Alm ost the whole of neuro-pathology rests on the neurone
doctrine, which sees in the axis-cylinder a prolongation of a
central cell. The problem of the relation of the nerve fibre to
the nerve cell involves a consideration of facts relating to the
continuity or independence of the central cell and its peripheral
ramifications. The old retioular theory of Guerlach, who saw in
the nervous system an uninterrupted protoplasmic network, was
destroyed by the findings of Golgi in 1875 and Cajal in 1891.
These observers, by specific staining methods, showed the existence
of free terminations of the processes of the ganglion cells and of
the axis-cylinder ramifications—a mere relation of contiguity of
elements being thus indicated. In 1891 Waldeyer put forward
1 Based on “ Nerfs,” by G. Duran TB, in Manuel d'Histologie Paihologique.
Comil et Banvier (Paris), 1907.
22
236 ALEXANDER BRUCE AND JAMES W. DAWSON
the view that the nervous system is constituted of an infinity of
anatomical units which, embryologically, are independent of each
other. He proposed the term “ neurone ” to designate the cellular
unit formed each of a ganglion cell, its nerve fibre process, and
protoplasmic processes with their terminal ramifications. The
simplicity of this view is greatly in its favour, for the ensemble
constitutes a cytological unit developed from a single central
neuroblast.
The conception of the cell-chain theory is opposed to the
neurone doctrine. The nerve fibre, according to this view, repre¬
sents a chain of special cells (segmental neuroblasts) secondarily
brought into relation to the central cell. In each element there
has differentiated from its individual protoplasm a fatty substance
(myelin) and a fibrillated substance (axis-cylinder). Dogiel, Apathy,
and Bethe have shown that the fibrils within an axis-cylinder can
be related not alone to one ganglion cell but to several, and also to
the peri-cellular network, and that, reciprocally, the network of a
ganglion cell can be in relation to the fibrils of several axis-
cylinders.
Durante, to whose work we desire to acknowledge our
indebtedness, sees in this functional grouping of central and
peripheral elements an analogy to a gland lobule. He proposes
the term “neurule” to designate this physiological, polycellular
ensemble a true primitive nervous lobule. The ganglion cell, charged
not to create but to receive, perhaps to modify or accumulate, then
to expedite the nervous impulse, is compared to a gland acinus.
The segmental neuroblasts, charged to transmit from place to
place this impulse to its destination, are compared to the excretory
canals. In the neurule the elements have a reciprocal dependence
in functioning, but may be individually independent ( e.g ., in toxic
or infectious conditions). This conception of a primitive nervous
lobule allows of the nervous system being brought into line with
other organs and simplifies the understanding of pathological
lesions.
The neurone view teaches that the interannular segment of the
peripheral nerve is composed of two distinct parts: one, the axis-
cylinder, a prolongation of a central cell; the other, the rest of
the segment, consisting of myelin sheath, sheath and nucleus of
Schwann. The cell-chain theory teaches that the interannular
segment represents a single complete cell element (le neuroblaste
NEUROMATA OF CENTRAL NERVOUS SYSTEM 237
segmentaire), whose protoplasm has elaborated in situ the differen¬
tiated substances, axis-cylinder, and myelin. The axis-cylinder is
regarded no longer as a gigantic cell prolongation of central origin,
but simply as a bundle of fibrils differentiated in each segmental
cell, the myelin also being a product of the differentiation of the
cell substance. The condensed outer layer of the cell substance
forms the sheath of Schwann; the original nucleus, pushed to the
periphery, lies in the thin zone of the remaining undifferentiated
protoplasm. In the normal functioning nerve tube the differen¬
tiated substances preponderate greatly over the non-differentiated
substance, but the former have, properly speaking, no life of their
own and disappear in pathological conditions. The non-differentiated
substance, on the other hand, represents the living element of the
cell, and on it devolves the role of nutrition, defence, and repro¬
duction ; in pathological conditions it takes up its vegetative r6le,
and the cell returns to its embryonic condition.
The normal histology of the peripheral myelinated nerve fibre,
according to this view, is the following: In each nerve tube we
recognise (1) axis-cylinder, (2) myelin, and (3) the sheath of
Schwann, a thin membrane limiting the nerve tube on the outside;
between it and the myelin lines (4) the nucleus of Schwann in a
thin zone of undifferentiated protoplasm—normally scarcely visible.
The myelin is interrupted at regular intervals at the nodes of
Ranvier, and the portion of the nerve fibre comprised between two
constrictions constitutes the interannular segment. Each segment
contains usually only one nucleus and has the import of a highly
differentiated cell.
The axis-cylinder is formed of two substances, conducting fibrils
(the primitive fibrils of Apathy and Bethe) and interfibrillar
substance (the axoplasm of Schiefferdecker). Between axis-cylinder
and myelin is a thin zone of undifferentiated protoplasm, which
Schiefferdecker regards as a periaxial lymph-space.
The myelin is composed of protoplasm of specific characters
and is constituted by a network of neuro-keratin, whose meshes
contain a phosphorised fat. The continuity of the myelin is
broken by oblique notches arranged in an imbricated manner, the
incisures of Lantermann, which stain by Strahiiber’s method
similarly to the axoplasm of Schiefferdecker, and probably repre¬
sent a portion of the undifferentiated protoplasm. Some observers,
however, look upon both incisures and network as artefacts, others
238 ALEXANDER BRUCE AND JAMES W. DAWSON
regard them as a stage in the evolution of the nerve fibre—as they
are much more evident in the early stages of development, and
still others compare them to the canals met with in other cell
protoplasms. According to SchiefFerdecker and Durante, both
incisures and network are present in the fibres of the central
nervous system.
The sheath of Schwann is the thin condensed outer border of
the protoplasm of the interannular segment. It is often difficult
to distinguish it from the endoneurium which surrounds each
individual nerve fibre. The nucleus of Schwann is the nucleus of
the original cell lying in a thin zone of undifferentiated proto¬
plasms in which, in early stages of development, fine granules,
comparable to Nissl’s granules in the nerve cell, can be recognised.
Remains of undifferentiated protoplasm are thus found in the
interfibrillar substance of the axis-cylinder, in the periaxial zone,
in the incisures of Lantermann, and in the perinuclear zone. It
is the nucleus and this undifferentiated protoplasm which increase
so greatly in pathological conditions.
A nerve trunk is surrounded by a connective tissue envelope,
the epineurium, and around each funiculus is the perineurium.
The endoneurium passes between the nerve fibres of the funiculus,
and its finest ramifications, lined by flattened endothelial cells, form
round each nerve fibre a fibrillar network (the sheath of Henle).
Durante has also emphasised the complete analogy, according
to this view, between muscle and nerve elements. The muscle fibre
consists of (1) myoplasm—the fibrillar contractile substance—
which is a product of the internal differentiation of the sarco¬
plasm, (2) the remaining undifferentiated sarcoplasm, (3) the sarco-
lemma, the condensed outer layer of the non-differentiated sarco¬
plasm, with (4) its peripherally placed sarcolemma nucleus in a
thin zone of undifferentiated protoplasm. Under normal condi¬
tions the differentiated substance greatly preponderates over non-
differentiated, but in pathological conditions the differentiated
substance degenerates and the nucleus and non-differentiated sub¬
stance take on a vegetative role and return to their embryonic
condition.
(1) Embryogenesis.
Regarding the initial stages of the development of the peri¬
pheral nerves, there is far from any agreement amongst embry¬
ologists. At present three different theories hold the field, to
NEUROMATA OF CENTRAL NERVOUS SYSTEM 239
which Durante has given the names of central budding, cellular
lengthening, and cell migration with the formation of cell-chains.
Others have called them the outgrowth theory, the protoplasmic
or intercellular bridge theory, and the cell-chain theory.
1. Theory of Central Budding. —Bidder and Kupfer, in 1857,
put forward the view that the peripheral nerves develop by the
budding of a central cell, whose prolongation—a homogeneous axis-
cylinder without nuclei—reaches to the periphery and is only
secondarily surrounded by mesodermic elements to form its sheath.
His, Kolliker, and others have supported this view.
2. Theoi'y of Cellular Lengthening. —In numerous animals we find
at the limit of ectoderm and mesoderm certain elements possessing
the characters of nervous and muscular elements. These neuro¬
muscular cells become constricted in the middle, the part remaining
in the ectoderm becomes sensory, the part remaining deeper purely
contractile, and the protoplasmic bridge uniting them differentiates
into a rudimentary nerve. This view is associated with the name
of Hensen, and, with certain modifications, has been supported by
Sedgwick, Held, and Graham-Kerr. Some of its supporters think
that the cell connection is a secondary formation and is not due to
an incomplete division, as Hensen believes.
3. Theory of Cell Migration and the Formation of Cell-Chains .—
Balfour, Beard, Dohrn, Hoffmann, and others have demonstrated
during the first days of embryonal development, especially in
Selachians, the migration of neuroblasts from the nerve centres
into the mesoderm. At the level of the lateral line of the neural
tube it is possible to distinguish three kinds of neuro-epithelial
elements. These three, primarily identical, are derived from the
invagination of the dorsal epithelium, and later differentiate into
cells each of which elaborates a specific substance: (a) ganglion
cell—the neuro-chromatin granules, (h) glia cells—the glia fibrils,
(c) neuro-formative cells or peripheral neuroblasts—the conducting
fibrils. These last alone give origin to nerve fibres by migrating
and in their further proliferation arranging themselves into unin¬
terrupted cell-chains. The evolution of the nerve fibre according
to this view shows three phases: fusiform embryonic cells, the
union of these into long nucleated plasmodial bands, and the sub¬
division of these into segmented elements — the interannular
segment.
It is necessary to note, firstly, that the supporters of the first
240 ALEXANDER BRUCE AND JAMES W. DAWSON
view do not deny the importance of the periphery in forming the
path for the nerve fibres, and, secondly, that the supporters of the
second view do not disclaim the influence of the ganglion cell upon
the differentiation of the primary protoplasmic connections into
nerve fibres.
Hensen (1864) thought that it was almost impossible to believe
that the nerve filament found the muscle fibre without a guide.
He supposed that the junction is effected early, whilst the two are
in contiguity, and that the subsequent elongation of the nerve
fibres is due to the change in the situation of the muscle. Primary
tracts were thus laid down in the embryo which, later on, by
some unknown process transformed themselves into nerve paths.
Ranvier held that the axis-cylinder is uninterrupted from ganglion
cell to periphery, but that it passes through a series of cells.
His position, therefore, approaches Hensen’s, and Gedoelst agrees
with Ranvier’s point of view.
His (1879-1886) describes the first rudiments of the nerve under
the form of chromogen material, without nuclei, passing out from
the spinal cord. He showed that special differential cells in the
medullary tube—primitive neuroblasts derived from the Keimzcllen
—send out processes which form the anterior root-bundles, which,
when they reach the limit of the medullary tube, are surrounded
by mesenchyme elements that later penetrate the bundles.
According to His, the spinal ganglia are not outgrowths from the
medullary tube, but have at first no attachment to it. His and
Kolliker state that the connection is established by the ganglion
cells sending out processes which reach the cord. Before the
attachment takes place the ganglionic anlagc of each side divides
into two portions, the spinal ganglion and the sympathetic
ganglion. His did not definitely establish the precise origin of
the Keimzcllen.
Kolliker (1884) showed that the Keimzcllen of His are derived
from the original epithelial layer of the primitive tube, that these
Keimzcllen, through mitotic division, give rise to ganglion cells and
glia cells, and that the fibres arise as non-nucleated processes of
the ganglion cells and are continued as nerve fibres without any
participation of cells in their course. By means of frontal longi¬
tudinal sections of the cord with developing nerves Kolliker has
shown the naked compact bundles of nerve fibres. He states that
the capsule cells of the spinal ganglia are mesodcrmic elements,
NEUROMATA OF CENTRAL NERVOUS SYSTEM 241
and that these grow into the ganglion and gradually surround each
individual cell. It is to be noted that Kolliker in his last paper
has admitted that the Schwann cells are ectodermic elements, and
also that the growing nerve fibre at its tip is surrounded by a
capsule of Schwann cells.
Balfour (1888), in Elasmobranchs, has shown that cells, migrat¬
ing from the spinal cord, become arranged into spring-like groups
with a wide attachment to the spinal cord. In these cells the
nerve fibres develop. He remarks: “The cell structure of the
embryonal nerve is a point on which I should have thought that
a difference of opinion was impossible.” Balfour was one of the
first to note the structure which is generally called the neural
crest. He also pointed out that the sympathetic ganglia arise as
swellings on the posterior groups of the spinal nerves and soon
become removed from the latter to form isolated masses.
Dohm (1888-1892) has investigated the development of the
nerves in Selachians, and states that the first rudiments of the
nerve roots appear as protoplasmic columns uniting the spinal cord
to the muscle segments before any differentiation of the cells of
the early neural tube has taken place. In these protoplasmic
columns were found numerous nuclei which Dohm believed had
migrated from the primitive medullary tube: the protoplasmic
column later individualises into separate fusiform cells, which
unite by their tapering extremities to form moniliform bands, and
the protoplasm afterwards undergoes a differentiation into fibrils.
The cells nearest the medullary tube fuse with the centrifugal
process of the nerve cells in the cord. In this first stage there is
no enveloping of the bundles by mesodermic cells; the latter
penetrate later with the vessels and have no role in the formation
of the nerve tube. V. Vijhe likewise considers that the nerve
fibres are produced through a differentiation of the protoplasm of
cell strands, which he, like Dohm, saw extending from the cord to
the muscle segments in Selachians. It is necessary to add that
Dohm, in continuing his work on Selachian embryos, saw appear¬
ances which he felt might be used for or against his previous views.
The mesodermic elements lie so close to the emerging ganglion
cell process that any distinction between the two is lost, especially
as mesodermic cells predominate. Dohm also thinks that an
early penetration of mesodermic elements into the emerging zone
of the motor fibres may have misled him.
242 ALEXANDER BRUCE AND JAMES W. DAWSON
Beard (1892), in embryos of Raja baits, has shown that the
transient ganglion cells are the first-formed ganglionic elements
from the neuro-epithelium, and that their nerves are mere trans¬
formations of chains of nerve-forming cells, i.e., migrated ganglion
cells. The motor end-plates are also derived from migrated
ganglion cells. He also early noted the great resemblance between
muscle fibre development and nerve fibre development. Beard
has also shown that the lateral nerve in Raja is formed by a chain
of nerve-forming cells arisen from the neuro-epithelium at the
level of the lateral line, and that axis-cylinder and myelin are
differentiated in these cells. He thinks that the histogenesis of
motor spinal nerves simply repeats the history of such a nerve as
the lateralis if the region which will become the anterior horn of
the spinal cord be looked upon as the parent neuro-epithelium.
The chain of cells leaves the cord in the same manner, and the
terminal cells form the motor end-plates and must therefore also
be looked upon as ganglionic in character. The attachment of
the spinal ganglia to the cord takes place by a chain of un¬
differentiated ganglion cells from the spinal ganglionic anlage
developing into nerve-forming cells. These short cell-chains reach
upwards from the ganglion and form a continuous chain of several
rows of cells along the route of the future posterior columns, and
Beard’s observations lead him to conclude that whenever a column
or tract of fibres arises in the nervous system its development, as
in this case, is initiated by the laying down of a chain of nerve¬
forming cells.
Apathy (1892-1907) believes that there is a primary differentia¬
tion of neuroblasts into central and peripheral groups; the latter
migrate and develop into the nerve fibres, and the continuity
between centre and periphery takes place later. Each individual
cell, central and peripheral, consists, according to Apathy, of
protoplasm and an intercellular differentiation of the cell proto¬
plasm—the transmitting substance—fine fibrils.
Sedgwick (1895) has strenuously upheld the view that the
mesenchyme is not a tissue of branched cells but a reticulum with
nuclei at the nodes. He believes that the neural crest gives rise
to nuclei, which spread out in the mesoblast reticulum, and that
the nerves are developments of the reticulum, i.e., that the nerves
are, as it were, a gathering up into bundles of the reticular strands.
The development of a nerve, therefore, arises from the differentia-
NEUROMATA OF CENTRAL NERVOUS SYSTEM 243
tion of a substance which was already in position, and this
differentiation takes place from centre to periphery. The nerve
roots are simply special enlargements of the connecting strands of
the original reticulum joining the embryonic medullary wall to
the general mesoblast reticulum. Sedgwick’s position approaches,
therefore, very near to that of Hensen.
Schaper (1897), together with Kolliker, was one of the first to
prove the precise origin of the Keimzdlen from the original
epithelial layer of the primitive medullary tube. He further
showed that these Keimzellen, by mitosis, give rise to nerve cells
(neuroblasts) and indifferent cells, and that the latter may
differentiate in very various directions, e.g., into the cells of the
granular layer of the cerebellum. Glia cells and peripheral
neuroblasts may also arise from a further differentiation of the
indifferent daughter cells of the primary cell groups. Schaper
thought that in certain primitive conditions, e.g., in amphioxus, the
indifferent cells might possibly differentiate into nerve cells. Such
indifferent cells may remain in an undifferentiated condition and
later on might possibly play a r61e in regenerative processes in
the central nervous system. This term “indifferent cells” has
been largely used by later writers on the embryogenesis of nerves.
Kolster (1899), Gurwitsch (1900), Bardeen (1902) all agree
that the first stage of the nerve bundle is an entirely non-nucleated
one. Kolster chose as objects of study the embryos of Salmo,
because here the first phases of development pass slowly. In
Salmo the first anlagc of the peripheral nerves is a narrow
bundle of very fine fibrils proceeding from the spinal cord: the
bundle shows no nucleus but pushes before it the layers of con¬
nective tissue, so that a single sheath covers the bundle. Later,
the connective tissue cells proliferate and penetrate the bundle.
Kolster stated that the first traces of myelin appear before any
nuclei are present in the bundle, and that the myelin development
progresses peripheralwards. The first myelin appearance within
the central nervous system is likewise before the differentiation
of the glia cells, when there is present only a framework of
ependymal cells and processes.
Schultze (1904-1906) takes up a quite independent position.
A pronounced supporter of the cell-chain constitution of the
peripheral nerves, he holds also a modification of the protoplasmic
bridge theory, for he denies the migration from the medullary tube.
244 ALEXANDER BRUCE AND JAMES W. DAWSON
Schultze’s very extensive studies have covered the development of
peripheral nerves in Amphibia, fowl, and mammal. His observa¬
tions in a sheep embryo of 8 mm. show that the early motor roots
consist of bundles of primitive fibrils converging towards the
myotome, and that these are traversed by innumerable elongated
nuclei. In later embryos only the distal end of the nerve shows
many nuclei, and this end may split up into a brush of fibrils
amongst which lie typical elongated nuclei. The picture is that of
a syncytium, for cell limits cannot be recognised. Regarding the
sensory nerves, Schultze states that below the corium in amphibian
larvae he finds a network of very delicate bipolar and multipolar
cells with long processes continuous with nuclear rich nerve fibres.
Here there is no fusion of individual cells into chains but a con¬
tinuous sensory syncytium spreading over the whole surface of the
body by the continued preservation of intercellular connections,
following mitotic division of the nucleus. Schultze regards the
nodal points as peripheral neuroblasts, and as he finds them
beneath the skin in all mammals, he concludes that the whole
nervous system in its specific elements is constructed out of
millions of central and peripheral neuroblasts. This becomes clearer
the further back we go in phylogeny, for the diffuse nervous
system of the vertebrates and invertebrates, as far as it is known,
consists of networks of cells and processes. This continuous
integumental network of nerve-forming cells proves the analogy
of the nervous system in all animals and gives the key to the
understanding of the morphogeny of the nervous system from the
Coelenterates to man. Schultze’s very careful and exhaustive
studies have convinced him that the present-day neurone teaching
rests on no indisputable observation; that a right understanding
of the nervous system in its ontogenetic and phylogenetic relations
can be gained only on the ground of its cellular or syncytial
structure from elements, central and peripheral, which are termed
neuroblasts; that these elements are originally of equal significance
and become partly central and peripheral ganglia or nerve cells,
and partly elements which serve for the syncytial structure of the
peripheral fibres, i.e., peripheral nerve fibre cells. The chief point
is that neuro-protoplasm does not grow out, but represents ab ovo
a “continuum” formed by a few cells and their intercellular
bridges. Whether the neuro-fibrils or the interfibrillar substance
is the conducting part Schultze does not decide. In his latest
NEUROMATA OF CENTRAL NERVOUS SYSTEM 245
paper he states that the impetus to the formation of the neuro¬
fibrils may proceed from the central organs as from a dominating
centre—proceeding peripheralwards into the performed syncytial
channel.
Kohn (1905).—Kohn’s researches into the development of the
dorsal nerve root in mammals and the development of the sympa¬
thetic nervous system mark a distinct advance in our knowledge
of the structure of the peripheral nervous system. After his work
appeared even Kolliker and Lenhossek admitted the ectodermal
origin of the sheath of Schwann cells. Kohn looks upon the
problem of the origin of the sheath of Schwann cells as the crux of
the question. If these were really acquired mesodermic elements,
it would be impossible to defend the view that they have a share
in the formation of the peripheral nerve fibre, but if they were of
ectodermic origin the chief bulwark of the theory of the unicellular
origin of the peripheral nerve fibre fell to the ground. It need
hardly be said that the question is by no means settled, and
distrust of the ectodermic origin, and specially of the nervous
nature, of the Schwann cells is deeply rooted; and even those
who admit their ectodermic origin, e.g., Kolliker, Lenhossek, and
Harrison, are still pronounced adherents of the outgrowth theory,
and say that the ectodermic or mesodermic origin of the Schwann
cells has nothing to do with the question whether the axis-cylinder
is an outgrowth or not. Kohn, however, was not blind to the
distinction between the problems of the origin of the sheath of
Schwann cells and the development of the axis-cylinder, but he
felt that a clear proof of the ectodermic origin of the cells in
question would be a very strong argument in favour of their par¬
ticipation in the building up of the nerve fibre.
Kohn, studying the development of the dorsal nerve root in
the rabbit embryo, found that the spinal ganglionic anlage is from
the beginning in direct continuity with the medullary tube. At
first this is only a protoplasmic connection which later develops
into a cellular stem composed of the very same cells which form
the ganglionic anlage. A further stage is the differentiation of the
cells in the ganglion into more and more typical ganglion cells,
and the cells of the stem into elongated tubes with oval nuclei
which, as the nerve root lengthens, become more and more the
typical cells of the sheath of Schwann with a differentiation of
their protoplasmic substance into nerve fibres. Later on, and at
246 ALEXANDER BRUCE AND JAMES W. DAWSON
first sporadically, connective tissue penetrates the root. Therefore,
from the cells of the embryonic an!age arise two types of cells,
ganglion cells and nerve fibre cells. The Schwann cells of the
posterior nerve roots, therefore, have not only an ectodermic origin
but are of true nervous nature—nerve-forming cells. To give the
name Scheidcnzellen to such elements, Kohn considers a serious
mistake, which has contributed greatly to their want of recognition
as nerve elements. He suggests the name “ neurocytes ” for the
early undifferentiated cells.
Kohn similarly traces the development of the sympathetic
ganglia and its nerves to the migration of embryonal undifferenti¬
ated neurocytes to form the sympathetic ganglionic aril-age. In
the anlage these cells can be recognised to differentiate into sym¬
pathetic ganglion cells and nerve fibre cells and the latter to form
nerve tubes. Before the characteristic ganglion cells have become
differentiated, i.e., while they are a-polar, the early nerve tubes
appear as elongated band-like syncytia with numerous nuclei. The
presence of ganglion cells in relation to cerebro-spinal nerves can
thus be traced to the migration of embryonal neurocytes. It is
thus seen that Kohn contests the view of the origin of the sympa¬
thetic ganglia directly from preformed ganglion cells cut off from
the distal pole of the spinal ganglia. In the rabbit embryo, and
also in Selachians, he has traced embryonal neurocytes bending
ventralwards from the path of the mixed nerve. By their pro¬
liferation we get cell accumulations which form the anlage of the
sympathetic cord, and by their further differentiation we get the
ganglion cells and the nerve fibres of the sympathetic. The
significance of this view in relation to the formation of ganglio¬
neuroma will be discussed later. Froriep (1905) admits the
ectodermal origin of the sheath of Schwann cells, but considers
the axis-cylinders to be outgrowths of a central cell. In Selachian
embryos he has been able to trace simultaneously the ganglion cell
processes passing out as naked fibres, which then became covered
with cells which have also emigrated from the wall of the
medullary tube.
Lenhossek (1906) considers the question of the origin of the
sheath of Schwann cells to be not immediately connected with
that of the mode of formation of the axis-cylinder. Though a
convinced centralist, he derives the Schwann cells, which he
terms lemnoblasts, from the spinal ganglionic anlage. In the fowl
NEUROMATA OF CENTRAL NERVOUS SYSTEM 247
embryo and in a very early human embryo he has shown that the
cells of the spinal ganglionic anlage differentiate into ganglion
cells and cells which pass along the nerve root as sheath of
Schwann cells, but that these latter do not form the fibres of
the sensory root. The lemnoblasts thus correspond to the glia
cells of the central nervous system. Lenhossek’s illustration of
the glosso-pharyngeal nerve with its ganglion, corresponding to a
posterior root ganglion, shows that through the whole extent from
the ganglion to the medulla the bundle of fibres is entirely non-
nucleated but is ensheathed by a single layer of cells, whose
nuclei are quite distinct from the surrounding mesenchyme
elements. Later, cells, proliferated and migrated from the side
of the ganglionic anlage, penetrate both motor and sensory roots,
and future lemnoblasts are formed by an independent increase of
those already penetrated. He believes that the spinal ganglionic
anlage provides the sheath of Schwann cells for the whole
peripheral nervous system, including the sympathetic. Lenhossek
says that the supporters of the cell-chain theory cannot get over
two facts: the one, the absolutely non-nucleated condition of
the white substance of the central nervous system; the other,
the almost non-nucleated condition of the peripheral nerves in
certain stages of their development. Lenhossek admits that it
is conceivable that under pathological conditions the sheath of
Schwann cells, in virtue of their origin from the neural crest,
may become nerve builders.
Bethe (1906), whose work on the regeneration of nerves we
shall refer to later, endeavours to answer Lenhossek in the
following terms: The first anlage of the peripheral nerve consists
only of a cell syncytium with nuclei arranged as a border; later,
the nuclei of this syncytium proliferate and penetrate the proto¬
plasm, giving rise to cells arranged in rows, and in the protoplasm
of these cells the first axis-cylinders form. Bethe argues that the
developing nerve is just as little non-nucleated as the cylindrical
epithelium of many gland tubes, and that Lenhossek and others
have used methods which revealed the axis-cylinders but not the
development of them within the cells.
Held (1906).—No review of the work on the development of
nerves can afford to ignore Held’s important memoir and later
papers founded on an exhaustive investigation of the embryos
of trout, shark, frog, rabbit, &c. It is almost impossible to give
248 ALEXANDER BRUCE AND JAMES W. DAWSON
an abstract of his views. They are so far a modification of
Hensen’s that they are referred to as the Hensen-Held hypothesis,
which may be stated thus: (1) The cells related to an embryonic
nerve path are (a) neuroblasts of His, which form the neuro-fibrils
and drive them forward, (J) conducting cells ( Leitzellcn ), in the
interior of which the neuro-fibrils pass. (2) The neuro-fibrils,
which arise in the fibrillogenous zone of the neuroblasts, are
continued into the interior of a system of pre-existing protoplasmic
bridges, represented in the central nervous system by the network
of the spongioblasts and in the mesoderm by the anastomosing
expansions (plasmodesmata) of star-shaped conducting cells
( Leitzellcn ). (3) These Lcitzellen, which may possibly be of ectodermic
origin and have the function of nourishing and protecting the axons,
would become ultimately the cells of the sheath of Schwann: yet
they are not capable of producing the neuro-fibrils. (4) In the
earliest stage a nerve is non-nucleated; the primitive neuro-fibrils
are enveloped in a granular neuroplasm which forms a broad and
entirely non-nucleated zone. (5) The process of neuro-fibrillation
i s an intraplasmatic progression from the neurogenetic centre. (6)
There scarcely exists any neurone independence, for the neuro¬
fibrils of one neuroblast penetrate into the interior of other neuro¬
blasts, producing a diffuse network.
The Hensen-Held hypothesis, therefore, is opposed to the
unicellular genesis of the nerve fibre and the neurone teaching
of the genetic unity of the ganglion cell and its ramifications, but
it agrees with His in looking on the neuroblasts as the chief
participators in the formation of the nerve path, i.e., from them
proceeds the genetic impulse for the formation of nerve tissue.
If we have read Held aright, he does not seem to have decided
whether the neuro-fibrils formed in the initial nerve path by the
neuroblast go on being formed progressively by their influence on
the plasma of the intercellular bridges, or whether the neuro¬
fibrils grow out within the plasma of the intercellular bridges by
the driving forward action of the neuroblast.
Cajal (1907).—The classical illustrations in all modern text¬
books of the development of the embryonic nerve fibre are taken
from Cajal’s works, and Cajal’s views are too well known to need
any detailed statement. His has had no more loyal and con¬
vincing supporter than Cajal, whose beautiful silver preparations
have conclusively proved to so many that the developing nerve
NEUROMATA OF CENTRAL NERVOUS SYSTEM 249
fibre is the result of the continuous outgrowth of the principal
prolongation of the neuroblast of His. Cajal has shown that this
prolongation has a free thickened end {cdnc de ci'oissance) which
glides between the cell interstices. This intercellular progression,
in contrast to Held’s intraplasmatic progression, takes place both
in the interior of the embryonic nerve tube and in the depths of
the mesoderm. The primary axon and the terminal cone have a
neuro-fibrillar structure with an unstained neuroplasm and a fine
limiting membrane. He has further shown that the cdnes dc
croissance are entirely naked in their passage across the peri-
medullary space. The first axons emigrating into the mesoderm
are isolated, the latter are in intimate relation to one another.
The adventitial cells (Leitzellen of Held, lemnoblasts of Lenhossek)
are always between the bundles. To explain why the nerve fibres
traverse the mesoderm and also their relation to the myotome and
epithelium, Cajal finds it necessary to suppose the existence of
specific chemiotactic substances, secreted by the myotome and the
epithelium, which excite the amceboidism of the cone of growth.
As early as 1892 Cajal had compared the cSnes de croissance with
their terminal filaments to nerve pseudopodia which have amoeboid
movement and a certain impulsive force.
Cajal explains Held’s pictures of the penetration of the terminal
cone into the interior of cells of the cord and mesoderm (plasmo-
desmata) as due to the shrinkage of the tissue and the agglutina¬
tion of the embryonic axons to the tissue elements. He thinks
that Held’s view simply places the question of the orientation of
the nerve paths and the peripheral connections on new ground.
“Au point de vue de cette thdorie, la question se reduit a ces
termes: en vertu de quelles conditions physico-chemiques se sont
produits, dans certains endroits de l’embryon et avant l’apparition
des axones, des chemins directs et parfaitement congruents entre
tous les organes qui doivent ulterieurement contracter des
connexions anatomiques et fonetionelles ? ’’
Harrison (1905-1910) thinks that the attempt to answer the
question of the development of nerves in normal embryos has been
largely a matter of individual interpretation. He has therefore
carried out a series of valuable investigations, along the line of
experimental embryology, to eliminate all possible sources of error
in coming to a conclusion as to the relation of the nerve fibres to
the nerve cells. By his final work he claims to have conclusively
250 ALEXANDER BRUCE AND JAMES W. DAWSON
established, on the basis of direct observation, the His teaching of
the outgrowth of the nerve fibre from the central neuroblast.
Harrison’s earlier embryological researches had led him to the
conclusion that the sheath of Schwann cells arise from the neural
crest, and, taking this as the starting-point, he tried first to
answer the question of the source of the elements of the nerve
fibres. In amphibian larvae, before any differentiation of nerve
cells and fibres has occurred, he removed the source of the sheath
of Schwann cells, i.e., the ganglion crest, and found that the motor
nerves developed as naked fibres without sheath cells. Harrison
then removed the source of the motor nuclei— i.e., the ventral half
of the cord, leaving the dorsal portion of the cord and the ganglion
crest—in order to answer the question: Can sheath cells without
ganglion cells form the nerve fibres ? The result was that sensory
fibres and sheath cells appeared but no purely motor rami. There¬
fore, sheath cells by themselves cannot form fibres, and ganglion
cells by themselves can form naked axis-cylinders.
Harrison next set himself to answer the question: What are
the factors that influence the laying down of the nerve paths
during embryonal development ? Is the nerve fibre a product of
the ganglion cell, or formed in situ in the peripheral path ? He
therefore first removed portions of the nerve centres and found
that no peripheral nerve developed in relation to the absent
ganglion cells. The second step consisted in the transplantation
of undifferentiated portions of the nerve centres to abnormal
positions of the embryo body, with the result that they gave rise
to nerve fibres which followed paths in which normally no nerves
were present. He concluded, therefore, that the nerve fibre is a
product of the ganglion cell and not a mere activation of
indifferent extra-ganglionic substance. In order to confirm this
observation Harrison carried out a further series of experiments.
Braus and Bianchi had previously transplanted buds of larval
extremities, in which there were no nerves at the time of trans¬
plantation, and had found nerves developed autochthonously with
no connection with the nerves of the host. Similar experiments
carried out by Harrison and Lewis led them to the conclusion that
nerves are not formed in situ in the transplanted limbs, but grow
into them from the nerves of the host, and that there is no
evidence that any specifically formed or localised structures,
essential to the formation of nerve fibres, are present.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 251
Harrison’s final step was to answer the question: Is the nerve
fibre entirely the product of the nerve centre? He recognised
that in all his former experiments the nerve fibre had developed
in surroundings composed of living organised tissue which might
possibly contribute organised material to the nerve elements.
He initiated, therefore, what he describes as a really crucial
experiment. This consisted in the placing of pieces of embryonic
tissue, taken before any histological differentiation has taken place,
in hanging drops of clotted frog’s lymph, and keeping the sealed
preparations under observation for a number of days. The cells
when taken were rounded, without any sign of differentiation, and
were found soon to manifest amoeboid movement—resulting in
the formation of long threads of hyaline protoplasm with free
filaments, which continually change their form and are exactly
similar to the pictures by Cajal in normal embryos. It is to be
noted that cilia of neighbouring epidermic cells remained active
and embryonic mesoblast cells became transformed into striated
muscle fibres, so that there was no doubt that even under artificial
conditions life and growth and differentiation were continuing.
The development of the nerve fibre is thus brought about by one
of the primary properties of living protoplasm common to all cells
—amoeboid movement, and Harrison points out that he had sub¬
stituted for the supposedly-essential protoplasmic bridges only
unorganised fibrin threads which could afford merely a mechanical
support for the growing nerves. The elementary factors in nerve
development are therefore two—the one, protoplasmic movement,
the other, the differentiation of this protoplasm by the formation
within it of neuro-fibrils.
Held and Harrison differ as to the source of the protoplasm
within which the neuro-fibrils develop. Held believes that it is
formed of cells scattered all through the embryonic body: Harrison
that it flows out from the central cells and thereby establishes the
path in which the necessary fibrils are formed. It is this laying
down of the path by means of a form of protoplasmic movement,
rather than the process of differentiation into neuro-fibrils, that
constitutes the problem in the development of nerves.
Carpenter and Main (1907), in pig embryos, have traced cells
which migrate from the medullary tube, pass into the ventral
nerve roots, and form the sheath cells. Kuntz (1909), also in pig
embryos, has made similar observations in relation to both ventral
2 3
252 ALEXANDER BRUCE AND JAMES W. DAWSON
and dorsal roots. He states further that these migrated cells pass
along the spinal nerves and ventral rami to form the anlage of the
sympathetic ganglia. All these writers refer to the cells as the
“ indifferent ” cells of Schaper.
Graham-Kerr (1910) has emphasised the necessity of selecting
suitable material, so that one does not become lost amongst the
details of observation. He chose the Lepidosiren on account of
the coarseness of its histologicaf structure and the size of the cell
elements. He has come to the following conclusions: that the
motor nerve trunk is already present as a protoplasmic bridge,
placing spinal cord and myotome in organic continuity, at a period
so early that these structures are in immediate contact, thus
placing His’s outgrowth theory out of account; that this proto¬
plasmic nerve trunk, at first merely glanular, gradually assumes a
fibrillated structure; that the at-first naked and non-nucleated
nerve trunk acquires a sheath, the heavily yoked material of whose
protoplasm demonstrates it to be of mesenchyme origin; that if
the conception of units is to be used as a working hypothesis, the
unit should be the complex consisting of nerve cell, nerve fibre,
and muscle cell—a myo-neurone; and that all the possibilities
seem to point to the nervous system having become evolved out
of a sub-epithelial plexus of the type which still persists in
Ccelenterates. The facts of development in Lepidosiren thus give
strong support to the protoplasmic bridge theory.
Graham-Kerr looks upon the differentiation of the neuro-fibrils
from the physiological standpoint, and regards their specialisation
in structure to be correlated to the repeated passage of impulses
along them. Each particular impulse as it is repeated between a
central cell and its end cell beats out, as it were, its own special
pathway. This we term a neuro-fibril. Referring to the recent
work of Harrison, he asks if these experiments have really the
finality which is claimed for them, and suggests the question: Has
Harrison excluded the possibility that the excised fragments of
the embryonic spinal cord included the nerve trunk rudiments?
He thinks that they simply prove that the young nerve grows in
length—a self-evident fact quite independent of any particular
theory.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 253
Note on the Genesis of Nerve Fibres in the Central
Nervous System.
•
Most of the observations upon the origin, development, and
structure of nerve fibres have been made upon the peripheral
nerves. The fibres of the central nervous system are described as
having no cells either as sheath cells or in any way related to their
course. Up till recently the theory that each nerve cell and fibre
in the central nervous system was developed from a single unit
was generally accepted. Many writers have indeed asserted that
it is inconceivable that the fibres of the central nervous system
can have any cells in relation to them except the central cell of
origin. This has been one of the strongest arguments of the
centralists, that the peripheral nerve fibre also had arisen solely
from a central cell. Fragnito, Capobiancho, and others, however,
have recently brought forward evidence in favour of the multi¬
cellular origin both of the nerve cell and central nerve fibre.
Capobiancho (1904), in kitten embryos and in the human foetus
at the third month, has described successive stages in the develop¬
ment of nerve cells from the neuroblasts in the cord and spinal
ganglion. The small groups of neuroblasts become approximated,
their protoplasm fuses into a single mass, and certain of the
nuclei undergo regressive changes and finally disappear. Not
only the body of the nerve cell but also its processes are formed
by this fusion of neuroblasts.
La Pegna (1904) has used chiefly Cajal’s and Donaggio's
staining methods for neuro-fibrils. He supports the view of the
independent origin of nerve fibres and nerve cells. His conclusions
are as follows: The nerve cell does not take part in the formation
of the nerve fibre; the nerve fibre in the first stage of its develop¬
ment has no connection with the nerve cell; the peripheral and
central nerve fibres are developed from cell-chains; the protoplasmic
processes, like the axis-cylinder processes, are also derived from
cell-chains; and the neuro-fibrils of the nerve cell are a late
product of differentiation—in the chick they do not develop before
the tenth day of incubation.
Fragnito (1905), in the chick embryo, has given a description
of the genesis of the central nerve fibre from chains of nucleated
cells. By the use of Donaggio’s intracellular fibril method he was
able to follow the disappearance of the nuclei, and the formation
254 ALEXANDER BRUCE AND JAMES W. DAWSON
of the neuro-fibrils. The fibre resembles a ribbon or thread with
fusiform swellings at regular intervals. It is inferred that each
swelling, of the thread represents a cell, whose nucleus is quite
evident, and whose protoplasm is elongated into two filaments
which unite with the filaments of two contiguous cells. The
nucleus tends gradually to disappear, and probably its substance
is diffused into a protoplasm, and transformed into the axis-
cylinder. In the cells of the same thread the nuclei are seen in
various phases of transformation, and as they fade the fusiform
swellings disappear, and the margins of the thread tend to become
parallel. Fragnito agrees with La Pegna that the axis-cylinder
is never seen in connection with the nerve cell before the tenth
day. This differs from the observation of Cajal, who states that
by the fifth day all the axis-cylinders have reached their destina¬
tion, and can be traced emerging from the cord by the anterior
roots as well-formed tubes of white matter.
Cantelli (1907) has examined the structure of the neuro¬
fibroblasts in the central nervous system of the chick by means
of Donaggio’s neuro-fibril method, and subsequent staining with
neutral red. There were found in the spinal cord long bands
with uniform spindle-shaped swellings, in the middle point of
which were dark granules: these granules stained intensely with
the nuclear stain, and were thus taken to correspond to nuclear
substance.
Hardesty (1905), studying the developing spinal cord of the
pig, noted the presence of half-moon or signet-ring-shaped cells
encircling the nerve fibres. In early stages the axis-cylinders run
as fine fibrils in a syncytium in which nuclei lie. During the
period at which the process of myelination is at its height, these
are distinct cells with considerable protoplasm lying in relation to
the developing nerve fibres. The protoplasm of the cells at first
often completely encircles the growing myelin sheath, but with
its further growth the protoplasm of the cells is used up. It is
suggested that the signet-ring cells represent elements derived
from the syncytium, and the protoplasm represents endoplasm
which is gradually transformed into exoplasm, which in its turn
is transformed into the lamellated reticulum of the central nerve
fibre by a process similar to that described in the development
of connective tissue fibres. The signet-ring cells, therefore,
diminish in number and size with the age of the embryo, and
NEUROMATA OF CENTRAL NERVOUS SYSTEM 255
later can scarcely be distinguished, even if present, from flattened
neuroglia cells.
Barile (1910) records the investigations of Paludino in Trygon
violaceus, in which he found nuclei in relation to the axis-cylinder
within the spinal cord, and also the examination of a teratoma
from the neck in which Niosi found a nodule of the structure of
the central nervous system, with the axis-cylinders developing
in relation to a chain of cells.
LITERATURE. 1
(1) Embryogenesis.
von Apathy. “ Bemerkungen zu den Ergebnissen Ramon y Cabal's hinsichtlich
der feineren Beschaffenheit des Nervensystems,” Anal. Anz., Bd. xxxi.,
1907, pp. 481, 523.
Balfour. “ The Development of Elasmobranch Fishes,” London, 1878.
Bardeen. “ The Growth and Histogenesis of the Cerebro spinal Nerves in
Mammals,” Amer. Journ. of Anat ., Vol. ii., 1902-3, p. 231.
Barile. “Struttura ed histogenesi di un neuroma fibrillare mielinico,” Lo
Sperimentale , T. Ixiv., 1910, p. 269.
Beard—
1. “Morphological Studies,” Quart. Journ. of Microsc. Sc. y Vol. xxix.,
N.S., 1889, p. 153.
2. “ The Transient Ganglion Cells and their Nerves in Raja bcUis” Anat.
Anzeiger , Bd. vii., 1892, p. 191.
Bethe. “Bemerkungen zur Zellkettentheo^ie,” Anat. Anzeiger , Bd. xxviii.,
1906, p. 604.
*Cantelli. “Su la fina struttura dei neuroblasti nei centri nervosi dei verte-
brati,” Annali di Nevrologia, xxv., 1907. From Neurol. Centralblatt 1908,
p. 561.
# Capobiancho. “ Ulteriori ricerche sulla genesi delle cellule nervose,” Annali di
Nevrologia , 1905, Fasc. 1, 2; Rows, Rev. Neurol, and Psychiat ., Vol. iii.,
1905, p. 606.
Carpenter and Main. “The Migration of Medullary Cells into the Ventral
Nerve Roots of Pig Embryos,” The Anat. Record , Vol. i., 1907, p. 63.
Dohrn. “ Die Schwann’schen Kerne der Sclachierembryonen,” Anat. Anzeiger ,
Bd. vii., 1892, p. 348.
Durante. “Nerfs,” in Manuel d’Anal. Pathologique , Cornil et Ranvier (Paris),
1907.
# Fragnito. “ Su la genesi delle fibre nervose centrali e il loro rapporto con le
cellule ganglionari,” Annali di Nevrologia , 1905, Fasc. 1, 2; Rows, Rev.
Neurol, and Psychial ., Vol. iii., 1905, p. 604.
Gurwitsch. “Die Histogenese der Schwann’schen Scheide,” Archiv fiir Anat.
u. Physiol. Anat. Abt ., 1900, p. 85.
* The authors have not had an opportunity of consulting the papers marked
with an asterisk.
256 ALEXANDER BRUCE AND JAMES W. DAWSON
Hardesty. “On the Occurrence of the Sheath Cells and the Nature of the
Axone Sheaths in the Central Nervous System,” Amer. Joum. of Anal.,
VoL iv., 1904 5, p. 329.
Harrison—
1. “Further Experiments on the Development of Peripheral Nerves,”
Amer. Joum. of Anal ., VoL v., 1905-6, p. 121.
2. “ Experiments on transplanting Limbs and their bearing upon the
Problems of the Development of Nerves,” Joum. of Exp. Zoology ,
VoL iv., 1907, p. 239.
3. “Embryonic Transplantation and the Development of the Nervous
System,” Anal. Record , VoL ii., 1908, p. 385.
4. “The Outgrowth of the Nerve Fibre as a Mode of Protoplasmic Move¬
ment,” Joum. of Exp. Zoology , VoL ix., 1910, p. 787.
Held—
1. # “ Die Enstehung des Nervengewebes bei den Wirbeltieren,” Leipzig, 1908.
2. “Zur Histogenese der Nervenleitung,” Anal. Anzeigtr, Bd. xxix., Erg.
Heft, 1906, p. 185.
3. “ Kritische Bemerkungen zu der Verteidigung der Neurobias ten- und der
Neuronen-theorie duroh R. Cajal,” Anal. Anzeigtr , Bd. xxx., 1907,
p. 369.
His. “ Die Neuroblasten und deren Entstehung,” Archivfiir Anal. u. Physio?.,
Anal. AbL, 1889, p. 290.
Kerr—
1. “ On some Points in the Early Development of the Motor Nerve Trunks,
and Myotomes in Ltpidosiren paradoxa,” Trans, of the Royal Soc.
Edin ., VoL xli., 1904, p. 119.
2. “Presidential Address, Royal Physical Soc. Edin., 1909,” Proc. of the
Royal Phys. Soc. Edin., VoL xviii., p. 1.
Kohn—
1. “ Ueber die Entwickelung des peripheren Nervensystems,” Anal. Anzeigtr,
Erg. Heft, Bd. xxvii., 1905, p. 145.
2. “Ueber die Entwiokelung des sympathischen Nervensystems die Sauge-
tiere,” Archiv fur Mikr. Anal., Bd. lxx., 1907, p. 266.
Kftlliker. “Ueber die Entwiokelung der Nervenfasem,” Anal. Anzeigtr, Erg.
Heft, 1904, p. 7.
Kolster. “ Beitrage zur Kenntniss der Histogenese der peripheren Nerven,”
Btilr. z. path. Anal. u. z. allg. Path., Bd. xxvi., 1889, p. 190.
Kuntz. “A Contribution to the Histogenesis of the Sympathetic Nervous
System,” Anal. Record, VoL iii., 1909, p. 458.
Lenhossek. “ Zur Frage der Entwickelung der periph. Nervenfasem,” Anal.
Anzeigtr , Bd. xxviii., 1906, p. 287.
Lewis. “ Experimental Evidence in Support of the Theory of the Outgrowth of
the Axis-Cylinder,” Amer. Joum. of Anal., VoL vi., 1906-7.
*La Pegna. “Su la genesi ed i rapporti reciproci degli elementi nervosi nel
medullo-spinale di polio,” Annali di Ntvrologia, 1904, F, 6; Ford Robertson,
Rev. Neurol, and Psychial., VoL iii., 1905, p. 608.
Schaper. “Die friihesten Differenzierungsvorgange im Centralnervensystem,”
Archivfiir Entwickelungmech. , Bd. v., 1897, p. 81.
Schultze—
1. “ Ueber die Entwickelung des peripheren Nervensystems,” Anal. A nzciger,
Erg. Heft, 1904,* p. 3.
A CASE OF CEREBRAL SYPHILIS
257
2. “ Beitrage zar Hiatoganeee dee Nervensystems,” Archivfur Mikr. Anat.,
Bd. lxvi., 1905, p. 41.
3. “Zar Histogenese der peripheren Nerven,” Anat. Anzeiger, Erg. Heft,
1906, p. 179.
Sedgwick. “On the Inadequacy of the Cellular Theory of Development and on
the Early Development of Nerves,” Quart. Joum. of Microsc. Sc., Vol. xxxvii.,
1895, p. 87.
(To be continued.)
A CASE OF CEREBRAL SYPHILIS OCCURRING
SIX MONTHS AFTER THE INITIAL LESION.
By Dn MENAS 8. GREGORY, New York, N.Y., and
Dn MORRIS J. KARPAS, New York, N.Y.
(From the Psychopathic Department, Bellevue Hospital, Hew York, X. Y.)
(With Plates 19 and 20.)
Such eminent authorities as Lannois, Fournier, Mingazzini,
Oppenheim, Nonne, Growers, and others have reported and seen
cases of cerebral syphilis which developed from one and one-half
months to one and one-half years after the appearance of the initial
syphilitic lesion. The interesting investigations of Rumpf and
Nauyn show that during the early period of luetic infection the
nervous system may be affected. Nauyn examined 335 cases (45
his own cases, and 290 from the literature), and demonstrated that
48 per cent, of these cases developed cerebral manifestations during
the third year, and from that time the frequency of cerebral syphilis
gradually and proportionately diminished from year to year.
Gilles de la Tourette reported a case of severe syphilitic
infection of brain and cord two months after the appearance of the
chancre. Fournier recorded a case of cerebral syphilis—right¬
sided hemiplegia—which developed two months after the initial
luetic ulcer. Kreibrich’s case manifested cerebral affection four
months after the infection.
Nonne, in his book, describes three cases; the first was one of
basal meningitis, occurring four months after the infection, and at
that time the patient presented a papular eruption. The second
case was that of a 24-year-old corporal, who became afflicted with
cerebral syphilis four months after the infection, and seven months
258 MENAS S. GREGORY AND MORRIS J. KARPAS
later death occurred. Autopsy showed a gummatous basal
meningitis, endarteritis, and hardening of veins. The third case
was that of a young woman, who during the secondary stage of
syphilis presented the picture of a cerebello-pontine angle tumour.
Jolly’s case developed a hemiplegia with total aphasia eight
months after the syphilitic infection. Quincke’s patient, four
months after contracting lues, displayed a picture of myelitis and
meningitis, and in a few days death occurred. Post-mortem
examination confirmed the diagnosis of cerebro-spinal syphilis.
Collins and Taylor reported a case of a young man who, four
months after luetic infection, suffered from syphilitic involvement
of the cord, which was demonstrated post mortem. Stursberg’s
patient during secondary syphilis presented definite cerebral
symptoms, such as headache, vomiting, eye disturbances, right¬
sided hemiplegia, &c., and the post-mortem findings corroborated
the clinical diagnosis of cerebral lues.
The following is a complete record of our case:—
The patient , Hungarian Hebrew, about 20 years of age, was
admitted to the Psychopathic Ward of Bellevue Hospital, 6 th October
1912. He contracted syphilis in the early part of May 1912, and
six months later a right-sided hemiplegia with motor aphasia
developed. Under active anti-luetic remedies a marked improvement
residted.
Family History .— There is no neurotic or vesanic taint in the
family or its collateral branches.
Personal History. —The patient is 20 years of age and a native
of Hungary. Nothing is known of his early childhood. He
immigrated to the United States of America eight years ago;
here he pursued various occupations, that of bell-boy, elevator
runner, chauffeur.
He was of temperate habits, but smoked to excess. He was
quiet and even-tempered, fairly intelligent, and was much liked
by his associates and employers.
In the early part of May 1912 the patient had two chancres
on his penis; one was soft and appeared three days after inter¬
course, the other was hard and developed one week after coitus.
3rd June 1912, he came under treatment by Dr Bernard Weiss,
to whom we are indebted for this history. At that time he had
enlarged glands of his groins and there were a few papules on
the abdomen, chest, and back; 18th June 1912, the secretion
Plate 19.
^iT fVi~\
c--——-
Sample of Writing from Dictation (Dec. 1912 ).
260 MENAS S. GREGORY AND MORRIS J. KARPAS
from the ulcer was examined, but no Spirochetce pallida were
demonstrated; 29th June 1912, papules appeared all over the
body and the mucous membrane of the throat was congested;
the glands in the groins were still enlarged; 1st July 1912, the
Wassermann test of the blood serum was positive. At that time
active anti-syphilitic treatment was instituted. Soon the eruption
began to disappear and the patient began to improve. However,
towards the end of July, the eruption reappeared, and the patient
looked “ haggard and worn out.” He admitted that he drank to
excess for a few days, and ate very little (this is the only history
we have of the patient indulging in alcoholic excesses; the friend
who gave us the history said that he was of temperate habits).
Our informant, the patient’s friend, stated that he saw the
patient two weeks prior to his admission to Bellevue Hospital, and
that at that time he enjoyed good physical and mental health.
He emphasised the fact that only three days before his coming
under our observation the patient began to complain of headache
and grew lethargic. Weakness of the right side of the body and
inability to speak developed thirty-six hours previous to his
admission to the hospital.
Upon admission to the Psychopathic Ward, the patient was
dull and drowsy; he answered few questions; his comprehension
was dull and sluggish. The right side of his body was partially
paralysed; within a day he became completely paralysed and
aphasic.
A complete status was taken, and the following is a brief
synopsis of the examination.
The patient was well developed, and his general nutrition
was fairly good; a papular eruption all over body, especially the
upper and lower extremities, was observed. There were no
mucous patches or enlarged glands. The ^temperature was
slightly elevated; the pulse was of fairly good volume and
tension; the visceral organs were without disease.
The ocular muscles were intact. The pupils were unequal
and slightly irregular in outline, especially the right; the left
pupil was smaller than the right; both reacted to light and on
accommodation sluggishly, particularly the right one. The right
side of the face was paralysed, the naso-labial fold was obliterated.
The tongue deviated to the right. Hearing was good. The
corneal and conjunctival reflexes were intact. The right side of
Plate 20.
Photo I.—Showing the Patient
in a standing posture and
raising his right arm.
Photo III.—Showing the Patient
in a standing posture on one
leg and raising the right thigh
and leg.
*
A CASE OF CEREBRAL SYPHILIS
261
the body was paralysed. Pain sense was diminished on the affected
side. There was a clonus and Babinski phenomenon on the right
side; the knee and Achilles jerks were unequal and somewhat
exaggerated, the right greater than the left. The reflexes of the
right upper extremity were more active than those of the left. The
abdominal and cremasteric reflexes on the right side were absent.
The patient was unable to assume a standing posture, nor was
he able to sit up. He remained lying in bed, and required
constant care and attention. He was nauseated, and at times
vomited a greenish fluid, and complained of headache.
Mentally he was dull and drowsy ; occasionally he was fidgety
and inclined to be restless; under examination he would become
easily fatigued. He was unable to speak, but at times carried out
a few simple commands; occasionally perseveration of movements
was noted. He was unable to name objects as they were shown
to him. When asked to repeat the sentence, “ I like to walk,” he
uttered a few indistinct sounds in a nasal tone. On account of
inaccessibility finer tests for aphasia were unsuccessful.
The Wassermann test of the blood and cerebro-spinal fluid was
completely positive. There were 618 lymphocytes per cubic milli¬
metre, and globulin was much increased.
The patient was put on anti-luetic treatment (salvarsan and
neo-salvarsan intravenously, potassium iodide in increasing doses,
and mercury sublimate intramuscularly), and following the first
intravenous injection of salvarsan the patient began to manifest a
marked improvement, which has been gradual and progressive.
He became bright and cheerful; he evinced interest in his
environment, was able to understand what was said to him, but
could not speak until 15th November 1912, when he suddenly
uttered a few words; since then his speech has gradually
improved.
His present condition (17th December 1912) is as follows:
The patient has made marked improvement, both mentally and
physically. He has gained in weight; his appetite has been
excellent and his sleep has been undisturbed. He is able to walk
without assistance, but he drags his right leg; he can stand
without being supported (vide photo 3); he is able to raise his
right arm (vide photo 1); however he cannot flex his right arm or
move his fingers on the right hand. The naso-labial fold is fairly
active (vide photo 2), but the tongue still deviates to the right.
262 MENAS S. GREGORY AND MORRIS J. KARPAS
The pupils are slightly irregular in outline, but react to light and
on accommodation very well. Recently Dr Charles May re¬
examined the patient and found that the optic neuritis, which was
previously present, had disappeared. The pain sense on the
paralysed side is slightly diminished, and the thermal sense is
affected inasmuch as the patient frequently mistakes cold for hot
and nice versa. The muscle and light touch sense is normal. The
reflexes on the right side of the body are exaggerated, and there is
a knee and ankle clonus; Babinski phenomenon is not demon¬
strable ; the right abdominal and cremasteric reflexes are absent.
Co-ordinated movements show no defect.
Mentally the patient is cheerful and optimistic; he evinces
active interest in the general affairs of life; he takes out-door
exercise; and his general conduct is fairly natural. He is very well
oriented, and memory and retention show no impairment. The
following answers to questions will serve as illustrations:—
How do you feel ? I feel all right.—Are you happy ? Yes,
sir.—Why? You gave me all my life.—How is that? By
putting five times “ 606.”—How is your head ? All right.—How
old are you ? 21.—Where were you bom ? Austria.—How long
have you been in the United States ? Ten years.—How old were
you when you came here ? Eleven years.—Did you come alone ?
Yes, sir.—Have you a father ? Yes.—Have you a mother ? Yes.
He knows the day, month, and year; he knows how long he
has been here. 6 times 6 is 36; 9 times 9,1 don’t know; 7 times
7,1 don’t know; 4 times 4 is sixteen; 5 times 5 is 25 ; 4 and 9 is
13; 13 and 7 is 20 ; 17 and 18 is 35.
An aphasic status 1 was again taken, which revealed that there
is a marked defect in the patient’s spontaneous speech; he is
unable to give a long account of himself; in attempting to tell
how his illness developed he becomes incoherent, a few paraphasic
expressions are noted, and at times he mispronounces a few words.
The following is a specimen:—
How did you get sick ? Yes—yes—doctor, I got sick that way
—I got sick that way three months—I got sick when I went to
doctor—cr-er-er—on 79th Street and 3rd Avenue. Doctor he tell
me—all right—you got a chancre. I will have to cure you—six
weeks to get cured. I went six or seven weeks to get cured. I
got a chancre doctor tell me. No, but you have to go—er-er-er—
1 According to Professor Adolf Meyer’s outline of aphasic examinations.
A CASE OF CEREBRAL SYPHILIS
263
at the Hospital—16th Street Hospital—I went there—like my—
get cured.
And—er-er-er—three days (patient snaps fingers)—er-er-er—
three years—but he is going to get his “ blut ” cured; doctor—er
—tell me, is it for me. (Interrupted by stenographer.) No, not
for me, for you (laughs). Doctor, I went that time for a job
—chaffeur—er-er—now I don’t know.
One could readily see that he laboured to find necessary words
to express his thoughts. He tried several times to give the
alphabet in consecutive order, but failed to do so. He gave the
months correctly. He was able to count from one to sixty-four,
but in going from twenty to one, he went as far as nine only.
He carried out simple commands promptly, and Marie’s test
was well performed. He could repeat simple sentences. He was
able to pick out objects, but at times had difficulty in naming
things. However, when his attention was called to the error, he
recognised it as such. He could read words and simple sentences,
and carried out simple written commands. He could also recognise
a few symbols, such as U.S.A., U.S.M., Y.M.C.A. 1 He wrote with
his left hand, but his writing was unintelligible; he could copy
a few drawings correctly {vide specimens). There was no apraxia
or asymbolia.
The Wassermann test in the blood is now weakly positive;
there are only 17 cells per cubic millimetre; and globulin
according to Noguchi’s method (formerly the Kaplan method
was employed) is normal; the Wassermann reaction in the
cerebro-spinal fluid is still positive. The following diagram will
show the relation of the Wassermann test, cytological and
chemical content of the cerebro-spinal fluid to treatment:—
1 Internal language intact.
264 MENAS S. GREGORY AND MORRIS J. KARPAS
w
a
X
So
®V © rrt'
^ ^ • pH
Cfl
6
© 3
. ©
ci
>
c
S5
o
Cl
i£
%x
x 5t
-ci
>
o
XS
CO
2 E
0
a
C S3
8 l
X ©
& Gh
c
pH
apaerma
bro-spin
positive
S
3
X
0
r—»
O
£
ar
:
g ,>>
G X
< 2
E *
©
© . >
ao 'y *•*->
CC X '*
*3 g.
>
C
to
E ^
o
Ph
ce •
a, ^
. U)
G O
©
»m
©
%
Si
£ ^
"3 co
6-
©
9 x
CO
© .
>.E
© °
£ *
-S M
G- 04
g
g
X3
o
2:2
© 3
<->«
C ^
5 d
«$ c ©
©
g >
12
E S
1m cl
©
0- *? a: ^t-T
© . ■«
coo®
* U O
<&X pH
>
ce
©
T3
C t-
— U)
i|
5 w
3
<2
ce •
* &
fc*H»
3 ■**
©
L
©
S3
cs c
^ to
"5 °
I*
00
r-
I *E
J 3 ©
P.O*
E
£
£3
© p
©CP
G c _
~ C C5
3 eco
I If 2
O » o &
5 l. o
do ^
fe
©
c >
I!
S O-
V. «■•
or. rrj
ce o
£-2
^ §
o'
©
T3
•r-
E —
3 »o
■s h«
0Q «
3
o
to
>>
©
1
^ 6
1—1 ©
G
„TJ 5
£ § £
CC « (m
, ce
s'*" c
fc 4 Is
s
I
©
O
xs
5
00
W"*
CO
r* H
® . —
© X G
f G ^3
>*> © p
J S, is
i
►H
g'G
si
|*3
G G ©
r&s
S s O
e n ©
£
1
XS
«L>
©
E
x
©
g
to
o
fc
Ci
*8
©
s
Epicrise.
The fact that we are
dealing with a case of
cerebral syphilis cannot
be disputed. The positive
history of syphilis, the
complete laboratory re¬
port, and the development
and course of the clinical
picture, will all speak in
behalf of this diagnosis.
The underlying patholo¬
gical process is most pro¬
bably one of acute exu¬
dative meningitis, with
either thrombosis or en¬
darteritis of the lenticulo-
striate arteries. The
former expressed itself in
headache, nausea, vomit¬
ing, drowsiness, stupor,
optic neuritis, and a
marked lymphocytosis of
the cerebro-spinal fluid;
the latter would explain
the right-sided hemiple¬
gia and motor aphasia.
Erb, in discussing the
pathology of cerebro¬
spinal syphilis during the
first and second stages,
remarks : “ The changes
in the nervous system
during the first and
second stages of syphilis
are not very well known,
although the clinical
manifestations during
these stages are ob-
A CASE OF CEREBRAL SYPHILIS
2G5
served. It is believed that various irritative processes may
occur, perhaps in the form of serous exudation and diffused
infiltration, which are mostly absorbed without leaving any
traces, and occasionally thickening of the tissue may be the
only residual. However, according to Schmaus, one thing may be
frequently present in the early stages, that is, a marked patho¬
logical process of the blood vessels, perhaps also meningitis.”
Evidently in our case the luetic infection was virulent in form,
inasmuch as the first symptoms appeared one week after exposure,
and the cerebral affection developed six months later. In this
connection it would be interesting to call attention to Dreyfus’
studies of the Wassermann tests, and of the cytology and chemistry
of the cerebro-spinal fluid in secondary syphilis. He was able to
demonstrate in a large majority of his cases a pathological con¬
dition of the fluid; in 17 out of 22 cases the cerebro-spinal fluid
showed either a lymphocytosis or an increase of globulin content,
and in five instances the cerebro-spinal fluid was under high
pressure. It is necessary to emphasise the fact that in none of
these cases did the nervous system show any evidence of organic
disease, and, moreover, his patients were not treated with anti¬
syphilitic remedies. He refers to the following interesting case:—
Prostitute, age 23, was admitted to Cologne General Hospital.
November 1911; at that time she was treated for gonorrhoea;
a Wassermann test was then made, which proved to be negative.
In January 1912 she contracted syphilis; a month later a maculo-
papular eruption appeared all over the body. However, there were
no objective or subjective signs of affection of the nervous system.
He gives the following diagram, which illustrates the relation of
salvarsan to the Wassermann test and the other findings in the
cerebro-spinal fluid:—
Examination of the Cerebro-Spinal Fluid.
2GG
ABSTRACTS
We feel that Dreyfus’ painstaking investigations should receive
careful attention, and, indeed, the cerebro-spinal fluid should be
examined in all cases of systemic syphilis, even in cases without
objective or subjective cerebral manifestations. In such a manner
we might be enabled to prevent a progressive syphilitic, possibly
a meta-syphilitic, process of the nervous system.
References.
Collins and Taylor. Amer. Jour. Med . Sci. y Feb. 1909.
Dreyfus. Munch. Med. Wchnschr. t lix., 1912.
Fournier, Ann. dt Derm, el Syph. Paris, 1885, 2 s£r.
Forster. Handbuch f. Nervenheilk . (Lewandowsky), 1912.
Gowers. Quoted by Forster.
Gilles de la Tourette. Quoted by Nonne.
Joly. Ibid.
Kriebrich. Med. Klinik. 9 1907.
Lannois. Quoted by Forster.
Mingazzini. Ibid.
Nonne. “ Syphilis und Nervensysteme,” Zweite Auflage, 1909.
Nauyns. Quoted by Nonne.
Oppenheim. “ Syphilitische Erkrankungon der Gehim,” NothnageVa Handb. 9
1903.
Quinke. Deut. Ztschr.f. Nervenheilk. , v., 36.
Rumpf. Quoted by Nonne.
Stursberg. Deut. Ztschr.f. Nervenheilk. , v., 39.
abstracts
ANATOMY.
MEYNEBT’S BUNDLE=I.A. EL Arbeiten aus detn Himanat. Inst, in
(205) Zurich., Hft. vi., 1912.
Fuse has given a minute anatomical description of the cerebellar
tract known as Meynert’s bundle, or I.A.K. (innere Abteilung des
Kleinhirnstiels), and Deiter’s nucleus. His conclusions are based
on embryological and experimental studies carried out in
Monakow’s Institute in Zurich, and contain many valuable addi¬
tions to the already existing knowledge on this region of the
brain. The I.A.K. is a definite group of fibres stretching from the
caudal end of the med. oblong, to the cerebellum, and passing
ABSTRACTS
267
through the region of the sixth nucleus. The writer divides it
as follows:—
1 . Oblongata portion.
2 . Pons portion.
3. Cerebellar portion.
Its structure varies in different species of animals. Through¬
out it consists of a grey reticulum, in which cells of varying size
are embedded. Large cells of the Deiter's type are found in the
pars pontis, and the pars oblong., but the typical group of these
cells, the so-called Deiter's nucl., lies in the pars pontis only, and
consists of a group of giant cells and smaller cells stretching from
the junction of the medul. oblong, and cerebellum as far as the
oral limit of the I.A.K.
Bechterews nucleus is at the level of the sixth nucleus. It is
rudimentary in the lower mammals, but in man well-defined. It
consists of small and moderate-sized cells.
Lewandowskys nucleus is very distinct in the lower mammals,
indistinct in man. The writer considers this group belongs more
to the fifth nucleus than to the I.A.K.
Ventrally the I.A.K. is associated with the Tractus solitarius
and the spinal fifth nucleus, and the latter association is very
intimate and complex.
Laterally the I.A.K. is very closely associated with Burdock's
nucleus.
Dorsally the IA..K. is bounded by Monakow's strice, and it
terminates, in the central nuclei of the cerebellum.
In man the I.A.K. is much more marked in the ventral direc¬
tion, and is less well-defined in the portion adjoining the fourth
ventricle. In lower animals these two parts are reversed in
importance.
The large cells of Deiter's nucleus are much fewer in number in
man than in the lower mammals, and Deiter's nucleus itself is
smaller in size. The smaller cells are in contra-distinction con¬
siderably increased in number.
The writer found the form of Deiter's cells alike in all mammals.
They are multipolar, and contain spindle-shaped and rod-like
granules. Their dendrites are very thick and long, and their
axis cylinder prolongations terminate in medullated fibres. The
nucleus, as a rule, contains only one nucleolus.
The associations established by the writer are as follows:—
A. Cerebello-fugal tracts traversing the I.A.K.
1. In the cerebellar portion of the I.A.K. lying medially to the
Brack, conj. numerous fibres enter Deiter's nucl. directly, forming
associations in all directions. The majority seem to terminate in
*4
268
ABSTRACTS
the upper portion of the nucleus. There is a connection with the
subst. moleculari8 (Horsley and Clarke).
2. A further bundle from the Fibrae arcuatae of the formatio
retie, of the same side.
3. Association between cerebellum and post. long, bundle.
This confirms the observations of Van Gehuchten, Winkler, &c.
4. A further tract proceeds within the I.A.K. and lies laterally
to the Brach. conj. in the cerebellar region.
5. The writer could not confirm the observations of Biedl and
Bechterew regarding a particular lateral bundle tract connected
with the cerebellum.
6 . On the other hand the nucl. retie, para-olivaris receives
numerous fibres direct from the cerebellum, which terminate in
the subst. molecularis.
B. Cerebcllopetal tracts.
1. Associations between the nerve cells of the formatio reticu¬
laris and cerebellum.
2. Triangulo-cerebellar tract.
Numerous fibres proceed from nucleus triangularis dorso-
laterally, traverse the I.A.K., and enter the cerebellum (Edinger).
3. From Bechterew’s nucleus there are also fibres to the cere¬
bellum. The writer could not be certain whether these go by
way of the Brach. conjunct., whether they end in the central
nuclei, or whether they proceed to the decussat. of the nucl. teeth
4. Fibres proceeding from cells of I.A.K. to cerebellum
( Vejas, v. Gudden, and v. Monakow).
5. Associations from Lewandowsky's nucleus to the cerebellum of
the same side. The writer does not agree with Kohnstamm that
these are centrifugal. He could not, however, determine their
final goal.
6 . A nucleus situated in the caudal level of Deiter’s nucleus,
dorsally to corpus restif., gives off fibres which proceed to the
cerebellum of the same side.
7. Fibres from the lateral portion of Burdach’s nucleus to the
cerebellum.
C. Commissura system between the two I.A.K.
A system by means of the Fibres arcuaice through the Raphe
(observed by Ram6n y Cajal). The writer could not establish the
very finest associations of the commissura tracts either to the
grey substance of the cerebellum or to that of the I.A.K. Nor
could he establish any certain association of the two I.A.K. by
means of the cerebellum.
B. Associations between the grey substance of the I.A.K. and
the Form. retie.
E. Association between the grey substance of the I.A.K. and
ABSTRACTS
2G9
the spinal cord by means of the dorso-medial part of Burdach’s
nucleus.
F. Associating tracts from the posterior longit. bundle.
0. Associations between nervous vestibularis and I.A.K. A con¬
siderable number of fibres proceed through the I.A.K. to the
nucleus tecti.
The writer could not establish any association between these
fibres and the sixth nucleus.
H. Associations with the thalamus and corpora quadr. seemed
not improbable to the writer, but he could not be certain of these.
Von Monakow (Neurol. Ccntralbl., No. 13, 1910), who, with
Schellenberg, has worked at the subject for years, describes the
red nucleus as a large, well-defined group of cells, originating in
the neighbourhood of the third nerve. Represented by only a few
scattered cells in the lower vertebrates, it attains in mammals the
form of a true nucleus.
The primitive nucleus, the so-called nucleus magno-cellularis,
which stands out markedly in the lower mammals, reaches its
maximum in the ungulata. In the lower apes it begins to
diminish in size, and becomes rudimentary in anthropoids. In
proportion as the magno-cellularis diminishes, another group of
cells, the so-called parvo-cellularis, situated orally, which, lower
down in the animal kingdom, is quite rudimentary, gradually
assumes larger proportions. In quadrupeds the nucleus magno-
cellularis dominates; in the macacus the two groups are about
equal in size, whereas in anthropoids the phylo-genetically younger
group (parvo-cellularis) represents the chief mass, and is of con¬
siderable size. The writer shows that the structure and associa¬
tions of the red nucleus become more and more complex as the
animal kingdom ascends, and keep pace with the development of
the frontal lobes and cerebellar hemispheres. The gradual perfec¬
tion of the red nucleus is characterised by a development of its
tegmental portion, through which the spinal cord receives sensory
fibres by means of a complex chain of neurons. The writer thinks
that the increase of this part of the nucleus expresses anatomically
the upright position of man.
Laura Forster.
SEGMENTAL DISTRIBUTION OF SPINAL ROOT NUCLEUS OF
(206) THE TRIGEMINAL NERVE. Andrew H. Woods, Joum. New.
and Ment. Dis ., Vol. 40, No. 2, Feb. 1913.
The author’s conclusions are as follows :—
I. It is probable that the touch and pressure sensations are
conducted to the Gasserian ganglion, pass to new axones, enter the
270
ABSTRACTS
sensory root, and go directly into the chief trigeminal nucleus.
Thence new axones conduct them to higher levels, across the raphe
and into the lemniscus. And that
2 . Pain and temperature sensations pass from the ganglion,
also along secondary axones, go through the sensory root down
within the “ spinal root ” to the nucleus of that root. Thence new
axones pass cephalad within the formatio reticularis, decussate and
finally reach the lemniscus.
3. The two cases here presented suggest that the facial area
connected with the caudad end of the “ spinal root ” nucleus is a
band lying along line 8 (Fig. 1), and that each higher level of the
nucleus is connected with a band of skin roughly concentric with
the first, but nearer the mouth. Finally a zone of skin around the
nose and nostrils is connected with the cephalad end of the
nucleus. The fibres extending from any skin zone to the corre¬
sponding point in the nucleus may pass through all three
peripheral branches of the nerve.
D. K. Henderson.
THE DEVELOPMENT OF THE CRANIAL SYMPATHETIC
(207) GANGLIA IN THE PIG. Albk&t Kuntz, Joum. of Comp.
Neurol ., Vol. 23, No. 2, April 15, 1913, pp. 71-96 (15 figs.).
The mode of development of the ciliary, spheno-palatine, otic, and
submaxillary ganglia in the pig corresponds exactly with that of
the ganglia of the sympathetic trunks, the prevertebral sympathetic
plexuses, and the “vagal sympathetic” plexuses, as found by
Kuntz in his earlier studies on the development of the sympathetic
nervous system in all vertebrate classes, viz., from (1) cells which
migrate out from the ventral part of the neural tube along the
motor roots, and (2) from cells which pass peripherally from the
anlagen of the sensory ganglia. The earliest anlage of the ciliary
ganglion arises in contact with the oculomotor nerve; cells migrate
from the wall of the mesencephalon along the roots of this nerve:
later, a small number of cells wander from the Gasserian ganglion
peripherally along the ophthalmic nerve to the anlage of the
ciliary ganglion. In the cases of the spheno-palatine, otic, and
submaxillary ganglia cells migrate from the wall of the rhomb¬
encephalon along the motor trigeminal roots, and also from the
Gasserian ganglion along the maxillary, mandibular, and lingual
nerves respectively. Thus all the four cranial autonomic ganglia
are formed from a mixture of medullary and ganglionic cells.
Kuntz holds that “ ontogenetic evidence warrants the conclusion
that they are sympathetic in character.”
Leonard J. Kidd.
ABSTRACTS
271
THE AFFERENT OANOLIONATED NERVE FIBRES OF THE
(808) MUSCLES INNERVATED B7 THE FIFTH CRANIAL
NERVE; AND THE INNERVATION OF THE TENSOR
VELI PALATINI AND TENSOR TYMPANI. F. H. Edok-
worth, Quart. Joum. of Micr. Sci., Vol. 68, pt. 4, March 1913,
p. 693 (21 figs.).
In Macacus cynomolgus, man, rabbit, and dog, the muscles inner¬
vated by the fifth cranial nerve, including the tensor palati and
tensor tympani, receive afferent fibres which originate in the
Gasserian ganglion and pass into the motor root. This conclusion
is based (1) on the results of division of the trigeminal roots
proximal to the Gasserian ganglion in two monkeys, and (2)
serial sections made through the mandibular division of the fifth
nerve in man, rabbit, and dog. Edgeworth finds that “ the pro¬
portion of ganglionated afferent nerve-fibres found in the muscle-
branches of the trigeminus is closely similar to that shown by
Sherrington to exist in the branches of spinal nerves passing to
skeletal muscles ” (i.e., a little over one-third of the total number).
Leonard J. Kidd.
THE INNERVATION OF THE BLADDER: ANATOMICAL AND
(209) EXPERIMENTAL STUDIES. (Recherches anatomiques et exp&i-
mentales but l’innervation de la vessie.) G. Debaisibux, Le
Ntvraxe, Vol. 13, F. 2-3, April 1, 1913, pp. 119-159 (35 figs.).
This research was undertaken to find out if the sacral autonomic
and the thoracico-lumbar sympathetic systems have contrary
actions on the bladder-muscle. The twenty-four experiments
were performed almost entirely on dogs: sometimes the principal
conclusions were controlled on cat and rabbit. Part 1 deals with
the anatomical distribution and histology of the vesical nerves,
and part 2 with their action on vesical motility. There are
numerous points of importance brought out, which must be studied
in the original. The author gives the following list of conclusions:
(1) The nervus erigens is composed for the most part of medullated
fibres which come from the three first sacral roots. Of the motor
fibres of this nerve, some ascend to the homolateral hypogastric
nerve, others terminate in the ganglia of the pelvic plexus and the
“vesical ganglia,” properly so-called. (2) A reflex path passes
from one nervus erigens to its fellow; the reflex centre is probably
in the spinal cord. (3) The hypogastric nerve contains about three
hundred medullated fibres: none of these fibres rises in the cells
of the inferior mesenteric ganglion: the greater part, if not all,
come from the spinal cord by the intermediation of the second,
third, and fourth lumbar roots. These are the motor fibres, partly
direct and partly crossed. (4) Excitation of the nervus erigens
provokes a strong contraction of the corresponding half of the
272
ABSTRACTS
bladder; excitation of the nervus hypogastricus gives a feebler
contraction, also homolateral. It was not possible to determine
the slightest antagonism between the functions of these two
nerves. The author, therefore, has to conclude that the general
law, by virtue of which two systems of nerves of different origin
act in an inverse manner on organs containing unstriped muscle,
does not apply to the bladder. (5) Stimulation of the central end
of the nervus hypogastricus never gave a notable vesical contrac¬
tion : the reflex described by Sokownin, if it really exist, appears
to be an inconstant phenomenon.
As a general rule, Debaisieux found that the contraction-curve
obtained by stimulation of the hypogastric nerves was much
greater when the nervi erigentes had been previously divided.
In his stimulation experiments he used an apparatus like that of
Langley. This paper is a model of thoroughness: the innervation
of the sphincter vesicie is to form the subject of a future paper.
Leonard J. Kidd.
DISTRIBUTION OF NERVES IN THE HEART. Winifbed Cullis
( 210) and Enid. M. Tribe, Joum. of Physiol., Vol. xlvi., No. 2, April 25,
1913, p. 141 (11 figs.).
The authors worked mainly on rabbits, but also on some cats: the
heart in situ was perfused through the coronary circulation with
Locke’s solution, by means of a cannula tied into the aorta and
connected by rubber tubing to the heart perfusion apparatus of
Brodie and Cullis. Conclusions:—After section of the A.-V.
bundle, pilocarpine and muscarine do not produce their normal
slowing and inhibitor action upon the ventricles, though they act
normally upon the auricles; atropine following these drugs
abolishes their action upon the auricles, but produces no effect on
the ventricles. Under similar conditions adrenalin still produces
its normal effects on the ventricles. From this the authors
conclude: (1) that the ventricle does not receive vagus fibres, and
that therefore the normal action of the vagus on the ventricles is
an indirect one ; and (2) that the ventricle is abundantly supplied
with sympathetic fibres, which do not pass in only by way of the
A.-V. bundle. Leonard J. Kidd.
PHYSIOLOGY.
NOTE ON THE FUNCTIONS OF THE CORTEX CEREBRI. T.
(211) Graham Brown and C. S. Sherrington ( Proc. Physiol. Soc., March
15, 1913), Joum. Physiol., Vol. xlvi., No. 2, April 25, 1913, p. xxii.
The authors found that after destruction of the arm area of the
left motor cortex in a chimpanzee ape, “voluntary” movement at
ABSTKACTS
273
the right elbow was present. In the succeeding few months so
great a recovery of the movements of the arm took place that
there was no obvious difference between the movements of the
two arms. This recovery is not due to regeneration of the area
destroyed. It is also not due to the taking over by the corre¬
sponding area of the other cortex of the movements of both arms,
and it is not due to the taking over by the post-central cortex of
the functions of the motor cortex. A. Nini an Bruce.
THE ACTION OF PBOSTATIC EXTRACTS ON THE CEREBRAL
(212) AND RENAL CIRCULATION. (Action des extraits de pro¬
state sur les circulations cdrArale et rdnale.) C. Dubois and
L. Boulet, Compt. Rend. Soc. de Biol., Vol. lxxiv., No. 14, April 25,
1913, p. 811.
Several observers have found that intravenous injection of
prostatic extracts give a fall of arterial pressure and contraction
of the urinary bladder: vaso-dilatation of the penis has been
obtained by Hallion, Morel, and Papin (1913). The authors
have studied the variations of the volume of the brain by means
of the plethysmograph, according to the procedure of Wertheimer,
and have found constantly a fall of arterial pressure, with or
without a slowing of the heart, together with an augmentation of
volume of the brain : they regard this cerebral vaso-dilatation as
due to an active vasodilator action. In certain cases, at any rate,
prostatic extracts act as an excitant of the vaso-constrictor
centres: the volume of the kidneys is usually diminished simul¬
taneously with the fall of arterial pressure.
Leonard J. Kidd.
THE EFFECT OF THE REMOVAL OF THE HYPOPHYSIS IN THE
(213) DOG. J. E. Sweet and A. R. Allen, Annals of Surgery., Vol. lvii.,
April 1913, p. 485 (6 figs.).
Hypophysectomy was performed on twenty-two adult dogs, some
being quite old. Three well-marked constant post-operative changes
were found on autopsy: (1) the pancreas presented a striking red
coloration, similar to that seen at the height of digestion, but no
marked microscopical changes were evident in it; (2) genital
atrophy, especially of the testes: this appears early, and is
extremely marked by the end of the second week; ( 3 ) increase of
body-weight and obesity appearing some months after operation :
its mode of production is uncertain. The authors believe that the
entire hypophysis can be removed without danger to life, and that
“ there is but one surgical indication for operating, namely intra¬
cranial pressure.” They prefer the intracranial mode of approach.
Leonard J. Kidd.
274
ABSTRACTS
FURTHER STUDIES ON THE B6lE OP THE HYPOPHYSIS IN
(214) THE METABOLISM OF CARBOHYDRATES. THE AUTO¬
NOMIC CONTROL OF THE PITUITARY GLAND. L. & Weed,
H. Cushing, and C. Jacobson, Bull. John» Hopkint Hotp ., YoL 24,
Feb. 1913, p. 40.
The authors of this admirably planned and executed experimental
study on cats, rabbits, and dogs give the following conclusions:—
The pituitary body, and more particularly its posterior lobe, plays
a significant role in the metabolism of carbohydrates, and its
action in this respect is under the control of fibres which reach
the gland by way of the superior cervical sympathetic ganglion.
Stimulation of this nervous pathway at the so-called sugar centre
in the fourth ventricle, at the superior cervical ganglion, and by
excitation of the pituitary body itself, liberates a chemical sub¬
stance which causes glycogenolysis and glycosuria, independent of
any possible nervous impulse reaching the glycogen-holding cells
of the muscles or abdominal viscera.
There is an appendix on the significance of “ available
glycogen”: the authors explain clearly the sense in which they
use this expression. Leonard J. Kidd.
PINEAL MEDICATION AND FUNCTIONS. C. L. Dana and W. N.
(215) Berkeley, Medical Record , Vol. 83, No. 19, May 10, 1913, p. 836
(3 figs.).
This paper contains the first record of pineal feeding experiments
in young animals and children: these were carried out with the
help of Drs H. H. Goddard and W. S. Cornell. Extirpation of the
pineal of rabbit and guinea-pig intra vitam was found to be im¬
possible : cautery-destruction experiments on young guinea-pigs
were incomplete, and are to be pursued on a larger scale. Extracts
of the pineals of young bullocks, aged one or two years, had no
effect on blood-pressure when injected intra-venously into dogs.
Feeding experiments with these pineal extracts gave these results:
—(1) Increase of metabolic activity in young babies, as shown by
increase of nitrogen in the urine: (2) in young guinea-pigs, rabbits,
and kittens, when kept up for a period of some months, definite
increase of growth was evident when compared with that of
controls. Fifty cases of backward children under the age of eight
or nine years, when fed on pineal extracts, gave results which
astonished and pleased their school teachers: full particulars of
twenty-one cases are given. The authors find that pineal feeding
is useless in idiocy and gross physical defect, but of distinct value
in cases of simple mental retardation in young children, and also
in Mongolism. All parts of this most welcome comparative pineal
investigation are to be continued and amplified.
Leonard J. Kidd.
ABSTRACTS
275
ACTION OF CERTAIN DRUGS ON ISOLATED STRIPS OF VEN-
(216) TRIOLE. Constance Lkbtham, Joum. of Physiol., YoL xlvi, No.
3, April 36,1913, p. 161 (10 figs.).
The authoress studied the effects of pilocarpine, muscarine, and
adrenalin on cats and two dogs, using the strip method adopted by
Porter in 1897. Her work confirms that of Miss Cullis and Mrs
Tribe ( v. supra). She concludes that in ventricular muscle
sympathetic nerve-endings are present, but no vagus nerve-
en dings. Leonard J. Kidd.
PATHOLOGY.
ON TOXIC NEURITIS (NEUROLYSIS) OF THE EIGHTH NERVE
(317) AND ON THE CHANGES IN THE CORRESPONDING
GANGLIA IN DIPHTHERIA. Leo Lewin, Ztschr. f. Ohrenheilk .,
Bd. lxvii., Feb. 1913, S. 193.
The nerves and ganglia from fifteen children who had died of
diphtheria were examined. In one case there was acute otitis media,
and in a second some mucous in the middle ear, otherwise the
middle ear was healthy. Changes were found in the nerves in
seven cases, four bilateral; and in the ganglia in ten cases, all
bilateral. In each case both long and cross sections were cut.
Cross sections of the nerve unstained and with small magnification
showed numerous disseminated islets of various form and size,
lighter in colour than the surrounding tissue. Stained by the
Weigert-Pal method, the islets showed light yellow in the black
stained tissues. The high power showed they consisted of small,
close-lying granules like dust sprinkled on a lighter background,
some scattered round nuclei, here and there cells with large
nucleus and little protoplasm, as well as bodies resembling corpora
amylacea. Longitudinal section showed the nerve fibres deviating
to make room for these spaces. Some fibres disappeared in the
granular substance, others lost their coats and went on as axis
cylinders, others further degenerated showed themselves as rows
of myelin globules. The surrounding tissue was sometimes normal,
but it often showed various stages of parenchymatous degenera¬
tion. These changes were never found in the facial nerve.
Changes were also found in the vessels, dilatation and haemorrhages.
The author does not think the changes are artefacts, and argues
the point. He thinks the granules sprinkled on a homogeneous
background represent the coagulation product of a fluid, a transuda¬
tion from the diluted vessels which has a toxic effect on the nerves.
He draws attention to the striking similarity of the changes
276
ABSTRACTS
Eppinger found post mortem in hearts from cases of diphtheria
which had died of heart failure.
The changes in the ganglion cells were very various, usually
they showed shrinking of the protoplasm and the Nisei's granules
did not stain well. R. V£rel.
CLINICAL NEUROLOGY.
A NEW ESTHE8IOMETER. Siegmund Auerbach. Joum. Nerv. and
(218) Meni . Dit ., Yol. 40, No. 2, Feb. 1913.
A very useful form of pocket esthesiometer has been devised by
Auerbach which allows one to test all the qualities of sensation of
the skin with the exception of perceiving both points of a compass
and also excepting electro-cutaneous sensibility. The instrument
is manufactured by Kay, Scherer, & Company, and costs seven
dollars. D. K. Henderson.
CORNEAL SENSIBILITY AND CORNEAL NERVE TERMINA-
(219) TIONS IN NEWLY-BORN CHILDREN. (La sensibility
coralenne et les terminaisons nerveuses dans la comle du
nouveau-n6). Verderame (Congrts dOphthal. dHeidelberg., 1912),
Arch. dOphthalmol., Vol. 33, April 1913, p. 248.
Axenfeld found that corneal sensibility is very feeble in the
newly-born. The author has examined 200 newly-born children
and nurselings up to the age of two years. Corneal sensibility
does not appear till the fourth day, and is fully developed only by
the sixth to tenth month. The methylene blue method shows no
histological differences between the corneal nerve-terminations
of the newly-born and the adult. The feeble corneal sensibility
in the former must then depend on incomplete development of
sensory conduction or perception. Leonard J. Kidd.
A CASE OF DYSTONIA MUSCULORUM DEFORMANS (OPPEN-
(220) HEIM). I. Abrahamson, Joum. Nerv. and Ment. Dit ., Yol. 40,
No. 1, Jan. 1913, p. 38.
A Jewish girl, 13 years, who five years ago started to have tonic
spasms of her right hand, interfering with her writing. One
year later the left hand became similarly involved. For the past
two years marked disturbances of gait and station; she also
exhibits scoliosis with slight lordosis, easily induced fatigue,
absence of hypertonus, loss of tendon reflexes in the upper and
inconstant presence in the lower extremities, and absence of
grimacing or facial over-action. D. K. Henderson.
ABSTRACTS 277
M7AT0NIA CONGENITA. Alfred Gordon, Joum. New. and Ment.
(221) Dis., Vol. 40, No. 2, Feb. 1913, p. 109.
Two cases are briefly reported presenting partly the symptom-
group of Oppenheim’s disease, and partly that of Werdnig-
Hofifrnann’s type. D. K. Henderson.
PRURITUS IN TABES AND ARSENO-BENZOL. (Pruitt tabtftique et
(222) arsdnobenzol.) M. Pujol, Progrh mid., 1913, zli., p. 100.
A case of lumbo-sacral pruritus in a man, aged 41, accompanied
by slight lichenification. There was no inco-ordination, and the
knee jerks were normal, though the ankle jerks were lost. The
pruritus had persisted for eight weeks in spite of treatment, and
presented intolerable exacerbations. Complete disappearance of
the pruritus and slight improvement in the lightning pains
followed small and repeated doses of neo*salvarsan. Wassermann’s
reaction remained positive, and the spinal lymphocytosis was not
affected. J. D. Rolleston.
EPIDEMIC CEREBRO SPINAL MENINGITIS CUBED BT DIPH
(223) THERIA ANTITOXIN. (Ein Pall von epidemischer Zerebro-
spinalmeningitis geheilt durch Antidiphtberieserum.) N. A
Rawitsch, Zentralbl. f . inn. Med., 1913, zxziv., p. 393.
A record of a case in a youth, aged 17, who showed a
number of meningeal symptoms, including facial herpes, but no
lumbar puncture was performed. Antimeningococcic serum not
being available, three subcutaneous injections of diphtheria anti¬
toxin were given and recovery took place ( v. Revievj, 1909, vii.,
p. 607). J. D. Rolleston.
PARAMENINGOCOCCUS CEBEBBO • SPINAL MENINGITIS.
(224) MENINGOCOCCAL AND PABAMENINGOCOCCAL SERO¬
THERAPY. DEATH. (Mdningite cdrdbro-spioale paramdningo-
coocique. Sdrothdrapie mdningococcique etparamdningococcique.
Mort.) A. Follbt and J. Bourdiniere. Bull, et mim. Soe. mid.
H6p. de Paris , 1913, xxxv., p. 605.
A case in a woman, aged 27. No improvement followed the use
of parameningococcus serum, but each fresh injection increased the
purulence of the cerebro-spinal fluid and the number of micro¬
organisms, and aggravated the symptoms. Possibly the result
may have been due to anaphylaxis, as the first injection had
been given thirteen days before. On the other hand, serum
meningitis, as described by Sicard (v. Review, 1910, viii., p. 702),
is characterised by an intense polymorphonuclear reaction but an
absence of micro-organisms. A more probable explanation is that
278
ABSTRACTS
there was a special variety of parameningococcus at work, which
was not affected by the serum used. J. D. Rolleston.
MENINGEAL STATE AT THE ONSET OF SEVERE AND PRO-
(225) LONGED PARATYPHOID B FEVER. (Etat mining* an
debut d’une fllvre paratyphoids B grave et prolonged.) L. Boidin,
Gaz. d. H6p ., 1913, lxxxvi., p. 229.
A man, aged 29, suddenly developed symptoms resembling cerebro¬
spinal meningitis. The cerebro-spinal fluid was clear, sterile,
and without marked hypertension. On the tenth day the
meningeal symptoms diminished, and on the thirteenth rose spots
appeared on the trunk. The general appearance was that of
typhoid fever, but Widal’s reaction was negative, and paratyphoid
B bacillus was isolated from the blood. The temperature became
normal on the forty-seventh day, and recovery took place without
complications. J. D. Rolleston.
TWO SIMULTANEOUS OASES OF ACUTE POLIOMYELITIS IN
(226) TWO CHILDREN OF THE SAME FAMILY: TYPICAL
PARALYSIS IN ONE, SIMPLE MENINGEAL STATE IN
THE OTHER. (Deux cas simultanls de poliomyllite aiguB ches
deux enfants d’une mime f&mille: Paralysies typiques chez Tun;
simple *tat mining* ches l’autre.) R. Moric hau-Bkauchant,
R. Guyonnet, and Corbin, Bull. et. vUm. Soc. me'd. U6p. de Paris,
1913, zxxv., p. 543.
A girl, aged 5 years, was suddenly seized with headache, vomiting,
and fever, followed next day by nuchal rigidity and Kemig’s
sign, and on the third day by almost complete paralysis of the
right leg and left arm. The fever disappeared on the fourth day,
and the general condition improved, but the paralysis persisted.
The cerebro-spinal fluid was clear and sterile, and contained a
small quantity of lymphocytes and polymorphs in equal proportions.
A sister, aged 4 years, was taken ill with meningeal symptoms
one week after the onset of the first child’s illness. The symptoms
lasted three days and then disappeared, and no paralysis developed,
though there was a diffuse muscular weakness for two days.
J. D. Rolleston.
ON A CASE OF RECKLINGHAUSEN’S DISEASE WITH HYPER
(227) NEPHROMA. (Ueber einen Fall von Morbus Recklinghausen,
mit Hypernephroma.) Saalmann, Virchotds Arckiv , 1913, ccxi.,
p. 424.
A woman, aged 35, suffering from typical Recklinghausen’s disease,
died from pulmonary embolism following an operation for removal
of an elephantiasic tumour of the arm. Post mortem a hyper-
ABSTRACTS
279
nephroma, which had originated in a suprarenal rest, was found
in the liver. The suprarenale themselves were normal. Re¬
ference is made to a similar case reported by Kawashima {v.
Review, 1911, ix., p. 387). J. D. Rolleston.
FOUR FAMILIAL OASES OF MULTIPLE NEUROMYXOFIBRO-
(228) 8ARC0MAT08IS. (Vier familiars FBlle von multipier neuro-
myxoflbrosarcomatose.) A Mathies, Ztschr. f. klin. Med., 1813,
lxxvii., p. 60.
A RECORD of a woman, aged 35, and her three sons, aged 14, 12,
and 10 years respectively. In the mother the disease began at 15,
in the two elder children it was noticed before they first attended
school, and in the youngest child it was not seen until he was
examined by Mathies. None of the cases showed tumours or pig¬
mentation of the skin or mucosae, but all had tumours of the
peripheral nerves. None showed any intellectual impairment. In
the mother the diagnosis of tumours of the cranial nerves made
during life was confirmed after death. All but V. and XII. were,
affected. The spinal nerve roots, intercostal, ulnar, median
musculo-spiral, sciatic and cervical sympathetic also showed small
tumours. The eldest son showed involvement of II., VI., and VIII.,
and numerous tumours of the peripheral nerves. In the other two
children there were a few tumours confined to the peripheral
nerve. Examination of the tumours in all the cases showed their
myxofibrosarcomatous nature. The mother was nine months
pregnant at the time of death. Nothing abnormal was found in
examination of the nerves of the foetus. J. D. Rolleston.
ON THE OCCURRENCE OF A HEMIANOPIC CENTRAL SCOTOMA
(229) IN DISSEMINATED SCLEROSIS AND RETROBULBAR
NEURITIS (NEURITIS OF THE CHIASMA AND OPTIC
TRACT). (Ueber des Vorkommen ernes bemianopischen zentralen
Skotoms bei disseminierter Sclerose und retrobulb&rer Neuritis
(neuritis chiasmatis et tractus optici).) Ronne, Klin. Monats-
bldtter f. Augenheilk., Vol. 50, 1912, S. 446.
Hkmiopic conditions of the field of vision, which indicate the optic
chiasma or tracts as the site of the lesion, have up to the present
been generally attributed to some influence acting on the chiasma
from outside, such as pressure. The occurrence of a primary lesion
of the chiasma has, however, been established in certain cases of
acute myelitis associated with retrobulbar neuritis, and other cases
have been described in connection with blood poisoning and tabes.
In the present paper five cases are described in which hemiopic
central scotomata occurred. These scotomata are characterised by
280
ABSTRACTS
a straight mesial border which follows the vertical meridian of the
field of vision, almost always dividing the fixation point. The
scotoma may involve the apices of one or more quadrants, the
central part of the field behaving somewhat as an independent
field within the field of vision.
In the first two cases the diagnosis of disseminated sclerosis
was fully established by other evidence, the nature of the
scotomata indicating the presence of affected foci in the optic
tracts. In the remainder the cause was obscure, and they are
held by the author to be analagous to cases of acute idiopathic
retrobulbar neuritis, differing only in the more posterior situation
of the lesion, and therefore belonging to the, at present, little
known group of primary lesions of this part of the optic path.
The author concludes by expressing the hope, which must
be heartily endorsed, that the possibility of the presence of bucIi
primary lesions in connection with the hemiopia of chiasmal
origin will always be considered. H. M. Traquair.
CEREBRAL HEMIPLEGIA WITH ATROPHY, FLAOCIDITY, AND
(230) LOSS OF REFLEXES. F. X. Dercum, Joum. New. and Ment Din.,
Vol. 40, No. 2, Feb. 1913, p. 111.
The case is reported of a man, 31 years, who ten days after a head
trauma developed a right-sided hemiplegia and a sensori-motor
aphasia. D. K. Henderson.
DIPHTHERITIC HEMIPLEGIA J. D. Rolleston, Proc. Roy. Soc.
(231) Med., 1913, vi. (Clin. Sect.), p. 69, and Clin. Journ., 1913, xlii., p. 12.
The author briefly relates 6 personal cases which occurred among
a total of 9,075 completed cases of diphtheria in the course of
thirteen years, and mentions the cases published since his last
paper on the subject (v. Review, 1905, iii., p. 722). Eighty cases are
now on record: 28 were males, 37 females, and in 15 the sex was
not stated. The. ages ranged from 1£ to 17 years. Right hemi¬
plegia occurred in 48, in 21 of whom aphasia was noted, left in 27,
and in 5 no details were given. The hemiplegia occurred at the
following dates: First week, 1 case; second week, 14; third, 27;
fourth to seventh, 12. In 14 cases where no exact date is given
it is said to have occurred in convalescence, in 12 no date whatever
is given. Recovery took place in 52, death in 24, and in 4 no
details are given. Necropsies were held in 18 cases: embolism
was found in 13, thrombosis in 3, haemorrhage in 1, and sclerotic
atrophy in 1. In all the cases where details are given the initial
attack was severe. Albuminuria and ordinary diphtheritic paralysis
were present in a large number. Author’s Abstract.
ABSTRACTS
281
A CASE OF THROMBOSIS OF THE VERTEBRAL AND POSTERIOR
(232) AND INFERIOR CEREBELLAR ARTERIES. (Di un caso di
trombosi dell’ arteria vertebrale e delle eerebellare posteriore ed
Inferiore.) A Salmon, Lo SperimentaU , 1913, lxvi., p. 442.
A case of an alcoholic man, aged 68, whose symptoms were vertigo,
vomiting, hypoesthesia of the left side of the face, paralysis of the
left ocular sympathetic and lower facial, disturbances of deglutition
from lesions of the nucleus ambiguus, anaesthesia in the right
upper and lower limbs, asynergy of the left lower limb, with
tendency to fall on the same side, and loss of tendon reflexes in all
four limbs.
The absence of any affection of X. and XII. was explained by
the fact that their nuclei are supplied by the anterior spinal
artery.
Some improvement took place owing to the establishment of
collateral circulation. J. D. Rolleston.
TYPHOID SPINE. (La apondylite typhique.) J. Bonhouke, Theses, de
(233) Paris, 1912-13, No. 118.
Typhoid spine is most frequent between 15 and 35. In eight out
of ten cases it affects the male sex. It may be met with in all
forms of typhoid fever, but is most frequent after severe attacks.
It may occur in the course of the disease, or more frequently
during and after convalescence. The original seat of the lesions
is the lumbar column. The symptoms are divided into osteo-
articular, radiculo - medullary, and general. The X-rays show
(1) changes in the intervertebral discs; (2) thickening of the
perivertebral tissue and vertebral periosteum; and (3) lesions in
the bodies of the vertebne. Treatment consists in early and
prolonged immobilisation. Lumbar puncture may give relief when
there is cerebro-spinal hypertension. Massage and gymnastic
exercises may be required later to overcome the spinal rigidity.
The thesis contains the histories of seventy cases collected from
literature from 1889, when the condition was first described by
Gibney, to 1912. J. D. Rolleston.
CEREBELLAR INTERMITTENT CLAUDICATION. T. H. Weisen-
(234) bubo, Joum. Nerv. and Afent. Dis., Vol. 40, No. 2, Feb. 1913, p. 110.
The patient, a boy 14 years, at three months had erysipelas
complicated by encephalitis, followed by typical epileptic convul¬
sions, which persisted until the boy was 5 years of age. At the
age of 5 the patient began to have attacks in which he became
paralysed on the right side, and which lasted from a few minutes
282
ABSTRACTS
to several hours or a clay. About a year later he began to have
similar attacks on the left side, and since then when excited, or
sometimes without any cause, he develops a hemiplegic attack
either on the right or the left side, and rarely both. No similar
case is on record. D. K. Henderson.
UNILATERAL INTERMITTENT CLAUDICATION OF THE
(235) LUMBAR REGION. J. Ramsay Hunt, Joum. Nerv. and Menu
Bis., VoL 40, No. 2, Feb. 1913, p. 123.
The case of a woman, 66 years old, who had been under observa¬
tion for ten years, and in whom the lumbar pains were strictly
limited to one side. D. K. Henderson.
SUPPURATION IN THE NEEDLE TRACK AFTER LUMBAR
(236) PUNCTURB (Znr Frags der Sticheiterung nach Lumbal-
jnmktion), E. H. B. van Lier (Utrecht), Mittal, a. d. Grenzgeb. d.
Med. u. Chir., 1912, xxv., p. 132.
A record of two cases. 1. Girl, aged 14, admitted to hospital with
continued fever. No evidence of typhoid, tuberculosis, or menin¬
gitis. The fluid drawn off in the first two lumbar punctures was
purulent, but in the third was clear, though it contained an excess
of polymorphs and staphylococci. The pus was then found to be
due to an abscess in the sacrospinalis muscle. Recovery took place
after multiple abscesses, but no meningitis ensued.
2. Case of chondrodystrophy with spinal deformity. Lumbar
puncture was performed in the morning, and the temperature,
hitherto normal, rose to 104° the same evening. Death from
pyaemia some weeks later. The necropsy showed circumscribed
purulent meningitis and suppuration extending along the nerve
lymph sheaths caused by bilateral psoas abscess, as well as purulent
pericarditis and pulmonary abscess. J. D. Rolleston.
A CASE OF SPASTIC PARAPLEGIA, WITH DORSAL ROOT
(237) SECTION FOR PAIN AND SPASTICITY. Lesser Kauffman*
and Prescott le Breton, Joum. Amer. Med. Assoc., No. 13, March
29, 1913, p. 982.
Patient was a man, aged 37, single, with a positive Wassermann,
who had for some time past complained of girdle pain with some
numbness of the legs and trouble in walking. On admission to
hospital a diagnosis of hysteria was made, changed later to spastic
paraplegia due to syphilis of the cord. In spite of three doses
of salvarsan, the positive signs of spinal cord involvement grew
worse, and great pain in the abdomen and legs was complained of.
The spasticity increased until he could be lifted from the bed like
ABSTRACTS
283
a board, and as the pain and spasticity were still increasing and
were unrelieved by treatment, it was decided to divide the posterior
nerve roots in the lower dorsal region. This was done. Next day
the spasticity had disappeared, the loss of bladder control was
complete, and there was great pain still inside the abdomen. In
ten weeks’ time the spasticity had completely returned, the pain
continued to get worse, and he died from inanition and exhaustion.
No necropsy. A. Ninian Bruce.
CEREBELLAR TUMOUR. Mat Mailhouse and W. F. Verdi, Joum.
(238) Nerv. and Ment. Dm., Vol. 40, No. 2, Feb. 1913, p. 118.
An interesting case of successful removal of a cerebellar tumour in
a girl 15 years old. The patient has made a complete recovery.
D. K. Henderson.
MENINGEAL FIBRO-ENDOTHELIOMATA Harvey Cushing, Joum .
(239) Nerv. and Ment. Dm., VoL 40, No. 1, Jan. 1913, p. 41.
A NUMBER of cases were reported in detail, and the subject was
discussed generally by Starr, Sachs, Ramsay Hunt, Kennedy,
Abrahamson, and Clark. D. K. Henderson.
PITUITARY AND UNCINATE SYMPTOMS AND LESIONS.
(240) Charles K. Mills and William B. Cadwalader, Joum. Nerv.
and Ment. Die., Vol. 40, No. 2, Feb. 1913, p. 114.
Two cases are described and the different types of pituitary
disease are discussed. D. K. Henderson.
CONTRIBUTION TO THE .ETIOLOGY OF BITEMPORAL HEMI-
(241) OPIA WITH PARTICULAR REFERENCE TO HYPOPHYSIS
DISEASE. (Beitrag zur Aetiologie der bitemporalen Hemian-
opeie mit besonderer Beriicksichtigung der Hypophysiskran-
kungen.) Bogatsch, Klin. Monattbl. f. Augenheilk., Bd. 60,
1912, S. 313.
Since the work of Marie in 1886 stimulated increased attention
to pituitary disease as a factor of importance in bitemporal
hemiopia its presence has been much more frequently diagnosed.
Statistics of 59 cases reported before 1886 show 5 per cent, as
due to pituitary disease, and 40 per cent, without known cause,
while of 256 reported since that date no less than 50 per cent,
are attributed to this cause and the unexplained cases are reduced
to 13 per cent. More exact details are given in tabulated form
of 34 additional cases, of which 19 occurred in connection with
*5
284
ABSTRACTS
proved or probable pituitary disorder, while in 6 no cause oould
be assigned. The remaining cases are attributed to sixteen
different causes, amongst which basal syphilis, tumours in the
neighbourhood of the pituitary, fractures, vascular disease and
meningitis are the most productive.
The diagnosis of hypophysis disease may be regarded as
established if there is positive evidence in regard to three points:
bitemporal hemiopia, the general condition of the patient and
the result of X-ray examination.
The occurrence of relative hemiopia and of paracentral
scotomata is mentioned but without suggesting any inference as
to the diagnostic significance of these symptoms.
The author refuses to accept the view recently advanced by
Fuchs that bitemporal hemiopia may be due to tabes until actual
post-mortem evidence is forthcoming.
Some light is thrown upon the relation of acromegaly to
pituitary disease and bitemporal hemiopia by these figures, which
show in the larger series of 315 cases 40 per cent, of acromegalies
in 118 pituitary cases, and in the additional 34 cases in 19
pituitary cases 10 per cent, of acromegalies. On this evidence
the majority of cases of hypophyseal disease with bitemporal
hemiopia would appear to be unassociated with acromegaly, though
more statistics and further investigation will be necessary to show
which of these two percentages more nearly indicates the true
relation, which depends, of course, to a great extent on the
minuteness of the examination of the field of vision. Those who
are interested in this subject will find a great deal of information
in this very useful paper. H. M. Traquair.
INFANTILISM. (A propos d’infantilisme.) F. D’Hollander, Joum.
(242) de Neurol., Ann. 17, No. 11, June 5, 1912, p. 201.
An account of a case of very pronounced infantilism, the patient
being a woman of 40, suffering from an attack of acute excitement.
When 7 years old the patient had an attack of typhus fever, and
from that time she never developed normally. The author thinks
that one of the ductless glands, probably the thyroid, may have
been injured by the typhus toxin. He also points out that the
symptoms could be accounted for by the assumption that a
number of the ductless glands were not functioning properly.
Several of the other members of the family were cretins (thyroid),
there was complete absence of secondary sexual characteristics
(ovaries), there was marked disproportion between the size of the
hands and feet and the rest of the body (pituitary), and the skin
of the forehead was abnormally pigmented (suprarenale).
W. Boyd.
ABSTRACTS
285
EUNUCHOIDISM IN DIABETES INSIPIDUS. (Ueber Bunuchoidia
(243) mna bei Diabetes insipidus.) Erich Ebstein, Mitteil. a. d.
Qrerugeb. der Med. u. Ckir., 1912, xxv., p. 441.
A RECORD of two cases. 1. Man aged 52. In addition to
symptoms of diabetes insipidus of 16 years’ duration there were
a tumour of the hypophysis, with bitemporal hemiachromatopsia,
adiposity of the lower abdomen, breasts, upper arms and thighs,
genital hypoplasia and impotence, changes in the hair (oligo¬
trichosis lanugensis et terminalis), and trophic disturbances in the
skin.
2. Boy aged 15. In addition to diabetes insipidus he had the
characteristic adiposity, genital hypoplasia, and oligotrichosis.
There was no definite evidence of a pituitary tumour, but the low
blood-pressure and small thyroid showed that other glands of
internal secretion were affected. J. D. Rolleston.
LOCALISED ENCEPHALITIS WITH EPILEPSIA OONTINUA.
(244) S. Krumholz, Joum. Kero, and Ment. DU., Vol. 40, No. 1,
Jan. 1913.
The case of a girl, 14 years, who after a prodromal period of a
few days became suddenly ill with epilepsia continue without
any known cause. During the illness, which lasted for twenty-
five days, she had one general epileptic convulsion, but otherwise
presented clonic convulsions of separate muscle groups, Jacksonian
in type, which persisted with equal frequency until fatal termina¬
tion. The autopsy showed acute cerebral changes characteristic
of encephalitis hemorrhagica, and a vehement gliomatous pro¬
liferation of the left motor cortioal region. The difficulties of
diagnosis are discussed in detail. D. K. Henderson.
SYPHILIS WITH CONCEALED PRIMARY LESION, (fiber Syphilis
(246) mit verstektem Prim&raffekt.) J. Almkvist, Dermat. Wchenschr.,
1918, lvt, p. 190.
A HAN, aged 20, contracted syphilis and gonorrhoea simul¬
taneously. Although he was kept under close examination, no
primary lesion was found. About three months after infection a
maculo-papular eruption appeared. Examination of the urethral
discharge then showed typical Spirochastce pallida and an erosion
was found in the urethra behind the fossa navicularis.
J. D. Rolleston.
286
ABSTRACTS
ON “PRECOCIOUS” CEREBRAL SYPHILIS. (In tema di giflUde
(246) cerebrals “precoce.”) G. Pellacani, Riv. di Patol. new. e ment.,
1912, zvii., p. 536.
The term “ precocious ” as applied to cerebral syphilis is incorrect,
as the great majority of cases of cerebral involvement occur at
an early stage of the infection. Pellacani records three cases in
men, aged 44, 34, and 21 respectively, of gummatous basal menin¬
gitis, the symptoms of which developed eight to nine months after
the chancre in two cases, and in a little more than one month in
the third. The most striking clinical feature was the unilateral
peripheral paralysis of certain cranial nerves. The seventh nerve
was affected in all three, and in two the twelfth and eighth nerves
also. Psychical symptoms were present in all, depression was
marked, and led in two cases to suicidal attempts. Rapid im¬
provement followed treatment by salvarsan and grey oil, and
Wassermann’s reaction, which had at first been positive, became
negative two months after treatment in each case.
J. D. Rolleston.
THE WASSBRMANN REACTION IN DIABETES MELLITU8, WITH
(247) SPECIAL REFERENCE TO ITS RELATION TO ACIDOSIS.
John H. Richards, Journ. Amer. Med. Assoc., Yol. lx., No. 16,
April 12,1913.
In four cases of diabetes with marked acidosis, a positive Wasser-
mann reaction was found which was unaffected by antisyphilitic
treatment. In two cases of diabetes, in which the urine showed
no acetone bodies in one, and only a slight amount of acetone in
the other, the Wassermann reaction was negative, and in one
case of non-diabetic acetonuria, with the absence of diacetic acid
and of beta-oxybutyric acid, the reaction was also negative.
Syphilis was not an etiologic factor in any of the cases studied,
and thus a positive Wassermann reaction in diabetic acidosis is
not necessarily indicative of syphilis. A. Ninlan Bruce.
ANURIA—PERHAPS HYSTERIC. F. J. Shkahan, Journ. Amer. Med.
(248) Assoc., 1913, lx., p. 286.
A case of complete anuria in a man, aged 25, in whom the writer
says deception could be excluded. Cystoscopy and catheterisation
of the ureters showed that there was no obstruction. Headache,
vomiting, muscular twitching, and general anasarca developed.
After other treatment had failed, recovery followed the administra¬
tion of a powerful kidney stimulant. Reference is made to
Charcot’s case of a hysterical young woman in whom suppression
lasted eleven days, and to Bailey’s case in a girl of 11 years
who passed no urine for three days. J. D. Rolleston.
ABSTRACTS
287
ADIPOSIS DOLOROSA IN SCIATICA: A VARIETY LOCALISED
(249) EN THE AFFECTED LOWER LIMB. (Sur one vari6t4 d’adipose
dcralourease localised anx membree infdrienrs atteintes de
sciatdqne.) M. Favrb and A. Tournade, Lyon Medical ., Vol. 120,
No. 19, May 11,1913, p. 1005.
The authors have studied clinically the subcutaneous thickening
of the cellular tissue of the affected lower limb in sciatica, which
was described by Landouzy in 1875: it is easily demonstrated on
picking up the integuments between finger and thumb: it is not
constant, but occurs especially in inveterate cases: the limb may
be greatly enlarged by this local adiposis which is painful on
manipulation: nodular thickenings may be present. It is very
amenable to massage, directed specially to the nodules: the
cellular tissue also should be kneaded. The authors regard this
panniculitis as trophic, and due to the neuritis; in its turn it
compresses and irritates the sensory nerve-fibres, and so keeps up
the neuralgic pains. But the circumscribed panniculitis is not
always secondary. A case is quoted in which the cellulitis was
apparently primary: a young rheumatic girl showed a plaque of
tender induration in one buttock, that developed in the course
of a few days: it was accompanied by radiating pains in the
whole of the gluteal region: a year previously she had had a
similar attack which yielded to massage in a few days.
Leonard J. Kidd.
OLINIOAL AND PATHOLOGICAL-ANATOMICAL STUDIES ON
(250) THE QUESTION OF LABYRINTH SUPPURATION. W. Burk,
Ztschr. f. Ohrenheillc., Bd. lxvi.-lxvii., Nov. and Jan. 1912 and 1913,
pp. 267 and 1.
A very full description is given of the histological findings in
eight temporal bones showing suppurative labyrinthitis. The
conditions are illustrated by excellent drawings. The cases are
discussed in full The cause of labyrinthitis was in four cases
acute otitis media, in three chronic middle ear suppuration with
cholesteatoma, in one a primary tumour of the tympanic cavity.
In the acute cases the infection reached the labyrinth in one
through the macroscopically intact windows, in one by way of an
extradural abscess of the posterior fossa, in one by a defect in the
external canal, and in one by destruction of the ampullary limb of
the posterior canal, caused by an inflammatory process in the wall
of the jugular bulb. In the chronic cases, in two by defect in
the horizontal canal and irruption of fibrous tissue through the
windows, in one by opening of all canals and irruption of granula¬
tion tissue through the round window. In these cases fibrous
tissue and fresh suppuration were present together. In the
288
ABSTRACTS
tumour case the round window was destroyed. Sinus thrombosis
complicated four cases, extradural abscess three, cerebellar abscess
one. Meningitis caused death in seven cases, cerebellar abscess
in one (early meningitis was present). In four of the cases
meningitis spread from the labyrinth; in two along the sheath of
the cochlear nerve and the aqueduct of the cochlea; in two by the
aqueduct of the cochlea. A very full discussion of the question
of labyrinthitis follows, founded on 155 collected cases, in which
histological examination of the inner ear has been made. The
cases comprise the following: acute middle ear 34, scarlatina 14,
tuberculous 29, chronic middle ear 78. The discussion includes
the questions of suppurative labyrinthitis, serous labyrinthitis
(does it exist ?), circumscribed labyrinthitis, diagnosis, prognosis, and
treatment. Treatment consists in absolute rest in bed or the
labyrinth operation. If for any other reason an operation is
necessary, the labyrinth must be operated on at the same time.
An abstracted literature follows. R. VtfREL.
PELLAGRA with special Reference to Pathology of Gastrointestinal
(251) Tract. H. P. Mills, Joum, A trier. Med, Attoe., VoL lx., No. 12,
March 22, 1913, p. 889.
A brief report of four cases of pellagra with post-mortem findings,
with special reference to lesions of the digestive tract. All four
cases were females, and died at the ages of 57, 64, 40, and 59
respectively. The first case showed catarrhal inflammation of the
ileum, coecum, and ascending colon. The second showed catarrhal
inflammation of the lower quarter of the oesophagus and all the
stomach, with redness of the duodenum and inflammation of the
jejunum, ileum, and coecum. The descending colon, sigmoid, and
rectum were normal. The third showed catarrhal inflammation
of the entire tract from the stomach to the coecum, and the fourth
showed a similar condition from the duodenum to the hepatic
flexure. The nervous system was not examined in any of the
cases.
On the whole the changes found were those of a chronic
catarrhal inflammation, and would seem to coincide with the
theory that toxic products cause pellagra, whether taken with food
or of endogenous origin. A. Ninian Bruce.
PERIODICITY IN THE MALE. C. P. Oberndorf, Journ. Nerv. and
(252) Ment. Dts. t Yol. 40, No. 1, Jan. 1913, p. 37.
The case of a man, 28 years, whose physical development had
progressed normally up to the age of 13, when he noticed
that his left breast gradually began to increase in size, until it
ABSTRACTS 289
attained its present development, about the size of that of a
young girl.
At 18 he began to notice that his sexual desires were
active only once a month, and that at the same time the left
breast would become not only stiff and erect, but also extremely
sensitive and tender, a condition which usually persisted for
about four days.
On account of worry over his physical condition he merged
into a psychosis. D. K. Henderson.
PSYCHIATRY.
TWO NEW OASES OF SUPPURATIVE PAROTITIS IN GENERAL
(968) PARALYSIS. (Deux nouveaux cas de parotidite supports Chez
des paralytiques gdn&aux.) R. Horand, P. Pcullet, and L.
Mobil, Gai. des H6p ., 1912, lxxxv., p. 1953.
Case 1. Man, aged 50. Left parotitis. Incision without anaes¬
thesia. Death a week later, a fortnight after the onset of parotitis.
Case 2. Woman, aged 50. Right parotitis followed by death four
days later. No operation. Parotitis is rare in general paralysis.
It is more frequent on the right, possibly on account of the lateral
decubitus. It is a very grave sign. J. D. Rolleston.
THE DUCTLESS GLANDS IN DEMENTIA PRjEOOX. F. X.
(964) Dbbcum and A. G. Ellis, Journ. New. and Ment. Die., VoL 40,
No. 2, Feb. 1913.
The authors believe that dementia prfecox is in all probability
due to a toxin or toxins which call forth, by their action on the
cortical neurones, hallucinations and delusions. Acting on this
assumption they have investigated grossly and microscopically
several of the ductless glands in eight cases of dementia praecox. *
The clinical records are exceedingly meagre, all of the patients
suffered from extensive tuberculosis—which must invalidate the
results—and it is admitted that their results are difficult of
interpretation.
The thyroid, hypophysis, adrenals, parathyroids, and carotid
bodies were the glands investigated. D. K. Henderson.
RETARDATION AND CONSTITUTIONAL INFERIORITY. J. J.
(266) Thomas, Jown. New. and Ment. Dis. y Vol. 40, No. 1, Jan. 1913.
A statistical review is given of the number of backward children
in the Boston public schools during the years 1909, 1910, and
1911. The relationship of feeble-mindedness to crime is con-
290
REVIEWS
sidered, and various educative and remedial measures are suggested.
For slight grades of mental defect special classes in schools are
recommended which should be under medical supervision so as to
prevent such classes being filled by unimprovable imbeciles. It is
also recommended that medical men should be in association with
the courts so that the mentality of abnormal persons may be
investigated, and so that the needs of each individual case may
be accurately determined. D. K. Henderson.
IReviews.
CONTRIBUTION k L’flTUDE DB OERTAINES FAOULTfiS 0 £r£
(266) BRALBS M£C0NNT7ES. Dr W. C. db Sermyn. Paris: F61ix
Alcan, 1911. Pp. 612. Price 7 fr. 60.
This is in many ways a remarkable book. It is certainly a record
of a remarkable number of extraordinary cases, which have come
under the notice of one observer. The book is divided into three
parts: first, extraordinary cases observed by the author; second,
an analysis of the facts observed; and third, the philosophy which
emerges from this analysis. From the purely medical standpoint,
the first section is naturally the one of the greatest interest and
most deserving of attention. The simple recording of the facts of
such cases as these which partake of a mysterious and even
mystical nature is difficult enough, but when one finds 500 pages
devoted to theorising on these facts, one feels loth to follow the
author on to such dangerous and treacherous ground. The cases
themselves, however, are of the deepest interest. There are three
cases of predicted death, four of premonitory dreams, and a number
of miscellaneous ones. The case of Jean VitaliB is characteristic.
A robust, well-nourished man, 39 years of age, was suddenly
seized with an acute attack of rheumatic fever. The joints of the
shoulder, hands, and knees were swollen and very painful, but on
the morniDg of the sixteenth day his physician found to his
surprise that his patient was up, fully dressed, and appeared to be
perfectly well. He attributed his sudden recovery to a vision of
his father which he had had in the night; he had been informed
at the same time that he would die next evening at nine o’clock
precisely. The author examined the patient with the greatest
care, but could detect no abnormality in his physical condition.
Nevertheless, when the fatal hour arrived he called his family
around him, lay down upon a couch, and died in the presence of
the doctor as the clock struck nine. The other cases of predicted
death are equally striking. A certain explanation of these cases
REVIEWS
291
may be hazarded on a physical basis, but it is difficult or impossible
to do so in the cases of premonitory dreams, and still more so in
such a case as the following. The author was one day called in to
see a young woman dying from profuse uterine haemorrhage, due
to an abortion. It appeared that she had been seduced, and with
her dying breath she cursed her seducer, ending with the words,
“ let cancer devour him.” Four months later the author was called
in consultation to see a young man with a large cancer of the
upper lip. It was the seducer, on whom the curse had fallen. The
element of chance, so marked in such a case as this, can be elimin¬
ated from the cases of Mary B-and Giselle, which, however,
must be read in full. The discussion which follows these cases is
full in the extreme, but the main thesis which emerges is that
the powers possessed by the ordinary medium are normally present
in everyone, although in a lesser degree, that those who have these
powers developed are the ones who dominate the world, and that
mediumship is a mode of progression, an evolution towards a new
sense, the attainment of which is to be one of the great aims of
mankind. The cases described in the earlier part of this book
merit the closest study by those interested in a subject generally
regarded as lying almost beyond the pale of science, although we
may not be prepared to follow the author into all the tortuous by¬
ways whither he would lead us. W. Boyd.
DREAMS AND MYTHS: A STUDY IN RAOE PSYCHOLOGY. By
(267) Karl Abraham. Translated by William A. White. Nervous and
Mental Disease Monograph Series, No. 16. Pp. 74. $1.00.
Ten, or even five, years ago it would have been somewhat startling
to find a volume with this title being published in a neurological
series, and the occurrence may be taken as an indication of the
remarkable extension of the field of psychological medicine in this
time. Detailed studies of the phantasies that make up the
pathological manifestations of the neuroses and insanities have
shown that these bear the closest resemblance to other products of
the imagination that at first sight seem to be only very distantly
related to them. The first of these allied fields to be investigated
was that of dream life, our knowledge of which is now, thanks to
the researches of Freud, in an advanced stage. That of other
fields, such as the present one of mythology, is much less complete,
partly because the data are less easily controlled objectively so
that progress has to be particularly cautious. Abraham’s volume,
which appeared some four years ago, was one of the first publica¬
tions on the subject, i.e., of the application of psycho-analysis to
mythology, and since then much more extensive studies have been
published. Nevertheless it still serves as probably the best
?6
292
BOOKS AND PAMPHLETS RECEIVED
introduction to the problems, and also affords an excellent mode of
approach to the general Freudian views with their bearing on the
mental life of both the individual and the race.
White’s translation, though possibly a little too literal, is very
well done, and can be relied on to give the correct sense in an
unusually lucid style. The book should be of great value for the
purposes indicated above. Ernest Jones.
BOOKS Ain) PAMPHLETS RECEIVED.
Anton, G., and Bramann, F. G. v. “ Behandlnng der angeborenen and
erworbenen Gehirnkrankheiten mit Hilfe des Balkenstiches,” S. Karger,
Berlin, 1913. Pr. M. 9, geb. 10.60.
Brill, A. A. “ Psycbanalysis; its theories and practical application,”
W. B. Saunders Co., Philadelphia, 1913.
Edinger, Ludwig. “Zur Funktion des Kleinhirns” (Deut. Med.
Wchnschr., No. 14, 1913).
Flexner, Simon, Clark, Paul F., and Fraser, Francis R. “Epidemic
Poliomyelitis,” Fourteenth Note : “ Passive Human Carriage of the Virus
of Poliomyelitis” ( Joum . Amer. Med. Assoc., Vol. lx., No. 3, Jan. 18,1913).
Freud, Sigmund. “The Interpretation of Dreams” : Authorised trans¬
lation of third edition, with introduction by A A. Brill. Demy 8vo.
George Allen A Co. Ltd., London, 1913. Pr. 16a net.
Hitschmann, Eduard. “Freud’s Theories of the Neuroses” (Nervous
and Mental Disease Monograph Series, No. 17), New York, 1913. Pr. $2.00.
Hug-Hellmuth, H. von. “ Hus dem Seelenleben des Kindes. Eine psy-
choanalytische Studie,” ( Schriften zur angewandten Seelenkunde, H. xy.).
Frank Deuticke, Leipzig and Vienna, 1913. Pr. M. 6.
Kraepelin, Emil. “General Paresis” (Nervous and Mental Disease
Monograph Series, No. 14). New York, 1913. Pr. $3.00.
Lowy, Max. “Uber ‘ meteoristische Unrubebilder’ und ‘ Unruhe’ im
Allgemeinen” ( Prag. Med. Wchnschr., xxxvii., Nr. 24, 1912).
Intemat. Ztschr. f. Arztliche Psychoanalyse, J. i., H. 1, Januar 1913.
Hugo Heller A Cie, Leipzig and Vienna. (Herausgegeben von Prof. Dr
Sigm. Freud, Redigierd von Dr S. Ferenczi and Dr Otto Rank.)
Juristisch-psychiatrischc Grenzfragen, Bd. ix., H. 1, 1913. Carl
.Marhold, Halle a. 8., 1913. Pr. M. 1.20.
“ Uber die Zurechnungsfahigkeit.”
I. Engelen, O. “ Behandlung der sogenanniten vermindert Zurech-
nungsfahigen.”
II. Kahl Wilhelm. “ Der Stand der europaischen Gesetzgebung uber
verminderte Zurechnungsfahigkeit.”
III. Mezger, E. “ Die Klippe des Zurechnungsproblems.”
Schefold and Werner. “Der Aberglaube in Rechtsleben.”
Juristisch-psychiatrische Grenzfragen, Bd. viii., H. 8, 1912. Carl
Marhold, Halle a. S., 1912. Pr. M. 1.50.
Klinik f. psychische u. nervose Krankheiten, Bd. viii., H. 1,1913. Carl
Marhold, Halle a. S. Pr. M. 3.00.
The Training School, Vol. x., No. 2, April 1913.
IReview
ot
IReurolog^ anb f>8£cbiatr£
Original Hcttcles
MULTIPLE NEUROMATA OF THE CENTRAL
NERVOUS SYSTEM; THEIR STRUCTURE
AND HISTOGENESIS.
By tho Ia( 6 ALEXANDER BRUCE* M. D. * LL . D, * F. R.C. P. E.; And
JAMES W. DAWSON, M.D. (Carnegie Research Fellow).
(Continued from page 255.)
(2) The Histogenesis of Nerve Fibres in Regeneration.
It has long been recognised that the manner of regeneration
of any tissue follows very closely its first development, i.e., that
the first stage of each newly produced anatomical element is an
embryonal one, and this undergoes successive transformations.
We would thus expect to meet with the same diversity of views
regarding the origin of the new-formed fibres in regeneration of
a nerve after section as we found in regard to its embryogenesis.
The possibility of connective tissue cells, in virtue of some
mysteridus adaptation, taking over the role of embryonic nerve
cells, and forming new nerve fibres, is too improbable to be
discussed. We therefore pass at once to state the two main
opposing views:—
1. The classical teaching is that a budding of the axis-cylinder
takes place from the last preserved segment of the central end.
This corresponds to the central budding or outgrowth theory of
development, and has also been named the monogenist, or uni¬
cellular, or centralist view.
27
294 ALEXANDER BRUCE AND JAMES W. DAWSON
2. The newer teaching is that regeneration takes place by
means of the differentiation of new-born cells which have arisen
from the proliferation of the sheath of Schwann nuclei. This
corresponds to the cell-chain theory of development, and has also
been named the autogenist, or multicellular, or peripherist view.
We may here note that though complete agreement has not by
any means yet been reached, a certain accord, as we shall see later,
has been attained. Many centralists have yielded the ectodermic
origin of the sheath of Schwann cells, thus eliminating the most
serious objection that mesodermic element shared in the regenera¬
tion of nerve fibres; they have also allowed the constant presence
of cell-chains in regeneration, denying only the actual genesis of
the nerve fibres from them. The peripherists, on the other hand,
whose common standpoint is the conception of the peripheral
genesis of the nerve fibre, have nearly all conceded that the
ultimate differentiation comes only after the establishment of a
connection with the centre.
Waller, in 1851, communicated to the Academic de Science the
first facts regarding the secondary degeneration of peripheral
nerves after section, and the term “Wallerian degeneration”
is a permanent record of this historical fact. He also enunciated
the law of the dependence of the nerves for their nutrition on
trophic centres. Waller believed that the new nerve fibres in
regeneration are formed as outgrowths from the central end, and that
regeneration could occur only when the peripheral end was joined
to the central end. Phillipeaux and Vulpian, in 1863, showed
that a distal end separated from the centre could regenerate, and
also that a portion of a nerve transplanted under the skin of
another region contained nerve fibres after six months. They
believed that the axis-cylinder was not destroyed during
degeneration, and that regeneration consisted simply in a re¬
accumulation of the myelin. Neumann (1868) maintained that
during degeneration the axis-cylinder and the myelin of the nerve
fibre were only modified chemically, and that they fused into a
specific nucleated protoplasmic substance which retained in some
form the actual nervous elements.
Ranvier (1871) maintained, on the contrary, that the actual
nervous elements disappeared in toto. He definitely placed the theory
of budding from the central end on a firm basis by showing that
the new fibrils are formed by a longitudinal division of the axis-
NEUROMATA OF CENTRAL NERVOUS SYSTEM 595
cylinder of the preserved central end. These newly formed fibres
reach the distal segment and pass into the old preserved sheaths
of Schwann. For nearly twenty years this view was generally
accepted, and Vulpian himself, admitting that possibly branches
of nerves in the vicinity took part in the regeneration in the
distal end, withdrew from his former position.
In 1891 Von Biingner’s fundamental memoir marked a new
phase, for he demonstrated the practical significance of his
findings. Clinical observation, which had stimulated interest in
this line of research, seemed to indicate that the time required
for such a process as budding was not in accordance with clinical
experience. This was specially the case in secondary suture,
where the rapid return of sensation and the re-establishment
of conductivity seemed to indicate the re-union of the nerve.
Von Bungner, using aniline dyes, asserted that the nerve fibre
did not degenerate, but was simply transformed into a nucleated
protoplasmic band ( Axialbandfasern ), or into individualised fusi¬
form cells which arose from the mitotic division of the nucleus
of the sheath of Schwann. These spindle-shaped cells unite end
to end as in embryonal development, and again take the form
of protoplasmic bands. The proliferated and enlarged nuclei
group themselves in the direction of the fibres, and the homo¬
geneous protoplasm lying between them soon assume a fibrillar
striation—the commencing axis-cylinder formation. Von Bungner
has, therefore, modified and completed Neumann’s view, and his
work in turn has been completed by Durante, who has shown
that the so-called Wallerian degeneration is really the formation
of these Axialba ndfasem ot Von Bungner. To this process
Durante has given the name of “ cellular regression,” as it is due to
the abnormal activity of the nucleus and the undifferentiated pro¬
toplasm of the interannular segment, which, when the differentiated
substances have disappeared, take on a vegetative activity. , The
protoplasmic or plasmodial bands have thus arisen from the
mitotic division of the sheath of Schwann nucleus and the
augmentation of the protoplasm, while if each nucleus surrounds
itself with protoplasm and individualises, instead of a plasmodial
nucleated band we get the formation of fusiform cells.
During the ten years following Von Bungner's fundamental
work, a very marked tendency set in towards this new teaching,
and so much did the peripherist view seem destined to replace
296 ALEXANDER BRTJCE AND JAMES W. DAWSON
the outgrowth theory, that many writers did not hesitate to
speak of the death of the old view, and by implication the death
of the neurone doctrine. The writers whose names must be
mentioned during this decade are, with one or two exceptions,
peripheri8ts.
Stroebe (1893) strongly opposed Von Biingner’s views. By
a new axis-cylinder staining method he showed that the peripheral
end and the intervening scar-tissue were neurotised by young
fibres which passed from the old axis-cylinder. His contribution
to this subject, in addition to the introduction of the aniline blue
and safranine staining method, was his insistence on the completely
passive role played by the peripheral end as a conducting path
or scaffolding for the young fibres.
Galeotti and Levi (1895) studied the regeneration of nerves
in the newly formed tails of salamander. The tails were cut off in
sunny weather, and new tails grew in about fourteen days. These
cold-blooded animals were chosen because it was found that in
mammals the inflammatory reaction was so intense as to make
it impossible to distinguish between the young neuroblasts and
the cells which had arisen from the proliferation to Henle’s sheath,
the epi- and peri-neurium, or immigrated leucocytes. Galeotti
and Levi found among the newly-formed muscle fibres more
or less long chains of slender elongated cells, the chain usually
ending in a cluster of radiating similar cells. The cells of the
end cluster in their turn proliferate, elongate, and gradually
become arranged in a chain amongst new muscle fibres. In the
cytoplasm of each cell, by means of the gold chloride method,
a granular filament could be recognised, and as this increased
in amount the nucleus was pushed more and more to one side.
This differentiation could often be observed in different stages
in the same chain of cells. At first every element retains its
individuality, then the processes of each cell unite in an imbricating
manner and fuse to form nucleated bands which show a bulging
opposite the nucleus. The granular filaments of each original
cell unite when the cell borders disappear. The outer layer
becomes condensed and forms a definite membrane to the band—
the later sheath of Schwann. Specific myelin sheath stains were
not used, but its development could be followed by means of
aniline dyes which showed the double contour and constrictions
of the fibres.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 297
The authors were convinced that these fusiform elements, in
which the granular filaments form, arise from the proliferation
of the nucleus of the sheath of Schwann. In the salamander the
connective tissue cells could be easily distinguished from these
cells, and there were few connective tissue elements and immi¬
grating leucocytes between the developing muscle fibres. It is
important also to note that the regeneration of the nerve fibres
was later than that of the muscle fibres, so that the neuroblasts
could not be confounded with the developing myloblasts. The
authors finally refer to the remarkable analogy between nerve
fibre and muscle fibre regeneration; an analogy to be emphasised
by Durante and Lustig. Galeotti and Levi later traced the
development of muscle fibres and nerve fibres in the tail of newly
hatched lizards, and found that regeneration had proceeded along
lines exactly comparable to the stages in the first development.
Kennedy (1897-1904), in the microscopic examination of
portions of nerves removed previous to secondary suture, found in
both central and peripheral ends irregularly arranged groups of
nerve fibres. The fibres cut longitudinally showed a delicate axis-
cylinder in the centre, a granular deposit of myelin around it, a
homogeneous protoplasm zone around the myelin, and oval nuclei
arranged at intervals. The transversely cut fibres appeared as
clearly defined circles, each containing an axis-cylinder in the
centre and many with an attached nucleus. The arrangement
of the bundles was very irregular, and there were found trans¬
versely cut bundles with longitudinal and oblique fibres coursing
around them. The enormous number of spindle-shaped nuclei
amongst the nerve fibres indicated that these elements had arisen
by proliferation from the nucleus of the sheath of Schwann, and
Kennedy believes that these new nerve fibres in the peripheral
stump of a still-severed nerve—showing axis-cylinder and com¬
mencing myelination—could have arisen only from the nucleus
and protoplasm of the mterannular segment, which must therefore
be regarded as a neuroblast. Further steps to complete differen¬
tiation of the nerve fibre probably depend on a restoration of
continuity. A fibre may remain in this incompletely differentiated
stage for a very long time, and this resting-stage, as it were, affords
an explanation of the very rapid return of sensation after secondary
suture, for the nerve path is practically ready to transmit impulses,
and needs little further differentiation.
298 ALEXANDER BRUCE AND JAMES W. DAWSON
Ballance and Stewart (1901) have made a very thorough
histological investigation of the process of regeneration in nerves
after section, both with and without suturing of the proximal to
the distal segment, and also of the changes which occur in nerve
grafts. The experiments were carried out on monkeys, dogs, and
cats, and the histological methods used were very complete:—
Weigert’s medulated sheath stain, the Golgi and Stroebe methods
for axis-cylinders, and Van Gieson’s method for cellular and
protoplasmic structures. The neurilemma cells commenced to
proliferate on the second day after section; the resulting cells
preserved the longitudinal direction of the parent cell, and from
their opposite poles sent out fine protoplasmic processes. These
proliferated neurilemma cells play only a transient role in the
absorption of the fatty debris of the degenerated myelin, and the
chief part in phagocytosis is carried out by immigrated cells from
connective tissue and blood.
The proliferated neurilemma cells in both central and distal
ends take on an active neuroblastic function. They secrete short
lengths of ax is-cylinder which increase in length and diameter,
and the imbricating ends fuse together to form a continuous axis-
cylinder. Ballance and Stewart were able to assure themselves
that the neuroblasts, demonstrated by the Golgi method shooting
out beaded axis-cylinders from opposite poles, were identical with
the proliferated neurilemma cells, which, with Stroebe’s method,
showed the earliest stage of a new axis-cylinder as a deposition
along one side of the cell. The Stroebe method showed axis-
cylinder intensely blue against a pink background. The new
myelin sheath is also laid down by a process of secretion along one
side of a spindle-shaped neurilemma cell, probably being wrapped
round a pre-formed axis-cylinder. It grows in length, shows like
the axis-cylinder a beaded appearance, and ultimately anastomoses
with adjoining sheaths. The beaded appearance of the myelin
sheath is due to the presence of the nucleus of the cell in which
it is developed: as the sheath grows in size the nucleus becomes
less conspicuous, and finally can be found only in each internode.
Within a graft the neuroblasts are developed from the proliferation
of neurilemma cells of the proximal and distal segments. They
travel into the graft alongside the blood-vessels, for the embryonic
sheaths are found in greatest abundance in the immediate vicinity
of the vessels. The graft is therefore a scaffolding invaded by
NEUROMATA OF CENTRAL NERVOUS SYSTEM 299
neurilemma cells, predisposed to assume a longitudinal direction,
within which new axis-cylinders and myelin sheaths are secreted.
The difference between the changes which characterise regenera¬
tion in a re-united nerve, and in the distal segment of a non-united
nerve is one merely of degree and not of kind. Even in the latter
case regeneration of the axis-cylinders and the myelin sheaths
takes place, although full maturity of the nerve fibre is not
attained unless the distal segment be joined to the proximal, so
that their fibres may become functionally continuous. In both
axis-cylinder and myelin sheath the beaded stage is apparently the
limit of development in cases where functional conductivity is not
re-established.
Ballance and Stewart are convinced upholders of the view of the
multicellular structure of the peripheral nerve fibre and of the
neuroblastic function of the neurilemma cells. They believe that
the peripheral nervous system is to be considered as made up of a
chain of cells, and further, that the activity of one variety of cell,
and one variety only—the neurilemma cell—is responsible for the
regeneration of a peripheral nerve, not only for its axis-cylinder,
but also for its myelin and neurilemma sheaths.
Bethe (1901-1907) is at present the most prominent and
strenuous supporter of the peripherist theory, and his work since
the beginning of the century has formed the main point of attack
of the centralists. After a very complete series of experiments,
which has seemed to exclude every possible fallacy, he sets himself
to answer the following questions:—Can regeneration be purely
central ? Or purely peripheral ? Or does it rest upon a co¬
operation of both central and peripheral influences ? If this last,
how can the share of each be determined ? It is impossible to
give a complete review of his numerous articles, in which answers
to these questions are given with the most elaborate detail. We
endeavour to present only the main conclusions and hint at how
they were reached. (1) The ganglion cell of the anterior horn,
deprived of its axis-cylinder process, cannot form a new nerve
process if it is not in connection with a cell of the sheath of
Schwann. All experiments which seem to prove this had always
left a considerable part of nerve root with attached Schwann cells,
so that it was impossible to state how much was to be put down to
the central cell and how much to the Schwann cell. Bethe severed
the anterior nerve bundle just within the pia, thus leaving no sheath
300 ALEXANDER BRUCE AND JAMES W. DAWSON
of Schwann cells, and found that the ganglion cells never produced
a new axis-cylinder process. If any sheath of Schwann cells were
left, i.e.y if section was extra-medullary, Bethe found that small
neuromata developed in the pia, and that this production was more
marked the further from the cord section had taken place. There¬
fore the central end alone cannot produce a new axis-cylinder
process, and the production of the new nerve is in the first degree
the function of the Schwann cells. (2) In young animals nerve
fibres permanently severed from their trophic centre, e.g., by the
excision of 4-6 cm. of the nerve trunk, regenerate autogenously
and become capable of excitability and conductivity. Bethe en¬
closed the upper end of the distal segment of the cut nerve in a
capsule, and in several other ways avoided the possibility of a
connection of the peripheral with the central end. He therefore
concluded that in young animals the peripheral end could re¬
generate autogenously. In adult animals he admitted that
regeneration never went beyond the stage of protoplasmic bands,
Axialbandfasern, or embryonic fibres, unless union with the
central end was effected. He is convinced, however, that the
growth of the axis-cylinder and myelin sheath in these embryonic
fibres is definitely a cell differentiation and not an outgrowth from
the central end. Bethe’s searching criticism of the centralist’s
position must be very carefully considered by anyone taking up an
opposite opinion. It has seemed to us that none of those who
during the past ten years have sought to answer his objections
have sufficiently recognised the pains he has taken to fulfil the
very conditions they have themselves laid down as essential. We
can mention only one or two out of many points which Bethe
has emphasised. Cajal and Perroncito, as we shall see later, show
that Schwann cells form the outermost part of the bulbous end of
the young central axis-cylinder, and yet claim this fact as support¬
ing the outgrowth theory. Bethe explains this as a regeneration
proceeding from the proliferation of the last-preserved Schwann
cells nearest the point cut through. Again, the impossibility of
the functional reunion of motor and sensory fibres, also of pre¬
ganglionic and post-ganglionic fibres, proves that the remains of
the nerve fibres retain, after degeneration is accomplished, a
certain degree of their specific function. This is against the
indifferent character attributed by the centralists to the cells of
Schwann sheath.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 301
Fleming (1902) holds an opinion which he describes as midway
between that held by the central and peripheral theorists. In
numerous sections from the peripheral ends of divided nerves in
rabbits—“ nerves so divided that all regeneration from the central
end was prevented by every possible means ”—he found what he
believed to be a limited peripheral regeneration of axis-cylinders.
The neurilemma nuclei were proliferated and had formed chains,
and definite young axis-cylinders had appeared in connection with
these neurilemma nuclei which, in consequence, he looked upon
as neuroblasts. The immature axis-cylinders tended to join on
end to end with other axis-cylinders to form nerve fibres. Similar
changes were found in portions of the sciatic nerves of rabbits
divided, proxiinally and distally, by double sutures. These
appearances were not seen until twenty days had elapsed after
section or suture. These peripherally formed nerve fibres, or at
least axis-cylinders, do not become myelinated or capable of
functionating until they are joined on to the central segment—
in other words, to their central and trophic neurones.
Fleming also accepts central regeneration and has often seen
evidences of it, but he does not and cannot believe that central
regeneration alone can ever explain the phenomena of secondary
nerve suture. No explanation given by the centralists of those
undoubted cases in which conduction of nerve impulses followed
within a few days of secondary suture seems to him reasonable or
possible.
Langley and Anderson (1904) have objected to the conclusions
of Kennedy, Ballance and Stewart, and other autogenists, on the
ground that there iB no satisfactory evidence in their experiments
that the peripheral end of a nerve, remaining ununited with a
central end, had not united with the nerve fibres of the central
end of other nerves cut through at the operation. They carried
out a series of experiments to settle this point, and found that,
when the peripheral end of a cut nerve was sewn into the skin or
left lying amongst muscles, it made connection with the central
nervous system by means of the nerves of the surrounding cut
tissue, although it made no connection with its own central end.
They have demonstrated that ail the medullated nerve fibres which
reform in the peripheral end of a cut nerve degenerate when the
nerves which run to the surrounding tissue are cut, or when the
original nerve is again cut across on the central side of the
302 ALEXANDER BRUCE AND JAMES W. DAWSON
original point of section. They have further noted that the
number of medullated nerve fibres found in the peripheral end of a
cut nerve is very variable: a fact easily explained by the naturally
varying connection with the central nervous system, but not
explained by the autogenist view. It will be remembered that the
difficulty in proving the absence of central connection with
neighbouring nerves was the determining factor which ledVulpian
to give up his earlier position.
Langley and Anderson conclude from their experiments that
the peripheral ends of cut fibres exercise a cheraiotactic influence
on the central ends, and that this chemiotactic influence has
numerous gradations, e.g., it is greater between fibres of one class,
as it is well known that afferent fibres of one nerve can unite with
the afferent fibres of another, but they cannot unite with the
afferent fibres so as to produce any functional result. The evidence
is still insufficient to show whether nerve fibres giving rise to one
sensation can unite with the fibres giving rise to another sensation.
Mott, Halliburton, and Edmunds (1904-1906) have also
exposed what they consider the fallacy underlying the work of
Kennedy, Ballance and Stewart, and others. Their own experi¬
ments were carried out in such a way as to obviate the
possibility of new nerve fibres "finding their way by devious
channels” into the peripheral stump. The incisions were very
small, and the upper end of the distal segment of the cut nerve
was enclosed in a capsule of sterilised guttapercha. After 100-
150 days there was found no response of any kind to stimulation,
and the microscopic examination of the peripheral end showed
no trace of regeneration, and in many parts no nervous structure
could be recognised. Two of Vulpian’s experiments were repeated,
one in which the segments of nerve were transplanted to a part
devoid of nerves, e.g., the peritoneal cavity, and no autogenous
regeneration could be proved; the other was an experiment in
which the nerve was again cut across on the peripheral side of
the original site of section, and it was found that the degeneration
took place solely peripheral to the second section. As it was
assumed that the direction of regeneration is always the direction
of growth, this experiment proved that the growth of new fibres
had started from the centre peripheralwards, and not in the
reverse direction.
It is, however, admitted that the activity of the neurilemma
NEUROMATA OF CENTRAL NERVOUS SYSTEM 303
cells has some definite relation, perhaps nutritionally, to the
development of new nerve fibres; that the proliferation leads to
the formation of what seem embryonic fibres; but that this is
only the scaffolding for the axis-cylinder, which has an exclusively
central origin.
Kennedy has criticised the objections raised by these observers
and also by Langley and Anderson to his experiments and those
of Ballance and Stewart. He thinks that the possibility of fibres
from surrounding cut nerves growing into the distal end is a
far-fetched explanation, and that it assumes an extraordinary
affinity between young nerve fibres and the old nerve trunks—
an affinity which, If it existed, would assure spontaneous union
after accidental division. Kennedy also, referring to the doubt
that Mott, Halliburton, and Edmunds throw on the very early
return of sensation after secondary suture, explains the care with
which the clinical facts of the return to conductivity and sensory
impulses are ascertained.
- Head and Ham (1904) have shown that an ununited distal
end may remain in the “ resting stage ” (Kennedy) for 540 days
if the blood supply is sufficient. If even then united to the
central end, it is completely restored. Shortly after union the
spindle-shaped cells lengthen, form definite fibres, and are able
to conduct stimuli to the central nervous system—even before
axis-cylinder and myelin sheath can be demonstrated histologically.
The first axis-cylinders and myelin sheaths are well formed, yet
are thin and stain lightly, but later they stain deeply with specific
stains.
Head, Rivers, and Sherren (1905).—As this paper deals
chiefly with histological data, we can only briefly refer to the
important clinical investigations of Head, River's, and Sherren.
These observers state that the return of function and sensation
in man, after secondary suture, coincides closely with the data
obtained in animals for the re-appearance of new and fully-formed
fibres. They think that earlier observers, who had deduced from
a rapid return of sensation the presence of pre-formed fibres, had
been led into error by the vague nature of certain kinds of
sensation.
Barfurth (1905) has carried out a series of sections of the
sciatic nerve of the dog, and has come to conclusions almost
identical with those of Bethe. He criticises Langley and
304 ALEXANDER BRUCE AND JAMES W. DAWSON
Anderson’s acceptance of the presence of degeneration in the distal
end after a second excision in the central stump as a proof of
the ingrowth of fibres from the centre. He shows that this
occurred in Langley and Anderson’s experiments only after
119-737 days, and remarks that surely some central fibres could
in that time grow into the peripheral end. In his own experi¬
ments a second portion was excised 69 days after the first excision,
and no trace of degenerated fibres could be found in the peripheral
stump. His conclusions are that in favourable circumstances
a regeneration of nerve fibres can take place in a peripheral nerve
cut off from its central end, that this can go on to all the essential
constituents of the nerve (axis-cylinder, myelin sheath, and
neurilemma sheath), and that it takes place essentially by means
of the nucleus of the sheath of the Schwann cells. His closing
words are too interesting to omit quoting: “These nuclei can
therefore be no plebeian mesenchyme cells, but are neuroblastic
elements of aristocratic ectodermic nature.”
Lapinsky (1905) also supports the peripherist view. His
contribution to this question is twofold: firstly, he shows that
the regeneration in the central end is emphatically the same as
that in the peripheral end—a point not quite so clearly brought
out by previous writers; and secondly, he draws a marked
distinction between autochthonous regeneration and neurotisation.
In the former case the newly arising axis-cylinders remain un¬
connected with the centre, and microscopically they are very
thin, show no fibrillar differentiation, have no resisting power,
and soon degenerate; the myelin sheath also develops only in¬
completely and soon degenerates. In neurotisation the peripheral
end is connected with the centre; there is therefore complete
myelin sheath and axis-cylinder differentiation and complete
functioning power. “Obviously through this connection with
the anterior horn cells the sluices are opened to the special
stimuli which supply to the regenerated tissue its complete
structure.”
Raimann (1905) and Lugaro (1905) have used the most radical
methods to exclude the influence of the centre. Raimann, in
newly born dogs, removed the spinal cord from the 2nd lumbar
segment downwards together with the spinal ganglia as far as
possible. In the single dog surviving out of seven operated upon,
in the sciatic nerve on the right side, which, of course, had been
NEUROMATA OF CENTRAL NERVOUS SYSTEM 305
left untouched in its bed of tissue and in which, therefore, there
could be no ingrowth of fibres from the neighbouring tissue, he
found so large a number of fibres that they could not be explained
except by regeneration. He drew the conclusion that the cells
of Schwann’s sheath had produced a second nerve tube, which
however, he admits leads a transitory life. Lugaro, in adult dogs,
removed the whole lumbo-sacral cord and spinal ganglia, thus
including the nuclei of origin not only of the sciatic nerve but
also of the crural and obturator nerves, and three months later he
found no regeneration. The sheath of Schwann cells had arranged
themselves in protoplasmic bands, but these contained neither
axis-cylinder nor myelin. There were present fine axis-cylinders,
so numerous that they seemed to speak in favour of autogenous
regeneration, but Lugaro assumed that they were sympathetic
fibres. In one dog, therefore, he completely severed the central
end of the sciatic from its connections with the sympathetic
nerves, but he left the sympathetic attachments to the obturator
and crural nerves. By means of Cajal’s reduced silver method,
a hundred days after the operation, he was able to demonstrate
large numbers of axis-cylinders in the obturator and crural nerves,
but none in the sciatic nerve.
Modena (1905), Munzer and Fischer (1905), Von Krassin
(1906), and Besta (1906), must be mentioned amongst those whom
Bethe’8 results stimulated to an experimental endeavour to solve
this difficult question. Modena and Besta relate the development
of the new fibres to the Schwann cells, but insist on the necessity
of the central influence for their complete differentiation. The
others are centralists. Von Krassin used the intravital methylene-
blue method of Ehrlich, up till then scarcely applied in the study
of regeneration.
Marinesco (1905) performed section of the sciatic and crural
nerves both in newly-born and adult animals. He states that
reunion of cut ends is not essential to regeneration, and that this
can arise in both central and peripheral ends through the pro¬
liferation of the sheath of Schwann cells. The details are those
which we have seen in Von Biingner’s work: the formation of
fusiform cells and protoplasmic bands with at first fine, almost
invisible, lines within the cell protoplasm; later, thicker black
lines stained with Cajal’s silver method and the development of
the myelin sheath and sheath of Schwann. An illustration given
306 ALEXANDER BRUCE AND JAMES W. DAWSON
by Marinesco in this paper is a very striking proof of the spiral
formations having arisen within cells. Around an old axis-
cylinder of the central end coils spirally a thin fibre, and the
components of the spiral are within cells in the protoplasm of
which they have developed: the cells are arranged transversely
to the old fibre.
In the following year, however, Marinesco and Minea carried
out a new series of experiments which led Marinesco to change
his views on autogenous regeneration. Both authors look upon
the cells within which the axis-cylinders were thought to have
developed only as an advance guard to provide for the nutrition
and orientation of the new fibres. They attribute the young
fibres to outgrowths from the central end, the axis-cylinder of
which, by longitudinal dissociation, has formed fibrils, each of
which terminates in a cone de croissaiice. Collateral division
of the central end axis-cylinder may also take place, and such
collateral fibres tend to assume a spiral direction round the old
fibres. These authors part company from Cajal in attributing
no phagocytic rdle to the proliferated cells, which they term
cellules o,potrophiqucs. In a further series of experiments Marinesco
grafted small pieces of nerve into animals of the same and different
species. In the homo-transplanted series there was no new axis-
cylinder formation, as the apotrophic cells were present only in
small numbers, and in the hetero-transplanted series the grafts
were entirely removed by phagocytosis on the part of. polymorpho¬
nuclear cells—just as the blood corpuscles of one animal are
destroyed by the body fluids of an animal of another species.
Perroncito (1907) divided the sciatic nerve in. dogs, and
observed, by means of Cajal’s reduced silver method, the changes
which occur from the very earliest period onwards. He was the
first to show that the signs of regeneration described by Cajal
occur very early. Twenty-four hours after section Perroncito
found traces of collateral and terminal ramifications, and already,
in two days, newly-formed fibres which spring from the central
stump have reached the scar-tissue and show a very fine fibrillar
structure, with end thickenings and terminal balls. He has also
described a process of the unravelling of the thickened central
end a.\is-cylinder which precedes the development of the new
fibres, an appearance which Cajal has termed “ the phenomenon
of Perroncito.” Axis-cylinders may later grow out as compact
NEUROMATA OF CENTRAL NERVOUS SYSTEM 307
axis-cylinders, become dissociated into fibrils, and unite again
into a compact axis-cylinder. On the tenth day after section
the connection between the separated ends of a non-united nerve
is completed by newly-formed fibres, many of which show forkings
with terminal balls. Perroncito also draws attention to the
length of time that old axis-cylinders may be recognised in the
peripheral stump, and concludes that they are non-medullated or
Remak’s fibres.
Cajal (1904-1907).—It is impossible in a short review to do
justice to the work of Cajal, which has been the source of inspira¬
tion to so many. It is the less necessary to attempt this, as many
of his beautiful illustrations, showing stages in the regeneration
of the axis-cylinder, are reproduced in the more recent text-books,
and all are familiar with his terms —cone de croissance, massue dc
croissance, and boules terminates. As in the early development, so
in the genesis of the new fibres in regeneration the work of
Cajal was the first that seriously opposed the new teaching that
set in with Von Biingner’s researches and that seemed destined
to replace the outgrowth theory. This reaction in favour of the
outgrowth theory must be associated with the names of Cajal,
Perroncito, and Lugaro. It need therefore scarcely be added that
Cajal’s researches have demonstrated that the nerve fibres of the
scar-tissue and peripheral end are always formed by growth from
the central end. In the peripheral segment near the cut portion,
preceding the degeneration of the axis-cylinder, Cajal noted signs
of regeneration—indicating that the axis-cylinders do not die
immediately that they are cut off from their trophic centres, but
that during the short period of their survival they attempt
regeneration. By the eighth day all the axis-cylinders in the
peripheral segment have undergone a granular degeneration except
the fibres of Remak, which resist longer.
In the central end the axons commence to modify on the
first day, the first change being a terminal massue de croissance,
from which filaments proceed; other axons show a reticulated
or dissociated appearance. The filaments and the dissociated
fibrils increase in length and penetrate the exudate between the
cut ends, each filament and fibril having a terminal cone or ring.
Collateral intratubular regeneration may also occur, the short
collaterals being provided with buds or thin tangential collaterals,
more frequently with rings. The collateral fibres tend to form
308 ALEXANDER BRUCE AND JAMES W. DAWSON
spirals or groups round the old axon. Cajal has laid great stress
on the important fact that during these early stages of degenera¬
tion there has been no proliferation of cells within which the
young axis-cylinders could develop, but he adds that from the
third day onwards each terminal cone appears enclosed by a
few cells.
The passage of the new axis-cylinders across the scar-tissue
and into the old sheath of Schwann, is regulated by chemiotactic
substances elaborated by the proliferated cells of the sheath of
Schwann, which have been transformed into the Axialbandfasern
of Von Biingner. Cajal attributes three functions to the prolifer¬
ated nuclei: firstly, a phagocytic function; secondly, that of
secreting a chemiotactic or neurotrophic substance to attract the
young fibres from the central end and guide them into the
sheaths; and thirdly, the function of maintaining the nutrition
of the young fibres when they arrive. Cajal reproaches all who
are in favour of autogenous regeneration with having used methods
"unreliable or insufficient.” It is impossible to avoid noting
here that Lugaro, Perroncito, and Marinesco—on the strength of
whose observations, together with his own, Cajal claims that the
cell-chain conception has been definitely refuted—have all used
only impregnation methods.
Poscharisky (1907), who has used Cajal’s and Bielschowsky’s
silver methods, confirms many of Cajal’s observations, but has
oome to different conclusions regarding the significance of the early
phenomena observed in the two ends. While not denying the
possibility of growth from the central axon, he looks upon the
terminal cones, balls, and rings as signs of a dying condition of the
axis-cylinder. He believes that regeneration commences only on
the third day, i.e., after the proliferation of the cells of Schwann’s
6heath is in full activity. He thinks that silver impregnation
methods are not sufficient to lead to any definite conclusion,
whether the new axis-cylinders have arisen within these proli¬
ferated cells, or are outgrowths from the centre.
Margulies (1908) found, after permanently separating the
distal end of a cut nerve in the rabbit, that a new tissue arose
which agreed in many respects with certain embryonal stages of
development, i.e., the Axialbandfasern stage of Von Biingner. In
the young animal this neurogenous tissue led to a spontaneous
regeneration, but in the adult never advanced to completely
NEUROMATA OF CENTRAL NERVOUS SYSTEM 309
differentiated fibres. Margulies, taking his stand upon the fact of
the undisputed proliferation of the Schwann nuclei, and on the
generally accepted opinion of their ectodermal nature, concluded
that tinder all circumstances an autogenous regeneration takes
place even without the influence of the central ganglion cell. It
is incomplete, however, till the functional activity of its elements
is brought into play, and this can be only when it is anew related
to the centre. Even in young animals, where a complete regenera¬
tion takes place, the new-formed fibres do not remain long in this
complete condition, but tend to reassume the Axicdbandfasern stage.
Durck (1908), who has made a very exhaustive microscopic
investigation of the peripheral nerve in beri-beri, has found in
numerous cases a transformation of the nerve fibre into a nucleated
neuroplasmatic cylinder, i.e., a cellular regression to the Axialband-
fasem stage. Segments showing this have become functionally
incompetent, but are none the less specific neurogenous tissue.
This specific tissue, Durck was convinced, had arisen from the
proliferation of the sheath of Schwann cells, and he believes that
the changes in the nerves in such conditions as beri-beri form a
striking conformation of the multicellular structure of peripheral
nerves.
Alzheimer (1910) has studied regeneration in experimentally
produced lead neuritis of guinea-pigs and rice neuritis of fowls. In
such neuritis the axis-cylinders may remain preserved for a long
time after the myelin sheath has not only degenerated, but after
the degenerated products have been removed. When the axis-
cylinder itself has disappeared, there is found a Wallerian degenera¬
tion distally. Alzheimer studied the regeneration which occurred
at such a point of the interruption of the axis-cylinder, and found
numerous terminal divisions of the old axis-cylinder of the central
end, also numerous collateral branches, and that each new fibril
ended in a ring or club. These new fibrils grow preferably, but
not exclusively, within the intercellular plasmatic bridges of the
proliferated Schwann cells. Osmic acid preparations show that
these new fibrils rapidly assume a thin myelin sheath. He
believes that the sheath of Schwann cells are in the peripheral
nervous system the biological equivalents of the glia cells in the
central nervous system, and that they play, like glia cells also,
only a transient rdle in the phagocytosis of degenerated elements.
Throughout the works on regeneration, we have heard only
28
310 ALEXANDER BRUCE AND JAMES W. DAWSON
faint echoes of the intercellular bridge theory of development in
the discussion of the genesis of fibres in regeneration, but we
close this section with the work of Alzheimer—a supporter both
of the outgrowth and intercellular theories of development.
Note on the Regeneration of Fibres in the Central
Nervous System.
A complete anatomical and functional regeneration of fibres
has been proved for the peripheral nervous system. Similar proof
is wanting for the fibres of the central nervous system, but there is
evidence both from experimental work and pathological conditions
that there is a considerable effort at regeneration. In this
attempt at regeneration a specially important r6le seems to be
taken by the blood-vessels, which act as a conducting path for the
new fibres.
Nageotte (1899-1906) has described a special type of regenera¬
tion in tabes, which he has designated “ collateral regeneration.”
According to Nageotte, the initial lesion in tabes is a transverse
neuritis of both anterior and posterior roots, starting from the
point where the nerves pass through the dura mater. In the
anterior roots, in addition to the secondary descending degenera¬
tion, there is a retrograde degeneration extending to a greater
or lesser extent towards the cord, and from the point where this
may be arrested there is an attempt at regeneration. If the old
sheaths are uninjured the new fibrils grow out into the old
sheath, each leash of new fibrils representing a destroyed nerve
tube. If the degeneration is arrested just within the pia, and if
the old sheath is injured, the new fibres grow into the pial spaces,
forming neuroma nodules. The posterior root shows a similar
regeneration, but here the fibres are not myelinated. The Weigert
stain shows only a few fibres, while Cajal’s silver method reveals
numerous fine fibrils reaching up to the cord. Nageotte finds it
difficult to explain why the posterior fibres of regeneration are
without myelin. He states that the new-formed fibres may start
from three points: the cell-body, the intra-capsular, and the extra-
capsular portions of the axon. The fibres are not terminal, but
are actual new processes of the cell or collaterals of the preserved
portion of the axon. The term “ collateral regeneration ” in tabes
is thus used. Many of the new fibres even those within the
NEUROMATA OF CENTRAL NERVOUS SYSTEM 311
capsule, may show cSnes and massues de croissance. Similar
appearances are found under normal conditions in the posterior
root ganglia: in tabes and other pathological conditions there is
only an exaggeration of the normal. Nageotte has also carried
out a series of transplantations of the spinal ganglia to the
peritoneal cavity and other parts of the body, and has found that
the change of nutrition has caused the new protoplasmic processes
to change in type, e.g., to take on the aspect of the sympathetic.
Under these abnormal conditions, the peri-cellular and peri-
glomerular arborisations were also reproduced.
Nageotte states that the regeneration in tabes cannot re¬
establish function, as the terminal masMies and cdnes are arrested
at the area of inflammation where the first fibres were destroyed.
Fickler (1900) examined two cases of compression of the cord
at the lower dorsal region, in both of which there had been a
great amelioration of the cord symptoms for some time before
death. He found above the compressed part numbers of fine
axis-cylinders, especially in the adventitia of the small vessels
of the cord. These appeared first in the vessels at the periphery
of the grey matter in the corner where the anterior and posterior
horns meet. At a slightly lower level the fibres passed in the
vessel walls to the commissural vessels and thence to the vessels
in the anterior fissure. Just above the point of greatest com¬
pression the fibres filled the anterior fissure and overflowed into
the adjoining pia. Opposite the compressed part there were no
fibres at all within the cord—all had passed into the anterior
fissure and pia. Below the area of compression the fibres, collected
into small groups, passed again from the vessels of the anterior
fissure to the commissural vessels and were distributed in the
grey matter. On their whole course they were surrounded by
a sheath of Schwann. Fickler states that these are new-formed
offshoots of the fibres of the crossed pyramidal tract above the
lesion, which in this way have restored connection between the
fibres above and the ganglion cells below the level of compression.
In the second case there were present nerve fibres in the posterior
septum, which were looked upon as new-formed sensory fibres.
Fickler concluded that the nerve fibres of the cord are capable
of regeneration, even to the complete restoration of function, as
long as the blood-vessel apparatus of the cord is intact. The
fibres had arisen by the axis-cylinder breaking up into its
312 ALEXANDER BRUCE AND JAMES W. DAWSON
primitive fibrils; one axis-cylinder could therefore become con¬
nected with several ganglion cells below the point of compression.
In a recent paper Fickler considers that the new-formed fibres
were derived, not from the pyramidal tract above the lesion, but
from the ganglion cells of the grey matter and of the spinal
ganglia. The appearance of the sheath of Schwann, as soon as
the fibres enter the vessels, argues in favour of the mesodermic
nature of the sheath of Schwann. Bikeles (1904), in a case of
rupture of the cord, where the patient survived ten months after
the injury, found a certain amount of regeneration. Continuous
with the regenerated fibres of the proximal portion of the
posterior root, there were present very delicate irregular fibres
in the posterior columns, though no other nerve fibres were
present. Clark (1906), after section of the cord, noted that
regeneration is limited solely to fibres of peripheral character.
He thinks, therefore, that the cells of the sheath of Schwann are
necessary to regeneration.
Bielschowsky (1906-1909) has made a very careful examina¬
tion, by the aid of his new silver method, of the axis-cylinder
formations found within tumour nodules in the brain and cord,
and in the zones bordering areas of compression in the cord.
His investigations have confirmed him in the conviction of the
capability of regeneration of the central nerve fibres. The
numerous fine fibres ending with rings or button-shaped swellings,
and the fact that similar fibres were found in the vessel walls,
especially of the marginal zones—could, he thought, be nothing
else than a new formation of fibres. In the white matter of the
cord the new fibres were present in a direction corresponding to
the fibre systems of the cord displaced by the tumour, and had
arisen from the dissociation of old nerve fibres persisting within
the tumour mass and of fibres of tracts interrupted by the tumour.
In a case where the posterior nerve roots were penetrated by
cancer cells, and Weigert’s medullated sheath stain showed empty
nerve tubes, Bielschowsky found in the transition zone between
healthy and diseased parts very fine fibrils with exactly similar
appearances growing from the stump of the interrupted fibres.
The collateral regeneration of Nageotte, found in tabes, must be
related to the influence of the ganglion cell, though it is admitted
that the capsule cells and the cells of Schwann's sheath take
their share in the formation of the new fibres. Bielschowsky,
NEUROMATA OF CENTRAL NERVOUS SYSTEM 313
in opposition to Nageotte, holds that it has not been proved that
the fibrils represent the most essential constituent, but thinks
rather that they must be looked upon as supporting axes for the
conducting neuroplasm.
Bielschowsky concludes that for the regeneration of the fibres
in the central nervous system two factors are essential; the one,
sufficient vascularisation; the other, the presence of special
decomposition cells. Such cells may possibly exert a chemiotactic
influence, but more likely, by means of their syncytial connections,
exercise a plastic function as pre-formed cell bridges. They have,
therefore, the same significance as the proliferated sheath of
Schwann cells in the regeneration of peripheral nerves. Biels¬
chowsky thus declares himself to be a supporter both of the
outgrowth and intercellular bridge theories of development.
Marinesco and Minea (1906-1909) have looked for evidence of
regeneration of central nerve fibres in cases of experimental section
of the cord in dogs and in compression of the cord in man. They
believe that a certain amount of restoration may take place
through the formation of new fibrils, but that this can rarely go
on to functional restoration, as the re-establishment of the inter¬
neuronal connections of the new fibres would be almost impossible.
Both in experimental and pathological conditions fibres of new
formation can pass into the cicatrix from both upper and lower
ends. The new fibres are of fine calibre, show moniliform swell¬
ings, and end in cSnes and massues. They are derived, as in
peripheral nerves, from the dissociation of the preserved axis-
cylinder with successive ramifications: collateral branches may
also be given off', and these divide and ramify. The vessels,
especially at the periphery of the cord, are surrounded almost
with a plexus of new fibres.
Marinesco and Minea attribute an important rOle to the
presence of the celltdes apotrophiques which are found in the tissue
between the interrupted fibres. These are fusiform cells which
frequently form protoplasmic bands as in the peripheral nerves.
They have chemiotactic and nutritive properties in relation to the
new fibres which may be found even within the protoplasm of the
cells. Cajal has stated that in hemisection of the cord in cats the
new fibres atrophy in consequence of the absence of cells capable
of secreting a chemiotactic substance. Marinesco has also described
the neurotisation of areas of cerebral softening, tubercular and
314 ALEXANDER BRUCE AND JAMES W. DAWSON
syphilitic nodules, and gliomas by means of bundles of fine fibres
which form a reticulum around the lattice and tumour cells or
within the vessel sheath. Here again there can be no functional
restoration, and there is no intimate relation between the new
fibres and the actual elements of new formation to register a
symbiosis.
Miyake (1908), using Cajal’s silver methods, compares the
changes of the axis-cylinder in pathological processes and in experi¬
mental sections of the cord. He found at the margin of cerebral
tumours vacuolation and terminal varicose swellings of the axis-
cylinders. Such swellings often showed the dissociated fibrils
ending in rings and buds. In a sarcoma of the dura, which had
no association with the brain, similar appearances were found in
the vessels. To determine whether the above changes were de¬
generative or regenerative Miyake carried out a series of experi¬
mental sections of the cord in rabbits. In the necrosed zone and
the zone of reaction the axis-cylinders showed terminal swellings
aud vacuolation, but adjoining the healthy zone there was a dis¬
sociation of the axis-cylinder into fibrils with terminal cones—
probably regenerative. The author has come to the conclusion
that only terminal buds and rings following a fine axis-cylinder
can be looked upon as signs of regeneration, and that even these
must be accepted with great caution, as they were found in the
dural sarcoma.
Rossi (1909) found, in aseptic hemisection of the cord in young
rabbits and dogs, that there was a very manifest production of
new fibres which pass the zone of degeneration of both stumps,
reach the cicatricial zone, and are there arrested by the prolifera¬
tion of the supporting elements. After intra-cranial section of
the optic nerve the fibres in connection with the central (retinal)
cells show during the first month considerable regenerative
activity. Rossi holds that fibres separated from their central cells
could not regenerate spontaneously.
Perrero (1909) considers that the question of the regeneration
of the fibres of the central nervous system may be counted as
solved, thanks to the methods of Cajal and Bielschowsky. By
means of these methods it is possible to avoid the fallacy which
underlay previous observations of those who used methods which
stain axis-cylinder and glia-fibres alike. Perrero examined the
cord from a man who died with symptoms of complete transverse
NEUROMATA OF CENTRAL NERVOUS SYSTEM 315
lesion 29 days after fracture of the 5th and 6th cervical vertebrae.
Immediately above and below the completely softened segments
of the cord, corresponding to the injured vertebrae, numerous
formations were found which were regarded by the author as
undoubted phenomena of regeneration, e.g., divisions of fibres,
cones, rings, and balls. From some of the terminal balls fine
black threads could be traced; other axis-cylinders were found
dissociated into fibrils which frequently formed a plexus formation
around the vessels. These appearances were noted especially in
relation to the pyramidal fibres of the cord above the lesion and to
the posterior columns and posterior roots immediately below the
lesion. The regeneration was not sufficient to pass through the
zone of softening.
(To be concluded.)
LITERATURE.
(2) Genesis in Regeneration.
Alzheimer. 44 Uber die Degeneration u. Regeneration an der peripheren Nerven-
faser,” Neurol. CerUralbl ., Bd. xxix., 1910, p. 715.
Ballanoe and Stewart, 44 The Healing of Nervee,” London, 1901.
Barfnrth. 44 Die Regeneration peripherer Nerven,” Anal. Anzeiger , Erg. Heft,
Bd. xxvii., 1905, p. 100.
# Besta. 44 Sopra la degener&zione e regenerazione delle fibre nervose periferiche,”
Riv. Sperim. di Frenalria , T. xxxii., 1906, p. 99; Neurol. CerUralbl ., Bd. xxv.,
1906, p. 813.
Bethe. 44 Neue Versuche fiber die Regeneration der Nervenfasern,” Archiv fur
die Physiol ., Bd. cxvi., 1907, p. 385.
BielschowBky—
1. #44 Uber der Bau der Spinalganglion unter normalen und pathol. Verhalt-
nissen. Ein Beitrag zor Kenntniss der Regeneration vorgange an
Ganglionzellen und Nerven,” Joum. f. Psychol, u. Neurol ., Bd. xi.,
1908, p. 188.
2. * 44 Uber Regenerationsersoheinungen an centralen Nervenfasern,” ibid.,
Bd. xiv., 1909, p. 131.
Cajal—
1. 4 4 Lea metamorphoses pr6coces des neurofibrilles dans la regeneration et la
degeneration des nerfs,” Travaux du Laboratoire de Recherches Biolo -
giqtuA, Madrid, T. v., 1907, p. 47.
2. "Nouvelles observations sur revolution des Neurobla8tes, , * ibid., T. v.,
1907, p. 169.
3. 44 Die Histogenetischen Beweise der Neuronentheorie von His und Forel,”
Anal. Anzeiger, Bd. xxx., 1907, p. 113.
Durck. 44 Untersuchungen fiber die path. Anat. der Beri-beri,” Beitr. z. path.
Anat. u. z. ally. Path., SuppL, Bd. viii., 1908, p. 1.
316 ALEXANDER BRUCE AND JAMES W. DAWSON
Fickler—
1. “Studien zur Path, und path. Anat. des Ruckenmarkoompression bei
Wirbelcaries,” Dtut. Zeit. fur Nervenheilk., Bd. xvi., 1909, p. 1.
2. “Recherches exp^rimentelles sur Fanatomic de la D4g4n6ration trau-
matique et la R4g6n6ration de la moelle 6pinifere,” ibid., Bd. xxix.,
1905, p. 1.
Fleming. “ The Peripheral Theory of Nerve Regeneration, with special reference
to Peripheral Neuritis,” The Scottish Med. and Surg. Journal , Vol. xi., 1902,
p. 193.
Galeotti and Levi. 44 Ueber die Neubildung der nervosen Elements in dem
wiederzeugten muskelgewebe,” Beitr. z. path. Anat. u. z. allg. Path., Bd.
xvii., 1895, p. 369.
Head and Ham. “ The Process of Regeneration in an Afferent Nerve,” Joum. of
Physiol., VoL xxxii., 1904-5, p. 9 (Proc.).
Head, Rivers, and Sherren. “ The Afferent Nervous System from a New Aspect,”
Brain , 1905, Vol. xxviii., p. 99.
Kennedy—
1. 44 Regeneration of Peripheral Nerves,” Trans. Boyal Soc. Land., 1897,
B. 188, p. 257.
2. 44 On the Histological Changes occurring in Ununited Divided Nerves,”
British Medical Journal , 1904 (2), p. 729.
von Krassin. 44 Zur Frage der Regeneration der periph. Nerven,” Anat. Anzeiger,
Bd. xxviii., 1906, p. 449.
Langley and Anderson. 44 On Autogenetio Regeneration in the Nerves of Limbs,”
Joum. of Physiol., Vol. xxxL, 1904, p. 418.
Lapinsky. “ Uber Degeneration u. Regeneration peripherischer Nerven,”
Virchow's Archiv , Bd. clxxxi., 1905, p. 452.
Lugaro—
1. 44 Zur Frage der autog. Regeneration der Nervenfasern,” Neurol. Centralbl.,
Bd. xxiv., 1905, p. 1143.
2. 44 Wei teres zur Frage der autog. Regeneration der Nervenfasern,” Neurol.
Centralbl ., Bd. xxv., 1906, p. 786.
Margulies. “Zur Frage der Regeneration in einem dauernd von seinem Zentrum
abgetrennten peripherischen Nervenstumpf,” Virchow's Archiv, Bd. 191,
1908, p. 94.
Marinesco. “Recherches sur la R6g£n£rescence autogene,” Revue Neurol.,
T. xiii., 1905, p. 1125.
Marinesco and Minea—
1. “Recherches sur la r£g6n6rescence des nerfs peripheriques,” Remit Neurol.,
T. xiv., 1906, p. 301.
2. 41 Recherches sur la r£g6n6rescence de la Moelle,” Nouvelle Icon, de la
Salptiritre, T. xix., 1906, p. 417.
Miyake. “Zur Frage der Regeneration der Nervenfasern im Zentralen Nerven-
system,” Arb . a. d. Wiener Neurol. Inst., Bd. xiv., 1908, p. 1.
Modena. “Die Degeneration u. Regen. des periph. Nerven nach Lesion
desselben,” Arb. a. d. Wiener Neurol. Inst., Bd. xii., 1905.
Mott, Halliburton, and Edmunds. * 4 Regeneration of Nerves,” Joum. of Physiol.,
Vol. xxxi., 1904, p. vii. (Proc.); Proc. Roy. Soc. Lond., Vol. lxxvii., 1906,
p. 259.
ABSTKACTS
317
Munzer and Fischer. “ Giebt es eine autogene Regeneration der Nervenfasem ?”
Neurol. Ceniralbl., Bd. xxiv., 1905, p. 1013.
NageotteA “ R6g6n6ration collateral© des fibres nerveuses terminfes par les
ma8sues de croissance,” Nouv. Icon, dt la SalpHrikre, T. xix., 1906, p. 217.
Perrero. “ Contribution k l’etude de la r6g£n6ration des fibres nerveuses du
systems nerveux central de l’homme,” Arch. Ital. de Biol., T. liii., 1910, p. 21.
Perroncito. “Die Regeneration der Nerven,” Beitr. z. path. Anal. u. z. allg.
Path., Bd. xlii., 1907, p. 354.
Poscharisky. “ (Jber die histol. Vorgange an den peripherisohen Nerven nach
Kontinuitatstrennung,” Beitr. z. path. Anal. u. z. allg. Path., Bd. xli.,
1907, p. 52.
Raimann. “Zur Frage der autog. Regeneration der Nervenfasem,” Neurol.
Ceniralbl., Bd. xxv. f p. 263.
Rossi. “Processus r6g£n6ratifs et d6g6ne'ratifs oonsecutifs k des blessures
aseptiques du systfeme nerveux central,” Arch. Ital. de Biol., T. ii., 1909,
p. 413.
Stroebe. “ Expeditiontelle Untersuohungen fiber Degeneration und Regenera¬
tion peripherer Nerven nach Verletzungen,” Beit. z. path. Anal. u. z. allg.
Path., Bd. xiii., 1893, p. 160.
abstracts
ANATOMY.
THE CENTRAL FISSURE OF THE CEREBRUM. J. Symington and
(258) P. T. Crymble, Joum. Anat. and Physiol., Vol. xlvii., April 1913,
p. 321.
Symington and Crymble, from an examination of almost 150
human brains, propose a new description of the surface form of
the central or Eolandic fissure. They have relinquished the term
genu as there are five genua in the typical fissure, and the term
has been frequently used in a vague and indefinite manner.
The curves of the fissure are due to the formation of two
buttresses on the anterior wall, a medial or upper buttress (Bj),
and a lateral or lower buttress (B 2 ). Between Bj and the longi¬
tudinal fissure, the central fissure is directed backwards and
inwards, while below B 2 is a vertical terminal portion, measuring
1 to 2 cms. in length.
These buttresses are often well marked in foetal brains, and
have been observed as early as the sixth or seventh month. Nine¬
teen out of twenty-three children’s hemispheres exhibited them.
318
ABSTRACTS
In connection with the lateral half of there is an elevation
of the fissure floor, the ascent to the highest point of the elevation
being much steeper when approached from the lateral aspect. Its
lateral limit is, therefore, more easily defined than its medial limit.
The histological researches of Campbell have shown that the
precentral gyrus at this elevation contains the centres for the
trunk muscles. When one applies our knowledge of motor
localisation to this typical central fissure, the following results are
obtained.
1. Bj is a leg-trunk buttress, the medial end of the floor eleva¬
tion defining the leg-trunk junction, and the lateral end defining
the arm-trunk junction.
2. B 2 is a pure arm buttress, its junction with the head and
neck being marked by the sharp bend of the fissure at the upper
end of the vertical terminal piece.
3. The terminal vertical piece, 1 to 2 cms. long, limits pos¬
teriorly the head and neck region.
The most common distance of the various junctions from the
median end, measured directly, are:—
Leg-trunk junction
- 3 to
4 cms.
Trunk-arm junction
- 4 „
5 „
Arm-face junction
- 7 „
8 „
Total fissure ...
- 8 „
10 „
Authors’
Abstract.
THE POSTERIOR LONGITUDINAL BUNDLE: AN ANATOMICAL
(259) STUDY. (Etude anatomique du f&isceau longitudinal postdrieur.)
A van der Schueren, Lt Nivraxe, Yol. 13, F. 2, 3, April 1,1913,
pp. 183-309.
The experimental part of this comprehensive research was per¬
formed on rabbits, kept for from five to fifty days: certain points
were verified on cats. The methods used were chiefly (1) that of
combined degenerations—chromolysis and direct Wallerian—and
(2) van Gehuchten’s indirect Wallerian degeneration method. As
many as eighteen separate experimental sections at various levels
were performed. The histological methods used were those of
Nissl, Pal, and Cajal. The author divides the fibres of the P.L.B.
into two groups, ( a ) those of non-vestibular origin, ( b ) those of
vestibular. His conclusions are here given:—
A. Non-Vestibular Fibres of Posterior Longitudinal Bu ndle.
1. Fibi'ts rising in Mesencephalic Bcticular Cells. —In the
proximal part of the mesencephalon the P.L.B. receives a strong
ABSTRACTS
319
contingent of descending fibres, generally direct, which rise in
scattered cells, not grouped in definite nuclei, and are distributed
at various levels of brain and cord: the largest of these cells send
their axons to the sacral cord, the smaller cells to various levels of
the brain-stem: the larger cells are generally homolateral, the
smaller both homo- and heterolateral.
2. Fibres rising in Peri-AqueductaL Cells .—The P.L.B. receives
both the crossed and direct fibres of some of the cells of Kohn-
stamm’s intra-trigeminal nucleus, and the direct fibres of the
ventral cells of Kohnstamm’s intra-commissural nucleus. (The
dorsal cells of the latter nucleus send their axons into the
posterior commissure. The author concludes that Kohnstamm’s
intra-trigeminal nucleus gives origin to two systems of descending
fibres: (a) direct fibres which form Probst’s bundle, (b) both
crossed and direct fibres which enter the P.L.B. and the predorsal
bundle. He failed to get any chromolysis in the intra-trigeminal
cell-group after section of the upper cervical cord (Kohnstamm’s),
and he also failed to trace Probst's bundle into the dorsal vagus
nucleus: apparently it ends just anterior to it).
3. Fibres rising in Bulbo-Pontine Reticular Cells .—Scattered
cells from the pyramidal decussation to above the posterior
corpora quadrigemina give origin to fibres which descend in the
anterior column of the spinal cord: they are the ventral reticulo¬
spinal fibres. For purposes of description the author divides these
cell-groups into (1) Cajal’s superior magno-cellular nucleus, (2) his
inferior ditto. The P.L.B. in the rabbit receives the direct fibres
of a cell-group which corresponds topographically with the
superior magno-cellular nucleus described by Cajal for birds: this
nucleus contains giant cells, but also (in rabbit) some small cells
whose axons probably end in the brain-stem. The P.L.B. also
receives fibres, both direct and crossed, from reticular cell-groups
analogous with Cajal’s inferior magno-cellular nucleus: the crossed
fibres rise mostly in cells situated distally of the facial nerve: the
direct fibres come from the proximal cells. (The P.L.B. does not,
in the rabbit, receive any fibres from the nucleus of the raphe.)
The longer descending fibres from the superior magno-cellular
nucleus connect it with various levels of the neuraxis, and reach
as far as the sacral cord: the shorter fibres, rising in its smaller
cells, end in the brain-stem.
B. Vestibular Fibres of the Posterior Longitudinal Bundle.
1. The Nucleus of the Descending Vestibular Root sends both
direct and crossed descending fibres into the P.L.B. To judge by
Marchi’s method, these fibres are not connected with the hypo¬
glossal nerve (< contra Keller, Probst, Edinger, Winkler, &c.); and
320
ABSTRACTS
they do not go beyond the thoracic spinal cord (6 Th.); this
agrees with Fraser, Russell. This nucleus also sends ascending
fibres into the P.L.B., mainly crossed: most of these are intimately
connected with the oculomotor and trochlearis nuclei: others
terminate towards the distal end of the diencephalon in the
neighbourhood of Meynert’s bundle.
2. The Triangular ( Dorsal ) Vestibular Nucleus .—From its large
cells come (a) descending fibres, chiefly direct, mainly from its
ventral cells, which reach the P.L.B. via the internal arciform
fibres, and (6) ascending fibres, mainly crossed: these rise in both
the dorsal and the ventral parts of the nucleus. (The triangular
nucleus also sends some fibres into the vestibulo-spinal tract.)
3. The Nucleus of Dexters, Sensit Strictiori. —By this term the
author means the large cells of the internal segment of the inferior
cerebellar peduncle: this nucleus sends a few descending fibres
into the P.L.B., both direct and crossed (Kohnstamm denies
crossed); it also gives origin, at any rate largely, to the direct
vestibulo-spinal tract which does not enter the P.llB.
4. The Angular Nucleus of Bechterew sends into the P.L.B. only
ascending fibres, apparently mainly direct. (This reservation is
explained on p. 299.) It also gives origin to van Gehuchtens
Vestibulo-Mesencephalic bundle which occupies the lateral part of
the P.L.B. (The author thus describes two ascending tracts of
vestibular origin: (1) a compact, median, heterolateral one from
the triangular and the descending vestibular nuclei, and (2) a
scattered, lateral, homolateral one from Bechterew’s nucleus, viz.,
the vestibulo-mesencephalic tract of van Gehuchten.) The author
could not exclude the existence of some crossed fibres which may
possibly come from Bechterew’s nucleus, but he did prove that no
descending fibres rise in it.
The following are some of the most important facts (many
being quite new) established by the author: 1. The rabbit’s P.L.B.
shows a compact, dorso-median portion, and a scattered, lateral one:
but anatomically these two portions have analogous connections.
2. The crossed ascending and descending fibres of the P.L.B. cross
at the level of their cells of origin: there is no crossing of bundles
in mass anywhere. 3. There are some direct fibres which cross
the median line just before their termination, especially certain
fibres of van Gehuchten’s vestibulo-mesencephalic bundle: some of
these fibres, arrived at the level of the third nucleus, cross to
terminate in the opposite third nucleus (as van Gehuchten main¬
tains). 4. There is no commissure in the P.L.B. 5. The posterior
commissure—contrary to the opinion of many authors—is not
formed by fibres which belong to the P.L.B. 6. Certain fibres of
the posterior commissure rise in Kohnstamm’s intra-commissural
nucleus, but do not descend in the P.L.B. properly so-called; after
ABSTRACTS
321
section of the posterior commissure a small fine bundle degenerates
on each side, lateral and dorsal of the P.L.B.: its origin was not
established: it is different from the tegmental bundle of
v. Gudden. 7. Experiments by the combined chromolysis and
direct Wallerian methods show that in the rabbit no fibres, rising
in the 6th nucleus, pass by the P.L.B. into the root of the contra¬
lateral 3rd nerve (contra Duval and Laborde, and almost all writers
except van Gehuchten). 8. The law of the excentric position of
nerve-tracts applies to the greater part of the fibres of the P.L.B.
9. A very few commissural fibres pass from Bechterew’s angular
nucleus to the contralateral vestibular zone in rabbit and cat.
10. The superior cerebellar peduncles receive no fibres from
Bechterew’s nucleus. 11. The P.L.B. contains (a) no ascending
fibres of spinal cord origin, (b) no primary vestibular fibres (contra
Winkler, Cajal). All these statements refer to the rabbit.
Of the descending fibres of the P.L.B. (1) the mesencephalo-spinal
reach the upper lumbar cord, (2) the metencephalo-spinal the
sacral, (3) the fibres from the nucleus descendens vestibularis and
the distal part of the nucleus triangularis vestibularis do not pass
beyond the mid-thoracic cord. And, finally, all the ascending
fibres of the P.LB. are of vestibular origin. Unfortunately the
author’s figures have had to be kept back till the appearance of
the next number of Le N&vraxe ; they have been missed by the
reviewer in places. Leonard J. Kidd.
A GANGLION IN THE HUMAN TEMPORAL BONE NOT
(260) HITHERTO DESCRIBED. A. A. Gray, Proc. Boy. Soc. Lond.,
Vol. B. 86, No. B. 588, May 22,1913, p. 323.
In a macroscopic preparation of the sheep’s middle ear Gray
found a large nerve plexus on the posterior surface of the bulla,
composed of bundles coming from the vagus and facial nerves.
Microscopical sections of the human temporal bone revealed the
plexus in the substance of the bone, close to the lowest point of
the stapedius muscle: the plexus is much smaller than in the sheep,
and its fibres are derived from the facial nerve and the auricular
branch of the vagus. A comparatively large, irregularly shaped
ganglion, associated with the plexus, was found embedded in the
bone; it is situated immediately below the inferior termination of
the stapedius muscle. It contains rather a large proportion of
nerve fibres relative to the number of nerve cells: most of its cells
are multipolar: a few bipolars are found in the upper portion.
Its physiological rdle must be determined by experiment and
dinico - pathological observation. Gray suggests that as the
common disease otosclerosis presents diminution of cerumen, and
322
ABSTRACTS
diminished sensitiveness of the tympanic membrane and the
posterior wall of the external meatus (regions supplied by Arnold’s
nerve formed by the union of bundles from the vagus and facial),
it is possible that autonomic fibres run from it to these regions.
Five figures show the relations and structure of this ganglion for
which Gray suggests the name “ stapedial ganglion.”
Leonard J. Kidd.
THE CARDIAC PLEXUS AND INNERVATION OF THE AORTA
( 261 ) (Recherchea snr le plexus eardiaque et but l’innervation de
i’aorfee.) Y. Manou£llan, Com.pt. Rend, de VAcad. det Sci., Yol.
166, Sem. 1, No. 24, June 16,1913, p. 1846.
A histological study by the silver nitrate method in dogs. The
posterior cardiac plexus contains abundant nerve ganglia, mostly
microscopic, whose cells are of sympathetic type; similar solitaiy
nerve cells occur also in the interstitial tissue of the plexus, on
its nerve filaments, and in the connective tissue of the middle coat
of the proximal part of the aorta. ( A ) Nerve terminations in the
elastic fibres and unstriped muscle: (1) The nerve fibres, of
varying size and wavy outline, leave the connective tissue of the
mesarterium and end in the elastic tissue either by a bud-shaped
swelling or a tapering extremity; (2) the endings for the unstriped
muscle cells are by arborisations analogous to the motor end-plates
of striped muscle. (£) Nerve terminations in the connective
tissue of the mesarterium: This tissue is richly innervated; the
larger nerve fibres end in a large swelling of hatchet or club shape;
the fibrils form a fine network. Other fibres end in large buds
with small excrescences, and yet others in fine fibrils arranged
like a ball of string. The author says the nerve fibres which end
in the connective tissue must be sensory: he has not found sensory
terminations in the mesarterium. The afferent fibres are of great
importance in the mechanism of arterial dilatation and constriction:
they subserve a reflex which begins in the sensory arborisation
and ends in the motor nerve termination in the unstriped muscle.
No figures are given. Leonard J. Kidd.
PHYSIOLOGY.
OBSERVATIONS ON THE PREFERENTIAL USE OF THE RIGHT
( 262 ) AND LEFT HANDS BT MONKEYS. Shiphkbd Ivoby Franz,
Jovrn. Animal Behaviour , March-April, Vol. 3, No. 2, 1913, pp.
140-144.
It was found, from an examination of six monkeys, that one
showed an apparent preference for the use of the right hand, and
ABSTRACTS
323
two for the left; but more observations are needed before any
definite preferential use of the hands in monkeys may be accepted
as proven. A. Ninian Bruce.
THE NERVOUS MECHANISMS WHICH REGULATE OO-ORDINA
(263) TION OF LOCOMOTOR MOVEMENTS IN DIPLOPODA (Bur
lee m&anismes nerveux qni rdglent la co-ordination des mouve-
ments locomoteurs ches les Diplopodes.) A. Clemknti, Arch.
Ital. de Biol., Vol. lix., F. 1, May 10,1913, p. 1.
Experiments on lulus. Conclusions. —1. Section of the nerve-cord
does not abolish irreparably co-ordination of ambulatory move¬
ments of the legs between the metameres separated by the section.
2. Solar rays at temperature of 20° to 30° cause the reappearance
of co-ordination of these movements apparently as perfect as those
of the intact animal. 3. Backward movement of the legs—seldom
seen in the normal animal—is possible in the segment deprived
of all nervous connections with the oesophageal ganglion; but the
auxiliary locomotor movements of the segments do not return.
4. Passive backward displacement of legs causes a wave of forward
movement of the legs of the opposite side. 5. Decapitation does
not abolish the rolling-up reflex; prolonged compression of the
three first metameres evokes it, but it is not durable as in the
normal animal. Extirpation of these metameres abolishes it.
6. The reaction to tactile and thermal stimuli changes its form
with variation of the intensity of the stimulus.
The author interprets these findings to mean that diplopoda
have an internal musculo-articular sensibility; that the oesophageal
nerve-ganglion apparatus is the seat of the upper Bensory, motor,
and tonic centres; that the ventral nerve-chain of the three first
metameres is the seat of the immediate centres of the rolling-up
reflex; and that in the rest of the nerve-chain are distributed the
segmental centres which regulate co-ordination by means of
reflexes determined by the tactile and musculo-tendinous sensibility.
The mode of walking of a normal lulus is well figured and described.
Leonard J. Kidd.
THE FUNCTIONAL AUTONOMY OF THE SPINAL OORD: EX
(264) PERIMENTS ON THE AVIAN LUMBAR OORD. (Contribu¬
tions b l’ltude des fonctions autonomes de la moelle Ipinitre.
Recherches explrimentelles sur la moelle lombaire des oiseaux.)
A Clxmksti, Arch. Ital. de Biol., Vol. lix., F. 1, May 10,1913, p. 16
(14 figs.).
Six separate series of experiments were performed on ducks,
Italian fowl, adult pigeons, and twenty-one newly hatched pigeons:
324
ABSTRACTS
these last survived for from one to five days: in them station and
locomotion develop only at the thirteenth to the fifteenth day.
General conclusions: (1) The avian lumbar cord has a marked
functional autonomy. (2) Independently of higher centres it can¬
not only permit of co-ordination of movements of the lower limbs
but also evoke adequate equilibration reflexes during special
alteration of the position of the bird's body. (3) The nervous
mechanisms are reflex ; those of reflex inhibition and antagonistic
innervation play a notable part. (4) In general the musculo-
articular superficies of the legs and rump represents the point of
departure of the stimuli which can set in action the nervous
mechanisms for locomotion of the limbs and for equilibration
movements of the rump: stimuli of the force of gravitation and
active experimental stimuli alike act thus. (5) The lumbar nerve-
mechanisms of limb-locomotion are already active in the pigeon
twenty-four hours after birth, when it cannot walk. (6) In the
avian lumbar cord, like the canine, the functional autonomy of
each separate segment has been lost: there is, however, a collective
autonomy of many segments in the exercise of sensori-motor
activities. The author suggests the name of “ pluri-segmental ”
autonomy to distinguish it from the pure segmental autonomy of
many invertebrates.
Specially interesting parts of this interesting study are (1)
section four, which deals with alternate rhythmic swimming move¬
ments of the duck obtained in the isolated lumbar cord; and
(2) section five, which deals with the existence of equilibration
movements independently of the activity of the semicircular
canals. The author upholds the teaching of Luciani—in whose
laboratory these researches were carried out—that the semi¬
circular canals are not the only equilibratory organs of the body.
Leonard J. Kidd.
REMARKS OR THE ORIGIN OF THE PHRENIC NERVE IN THE
(265) RABBIT, OAT, AND DOG. Abby H. Turner, Amer. Joum.
Physiol., Vol. xxxii., No. 1, May 1913, p. 65.
Section and stimulation of the phrenic nerve often lead to doubt
as to whether the whole or only part of the nerve is involved.
Different individuals and the two sides of a single animal may vary
in the number of phrenic roots and in their place of union. In
the rabbit there are usually three roots, one each from the fourth,
fifth, and sixth cervical nerves, but there may be two or four. In
the cat the origin is from the fifth and sixth cervical nerves, only
rarely from the fourth. In the dog the origin is from the fifth,
sixth, and seventh cervical nerves. The place of final union of all
ABSTRACTS
325
these branches varies, but is often among the great veins in the
neck, and hence it is always advisable to divide or stimulate the
phrenic nerve in the thorax rather than in the neck.
A. Ninian Bruce.
DIRECT AND CROSSED RESPIRATION UPON STIMULATION
(266) OF THE PHRENIC, THE SCIATIC, AND THE BRACHIAL
NERVES. W. T. Porter and Abby H. Turner, Amer. Joum.
Physiol ., Vol. xxxii., No. 2, June 2,1913, p. 95.
In the study of crossed respiration, the section and stimulation of
the phrenic nerve within the chest and the direct inspection
of the diaphragm are of great advantage. The accurate stimulation
of the central end of the phrenic nerve in the rabbit does not
cause contraction of the diaphragm or other reflex movements.
In the cat reflex contractions of the diaphragm may follow the
stimulation of the phrenic nerve. In the cat a strong stimulus
is required to call forth a reflex with the phrenic nerve, while in
the same individual a very weak stimulus to the sciatic or the
brachial nerves will cause reflex contractions of the diaphragm.
Hemisection of the spinal cord between the bulb and the phrenic
nuclei stops the contractions of the diaphragm on the same side,
but these contractions are at once resumed when the opposite
phrenic nerve is severed by freezing. A mechanical stimulus,
therefore, cannot be the cause of the crossed respiration.
A. Ninian Bruce.
CARBON DIOXIDE PRODUCTION FROM NERVE FIBRES WHEN
(267) RESTING AND WHEN STIMULATED; A CONTRIBUTION
TO THE CHEMICAL BASIS OF IRRITABILITY. Sbiro
Tashiro, Amer. Joum. Physiol., Vol. xxxii., No. 2, June 2, 1913,
p. 107.
All nerve-fibres give off carbon dioxide. When nerves are
stimulated they give off more C0 2 . The C0 2 output of resting
nerve is due to a vital active process. Anaesthetics greatly reduce
the C0 2 output of nerves and dry seeds. Mechanical, thermal,
and chemical stimulation also increases the C0 2 output of nerves.
Single dry living seeds (oat, wheat, &c.) react in most particulars
similar to nerves as regards their irritability, relation to anaes¬
thetics, mechanical stimulation, and carbon dioxide outputs.
The general conclusion is drawn that irritability is directly
dependent upon and connected with tissue respiration, and is
primary a chemical process. These results Btrongly support the
conception that conduction is of the nature of a propagated
chemical change. A. Ninian Bruce.
29
326
ABSTRACTS
THE CARDIOVASCULAR ACTION OF PITUITARY POSTERIOR
( 268 ) LOBE EXTRACT IN ACUTE ADRENAL INSUFFICIENCY.
H. Claud, and R. Porak Compt. Rend. Soc. de Biol., Yol. Ixxiv.,
No. 17, May 16,1913, p. 1021.
The authors showed recently that when purified and delipoided
extracts of the posterior lobe of the pituitary of the ox were
injected into man, rabbit, and dog, they produced, among other
effects, a marked fall of arterial pressure. They here record
experiments on eight rabbits in which acute adrenal suppression
had been performed under chloroform anaesthesia, either by bilateral
adrenalectomy or by forceps-compression of the hilum of each
adrenal. On injecting intravenously posterior lobe pituitary
extracts within from 5 minutes to 6 hours after the time of the
bilateral adrenal suppression, a marked carotid hypertension was
constantly produced, i.e., the opposite effect of that obtained in the
intact animal. Leonard J. Kidd.
THE EFFECTS OF ADRENAL MASSAGE ON BLOOD PRESSURE.
(269) R. G. Hoskins and C. M'Peek, Joum. Amer. Med. Assoc., Vol. 60,
No. 23, June 7, 1913, p. 1777.
Adrenal secretion has a depressor as well as a pressor action on
vascular tension. Cannon and Lyman (1912) found that, in the
cat, when blood-pressure is at a normal height, injection of pure
epinephrin, in minute' doses and at the proper rate, invariably
produces a depression; this can be secured time after time; it
varies, however, according to the existing degree of vascular
tonus; if initial tension be low, only an augmented pressure can
be secured. Hoskins and M'Clure also showed that, in the dog,
fall of pressure follows minute doses; as these are increased the
depressor is followed by a pressor effect. Stewart (1912) showed
that massage of the adrenals causes an augmented adrenalin
secretion. The authors find that in dogs of quiet temperament,
gently handled, and etherised with as little excitement as possible,
the exposed adrenals can be massaged; care was used to avoid
traction on the mesentery or undue visceral irritation. The results
obtained confirmed the observations of Hoskins and M'Clure on
the effects of varying dosage of adrenalin; they ranged from marked
depression with a small discharge to considerable rise when the
glands were vigorously massaged, but the rise was never as great
as that got by ordinary therapeutic dosage of adrenalin; tracings
of the pressure are shown. Conclusions: (1) Adrenal secretion
cannot be an immediate factor in normal blood-pressure; (2) a
ABSTRACTS
327
small amount of normally circulating adrenalin has either no
effect, or else a depressor effect, on arterial tension; (3) hyper¬
tension occurs only with an abnormal quantity of adrenalin; (4)
the low blood-pressure of experimental hypoadrenalism or of
Addison’s disease is due, not to failure of a normal tonic stimulant
to the sympathetic system, but probably to an interference with
muscular metabolisms, including those of the heart and arteries.
Leonard J. Kidd.
PATHOLOGY.
HISTOLOGICAL RESEARCH ON THE CENTRAL NERVOUS
(270) SYSTEM IN A CASE OF CATATONIC DEMENTIA PR.SOOX.
(Ricerche istologiche sui centri nervosi in un caso di demenza
precoce catatonica ) Vincenzo Scarpini, Rassegna di Studi
Ptichiat., Vol. II., F. 1, Gennaio-Febbraio 1912, p. 1.
The author examined microscopically the brain of a case of
catatonic dementia prsecox, who had died from tubercular pleurisy.
The changes in the cortex were mostly similar to those already
described. In addition, however, he found marked cellular changes
in the basal ganglia and cerebellum, both white and grey matter
being affected, and he asks if perhaps some of these latter altera¬
tions may not be responsible for producing some of the clinical
symptoms of the disease. A. Ninian Bruce.
PUNCTIFORM HEMORRHAGIC PIGMENTATION OF THE GERE-
(271) BRAL PIA MATER. E. M. Williams, Jour. Nerv. and Ment.
Di». t Vol. 40, No. 4, April 1913.
The case of a man, 58 years, who had shown a stuporous mental
condition and some weakness of the right side of his body. The
brain macroscopically showed numerous minute brownish pig¬
mented areas of pin-point size. A microscopical examination of
these areas showed them to be lumps of granular pigment. They
were mostly independent of the blood vessels, but some occurring
around as well as within the vessel walls suggested the probability
of their haematogenous origin.
The general appearance of the pia was that of a case of syphilis,
as there was marked round and plasma cell infiltration.
D, K. Henderson.
328
ABSTRACTS
CLINICAL NEUROLOGY.
BROWN - 8&QUARD SYNDROME WITH DISSOCIATION OF
(272) SENSORY LOSS OF THE SYRINGOMYELIC TYPE-
PATHS OF SENSORY CONDUCTION IN THE SPINAL CORD.
(Sydrome de Brown-Syquard avec dissociation ByringomyClique
do la sensibility (voies de la sensibility dans la moelle ypiniftre).)—
A Souqubs and R. Mionot, Rev. Neurol., Ann. xxi, No. 8, April 30,
1913, p. 509.
The clinical history and examination of a case of hsematomyelia in
which a Brown-S^quard syndrome was present below the 7th
dorsal segment are given and serve as an introduction to a brief
account of present views on sensory conduction in the cord.
P. W. Saunders.
THE RESPONSE OF THE LOWER LIMBS TO EXTERNAL
(273) STIMULI IN NORMAL INDIVIDUALS AND IN PATIENTS
SUFFERING FROM SPASTIC PARAPLEGIA - NORMAL
MOVEMENTS OF DEFENCE AND PATHOLOGICAL MOVE¬
MENTS OF DEFENCE. (Sur les rdactions des membres
infyrieurs aux excitations extyrieures chez l’homme normal et
chez le parapiygiqne spasmodique. Movements de defdnse
normaux, movements de ddfense pathologiques.) Mabinesco
and NoIca, Rev. Neurol., Ann. xxi., No. 8, April 30, 1913, p. 516.
The authors compressed one lower limb by an Esmarch’s bandage
after the methods adopted by Babinski, and then stimulated the
sole of the anaemic limb as in testing for Babinski’s plantar
reflex.
In the anaemic limb of the normal individual they found an
abolition of the Achilles jerk, and an exaggeration of the defensive
movements of the toes, foot, leg, or limb as a whole. In individuals
whose spastic paraplegia was so advanced that all or almost all
voluntary movement of the legs was lost, the Babinski plantar
reflex disappeared when the ansemic limb was tested and move¬
ments of defence diminished in intensity. In those individuals
who still had considerable motor power in their legs and consider¬
able sensation present, the anaemic limb showed loss of Babinski
reflex, but movements of defence not only persisted, but might
be exaggerated as in the normal person.
In correlating their results, the authors make use of the
physiological conception that movements of defence exist under
two categories. Firstly, there are the normal conscious move¬
ments which can be inhibited by the will up to a certain extent,
that is, until the painful stimulus that tends to provoke them
becomes unbearable. Such are the quick nervous movements of
ABSTRACTS
329
resistance or withdrawal that the limb of the normal individual
shows when the skin of the sole is painfully stimulated, and
which were more energetic and even made bilateral when the
normal limb was rendered anaemic or asphyxiated before being
tested. Secondly, there are the involuntary movements not
accompanied by any conscious sensation, let alone painful impres¬
sion, movements over which the will has no control To this class
belong the Babinski reflex, and the slow, sluggish movements of
flexion and withdrawal that may accompany it in paraplegic cases,
movements that became diminished or absent in the anaemic para¬
plegic limbs and began to increase or appear again in the first few
minutes after the ligature was removed. P. W. Saunders.
LAMINECTOMY IN COMPRESSION PARAPLEGIA (La lami-
(274) nectomie dans la compression mddnllaire: treise interventions
chez onze malades. Un css de gndrison complete.) A van
Gehuchten and A Lambotte, Le AVvraxe, Vol. 13, F. 2,3, April 1,
1913, p. 311.
The case of recovery after laminectomy for compression paraplegia
by a spinal cord tumour seems to be the first successful one yet
recorded in Belgium. It was one of intradural tumour, in a man
of 47, operated on early; an interesting feature was that Wasser-
mann in the blood was positive, but lumbar puncture gave a clear
fluid, with negative Wassermann and no lymphocytosis. Two
fatal cases are recorded: one showed by Marchi no ascending or
descending degeneration in the spinal cord. Three times diagnosis
was erroneous: in the first case, a man of 50, operated on for
symptoms of medullary compression, nothing was found, and
patient survived. The second and third were cases of the para¬
plegic type of disseminated sclerosis: one, a nun of 31, died four
months after operation ; the other, a woman of 52, died six months
after operation; this case is noteworthy because the first symptoms
began as late as 51 years of age. In both these cases of micro¬
scopically typical disseminated sclerosis there was a definite level
on the trunk of objective anaesthesia: the younger woman showed
a definite level of loss of sensibility to pain below the third rib in
front, and the fifth thoracic spine behind; the older woman had
total loss of superficial and deep sensibility below fifth rib in front,
and ninth thoracic spine behind. It was noted also in these two
cases at the operation that there was absence of cerebro-spinal
fluid on incision of the dura. Case eleven is held to be the most
instructive: it showed the necessity for early operation. The
authors maiutain that the vertebral laminae are of little importance
for the stability of the vertebral column: in their case eleven, nine
330
ABSTRACTS
laminae were resected; in one case operated on by Desguin ten
laminae. They also believe that the alleged evil effects of loss of
cerebro-spinal fluid have been greatly exaggerated. The future of
surgical neurology depends, they hold, on improvement in diagnosis
and earlier operative intervention. The paper has six figures.
Leonard J. Kidd.
ATROPHY OF DISTAL MUSCLES IN ALL FOUR EXTREMITIES.
(275) ? CAUSE. F. E. Batten, Proc. Roy. Soc. Med., Vol. vi., No. 2,
Dec. 1912 (NeuroL Sect.), p. 43.
The patient was a woman, aged 33. She had had three
pregnancies. The first resulted in a miscarriage, the second and
third in healthy children. After the second she had weakness
of the extremities for three months, from which she completely
recovered. The legs again became weak after the third confine¬
ment, and a few months later her hands also became affected.
The muscles began to waste, she lost sensation, and liecame
unable to walk. All the deep reflexes were abolished, and the
plantar and abdominal reflexes were lost. The electrical reactions
show a diminution of response in all the peripheral muscles. The
proximal react normally. The Wassermann reaction is negative.
The case was discussed at the meeting; the general trend of
opinion lay in the direction of peripheral neuritis.
A. Ninian Bruce.
CASE OF ORGANIC HEMIPLEGIA FOLLOWING TYPHOID
(276) FEVER, IN WHICH THE PLANTAR REFLEX IS FLEXOR,
BUT BABINSKI’S “ SECOND SIGN COMBINED MOVE¬
MENT OF THE TRUNK AND PELVIS—IS PRESENT. A. F.
Hertz, Proc. Roy. Soc. Med., Vol. vi., No. 3, Jan. 1913 (Clin. Sect),
p. 63.
The patient was a man, aged 31, who at the end of the second
week of typhoid woke one morning to find that the left side of
his face and his left arm and left leg were paralysed. The
paralysis diminished for a time, but after some months no further
improvement occurred. The evidence was in favour of an organic
hemiplegia, due probably to cerebral softening following thrombosis
occurring during typhoid fever. The left plantar reflex, however,
was flexor. Babinski’s “ second sign ” was present. The patient,
lying flat on his back, with his arms folded across his chest and
his legs widely separated, is told to rise to the sitting position
without using his arms. At each attempt to do so the paralysed
leg rises, the other leg remaining on the floor or rising considerably
ABSTRACTS
331
less high. In hysterical hemiplegia the paralysed leg remains
flat on the floor. This sign is often of great value.
A, Ninlan Bruce.
ACUTE POSTERIOR GANGLIONITIS, SIMULATING SURGICAL
(277) CONDITIONS IN THE ABDOMEN. L. Litchfield, Journ.
Amer. Med. Assoc., Vol. lx., No. 22, May 31, 1913, p. 1691.
Herpes zoster is the eruption, the peripheral manifestation, of
acute posterior ganglionitis. The prodromal period may extend
over several days, and be attended by such sharp and severe pain
as to simulate appendicitis, renal colic, gall-stones, &c., and lead
to surgical interference. Two cases are recorded, one with sharp
pain over the left ureter, and the other with severe pain over the
upper part of the abdomen. In both cases the eruption appeared
before operation had been attempted. A. Ninlan Bruce.
SPONTANEOUS H ASM ATOM AT A IN A TABETIC WOMAN. (Sur
(278) un cas de hamatfimes spontantos chez one tabdtique.) J. Fischel,
Theses de Paris , 1912-13, No. 208.
The thesis contains the histories of nine cases, including the follow¬
ing unique personal one: A woman, aged 44, who had suffered
from tabes for ten years, after attacks of lightning pains, showed a
diffuse oedema of the thigh extending from the knee to the buttock.
As the oedema subsided the haematomata appeared, and gradually
absorption took place. The phenomenon is attributed partly to
syphilitic vascular lesions and partly to vaso-motor disturbances.
J. D. Rolleston.
REPORT OF A CASE OF PNEUMOCOCCUS MENINGITIS WITH
(279) NORMAL CEREBRO SPINAL FLUID. Jules M. Brady,
Joum. Amer. Med. Atsoc., Vol. lx., No. 13, March 29, 1913, p. 973.
The patient was a boy, aged 1 year, who suffered from an attack
of broncho-pneumonia with exudative pleurisy. As he also showed
a number of nervous symptoms suggesting pneumococcus meningitis
a lumbar puncture was performed, but the cerebro-spinal fluid was
clear, and contained no organisms. After death, however, a
thick fibrino-purulent exudate was found over the frontal and
parietal lobes. The base was not involved.
A. Ninian Bruce.
332
ABSTRACTS
ENOEPHATiO - MENINGITIS DUE TO PFEIFFER’S OOCOO
(280) BAOILLUS. (Enc<phalo-m6ningite k cocco-bacille de Pfeiffer.)
G. Rosenthal, Joum. de mid.. de Paris, 1913, xxxiii. , p. 244.
A fatal case in a youth of 18. There was sudden onset with
headache, fever, and vomiting. The patient rapidly got worse, and
coma set in on the sixth day. Lumbar puncture gave issue to an
almost clear fluid without hypertension, containing a small number
of polynuclears and yielding Pfeiffer’s organisms in cultures.
Death took place next day. No necropsy.
J. D. Rolleston.
A CASE OF MENINGITIS DUE TO SERUM (Un cas de mtaingite
(281) stoique.) E. Job and L. L£vy, Paris mid., 1912-13, i., p. 582.
A man, aged 32, was admitted to hospital with meningococcal
meningitis, which was treated with Dopter’s serum. After four
days’ apyrexia the temperature rose again. Although the cerebro¬
spinal fluid was perfectly clear, a fresh injection of serum was
given, and within three hours severe headache, general hyper¬
esthesia, and pains in the lower limbs ensued. Lumbar puncture
performed six hours after the injection gave issue to a puriform
fluid under hypertension, and was followed by immediate relief of
the symptoms, which completely disappeared within forty-eight
hours. The puriform fluid was sterile, and contained perfectly
normal polymorphonuclears and a few red cells (c/. Review, 1910,
viii., p. 702, and 1911, ix., p. 575). J. D. Rolleston.
A POSSIBLE SOURCE OF DANGER IN THE USE OF ANTI
(282) MENINGITIS SERUM S. P. Kramer, Joum. Amer. Med.
Assoc., Vol. lx., No. 18, May 3, 1913, p. 1348.
The author describes the case of a child who received an intraspinal
injection of antimeningitis serum for cerebro-spinal meningitis.
Two minutes later she stopped breathing and became livid, the
pupils being contracted and the heart beating strongly. After
three minutes of artificial respiration she again breathed normally,
and showed an internal strabismus of the right eye. An hour
later a left hemiplegia developed, which partially passed off. She
died a week later from pneumonia.
Three other somewhat similar cases are recorded, and the
author considers that the great similarity of these cases of respir¬
atory paralysis to that following the lumbar injection of cocain
points to their being toxic in origin.
He suggests that if the needle should injure the filum and
ABSTRACTS
333
make an artificial opening into the central canal, & direct channel
is opened which might deliver a toxic material injected into the
subdural space to the fourth ventricle. Serum containing 0’5
per cent, tricresol cannot safely be injected into the subarachnoid
space. A. Ninian Bruce.
8EBOUS OTITIC MENINGITIS, WITH SEPTIC THROMBOSIS OF
(283) THE LEFT LATERAL SINUS AND INTERNAL JUGULAR
VEIN, SUCCESSFULLY TREATED BY OPERATION. E.
Malcolm Stockdale, Journal of Laryngol., Rhinol., and Otol .,
Yol. xxviii., No. 1, Jan. 1913.
A case of chronic otitis media, with extensive thrombosis of sinus
and internal jugular vein. Staphylococci were found in the
cerebro-spinal fluid at operation and subsequently. Six days later,
as the temperature was rising and patient worse, the subarachnoid
space was opened for drainage above and below the sinus. This
was followed by improvement, but a cerebellar hernia developed,
and in two months’ time reached the size of a hen’s egg. Rotatory
spontaneous nystagmus was present on looking to the right and
left, inco-ordination of arm movements, slight Rombergism falling
to the side of the lesion; occasional vomiting also present. The
hernia burst and the patient was collapsed. The same evening
the hernia was very slowly removed, a ligature being tightened
round it. The operation was completed next day as the patient
was very collapsed. The portion of cerebellum consisted of medulla
and cortex. Recovery was complete, there being no obvious defect
due to the loss of cerebellar tissue. R. V£rel.
ATHETOSIS OF LEFT HAND WITH TREMOR OF RIGHT
(284) HAND. E. G. Feaensides, Proc. Roy. Soc. Med., Vol. vi., No. 4,
Feb. 1913 (Neurol. Sect.), p. 81.
The patient was a man, aged 67. Nineteen years ago he was
walking along the road when he suddenly turned giddy and almost
fainted. He then walked home and was put to bed, and during the
next few hours his left face became twisted, and later the left half of
his body and his left arm and left leg became weak, numb, and
cold. He was off work for three months, and gradually improved,
although the numbness and coldness persisted. In August 1911
he came under observation for “indigestion,” and was found to
have athetosis of the left hand, weakness and numbness of the left
half of the body, and a tremor of his right hand. History of
alcoholic excess, had no syphilis. Wassermann negative.
334
ABSTRACTS
The above association is rare, and at the discussion it was
suggested by Dr S. A. K. Wilson that these symptoms might be
produced by a lesion on the right side in the extreme upper part
of the pons just below the red nucleus. Such a lesion, involving
Manakow’s bundle after it had crossed, would cause tremor of the
right limbs. Probably the lesion also involved the fillet, and if it
were to include the superior cerebellar peduncle after it had crossed
it would produce such an effect on the opposite cortex as to allow
of athetosis of the left side. A. Ninian Bruce.
A CASE OP PEBIODIO PARALYSIS. H. Willoughby Gardner,
(285) Brain , Vol. xxxv., Part iii., 1913, p. 243.
The patient was first seen in the spring of 1907. For two years
he had been subject to attacks of complete paralysis of his arms
and legs, which attacks were getting more frequent and more
severe, and threatened to incapacitate him completely. The first
attack occurred in August 1905 when he was fifteen years of age.
The second nine months later, and the third, fourth, fifth, sixth,
and seventh attacks at diminishing intervals of six months, three
months, two months, one month, and two weeks respectively, and
the interval between the eighth and ninth attacks was only ten
days. The attacks were becoming not only more frequent, but
also more severe and longer in duration. The sixth and eighth
attacks each lasted three whole days. Between the attacks the
patient was apparently in perfect health. For as long as he could
remember before their commencement he had been subject to
“sick headaches”; these ceased when the attacks of paralysis
commenced.
No similar attacks had ever occurred in any member of his
family; he was not in any way neurotic, nor was there any
neurotic family history.
The attacks always began in the early hours of the morning.
The patient would wake up with a headache, aching all over, and
would find himself unable to move his arms, legs, or head, though
his legs were always more completely paralysed than his arms.
The intercostal muscles were in some attacks greatly affected, so
that his respiration was entirely diaphragmatic; but in other
attacks little or not at all.
The knee jerks and ankle jerks were completely absent, and so
were the deep reflexes in the upper limbs, and there was no ideo-
muscular contractibility in the affected muscles. The skin reflexes
were present, but greatly diminished. The paralysed muscle did
not contract at all in response to the faradic current. In several
attacks the patient was unable to pass water, and the use of a
ABSTRACTS
335
catheter was necessary. The bowels also never acted during an
attack. There was no loss of sensation to touch, pain, or heat and
cold The pulse was 42, and there was well-marked cardiac
dilatation, the apex being half-an-inch outside the nipple line,
and a soft systolic murmur being present. •
After the paralysis had lasted for one, two, or three days the
patient would awake nearly well, and would rapidly recover com¬
pletely, and be able to walk five miles home, and even to return to
work. His motor power would then be perfect, his knee jerks and
other deep reflexes brisk, his skin reflexes and electrical reactions
very active; all headache and aching of the limbs would have
disappeared, and the cardiac dilatation would be rapidly subsiding.
It was noticed that the attacks, or at least the warnings thereof,
nearly always began on a Sunday. The exciting cause seemed to
be violent exertion, such as a football match on the Saturday half
holiday, especially if followed by a heavy supper.
The writer came to the conclusion that the attacks were due
to auto-intoxication, the presence of the special toxins being due to
some congenital defect in metabolism. His reasons were:—
1. The many points of resemblance to other conditions un¬
doubtedly due to auto-intoxication, many of which show a similar
“ periodicity ” in their manifestations.
2. The sudden onset and the rapid recovery.
3. The invariable recurrence of the phenomena during the
night after some hours of sleep, when waste and toxic products
may be assumed to have accumulated, and when intestinal digestion
is taking place.
4. The fact that the condition could at its commencement
occasionally be shaken off if the patient was able to get up and
walk about.
5. The symmetrical distribution of the paralysis.
6. The occurrence of headache, drowsiness, thirst, anorexia,
aching of the limbs and sweating during the attacks—symptoms
practically common to many toxaemic conditions.
7. The high specific gravity of the urine passed during the
attacks, and the presence in it of small quantities of indican.
8. The fact that in Borne attacks severe bilious vomiting coming
on after some time seemed to cause rapid disappearance of the
symptoms, and that in one instance a prompt attack of such severe
vomiting apparently prevented the development of paralysis.
9. The fact that the attacks of paralysis apparently took the
place of previous attacks of “ bilious headache.”
Believing this, the writer hoped that treatment adapted to
meet or to prevent such auto-intoxication would prove useful.
The treatment prescribed was to take no beer or rich food of
any kind; to drink large quantities of water; mag. sulph. O.P.M.
336
ABSTRACTS
calomel gr. ii. once a fortnight, and whenever an attack seemed to
be threatened, caffein gr. vii ss. with pot. brom. and acid hydro-
brom. dil. whenever any warning symptoms occurred.
The success of the treatment was immediate. The attacks
ceased for two years. Then one oocurred after a hard game of
football. The patient was told to take the calomel, and a dose of
the caffein mixture, to eat only a light supper, and drink much
water after a football match. As long as he followed instructions
no attacks occurred, and he was able to play football with impunity.
After a time he discontinued treatment; the attacks recurred, but
have ceased since the patient once again obeyed instructions.
The case is noteworthy for its extreme rarity, and for the fact
that though usually a family disease, no other members of the
family have so far been affected; also for the success of the
treatment adopted. Author’s Abstract.
REPORT OF A CASE OF BRAIN TUMOUR. E. E. Morrison, Joum
(286) Amer. Med. Assoc., Vol. lx., No. 17, April 26, 1913, p. 1280.
Case of a woman, aged 59, who suffered progressively from
drowsiness, headache (mostly occipital), vomiting, defective vision,
vertigo, hebetude, delusions, hallucinations, paresthesia, paralysis
of left lower limb, and ataxia in the right lower limb, and dis¬
orientation. Optic neuritis was present. No operation. At the
autopsy a partially encapsulated, round, dark-coloured tumour about
the size of a walnut was found in the right hemisphere of the
cerebellum behind the wall of the fourth ventricle, and pressing
on the pons. On section the tumour was considered to be a
gliosarcoma. A. Ninian Bruce.
TUMOURS OF THE CEREBELLO PONTINE ANGLE. A. W. Lucre,
(287) Cleveland Med. Joum., Vol. xii., No. 5, May 1913, p. 326.
A case is here described of a man, aged 54. He had always been
healthy until eight years ago, when he had typhoid fever, and
about this time began to notice he had difficulty in hearing with
the right ear and tinnitus. Later he became completely deaf,
and developed a walk like a drunken man. His eyesight then
failed, and mental condition became impaired, and severe head¬
aches developed. A cerebello-pontine angle tumour of the right
side was diagnosed, and he was trephined over both posterior
fossae. Five days later the dura was incised, and a tumour, later
found to be a fibroma, was removed from the right antero-lateral
wall of the cerebellum. The patient was discharged from hospital
three weeks later, and returned to work.
ABSTRACTS
337
There is a short account of the symptoms of such tumours
appended. A. Ninian Bruce.
A CASE OF CHOLESTEATOMA OF THE BRAIN. L Strauss, Jour.
(288) Nero, and Meat. DU., VoL 40, No. 4, p. 257.
Tub case of a woman, 34 years, who presented somewhat anomalous
clinical symptoms. At the autopsy an encapsulated tumour was
found which microscopically proved to be a cholesteatoma, possibly
of embryonal origin. D. K. Henderson.
A CASE OF H YPOP HYSIS TUMOUR OPERATED ON BY
(289) HIRSOH’S METHOD. (Uber einen Fall von Hypophysen-
tuxnor, erfolgreich nach Hindi operiert.) Q. Holmgren, Ztschr.
/. Ohrenheilk ., B. lxvL, H. 1 and 2, 1912, S. 39.
Patient has had symptoms for two years, and increasing affection
of his sight. Admitted. In the right eye only light perception,
with the left could count fingers immediately in front of the eye.
X-ray showed: anterior boundary of the sella turcica much less
sharp than normal, posterior absent. Decompression determined
on. Operation by Hirsch’s method. The roof and posterior
walls of the sphenoid sinus were found soft, red, and bulging into
the sinus. Orientation was difficult. The dura was opened, and
some tumour masses removed with the spoon.
After becoming worse for a few days the sight steadily
improved, and is now T V R. VErel.
CASE OF CYST OF THE PITUITARY FOSSA; OPERATION BY
(290) THE NASAL ROUTE. C. I. Graham, Proc. Roy. Hoc. Med.,
Yol. vi., No. 3, Feb. 1913 (Laryogol. Sect.), p. 61.
The patient was a woman, aged 37, who was admitted to hospital
for failing sight for eighteen months, temporal headaches,
drowsiness, slow mental reaction, and incontinence. The drowsi¬
ness increased to coma and the respiration slowed to nine or ten
per minute. Optic atrophy in right eye, vision present in nasal
field of left eye.
Operation was undertaken by the nasal route. On opening
into the pituitary fossa 1 to 2 dr. of blood-stained fluid rushed out.
The wound was closed. The respiration became twenty-four.
During the first twenty-four hours after the operation there was
great thirst, frequency of micturition and polyuria. She became
practically normal except for the eyesight, which only improved
slightly. The patient left hospital twenty days after the
operation. A. Ninian Bruce.
338
ABSTRACTS
ON THE PHYSIOPATHOLOGIOAL RELATIONS BETWEEN THE
(291) HYPOPHYSIS SYSTEM AND VARIOUS CHRONIC DISEASES
OF THE NASOPHARYNX AND SPHENOIDAL SINUS
(Ueber die physio-pathologischen Beziehungen zwischen dem
Hypophysensystem and verschiedenenen chronischen Erkrank-
nngen des Nasenrachens and der Keilbeinhohlen.) R. V£rel
and Prof. Citzlli, ZUchr.f. Laryngol. Rhinol. u. ffremgeb., Bd.
H. 3, Juli 26, 1912, S. 513.
The author examined histologically five hypophyses from adenoid
patients. The ages varied from 6 months to 26 years. They all
showed signs which are usually recognised as those of hyper¬
secretion and hyperplasia. In control cases of similar ages these
signs were absent. Three cases are quoted next in whom adenoids
were present. All complained of being easily tired, inability to
concentrate or remember, physical torpor, and tendency to fall
asleep. Two of these cases were treated with Wellcome’s pituitary
extract, and recovered completely; the adenoids were then removed.
In the third the adenoids were removed first, but no improvement
took place until pituitary extract was given. The amnesia cleared
up last. A case of soft fibroma of the roof of the nasopharynx
showed similar symptoms, and was cured by removal of the growth.
Similar symptoms may be found in disease of the sphenoidal sinus
A VfiREL.
THE PRESENT KNOWLEDGE OF THE STATUS OF APRAXIA
(292) Alfred Glascock, Journ. New. and Merit. Dit., Vol. 40, Nos. 3 and 4,
March and April 1913.
A brief historical sketch is given of the origin of the term apraxia,
and credit is given to Liepmann and the German School for the
clear way their views have been expressed on the subject. The
present status of agnosia is also briefly considered.
The term apraxia is employed where there is a disturbance on
the motor side of the sensori-motor arc. It means that the
individual fails to carry out some subjective purposive movement,
or movement complex, notwithstanding his appreciation of what is
required of him, and the absence of sensory disturbances, motor or
co-ordination defect.
The classification advocated by Liepmann is given in detail.
In discussing the localisation of apraxia, it is said to be due
either to a cortical or sub-cortical lesion, is always supra-capsular
in origin, and a sign which proves this, according to Liepmann, is
the presence of aphasia. Summary statements are given of the
views of Heilbronner, von Monakow, and others, and the cases
of Liepmann, Hartmann, Kleist, and others are discussed.
ABSTRACTS
339
The case of a man, 64 years, suffering from arterio-sclerotic
brain disease is fully reported.
He presented a motor aphasia, marked dysarthria, and some
paraphasia. His understanding of spoken language was un¬
impaired. To what extent alexia, if present, existed, it was
difficult to ascertain owing to impaired vision. There was almost
complete tactile agnosia in both hands. In spite of the absence of
paralysis there was a bilateral inability to perform certain motions
or motion complexes, notwithstanding in each test complete
understanding by the patient of what was required of him.
D. K. Henderson.
A CASE OF HYPOGLOSSAL NUCLEI PARALYSIS. A. M. Moll,
(293) Jour. Nerv. and Meat. Die ., Vol. 40, No. 3, March 1913.
A man, aged 30, with a specific history had, a few days previous to
his entering the hospital, some difficulty in speech. Following this
he experienced difficulty in swallowing, in mastication, and in
walking, but at no time was there any loss of consciousness. A
month later difficulty in eating and speaking developed, he was
unable to whistle, saliva dropped from the mouth, and the tongue
was found to be flaccid, atrophied, showed fibrillar tremors, and
could not be protruded. The faradic responses of the tongue were
much diminished. The point of chief interest in the case was that
the orbicularis oris clearly participated in the electrical reactions.
The patient has shown considerable improvement by means of
treatment with mercury and the iodides. D. K. Henderson.
CASE OF SEVENTH AND EIGHTH NERVE PARALYSIS AFTER
(294) NEO-8ALVARSAN INJECTION. A. M. H. Gray, Proc. Boy.
Soe. Med., Vol. vi., No. 3, Jan. 1913 (Dermatol. Sect.), p. 79.
The patient was a man, aged 22, who showed a typical
syphilitic eruption all over. He was given 0*9 gr. of neo salvarsan.
The symptoms all cleared up. Six weeks later he became deaf
on the left side, and noticed the left side of his face did not move.
The author considered that the treatment had been insufficient,
and that a localised lesion had developed in his internal auditory
meatus, probably syphilitic in nature. The case was discussed
at the meeting, especially as to whether the paralysis was the
result of the disease or of the remedy. A. Ninian Bruce.
AN EYE LESION FOLLOWING TWO INTRAVENOUS INJECTIONS
(295) OF SALVARSAN, BUT RELIEVED BY ITS FURTHER USE.
Harold J. Levis, Joum. Amer. Med. Atsoc., Vol. lx., No. 18 ,
May 3, 1913.
The patient was a man, aged 22, with three primary lesions.
He was given 0 6 gm. salvarsan intravenously, repeated twenty-
340
ABSTRACTS
three days later. A few weeks later he developed a congestion of
the bulbar conjunctiva and photophobia, followed by diminution
of vision, which grew rapidly worse. A marked and steady
improvement followed a third injection.
It is pointed out that this case also shows that salvarsan is
not contra-indicated in active syphilitic eye disease.
A. Ninian Bruce.
THE TREATMENT OF SYPHILIS WITH SALVARSAN: FIRST
(296) 1,000 OASES TREATED AT THE ROYAL NAVAL HOSPITAL
AT PLYMOUTH. L. Kilkoy, Lancet, Feb. 1,1913, p. 302.
Two thousand one hundred and forty-seven injections were given
to 1,000 cases with 13 invalidings, no deaths, and 22 clinical
relapses re-admitted to this hospital, 2 admitted to other naval
hospitals, and 2 occurring in ships. No salvarsan was given to
cases of (1) heart disease, (2) albuminuria, (3) diabetes, (4) ad¬
vanced tabes, (5) general paralysis of the insane; 17 cases received
one injection each here with no clinical relapses ; 901 received two
injections here, of which 25 relapsed; 68 received three injections,
with 1 relapse ; and 14 received four injections, with no relapses.
A. Ninian Bruce.
OILY INJECTIONS OF SALVARS ANA WARNING. H. H.
(297) Hazbn, Jowm . Amer. Med. Assoc., Vol. lx., No. 21, May 24, 1913,
p. 161&
Oily injections give excellent results as far as the effect on the
lesions and Wassermann reaction, and as far as pain and disability
are concerned, but they are apt to be followed by sterile abscesses
at the site of injection in from three to twenty-four months later,
apparently the material injected being toxic to the tissue at the
site of injection, and the dead tissue, if not absorbed, gives rise to
the abscess. A. Ninian Bruce.
A CASE OF PUERPERAL TETANUS. (Un cafl de tft&nos puerperal.)
(298) Pierrbt and H. Leroy, L'Echo mid. du Nord, 1913, xvil, p. 131.
A woman, aged 35, had a miscarriage at two months which was
followed by persistent haemorrhage requiring repeated vaginal
injections. Seven days after the miscarriage symptoms of tetanus
developed, and death took place within twenty-two hours. The
cerebro-spinal fluid was normal, and no visceral lesions were
found post mortem.
Cases of puerperal tetanus are very rare, and form only 3 per
cent, of all cases of tetanus. J. D. Rolleston
ABSTRACTS
341
TETANUS; CHLORETONE POISONING; RECOVERY; FOLLOWED
(299) BY POLYNEURITIS. E. G. Fearnsides, Proc. Roy. Soc. Med.,
VoL vL, No. 2, Dec. 1912 (Neurol. Sect.), p. 54.
The patient was a boy, aged 13, who ran a piece of old iron into
his perineum while playing on some planks. At the time no
abrasion of the skin could be found. Five days later stiffness of
the right leg set in. Three days later a large perineal abscess
developed, requiring evacuation under an anaesthetic. Four days
later the stiffness and pain increased and spread to his left leg and
jaw. On any movement he fell into general tonic spasms, and
his face showed a risus sardonicus. He was given 20 c.c. twice
a day of antitetanic serum, with 120 gr. pot. brom. and 60 gr.
chloral hydrate. As their effect was very slight, 30 gr. of chloretone
was given four-hourly. This controlled the spasms, but produced
coma and broncho-pneumonia, and he was considered to be mori¬
bund. He is, however, gradually recovering, though there is much
general muscular weakness and wasting.
The case was discussed at the meeting, special attention being
given to the cause of the polyneuritis as the result of the (a) abscess;
( b ) chloretone; (c) serum ; (d) tetanus. A. Ninian Bruce.
OASB OP RAYNAUD’S DISEASE. H. C. Semon, Proc. Roy. Soc.
(300) Med., VoL vi, No. 3, Jan. 1913 (Dermatol. Sect), p. 82.
The patient, a woman, aged 56, came with a seven years’ history
of recurrent local asphyxia of fingers, toes, and nose. The tips of
the fingers of the right hand had become gangrenous for the last
few months. Wassermann’s reaction was positive, but she had
had no miscarriages, and no other symptoms pointing to syphilis.
At the discussion various opinions were put forward in regard
to the relation of syphilis to Raynaud’s disease.
A. Ninian Bruce.
ON THE FUNCTIONAL ASSOCIATION OF THE THYROID AND
(301) OVARY (Au sujet de l’association functionelle entre la glande
thyrolde et l’ovaire.) G. Battez, L'Echo mid. du Nord, 1913,
xvii, p. 210.
The patient was a woman, aged 46. At 44 she had a miscarriage
at seven months, and subsequently menstruation became scanty,
and then ceased suddenly. Symptoms of Graves’ disease then
began. Ovarian opotherapy was started in March 1912, and
continued in June, August, and October. There was an immediate
slowing of the pulse, and in January 1913 menstruation reappeared,
and became normal the following months. Although she had had
3o
342
ABSTRACTS
no treatment since October 1912, her general condition in April
1913 was good, the appetite was normal, insomnia had ceased, and
there was a marked diminution of the tremors and exophthalmos.
J. D. Rollkston.
PELLAGRA: SOME FACTS IN ITS EPIDEMIOLOGY. R. M.
(302) Gbimm, Joum. Amer. Med. Assoc., Vol. lx., No. 19, May 10, 1913,
p. 1423.
More cases develop among the whites than among the negroes.
More cases occur among females of both races than among the
males. More cases develop at ages between twenty and forty
years than at other ages. Among the married and widowed
pellagrins the females predominate; the single pellagrins are
equally divided between the sexes. More cases had their onset
during the months of May and June than in other months, and
more in 1911 than in any previous year. More cases develop
under conditions of poverty than of comfort, and more under con¬
ditions of comfort than of affluence. More cases develop in the
vicinity of other cases than otherwise. None of the facts seem to
indicate that pellagra is hereditary. The food used by the people
in whom pellagra is prevalent deserves consideration as a possible
etiologic factor. A. Ninian Bruce.
TUBERCULOUS NEURITIS. (Neurites tuberculosas.) F. Esposel,
(303) Arch. Bras, de Med., 1913, iii., p. 129.
Esposel comes to the following conclusions: Tuberculosis is a
frequent cause of neuritis. In many patients it may be regarded
as the only cause, in others it may act in conjunction with other
factors, viz., auto-intoxication, especially by alcohol or arsenic.
Many useful signs for the early recognition of tuberculosis are due
to neuritis or neuromyositis. Generalised polyneuritis is not
frequent. 95 per cent, of the tuberculous patients examined
by Esposel showed some form of disturbance of sensibility. The
tendon reflexes in the lower liml)s were diminished in 37 per cent.,
normal in 32 per cent., absent in 18 per cent., and increased in
13 per cent.
All showed diminished excitability to galvanic and far&dic
currents in examination of the lower limbs.
J. D. Rolleston.
ABSTRACTS
343
▲ NEW METHOD OP TREATING NEURALGIA OF THE TRIGE-
(304) MINUS BY THE INJECTION OF ALCOHOL INTO THE
GASSERIAN GANGLION. Julius Grinker, Joum. Amer. Med.
Assoc., YoL lx., No. 18, May 3, 1913, p. 1354.
The method described here is that recommended by Dr Hartel of
Bier’s clinic, and is as follows: The needle is introduced through
the cheek opposite the alveolar process of the second upper molar
tooth. The patient then approximates his teeth, and the operator
puts the index finger of his left hand into the mouth and guides
the needle between the border of the inferior maxilla and the
tuberosity of the superior maxilla. The needle is then pushed into
the zygomatic fossa on to the broad under surface of the great
wing of the sphenoid, from which it is pushed into the formamen
ovale at a depth of about 6 cm. from the point of entrance.
Violent pain is at once felt in the distribution of the inframaxillary
nerve and the needle is pushed on until pain is also experienced in
the second branch of the trigeminus within the ganglion. From
0 - 5 c.c. to 1 c.c. of 80 per cent, alcohol is then injected.
The most important objection to this method is the risk of
neuroparalytic keratitis, and thus it is a method only to be used in
the worst cases after peripheral nerve injections have proved un¬
successful. A. Ninian Bruce.
PSYCHIATRY.
THE OCCURRENCE OF THE SYPHILITIC ORGANISM IN THE
(305) BRAIN IN PARESIS. J. H. Moore, Jour. Nerv. and Ment
Dis., Vol. 40, No. 3, March 1913.
A somewhat fuller account is given in this article than in that
by Noguchi and Moore in the Jour, of Exp. Med., Feb. 1, 1913
(v. Review, 1913, xi., p. 174) in regard to the discovery of the
Treponema pallida in twelve out of seventy cases of general
paralysis. Most of the sections were from the frontal and gyrus
rectus regions, and the sections were stained by the usual Levaditi
method. The great majority of the organisms occurred in the
nerve-cell layers of the cortex; there did not seem to be any
relationship between their numbers and the severity of the general
paralytic process. D. K. Henderson.
THE NEUROPATHIC INHERITANCE. F. W. Mott, Joum. Mental
(306) Science , April 1913.
An interesting paper dealing with the neuropathic inheritance
in relation to insanity, genius, suicide, degeneracy, &c. An
344
ABSTRACTS
account, containing many tables and pedigrees, is given of the
investigations of relatives in the London County Asylums. The
neuropathic inheritance in relation to general paralysis and
the creation of the neuropathic inheritance are discussed at
length.
The author has found that there is a signal tendency in the
insane offspring of insane parents for the insanity to occur at an
earlier age and in a more intense form; the form of insanity being
usually either congenital imbecility or primary dementia of
adolescence. J. Stanley Hopwood.
MANIC-DEPRESSIVE PSYCHOSIS. GRAVES’ DISEASE AND
(307) MARIE’S ATAXY; FRIEDREICH’S DISEASE. (Psicosi maniaco-
depressiva, morbo di Basedow e atassia tipo Marie; malattia di
Friedreich.) P. Angelo, Riv. ital. di NeuropatoL, Psychiatr. ed
Elettroter ., 1913, vi., p. 97.
A record of a case of cerebellar ataxia in a woman which developed
in convalescence from typhoid fever at the age of 22, and of a case
of Friedreich’s disease in her brother which had first appeared at
the age of 11 years.
The woman's thyroid had been enlarged since childhood, but
it was not until after typhoid that the other symptoms of Graves’
disease appeared. The manic-depressive psychosis followed an
attempted rape a year previously, and was much aggravated by
the attack of typhoid. J. D. Rolleston.
THE BLOOD-PRESSURE IN THE INSANE. (La pressione sanguigna
(308) negli alienati di mente.) E. A. Sagini, Riv. ital. di Newropat.,
Psychiatr. ed Elettroter., 1913, vi., p. 169.
The writer examined the blood-pressure of 38 women and 33 men,
aged from 30 years upwards, suffering from various forms of
mental disease, with Riva-Rocci’s sphygmomanometer. His con¬
clusions are as follows:—
1. There is no constant relation between the number of pulse
beats and the degree of blood-pressure.
2. In all mental diseases advanced age determines a rise of
blood-pressure (c/. J. Turner, Review, 1909, vii., p. 677).
3. In all mental diseases the curve of blood-pressure in the
right arm is a little higher than that in the left.
4. Occasional excitement and emotion of a certain degree is
followed by a rapid rise of pressure without a corresponding varia¬
tion in the pulse.
5. In every form of mental disease food always causes a fall of
blood-pressure.
ABSTRACTS
345
6. The mean blood-pressure of epileptics is lower than that found
usually in normal individuals. Their pressure varies, but never
reaches a stage of hypertension, even in the period which
precedes or follows the fit.
7. It cannot be affirmed that a definite relation exists between
mental conditions and the blood-pressure, nor that constant varia¬
tions exist in the blood-pressure in relation to every form of mental
disease, but there is an obvious tendency to increased pressure in
paranoia, alcoholic insanity, and hysteria, and a tendency to low
pressure in depressive states. J. D. Rolleston.
THE PSYCHO PATHOLOGY OF EMOTIONAL PSYCHOSIS DURING
(309) THE WAR. (Sulla psico-patologia dell’ emozione durante la
gnerra.) Luigi Daneo, Rataegna di Studi Ptichiat., Vol. iii., F. 2,
Mano-Aprile 1913.
There does not exist any mental disorder which may be considered
different from the others and characteristic of war. Mental
disease only develops in war in persons with weak brains; in
persons with strong brains war confers an immunity against the
graver effects. The author observed chiefly depressive psychoses
in the African War. A. Ninian Bruce.
INSANITY IN TWINS. (Quelques reflexions sur les folios glmellaires
(310) et fiuniliales.) Prof. Bajenopf (Moscow), Arch, intemat. dt Neurol.,
1913, xL, sir. 1, p. 213.
The writer reviews the literature, and gives a brief account of
twins who developed dementia praecox at puberty, one of them
being in Constantinople, while the other was in Egypt. As in
other cases, hereditary predisposition caused a simultaneous evolu¬
tion of the disorder without the co-operation of any mutual
psychical influence (cp. Review, 1913, xi., p. 176).
J. D. Rolleston.
THE USE OF OODEIN IN MENTAL THERAPEUTICS, IN
(311) PARTICULAR IN MELANCHOLIC STATES. (De l’emploi de
la codline en thlrapeutique mentals en parti culier dans les Itats
mAancholiques.) A. Leroy, Joum. de Neurol., Ann. 17, No. 10,
May 20,1912, p. 181.
The author comes to the following conclusions from his observa¬
tions with phosphate of codein in mental disorders.
1. A dose of 5 to 10 centigrammes given subcutaneously
produces no sedative effect in maniacal states.
346
REVIEW
2. It seems to have only a variable and very uncertain action
on the disorders of general sensibility and the mental pain of
states of melancholia.
3. It is remarkably well tolerated in depressed states, large
doses often producing little or no effect. W. Boyd.
■Review.
BOLERO-CORNEAL TREPHINING IN THE OPERATIVE TREAT-
(312) MENT OF GLAUCOMA. Robert Henry Elliot, M.D. Lieut.*
Colonel LM.S. George Pulman A Sons, Ltd. London, 1913,
pp. 117. Pr. 7a 6d. net
In a sense this is a little book; on the other hand, relatively to its
subject, it may quite well be called a big book, as its 117 pages of
fairly close print are devoted to the one operation of sclero-corneal
trephining in glaucoma, in regard to which it may be regarded as
an exhaustive treatise containing the results of the author’s un¬
rivalled experience in the procedure which is associated with his
name.
There are twelve chapters, of which the second—the longest—
and the last are reprinted papers by other writers, and deal with
the history of the operation, and the importance of the site of
application of the trephine. In the remainder the author
gives a very full account of the indication and preparations for the
operation, his own technique and the suggested modifications of
others, the possible complications and the after-management
There are also chapters on the diagnosis of glaucoma in Southern
India, on the method of compiling statistics, and on the results
which show the great thoroughness with which the author has
dealt with his subject.
Numerous illustrations and an excellent index are provided,
and the book may be heartily recommended to those who wish to
consult a complete account of this important operation.
H. M. Traquair.
BOOKS AND PAMPHLETS RECEIVED
347
notice of Meeting.
A Meeting of the International League against Epilepsy will be
held in the House of the Royal Society of Medicine, 1 Wimpole
Street, London, W., at 10 A.M. on Wednesday, 13th August.
The programme will include the discussion of the Reports of
the National Committees of the League and other papers.
By the kind invitation of the managing committees of the
Institutions, two visits have been arranged; the first on Wednesday
afternoon, 13th August, to the London County Council Epileptic
Colony at Epsom, Surrey; and the second to the David Lewis
Epileptic Colony, Sandle Bridge, near Alderley Lodge, on Thursday,
14th August.
BOOKS AND PAMPHLETS RECEIVED.
Becker, Worn. H. “ Spezielle Prognose der Geisteskrankheiten ”
(Sammlung Hoche, Bd. x., H. 3, 1913). Carl Marhold, Halle a. S. Pr.
M. 1.00.
Cyriax, E F. “Medical Gymnastics considered as a Prelude to
Physical Education in the Treatment of Mentally Deficient Children”
{Med. Press and Circular , May 14,1913).
Cyriax, E F. “La gymnastique m&Licale consid6rde comme prelude
k l’6ducation physique des enfants arrive ” (Congres Internal. de lTSduca-
tion Physique, Paris, Mars 17-20,1913).
Flexner, Simon. “The results of the serum treatment in thirteen
hundred cases of epidemic meningitis” ( Joum Exp. Med., Vol xvii., No. 5,
1913).
Flexner, Simon, and Clark, Paul F. “Paralysis in a dog simnla ting
poliomyelitis” (Joum. Exp. Med., VoL xvii., No. 5,1913).
Franz, S. Ivory. “ The functions of the cerebrum ” (Psychol. Bulletin,
Vol. x., No. 4, April 1913, pp. 125-138).
Franz, S. Ivory. “ Mental Status of some Cranks ” (Lawyer a* Magazine,
Rochester, N.Y., Vol. 19, No. 12,1913).
Hinchfeld, Magnus, and Burchard, Ernst. “ Der sexuelle I nfantilism us ”
(Juristisch-psychiat. Gremfragm, Bd. ix., H. 5, 1913). Carl Marhold,
Halle a. S. Pr. M. 1.20.
348
BOOKS AND PAMPHLETS RECEIVED
Kinberg, Olaf. “ Uber das strafprozessoale Verfahren in Schweden bei
wegen Verbrechen angeklagten Personen zweifelhaften Geisteszustandes
nebst Reformvorachlagen ” ( Jvristisch-psychiat .. Grenzfragen, Bd. ix., H. 2/4,
1913). Carl Marhold, Halle a. S. Pr. M. 3.60.
Loudon, Julian. “Acromegaly with localised muscular atrophy”
(i Canadian Pract. and Review, April 1913).
Stern, Ludwig. “Kulturkreis und Form der geistigen Erkrankung”
(Sammlung Roche, Bd. x., H. 2, 1913). Carl Marhold, Halle a. S. Pr.
M. 1.60.
Wickman, Ivan. “Acute Poliomyelitis; Heine-Medin’s Disease”
(Nervous and Mental Disease Monograph Series, No. 16). Translated by
Dr Maloney, New York, 1913. Pr. $3.00.
Intemat. Ztschr. /. Arztliche Psychoanalyse, J. I, H. 3, Mai 1913. Hugo
Heller A Cie, Leipzig and Vienna.
Travaux de la clinique psychiatrique de VUniversite Imperials de
Moscau. Sous la direction de Th. Rybakow. No. 1,1913, Moscow.
The Training School, Vol. x., No. 9, May 1913.
tRevfew
of
UteuroloQE anb flteEcbiatq?
(Original Betides
THE SPREAD OF INFECTION BY THE ASCEND¬
ING LYMPH STREAM OF NERVES FROM
PERIPHERAL INFLAMMATORY FOCI TO THE
CENTRAL NERVOUS SYSTEM.
By Dbs ORR, ROWS, and STEPHENSON.
(From the Laboratories of Prtstwich and Lancaster Asylums.)
(With Plates 21-25.)
Since experimental observation has established the fact that
inflammation of the central nervous system is easily induced by
infection of the ascending lymph stream of nerves, it would seem
that the views regarding the etiology of inflammatory lesions of
the cerebro-spinal axis must undergo considerable revision, and
that an insufficient degree of importance has bo far been attributed
to the rdle and wide-reaching results of lymphogenous infection.
That the spinal cord and brain are exposed to infection along this
path cannot be doubted. This view is based upon both clinical
and experimental data; and its value in connection with the
elucidation of the etiology of some nervous lesions may now
receive more recognition, seeing that the range of application of
the hsematogenous theory is becoming more limited. To take one
example: acute anterior poliomyelitis is no longer regarded by
neurologists as a haematogenous infection of the spinal cord, with
a special selectivity for the motor nuclei Recent work shows
conclusively that the inflammatory phenomena can only be the
result of a lymphogenous infection.
3i
350
ORR, ROWS, AND STEPHENSON
The results of experimental work (1), (2), (3) have shown that
infection of the lymph system of peripheral nerves causes an
ascending neuritis which spreads upwards to pass over the
posterior root ganglia and along the spinal roots to the cord. The
tissue which shows the greatest degree of inflammation is the
loose areolar tissue covering the perineurium, the ganglion capsule,
and the dura mater. The adventitial elements of the veins and
capillaries contribute very largely to the inflammatory exudate.
Within the cord the inflammation diminishes in degree from
without inwards.
The clinical cases in this present paper form a direct con¬
tinuation of experiments carried out on animals to demonstrate
the facility with which infection spreads along the lymph
channels of nerves to the spinal cord. They in no way widen
the scope of the original research; they merely apply to the
human subject the phenomena previously observed, and the
principles derived from that research. It will be seen that not
only is the same path of infection demonstrable, but that
there is a perfect similarity in the type of reaction which varies
with the potency of the irritant.
Case 1. Carcinoma of the Tongue with Suppuration in the Tissues
below the Chin .—In this case an operation on the tongue had been
performed before the patient was admitted into the asylum. Soon
after admission an abscess developed in the sub-maxillary region,
and was opened on the 15th July 1912; another incision was
required a month later. The patient died on the 24th November
1912. At the post-mortem examination all the tissues in the
floor of the mouth were found to be bound together by the
malignant growth and the accompanying inflammation. A con¬
siderable quantity of pus was present in the subcutaneous tissues
and amongst the muscles of the neck. There was no gross lesion
of the brain; the pia mater was congested, slightly thickened,
and, over the pons Varolii, had a distinctly yellow appearance.
Broncho-pneumonia was present in the right lung.
The tissues examined in this case included the twelfth, seventh,
and fifth cranial nerves, i.e., nerves leading from the septic focus
to the central nervous system; the pons Varolii and the medulla
oblongata; the spinal cord, together with the nerves and the
posterior root ganglia connected with its cervical portion. The
THE SPREAD OF INFECTION
351
part of the hypoglossal nerve was taken from near the angle of
the jaw, and that of the facial nerve from just outside the mastoid
foramen. In both these the connective tissue cells of the epi-
and peri-neurium and the cells of the adventitial sheath of the
veins and capillaries were reacting actively to the irritant derived
from the septic focus under the chin. Considerable collections
of cells were present around the vessels and along the trabeculae
of the sheath of the nerves. Some of these had a rounded or
indented nucleus containing little chromatin and a faintly-stained
cell-body; mixed with these were small cells with deeply-stained
nuclei and a small amount of well-stained protoplasm around
them. In some of the capillaries the endothelial cells were much
enlarged and rounded, and projected into the lumen of the vessel.
Within the nerves the reaction was much less intense: the cells
of the adventitial sheath of the veins and capillaries were
increased in number and were swollen; in some areas typical
plasma cells were seen. The neurilemma cells were swollen. A
portion of the seventh nerve which included the geniculate
ganglion was examined also. Here the inflammatory condition
was less acute. There was some proliferation of the cells of the
epi- and peri-neurium and of the adventitial sheath of the veins
and capillaries: the capsular cells around the nerve cells also
showed signs of irritation.
The most intense inflammatory reaction in this case was found
around the fifth nerves outside the dura mater and in the Gasserian
ganglia. The cells of the sheath of the nerves and of the peri¬
neurium surrounding the nerve bundles exhibited a remarkable
proliferative activity, and large collections of reaction cells had
appeared (Photo 1). Many of these were of the polyblast type,
with the rounded or indented nucleus containing little chromatin
and a faintly-stained cell-body. Mixed with these were small
cells with a rounded, deeply-stained nucleus surrounded by a very
little well-stained protoplasm. Many stages between these two
forms of cells could be observed. In some instances the protoplasm
of the cells had assumed a reticulate structure, and many con¬
tained distinct refractile purple granules. Frequently the cell-
membrane had burst and the granules were escaping. They were
especially numerous where haemorrhage had occurred and blood-
pigment was present. It is probable that their appearance was
due to the fact that they had acted as scavengers, and had imbibed
352
ORB, ROWS, AND STEPHENSON
some of the blood-pigment. It is possible that these granules
correspond to the granules of hsemosiderin which Bonfiglio has
found in plasmatocytes in various pathological conditions of the
central nervous system.
The reaction within the Gasserian ganglia was less than that
around the nerves outside the dura mater, but it was still con¬
siderable around the bundles of the nerve as they entered the
ganglia. Polyblasts were less in evidence, and large rounded
cells with a darkly-stained nucleus and much well-stained
protoplasm were the most prominent feature. These cells
closely resembled the pseudoplasma cells described by Pappadia
as being numerous in acute inflammatory conditions, and as they
were associated with polyblasts, and with small cells having a
darkly-stained nucleus and very little protoplasm around it, it
is probable that they owed their origin, not to mono-nuclear
leucocytes, as suggested by this author, but to the proliferating
connective tissue and adventitial cells, as did the cells amongst
which they were lying. Amongst the tissues of the ganglia many
of the reaction cells exhibited the characters of plasma cells. The
capsular cells around the nerve cells were proliferating. The
nerve cells themselves showed various stages of injury: coagulation
necrosis and homogeneous atrophy of the nucleus were seen fre¬
quently. In other nerve cells the chromophile elements had
disappeared and neuronophagy had commenced.
The degree of the irritation in the pia mater over the pons
Varolii was much less than that in the structures already described.
Photo 2a shows an infiltration of the membrane with small round
cells, some of them possessing the characters of plasma cells. The
irritation extended from the pia mater along the adventitial sheath
of the vessel as it passed into the pons. This result, produced by
toxins derived from the suppurating focus under the chin, which
had reached the pons by ascending along the fifth nerve, resembles
very closely the condition produced experimentally in animals
when an acute inflammatory process had followed the bursting of
a celloidin capsule, containing a culture of micro-organisms, placed
close to an intervertebral foramen. The comparison of the photo¬
graphs (Photos 2a, 26), 1 one illustrating a condition found in a
1 Photos 2a and 26 should be compared with Photo 2c, from a section
kindly lent by Dr Coupland, of Lancaster, and sent to him by Professor Pettersson,
of Stockholm.
I
Platk 21.
I
tea? 1 ''
Bote? : -
ess tic 5
Mi &
( 0 : :
up 1 *
T& '•
Sll'i*'!
irolif^
lb si-
V
• t ;
s#; ;
3 a#'-
#*•
-
ij^-"
, f-
•Is
/
,pte'
id * 1
Photo I.—Inflammatory Reaction in the Perineurium of the
5th Cranial Nerve.
Photo 2a. —Vessel passing
from Pia Mater into
Pons Varolii.
Photo 2 h. —Compare with
Photo 2a,
Photo 2c. - Experimental
Acute Poliomyelitis in
Monkey. Vessel pass*
ing into White Matter
of Cord. Compare with
Photos 2d and l >.
THE SPREAD OF INFECTION
353
case of carcinoma of the tongue with suppuration in the adjacent
tissues in the human subject, and the other a condition produced
experimentally in a rabbit, is interesting and suggestive. Within
the pons the vessels were dilated to a great degree, and in many of
them the cells of the adventitial sheath exhibited signs of reaction.
Chromatolysis had occurred in many nerve cells; the neuroglia
cells were proliferating.
Examination of the posterior root ganglia and the nerves
connected with the cervical portion of the spinal cord demonstrated
that the toxins derived from the focus of suppuration had given
rise to an intense reaction, which was especially marked in the
epidural tissue and at the proximal pole of the posterior root
ganglia (Photo 3). This again corresponded closely to the results
obtained by experiments on animals. The reaction inside the
dura mater was slight, as compared with that nearer the focus
of origin of the irritant. The pia mater was infiltrated by small
cells with deeply-stained nuclei: some plasma cells were present.
This irritation of the pia mater was most marked in the cervical
and upper dorsal regions, and lessened over the lowest segments
of the spinal cord. Within the spinal cord the vessels were
dilated, and there was some irritation of the cells of their adventitial
sheath (Photo 4).
Case 2. Erysipelas of the Face .—This patient was an old woman
who had been in the asylum for many years. On the 26th May
1912 she became very ill; her temperature rose to 104°: on
each side of the nose a red flush appeared, which spread rapidly.
The tissues of the face became oedematous, and had the typical
appearance of erysipelas. She died on the 1st June 1912. At the
post-mortem examination it was found that the tissues of the
anterior half of the scalp, of the whole of the face and below the
chin, were puffy and cedematous : much of the subcutaneous tissue
had necrosed, and a pale sanious fluid poured out when an incision
was made into the skin. There was no gross lesion of the brain ;
patches of congestion were present in the pia mater over the
frontal and the left temporal regions. Nothing of importance was
noticed in the other organs.
The tissues examined in this case were the fifth nerves outside
the Gasserian ganglia, the Gasserian ganglia, and the pons Yarolii.
In the fifth nerves outside the Gasserian ganglia signs of an
inflammatory reaction were present in the form of haemorrhages
354
ORR, ROWS, AND STEPHENSON
into the epineurium, and a proliferation of the cells of the epi- and
peri-neurium, and of the adventitial sheath of the vessels contained
in them. This proliferation had led in some areas to large col¬
lections of reaction cells. The form of the cells varied from the
rounded cell, with a deeply-stained nucleus surrounded by a little
protoplasm, to cells with a larger, paler nucleus and a fairly large
cell-body. At the same time there were a large number of cells
with a small deeply-stained nucleus and a large cell-body con¬
taining quantities of refractile purple granules. In many instances
the limiting membrane of these cells had broken, and the granules
were escaping. They were again especially numerous in the
neighbourhood of haemorrhages. In the sheath of the Gasserian
ganglia collections of micro-organisms were found, and accompany¬
ing these there was an acute inflammatory reaction with large
collections of cells. Amongst these were cells showing various
stages of reaction, from the small cell with deeply-stained nucleus
to the typical polyblast (Photo 5). Many of the large cells
contained purple granules. An inflammatory reaction could be
followed between the nerve bundles passing into the ganglia.
Within the ganglia the evidences of irritation were less acute.
Proliferation of the connective tissues and of the cells of the
adventitial sheath of the vessels was taking place. The capsular
cells were more numerous than normal, and in many instances
surrounded the nerve cells in several rows. The nerve cells
exhibited marked chromatolysis, and many nuclei were in a
condition of homogeneous atrophy.
In the pia mater covering the pons Varolii the vessels were
much dilated, and in some areas the membrane was infiltrated
with small round cells having a deeply-stained nucleus and only
a little protoplasm. Within the pons the vessels were dilated,
and the cells of the veins and small vessels showed signs of
reaction. Chromatolysis was present in the nerve cells; the
neuroglia cells were proliferating, and some were surrounded by a
considerable amount of protoplasm.
Case 3 was one of juvenile general paralysis, who developed
bedsores over the sacrum, right hip, and elbow three weeks prior
to death. The sacral bedsore involved the muscles, which were
necrosed. At the post-mortem examination, on removing the
spinal cord, great excess of cerebro-spinal fluid escaped. The
outer surface of the dura mater was inflamed, and there was
Plate 22.
*
k
Photo 4.— Inflammatory Reaction in Wall of Vessel in White
Matter of 7th Cervical Segment.
Photo 3. — Inflammatory Reaction at the
Proximal Pole of 1st Cervical Posterior
Root Ganglion.
Photo 0.—4th Dorsal Nerve. Reaction of
the Peri- and Endoneurium Proliferation
of Neurilemma Nuclei.
THE SPREAD OF INFECTION
355
a small quantity of pus in the lowest portion of the spin&I canal.
From this the dura mater and nerve sheaths had been infected,
for micro-organisms could be followed in the epineural tissue to
the points at which the nerves pierce the dura. The presence
of these organisms had led to an inflammatory reaction most
marked in the epidural tissues. Here haemorrhages were present,
and the cells of the trabeculae of the connective tissue were pro¬
liferating actively; in some areas considerable masses of cells had
accumulated. The cells were irregular in shape, and differed
greatly in staining reaction. Some resembled polyblasts, but cells
with a more deeply-stained nucleus and a considerable quantity
of protoplasm surrounding it were more numerous. Mixed with
these were cells with a deeply-stained nucleus and very little
protoplasm. Within the dura mater no organisms were seen, but
the inflammatory reaction was still very marked. The cells of
the perineural sheath were proliferating actively, forming collec¬
tions of cells, with a rounded nucleus containing much chromatin,
and a large cell-body around it (pseudoplasma cells of Pappadia).
Within the nerve and within the posterior root ganglia the
reaction was less. The adventitial cells of the small vessels were
reacting, and many cells resembling plasma cells were present.
The capsular cells were proliferating, and lay in layers around
the degenerating nerve cells. In the pia mater around the
lower segments of the spinal cord there was some infiltration
by small round cells. Within the spinal cord the cells of
the adventitial sheath of the small vessels and the neuroglia
cells were reacting. These signs of irritation diminished higher
up the spinal cord, and in the cervical segments they were
very slight.
Case 4. H. F .—Case of Tubercular Nodules of Pleura.
History .—He is said to have had a severe attack of “ influenza ”
nine months before admission, and was forgetful and strange in
manner for four months. Five weeks before admission had a
“ strong fit,” followed at an interval of a week by another fit. Had
been in bed since. On admission he was feeble and shaky, in¬
coherent and confused, little idea of time or place, and wandered
restlessly about his room. Temperature normal, knee-jerks ex¬
aggerated, tongue tremulous, pupils dilated and sluggish; mouth
in a septic condition with pyorrhoea alveolaris; there was a trace
of albumen in the urine. He vomited brownish fluid on 27th May;
356 ORR, ROWS, AND STEPHENSON
his temperature went up to 100° F., and he died the same
evening.
The diagnosis made on admission was acute confusion or general
paralysis.
Post-mortem Appearances .—The dura was tensely filled. The
pia arachnoid was thickened and milky; decidedly more adherent
than normal. At the base the thickening was most marked; over
the left temporal lobe the pia arachnoid was adherent to the dura.
The cerebro-spinal fluid was very scanty. The cerebral convolu¬
tions were much flattened. On section the most extreme oedema
of white matter was apparent; the ventricles were small, with
very granular walls; on the floor of the fourth ventricle the
granulations were particularly large. The vessels were a little
thickened. In the right pleura there were rows of small hard
tumours from $ in. to 1 in. in diameter. The larger nodules
held softened centres, and contained pus-like material. These
nodules occurred in parallel rows in the parietal pleura, also on
the pleural surface of the diaphragm, the outer layer of the peri¬
cardium, and on the visceral pleura. The lung substance appeared
normal.
Microscopic Anatomy .—One of the tumours in the pleura was
examined and found to be composed of fibrous tissue, lymphocytes,
connective tissue cells with large clear nuclei, and giant cells. No
bacilli are found by Ziehl-Nielsen staining.
Dorsal Cord .—There was proliferation of the endothelial nuclei
on the inner surface of the dura mater. The perineurium of the
spinal roots and the septa between the nerve bundles were deeply
infiltrated with many lymphocytes, amongst which some plasma
cells were scattered; and there was marked proliferation of the
neurilemma nuclei (Photo 6), which were spindle shaped, often
irregular in contour, and frequently showed degenerative changes.
The greatest reaction in the spinal roots occurred where they
pierced the dura mater (Photo 7). The pia arachnoid was full of
lymphocytes (Photo 9), and plasma cells occurred to a much less
extent. These were not quite typical. The adventitial spaces
of the vessels were packed with lymphocytes. A group of three
giant cells lying in the pia arachnoid is shown in Photo 8.
Within the cord there was a high degree of adventitial pro¬
liferation and infiltration (Photo 10). Similar changes were
present in all the septa passing from the pia arachnoid into the
THE SPREAD OF INFECTION
357
cord. Two types of reaction cell were present. One had a faintly-
staining large clear nucleus, a pale green nuclear membrane,
and a pink nucleolus, by Pappenheim’s method; the other was a
typical lymphocyte. Plasma cells occurred occasionally, and near
the cord-margin. There was much neuroglial proliferation.
Marchi’s method showed considerable myelin degeneration
scattered uniformly throughout the cord.
Cervical Region .—Here there was much less reaction in the
pia arachnoid and in the adventitial sheath of the vessels. The
reaction cells were almost all lymphocytes. A few giant cells
occurred. There were a few lymphocytes in the outer sheath of
the vessels in the cord substance, and a slight degree of prolifera¬
tion of adventitial elements. Occasionally small haemorrhages
were seen in the white matter. The neuroglia was proliferating
and some neuroglial giant cells occurred in the vicinity of the
haemorrhages.
Lumbar Cord .—The vessels of the spinal roots showed a slight
degree of lymphocytic infiltration of the adventitia. There was
little alteration of the peri- and endo-neurium. Lymphocytes
were numerous in the pia arachnoid, and there were giant cells in
the adventitial sheath of the vessels. Within the cord the vessels
were dilated and engorged. There were some lymphocytes in the
external coat of the larger vessels, and the endothelium of the
capillaries showed proliferative changes. The neuroglia cells were
increased in number. No haemorrhages were present.
Case 5. J. P. —Case of Tubercular Lumbar Abscess. —On ad¬
mission he had delusions of grandeur, wealth, and ability; these
were soon lost, and he became sullen and impulsive; later, he
was demented and had lost all idea of time and place. Two
years after admission he developed pleurisy at base of left lung,
and from this time onward he was considered to be suffering
from pulmonary phthisis. In February 1912 a lumbar abscess
was noted, and it was aspirated in May. On 12th June he had
several attacks of vomiting, retraction of the head, sluggishly
reacting pupils, conjugate deviation of head and eyes to the left,
knee jerks exaggerated, and ankle clonus. He died on 14th June.
Post-mortem Appearances .—Pia arachnoid was slightly thick¬
ened and opaque, cerebro spinal fluid much increased and semi-
turbid. Brain (1,185 gms.) showed some atrophy of convolutions,
grey matter darker than normal, white matter very soft and
358
ORR, ROWS, AND STEPHENSON
oedematous. The ventricles were a little enlarged, and very
prominent granulations were present on the ependyma—especially
in the fourth ventricle. The vessels appeared normal. The spinal
pia arachnoid was thickened. The vessels were much engorged,
and the cord substance very soft. There was an abscess in the
right lumbar region—between the lowest rib and ilium ; its exact
origin was not determined—no diseased bone was found. The
lungs were both firmly adherent to the chest wall, and showed
many small hard tubercular masses. The mesenteric glands were
enlarged and calcified.
Microscopic Anatomy .—In the wall of the lumbar abscess there
were giant cells and tubercle bacilli present.
Lumbar Cord .—The spinal roots were practically normal:
nothing unusual was present beyond congestion and dilatation of
the vessels. The pia mater and adventitial spaces were infiltrated
with lymphocytes; a few plasma cells were present. Some giant
cells were present in the perivascular tissue. There was marked
congestion of the vessels in the cord substance, and the adventitia
showed a mild degree of proliferation. The neuroglia cells were
markedly increased in number: no hemorrhages were present.
Dorsal Cord .—The perineurium of the spinal roots showed a
high degree of inflammatory reaction (Photo 11). The exudate
consisted of lymphocytes, proliferated connective tissue cells, and
plasma cells. Rows of lymphocytes were seen in the septa between
the nerve bundles. The neurilemma nuclei were greatly increased
in number; and the vessels were engorged and dilated. The pia
arachnoid was filled with proliferated cells and lymphocytes, as
were the adventitial spaces of the vessels. The reaction cells
were for the most part lymphocytes, but a considerable number
of plasma cells were present. These were not quite typical, as
the nucleus was smaller and darker than normal, and the proto¬
plasm was not always vacuolated. Giant cells occurred in the
pia. There was a considerable degree of inflammation in the
septa passing from the deep surface of the pia into the cord. The
adventitial sheath of the vessels in the cord showed a high degree
of proliferation, and its spaces were filled with large clear nuclei or
with lymphocytes (Photo 12). There were some haemorrhages in
the white matter, and in the fourth dorsal segment, in the column
of Burdach, near the periphery of the cord, there was a small
isolated patch of myelitic softening. The neuroglia was proliferated,
THE SPREAD OF INFECTION
359
and Marchi’s method showed much diffuse degeneration, which
was more prominent round the outer portions of the cord. There
was a considerable degree of myelin degeneration in the spinal
roots also.
Cervical Cord .—Here the inflammatory reaction in the soft
membranes was well marked, but of less degree than in the dorsal
region. The perineurium of the spinal roots was also affected, and
the cell types were the same as noted in the dorsal region.
Giant cells again occurred in the adventitia of the vessels.
Haemorrhage was present in the spinal roots, and in both grey
and white matter of the cord.
Cerebrum .—The pia arachnoid was infiltrated with plasma cells
and lymphocytes. There were no giant cells. Plasma cells were
also found in the adventitial sheath of the larger vessels of the
cortex, but only near the surface; not in the deeper layers. The
endothelial nuclei of the capillaries were increased in size and
number; no plasma cells were seen in connection with them.
Case 6. C. L .—Case of Cancer of (Esophagus .—In the oesophagus
there was a flat-topped growth at the level of the crossing
of the left bronchus; some ulceration of the surface of the
tumour had occurred, and also of the mucous membrane above
the growth. The cervical lymphatic glands were enlarged. The
spinal cord appeared to be softened in the cervical region and the
vessels were engorged, but there was no evident meningitis. The
dura mater was thickened, with recent roughening and loss of
polish in the posterior cranial fossa. There was pus under the
pia arachnoid at the posterior border of, and on the upper surface
of the cerebellum, and at the tip and along the inferior surface of
temporal lobe of the cerebrum. Over the upper part of the frontal
and parietal lobes the pia arachnoid was much thickened. The
brain weighed 1,230 gms. Its convolutions showed great atrophy.
There was marked oedema of the white matter, and a small
softening in the left lenticular nucleus. There was much thicken¬
ing with calcareous deposit in the large vessels at the base. There
was red staining of the heart valves and of the intima of the aorta.
The left kidney weighed 70 gms., the right 60 gms.; the capsules
were adherent, and the cortex much atrophied.
Microscopic Anatomy .—The tumour in the oesophagus was an
epithelioma; adhering to its surface there were large masses of
micro-organisms. Ulceration of the oesophagus was seen above
360
ORR, ROWS, AND STEPHENSON
the level of the epithelioma. There was marked proliferation of
tissue cells in this part of the wall of the oesophagus.
Cervical Cord .—In the epidural tissue the vessels were greatly
congested, and there were extensive hemorrhages. Many micro¬
cocci (Photo 13) were present, arranged in pairs or short chains,
and many degenerate cells, in all probability polymorphonuclear
leucocytes. The outer layers of the dura were infiltrated with
reaction cells of the same type (Photo 14), and there were many
cocci. Some mast cells were present in the dural tissue. The
perineurium of the spinal roots was infiltrated with small round
cells possessing a small deeply-staining nucleus. This infiltration
extended into the proliferated septa between the nerve bundles,
and in the case of one anterior root there were micrococci, similar
to those in the dura, lying amongst the reaction cells. The
neurilemma nuclei were greatly proliferated, as were the capsular
cells surrounding the posterior root ganglion nerve cells (Photo
15). The latter showed acute chromatolysis, and were almost
devoid of chromophile substance.
There were small groups of micrococci in the pia arachnoid
and many degenerate polymorphonuclear leucocytes, lymphocytes,
and proliferated connective tissue cells. Within the cord there was
a high degree of adventitial proliferation. Lymphocytes were few
in number, and there were no plasma cells. The neuroglia was
proliferated, and in many the nucleus was swollen, rich in chromatin,
while the cell-body was enlarged and possessed branching processes.
Dorsal Cord .—The dura mater was normal. The pia arachnoid
was infiltrated with polymorphonuclear leucocytes and lymphocytes,
the former occurring in greater number than the latter. Here and
there were groups of degenerated leucocytes. In the spinal roots
the blood vessels were engorged, and there were many polymor¬
phonuclear leucocytes in the perineural sheath. The adventitial
and connective tissue elements were markedly proliferated. The
neurilemma was normal. There was much proliferation of the
adventitia within the cord, and in places this sheath was infiltrated
with lymphocytes. The endothelial cells of the capillaries were
swollen and proliferated. Small haemorrhages were frequently
seen. The neuroglial cells, especially round the cord margin, were
enlarged, and the cytoplasm was prolonged into branching processes.
Lumbar Region .—There were many polymorphonuclear leuco¬
cytes in the pia arachnoid, and lymphocytes were present
Pl.ATE 24 .
J
:
jr Biff'
tt dsiff ;
iteii ^
■ere®?
me.
ill tt®-
iSititf
Irn#
i**
lb B*
caf^
iP
allDitf
wyi*
ere**
jeft*
ia ***
i®aW
(fl#
illlll®
,it£
f icj
n $
#■
pti*
IV
(In’ *
i[^
•erf
4
?j«
£
0* 1
it
Photo 8. —4th Dorsal Segment. A group
of Riant-Cells in the Spinal Pia-Arach¬
noid.
Photo 10. — 4th Dorsal Segment.
Infiltration of the Adventitial
Sheath ; Increase of Neurog¬
lial Nuclei.
Photo 11 . — 4th Dorsal Segment showing a Posterior Root Bundle.
Infiltration of the Perineurium.
THE SPREAD OF INFECTION
361
in somewhat fewer numbers. The vessels were engorged
here, and also in the spinal roots, whose fibrous sheaths
were filled with both leucocytes and lymphocytes. Here and
there in both pia and spinal roots there was a moderate degree of
adventitial proliferation. The neurilemma was normal. Within
the cord the vessels were engorged, and a very few lymphocytes
were present in the adventitial spaces. Small haemorrhages were
present in the grey matter.
Medulla .—There were well-marked changes in the pia arachnoid.
Polymorphonuclear leucocytes, polyblasts, and micrococci were
present. There was proliferation of the adventitial coat of the
vessels; the middle coat of the larger vessels showed hyaline
thickening, and in some the intima had so increased in thickness as
to almost occlude the lumen. Within the medulla there was some
adventitial infiltration with lymphocytes, and the endothelium of
the capillaries was swollen and proliferated. Some of the vessels
of the pia and medulla were filled with polymorphonuclear
leucocytes.
Cerebellum .—In the sub-arachnoid space there was a thick
inflammatory exudate, composed for the most part of degenerate
polymorphonuclear cells. There were no micro-organisms, no
polyblasts, and no plasma cells. In the deeper parts of the sulci
the exudate was much less in quantity, and at the bottom the
reaction was very slight. There was a slight degree of infiltration
of the adventitial sheath with cells which had the appearance of
degenerate polymorphonuclear cells.
Cerebral Cortex .—Here the inflammatory reaction was less.
There were scattered haemorrhages in the cortex, and collections of
polymorphonuclear leucocytes in the pia arachnoid.
Case 7. S. C. H., aged 34. — General paralysis of the insane: of
about two years’ duration. Fourteen days previous to death he
developed hemisudosis of the right side of the head and neck, which
rapidly involved the entire right side of the body. At the same
time a right dorsal herpes zoster made its appearance, extending
from the angle of the scapula through the axilla to the sternum.
There was marked dullness of the base of the right lung. At the
post-mortem examination all the signs of general paralysis were
found, and in addition a right-sided empyema.
Right Intercostal Nerves (fourth, fifth, sixth).—The loose areolar
tissues covering the perineurium showed abundant evidence of
362
ORR, ROWS, AND STEPHENSON
inflammation. The vessels were congested, and at many points
there were haemorrhages. No thrombi were present. The inflam¬
matory exudate had the same distribution as we have already
noted in nerves infected experimentally, and its character was that
of a subacute reaction passing on to the chronic stage. There
were no polymorphonuclear leucocytes present There were many
small lymphocytes, numerous plasma cells, and fibroblasts. The
endothelial cells lining the trabecuhe had proliferated. Mast cells
were frequently met with.
The large majority of the plasma cells had undergone re¬
pressive changes. They were paler than normal, distorted, and
the nucleus was rarely typical. As a rule it was small in size,
round, irregular, or kidney-shaped, and stained very darkly.
Many of the altered plasma cells resembled compound granular
corpuscles, of which there were many examples. The mast cells
were of varying shape—round, oval, or provided with elongated
processes filled with granules—the so-called clasmatocytes of
Ranvier. The adventitial elements of the veins and capillaries
showed active proliferative changes and plasma-cell formation.
Very frequently these cells lay in clusters round the vessels.
There was a considerable degree of inflammatory reaction of
the perineurium and its prolongations between the nerve bundles.
The connective tissue nuclei were swollen, elongated, and immature
fibroblasts were present. The adventitia of the veins and
capillaries had reacted. The neurilemma cells showed signs of
irritation. Their nuclei were swollen, round, and pale, while the
protoplasm at either extremity contained numerous lilac-coloured
granules (Reich’s corpuscles).
The right fourth dorsal posterior root ganglion was cut
longitudinally, and the sections stained by Van Gieson’s method.
A large portion of the ganglion had been destroyed, and this area
was occupied by fibrous tissue, some nerve fibres, and degenerated
nerve cells. Many nerve cells had disappeared, and in those which
remained there were no details of structure recognisable. In this
sclerotic area there were no cells of reaction, but in the tissue
immediately surrounding it there was a thick band of small cell
infiltration. A similar type of exudation was evident in the layers
of the ganglion capsule and around its vessels. Here and there,
in the areolar tissue covering the capsule, in the capsule, and
around the nerve cells, there were small haemorrhages. In the
THE SPREAD OF INFECTION
363
portion of the ganglion which was not destroyed there were many
reaction cells which permeated the tissue between the nerve cells,
and were in some situations heaped up into small isolated clusters.
The posterior root (right fourth dorsal) was cut longitudinally,
and some sections were stained by Wolters - Kulschitzky’s
method; others by haematoxylin and eosin. About two-thirds of
the medullated fibres were degenerated, and the nuclei of the
corresponding neurilemma sheaths showed a high degree of
proliferation.
The spinal cord was examined by Marchi’s method alone. In
the fourth dorsal segment the vessels were dilated and congested.
There were small haemorrhages in the grey matter. In the right
root entry zone about two-thirds of the incoming posterior root
was degenerated; the degeneration affected the collaterals passing
into the grey matter, and also the descending branches of the
root fibres. The latter could be followed downwards as far as
the sixth dorsal segment. The degenerated root, when traced
upwards, gradually decreased in volume, and at the level of the
eighth cervical segment formed a narrow band lying against the
paramedian septum. It was still recognisable in the third cervical
segment where its most anterior portion lay against the median
septum and the remainder along the paramedian septum.
In connection with the above series of cases, it does not seem
out of place to mention the cord infection which sometimes
follows inflammation of the urinary bladder. Walker (4) has
recorded three instances of long-standing chronic cystitis which
terminated fatally by acute ascending paralysis of a most
malignant type. We have ourselves observed a case of trans¬
verse myelitis following chronic bladder trouble, the result of
prostatic cancer. Leyden (5) has stated that in a considerable
number of cases of so-called reflex paralysis, an anatomical affec¬
tion of the cord has been proved, which begins as a circumscribed
myelitis of the lumbar enlargement. He assumed that the
infective agent first involved the nerves, in which it induced a
progressive neuritis, and passed up to the cord. Another case
of great interest is described by Collins and Armour (6). It
was that of a boy in whom acute bulbar palsy followed an attack
of mumps. The inflammatory changes in the medulla and pons
were very intense and attained the maximum at the level of
364
ORR, ROWS, AXD STEPHENSON
the sixth nucleus, a fact highly suggestive of the spread of infection
along the seventh nerve.
Six of the seven cases on which this communication is based
show a diffuse meningo-myelitis of the cerebro-spinal axis, the
direct result of, and anatomically continuous with, toxi-infective
reaction phenomena of the peripheral nervous system. The con¬
dition, therefore, is one of meningo-myelitis secondary to ascending
neuritis. In one of our cases, that of herpes zoster, the further
spread of infection, which took origin in an empyema, was arrested
at the posterior root ganglion, the destruction of which naturally
resulted in a zone of degeneration in the posterior columns of
the cord.
The inflammatory phenomena in the cerebro-spinal axis and
its membranes vary considerably in intensity from case to case,
according to the degree of potency of the infective agent; and the
spread of the inflammation is by direct continuity, the mode of
extension now recognised as typical of lymphogenous infections.
Our cases show that any portion of the central nervous system may
be attacked by organisms or toxins passing up the nerves from
infective foci, and although the ultimate result of infection may
vary according to the quality of the exciting cause, the anatomical
path of entrance and spread is a constant one. For example, in
cases 4 and 5 of tubercular infection of the central nervous
system the meningo-myelitis has exactly the same distribution
as in the other cases, but shows the distinctive quality of the
exciting agent in the formation of giant cells.
It is important to recognise that where an area of infection
exists outside the central nervous system and the latter shows no
sign of functional or organic disturbance, still a variable degree
of inflammation may be present in its substance and membranes
(case 4). It is obvious, therefore, that absorption may take place
along the ascending lymph paths of the nerves for a considerable
period before the exciting agent is of sufficient potency to cause
symptoms. And there is an anatomical reason for the attenuation
of noxious agents as they approach the central nervous system.
The highly vascular epidural tissue and the dura itself form a
very efficient barrier to the inward spread of infection by the
lymphogenous path and neutralise to a great extent the patho¬
genicity of organisms and toxins. Thus it is that m the early stages
Plvtk 25.
i®0-
05 ii te
d ia.9
c-iotP 8
He*
J JsSfl-
iefnc*
ujbP
olios'-
[0S^
: anflP
I
0*
0&
;
jl*?
jtoS*
JUfk'
otf^
ri^
of*
0* l
it?
I#
.]*
l/ '
0* »
mP*
■jK#
inn*
f ^
r#l
Photo 12. —4th Dorsal Segment:
White Matter near Periphery
of Cord. Infiltration of Ad¬
ventitia of Vessel.
Photo 13.— High-power View of Photo2,
showing Micrococci.
Photo 14.— 4th Cervical Segment: Col¬
lection of Degenerate Polymorphs in
Dilated Dural Sp ace.
1, Dura Mater ; 2, Polymorphs.
Photo 15. — Posterior Root Ganglion :
4th Cervical. Showing increase of
Capsular Nuclei round the Nerve
Cells.
THE SPKEAD OF INFECTION
365
of infection the exciting agent reaches the cord in small quantities
or in an attenuated condition and gives rise to almost inappreciable
disturbance, but should the defence mechanism of the dura be
broken down then acute inflammatory phenomena make their
appearance. Cases 1 and 6 show how important a defence
mechanism the dura is; one of the most striking features in
their morbid anatomy is the marked diminution in the degree
of inflammatory reaction amongst the tissues internal to the dura
mater. A consideration of the above facts shows us, therefore,
that in cases similar to those under discussion the post-mortem
examination is not complete unless the cord and brain are in¬
vestigated ; for if neglected, many important and suggestive data
may escape observation.
It has been shown by experimental infection of the lymph
stream of the nerves and spinal cord that certain structures
invariably showed the greatest degree of reaction, and the result
of the examination of the above clinical cases coincides with our
earlier observations. These structures are the loose areolar tissue
covering the sheaths of nerves and the posterior root ganglia,
the epidural tissue, and the adventitial elements of the veins
and capillaries. The tissues furthest removed from the original
toxic source suffer least of all, as do the structures protected
by a fibrous sheath; hence the signs of ascending neuritis are
less marked within the perineurium of the nerves and in the
substance of the posterior root ganglia; while in the spinal cord,
medulla, and pons, the degree of reaction diminishes from without
inwards. That portion of the cerebro-spinal axis directly con¬
nected by nerves with the source of infection exhibits the highest
degree of inflammation. Still the signs of meningitis may be
very well marked both above and below the point of greatest
intensity (case 6), but the gradual attenuation in potency of
the infective agent is shown by the progressive diminution in
the degree of myelitic phenomena. While, in the area of primary
infection, adventitial inflammation, haemorrhage, neuroglial hyper¬
plasia, &c., are prominent, the only evidence of myelitis in distant
parts may be confined to the presence of a few round cells in
the adventitial spaces, and congestion of the vessels.
There are several additional observations in these clinical
cases which agree entirely with the data derived from experiment.
We again find that the adventitial elements proliferate readily
32
366 ALEXANDER BRUCE AND JAMES W. DAWSON
under stimulation and contribute largely to the inflammatory exu¬
date. In acute inflammation the neuroglia nucleus and cell-body
becomes swollen, and assumes an amoeboid appearance. There
is an entire absence of thrombi, and only in one case in which the
inflammatory process was extensive and acute was there any
tendency to the local accumulation of leucocytes in the vessels.
With regard to the origin of the cell types which compose
the exudate we have nothing to add to our last communication.
The same structures react in our clinical cases as in an experi¬
mentally induced neuritis and meningo-myelitis; and the morph¬
ology of the reaction cells varies with the potency of the irritant.
Many of the cell types are atypical, and the forms which they
assume naturally vary according to the duration and intensity of
the inflammatory process. The regressive changes which they
undergo in many instances renders their strict classification well
nigh impossible.
References.
(1) Orr and Rows. Review of Neurology and, Psychiatry, May 1907.
(2) Orr and Rows. Review of Neurology and Psychiatry, December 1910.
(3) Orr and Rows. Review of Neurology and Psychiatry, September 1912.
(4) Walker. Clinical Society's Transactions, Vol. xxxviii.
(5) Leyden. Quoted by Walker.
(6) Collins and Armour. Review of Neurology and Psychiatry, August 1912.
MULTIPLE NEUROMATA OF THE CENTRAL
NERVOUS SYSTEM: THEIR STRUCTURE
AND HISTOGENESIS.
By the late ALEXANDER BRUCE, M.D., LL.D., F.R.C.P.E.; and
JAMES W. DAWSON, M.D. (Carnegie Research Fellow).
(Continued from page 315.)
(3) Genesis of Fibres in Tumour Formation.
The histogenesis of nerve fibres has been discussed from the
developmental aspect and from the experimental aspect in the
regeneration of the divided nerve, but it has very rarely been con¬
sidered in pathological conditions. Here we have to do not with
the first development of the embryonal nerve fibre, nor with the
restoration of the distal end of a severed nerve, but with the new
NEUROMATA OF CENTRAL NERVOUS SYSTEM 3G7
formation of nerve fibres in a pathological tissue. Regarding
tumours in relation to nerves, we have in general two opposite
views: the one teaches that the tumours arise from the connective
tissue and have only a local relation to the nerves ; the other
accentuates the nervous nature of the tumours.
Virchow, in 1863, as we have already seen, had emphasised
the nervous nature of these growths, but his views did not gain
general acceptance, and the conception continued to prevail that
the tumours designated by the name “ neuroma ” arise from the
connective tissue sheaths and have only a secondary relation to
the nerves.
Von Recklinghausen, in 1882, noted the frequency of the
relation of multiple neuromata with skin fibromata. He looked
upon the tumours as essentially of the same structure—fibromata
arising in the connective tissue sheaths of the nerves, especially
the endoneurium; the difference lying in the difference of the
site, the nerve trunks, and the fine cutaneous twigs respectively.
Von Recklinghausen used the name “neurofibroma” as a com¬
promise with the old-established term “ neuroma,” but he thought
this terminologically incorrect, though it served to indicate the
nature of the tumour (fibroma) and its relation to a nerve. After
the appearance of Von Recklinghausen’s work multiple tumours
of the nerves were generally regarded as fibromata, and the
existence of Virchow’s supposed neuromata were more and more
discredited, except by a few authors, amongst whom must be
mentioned Knauss and Askanazy. These writers believed that
many of the tumours described as neuromata, with numerous
spindle-shaped nuclei, really contained non-medullated nerve fibres.
They considered, however, that the presence of ganglion cells was
essential to true neuroma formation, and ascribed the starting-
point to the minute sympathetic ganglia and branches present
in the vessel walls.
Alexis Thomson (1900) divided neuromata into true and false,
basing this classification on the anatomical structure. Under true
neuromata he identified only those tumours which contained
ganglion cells, and he doubts whether true neuromata without gang¬
lion cells can occur. Under the term false neuromata he classes:
(1) All circumscribed or solitary tumours growing from the connective
tissue of nerve trunks or of the ganglionic enlargements of nerves.
They resemble similar tumours originating in other tissues and
368 ALEXANDER BRUCE AND JAMES W. DAWSON
organs, and are subdivided into innocent and malignant. (2)
Traumatic neuroma. (3) Enlargements of nerves in leprosy,
syphilis, and tuberculosis. (4) Diffuse overgrowths of the con¬
nective tissue sheaths of nerves, and of ganglionic enlargements
of nerves, embracing a number of lesions affecting skin as well as
the nervous system, and capable of assuming very different forms.
French authors suggested the name “Von Recklinghausen’s
disease ” for this group, and Thomson has given to it the general
term “ neurofibromatosis.” It includes the following forms:—
(a) Multiple neurofibroma (generalised neurofibromatosis).—
The endoneurial connective tissue between individual nerve fibres
is the chief seat of the pathological process, and its increase may
cause visible thickenings and tumours of the nerves with a
dissociation and wavy course of the nerve fibres. The formation
of new nerve fibres is “ unlikely in the absence of nerve cells.”
In addition to the tumours of the nerve trunks, the terminal
filaments of the nerves exhibit the same fibromatosis, so that the
tissue of the true skin may be studded with innumerable minute
tumours. The sympathetic system is frequently extensively
involved, and the enlargement here also is stated to be due to an
overgrowth of the delicate connective tissue which supports the
nerve fibres and ganglion cells.
(b) Plexiform neurofibroma.—The pathological lesion here is
essentially the same as in the more generalised form, except in
its distribution and localisation; It is to be regarded as a
fibromatosis confined to the distribution of one or more contiguous
nerves or of a plexus of nerves. The nerve filaments in the pars
reticularis of the cutis may also be irregularly thickened and
studded with fibromatous nodules, in which the perineurium of
the affected nerve bundles may, however, not be defined from
the surrounding connective tissue.
(c) Cutaneous neurofibroma (molluscum fib'osum) are of the
nature of soft fibroma related to the terminal filaments of
cutaneous nerves, and may be distributed over the whole body.
( d) Elephantiasis neuromatosa.—In addition to the fibromatosis
of cutaneous nerves there is here a pronounced and diffuse over¬
growth of the connective tissue of the skin and subcutaneous
tissue, i.e., an extension of the fibromatosis from the endoneurial
connective tissue of cutaneous nerves to the tissue surrounding
them.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 369
(e) Pigmentations of skin associated with neurofibromatosis.
(/) Secondary malignant sarcoma, i.e., a sarcomatous transforma¬
tion of one or other of the forms of neurofibromatosis.
Thomson presents neurofibromatosis as a disease which, while
confined to the peripheral nervous system, may be distributed
throughout its whole extent, viz., the cerebro-spinal nerves, the
sympathetic nerves, and the nerve terminations in the skin.
These may be regarded as constituting one organ alike from
developmental, structural, and functional points of view. He
agrees with Goldman, Bruns, and others that the condition is a
form of gigantism or elephantiasis of the connective tissue elements
of the peripheral nervous system, and that it appears to be a
developmental disease dating from intra-uterine life. Thomson
significantly adds that a more accurate knowledge of the develop¬
ment of the peripheral nervous system may shed some light on
the origin of neurofibromatosis.
During the past ten years careful research into the embryo-
genesis and regeneration of nerve fibres has given an altogether
new view to the structure of tumours related to nerves, whether
circumscribed or diffuse.
Durante (1906) has related this new view to his conception of
the multicellular structure of the nerve fibres. According to it
the tumours represent true neuromata, and owe their origin to
a cellular regression of the segmental cells of the nerve fibre.
The differentiated substance of the interannular segment of the
nerve fibres disappears, and the undifferentiated vegetative proto¬
plasm increases in quantity; and, with a simultaneous proliferation
of the nuclei, forms homogeneous tubes or individualises into
spindle-shaped cells. These cells may again fuse and form proto¬
plasmic bands which have a great similarity to Remak’s fibres, and
must be looked upon as young nerve fibres. In proportion as they
persist at the stage of undifferentiated protoplasm or differentiate
further to elaborate myelin, they represent amyelinated or
myelinated neuroma. If the new elements that have arisen
through cellular regression remain as individual cells and proliferate
further, then there arises an embryonal malignant form of neuroma,
which in appearance resembles a sarcoma, and might be, in
contrast to the others, termed a cellular neuroma. Again, the
new-formed elements might undergo various metamorphoses,
e.g., atrophy, and take the appearance of connective tissue, or
370 ALEXANDER BRUCE AND JAMES W. DAWSON
imbibe mucin, or absorb fat; the tumours would then appear as
fibromata, myxomata, or lipomata, respectively, but would remain
in their nature essentially neuromata. In one and the same
individual the tumours might appear under various forms. In
all the various forms of neurofibromatosis the neoplastic element
is the segmental cell which undergoes cellular regression. Neuro¬
fibromatosis, or Von Recklinghausen’s disease, is a polyntvrome,
the elements of which for the most part undergo a fibrous
transformation instead of differentiating themselves into young
nerve fibres, or of remaining at the stage of cells of myelinogenous
type-
Durante’s conception of the nervous nature of these lesions
is in direct contrast to Von Recklinghausen’s conception of a
progressive fibrosis beginning in the perineurium and evolving
in the endoneurium. Thomson, while agreeing with Von Reckling¬
hausen, has pointed out that the fibrillar tissue had no tendency
to compress the nerve trunks, and was thus distinguished from
other connective tissue new formations, e.g., cirrhotic conditions.
To numerous factors has been attributed a share in the pathogenesis,
and nearly all writers have invoked a primary developmental
malformation of the connective tissue elements related to nerves
as the essential cause. Durante thinks that the exaggerated
vegetative activity of the segmental cell must be due to an
inherent instability in the differentiation of the nerve fibre, which
renders it liable to be affected by determining causes.
(a) Ganglio-Neuroma.
The great majority of observations referring to ganglio¬
neuromata have related these tumours to the sympathetic nervous
system. Their frequent occurrence in the medulla of the adrenal
is explained by the generally accepted view of the invasion of the
milage of the cortex of the adrenal by “ indifferent ” cells of the
sympathetic to form the medulla. In a few cases cranial nerves
have been the starting-point of ganglio-neuroma.
Busse (1898) has described a very large diffuse ganglion-celled
neuroma involving the entire abdominal portion of the sympathetic.
Microscopic examination of the tumour proved the presence of
large ganglion nerve cells similar to those found in the normal
sympathetic ganglion, numerous non-medullated, and a few
NEUROMATA OF CENTRAL NERVOUS SYSTEM 371
medullated nerve fibres. Busse thought it probable that the
tumour had arisen in the lumbo-sacral sympathetic cord, and on
account of its diffuse character allied it to the plexiform tumours
of spinal nerves.
Knauss (1898) records a case of very numerous ganglio-neuro-
mata in the subcutaneous tissue of the thorax, abdomen, and
thighs. The tumours were of very various size, and the micro¬
scopic investigation showed that all represented tumours of nerve
tissue consisting of ganglion cells, medullated and non-medullated
nerve fibres. The ganglion cells were found isolated and in
groups embedded amongst the nerve fibres: the non-medullated
fibres formed the great mass of the tumour, and the medullated
fibres showed a weakly developed myelin sheath. Knauss thought
the presence of the medullated fibres a confirmation of Virchow’s
statement that myelinated neuromata have a first non-inyelinated
stage. None of the non-medullated fibres could be traced to the
ganglion cells, nor was there any visible connection with any
filaments of cerebro-spinal nerves. He regarded the tumours as
having arisen from the minute ganglia intercalated on the fine
terminal fibres of the sympathetic system in relation to blood and
lymph vessels. Knauss thought that a true neuroma without
ganglion cells could not occur, though in this case he could trace
no connection between the nerve fibres and the processes of the
ganglion cells.
Beneke (1901) records two cases of ganglio-neuroma: the one
related to the cervical sympathetic, the other to the semilunar
ganglion. Microscopically the tumours consisted of a felt-work
of nerve bundles with groups of ganglion cells between them.
The cells had in general the character of sympathetic ganglion
cells: some were very small with no processes, while others were
large with very numerous processes. The neurite of many cells
could be traced in direct continuity with the nerve fibres, and
indeed a direct continuation of the cells of the capsule with the
cells of the sheath of Schwann was frequently noted. The
non-medullated character of the nerves was in proportion to the
non-medullated constitution of a normal sympathetic ganglion,
and the development of the nuclei was pari passu with the
development of the nerve bundles. The question whether mature
ganglion cells are capable of division cannot be answered
affirmatively from Beneke’s work, but he derives all the nerve
372 ALEXANDER BRUCE AND JAMES W. DAWSON
fibres from the ganglion cells of the tumour. The fact that the
nerve fibres preponderate is explained by the division of one
axis-cylinder into its primitive fibrils.
Oberndorfer (1907) describes a ganglio-neuroma in the medullary
substance of the adrenal which contained groups of cells separated
by septa of non-medullated nerve fibres and connective tissue.
The cells were of all sizes, from that of a lymphocyte with all
possible transitions to cells four or five times the size of ordinary
sympathetic ganglion cells. Some of the cells, therefore, have
the same morphological structure as the primitive cells from
which both the sympathetic nervous system and the medulla
of the adrenal develop. Ganglion cells were found in the meshes
formed by interlacing naked axis-cylinders, and only in the
marginal part of the tumour were there any axis-cylinders with
sheaths of Schwann. The presence of medullated fibres could not
be proved. The naked axis-cylinders with ganglion cells reminded
Oberndorfer of an embryonic nerve tissue, i.e., neuroblasts with
their offshoots. He concluded that the smaller cells were the
earlier forms of the ganglion cells, and thought it possible that
in early embryonal life these had separated themselves, retaining
their embryonic condition, till later some influence awakened
their slumbering developmental possibilities, and they developed
their morphological form of sympathetic ganglion cells. Oberndorfer
believes that every true neuroma must be a ganglio-neuroma.
Falk (1907) describes a ganglio-neuroma whose origin was
traced to the solar plexus. The essential constituents of the
tumour were non-medullated fibres with interstitial connective
tissue. The fibres were very delicate and undulating, with
regularly situated, elongated nuclei along their course. Ganglion
cells, isolated and in groups, were also found amongst the nerve
bundles. The cells were of very various size and shape, mostly in
various stages of degeneration, and all allowed to be recognised
their derivation from one common parent cell. Axis-cylinder
processes could be traced in only a very few ganglion cells: the
great majority gave the impression of being a-polar cells. The
author noted also the presence of small round or oval cells with
metachromatic staining granules similar to the chromotrope cells
found in the medulla of the adrenal and in the carotid gland.
The nerve fibres stained distinctly by Bielschowsky’s method.
Numerous sections were observed which contained only a few
NEUROMATA OF CENTRAL NERVOUS SYSTEM 373
ganglion cells, and nerve fibres formed the great mass of the
tumour. In teased preparations the fibres showed clearly that
the nuclei were within the nerve tube. Falk found it impossible
to believe that this great mass of fibres was derived from the
ganglion cells, which were not only mostly a-polar but degenerated.
He therefore turned his attention to the possibility of the Schwann
cells being the formative cells of the new nerve fibres: he found
that these were present in great abundance, that the direction of
their growth was parallel to the new axis-cylinder, and that within
the cells a continuous plasmatic stripe, which later became the
specifically staining axis-cylinder, was present. With Biel-
schowsky’s silver method the axis-cylinders showed no differentia¬
tion into actual fibrils. Falk felt justified in coming to the
conclusion that the new axis-cylinders had arisen by the
differentiation of the protoplasm of the proliferated sheath of
Schwann cells. He adds that with medullated sheath staining
the axis-cylinders took on the myelin stain, and that if the
sections were only slightly differentiated a weakly-staining myelin
sheath was evident in the nerve tubes. The non-medullated
character of the great majority of the fibres, therefore, does not
seem quite proved. Falk thinks it possible that the degenerated
ganglion cells constituted the chemiotropic influence which caused
the marked proliferation of the nerve fibres.
Wegelin (1909) records a case of ganglio-neuroma at the level
of the lower margin of the kidney. The cells again were of very
varied size, the fibres again greatly preponderated, and numerous
sections consisted exclusively of nerve fibres. These were collected
into interlacing bundles to form a dense felt-work. In longi¬
tudinal sections the fibres appeared as bright undulating bands,
with distinctly marked sheath and nucleus of Schwann. Most of
the fibres were non-medullated and showed a dark thread in the
centre corresponding to the axis-cylinder. The medullated fibres
stained pinkish and showed numerous varicosities. In contrast
to Falk’s case, Wegelin found no proliferation of the sheath of
Schwann cells, i.e., no increase over the normal nuclei of the
sympathetic fibres. He also found no spindle-shaped cells forming
protoplasmic bands which could be looked upon as the early stages
of non-medullated fibres. He thinks that the presence of the
completely naked axis-cylinders, found by Beneke and Obern-
dorfer, argues against the possibility of the origin of the nerve
374 ALEXANDER BRUCE AND JAMES W. DAWSON
fibre from the sheath of Schwann cells. In both axis-cylinder and
medullated sheath numerous degenerative phenomena could be
ascertained, which showed a definite dependence upon the degree
of degeneration of the ganglion cells. Wegelin, therefore, finds no
reason to depart from the generally accepted view that the nerve
fibres had arisen from the ganglion cells. He relates the starting-
point of ganglio-neuroraa to cell displacement in early embryonal
life.
Homer Wright (1910) has drawn attention to a group of
tumours which, at first sight, are apt to be mistaken for round-
celled alveolar sarcomata. The tumour tissue consists of cells and
fibrils. The cells have the same morphology as the cells from
which the sympathetic nervous system develops: they are
generally small, with round, deeply-staining nuclei and little
cytoplasm, or they may be pyriform with the cytoplasm pro¬
longed into filamentous processes. The fibrils are often of
considerable length: they do not stain like neuroglia or connective
tissue fibrils, and are like the fibrils occurring in the anlage of the
sympathetic nervous system. The fibrils may be arranged in
bundles, or ball-like formations of cells may occur, enclosing a
mesh-work of fibrils and filamentous processes of the cells. The
tumour tissue, therefore, presents the appearance of being com¬
posed of aggregations of more or less atypical embryonic
sympathetic ganglia bound together by connective tissue stroma.
The essential cells of the tumour are considered to be more or
less undifferentiated nerve cells or neurocytes or neuroblasts, and
hence the terms neurocytoma or neuroblastoma applied to the
tumours. The occurrence in a variety of situations, and especially
in the adrenal, is explained by the migration of undifferentiated
nerve cells from the embryonic central nervous system to form
the nerves and ganglia of the sympathetic nervous system.
(b) Circumscribed Neuroma.
Barile (1910) records the careful microscopic examination of
an egg-shaped tumour of the forearm. At the operation the
tumour, which was 5x4 cm. in size, was found surrounded by
a capsule, but at both poles seemed to have fibres of the radial
nerve attached to it. The tumour consisted entirely of bundles
of nerve fibres with scarcely any interstitial tissue, and was
I
NEUROMATA OF CENTRAL NERVOUS SYSTEM 375
without ganglion cells, therefore a true fibrillated neuroma. In
the periphery of the tumour the bundles had a parallel course,
but in the central parts the bundles interlaced in very varied
directions. The fibres are only in part myelinated, and these are
distinguished from normal adult fibres by their delicacy. They
are found mixed with some that have an axis-cylinder and
nucleus but no myelin sheath, and with others that correspond
to the plasmodial bands of Durante, in which are present filaments
that take the axis-cylinder stain. In addition, there are also
fusiform cells, the elements from whose fusion in a chain a great
part of the protoplasm bands are formed. There appear to be
also fibres growing into the tumour from the radial nerve, that
after a short course are modified in such a manner as to be
transformed into elements similar to the above-mentioned proto¬
plasmic bands. And, finally, there are present germ areas which
seem to consist entirely of fusiform cells with elements a little
further evolved.
Rarile concluded that in this tumour were to be found all the
various phases between the fusiform elements, from whose fusion
protoplasm bands have arisen, to the complete nerve fibre which
had arisen from the differentiation of these protoplasm bands.
The fibres of the radial nerve have undergone cellular regression,
and the individualised cells—from the proliferation of the nucleus
of the sheath of Schwann—had again formed protoplasm bands
which were found in a greater or lesser degree of differentiation
from the formation of granular filaments to the constitution of the
true axis-cylinder and myelin sheath. Here the new-formed
fibres take their origin from a nerve that retains its normal
connection with the centre.
Traumatic Neuroma must be included in this section. The
bulbous enlargements which form in relation to the ends of a
nerve that has been injured, or to nerves in a stump, have been
proved to consist of a dense plexus of nerve fibres. The origin of
these new fibres has been usually accepted to be from the dissocia¬
tion of the old axis-cylinder into its primitive fibrils and their
prolongation onwards. Kennedy, however, has shown that the
young nerve fibres have arisen within the proliferated cells of the
sheath of Schwann, and that they form interlacing bundles in the
scar-tissue.
376 ALEXANDER BRUCE AND JAMES W. DAWSON
(c) Neuro-Fibroma.
Verocay (1910), in a long article, “ Zur Kenntnis der Neuro-
fibrome,” discusses with very great detail the microscopic structure
of multiple neurofibromata occurring in the same individual and
the relation of these tumours to each other. After shortly referring
to a previously published case in which he found multiple tumours
of the cerebral and spinal dura, true gliomata of the cord, multiple
neuromata of numerous cerebro-spinal nerves, and tumours of
sympathetic nerves in the stomach wall, he passes to the descrip¬
tion of a most remarkable case. In a man thirty-one years old,
who was admitted to hospital with symptoms of cerebral tumour,
and died one month after the operation for its removal, there were
found multiple tumours on the inner surface of the cerebral dura
of the nature of fibro-endotheliomata, small gliomata in the
medulla oblongata and cord, tumours in both cerebello-pontine
angles of the nature of very cellular neuro-fibromata, multiple
tumours of the lumbo-sacral plexus, and finally, multiple tumours
of peripheral nerves. It is to the last group that we wish to draw
attention in this section. The relation of the groups to each other
will be referred to later.
The microscopic structure of the multiple tumours of the
nerves consisted of bundles of nerve fibres in the condition of
protoplasmic nucleated bands, together with ganglion cells in
various stages of development. Verocay starts from the assump¬
tion that ganglion cells and nerve-fibre cells (cells of Schwann’s
sheath) are derived in normal development from the same
mother-cell (embryonal neurocytes of Kohn). He looks upon the
ganglion cells as integral constituents of the tumour-development,
and believes that they and the nerve fibre cells which have pro¬
duced the nucleated bands have developed from the same
undifferentiated cell. The undifferentiated nerve-fibre cells, he
thinks, had proliferated greatly, and by their increase and
differentiation nerve fibres were developed on the one hand and
ganglion cells on the other. He thinks that the assumption of
the pre-existence of ganglion cells in such cases is altogether
unsatisfactory and unnecessary.
To Verocay the tissue of multiple neuro-fibromata, considered
by most writers as a connective tissue, is a specific neurogenous
tissue. Nerve fibre cells (peripheral neuroblasts) which have not
NEUROMATA OF CENTRAL NERVOUS SYSTEM 377
been used up in the normal construction of the nerve fibre are to
be regarded as the parent cells of both ganglion cells and nerve
fibre cells present in the tumour; he suggests the name
“neurinoma” for tumours of this nature. Such tumours may
undergo certain modifications, and to the term neurinoma might
be added a qualifying word signifying the dominating elements,
tjg., neurinoma-gangliosum, -gliosum, -fibrosum, -sarcomatodes, &c.
Verocay’s views thus differ from those of previous writers on
neuro-fibroma, who have regarded the developmental disturbance
as affecting the connective tissue in nerves. It seems quite
unintelligible to Verocay that only the connective tissue of the
nerves is affected, when this in early development is in direct
association with the other connective tissues of the body. He
finds it much easier to believe that the primary disturbance lies in
ectodermal elements, the connective tissue in relation to which
may be secondarily affected.
Verocay has described the tumours in the cerebello-pontine
angle as cellular neuro-fibromata. This agrees with the term
“ acoustic neuroma ” frequently applied to some of these tumours.
Froenkel and Hunt (1903) have also pointed out that histologically
these tumours are neuro-fibromata, arising in relation to the
intracranial portion of the cranial nerves. In advanced stages they
may become sarcomatous, fibro-sarcomatous, or glio-sarcomatous.
The glia elements may be explained by the fact that glia tissue
accompanies the intracranial nerve trunks for a short distance, or,
according to Verocay, who has investigated four such cases, the
tumour formation relates to a developmental disturbance of the
specific elements of the nerve tissue, affecting undifferentiated
cells (neurocytes) which are capable of differentiating along three
lines to form ganglion cells, glia cells, or nerve fibre cells.
Note on Genesis of Fibkes in Tumours of the
Central Nervous System.
(a) Olioma and Neuro-glioma.
Verocay (1910).—In the previous section we have seen that
Verocay regards the early embryonal neurocytes as capable of
differentiating to form ganglion cells, glia cells, and nerve fibre
cells. From this it will be readily understood that the combina¬
tion of glioma with multiple tumours of nerves found in both of
378 ALEXANDER BRUCE AND JAMES W. DAWSON
his cases is looked upon, not as an accidental occurrence, but is
traced to the same developmental disturbance. He believes that
when multiple tumours of nerves are more minutely investigated
this combination will be found more frequently.
Schmincke (1910) has described a case of ganglio-neuroma of
the brain in a man seventeen years old. The tumour was the
size of a large nut, was situated in the anterior portion of the
temporal lobe, and was not defined from the surrounding tissue.
Microscopically, the tumour consisted of the several components
of the nerve tissue, all in varying degrees of differentiation:
(1 ) ganglion cells in different stages of development, distinctly
recognisable as ganglion cells by their characteristic nucleus and
general morphological structure; (2) numerous glia cells of various
form and size and glia fibrils; (3) syncytial neuroblast chains
consisting of fibres with inserted nuclei, showing a definite axis-
cylinder but no myelin sheath, and therefore representing nerve
fibres in different stages of development. Schmincke considers
that the presence of these syncytial neuroblast layers may shed
some light upon the development of fibres within the central
nervous system. Schmincke holds that proof has been given in
favour of the formation of the peripheral nerve fibres from
neuroblast chains, but as yet no proof of a similar origin of the
fibres within the central nervous system. For an explanation of
this tumour Schmincke goes back to the detachment of a portion
of embryonic nerve tissue, and believes that the embryonic
neurocytes have differentiated along the three lines to form
ganglion cells, glia cells, and nerve fibre cells. He suggests that
the powers slumbering in this tissue have become active and have
succeeded in completing their differentiation. Neuro-gliomata
have thus the same origin as gliomata; there being no prolifera¬
tion on the part of pre-existing ganglion cells, but all the cells
of the tumour representing earlier or later stages of development
of indifferent embryonic cells in which the process started. These
cells are often far from any normal type.
(b) Neuroma of the Central Nervous System.
The literature referring to neuroma of the central nervous
system is very scanty and scattered. Early findings of tumours
consisting of nerve cells and medullated nerve fibres refer chiefly
to small nodules on the surface of the ventricles in hydrocephalus.
NEUROMATA OF CENTRAL NERVOUS SYSTEM 379
As the microscopic technique was at the time very deficient,
their value has been much discounted, and Courvoisier, in his
monograph, “Die Neurome,” 1886, makes no mention of them.
Recent observations are almost entirely limited to neuromata of
the spinal cord.
Raymond (1893), in a case of syringomyelia, found at different
levels of the cord numerous small fasciculated nodules in the
connective tissue septa of the posterior columns. The fine fibres
composing these nodules had the structure of peripheral nerves
and were grouped parallel to each other or intertwined. In
addition to the central gliosis, there were present gliomata at
various levels, forming diffuse and circumscribed infiltrations of
the white matter. The posterior roots, which were healthy
outside the cord, were interrupted in their intra-medullary course
by these infiltrations, and in serial sections a direct connection
could be traced between the entering posterior roots and the
fibres composing the nodules. Raymond looked upon the nodules
as neuromata of regeneration which had developed as a con¬
sequence of the interruption of the centripetal posterior roots by
glia tumour tissue.
Schlesinger (1895) found similar nodules in two cases of
syringomyelia and one such nodule in a case of tabes. In the
tabetic cord the nodule was found in the upper cervical region and
passed through only six successive serial sections. It was situated
at the periphery of the cord lateral to the posterior horn, and was
surrounded by a thin layer of dense glial tissue. The interlacing
fibres of the nodule were thinner and stained less clearly than the
fibres of the surrounding white matter. In the cases of syringo¬
myelia several microscopic nodules were found in the central
glious tissue: they were sharply contoured and composed of
bundles of very fine fibres showing a spiral arrangement. Numerous
elongated nuclei with their longitudinal axes parallel to the
longitudinal axes of the fibrils were found in the nodules. No¬
where could any connection be traced with fibres of any of the
columns of the cord or of the posterior roots, and in none of the
nodules were any ganglion cells present. Schlesinger attributed
the neuromata to a proliferative process, the result of a long-
continued irritation. He came to this conclusion because the
nodules were found always in a pathologically changed tissue with
a chronic proliferation of the supporting eleihents.
380 ALEXANDER BRUCE AND JAMES W. DAWSON
Wagner (quoted by Schlesinger) produced neuromata experi¬
mentally in cats by dividing the anterior spinal roots. The
neuromata always developed at the point where the anteri or
roots left the cord. In one case, where the roots were divided
intra-medullarily, the nodules developed within the cord. Similar
procedure at the posterior roots produced no neuroma.
Saxer (1896), in syringomyelia, found in the central gliosis
numerous nerve fibres, isolated or in bundles, partly in the
adventitia of vessels and partly free in the glious tissue. The
fibres could be traced to the anterior longitudinal fissure and had
the structure of peripheral nerves. In the obliterated central
cornal in the lumbo-sacral cord were numerous medullated
nerves. Saxer ascribed the presence of these fibres to a
regenerative process, but admits that he finds it impossible
to explain how this had come about. Herveroch (1900), also
-in a case of syringomyelia, Bischofswerder (1901), in two
similar cases, and Hauser (1901), in three, mention the finding
in the central glious tissue of isolated nerve fibres or definite
nodules composed of tortuous medullated fibres with the structure
of peripheral nerves. In all of the above the nodules were often
sharply delimited, and nowhere did the fibres of the periphery
seem to be prolonged into the surrounding tissue. Bischofswerder
draws attention to the frequent presence of vessels in the centre
or at the periphery of nodules, and suggests that this fact may
throw some light upon their origin.
Nageotte (1899), in tabes and in a case of hemisection of the
cord, has found nerve fibres, isolated and in bundles, in all parts of
the pia, but especially near tbe point of emergence of the anterior
roots. Fickler (1900), in a case of compression of the cord, has
found medullated fibres filling the anterior fissure from the
adjoining pia. The significance of these findings of Nageotte and
Fickler has already been referred to in the note on regeneration of
fibres in the central nervous system.
Pick (1900) has described nodules composed of unstripped
muscle fibres around the spinal cord vessels. Pick had previously,
in 1895, described similar formations around the vessels of the pia,
and had explained them as circumscribed proliferations of muscle
fibres of otherwise normal vessels. Hellich later drew attention
to the possibility of kick’s leio-myoma of the pia and cord being
I
NEUROMATA OF CENTRAL NERVOUS SYSTEM 381
true neuroma, which on account of their fascicular structure and
elongated nuclei gave the appearance of leio-myoma.
Thomas, Touche, and Jacob (1901) described a case of Pott’s
disease following a fracture two years before death. The 8th
cervical segment was compressed, and in the anterior fissure,
immediately above the point of compression, were found very
numerous nodules composed of fibres with the structure of
peripheral nerves. Small neuromata composed of a few bundles
of fibres were found also in the pia round the whole circumference
of the cord at this level, and in the lateral column of the right side
there was present a small nodule which at one point reached the
pia. In none of the nodules could the origin of the fibres be
traced, but the writers ascribe their formation without doubt to
regenerative processes, and believe that the new fibres have their
origin from the fibres of the tracts interrupted at the level of the
compression. Dercum and Spiller (1901) have described non¬
myelinated -fibres in the pia covering the posterior columns in a
case of adiposis dolorosa. The posterior roots were not degenerated
and the origin of the fibres could not be traced, but as there was
an alteration in the columns of Goll the fibres in the pia might
arise from a regenerative process in the posterior roots.
Helich (1902) has placed the whole question of neuroma of the
cord in a new light. In six cases of different affections of the
cord he found formations similar to those described by Raymond,
Pick, and others. Nerve fibres with myelin sheath and sheath of
Schwanu could be traced in the adventitia of vessels from the
periphery of the cord to the central canal vessels, whence they
radiated into Clarke’s column. Here and there the fibres develop
into nodules which, under a low power, appear as leio-myomata.
Hellich considers that they must be looked upon not as tumour
formations but as abnormal sensory centripetal nerves.
Rebizzi (1903), in a case of neuroma of the cord, found ganglion
cells with abundant formation of new nerve fibres which could
be traced to the ganglion cells. Rebizzi thought that a part of
a nucleus of grey matter had been cut off in early foetal life.
Switalski (1903), in the cord of a patient with the clinical
history of disseminated sclerosis, states that in addition to the
degeneration of the fibre systems there were present numerous
neuromata, especially in the lower dorsal and middle cervical
segments. The nerve fibres composing these nodules were of
33
382 ALEXANDER BRUCE AND JAMES W. DAWSON
very varying thickness, often with varicosities: they had no
sheath of Schwann, nor could an axis-cylinder be stained. Oval
vesicular nuclei, which gave the nodules a very characteristic
appearance, were always present. In the lower dorsal region
the nodules were altogether in the grey matter and always in
relation to blood vessels. In the cervical region the nodules
were found in the posterior columns and in the pia, and often
continued from the pia into the septa. In both regions they
lay always in a completely normal tissue, and in spite of very
exhaustive examination, Switalski could trace no connection of
the fibres composing the nodules with fibres in the neighbourhood.
He therefore sees no reason to think that these are neuromata of
regeneration. He grouped together from literature eleven cases
of true neuroma of the spinal cord, nine of which had appeared
in syringomyelia, and thinks that this association of neuromata
with syringomyelia points to the possibility of a developmental
anomaly or disturbed development accounting for these formations.
Orzechowski (1908), in a case of malformation of the lateral
recess of the 4th ventricle, together with tabes, found neuromata
in the region of the central canal and in the pia of the cord from
the 2nd lumbar segment downwards. The fibres which ran
spirally round one another to form dense tufts had a delicate axis-
cylinder, myelin sheath, and distinct neurilemma sheath and
nucleus. In serial sections it could be proved that the pial fibres
arise from the anterior nerve roots, for near the emerging anterior
roots small bundles of fine fibres could be found passing into the
adventitia of the pial vessels or free into pial spaces. The fibres
could be traced to the base of the anterior fissure, and formed
nodules in the region of the central canal. The distribution of the
pial fibres coincides with the localisation of the posterior root
affection in the lumbo-sacral region. Orzechowski considers that
these aberrant root fibres represent a developmental anomaly.
Reich (1910) investigated eight tabetic cords, and found typical
pial neuromata in three cases. Isolated fibres and bundles and
nodules were found distributed through the thickened pia, chiefly
of the lumbo-sacral cord. No distinction as to the origin of the
fibres could be drawn between the isolated fibres, the bundles, and
the nodules, and Reich confirms Orzechowski’s observations that
the fibres arise from anterior roots. He further states that the pial
nerve bundles unite together and leave the pia laterally as nerve
NEUROMATA OF CENTRAL NERVOUS SYSTEM 383
trunks. He therefore regards them not as aberrant anterior
root fibres, but as true anterior roots leaving the spinal cord in
an atypical way. Both Orzechowski and Reich suggest that the
frequent presence of medullated fibres in the pia in tabes re¬
presents one of the stigmata of the increased vulnerability of the
tabetic cord.
In reviewing these findings of neuroma of the spinal cord it
will be seen that all writers refer to microscopic nodules that lie
in the grey or white matter or in the pia and its septa, that are
perceptible in only a few successive sections, and that contain
medullated nerve fibres with a sheath and nucleus of Schwann.
The nerve fibres are finer than those of the surrounding tissue,
and present numerous varicosities. Orzechowski has classified
neuromata of the spinal cord into two groups. The one is related
to a regeneration of fibres of the central nervous system. This
origin of neuroma is probable where any lesion of the cord or roots
is present, causing an interruption of the fibres, e.g Fickler’s case
{spondylitis tuberculosa), Wagner’s experiments on cats, Nageotte’s
in hemisection of the cord and in tabes, Thomas, Touche, and
Jacob’s in Pott’s disease, possibly also in the cases of syringomyelia
of Raymond, Schlesinger, Saxer, Herveroch, Bischofswerder, and
Hauser. The other group includes those cases in which there was
no fibre interruption, and consequently could be looked upon not
as a reparatory process but as abnormally placed nerve fibres.
This interpretation was the more plausible as there were frequently
present other malformations. To this category belong Switalski’s
case in which the neuromata were accompanied by aplasia of the
cerebellum, the cases of pial neuromata which must be regarded as
aberrant or abnormally placed nerve fibres, and to this group also
more probably belong the neuromata found in syringomyelia.
Orzechowski thinks that to the neuromata described by Hellich as
abnormally placed centripetal tracks an independent position may
be ascribed on account of their functional character.
The work has been carried out in the Royal College of
Physicians’ Laboratory, Edinburgh, and during the tenure, by
one of the authors, of a Carnegie Fellowship. Generous assistance,
in the shape of grants, has been given by the Carnegie Trust
both during the lifetime of Dr Bruce and since his death.
It is a pleasure to record the great debt we owe to Dr James
Ritchie, the Superintendent of the Laboratory. His wise guidance
834 ALEXANDER BRUCE AND JAMES W. DAWSON
has always, in the most generous way, been at our disposal, and
his keen criticism has made it necessary for us to examine every
aspect of our argument with great thoroughness. For this and
for his sympathetic interest at every stage we desire to express
our gratitude.
We are indebted also to Dr David Orr of Manchester, Dr Rows
of Lancaster, Dr Harvey Pirie, and Dr Ninian Bruce for much
kindness, help, and criticism.
The illustrations in the text are by Dr Ninian Bruce, the
coloured illustrations by Mr Richard Muir, and the photographs
by Mr William Watson and Mr Muir: our thanks are due to
them for the great care with which these have been prepared.
LITERATURE.
(3) Genesis in Tumour Formation.
Barile. 41 Struttura ed Histogenesi di un neuroma fibriliare mielinico,” Lo Speri -
mentale , T. lxiv., 1910, p. 269.
Beneke. 44 Zwei Fall© von Ganglioneurom.,” Beitr. z. path. Anal. u. z. allg. Path.,
Bd. xxx., 1901, p. 1.
Bisohofswerder. “Nrfvromes intram&Jullaires,” Revue Neurol., T. ix. t 1901,
p. 178.
Busse. 44 Ein grosses Neuroma gangliocellulare des Nervus sympathicus,” Vir¬
chow's Archiv , Bd. oli., SuppL, 1898, p. 66.
Dercum and 6piller. 44 Fibres nerveuses k ray&ine dans la pie-m&re de la moelle
dpinikre,” Revue Neurol., T. ix., 1901, p. 222.
Falk. 44 Untersuchungen an einem wahren Ganglioneurom.,” Beitr. z. path.
Anal. u. z . allg. Path., Bd. xl., 1907, p. 601.
Fiokler. 44 Studien zur Pathologie und path. Anat. der Riiokenmarkcompression
bei Wirbelcaries,” Devi. Zeit.filr Nervtnheilk ., Bd. xvi., 1900, p. 1.
Froenkel and Hunt. 44 Tumours of the Ponto-Medullo-Cerebellar Space (Acoustic
Neuromata),” Med. Record , Vol. lxiv., 1903, p. 1001.
Hamilton and Thomas. 44 The Clinical Course and Pathological Histology of a
Case of Neuroglioma of the Brain,” Journal of Exp. Med., VoL ii., 1897,
p. 635.
Hauser. 44 Des N6vromes intram6dullaires dans la Syringomy61ie,” Revue
Neurol T. ix., 1901, p. 1098.
•Hellich. 44 Ueber die sogenannten Neurome und Leio myome des Riickenm&rks,”
Arch, hohim. de mid. clin., iii., 1902, p. 261 ; Neurol. Centralbl., Bd. xxi.,
1902, p. 1038.
Herveroch. 44 Tumeur de la moelle ^pinikre dans un c&s de Syringomy^lie,”
Revue Neurol., T. viii., 1900, p. 790.
Knauss. 44 Zur Kenntniss der achten Neurome,” Virchow's Archiv, Bd. cliii.,
1898, p. 29.
ABSTRACTS
385
Nageotte. 14 Note sur la pr4senoe de fibres h mytfline dans la pie-mfere spinale
des tabAtiques, en rapport avec la r£g6n6ration de fibres radiculaires
aatArieuree,” Comptes Rendus de la Soc. Biol., 1899, p. 738.
Oberndorfer. “Beitrag zur Frage der Ganglio-neurome,” Beitr. z. path. Afiat.
u. z. aUg. Path., Bd. xli., 1907, p. 269.
Orzechowski. 44 Ein Fall von Misabildung des Lateral recessus,” Arb. ausdem
ward. Inst., Bd. xiv., p. 406.
Pick. 44 Ueber umschrieben Wucherungen glatten muskelfasem an den Gef&sscn
des Riickenmarks,” Neurd. Centralbl., Bd. xix., 1900, p. 194.
Raymond. 14 Contribution k l’6tude des tumeurs nGvrogliques de la moelle
6pinidre,” Arch, de Neurdogie, T. xxvi., 1893, p. 97.
Reich. 44 Die Neuromenfrage,” Arb. a. d. neurd. Inst., Bd. xviii., p. 228.
RiseL 44 Uber multiple Ganglio-neurogliome der Gasserschen Ganglion und der
Hiranerven,” FerA. der deutsch. path. Oesellscha/t, Jg. xiii., 1909.
Saxer. 44 Anat. Beitrage zur Kenntniss der sogenannten Syringomyelic,” Beitr.
z. path. Anat. u. z. aUg. Path., Bd. xx., 1896, p. 332.
Schlesinger. 44 Ueber das wahre Neurome des Riickenmarks,” Arb. a. d. neurd.
Inst. d. Univ. Wien., Bd. iii., 1895, p. 171.
Sehmincke. 44 Beitrag zur Lehre der Ganglio-neurome,” Beitr. z. path. Anat. u.
z. aUg. Path., Bd. xlvii., 1910, p. 354.
SwitalskL 44 Ueber wahre Neurome des Riickenmarks und ihre Pathogenese,”
Pdnisches Archiv , Bd. ii., 1903, p. 158.
Thomas, Touche, and Jacob. 44 Des N6vromes de R4g6n6ration au cours du Mai
de Pott,” Revue Neurd., T. ix., 1901, p. 708.
Thomson (Alexis). 44 On Neuroma and Neuro-fibromatosis,” Ed in., 1900.
Verocay. 44 Zur Kenntniss der 4 Neurofibrome,’ ” Beitr. z. path. Anat. u. z. allg.
Path., Bd. xlviii., 1910, p. 1.
Wegeiin. 44 tiber ein Ganglio-neurom des Sympatbicus,” Beitr. z. path. Anat. u.
z. aUg. Path., Bd. xlvi., 1909, p. 403.
Wright. 44 Neurocytoma or Neuroblastoma,” Journal of Exp. Med., Vol. xii.,
1910, p. 566.
abstracts
ANATOMY.
THE EYE-MUS0LE NEB YES IN NEGTUBUS. Paul S. McKibben,
(313) Journ. of Comp. Neurol ., 1913, xxiii., June 15, p. 153 (8 figs). '
A study of twenty-five adult specimens of Necturua maculosus by
the Intra vitam, methylene blue method (a slight modification of
J. Gordon Wilson's technique). The optic apparatus shows poor
development compared with that of some other Urodeles. The eye-
muscle nerves are all present, but are very small, the abducens being
386
ABSTRACTS
the smallest. The oculomotorius showed sometimes certain pecul¬
iarities of distribution. The trochlearis varies greatly, even in an
individual specimen, on the two sides of the head; its root usually
contains sixteen to twenty-four fibres; about four to eight of these
“seem to enter the nerve uncrossed.” These direct fibres are
larger than the other trochlearis fibres, and seem to “ belong to the
mesencephalic root of the trigeminus.” In addition, “ two or three
smaller fibres from the tectum have been observed which appear to
enter the trochlear nerve uncrossed.” Once the right trochlearis
joined the oculomotorius; their fibres were so intermingled that
they could not be separated; the superior oblique muscle was
supplied by the dorsal ramus of the oculomotorius, “ presumably
by trochlear fibres.” “No group of cells corresponding to the
ciliary ganglion has been found, but there are quite constantly
present twigs from the ramus ophthalmicus profundus trigemini,
the oculomotor, and the abducent nerves, which enter the bulbar
fascia and the eye-ball. These twigs most often apply themselves
to the sheath of the optic nerve.” Leonard J. Kidd.
THE INNERVATION OF THE DIGESTIVE TUBE. Albert Kuntz,
(314) Journ. of Comp. Neurol ., 1913, xxiii., June 15, p. 173 (5 figs.).
A valuable histological study based primarily on preparations of
stomach and intestine of cat and dog: failure by Cajal’s and
Bielschowsky’s methods: in cat the Intra vitam, methylene blue
method sometimes answered : the pyridine-silver method, as used
by Ranson, was very useful, but less uniformly good than in other
parts of the sympathetic system. Author’s summary is as follows:
1. The ganglia of the myenteric plexus are interposed between
the longitudinal and circular muscular layers of the digestive tube.
The ganglia of the submucous plexus are imbedded in the sub¬
mucous layer. The ganglia of each of these plexuses are variously
connected by commissures of non-medullated fibres, among
which may be traced both axons and dendrites. 2. These two
plexuses are interconnected by fibrous commissures. Nerve fibres
also extend from the submucous plexus into proximity with the
digestive glands, where many of them terminate on gland-cells,
and into the gastric folds and plicse and the intestinal villi, where
many of them terminate on cells of the digestive epithelium. The
fibres which end on the latter are doubtless the dendrites of
“ receptive ” or sensory neurones. 3. The orientation of the
neurones in the ganglia of the myenteric and submucous plexuses,
and the distribution of their axons and dendrites, strongly suggest
that the sympathetic system, like the other functional divisions of
ABSTRACTS
387
the nervous system, is essentially a system of reflex arcs involving
both sensory and motor neurones, some of which are strictly local
while others are less local or even involve centres in the cerebro¬
spinal nervous system. 4. The normal nervous control of the
digestive functions is probably exercised primarily by the local
sympathetic mechanism, the general control which is exercised by
extrinsic nerves being largely tonic in character. The major part
of such tonic control is probably exercised by the vagi.
Leonard J. Kidd.
PHYSIOLOGY.
EXPERIMENTAL STUDIES ON THE NERVOUS MECHANISM
(315) IN THE PRODUCTION OF HYPERPLASIA. Walter Timme,
Joum. Nerv. and Ment. Dtt ., 1913, xl., May, p. 311.
Acting upon the supposition that the nerve impulses produced by
metabolism travel in certain circuits, the stomach with its nerve
supply both from the vagus and sympathetic seemed to offer
excellent conditions for experimental work. It was assumed that
if, without disturbing too much the motility and function of the
stomach, the nerve current produced by the activity of the gastric
cells could be made to flow in diminished volume via the vagus,
the excessive remainder must travel by the sympathetic. If this
is so, the control exercised by the sympathetic system over the
trophic functions of the gastric cells, e.g., growth, reproduction,
repair, is stimulated.
The author has tried to determine the truth or falsity of the
above inference. Cats were the animals used for this experi¬
mental work. Both the right and left vagus were ligated below
the oesophageal plexus, and following this, as controlled by normal
cats, an actual cell increase in the mucous membrane of the stomach
occurred. The trophic control over the gastric cells—growth and
reproduction—was excessively stimulated; the control of their
functional activity, and that of the stomach as a whole—the
production of the gastric juice, the expulsion of the contents from
stomach to intestine—was greatly in abeyance.
The supposition, therefore, of the nerve current passing in the
circuit of the sympathetic in increased quantity as a result of
partial closure of the vagus path is held as being supported by the
results of these experiments. D. K. Henderson.
388
ABSTRACTS
THE NOMENCLATURE OF THE SYMPATHETIC AND OF
(316) THE BELATED SYMPTOMS OF NERVES. J. V. Langley,
Zentralbl. f. Physiol., 1913, xxvii., p. 149.
The following nomenclature is suggested :—
Autonomic
Para-sympathetic Sympathetic Enteric
Ocular Oro-anal
Tectal BulLar Sacral Thoracic
Autonom. Autonom. Autonom. Autonom.
A few remarks on these terms are then offered.
A. Ninian Bruce.
PATHOLOGY.
THE ENDOGENOUS FIBRES OF THE HUMAN SPINAL CORD
(317) (FROM THE EXAMINATION OF ACUTE POLIOMYELITIS).
F. E. Batten and Gordon Holmes, Brain , 1913, xxxv., p. 269.
As a result of the examination by the Marchi method of the brain
and spinal cord in three cases of acute poliomyelitis in children,
the authors draw the following conclusions:—
(1) The spinal portion of the spinal accessory nerve has a large
intramedullary root which extends throughout the upper five or
six cervical segments of the spinal cord.
(2) The longer descending systems of the dorsal columns—
Schultze’s comma tract, Hoche’s marginal bundle, Flechsig’s oval
field, and Gombault and Philippe’s triangle—do not contain
endogenous fibres in man.
(3) The propriospinal fibres of the ventrolateral columns are
arranged in man as in other mammals, and conform in their
arrangement to the law that the longer fibres lie nearer the
surface of the cord.
(4) Many fibres of the ventrolateral columns ascend to the
brain-stem and terminate in the inferior olives, in the formatio
reticularis bulbae et pontis, in the nucleus centralis inferior, and
probably in the nuclei laterales of the medulla; others ascend in
the dorsal longitudinal bundles as high as the midbrain.
A Ninian Bruce.
ABSTRACTS
389
THE PATHOLOGY OF OHBONIO PROGRESSIVE CHOREA J. A. F.
(318) Pfeiffer, Brain, 1913, xxxv., p. 276.
Chronic progressive chorea is a curious affection which occurs
comparatively late in life, and is characterised by irregular move¬
ments, disturbance of speech, and an accompanying psychical
derangement, terminating gradually in dementia. Homogeneous
heredity is not always present, although of frequent occurrence.
It is at present disputed whether the disease is a clinical entity
distinct from Sydenham’s chorea or a variety of it.
The clinical history and post-mortem findings of two cases are
given here. In both the smallness of the brain and spinal cord
was marked. Diffuse degenerative changes in the nerve-elements
of the brain were found most severe in the optic thalamus, corpus
striatum, and in the frontal, pre- and post-central regions. The
Betz cells were well preserved. The ganglion cells showed acute
changes, but more commonly sclerotic changes, with great increase
of lipoid pigment. The neuroglia showed an enormous increase of
glia cells and glia fibres, especially in the lower layers of the
cortex, the corpora striata, and thalami. A deficiency of the
tangential and oblique fibres of the cortex was noticeable. The
most obvious pathological alterations in the vessels were found in
the lenticulate nuclei and thalami, the lumen being often nearly
obliterated. A great many amyloid bodies were seen in the cord,
thalami, and lenticulate nuclei.
In conclusion, the pathology consists not only of the degenera¬
tive process in the nervous elements of the cortex, but of the
thalamus and corpus striatum. A Ninian Bruce.
A STUDY OF THE BRAIN IN A CASE OF CATATONIC
(319) HIRNTOD. Samuel T. Orton, Amer. Joum. Insanity, 1913,
lxix., April, p. 669.
A case of a psychosis of acute onset followed by death within
fifteen days, and showing at autopsy neither gross nor micro¬
scopical visceral change of sufficient intensity to be regarded as
factors in the disease or causes of death. Clinically the diagnosis
is not definite on account of the short time of observation and
the condition of the patient, but the limited data place it probably
as a case of demeutia prsecox of the catatonic form. Sections
stained with thionin and by the Bielehowsky method yielded
findings which might be the result of post-mortem disintegration,
but which in the case of the thionin specimens at least were
probably ante mortem in occurrence. In specimens stained by the
Herxheimer and osmic acid methods considerable amounts of
390
ABSTRACTS
lipoid materials were found in the ganglion cells, glia cells, and
phagocytic cells of the perivascular spaces. By Alzheimer’s
methods IV. and VI., amoeboid glia cells with a variety of granules
were found widely scattered throughout the brain in the lower
layers of the cortex and particularly in the subcortical white
matter. A. Ninian Bruce.
THE EXPERIMENTAL PRODUCTION OF PELLAGRA IN THE
(320) MONKEY OF A BERKEFELD FILTRATE FROM HUMAN
LESIONS—A PRELIMINARY NOTH Wm. H. Harris, Joum.
Amer. Med. Assoc., 1913, lzv., June 14, p. 1948.
The inability to produce satisfactorily pellagra in animals by
means of various foodstuffs (spoiled maize, &c.), led to the
following investigations based on the hypophysis that pellagra is
caused by a living micro-organism and not by a chemical irritant.
Three monkeys were experimented upon, and were injected
with tissue from fatal human cases. The animals developed all
the essential clinical signs and symptoms, together with the
pathologic picture discerned in the disease in man. The author
suggests that the etiology of pellagra is a filterable virus or a
micro-organism capable of passing through the pores of certain
Berkefeld filters. A. Ninian Bruce.
c . CLINICAL NEUROLOGY.
THE ACCURACY OF LOCALISATION OF TOUCH STIMULI ON
(321) DIFFERENT BODILY SEGMENTS. Shepherd Ivory Franz,
Psychol. Review , 1913, xx., March.
An account of a series of tests, carefully carried out, dealing with
the localisation of touch stimuli on different bodily segments.
The skin was stimulated by means of a camel-hair brush, and
the subject was instructed to locate the point by touching the
skin as close as possible to the stimulated spot. The subjects used
were accustomed to observations and examinations of the different
parts of the body. They were artists’ models, women who had
been engaged in that capacity from one to ten years.
It was found that the average error of localisation of light
touch varied in different parts of the body, the most accurate
localisation being found for the face; the succeeding order being:
I
ABSTRACTS
391
foot, chest, fore-arm, abdomen, upper leg, upper arm, lower leg,
back.
The accuracy of localisation of light touch stimuli was greater
than that of more intense stimuli.
The average error was less than the double point threshold,
but these bore no constant relation to each other.
There appeared to be no constant relation between the average
lengths of the body hairs and localisation error.
Stimuli to a part were sometimes localised on an opposing
part, e.g., near the axilla there were localisations on the chest
when the arm was stimulated. J. Stanley Hopwood.
NOTE ON A OASE OF AMYOTONIA CONGENITA (Myatonia
(322) Congenita of Oppenheim.) [Six Illustr.] Denis Cottebill, Edin.
Med. Joum ., 1913, x., p. 619.
The patient was a girl, aged 2&, and was brought to the surgical
wards of the R. I. E. on account of a club foot. The child is the
youngest of a perfectly healthy family of three or four. Parturi¬
tion easy, no instrumentation. Immediately after birth the child
was noticed to be abnormally flaccid, and was on this account
quite difficult to hold. Child was unable to suck either from
breast or bottle, and was fed by having milk poured into its mouth.
No difficulty in swallowing. Crowing noise on breathing, which
continued till child was some months old.
On admission the patient was found to be well grown, fairly
well nourished, but rather pale and “ flabby ’’ looking. Facies is
dull and immobile; drooping of upper eyelids; mouth constantly
kept open. Mentally the child is distinctly backward, and is of a
most “ peevish ” disposition. No evidences of rickets, myxoedema,
or abnormality of thyroid. Skin, though pale, is not mottled or
cold. Head normal in shape and ossification. No squint.
Typical features of Amyotonia seen in this case .—Congenital
origin. Hypotonicity of muscles generally. Lower limbs more
affected than upper. No definite muscular atrophy. Abnormal
mobility of all joints. Practically normal electrical reactions.
No reaction of degeneration. Loss of patellar, Achilles, and
superficial reflexes. Sensation little if at all affected. Improve¬
ment in condition slow but definite.
Features in this case only occasionally noted in other cases of
Amyotonia .—Involvement of facial muscles. Difficulty in sucking.
Noisy breathing. Athetoid movements of hands. Presence of
kypho-scoliosis. Presence of certain muscular contractures and
club foot. Hyperextension of fungus. Slight genu-recurvation.
392
ABSTRACTS
Features in this case not known to have 'previously occurred in a
case of Amyotonia. —Dislocation and malformation of right hip
joint. Congenital genu-recurvation, with small patella and back¬
ward dislocation of femur. Position of thumb (extreme flexion)
with partial dislocation. Definite congenital origin and unilateral
distribution of certain contractures and club foot. Umbilical
hernia, weakness of upper part of abdomen in mid line, and
abnormal condition of lower part of sternum (simulating a
“ funnel ” chest). Considerable power shown at times, especially
in certain muscles, as result of an intense mental effort.
The article is preceded by a short survey of the previously
published cases. Author’s Abstract.
TABES AND SALVARSAN. (Tabes et Salvarsan.) Dr BouchR,
(323) Joum. de Neurol ., 1913, xviii., April 5.
An account of a few cases of tabes which have been treated with
salvarsan. A series of five injections were given, and many of the
symptoms of the disease were relieved after one or two injections.
In some cases the patient relapsed, and it was necessary to give
a second series of five injections. Patients who, owing to ataxia,
had been unable to walk, were enabled to do so after treatment.
The pains were diminished, and in one case incontinence was
relieved. Knee jerks, which were absent or sluggish before treat¬
ment, became normal, but the action of the pupil to light appears
to have been unaffected.
The author considers that these cases show the value of
arsenical treatment in certain tabetic symptoms, and the signi¬
ficance of symptoms of radicular irritation in the early diagnosis
of the disease. J. Stanley Hopwood.
A CASE OF SPINAL TUMOUR WITH SCOLIOSIS; OPERATION.
(324) Wilfred Harris and A S. Blundell Bankart, Lancet, 1913,
clxxxiv., June 21, p. 1730.
The patient was a woman, aged 57, who began to suffer from
weakness and aching in the back seven years ago. On examina¬
tion a dorsal curvature of the spine was found and she was ordered
a poroplastic jacket; but a year later weakness in the legs
developed, so that she was unable to get about without assistance,
and ultimately had to remain in bed. The paralysis was accom¬
panied by girdle-pain round the lower part of the chest and by
loss of sensation in the lower extremities. Owing to the presence
of the spinal deformity, arthritic disease of the spine, causing
pressure on the cord, had been diagnosed, and operation refused;
I
ABSTRACTS
393
but later, as the symptoms pointed clearly to pressure on the cord,
laminectomy was performed, and the fourth and fifth dorsal spines
and laminae removed. A soft pinkish tumour was then discovered
and removed at the level of the sixth dorsal vertebra. It was
about the size of a pigeon’s egg, and was found to be a psammoma.
Recovery was uninterrupted, and the patient can now walk
without assistance.
Scoliosis has not before been described in association with
6pinal tumour. In this case the growth of the tumour was very
slow (seven years), and its situation corresponded exactly with the
upper limit of demonstrable anaesthesia. A. Ninian Bruce.
MIRROR WRITING AND OTHER ASSOCIATED MOVEMENTS
(325) OCCURRING WITHOUT FALSV. C. W. Burr and C. B. Crow,
Joum. Nerv. and Mmt. Dis., 1913, xL, May, p. 300.
A MAN, 27 years old, whose hands at birth seemed to be useless,
and in whom it was noticed later that any movement in either
hand was accompanied by movement of the other. He could not
learn a trade on account of the fact that each hand did or tried
to do whatever he was doing with the other. When 25 years old
it was discovered when given two pencils and told to write with
both hands that the left hand wrote mirror writing.
Mirror writing is said by the authors to be the natural and
physiological way for right-handed persons to write with the left
hand. D. K. Henderson.
A STUDY OF THE FLACCID SPINAL PARALYSIS WHICH
(326) ATTACKED LOUIS PASTEUR IN EARLY MATURITY, AND
ITS SIMILARITY TO AN ATTACK OF ACUTE EPIDEMIC
POLIOMYELITIS. TOGETHER WITH A STUDY OF THE
SILKWORM AS A POSSIBLE MEDIAEY HOST OF THE SAME
DISEASE. J. van Vliet Manning, Med. Record, 1913, i., p. 976.
An interesting paper in which the writer attempts to prove that
the attack of left hemiplegia which Pasteur had at the age of 46
was due to acute poliomyelitis, and not to cerebral haemorrhage as
diagnosed by contemporary physicians. The acute febrile onset,
agonising pain in the arm, complete absence of coma, flaccid
paralysis and foot-drop, were all in favour of the former disease.
At the time of his attack Pasteur was engaged in the study of the
silkworm epidemic, and Manning suggests that the silkworm was
a host of the unknown organism of poliomyelitis.
J. D. Rolleston.
394
ABSTRACTS
A CASE OF LANDRY’S PARALYSIS, WITH ESPECIAL REFER-
(327) ENOE TO THE ANATOMICAL CHANGES. J. A. F. Pfeiffer,
Brain, 1913, xxxv., Part iv., p. 293.
The case of a man, aged 24, who on rising one morning noticed
he had difficulty in walking. This increased until he could not
stand without support. Paralysis of the arms followed, then of
the shoulder and neck muscles, and death took place shortly from
respiratory paralysis. The Wassermann reaction was negative
both in the blood and in the cerebro-spinal fluid.
Microscopically the brain, membranes, and spinal cord appeared
practically normal. A streptococcus was isolated from the spleen.
The motor cells were well preserved throughout the central
nervous system, the cellular changes which were present not
having any direct relation to the paralysis. On examining the
peripheral nerves, an interstitial neuritis was found, although
there were no sensory symptoms and no pain on pressure.
A. Nenian Bruce.
THE ABORTED FORMS AND PRE PARALYTIC STAGE OF
(328) ACUTE POLIOMYELITIS IN THE BUFFALO EPIDEMIC.
E. A. Sharp, Joum. Nerv. and Ment. Du., 1913, xl., May, p. 289. *
The epidemic of poliomyelitis which was prevalent in Buffalo ’
during the past summer and autumn was more extensive than )
any of the previous epidemics in Western New York. Altogether
up until 1st November 1912, 310 cases with 41 deaths had been !
reported to the Health Department in Buffalo. These cases were ’
classified into three groups: (1) Suspicious, (2) Aborted, and !
(3) Paralytic.
Cases were considered suspicious if they presented only
constitutional symptoms of a general nature without any local
nervous symptoms; aborted cases were those which showed some
involvement of the nervous system along with the general
symptoms, but no definite paralysis: and the paralytic cases were
those in which there was either a definite paralysis or a prolonged
weakness of muscles.
Out of 180 cases 29 were seen in a stage before the paralysis
developed, or which remained aborted. The results of the examina- J
tion in these cases are tabulated, and referred to in a detailed way.
All grades of transition were found to occur from the mildest i
gastrointestinal or simple febrile disturbances to the severe j
paralytic and rapidly advancing fatal cases.
D. K. Henderson. j
ABSTRACTS
395
REPORT OF A CASE OF PNEUMOCOCCUS MENINGITIS WITH
(329) NORMAL CEREBRO SPINAL FLUID. J. M. Brady, Journ.
Amer. Med. Assoc., 1913, lx., p. 972.
A fatal case in a male infant aged 1 year. The necropsy showed
broncho-pneumonia and pneumococcus meningitis of the convexity.
The normal cerebro-spinal fluid was due not to the shutting off
of the spinal canal, but to absence of liquefaction in the thick
and tenacious exudation covering the brain. Reference is made
to the paper of Oseki, who recorded four cases of clinically latent
meningitis in pneumonia, the condition beiDg first discovered
microscopically post mortem (v. Review, 1912, x., p. 387).
J. D. Rolleston.
ON A CASE OF PNEUMOCOCCAL MENINGITIS. (Notas clinicaa
(330) con motivo de un caso do meningitis pnenmocdccica.) F. R. G.
Fornos, Policlinica , 1913, i., p. 249.
A record of a case of pneumococcal meningitis of the convexity
in a woman, aged 30, following directly on a typical attack of
lobar pneumonia. Three intra-spinal injections of Merck’s anti-
pneumococcal serum were given, and recovery took place, but a
condition of mental deficiency resulted, and was unaffected by
injections of fibrolysin. J. D. Rolleston.
A FRESH CASE OF PARAMENINGOCOCCUS SEPTICEMIA WITH
(331) RECURRING MENINGEAL ATTACKS. (Un nouveau cas de
septiclmie k paramdningocoques avec Episodes meninges k
rlpltition.) Oettinoeb, P. L. Marie, and Baron, Bull, et mtm.
Soc. mdd. H6p. de Paris, 1913, xxxv., p. 935.
A man, aged 24, who had previously had malaria, was suddenly
seized with violent and almost daily attacks of intermittent fever,
accompanied by enlargement of the spleen. Quinine had no effect,
and within a month meningeal symptoms developed. These were
purely spinal in character, and consisted in very severe lumbo¬
sacral rachialgia and considerable stiffness of the lower limbs.
The parameningococcus was found in the blood and spinal fluid.
Under treatment with specific serum the meningitis, which resisted
antimeningococcus serum, cleared up, but the septicaemia persisted,
and a fresh attack of meningitis occurred which was jugulated in
a few days by larger doses of serum. A fortnight later there was
a third attack of meningitis, which also yielded to serum treatment.
Finally, after three and a half months of parameningococcus
septicaemia, complete recovery took place. {Cf. Review, 1911, ix.,
d. 205.) J. D. Rolleston.
396
ABSTRACTS
ON ACUTE, MILD, EPIDEMIC MENINGITIS (Contribution
(332) k l’ltude des- mtaingits aiguBs, bdnignes, Bpid&niques)
J. Chataignon, Theses de Paris, 1912-13, No. 252.
A certain number of cases of acute cerebro-spinal meningitis,
whose cytological formula resembles that of tuberculous meningitis,
though the fluid is sterile, should be classified with the nervous
infections due to the unknown agent of acute poliomyelitis
(medullo-virus). The diagnosis is sometimes confirmed by the
occurrence of paralysis or paresis.
The thesis contains the histories of eight original cases in
children aged from a few months to nine years.
J. D. Rolleston.
HAEMORRHAGIC TUBERCULOUS MENINGITIS IN A BABY.
(333) (Un cas da mtfningite tuberculeuse hlmorragique chez un poupon.)
C. Fairish and A. Remy (Nancy). Rev. mid. de VEst, 1913, xlv.,
p. 384.
A male infant, aged 5| months, was admitted to hospital on 10th
September for frequent convulsions, most marked on the right side.
Lumbar puncture gave issue to a pink fluid under hyper-tension.
Some improvement followed mercurial treatment which was
given on account of prominent veins in the temporal regions and
perineal erosions. On 13th September the convulsions ceased, and
there was paresis of the left lower limb. Lumbar puncture gave
issue to a very haemorrhagic fluid. Death from convulsions occurred
on the 16th. Post mortem general miliary tuberculosis was found.
Histological examination revealed small haemorrhagic foci in the
pia mater, and its prolongations into the brain substance almost
universally in the neighbourhood of the vessels, most of which
showed inflammation of their inner coat. An abundant leucocyte
infiltration was found round many of them, and invading their
walls.
The haemorrhagic form of tuberculous meningitis is probably
due to secondary infections — the present case had intestinal
troubles—which affect both the blood and the vessels. In some
cases syphilis, inherited or acquired, may explain the vascular
fragility, which is certainly not due to tuberculous infection alone.
J. D. Rolleston
ACCIDENTS FOLLOWING THE SUBDURAL INJECTION OF THE
(334) ANTIMENINGITIS SERUM. Simon Flrxner, Joum. Amer.
Med. Assoc., 1913, lx., June 21, p. 1937.
The reduction in mortality caused by epidemic meningitis and
brought about by the serum is from two-thirds to three-fourths
ABSTRACTS
397
of the average percentages occurring among patients not subjected
to the specific treatment.
The cases reported by Kramer ( v. Review, 1913, xi., p. 332) and
others, where sudden death followed the administration of the
serum subdurally, appear to be the result of excessive intracranial
pressure and not to anaphylactic shock. It is quite certain it is
not due to the phenol preservative. No other effective means of
treatment are known, and thus it is not justifiable to withhold the
remedy on account of some small risk in view of the far greater
danger of the disease itself. A. Ninian Bruce.
THE FIFTH CEREBRAL VENTRICLE (Le (cinguidme ventricule)
(335) cdrdbraL) Da Lit, Jowm. de Neurol., 1913, xviii., April.
A description, with photograph, of a definite fifth cerebral
ventricle in a patient who died of meningo-encephalitis. The
other cerebral ventricles were practically normal.
J. Stanley Hopwood.
A CASE OF TYPHOID SPONDYLITIS. (Sur un cas de spondylite
(336) typhigue.) Favbb and Bovteb, Lyon Mid., 1913, cxx., p. 777.
A case remarkable for the age of the patient—a woman of 60—
and the rapid evolution of the vertebral inflammation. The
spondylitis lasted only one and a half months. Improvement was
sudden, and the pains disappeared in a few days without special
treatment.
No X-ray examination nor lumbar puncture was made.
J. D. Rolleston.
THE DISSEMINATION OF DIPHTHERIA IN THE HEART
(337) BLOOD AND ORGANS. (Die Verbreitung der Diphtheria im
Henblut und in den Organen.) P. Sommsrfeld, Arch, f Kinder-
heilk., 1913 ; Bagutky Festschrift, p. 698.
The neurological interest of the paper lies in the following figures :
in 58 cases fluid from the ventricles or spinal canal was examined
post mortem. In 13 cases (22’4 per cent.) diphtheria bacilli were
found associated with cocci, in 14 (241 per cent.) there were cocci
only, and in 31 (53*5 per cent) no organisms were present. Of
28 cases in which the medulla was examined, diphtheria bacilli
associated with cocci were found in 2, cocci only in 2, and in the
rest there were neither diphtheria bacilli nor cocci, but sometimes
B. coli and Proteus. (Cf. Review, 1912, x., p. 292.)
J. D. Rolleston.
34
398
ABSTRACTS
DIPHTHERITIC PARALYSIS. J. D. Rolleston, Arch, of Fed., 1913,
(338) xxx., p. 335.
The paper is based on 2,300 personal cases of diphtheria observed
by the writer in the course of the last 10 years. 477, or 20 7 per
cent., showed some form of paralysis; 184 were severe, and 85 were
fatal. The direct relation between the initial angina and the
subsequent paralysis is shown by the fact that the percentage of
paralysis eases after very severe angina was 70*8; after severe,
46T>; after moderately severe, 23 0; after moderate, 1-3 6; after
mild, 2m; ami after very mild, 0. Of 30 cases of purely nasal
diphtheria only 1 had any paralysis. No paralysis occurred in 20
cases of purely laryngeal diphtheria. Paralysis was more frequent
(42T per cent.) in cases in which there was nasal involvement
than in those in which the fauces only, or together with the larynx,
were affected (14*1 per cent.). Loss of tendon jerks and the
presence of Babinski’s sign (v. Re view, 1910, viii., p. 404) were
also more frequent after severe attacks.
Palatal palsy occurred in 331 cases, cycloplegia in 236, squint
in 80, cardiac paralysis in 80, paraplegia in 36, pharyngeal paralysis
in 36, and diaphragmatic paralysis in 16. Of the 85 fatal cases, in
only 5 did the paralysis start after the end of the second week,
death in these 5 cases being due to paralysis of the diaphragm.
In the rest death was due to cardiac paralysis, the first sign of
which had arisen before the beginning of the third week.
The untoward significance of precocious paralysis of the palate
( v. Review, 1906, iv., v., 608) is shown by a percentage mortality
of 352 among 141 cases in which it was found, as compared with
a percentage mortality of T5 among 190 cases in which it first
occurred after the end of the first fortnight. Other prognostic
signs are described and the treatment discussed.
Author’s Abstract.
A LECTURE ON MINERS' NYSTAGMUS. T. Lister Llewellyn,
(339) Brit. Med. Joum., 1913, June 28, p. 1359.
A general account of this condition. It was first described in
Belgium in 1861. Two views are held in regard to its causation:
one, that it is due to the position assumed by the miner at his
work, and the other that it is due to deficient illumination. There
are two varieties of the disease. In the first the symptoms are
absent or latent, and the man is unaware of his nystagmus. In
the second the man is unable to work, and aware that his eyes are
affected. The first symptom is failure of sight; next, the lamps
dazzle the eyes, then headache, giddiness, and photophobia. The
physical signs are involuntary and irregular movements of the
ABSTRACTS
399
eyeballs, chiefly rotatory, tremor of the eyelids, eyebrows, and head.
The cause is, that owing to the deficient light of the mine the
images formed in the eyes are indefinite and inexact; this leads to
indecision on the part of the controlling mechanism in the brain,
so that irregular inco-ordinate movements of the eyeballs ensue.
The mean age was 39'8 years. Reference is also made to several
other points. A. Niki an Bruce.
CONGENITAL DEFICIENCY IN THE CRANIAL VAULT. F.
(340) Langmead, Proc. Roy. Hoc. Med., 1913, vL (Sect. Study Dis. Child.),
p. 101.
Langmead showed a boy aged 4 years, with a pulsating area, the
size of a threepenny piece, at the posterior part of the inter¬
parietal suture. J. D. Rolleston.
EXTIRPATION OF THE VESTIBULE OF THE LABYRINTH WITH
(341) CEREBELLAR ABSCESS. OPERATION; FURTHER A NEW
REFLEX PHENOMENON. (Extirpation des vestibul&ren L&by-
rinthes mit Kleinhimabszess. Operation; feroer einneues Reflex-
ph&nomen.) RrrcHER, Ztschr.f. Ohrenkeilk , 1912, lxvi., S. 94.
Female, aged 26. Left ear discharging since childhood. On
admission old left facial paralysis and ptosis. Nystagmus to
diseased side. Some left abdurens paralysis. Head bent back
and to left. Pain on moving it. Much headache, worse posteri-
ously, vomiting, giddiness. Patient cannot stand or walk. Radical
operation same day. Next day canals and vestibule removed,
dura of posterior fossa, in which was a small fistula oozing pus,
opened, and an extraordinary large cerebellar abscess evacuated.
Abscess drained at first by a tracheal canula No. 4. Recovery.
Hearing apparently remained in the left ear. Among others
the following method of testing employed.
A stethoscope with a celluloid membrane over the end and two
ear tubes is employed. The ear tubes are connected to the patient’s
ears. A vibrating tuning fork is stood on the celluloid membrane.
When the noise, which is great, strikes the ear the patient blinks.
The right tube here was pinched close. Even then the patient
blinked, with the right eye, of course, ptosis being present in the
left. Tested in a dark room, with the left ear she could dis¬
tinguish the quantity of sounds, but not their direction or distance.
The author then discusses the possibility of the semicircular canals,
in addition to their other function, having to do with sound
localisation, the vestibule with the distance of sounds.
R. VErel.
400
ABSTRACTS
CEREBELLAR TUMOUR. Max Mailhouse and W. F. Verdi, Joum.
(342) New. and Ment. Nit., 1913, xL, May, p. 303.
The description of the case of a gliomatosis cerebellar tumour
occurring in a girl 15 years, which was successfully operated on
and removed. The patient has made a good recovery.
D. K. Henderson.
THE END RESULTS IN SIXTY-THREE OASES OF OPERATION
(343) FOR BRAIN TUMOUR. William J. Taylor, Annalt of Surgery,
1912, lvi., p. 65.
Looked at from a surgical point of view the author divides
tumours of the brain into three groups: (1) Those which cannot
be localised with any degree of accuracy, and when the skull is
opened cannot be found. (2) A small percentage of cases when at
operation the tumour is found, but cannot possibly be removed.
(3) A very small number of cases when the tumour can be readily
located and completely or partially removed.
Six were tumours of the dura, and all of these came under
the group of class No. 3. The operative results of these were
successful, one patient living for twenty years after operation, the
other three cases died of recurrent haemorrhage within a few hours
of operation.
There were eight simple cyBts of the brain substance, four
cerebral and four cerebellar; six recovered from the operation of
simple drainage, one five and a half years after operation being
still alive. There were seven cases of brain tumours, gliomata and
indotheliomata, so localised that their complete removal was possible.
In group No. 2 there were nine cases, the infiltrating character
of the tumours preventing their complete removal.
In thirty-three instances the tumours could not be found at
operation.
The operation mortality was exceedingly high: six patients
died within the first five days, thirteen died from the sixth to the
tenth day: nineteen deaths all told within ten days of operation
(30 per cent.).
The final results were exceedingly bad: one case of dural tumour
lived for twenty years after the operation, a cyst of the cerebellum
is alive and well five and a half years after operation, a glioma of
the cerebrum is alive three years after operation but a recurrence
has appeared.
While the operation results as regards removal of the tumour
are exceedingly disappointing, the author draws attention to the
enormous benefit which results from a decompressive operation;
it relieves the intense headache and papilla oedema, and if under¬
taken sufficiently early it undoubtedly materially prolongs life.
J. Fraser.
ABSTRACTS
401
BEPOBT OF A OA8E OF A LARGE ENDOTHELIOMA OF THE
(344) FRONTAL REGION OF THE BRAIN. R L. Whitney, Amer.
Joum. Insanity , 1913, lxix., April, p. 705.
The patient was a man, aged 45. He was a highly intellectual
boy, becoming leader of an orchestra at the age of fourteen, and
was specially proficient in original composition and transposition.
Fifteen years ago he suffered from a nervous breakdown, resulting
in retirement from an active professional life. Subsequently there
occurred periods of lethargy, depression, and loss of ambition,
with final incapacity for self-support. Beginning with a transitory
period of unconsciousness, various neuro-muscular disturbances
were apparent which were followed by apathy, somnolence, and
progressive mental deterioration, which symptom, complex in the
absence of thorough neurological examinations, led to the diagnosis
of general paralysis.
At the autopsy a large endothelioma of the frontal region
of the brain was discovered, located chiefly in the right frontal
lobe, but also extending into the left frontal lobe. It was
apparently of slow growth. A. Niniah Bruce.
DIFFUSE GLIOMA OF THE PIA MATEB. Albert M. Barrett,
(345) Amer. Joum. Insanity , 1913, lxix., April, p. 643.
The material was obtained from a man who died at the age of 40,
after four months’ vague mental symptoms. A large glioma was
found growing in the subependymal substance in the right occipito¬
temporal lobe. It had invaded the adjacent pia mater, and spread
widely through the pia of the greater part of the brain, cerebellum,
cranial nerves, pons, medulla, and upper part of spinal cord. In
its extension it had pushed in among the fibres of the pia mater,
and in places lay in the subarachnoid space. From the spaces of
the pia, glia cells had invaded the lymph spaces of the adventitia
of the blood vessels, and extended deeply into the substance of the
brain, and in places these had broken through the vessel walls and
formed focal metastases in the perivascular area.
References to eighteen other cases are given.
A. Ninian Bruce.
NEW FORMATION OF NERVE CELLS IN AN ISOLATED PAST
(346) OF NERVOUS PORTION OF THE HYPOPHYSIS TUMOUR IN
A CASE OF ACROMEGALY WITH DIABETES, WITH
DISCUSSION OF THE HYPOPHYSIS-TUMOURS FOUND SO
FAB. Adolf Meyer, Amer. Joum. Insanity , 1913, lxix., April,
p. 653.
This case is one of typical acromegaly, in a woman aged 52, of
six years’ duration, associated with panansic disposition and
402
ABSTRACTS
adenoma-like tumour of the hypophysis of a hyperplastic-progres¬
sive character.
The conclusions are that the changes in the hypophysis in
acromegaly seem to be more uniform than the descriptive terms
in the literature would suggest. The differences of opinion may
be due in part to a limitation of the examination to one or few
portions of the tumour. In a sequestrated part of the nervous
portion, unmistakable new formation of nerve cells with Nisol
bodies had occurred besides other monstrosities.
A Ninian Bruce.
ACROMEGALY; DIABETES; PITUITARY TUMOUR. (Acromt
(347) galie, diatete, tumour hypophysaire). Carnot, Rathery, and
J. Dumont, Bull, ei mtvu Soc. mid. U6p. de Paris, 1913, xxxv.,
p. 921.
A woman, aged 58, was admitted to hospital for diabetes of three
years’ duration. Typical acromegaly was also present, and had
existed for many years. The diabetic symptoms suddenly became
more severe, and death took place within a mouth of admission.
Post mortem no macroscopical lesion was found t-o explain the
sudden termination. In addition to epithelioma of the hypophysis,
changes were found in all the glands of internal secretion, especially
haemorrhages and sclerosis in the suprarenals, sclerosis and hyper¬
trophy of the thyroid, and marked hyperplasia of the parathyroids.
J. D. Rolleston.
DISEASES OF THE LABYRINTH CAU8ED BY SUPPURATIVE
(348) MIDDLE EAR INFLAMMATION (COMPLICATIONS, DIAG¬
NOSIS, TREATMENT). (Die durch suppurative Mittelohrentsun,
dungen verursachten Labyrinthkraukheiten. Komplikationen,
Diagnose, und Behandlung.) V. Uchkrmann, Ztschr. f. Ohren-
heilk., 1912, lxvi, S. 49.
Complications; most frequent meningitis; usually the infection
spreads by way of the internal auditory meatus. Less common
are deep extradural abscess on the posterior surface of the pars
petrosa and brain abscess. The spread of infection here usually
by dehiscemes of the labyrinthin wall, fistula, or ductus endo-
lymphaticus. Brain abscess of labyrinthine origin is very rare.
The author distinguishes between a toxic serous meningitis,
“ meningo-encephalitis,” and a bacterial serous meningitis, which
is an early stage of purulent meningitis. The diagnosis of
meningitis is discussed at some length, stress laid on lumbar
puncture. As a rule, cloudy bacteria containing spinal fluid is a
sign of meningitis, but proves nothing as to the stage or depth of
the illness. In the diagnosing of abscess, which is usually
ABSTRACTS
403
cerebellar, the direction of the nystagmus and B&rdny’s pointing
reactions are of importance, as also the fact that in cerebellar
ataxia the direction of falling bears no relation to the direction
of the nystagmus and position of the head, in contradistinction
to vestibular ataxia. The treatment is discussed fully both of
suppuration labyrinthitis and its complications. R. Verel.
THE PASSING OP PARASYPHILIS. S. Pollitzbk, Med. Record,
(349) 1913, i., p. 797.
In specimens of two hundred cases of general paralysis—many of
them poorly stained sections only—Noguchi found Spirochcetce
'pallida in forty-eight. With improved staining, the frequency of
spirochaetes in paresis will probably be found to be greater.
Noguchi’s discovery proves that “paresis is not an indirect
effect of syphilis but is a disseminated spirillosis of the brain, is
syphilis itself.” The great majority of the cases had been of com¬
paratively short duration, and if further studies show that the
organism is absent from prolonged cases, the view will be confirmed
that the nervous system is an unfavourable soil for the growth of
bacteria.
Pollitzer thinks that similar findings will soon be made in
tabes, especially in cases of short duration, in which death has
been due to an intercurrent affection. J. D. Rolleston.
THE CUTANEOUS REACTION IN SYPHILIS (SECOND REPORT).
(360) Julian Mast Wolfsohn, Jowm. Amer. Med. Assoc., 1913, lx., June
14, p. 1866.
The author considers that the luetin reaction for syphilis is specific
when properly performed. Intensive antisyphilitic treatment in
the later stages of syphilis may produce a negative luetin reaction
which, after an interval in which treatment is withdrawn, may
become positive. Treated congenital and secondary syphilis is apt
to give positive luetin reactions. The luetin reaction is especially
valuable in parasyphilis, and tertiary and latent syphilis. In any
case of suspected syphilis, whether previously treated or not, a
negative luetin reaction must be watched for at least four weeks,
so as not to overlook a delayed reaction. A. Ninlan Bruce.
CASE OF EXOPHTHALMIC GOITRE CURED BY X-RAY. S. Tousey,
(351) Med. Record, 1913, i., p. 849.
A case of Graves’ disease with moderate exophthalmos and
marked cardiac palpitation and tremor in a woman aged 32.
X-rays and high frequency currents from a vacuum electrode were
404
ABSTRACTS
applied over the thyroid gland three times a week. Arsenic and
strychnine were the only drugs given, and only for a short time.
Recovery took place in three months, and no recurrence has taken
place in the course of over seven years, although within a year
of the treatment the patient was subjected to great anxiety owing
to the illness of her child. J. D. Rolleston.
PSYCHIATRY.
PRESENCE OF THE TREPONEMA PALLIDUM IN THE BRAINS
(352) OF THREE GENERAL PARALYTICS. (Presence du Treponema
pallidum dans trois cerveaux de paralytiques gdndraux.) A
Marie, C. Levaditi, and J. Bankowski, Bull, et mim. Soc. mid.
H6p. de Parit, 1913, xxxv., p. 881.
The brains of forty-five general paralytics from Marie’s service at
Villejuif were examined, and positive results were found in two,
in one of whom the disease had lasted seven years, while in the
other its course had been more rapid. In the third case, in which
the progress had also been rapid, numerous spirochaetes were
found in the frontal cortex.
Fontana-Tribondeau’s silver method was used.
J. D. Rolleston.
DELIRIUM TREMENS AND CRANIAL TRAUMATISM (Ddlirium
(353) tremens et traumatisme crani&n.) Dr Ley, Joum. de Neurol .,
1913, xviii., April 5.
A case of severe cranial injury, the symptoms of which were
entirely masked by the presence of delirium tremens. The
patient, a chronic alcoholic, fell from his horse, knocking his head
against a wall. The following day he developed the classical
symptoms of delirium tremens. The tendon reflexes were
abolished in the lower limbs and exaggerated in the upper.
The cutaneous reflexes were normal except the abdominal, which
were absent. Sensibility was diminished, and there was generalised
analgesia. The pupils reacted normally, and continued to do so
until death.
On the seventh day after the accident the patient developed
convulsions of the left side, with contracture of the right arm.
The convulsions increased in frequency, the temperature rose, and
the patient died on the eleventh day after the injury.
Post-mortem examination revealed the presence of a fracture
of the skull extending from the right parietal bone to the tip of
the petrous portion of the temporal bone. Large blood clots
were present in the right temporo-sphenoidal fossa, and in both
ABSTRACTS
405
frontal fossas. The external table of the parietal bone was
fractured, but the fracture did not extend to the inner table.
The severe delirious symptoms and the toxico-traumatic
origin of the mental state masked the local signs, and the
convulsions, which bore a resemblance to Jacksonian epilepsy, were
attributed to the delirium. J. Stanley Hopwood.
CONTRIBUTION TO ALZHEIMER’S DISEASE. (Nuovo Contribute
(354) per la “ Malattia di Alzheimer.”) Alberto Ziveri, Rassegna di
Studi Psichiat., 1913, iii., p. 187.
The case of a woman, aged 53, who suffered from progressive
mental weakness as shown by loss of memory, confusion, disorder,
excitement, and pronounced disturbance of speech. She died three
and a half years later in coma. There had been no previous
illness.
Later senile plaques were found scattered throughout the
whole of the cerebral cortex, with the characteristic alteration
of the neurofibrils described by Alzheimer. No special localised
lesion was found. The author considers that Alzheimer’s disease
is a clinical and histological entity.
Some remarks on the senile plaques follow, and on the presence
of argentophil granules in the nerve cells, which the author thinks
is independent of the changes in the neurofibrils.
A. Ninian Bruce.
A 81
OF NORMAL-LOOKING BRAINS IN PS70H0PATHI0
(355) SUBJECTS. E. E. Southard, Amer. Joum. Insanity , 1913, lxix.,
April, p. 689.
The main object of this communication is to stimulate interest in
normal or normal-looking brains in psychopathic subjects, so that
the question whether insanity is, or is not, always a matter of
structural brain-disease may approach settlement. Normal-looking
brains have now been found in a large fraction of senile dementia
cases in two autopsy series, so that the “ functionality ” of these
cases stands on as good a footing as that of various more generally
recognised “ diseases of mental function.” The issue in dementia
praecox is now clearly defined, since one series (Worcester) might
be interpreted to affirm the functionality, and the other (Danvers)
to affirm the structurality (“ organic nature ”) of the disease in
question. Incidentally the question has arisen whether dementia
praecox may not, on the ground of viability, be divided into
dementia praecox brevis (with early death, say, under two years from
onset) (katatonic form often here found) and dementia praecox
longa (death usually after eight years). It is hardly possible
from gross appearances to be able to assert abnormality of brains
35
406
KE VIEWS
unless at least three months have elapsed from the onset of some
cell-destructive process. Various nerve cells also, which are in
all respects intrinsically normal, may be essentially sharing in
processes extrinsically abnormal, and the whole cortex may be
intrinsically normal, but extrinsically abnormal, in its reactions to
a given chemical, physical, or other condition. It seems clear that
the general statement, “ insanity in brain disease '' is well-nigh
meaningless unless the particular structures thought to be involved
are specified. A. N ini an Bruce.
■Reviews.
LE LIQTJIDE CLPHALO - RAOHIDIEN, NORMAL ET PATHO
(356) LOOIQUE, VALEUR CLINIQUE DE L'EXAMEN CHIMIQUE
By W. Mestrezat. A. Maloine, Paris, 1912. Pp. 681. Pr. Fr. 12.
The examination of the eerebro-spinal Huid has at last been put
on a scientific basis by this admirable work, to such a degree that
all future work on this fluid must take Mestrezat’s book as a
starting point.
During the last few years much attention has been directed to
the eerebro-spinal fluid, and the cytology and albumen content
have been the subjects of much valuable work ; but this lias been
largely spoiled by inexact methods of technique, and by conclusions
drawn from insufficient data. The present work is free from both
these errors. The methods of examination employed, although for
the most part of extreme simplicity, are of great accuracy, and the
long tables of figures which intersperse the book free the reader’s
mind of any suspicion of dogmatism. In addition; the quantitative
examination of chlorides and sugar has been carried out in most
instances, and the freezing point, alkalinity, total ash, urea, &c.,
have also been the subjects of thorough investigation. Choline,
anti-bodies, and other supposed properties of the eerebro-spinal
fluid have also been sought, for the most part in vain.
As the book deals almost entirely with the chemical aspect of
the fluid, the cytological formula is usually dismissed very briefly.
The physiology of the production of the eerebro-spinal fluid (by
dialysis through the epithelium of the choroid plexus), and of its
circulation and absorption, are the only parts of the work to which
any objection of dogmatism could be raised. But it is necessary
for the author to put forward certain hypotheses for the explana-
REVIEWS 407
tion of the various conditions of the fluid, and those given seem to
be justified by the reaction of the fluid to varying factors.
Any doubtful statements made in the work are explained by
the author’s attention to the chemistry of the fluid rather than to
the clinical aspect of the disease. For instance, he asserts that
tubercular meningitis (with the presence of bacilli in the fluid) is
of necessity fatal; a statement which is not upheld by recent
experience. Such a statement is, however, outside the main object
of the work, and is more than counterbalanced by the formula!
given by which tubercular meningitis may be diagnosed by the
chemical examination of the cerebro-spinal fluid alone.
Especially interesting are the chapters dealing with the
syndrome of “ massive coagulation and xanthochromia ” of Froin;
with uraemia and the chloride retention of Bright’s disease; with
diabetes, fevers, and general intoxications.
It is interesting to note that although in cases of hydrocephalus
and cerebral tumours the author has found, or quoted from the
literature, estimation of albumen as high as any in the syndrome of
Froin, and associated frequently with yellow coloration and the
presence of fibrin, yet he has not suggested any co-relation or
similarity in the mode of production in these various conditions.
The suggestion offers that in each case this condition of the fluid
is due to the same cause, i.e., a shutting off of the dialysed ventri¬
cular fluid from the general circulation, thus allowing the more
albuminous contributions from the neural sheaths, pial vessels, &c.,
to accumulate. This hypothesis, however, needs to be verified by
further work along the lines of full chemical examination suggested
by the author's work.
The book closes with an exhaustive bibliography of forty-three
pages.
The comprehensive nature of the volume renders it valuable,
not only to neurologists, but to all who use laboratory methods in
the investigation of their cases. J. Godwin Greenfield.
OUTLINES OP PSYCHLATBY. W. A. White. Nervous and Mental
(367) Disease Monograph Series, No. 14. New York, 1913. Pr. $3.00.
This work is one of the volumes edited by Dre Smith Ely Jelliffe
and Wm. A. White in their Nervous and Mental Disease Mono¬
graph series. A consideration of the subjects treated in certain
other volumes of the series tends to strengthen the preliminary
reflection that a work upon the general outlines of so extensive
and varied a subject as psychiatry is somewhat out of place in a
series of monographs. Paranoia, hysteria, epidemic poliomyelitis,
and cerebellar functions are subjects well suited for such a series,
408
REVIEWS
but it may well be doubted if the suitability extends to the
subject indicated by the title of this book.
The work extends to a little over 300 pages, and is divided into
twenty-one chapters. The first two of these, headed “Psycho¬
logical Introduction ” and “ The Nature of Mental Disorder,”
extend to fourteen pages, and give early evidence of the some¬
what sketchy and incomplete nature of much of the book. It is
difficult to see what else could be the case. The psychological
terms mentioned in Chapter I. would, in themselves, provide
ample material for an exhaustive monograph.
Chapters III. and IV. on “ Classification and Causes of Mental
Disease,” and Chapter V. on “ Treatment,” are brief and didactic.
We are glad to note the strong recommendation of hyoscyamus,
given hypodermically, in conditions of acute excitement, but can¬
not agree with the author that in tube feeding the oesophageal
route is always to be preferred, and miss any mention of saline
rectal injections as a method of hydrotherapy.
Chapter VI. deals with "General Symptomatology,” and is one
of the more comprehensive and informative parts of the book.
The paragraphs upon illusion, hallucinations, disorientation, de¬
lusion, negativism, stupor, &c., if abbreviated, are concise and to
the point The same, however, cannot be said of the section
headed “The Complex,” which takes much for granted, and is
unconvincing.
The chapter on paranoia and paranoid states is of interest from
the large number of authors whose views are quoted, but we miss
any reference to Tanzi upon this subject, and generally throughout
the book the Italian alienists receive little recognition.
Chapter IX., upon “ General Paralysis,” gives a description of
the disease on the usual 1st, 2nd, and 3rd stage lines, but touches
very lightly upon the problems of etiology. No reference is made
to the views of Ford Robertson, and the numerous workers who
have put forward views in support or refutation of his opinions.
The discussion of “ Dementia Pnecox ” is interesting and sug¬
gestive, and stress is laid upon the views of Bleuler and Stransky
in regard to schizophrenia and intrapsychic ataxia. We note
with some alarm, however, the description of no less than five
varieties of the disease. The stenogram illustrative of hebephrenia
is extremely good and characteristic.
Chapters XI. and XIL deal with involutional melancholia and
the senile or prse-senile psychoses. The author does not seem to
us to distinguish clearly between involutional and climacteric
melancholia. We are glad to note the recommendation of alcohol,
alone or in combination with a hypnotic, in cases of senile insomnia.
Chapter XIV., on the toxic psychoses, deals with alcohol, opium.
NOTICE OF MEETING
409
cocaine, and other exogenous poisons. It is surely by mistake that
cirrhotic liver is mentioned so prominently under the head of
“Pathology of the Alcoholic Psychoses” (p. 211). Mott’s view
in a contrary sense is quoted on p. 196.
Livingston’s solution is recommended for chronic alcoholism,
and the prescription given in a footnote, but the author confuses
the directions he gives for its administration by the contradictory
use of equivalent terms. The outline of D.T. is good.
In Chapter XV. epilepsy is dismissed in four and a half pages,
and its treatment in three lines, and in the following chapter
the thyroid psychoses receive only half a page. We cite these
instances to show how cursory and brief are the references to
some important forms of mental disease.
Chapter XIX., upon “ Principles and Methods of Examination,”
is the longest in the book, and presents a most exhaustive scheme
of examination, with a degree of detail that seems excessive in a
volume of outlines.
Chapter XX., giving a scheme of minimum mental examination,
is more practicable, and is fully sufficient for ordinary work.
Chapter XXI. deals with the Binet Simon tests for deter¬
mining the psychological age of the child. The tests are given as
modified to suit American children, and would probably require
further modification for use in this country.
We have read this book with a sense of disappointment, for it
seems to us to fulfil the functions neither of a manual for the
student nor of a treatise for the specialist.
T. C. Mackenzie.
notice of fIDeeting.
A Meeting of the International League against Epilepsy will be
held in the House of the Royal Society of Medicine, 1 Wimpole
Street, London, W., at 10 a.m. on Wednesday, 13th August.
The programme will include the discussion of the Reports of
the National Committees of the League and other papers.
By the kind invitation of the managing committees of the
Institutions, two visits have been arranged; the first on Wednesday
afternoon, 13th August, to the London County Council Epileptic
Colony at Epsom, Surrey; and the second to the David Lewis
Epileptic Colony, Sandle Bridge, near Alderley Lodge, on Thursday,
14th August.
36
410 BOOKS AND PAMPHLETS RECEIVED
BOOKS AND PAMPHLETS RECEIVED.
Aldabalde, Valle y. “ El psicoanAlisis de Freud ” (Riv. de Med. y Cir.
prdct., 1913, xxxvii., Mayo 7 and 14, pp. 169 and 209).
Aldabalde, Valle y. “ Par&lisis de la delucidn ” (Riv. de Med. y Cir.
prdct., 1913, xxxvii., Mayo 7, p. 195).
Degeuer, Lyda May. “ The effect of thyroid extirpation on the hypo¬
physis cerebri in the rabbit” (Quart Joum. Exp. Physiol., 1913, vi, p. 111).
Dresbach, M., and Munford, S. A “Interpolated extra-systoles, of
frequent occurrence, in an otherwise normal human heart” (Proe. Soc.
Exp. Biol, and Med., 1912, x., Oct. 16).
Flournoy, Henri. “Epilepsie 6motionnelle” ( Arch, de Psychol, 1913,
xiii., Avril, p. 49).
Healy, Wm. “American institute of criminal law and criminology.
Second report of Committee. A further development of a system for
recording date concerning criminals.” Bulletin, No. 12, April 1913.
North-western University Law Publishing Association Press, Chicago,
Illinois.
Jaspers, Karl. “Allgemeine Psychopathologie. Ein Leitfaden fur
Studierende, Arzte und Psychologen,” Julius Springer, Berlin, 1912.
Pr. M. 8 80 ; geb. M. 9.80.
Pellizzari, Celso. “Istituto Fototerapico. Resoconto sommario dell
Esercizio, 1912.” Firenze, 1913.
Simpson, Sutherland. “The food factor in hibernation” (Prelim,
commun.) (Proc. Soc. Exp. Biol, and Med., 1912, ix., April).
Simpson, Sutherland. “ The pyramidal tract in the Canadian porcupine.”
(Erethizon dorsatus, Linn.) (Proc. Soc. Exp. Biol and Med., 1912, x.,
Oct 16).
Simpson, Sutherland, “ The motor cortex and pyramidal tract in the
Raccoon (Procyon lotor, Linn.) (Proc. Soc. Exp. Biol, and Med., 1912, x.,
Dec. 18).
Simpson, Sutherland. “The rate of growth in the dog” (Proc. Soc.
Exp. Biol, and Med., 1913, x., Feb. 1).
Simpson, Sutherland. “Age as a factor in the effects which follow
thyroidectomy and thyro-parathyroidectomy in the sheep ” (Quart. Joum
Exp. Physiol., 1913, vi., p. 119).
Trotter, Wilfred, and Davies, H. Morriston. “The peculiarities of
sensibility found in cutaneous areas supplied by regenerating nerves”
(Joum. f. Psychol, u. Neurol., 1913, xx., S. 102).
Vorkastner, W. “Wichtige Entscheidungen auf dem Gebiste der
gerichtlichen Psychiatric,” Carl Marhold, Halle a S., 1913. Pr. M. 1.
Wolf, Eduard. “Ferdinand August Maria Fr*nz von Ritgen. Ein
Beitrag zur Geschichte der Medizin und Naturphilosophie” (Beihe/te z.
Klinik f. psych, u. nervose Krankh.), Carl Marhold, Halle a S., 1913. Pr.
M. 1.50.
Zalla, Mario. “ Contribute alio studio dei nervi periferici nella paralisi
progressiva, nelle pellagra e nolle demenze senili.” Firenze, 1913.
Zalla, Mario. “ La neurite ascendent©.” Firenze, 1913.
Fifty-fifth Annual Report of the General Board of Commissioners in
Lunacy for Scotland. Edinburgh, 1913.
IReview
o t
ReuroloGE ant> fltei?cbiatn>
Original Hrticles
CLINICO-PATHOLOGICAL FINDINGS IN SYPHILIS
OF THE CENTRAL NERVOUS SYSTEM 1
By WILLIAM H. HOUGH, M.D.,
Clinical Pathologist, Government Hospital for the InBane, Washington, D.C.
Questions which frequently confront the psychiatrist and neurol¬
ogist are—Has the patient syphilis ? If so, does the disease affect
the central nervous system ? And has the patient syphilis or so-
called parasyphilis ?
These questions cannot be answered in a high percentage of
cases without the assistance of the clinical pathologist. In a small
percentage of cases it remains for the histopathologist to decide
the questions, and occasionally even this last resort leaves us with¬
out a definite answer. Not only are some of our best histologists
unable to differentiate in rare instances between paresis and
tertiary syphilis, likewise tabes and lues spinalis, but sometimes
unable to decide between syphilis and some non - syphilitic
conditions. However, I believe when our cases are thoroughly
examined by modem methods that we are enabled to make a
correct ante-mortem diagnosis in 98 per cent, of the cases of general
paralysis and about 85 per cent, of our cases of syphilis of the
nervous system.
While there are a great many laboratory tests recommended as
aids to the diagnosis of parasyphilis and syphilis of the nervous
system, the following are of the most practical utility at the
1 Read before the Society for Nervous and Mental Diseases of Washington,
D.C., at a Symposium on Syphilis of the Central Nervous System, 20th March,
1913.
37
412
WILLIAM H. HOUGH
present time, namely: The estimation of the protein content of the
cerebro-spinal fluid; the cell estimation of the cerebro-spinal fluid;
the Wassermann reaction with the cerebro-spinal fluid; the
Wassermann reaction with the blood serum. In this connec¬
tion should be mentioned also the luetin cutaneous reaction of
Noguchi, for although its use is rather limited at present in neuro¬
logical and psychiatrical practice it is of great value, under
certain circumstances. The same may be said of the provocative
Wassermann reaction.
The more delicate chemical analyses of the spinal fluid and
blood, the cytology of the blood, the estimation of the ferments of
the spinal fluid, the quantitative Wassermann reaction, animal
inoculation, &c., are of interest, and may prove to be of some
value, but at present their practical use is quite limited.
The work done thus far along this line by the writer includes
the examination of 650 specimens of spinal fluid and 3,000
Wassermann reactions including 225 cases of general paralysis and
100 cases of syphilis of the nervous system. As a general rule, it is
not difficult to determine whether or not a case belongs in the
syphilis-parasyphilis group, but difficulty often arises in differ¬
entiating syphilis from parasyphilis. Granting that parasyphilis
may be but another stage of syphilis, the fact remains that it
is exceedingly important for treatment and prognosis for us to
differentiate between these two conditions.
Considering the Several Teds individually. —First, the Wasser¬
mann reaction with the blood serum. On a complete positive
Wassermann reaction with the blood serum we may conclude as
a rule that the patient has syphilis. The conditions other than
syphilis, in which a complete positive reaction is found, are rare,
and are generally such that the question of differential diagnosis
seldom arises. Naturally it does not necessarily follow because
a case shows a positive Wassermann reaction with the blood
serum that the disease of the nervous system with which he may
be suffering is of a syphilitic nature. I have found four cases
reported (in the literature) in which a mistaken diagnosis of a
syphilitic disease of the nervous system was made on account
of a positive Wassermann reaction. We should not be surprised
to find, for example, a non-syphilitic tumour occasionally in a
syphilitic, the same as we find in them dementia praecox,
tuberculosis, &c.
SYPHILIS OF THE CENTRAL NERVOUS SYSTEM 413
In paresis approximately 98 per cent, of our cases show a
positive or partial Wassermann reaction with the blood serum,
the percentage of partial reactions being very small. In syphilis
of the nervous system 80 per cent, give a positive or partial re¬
action. My results in syphilis of the nervous system are 68 per
cent, complete positive, 12 per cent, partial, and 20 per cent,
negative. This is approximately the same as is found in tertiary
syphilis in general.
Second— As to the Wassermann Reaction with the Cerebro¬
spinal Fluid. —Concerning this reaction I believe we are now
justified in concluding that if, when properly carried out, a
complete positive reaction is obtained with the spinal fluid, it
most certainly means that we are dealing with syphilis of the
nervous system or parasyphilis, and my experience indicates that
fifteen in every sixteen cases showing such a reaction are cases
of general paralysis. That is to say, about 5 per cent, of the
cases of syphilis of the nervous system and 80 per cent, of the
cases of paresis show a positive reaction in the fluid.
The Protein Content of the Spinal Fluid. —An increase of the
protein content of the spinal fluid indicates an organic disease of
the central nervous system. Aside from acute meningitis it is
found more constantly increased in syphilitic and parasyphilitic
diseases, although it is not uncommon to find it increased in non¬
syphilitic conditions, as in some cases of cerebral arteriosclerosis
with softenings, cerebral and spinal tumours, &c. It is increased
in practically all cases of paresis and in about 90 per cent, of
the cases of syphilis of the nervous system. Repeated examination
of cases of syphilis of the nervous system, and especially examina¬
tion in the earlier stages of the disease, would probably show a
higher percentage.
The Cell Content of the Spinal Fluid. —First, as to the total cell
count.
The cell content of the spinal fluid does not run parallel with
the protein content. While I have always found an increase of
protein where there is a pleocytosis, the reverse has not always
been the case. I have found a number of times an increase of
protein sufficient to give a positive Nonne-Apelt or Noguchi
butyric acid reaction with a cell count well within the normal
limit, and it is generally found in non-syphilitic conditions or in
long-standing cases of syphilis of the nervous system. In this
414
WILLIAM H. HOUGH
connection I may mention that I have never found a cell-free
spinal fluid. Included in my cases are several supposedly
normal individuals including a child six months of age, a number
without nervous or mental diseases, psychoneurotics, many cases
of dementia prsecox, &e., but they have all shown some cellular
elements. Cellular elements have not always been found by the
French method and the Fuchs and Rosenthal method, but by the
Alzheimer they have been found invariably.
In paresis 100 per cent, show a pleocytosis. The degree varies
from time to time, being as a rule higher in the early stages of the
disease. As a rule the cell count in paresis is less than 200 per
c.mm., rarely above 300. My highest cell count in this disease
was 826 in a very acute case, the lowest six cells in a case of six
years duration. In syphilis of the central nervous system the
cell count varies much more than in paresis. As in paresis, we
find the highest cell counts in the early stage of the disease, but
unlike paresis it is not uncommon to find later in the disease,
especially in long-standing cases, a cell count well within the
normal limit, even though the patient may not have had anti-
syphilitic treatment, and may even show more pronounced clinical
symptoms. It is not difficult to understand this condition when
we consider the pathology of the disease. The degree of pleo¬
cytosis in syphilis of the nervous system varies according to the
form of the disease. The greater the meningeal irritation the
greater the pleocytosis. The pure endarteritic form of the disease
is said to show no cerebro-spinal pleocytosis; naturally we would
not expect a pleocytosis in this condition, but the pure endar¬
teritic form of the disease is very rare. I have had but one case
which showed histologically the pure endarteritic form of cerebral
syphilis, and two years before death this case showed a cell count
in the fluid of thirty-one cells per c.mm. I think it quite
probable that the great majority of the cases which show chiefly
a specific endarteritis would have shown earlier in the disease a
greater degree of perivascular and meningeal infiltration.
In considering the diagnostic value of cytological examination
of the spinal fluid in diseases of the nervous system occurring in
the early secondary stage of syphilis, as for example, in suspected
cases of nervous relapse following the use of antisyphilitfc treat¬
ment, we must bear in mind that about 50 per cent, of the cases
of secondary syphilis show a cerebro-spinal pleocytosis with-
SYPHILIS OF THE CENTRAL NERVOUS SYSTEM 415
out manifesting any clinical evidence of disease of the nervous
system.
The Differential Estiuiation of the Cells of the Cerebro-Spinal
Fluid. —For illustrations and technic, see Bulletins Nos. 1 and 2,
Government Hospital for the Insane, 1909 and 1910; also Folia
Neuro-biologica, Band v., No. 3, 1911. We are not sufficiently
well acquainted with the differential cell count to say what its
diagnostic value is for the syphilitic diseases of the nervous system.
Cells classified as lymphocytes as a rule constitute the great
majority of the elements found in the fluid in all chronic conditions
which show a pleocytosis. I do not believe that the estimation of
the three or four varieties of lymphocytes is of any great value in
assisting us to differentiate tertiary syphilis of the nervous system
from paresis and tabes. It has been claimed that the small
lymphocytes are more numerous in cerebral syphilis, and that the
large varieties are found in excess in paresis. Some investigators,
however, claim the reverse. My experience leads me to believe
that the small lymphocytes are generally more numerous in syphilis
of the nervous system than in paresis, but this certainly does not
hold for a very high percentage of the cases as shown by the
examination of many cases of the two diseases made at the same
time, and by exactly the same technic. Furthermore, these
elements vary from time to time especially in cases of cerebral
syphilis.
In regard to the cells, which I have classified as large mono¬
nuclear cells for want of a better term, I find that they are, as a
rule, in greater numbers in cases with a comparatively low cell
count such as we find more frequently in long-standing cases of
both syphilis and paresis and in cases under treatment. They are
found in all fluids, normal and pathological, and seldom exceed 15
or 20 per cent.
Plasma Cells. —These elements have been found in five con¬
ditions in my experience, namely, syphilis, parasyphilis, tubercular
meningitis, poliomyelitis, and acute meningitis. Concerning the
value of the presence of these elements for differential diagnosis,
I can only say that they are more constantly found in the fluid in
paresis than in tertiary syphilis of the nervous system, although
the highest plasma cell count that I have ever found was in a case
of cerebral syphilis. In this case there was a very high total cell
count. Under treatment there occurred a marked fall in the
416
WILLIAM H. HOUGH
pleocytosis, as shown by several spinal punctures. It was just
after the first most pronounced fall in the cell count that a high
percentage of plasma cells was found. The percentage of these
elements is generally less than 5 per cent., very rarely over 10
per cent.
Polymorphonuclear leucocytes are found in the fluid in many
cases of syphilis and parasyphilis, although, as a rule, the per¬
centage is very low. They appear to be somewhat more commonly
found after convulsive attacks in syphilis and paresis, but I have
not found them in all cases after convulsive attacks, and have
found them to rather suddenly appear in the fluid in cases of
paresis without convulsive attacks.
Gitterzellen and microphages are found in the fluid in many
cases of paresis—less frequently in syphilis. They are found in
very small numbers and are essentially pathological elements.
The percentage of Gitterzellen may be quite high in cases of ex¬
tensive cerebral softening.
Endothelial cells and fibroblasts are frequently observed in
fluids in which there is a cell increase, but they may occasionally
be found when the cell count is not above 5 per c.mm.
Cellular elements are found in the fluid in most cases which
we are unable to classify, but with our improved technic the per¬
centage is generally quite small.
I fully appreciate the fact that the classification that I have
given of the cells of the spinal fluid is far from satisfactory.
The Luetin Cutaneous Reaction of Noguchi.
This very interesting and important reaction I will refer to
here but briefly, because its practical value in neurological and
psychiatrical practice is as yet rather limited. Naturally it does
not aid us in localising the disease process any more than the
Wassermann reaction with the blood serum does. It appears to
be a specific reaction for syphilis; this is more than we can say
of the Wassermann reaction. In syphilis in general it is not found
positive in a higher percentage of cases than is the Wassermann
reaction, but it is found positive in a higher percentage of cases of
late syphilis — cases in which the Wassermann reaction is so
frequently negative so that its greatest value to us is under such
circumstances as the following: We have a case of organic
disease of the nervous system with no history of syphilis, and
SYPHILIS OF THE CENTRAL NERVOUS SYSTEM 417
showing a persistently negative Wassermann reaction in both
blood and spinal fluid. There may be a mild degree of pleocytosis
and an increase of protein, or, as sometimes occurs in cases of
longer standing, there may be an increase of protein and a normal
cell count; such conditions as are found in cases where there is
chiefly a specific cerebral endarteritis. The question is: Has the
patient syphilis or not ? If such a patient had syphilis he would
most probably give a positive luetin reaction, because experience
has shown that it is in the tertiary stage of the disease, in cases
that are latent or near latent, which give the highest percentage
of positive luetin reaction—about 90 per cent. If such a case
gave a positive luetin test, it would be a weighty factor in the
diagnosis. I do not mean to say that it would be conclusive. We
are seldom able to make an absolutely certain diagnosis of syphilis
of the nervous system except by histological examination of the
nervous tissue, and we know that occasionally it is not possible
even then.
The Provocative Wassermann Reaction.
This reaction is of some value, chiefly as a guide to treatment,
but I think that we have not had a sufficiently long experience
with the use of salvarsan to say that a patient is cured of syphilis
even though the test may be negative two or three years after the
discontinuance of treatment.
A word as to the quantitative Wassermann reaction.
The variation of the quantities of some of the ingredients of
the Wassermann reaction may perhaps be used to some advantage
under certain circumstances. It may perhaps be used to a certain
extent with the spinal fluid, but when we deal with the blood
serum other factors enter which complicate matters so that further
work is necessary before we can determine whether it will prove
to be of use. We must proceed with extreme caution in inter¬
fering with the standard of the Wassermann reaction, as we still
have some things to learn concerning it, and false conclusions may
be drawn very readily.
The very important matter in connection with this subject—
namely, the findings by the various tests referred to above in
cases of tabes—has not been considered except where the term
“ parasyphilis ” is used. I have not done so because my ex¬
perience with this disease is rather limited. I have but thirty-
418
WILLIAM H. HOUGH
six cases of tabes in my series. They were in various stages of
the disease; some had not been completely examined—that is,
they had not had all of the tests applied, and some had had
treatment before the tests were made, so that my statistics on this
disease are of practically no value. Judging from the work of
others it is difficult to make a definite statement concerning the
laboratory tests in tabes in general, it being important to consider
the stage of the disease. However, the general rule is—Wasser-
mann reaction in the blood, positive—about 80 per cent.; an
increased protein in the spinal fluid, nearly 100 per cent.; a cerebro¬
spinal pleocytosis, over 90 per cent.; and a negative Wassermann
in the spinal fluid. The percentage of positive Wassermann
reaction in the spinal fluid varies according to different investi¬
gators between 10 per cent, and 40 per cent. In tabo-paresis the
percentage of positive Wassermann reactions in the spinal fluid is
high. For a detailed account of this subject I refer to the most
excellent work of Nonne of Hamburg.
It is difficult for me to summarise this paper, as it is but little
more than a summary in itself. As previously stated, we have no
very great difficulty when all the tests can be applied and re¬
peated if necessary in deciding whether a given case belongs to the
syphilis-parasyphilis group, but we have difficulty in differentiating
within this group. We cannot' lay down any very definite rule
concerning the reactions as a whole. We are only beginning
to learn the relative value of the many combinations of reactions
met with in various conditions, and it behoves us to study them
carefully in as many cases and in as great a variety of conditions
as possible. Some years ago 25 per cent, of our cases of paresis
were not properly diagnosed, as shown by histological examina¬
tion, whereas now we rarely fail to diagnose this condition.
We still find, however, that the diagnosis of paresis is sometimes
made where paresis does not exist. In such errors the correct
diagnosis generally proved to be cerebral syphilis. When the
clinician now fails to diagnose paresis in cases where the labora¬
tory tests have been applied, as sometimes occurs in the early
stages of the disease when the symptoms are not definite, I have
reason to believe that the error is due in part at least to mis¬
interpretation of the tests, especially the Wassermann reaction in
the spinal fluid. I have known several instances where the
clinical symptoms were quite definite for paresis, but the diagnosis
SYPHILIS OF THE CENTRAL NERVOUS SYSTEM 419
of cerebral syphilis was made because the Wassermann reaction
in the fluid was negative or partial. We should bear in mind
that about 20 per cent, of our cases of paresis show a negative
Wassermann in the spinal fluid.
The various tests are to be looked upon as the property of the
clinic—they are indispensable in the clinic, and it is essential that
the clinician understands their proper meaning as far as is known.
A CASE WITH TRANSIENT ATTACKS OF
PARALYSIS: AUTOPSY.
By WALTER K. HUNTER, M.D., D.Sc.,
Muir head Professor of Medicine, Glasgow University ; and
M. E. ROBERTSON, M.B., Ch.B.,
Assistant Pathologist, Glasgow Royal Infirmary.
(With Plates 26 and 27.
The etiology of the transient attack of paralysis is a matter
which has created no small amount of interest, and the record
of the following case is offered as a contribution to the discussion
of the subject.
R. M., aged 55, an engineer by occupation, was admitted
to Ward 12 of the Glasgow Royal Infirmary, on 29th
January 1912, on account of a difficulty in speaking. It was
impossible, owing to this disturbance of speech, to obtain a detailed
history of the course of the illness, but it was elicited that the
loss of speech came on suddenly twelve months previously, and
that for a period of three months the patient was unable to
articulate a single word. Subsequent to that there was a partial
recovery, the patient being able to speak again, although very
indistinctly, and always after some preliminary stammering.
Coincident with the loss of speech there was paralysis of the
right side of the body. The duration of this hemiplegia is
uncertain, but the patient seemed to make a good recovery, and
he was able to resume work after an interval of six months.
He was one of a family of seven, four of whom were dead, of
causes unknown to patient. The others were healthy. He was
married, and had had two children, who were both alive and well.
On admission to hospital he was found to be a well-nourished
420 WALTER K. HUNTER AND M. E. ROBERTSON
and healthy-looking man. The pupils were equal, and reacted
to light and accommodation. There was no appearance of facial
paralysis, and mastication and deglutition were carried out without
any apparent difficulty.
There was some paresis of the tongue; but this seemed to vary
from time to time. Sometimes the tip of the tongue could not be
protruded beyond the lips, and at other times there was no such
disability. There seemed, however, to be a permanent difficulty
in moving the tongue to the right. Articulation was defective,
but this varied a good deal from time to time, the patient speaking
much more distinctly at one time than at another. The voice was
always rather high-pitched, and the words were always spoken in
a halting and stammering manner. The cough was noted to have
a somewhat toneless quality.
There was no paralysis noticeable in the arms or legs. The
tendon jerks in the four limbs were rather active, but the plantar
reflexes were both flexor.
The cardiac area was within normal limits. A ventricular
systolic murmur was to be heard at the apex. At the base the
first sound was indistinct, and the second had a metallic quality.
The respirations numbered 24 per minute, and were mainly
abdominal in character, the chest moving very little even on deep
inspiration. The examination of the lungs otherwise was negative,
and there was nothing abnormal to be made out on examination
of the abdomen.
The urine had a specific gravity of 1020, and was free from
albumen, sugar, pus, or bile.
Two days after admission the patient had the first of the
recurring attacks of paralysis. It was at one o’clock, and he was
sitting up in bed taking his midday meal, when suddenly he fell
back on his pillow. He was quite unable to speak. His mouth
was drawn to the right side, and the muscles of the right cheek
were seen to be twitching. The left arm was limp and helpless,
and the patient indicated that there was something wrong with
the left leg, for he could not raise it from off the bed. The face
was pale and the pulse of poor quality. The paralysis lasted for
about ten minutes, and then the patient began to talk, although
very indistinctly. Still, he was able to explain that he felt all
right again. A quarter of an hour later, however, he had a similar
seizure, lasting for five minutes.
TRANSIENT ATTACKS OF PARALYSIS: AUTOPSY 421
The following day (1st February), again at one o’clock, there
was a third attack of paralysis, with much the same characters as
the first two. The face was pale, the mouth being drawn to the
right, with twitching of the muscles on the right side of the
mouth. Speech was apparently impossible, nor could the tongue
be protruded. There was also paralysis of the left arm and left
leg: the attack lasted for four minutes. It was followed, twenty
minutes later, by yet another seizure; but this time there was no
twitching of the facial muscles.
There was no loss of consciousness during any of the attacks,
and no sensory disturbances.
On 2nd February there were again two seizures, and on
3rd February three seizures, each lasting about three minutes.
Between the seizures the patient could move his arm and leg
quite well.
After this he remained free from paralysis till 6th February,
when he had fourteen “seizures” between 10.45 A.M. and 12
midnight He was quite unable to speak all this time, and he
vomited frequently. The onset of each attack was recognised
by a cyanosed appearance of the face and a stertorous breathing.
During the attacks the patient was unable to open his mouth or
to move his left arm or leg.
From this date onwards there was no repetition of the seizures,
but the next morning (7th February) there was noted to be
complete paralysis of the left arm and leg, and there was slight
drooping at the left angle of the mouth. There was some rigidity
of the affected limbs. The tendon reflexes were exaggerated in
both arms and in both legs, but there was neither knee nor ankle*
clonus on either side. The plantar reflex on the right side was
flexor; on the left it was definitely extensor. The abdominal
reflexes were present. At this time the patient would not
attempt to speak. Indeed, he did not seem to be able to move
his lips, to separate them, or to purse them up as in blowing.
But on yawning, as he did frequently, the mouth opened widely
and the lips became considerably retracted. Neither did he seem
to be able to move the tongue. But there was no paralysis of
the muscles of the eyeballs, and no paralysis of the muscles of
respiration.
This left-sided hemiplegia, as well as the bulbar symptoms,
persisted, and a few days later (11th February) the patient passed
422 WALTER K. HUNTER AND M. E. ROBERTSON
into a semi-comatose condition, and would make no response when
spoken to. He swallowed milk, however, but swallowing was
attended with a good deal of coughing, and milk would escape
from the angle of the mouth. There was involuntary emptying of
the bladder, and this had been present since the onset of the hemi¬
plegia. It is also to be noted that during the transient attacks of
hemiplegia the urine was passed involuntarily. The breathing
had now become rapid, fifty-four per minute, stertorous, and
chiefly abdominal in type. The pulse, however, remained good.
Ultimately the patient became much cyanosed, and he died on
13th February, a fortnight after admission into hospital.
At the post-mortem examination the heart presented the ap¬
pearances of both hypertrophy and dilatation. The myocardium
was soft, and there were little haemorrhagic areas suggestive of an
acute myocarditis. There was no valvular lesion. The coronaries
were thickened with areas of patchy arterio-sclerosis, and at one
point, one and a half inches from the orifice of the anterior
coronary, the lumen was almost completely occluded. The aorta
was also atheromatous. The lungs were emphysematous, slightly
oedematous, and there were signs of old tuberculous disease at the
apices. The liver was congested, but showed no signs of cirrhosis.
The spleen seemed normal. The renal vessels were thickened
and the cortex of the kidneys was rather narrow, but otherwise
the appearances were normal.
The dura mater was firmly adherent to the cranium about the
vertex. The general appearance of the surface of the brain was
one of slight congestion, and the pia-arachnoid was possibly a
little thickened. No softening could be felt anywhere.
The arteries at the base showed an extreme patchy sclerosis,
and a number o! the patches completely surrounded the vessel,
looking like the thick knot on an earthworm.
The right posterior cerebral showed a particularly advanced
obliterating arteritis—scarcely any lumen being left—and most
of the other main branches showed patches of very considerable
narrowing.
A horizontal section (Fig. 1) through the brain showed, on the
left side, three small old softenings. Two were in the lenticular
nucleus. The first, about the size of a large pea, was situated just
external to the posterior part of the anterior limb of the internal
capsule, and extended upward and inwards above this limb of the
Platk 20'.
{|S#
#•
|^ *
!efl*
i
Jj<f ,
^ j
tic. 2.—Left Internal
Capsule.
Fiu. 3. — Crura—just below
Cerebrum.
TRANSIENT ATTACKS OF PARALYSIS: AUTOPSY 423
capsule, but did not reach the floor of the lateral ventricle. The
second was a good deal smaller, and was to be seen lying posterior
and external to the larger softening. The third softening was very
small, and was situated about the middle of the optic thalamus.
Occupying almost the whole of the anterior, two-thirds of the
posterior limb of the internal capsule, as well as the genu, was
a firm, yellowish, sclerotic patch. The patch was incompletely
divided into two by a narrow strand of white matter—the posterior
part of the patch being about twice as large as the anterior.
On the right side there was an oval area of recent softening,
| inch in length, in the posterior limb of the internal capsule—
the anterior end of the softening being f inch posterior to the
genu.
Sections were made from the internal capsules on both sides—
the crura and medulla at various levels, and from the cervical,
dorsal, and lumbar portions of the cord, and were stained by the
Weigert-Pal and Marchi methods. Cord sections were also stained
with haemalum and eosin, and with toluidin blue.
One or two of the posterior root ganglia (lumbar) on either
side were examined, some being stained by the Weigert-Pal and
Marchi methods, others with toluidin blue.
Weigert-Pal Sections.
(1) Left Internal Capsule (Fig. 2).—This showed a very well-
marked sclerosis in the posterior limb of the internal capsule,
occupying the firm yellowish area observed on naked eye examina¬
tion. Very few myelinated fibres remained except in the narrow
dividing strand of whiter tissue previously mentioned, where a
number of healthy fibres, chiefly running in a transverse direction,
were still present. No sclerosis could be made out in the right
internal capsule.
Crura (just below their entrance into the cerebrum) (Fig. 3).—
There was a sclerosed area occupying two-thirds of the inner half
of the left crus. The remaining one-third of this half of the crus
(the part nearest the median line) showed myelinated fibres.
The right crus appeared healthy.
A little lower down (about midway between the upper end of
the pons and the cerebrum) (Fig. 4) there was still a very well-
marked area of sclerosis occupying two-thirds of the inner half of
the left crus. The innermost one-third of this half of the crus
424 WALTER K. HUNTER AND M. E. ROBERTSON
appeared healthy, as did the outer half of the crus. No lesion |
could be made out in the right crus at this level
Upper Part of Pons (Fig. 5).—Sclerosis of the pyramidal I
bundles on the left side is well marked—more especially towards
the median line. The lateral parts of the bundles, except the |
most ventral, which is almost completely sclerosed, appear fairly '
normal Those portions of the ventral bundles on the right side, |
which lie nearest the median line, show slight pallor.
Lower Part of Pons (Fig. 6).—Here, where the pyramidal |
bundles are gathered more closely together, sclerosis was very
definite in the ventral and median part of the bundle of fibres on I
the left side. <
On the right side there was a small sclerotic area in the upper j
and median part of the bundle of pyramidal fibres.
Medulla (about middle) (Fig. 7).—There was distinct pallor of I
the left pyramidal bundle, especially in its upper and median part,
but sclerosis was not nearly so well-marked as in the pons or left j
crus. I
In the lower part of the medulla (Fig. 8) there was only slight j
pallor of the left pyramidal bundle.
Coi'd (Fig. 9) fc Cervical. —There was slight pallor on both sides !
in the pyramidal pathway—most marked on the right. j
Dorsal. —Same as cervical, only less marked. J
Lumbar. —Same as dorsal—difference between the sides very
slight indeed. |
Marclii Sections. |
_ '
Internal Capsides, Left Side (Fig. 10).—There was a very well- j
marked blackening in those areas shown by the Weigert-Pal
sections to be sclerosed.
The sclerotic areas were crowded with cells containing fat
droplets—these cells clustered especially round the vessels.
Blackening was most pronounced just about the middle of the
posterior limb of the internal capsule. i
Right Side (Fig. 11).—In the softened area already described
as occurring in the internal capsule of the right side a very few
scattered black dots were seen.
Crura — just below Entrance to Cerebrum (Fig. 12), Left Side .—
There was a very pronounced Marchi degeneration in the inner
half of the left crus—the fat droplets for the most part being
WEN; ERT-PAL SECTIONS— continued.
(
I
MARCHI SECTIONS.
Fio. 12.—Crura—just below Cerebrum. Fio. 13.—Crura—a little above Pons.
L. R.
Fio. 14.—Pons. Fio. 15.—Pona—low down.
L R.
juat below Pona, low down. Fio. 18.—Cord.
426 WALTER K. HUNTER AND M. E. ROBERTSON
contained in cells. The greatest amount of blackening was in the
middle part of this inner half of the crus. A small area, just at
the innermost part of the crus, was free from blackening.
Crura — a little above the Pons (Fig. 13).—The innermost half
of the left crus showed marked blackening—in this case extending
quite to the median edge of the crus.
The most dense blackening was about the middle of the inner
half of the crus. In the right crus, in the sections at both levels,
a very slight degeneration was seen in the middle third.
Pons—about the Middle (Fig. 14).—The more ventral bundles
of longitudinal fibres on the left side showed pronounced de¬
generation—most marked towards the median raphe. On the
right side there was one small blackened area about the middle,
as regards depth and towards the lateral aspect of the pons.
Pons — Lower Pnd (Fig. 15).—Here the whole of the pyramidal
bundle on the left side showed degeneration, but blackening was
most marked towards the median raphe.
On the right side there was an area of blackening of peculiar
shape—stretching in a thin line across the middle of the pyramidal
bundle, and widening out fan-wise at either end.
Medulla —(Figs. 16 and 17).—There was degeneration in the
pyramidal fibres on the left side—much less marked than in the
pons, but still quite definite. There was only a very slight patch
of degeneration on the right side.
Cord (Fig. 18), Cervical. —There was a slight degree of
blackening in both pyramidal pathways about equally marked
on either side.
Dorsal. —Here the condition was much the same.
Lumbar. —Blackening was so slight as to be scarcely noticeable.
In all the cord sections there was a degree of generalised
blackening which seemed to be due to deposit from the stain.
Toluidin Blue Sections.
Posterior Root Ganglia {Lumbar). —The nerve cells stained
rather darkly and diffusely, and showed a good deal of pigment.
There was some slight proliferation of the capsular cells, but
this was not a noticeable feature. Mast cells were numerous.
Cord. —The nerve cells of the cord did not show any chroma-
tolytic changes.
The sections of the posterior root ganglia stained by the
TRANSIENT ATTACKS OF PARALYSIS: AUTOPSY 427
Marchi and by the Weigert-Pal methods did not show any
degenerative changes.
There is little one need add to this case by way of commentary.
The actual cause of death seemed to be paralysis of the respira¬
tory apparatus, arid this was probably due to narrowing of the
vessels at the base of the brain interfering with the circulation of
the bulb. Transient spasm of these sclerosed vessels was probably
also the cause of the seizures of cyanosis and stertorous breathing
noted on 6th February. That there had been some involvement
of the circulation of the bulb was shown at the autopsy, in the
presence of a small softening about the centre of the pons.
The symptoms otherwise seem to have been determined by the
lesions in the internal capsules. The recurring attacks of left¬
sided hemiplegia were presumably caused by transient spasm of
the branches supplying the right internal capsule, and when
occlusion of these vessels ultimately became permanent, softening
of the capsule supervened, with the persistent hemiplegia noted
on 7th February. That this softening was recent is shown by the
almost complete absence of degeneration in this motor pathway,
even with the Marchi method of staining.
The right-sided hemiplegia which came on twelve months
prior to admission to hospital is to be explained by the older
lesion in the left internal capsule. This softening must have in¬
volved chiefly the fibres going to the bulb, for the descending
degeneration is much more marked in the crus and pons than in
the medulla, and it is scarce noticeable in the motor pathway in
the cord. The very complete recovery, too, of the right arm and
leg, with the absence of Babinsky’s signs, is also to be explained
by the lesion limiting itself mainly to the bulbar fibres. The
disturbance of articulation which was present on admission was
probably of the nature of a dysarthria, due to the lesion in the
anterior part of the posterior limb of the left internal capsule.
But it should be noted that the defect of articulation varied from
day to day, and it may, therefore, have some relationship to the
softening in the lenticular nucleus, for this same variability in
speech has been noted in other cases of lenticular degeneration.
There was probably also some interruption of a proportion
of the fibres of the anterior limb of this left internal capsule, for
with the Marchi staining degenerate fibres are seen in crus
(Fig. 13) to extend quite to the inner limit of the pyramidal fibres.
3»
428 WALTER K. HUNTER AND M. E. ROBERTSON
But the various softenings in the region of this internal capsule
are doubtless of different ages, and this partly explains why
certain groups of fibres show degeneration with Marchi’s stain,
and others with Weigert’s stain.
The recurring attacks of complete loss of speech (first noted
on 31st January) which accompanied the recurring attacks of left¬
sided hemiplegia must have been of the nature of a pseudo-bulbar
paralysis. That is to say, there was a permanent lesion in the
bulbar fibres of the left internal capsule, and an intermitting
(ischaemic) affection of the corresponding fibres in the right
capsule. When the left-sided hemiplegia became permanent, so
did the loss of speech, as well as the other bulbar symptoms. It is
true that the softening which produced this hemiplegia did not
seem to extend quite to the genu of the right internal capsule,
but nevertheless the function of the bulbar fibres must have been
disturbed by the lesion in their near neighbourhood. Also, if we
take the distribution of the degenerate fibres in the left internal
capsule (Figs. 2 and 10) as some indication of the disposition of
the bulbar fibres in the capsule, it is apparent that they extend
over an area which extends much further back than the genu.
It is interesting to note that at the time when the bulbar
paralysis seemed complete, when the patient could not voluntarily
open his mouth, or move his lips or tongue, that with an automatic
movement like yawning the mouth was opened wide and the lips
much retracted. Probably such automatic movements are initiated
in the central ganglia, being quite independent of the cerebral
cortex.
The involuntary emptying of the bladder during the recurring
attacks of hemiplegia with bulbar symptoms, in spite of the fact
that the patient remained fully conscious, is of interest, in that
polyuria and incontinence of urine have been not infrequently met
with in cases of pseudo-bulbar paralysis. It is to be noted, too,
that the bladder trouble persisted after the pseudo-bulbar symptoms
became permanent.
ABSTRACTS
429
Hbstracts
ANATOMY.
THE MOTOR CORTEX AND PYRAMIDAL TRACT IN THE
(358) RACCOON ( Procyon lotor, Linn.). Sutherland Simpson,
Proc. Soc. Exp. Biol, and Med., 1912, x., Dec. 18, pp. 46-47.
It is generally believed that the direct pyramidal tract is limited
to man and the anthropoid apes; but this is not the case, as it
is present in the raccoon and in the porcupine (v. infra).
The author exposed the cerebral cortex on the left side, located
the motor area by stimulation, and removed it. The animals
(five in number) were killed two weeks later, and the brain and
cord examined by the Marchi method. It was found that while
the pyramidal fibres cross the mesial raphe into the lateral column
of the cord, in three animals a large number of the fibres remained
uncrossed, and formed a direct ventral pyramidal tract extending
along the margin of the ventral median fissure. This tract could
be traced to the mid-dorsal region. A. Ninian Bruce.
THE PYRAMIDAL TRACT IN THE CANADIAN PORCUPINE,
(359) ( Erethizoa donatus, Linn.). Sutherland Simpson, Proc. Soc.
Exp. Biol, and Med., 1912, x., Oct. 16, pp. 5-6.
In the guinea-pig, mouse, rat, and squirrel, and in the monotremes
and marsupials, the crossed pyramidal tract lies in the dorsal, and
not in the lateral column of the cord.
The author located the motor cortex in the porcupine by
electrical stimulation, and extirpated it in the usual way. The
resulting degeneration was examined by the Marchi method, and
it was found that in this animal the decussation of the pyramids
is incomplete, the fibres dividing into four bundles, two crossed and
two direct—a crossed dorsal and a crossed lateral pyramidal tract,
and a direct ventral and direct dorsal pyramidal tract. The crossed
lateral and direct dorsal tracts pass as far down as the upper dorsal
region, while the crossed dorsal and direct ventral tracts are much
larger than the other two, and can be traced as far as the lower
sacral segments. A. Ninian Bruce.
430
ABSTRACTS
the physiological analysis of the posterior longi-
(360) TUDINAL FASCICLE. L. J. J. Moskens, Le Nevraxe, 1913,
xiv., p. 299. (Manuscript accepted for publication, Dec. 1912.)
In a large number of animals (cats and rabbits) the posterior
longitudinal bundle formation and the vestibular complex were
severed in different ways. Accurate notes were taken about the
forced movements in two planes; circus movement and the allied
phenomenon of conjugate deviation of the head and eyes; rolling
movements and their minor manifestations, e.g., tendency to fall or
to lie down on one side. The specimens were examined by the
Marchi method. From this set of experiments, together with a
complementary set of observations after direct lesion to the
vestibular nuclei, proof was forthcoming that in the entire P.L.B.
formation including its lateral horns, are found ascending tracts
arising from the homolateral and heterolateral vestibular nuclei.
Only in the innermost part of the P.L.B. two strands of fibres were
found degenerated in those cases of lesion of the region of the
posterior commissure, that had shown particular forms of forced
movements, both tracts having appaxently different functions.
These tracts having been named by the author in this paper, and
his previous publications (Transactions of the Netherlands Royal
Academy, Oct. and Nov. 1912), the commissuro-medullary and
the interstitio-spinal tracts, indicating in that definite way their
origin and termination. The first one is found degenerated after
lesion of a cell-group, oral and dorsal to the red nucleus, the
second thick-fibre tract after a lesion oral and lateral to the red
nucleus. Both tracts are homolateral.
With this combined anatomical physiological method it was
proved for the first time that after lesion to Bechterew’s nucleus
a homolateral ascending tract is exclusively found degenerated,
and not, as in the case of lesion to Deiter’s nucleus, a voluminous
heterolateral and a less voluminous homolateral ascending tract.
Author’s Abstract.
PHYSIOLOGY.
THE EFFECT OF THYROID EXTIRPATION ON THE HYPO-
(361) PHYSIS CEREBRI IN THE RABBIT. Lyda May Degeneb,
Quart. Joum. Exp. Physiol ., 1913, vi., p. 111.
The thyroid glands were completely removed from twelve adult
rabbits, which were killed at periods varying from 10 to 179 days
after the operation. The hypophyses were weighed after death,
and found to be distinctly heavier than in control animals. The
increase in weight appears to run parallel with the time that
intervenes between thyroidectomy and the death of the animal.
ABSTRACTS
431
After an interval of 179 days (six months), the pituitary had
increased to about three times the normal size (v. Review, 1913,
xi., p. 164). A. Ninian Bruce.
AGE AS A FACTOR IN THE EFFECTS WHICH FOLLOW
(362) THYROIDECTOMY AND THYRO-PARATHYROIDECTOMY
IN THE SHEEP. Sutherland Simpson, Quart. Joum. Exp.
Physiol ., 1913, vi., p. 119.
Removal of the thyroid with the contained internal parathyroids
in thirteen adult sheep, and sixteen lambs from 7 to 8 months old,
led to practically no ill effects. As the result of a similar opera¬
tion, three lambs about 2 months old became typical cretins. The
complete operation (thyro-parathyroidectomy) in four adult
sheep was followed by no symptoms during the time (3 to 4
months) they were under observation. The same operation
(thyro-parathyroidectomy) in four young lambs (5 to 7 weeks)
resulted early in acute and fatal tetany. Removal of the two
external parathyroids from the three cretins when about 1 year
old was followed by only slight symptoms. With regard' to the
effects, both of thyroidectomy and of parathyroidectomy in the
sheep, age is a very important factor. A. Ninian Bruce.
PATHOLOGY.
INDICATIONS OF NERVE LESION IN CERTAIN PATHOLOGICAL
363) CONDITIONS OF BLOOD-VESSELS. T. Wingate Todd, Lancet,
1913, May 17, p. 1371.
The mechanism of production of vascular changes in the lower limb
is likely to be similar to that found in the upper limb. In view of
the probable causation of vascular changes in “ cervical rib ” by a
nerve lesion (v. Review, 1913, xi., p. 92), it is possible that a
similar explanation may be found to hold good for certain other
diseases exhibiting pathological changes of obscure origin in the
blood-vessels. No explanation will be found satisfactory if it
depends on the unproven and improbable hypothesis that
sympathetic fibres for peripheral vessels pass to their distribution
along the trunks of main vessels. A Ninian Bruce.
CONSIDERATIONS ON THE PATHOLOGICAL PHYSIOLOGY OF
(364) CONTRACTURE. (Oonsiderazioni sulla fisiopatologia della con-
trattura.) M. Buscanio (of Florence). Riv. di Pat. new. e ment.,
March, 1912.
The author, after a review of the various views of the nature of
contracture which have been formulated, concludes that when
432
ABSTRACTS
muscles become immobile from suppression of the cortical impulses,
contracture is due to nervous currents, of essentially toxic peri¬
pheral origin, which pass along the same reflex paths as the
normal currents of muscular tone, passing mainly through the
higher centres of tone before reaching the anterior horn cells.
(Cp. Review, 1912, x., p. 571.) C. Macfie Campbell.
CLINICAL NEUROLOGY.
A KEFLEX PHENOMENON IN THE UPPER LIMB-THE “FORE
(366) ABM SION.” (Un ph6nom&ne riflexe du membre sup&ilure:
Le “Signe de l’av&nt-bras.”) AmdeE L£ri, Rev. Neurol ., 1913,
No. 6, March 16, p. 277.
The author describes a reflex phenomenon which he has observed
in the upper extremity, and which he calls the forearm sign. It
is produced as follows. The observer instructs the patient to let
the arm be quite lax, while he supports it under the wrist or
forearm with his left hand. With his right hand, he then flexes
the patient’s fingers into the palm, flexes the palm on the forearm,
rolls so to speak, the hand on itself, uses a little force, and then
the patient’s forearm is observed to flex gradually on the arm.
The author has investigated the phenomenon in 275 cases,
50 of which were non-nervous. He finds it is constantly present
in the normal individual and in the absence of organic disease
of the nervous system, and though varying in different individuals
is equal on the two sides of the same individual Its centripetal
path is probably by way of one of the sensory nerves of the skin
or wrist. It can be considered pathological only when it is
completely, or almost completely, absent, or is asymmetrical (that
is, enfeebled on one side). It can disappear when there is an
organic lesion in some part of the reflex path above the fifth
cervical segment, or in the sensory or motor tracts from this level
to the cerebral cortex. P. W. Saunders.
AN ORGANIC SION-" THE FLEXION OF THE KNEE.” (Un signe
(366) organique: La flexion du genou.) Noica and Paulian, Rev .
Neurol., 1913, xxi., No. 6, p. 288.
A normal individual lying on his back with legs extended is able
to raise his legs from the ground with the knee kept extended.
A hemiplegic or a paraplegic in raising the affected leg always
bends the knee. The phenomenon depends on a weakness of the
extensor muscles of the knee, and may be found not only in
lesions of the pyramidal tract, but in, say, an alcoholic polyneuritis.
P. W. Saunders,
ABSTRACTS
433
THE INTERNEURONIC SYNAPSE IN DISEASE B. Henry
(367) Shaw, Brit. Med. Joum ., 1913, May 10, p. 989.
The author considers that the delirium resulting from sudden
nervous shock cannot satisfactorily be explained by the theory
of nerve exhaustion, and that it is probable that a very intense
nervous discharge may cause serious damage to the finer nerve
arborisations and synaptic junctions, and that, just as under
similar conditions electrically the fusion of a wire may take place,
so here, as a result of intense shock, we may have some degree
of what might be termed “ synaptic fusion ” of the higher neurone
terminals and interneuronic membranes, causing dissociation of
the higher centres, and misinterpretation of stimuli.
A. Ninian Bruce.
GRAPHIC RECORDS OF RESPIRATORY PARALYSIS. Q. A.
(368) Sutherland, Lancet , 1913, July 12, p. 75.
Paralysis of the respiratory muscles is often difficult to detect,
but may be easily recognised by means of graphic methods by the
use of Mackenzie’s ink polygraph, one bag being placed over the
lower part of the abdomen and the other over the mid-sternal
region. Under normal conditions of respiration the two curves
are synchronous. If the diaphragm be paralysed, the thoracic
tracing is normal and the abdominal tracing inverted. If the
intercostals be paralysed the abdominal tracing is normal and the
thoracic inverted. A. Ninian Bruce.
A PRELIMINARY NOTE UPON AN EXPERIMENTAL IN-
(369) VESTIGATION OF CONCUSSION OF THE SPINAL CORD
AND ALLIED CONDITIONS. Alan Newton, Brit. Med.
Jovrn., 1913, May 24, p. 1101.
The spinal cord is extremely sensitive to slight degrees of con¬
cussion and compression. Despite the slight anatomical changes
demonstrable after lesser degrees of injury, the resulting dis¬
turbance of function is considerable. After concussion which has
quite abolished motor efferent conduction, sensory conduction can
still be demonstrated. Arrest of the spinal cord circulation by
aortic compression abolishes spinal cord function in from fifteen to
thirty seconds. The author considers that his experiments
support the view that there is an organic basis for the signs and
symptoms of “ railway spine ” and allied conditions of traumatic
neurasthenia. A- Ninian Bruce.
434
ABSTRACTS
A CASE OF CERVICAL ZOSTER. (TJn cm de zona cervical.) J.
(370) Galippk, Bull. Soc. de Pid. de Paris , 1913, rv., p. 200.
A boy, aged 14, with recent cervical zoster in the area of the second
and third right cervical nerves, came to hospital the same day as
his friend, a boy, aged 15, who presented a desiccating intercostal
herpes in the area of the right fourth dorsal nerve. The former
had developed the eruption four or five days after the latter, and as
the two boys lived in the same house and saw each other daily,
Galippe regards this as a case of contagion ( v. Review, 1911, x.,
p. 531). J. D. Rolleston.
SPONTANEOUS REDUCTION OF A DISLOCATION OF THE
(371) CERVICAL VERTEBRAE. W. C. Bkntall, Brit. Med. Joum.,
1913, July 12, p. 69.
The patient was a man, aged 65, who fell from a tree on to his
back. He was perfectly conscious, had no pain, but had no
power in his arms or legs. That evening slight movement of his
legs was noticed, which was increased next morning. There was
no pain anywhere except on movement at the back of the neck,
where he was also conscious of a creeping sensation. The arms
were hypersensitive on their radial aspects, which is the area
supplied by the fifth cervical root. Nothing was done, and two
months later the patient could walk unaided, but could not dress
himself or perform the finer movements. Fifteen months later
he returned to work, but still had numbness in his finger-tips,
and occasional twinges in the muscles of the neck.
A. Ninian Bruce.
A CASE OF VOLEMANN’S ISCHEMIC CONTRACTURE OF THE
(372) HAND. (2 lllust.) G. de Swiktochowski, Lancet , May 17,
p. 1380.
A girl, aged 12, fell and injured her left elbow. A fracture was
diagnosed and a splint applied. Next day the left hand was
swollen and very painful, and she had lost her power over the
fingers. After six weeks’ treatment no improvement had taken
place.
She was seen four years later by the author, who found the
wrist flexed ad maximum, the metacarpo-phalangeal joints hyper-
extended, and both interphalangeal joints flexed to the highest
possible degree like the wrist. The hand was much smaller than
its fellow, and the muscles wasted. She was given passive move-
ABSTRACTS
435
ment, massage, and various splints, their shape and application
being altered every week. Great care had to be taken on account
of the skin, the slightest pressure at first giving rise to sores.
Later, faradism and Bier's elastic bandage were used, and it was
expected that in a few months’ time she would get the full use
of her hand. A. Ninian Bruce.
THE FORM OF THE FIELD OF VISION IN TABETIC OPTIC
(373) ATROPHY. (Die Geaichtsfeldformen der tabischen Sehnerven-
atrophie). K. Langenbkck, Klin. Monatsbl. f. Augenheilk , 1912,
1., August, S. 148.
In 130 cases peripheral contraction was found in 81, nasal
defects in 37, temporal in 33, above in 25, below in 7, and central
in 18.
The fields fall into two main groups.
Group I. Loss of function occurs over the whole field, the
colour fields become contracted, and vision is reduced. The con¬
traction of the colour fields is often an early sign of the develop¬
ment of the defect before there is any loss for white. Early
affection of the entire thickness of the optic nerve characterises
this group.
Group II. Here the unaffected part of the field retains com¬
pletely intact colour sensation right up to the boundary of the
defect. The healthy and diseased parts of the nerve are sharply
demarcated, and central vision may remain relatively good for
some time.
As regards prognosis, it is not possible to make any distinction
between these two groups.
Central scotomata occurred in fourteen cases, or about 10 per
cent, of the author’s material; they may, though rarely, be a mani¬
festation of uncomplicated tabetic atrophy. In most cases these
scotomata may easily be differentiated from those occurring in
retrobulbar neuritis or toxic amblyopia, though occasionally the
diagnosis may be doubtful for some time.
The author strongly combats the view of Fuch’s that anything
in the way of an inflammatory process ever occurs in uncomplicated
tabetic atrophy. Hemiopic fields are rare and, in the author’s
view, not due to uncomplicated tabes. He agrees with the opinion,
stated by Leber over thirty-five years ago, that such hemiopics are
either due to an accidental symmetrical affection of the optic
nerves or to a basal complication. Tabetic atrophy depends upon
a purely peripheral affection of the optic nerves and not on any
degenerative process of the chiasma or tracts.
H. M. Traquair.
436
ABSTRACTS
TABETIFORM GASTRIC GRISES IN ULCERATIVE GANGER OF
(374) THE LESSER CURVATURE (Grises gastriques taWttformee
an cours d’un, ulclro-cancer de la petite conrbure). Duhot
and Leboy, UEcko med. du Nord, 1913, xvii., p. 252.
Man, aged 49. Tabes was excluded by the normal character of
the reflexes, and of the cerebro-spinal fluid. Laparotomy showed
cancer of the lesser curvature with deep and extensive infiltration.
The severity of the pain was probably due to the cancer being
grafted upon an ulcer. Reference is made to a similar case
reported of Babinski, Chauvet, and Durand (Soc. de Neurol.,
March 6, 1913). J. D. Rolleston.
>LEGIA IN SCARLET FEVER. (H&nipldgie an conn de la
(375) Scarlatina.) P. Savy and M. Favre, Lyon m/d., 1913, cxx., p. 1142.
A man, aged 19, suddenly developed right hemiplegia on the tenth
day of an ordinary attack of scarlet fever. Death, preceded by coma
took place forty-eight hours later. No necropsy. As there was no
obvious cardiac lesion present during life, embolism was excluded,
and thrombosis was regarded as a more probable explanation of the
hemiplegia than encephalitis. Reference is made to the cases
reported by the reviewer (v. Review, 1908, vi., p. 530) and by
Gouget and Pelissier {ibid., 1909, vii., p, 545).
J. D. Rolleston.
DIPHTHERITIC HEMIPLEGIA (Die Hemiplegia postdiphtheritica.)
(376) W. H. Leeds, Zeitschr. f. Kinderheilk 1913, viii., p. 88.
Among 6,300 cases of diphtheria admitted to the Hamburg-
Eppendorf Hospital between October 1909 and January 1913, four
developed hemiplegia, of which three were fatal.
1. Man, aged 24. Right hemiplegia on 16th day. Aphasia,
hemianopsia, and albuminuria. Death on 18th day. Cerebral
softening found at autopsy.
2. Girl, aged 8 years. Left hemiplegia on 25th day. Cardiac
dilatation and enlargement of liver. Albuminuria. Recovery with
spastic paresis and athetosis.
3. Male, aged 18 years. Left hemiplegia on 21st day of only
twenty-four hours’ duration. Cardiac dilatation and albuminuria.
Death on 33rd day. Necropsy: Fatty degeneration of heart, but
no macroscopical lesions in brain to explain hemiplegia.
4. Boy, aged 3 years. Right hemiplegia with aphasia on 23rd
day. Albuminuria. Death on 46th day from broncho-pneumonia.
ABSTRACTS 437
Necropsy showed softening of left corpus striatum, optic
thalamus, and sub-thalamic region.
Cardiac thrombi were found in case 1 only. The paper contains
a review of sixty-three cases from the literature.
J. D. Rolleston.
MENINGISM IN SO ABLET FEVER. (Meningismus bei Scharlach.)
(377) H. Sachs, Jakrb.f. Kinderheilk., 1911, “Erg.-Heft,” p. 68.
During a period of nine months at the infectious department of
the Virchow Hospital, Sachs found sixteen cases with clinical signs
of meningitis among 400 scarlet fever patients. The occurrence
of so many cases in a short time is attributed to the character of
the epidemic. Two were adults, eleven children from 8 to 13,
and three from 2 to 5 years of age. The disease ran much the
same course in all. On admission, the patients had high fever
and were in a comatose condition. The most frequent combina¬
tion of symptoms was nuchal rigidity, Kemig’s sign, hyperaesthesia
and stupor. The symptoms lasted two or three days and then
gradually subsided.
Lumbar puncture was made in fifteen cases. In only eight was
there hypertension, and in one out of five examined there was an
excess of albumin. None showed leucocytosis nor micro-organisms.
The amount of fluid withdrawn varied from 3 to 50 c.c. Although
the increase of pressure and amount of fluid were in favour of
serous meningitis, the other findings contraindicated this, and
autopsies, which were held in two cases, showed an absence of
meningitis.
The pathological anatomy of meningism is unsettled, but the
condition is probably brought about by a combination of vasomotor
changes and damage to the central nervous system. The aetiology
is also obscure. Probably meningism is due to the toxines of the
unknown agent of scarlet fever or of streptococci. Diagnosis can
only be made by lumbar puncture.
A clinical distinction between meningitis and meningism has
not been established. The prognosis is on the whole good. The
fatal issue of five cases in this series was due to the severity of the
scarlatinal attack.
Treatment is symptomatic. Lumbar puncture was found only
to be of benefit in cases with hypertension. J. D. Rolleston.
MENINGISM. A REVIEW. (Meningiamufl. Ueberaichtsreferat.)
(378) C. Kaysee, Berl. klin. Woch. t 1913, L. p. 1021.
There is hardly any infectious disease in which meningism has
not been observed and described. French medical literature is
438
ABSTRACTS
especially rich in illustrative cases. Sachs has recently found
symptoms of meningitis in 4 per cent, of all his scarlet fever
patients, while the lumbar puncture findings—no bacteria, no
cellular elements, normal or occasionally raised pressure—justified
the diagnosis of meningism. Laurel Stursberg and others have
recorded meningism in typhoid, and several authors have observed
it in pneumonia. Thus Kircheim found it in 13 out of 500 cases.
Schottmuller has recorded cases occurring in puerperal fever,
measles, and whooping cough. It has also been noted in
helminthiasis. In the few fatal cases on record only hyperaemia
and oedema of the meninges have been found. The prognosis is
good. There is never any paralysis or other cerebral disturbance
left as a residue. Treatment is symptomatic. Relief is afforded
by lumbar puncture. J. D. Rolleston.
SUBACUTE MENINGEAL SYNDBOME OF SYPHILITIC ORIGIN.
(379) (Syndrome, mining* sub&igu d’origine syphilitiqne.) Pikrekt and
Du HOT, L'Echo mid. du Nord , 1913, xvii., p. 249.
Man, aged 20. The symptoms suggested tuberculous meningitis.
Acquired syphilis was denied, but the family history indicated
the inherited disease. The cerebro-spinal fluid was clear, and
showed intense lymphocytosis. Wassermann positive both in
blood and cerebro-spinal fluid. Marked improvement followed
injections of benzoate of mercury, but Wassermann remained
positive, and the lymphocytosis though less was still appreciable.
J. D. Rolleston.
TUBERCULOUS MENINGITIS IN ADULTS. G. A. Crace-Calvert,
(380) Med. Prest arul Circ ., 1913, il, p. 37.
The paper is based on seven cases that occurred among 520 cases of
pulmonary tuberculosis treated by the writer in his sanatorium
during the last eleven years. Six were males. The ages ranged
from 29 to 44. The onset was usually very insidious. Headache
was usually the most marked symptom. Vomiting was not so
constant as in the child. Retention of urine was frequent. The
abdomen was usually retracted, and the pulse quickened and
irregular. Kernig’s sign was present in all but two. Tache
cirtbralc was present in only one case. Optic neuritis was absent
in at least four cases. No other ocular signs were noted. Coma
usually developed several days before death.
The duration of the disease varied from nine days to six weeks
( c f. Berietv, 1911, lx., p. 30, and 1912, x., p. 488).
J. D. Rolleston.
ABSTRACTS
439
TWO UNUSUAL OASES OF ENTERIC FEVER Sir John Moore,
(381) Dublin Joum. Med . Sc., 1913, i., p. 419.
The first of these was complicated by two relapses followed by
catarrhal jaundice, but presented no nervous symptoms. The
second was a case of “ typhoid spine ” in a man aged 38. Enteric
fever developed in August, and ran a protracted course, being
complicated by intestinal haemorrhage. During convalescence
in October pain occurred in the back and lower limbs, and was
mistaken for rheumatism. On examination a globular swelling
was found over the great trochanter and incised, but proved to
be a phantom tumour, probably due to the flaccid gluteal muscles.
The diagnosis now lay between toxic peripheral neuritis tuber¬
culosis of the sacro-iliac synchondrosis and “ typhoid spine,” and
was settled by the X-rays, which showed osteo-periostitis of the
left side of the third lumbar vertebra and upper half of the fourth.
Treatment consisted in rest to the spine, with massage of the back
and lower limbs, but recovery did not take place till the beginning
of March ( v. Review, 1913, ix., p. 281).
J. D. Rolleston.
APHASIA IN THE TYPHOID FEVER OF CHILDREN. (L’aphasie
(382) dans la fidvre typhoid© infantile.) M. Brelet, Gaz. mid. de
Nantet, 1913, xxxi., p. 401.
Aphasia is a rare complication of typhoid fever ; it is confined
almost exclusively to children. In most cases it is an isolated
symptom, unaccompanied by any other sign of involvement of
the nerve centres. It usually appears at the height of the
disease, more rarely in convalescence ; sometimes during a relapse.
After a variable time, three weeks on the average, complete
recovery takes place. Pathogeny. With the exception of perma¬
nent aphasia, accompanied by hemiplegia where gross vascular
lesions are present, aphasia in typhoid is due to slight circulatory
disturbances (circumscribed oedema or anaemia) or to fine lesions of
the nerve centres, readily admitting of repair.
The rapid disappearance of this toxic aphasia is due to the
fact that in early life the brain can rid itself of its toxins much
more readily than later.
J. D. Rolleston.
PARALYSIS IN A DOG SIMULATING POLIOMYELITIS. Simon
(383) Flexner and Paul F. Clark, Joum. Exp. Med., 1913, xvii., p. 577
A pet dog developed a form of paralysis simulating the paralysis
of epidemic poliomyelitis. The autopsy showed changes in the
440
ABSTRACTS
spinal cord and intervertebral ganglia, resembling, but not identical
with, the lesions of poliomyelitis in man. Inoculation of the affected
spinal cord into the nervous system of young dogs and Macaws
rhesus monkeys was not followed by the production of paralysis
or other obvious symptoms of disease. The illustrations are
particularly good. A. N INI AN Bruce.
THE DIAGNOSIS OF CEBEBBAL HAEMORRHAGE BT MEANS OF
(384) LUMBAB PTINCTURE. O. P. Bioblow, Cleveland Med. Joum.,
1913, xii., p. 265.
Bigelow, as the result of his observations, comes to the following
conclusions: Cerebral luemorrhage can be detected by examination
of the spinal fluid in perhaps 90 per cent, of eases if the examina¬
tion be made within three weeks of the “ stroke.” For the first
four days or so there is a cloudiness or bloodiness of varying
degree according to the amount of blood which has escaped.
Then a colour due to hiemoglobin, varying from canary-yellow to
reddish-brown, appears and persists for about three weeks. There¬
after the only guide in the spinal fluid is a probable persistence
for some time of a slightly raised cell count and protein content.
J. D. Rolleston.
BILATERAL HAEMORRHAGIC SOFTENING OF THE BADIA
(385) TIONS OF THE CORPUS CALLOSUM. (R&mmollimcnto wnor-
ragico bilaterale delle radiazioni callose.) G. Minoazzini (of
Rome), Riv. di Pat. new. e ment., Feb. 1912.
The patient, a man of 65, alcoholic but not syphilitic, eight
months before death became peculiarly irritable and occasionally
violent, his memory became defective, and his behaviour showed
a loss of the sense of shame. He later passed into a state of
confused excitement, and had two convulsive attacks, followed by
a stuporous condition of varying depth which lasted up to the
patient’s death. The neurological picture consisted of deviation
of head and eyes to the left, contracture of the neck, hypotonia of
the inferior facial, spasticity of all the limbs, more accentuated on
the left side, deep reflexes active, negative cerebro-spinal fluid.
The autopsy disclosed two large, rust-coloured foci of a softening
of arteriosclerotic origin, which destroyed almost completely on
both sides the radiations of the corpus callosum, and on the right
extended for a certain distance into the centrum semi-ovale.
C. Macfie Campbell
ABSTRACTS
441
OCCLUSION OF THE POSTERIOR INFERIOR CEREBELLAR
(386) ARTERY. (Report of case). G. W. Robinson, Joum. Amer.
Med. Assoc., 1913, lxi., July 19, p. 179.
An account of a case in a man, aged 45, a farmer by occupation,
together with a brief note on the anatomical structures involved
and on the symptomatology of such lesions.
A. Ninian Bruce.
A CASE OF FACIO-HYPOGLOS8AL ANASTOMOSIS. Edmund C.
(387) Bevers, Lancet , 1913, May 24, p. 1450.
A description of a successful case, with two photographs, of a
facio-hypoglossal anastomosis in a girl, aged 14, who developed
a complete paralysis of the right side of the face after a radica
mastoid operation for acute middle ear suppuration.
A. Ninian Bruce.
MITRAL DWARFISM. F. Pakkes Webee, Brit. Jour. Child. Dis ., 1913,
(388) x., p. 203.
The patient was a girl, aged 15, though her size was that of a child
of 10 years. She was 50 in. (127 cm.) in height, and weighed
54 lbs. (24| kgm.). The heart showed evidence of mitral obstruc¬
tion and incompetence. Mentally the child appeared normal.
Von Pirquet’s and Wassermann’s reactions were negative. There
was no family history of dwarfism nor infantilism. The cardiac
disease was probably of rheumatic origin, and had commenced at
a relatively early period of extra-uterine life. Mitral obstruction
was a more important factor than incompetence in the production
of the dwarfism, which the writer regards as a conservative
hypoplasia—“ Nature’s attempt to limit the growth of the patient
in accordance with the limited blood supply.”
J. D. Rolleston.
ACROMEGALY WITH LOCALISED MUSCULAR ATROPHY
(389) Julian Loudon, Canad. Bract, and Review , April 1913.
A description, without illustrations, of a case of acromegaly
combined with progressive muscular atrophy in a man, aged 37.
A. Ninian Bruce.
TUMOUR OF THE HYPOPHYSIS IN A CASE OF ACROMEGALY.
(390) Julius Gkinkeb, Joum. Amer. Med. Assoc., 1913, lxi., July 26, p.
235.
The patient was a man, unmarried, who had suffered from
acromegaly for about fifteen years. The symptoms followed a
442
ABSTRACTS
fright and an infected vaccination wound on the arm, and were
accompanied by attacks of petit mcd ; later there were added
somnolency, cephalalgias, and change of character. Though pre¬
senting the classic picture of acromegaly the patient never suffered
from any of the usual visual disorders of this disease, such as
hemiopia and central scotoma. In the course of time, however,
attacks of major epilepsy and uncinate fits supervened and the
patient died in coma.
The post-mortem examination showed a large adenoma, which
had pushed up the optic chiasma, extended into the lateral
ventricles and incidentally caused a bilateral hydrocephalus, more
marked on the left side. Complete absence of the thyroid gland
is also recorded. A. Ninian Bruce.
I FATAL PELLAGRA IN TWO ENGLISH BOTS. Charles R Box,
(391) Brit. Med. Joum., 1913, July 5, p. 2.
The first case, a boy aged 8, “ fainted ” while playing cricket three
months before coming under observation. Two months later he
had a fit, his body becoming rigid, but consciousness was not lost.
His walk became ataxic and spastic, his speech indistinct, and a
coarse nystagmus was present. The dermatitis on his face and hands
resembled acute sunburn, and is clearly shown in a coloured plate.
The cerebro-spinal fluid was normal He later developed slight
delusions. An acute suppurative balanitis appeared a fortnight
before death.
At the autopsy the brain and cord appeared healthy on their
removal, and were examined by Dr Mott (v. infra).
The second case, a brother of the first, was only under observa¬
tion for a fortnight. He had been weak on his legs for about six
years, and dull and backward in his studies. The eruption
appeared on his face, neck, and hands. He grew gradually worse,
and died in January 1911, the nature of the disease being not
then suspected.
A third member of this family, a boy of 7, was also attacked
by the disease. A. Nikian Bruce.
n. THE HISTOLOGICAL CHANGES IN THE NERVOUS SYSTEM
(392) OF DR BOX’S CASE OF PELLAGRA, COMPARED WITH
CHANGES FOUND IN A CASE OF PELLAGRA DYING IN
THE ABASSIEH ASYLUM, CAIRO. F. W. Mott, Brit. Med.
Joum., 1913, July 6, p. 4.
Diffuse and scattered degenerated fibres were found throughout
the white matter of the spinal cord, but more marked in the
postero-lateral and postero-median columns; scattered degenerated
ABSTRACTS
443
fibres were also found in the sciatic nerve. The tracts of Flechsig
and Gowers, the column of Goll, and the crossed pyramidal tract
show a general diffuse sclerosis.
Microscopically no evidence of meningeal or perivascular
infiltration with lymphocytes, or plasma cells, or polymorphs was
found. The absence of chronic meningo-encephalitis and meningo-
myelitis contraindicates the protozoal theory of the disease, although
it does not disprove it. The nerve cells showed a marked chromato-
lysis, swelling of the cell, and disappearance of the Nissl granules,
except at the periphery, and frequent eccentric position of the
nucleus. The changes were seen in the Betz cells, in the Purkinje
cells, and in the cells of Clarke’s column, and rather indicate a
chronic toxaemic condition.
Comparison of the above changes found in Dr Box’s case with
those of a pellagrous patient who died at the Abassieh Asylum,
Cairo, and whose case is here reported, showed no essential
difference. A. Ninian Bruce.
HI THE NATURAL HISTORY OF PELLAGRA WITH AN
(393) ACCOUNT OF TWO NEW CASES IN ENGLAND. Louis
W. S ambon, Brit. Med. Jvum., 1913, July 5, p. 5.
A case of pellagra is here described in a man, aged 36, born at
Beaulieu. He presented a typical rash with depression, tremor,
and vertigo. He had never eaten maize, but close to where he
lives there are streams harbouring Simuliidce.
A second case in a boy, aged 7, is also described.
Pellagra is essentially an endemic disease. It has scattered
strictly limited stations within which it is rampant, and affects
newcomers; outside these stations it cannot be contracted. The
most striking feature of these stations is a swiftly flowing stream.
The author thinks that pellagra is an insect-borne disease, and
that the Simuliidai appear to coincide geographically, topo¬
graphically, and seasonably with the disease, together with some
blood-sucking midges such as Leptoconops. A description, with
three illustrations of Simulium, is given, and a number of interest¬
ing points in connection with the disease abroad, which seem to
strongly support the above view, and the paper concludes with a
short description of the disease as found in foreign countries.
A. Ninian Bruce.
PELLAGRA IN GREAT BRITAIN: three new indigenous cases.
(394) Louis W. Samson, Brit. Med. Joum., 1913, July 19, p. 119.
The first case occurred in a girl, aged 7 years, who had never
eaten any maize. She was perfectly well until 4 years of age,
39
444-
ABSTRACTS
when nocturnal enuresis developed and “eczema” on the hands
and face in spring, lasting all summer, and disappearing in the
winter. Her speech was affected, her mental standard was low.
Convulsive fits became more and more frequent, and she died
after a more than usually severe attack.
The second case was in a woman, about 65 years of age, who
suffered from an erythema-like dermatitis on the backs of both
wrists and hands, brownish-red in colour, and coming on in spring
and autumn. Apart from a little depression there were no
nervous symptoms.
The third case was in a young woman suffering from typhoid
pellagra with vivid hallucinations, tremors, acute confusional
insanity, coma vigil, and a pellagrous dermatitis on the face and
hands.
Notes on two other cases with marked nervous symptoms are
also given, one in a woman aged 74, and the other in a woman
aged 37. A Ninian Bruce.
PELLAGRA IN GREAT BRITAIN. NOTES OF SOME FURTHER
(395) CASES. Louis W. Sam bon, Brit. Med. Joum., 1913, Aug. 9,
p. 297.
Several more cases are here recorded, one of which in a girl,
nearly 17 years of age, is reported at considerable length.
The nervous and mental symptoms were both well marked, and
the distribution of the rash was typical.
A. Ninian Bruce.
A CASE OF PELLAGRA IN ENGLAND. PROBABLY CON
(396) TRACTED IN SCOTLAND. J. A. B. Hammond, Brit. Med.
Joum., 1913, July 5, p. 12.
A young woman, aged 33, who had always led an active outdoor
life, began to suffer from headache, lassitude, abdominal pain and
tenderness over the right iliac fossa. Removal of the appendix
caused a temporary improvement, after which the symptoms
became much worse. An exploratory laparotomy revealed nothing.
In the late spring, when she was taken into the garden, a dermatitis
appeared over the hands, wrists, and face. She grew rapidly
worse, became extremely emaciated, the mouth acutely ulcerated,
and mental symptoms set in. The prostration and cachexia
continued, and she finally died in April 1913. There was no
history of eating maize, but she was a frequent victim to insect
bites. A Ninian Bruce.
ABSTRACTS
445
SOME HEMATOLOGICAL FINDINGS IN PELLAGRA. O. S. Hill-
(397) mam, Amer. Joum. Med. Sc., 1913, cxlv., April.
This is the first of a series of reports of work performed under the
auspices of the Thompson-M'Fadden Pellagra Commission of
the New York Post-Graduate Medical School.
The haemoglobin content, the number of red and white cells
per cubic millimetre, the differential leucocyte count, and the
general morphologic characteristics of the blood were determined.
A few observations were also made on the coagulation time.
The patients were divided into two groups. Under group A
were included hospital cases, who received no medicine, and were
allowed a liberal diet. Under group B were included those cases
in which only differential leucocyte counts were done.
In group A the haemoglobin varied from 58 to 107 per cent.,
the average being 83 per cent. The average red-cell count was
4,758,000 per cm The colour index was 1 or plus 1 in twelve
determinations, and in twenty instances it was under 1, the
lowest being 0 6; the average index was 0*8.
The average leucocyte count was 10*403 per c.mm.
The differential leucocyte count revealed an absolute poly¬
nucleosis in those cases associated with a leucocytosis of over
10,000, except in one instance. The average total lymphocytosis
was 33*99 per cent., the average large mono-nuclear count was
2*59 per cent., the average transitional cell count was 1*5 per
cent., and the average eosinophile count was 2*73 per cent.
The differential leucocyte count on a series of slides taken
from thirty-seven cases at their homes in South Carolina showed
no variation from those recorded. The coagulation time of the
blood determined in three cases was within normal range.
D. K. Henderson.
METABOLISM IN PELLAGRA Y. C. Myers and M. S. Fine, Amer.
(398) Joum. Med. Sc., 1913, cxlv., May.
This paper forms a part of the work performed by the Thompson-
M'Fadden Pellagra Commission of the New York Post-Graduate
Medical School.
A study of the metabolism in pellagra is of interest as an aid
to the interpretation of the gastro-intestinal symptoms generally
observed; in connection with the maize theory of the etiology of
the disease, and because of the resemblance to beri-beri, in which
the etiologic factor appeals to be an inadequate dietary.
The methods of examination employed are thoroughly detailed,
and the results of this study are summarised as follows:—
The elimination of mineral and nitrogenous constituents in the
446
ABSTRACTS
urine is such as would be anticipated under the dietary and
physical conditions of the individual. A lower physiologic
efficiency is indicated by the low creatin in coefficients, and the
elimination of small amounts of creatin in the urine.
Anacidity is common in pellagra, as it was found in eight out
of fourteen cases. It is generally associated with an entire
absence of pepsin, or with pepsin in very minute quantities.
A marked indicanuria is present, which is excessive in cases
with gastric inefficiency. The quantities eliminated are much
higher where anacidity exists, and they furthermore hold a higher
ratio to the inorganic sulphates.
The faeces contain decidedly abnormal amounts of indol and
skatol, especially the latter.
The presence of excessive amounts of indican in the urine,
associated with a high elimination of ethereal sulphates, when
considered in connection with the abnormal amounts of indol and
skatol in the fceces, points to some unusual bacterial conditions in
the intestine. D. K. Henderson.
THE RELATION OF SYPHILIS TO PROGRESSIVE MUSCULAR
(399) DYSTROPHY. W. B. Cadwalader and E. P. Corson-White,
Med. Record, 1913, i., p. 1033.
The writers investigated twenty-seven cases with the Wassermann
and Noguchi reactions. Seven were positive, in three one of the
parents also was positive, and one of them had facial paralysis,
which might have been due to syphilis. Unaffected brothers or
sisters gave positive reactions in three families. Miscarriages
had occurred in five families. Whether hereditary syphilis is
necessary for the development of progressive muscular dystrophy,
or whether there was a mere coincidence in these cases of two
distinct diseases, is left undecided. J. D. Rolleston.
A CASE OF GRAVES’ DISEASE WITH SCLERODERMIA AND A
(400) POSITIVE WASSERMANN REACTION, TREATED WITH
8ALVARSAN. H. F. L. Ziegel, Med. Record, 1913, i., p. 1124.
The patient was a married woman, aged 28, with no history nor
clinical evidence of syphilis. Wassermann negative in son aged
7 years and husband. Administration of salvarsan and other
forms of arsenic was followed by a negative reaction, marked
improvement in the sclerodermia, diminution of the thyroid
swelling, and disappearance of the nervous symptoms and
tachycardia. J. D. Rolleston.
ABSTRACTS 447
THE DANGERS AND COMPLICATIONS OF SALVARSAN TREAT
(401) MENT. Hugh Wansey Bayly, Lancet, 1913, May 24, p. 1443.
The author considers that:—
1. The risk of death is so small that if due care is taken in
preparation of the patient, and no errors are made in preparation
of the solution of the drug, technique of administration, interval
between injections, or subsequent treatment, fear of death cannot
justifiably be advanced as a reason for withholding salvarsan
treatment.
2. The slight risk of serious complications or sequelae is more
than counterbalanced by the therapeutic results obtained.
3. All sufferers from syphilis, in whatever stage, and all
cases of early parasyphilis should, as a matter of routine, be
permitted the advantage of salvarsan treatment.
A. Ninian Bruce.
THE EFFECT OF INTRAVENOUS INJECTION OF SALVARSAN
(402) UPON THE KIDNEYS. (Salvananets inverkan p& njurama
vid intr&vendsa injektioner.) H. L Schlasbkro, Nord . Med.
Arleiv ., 1913, xlv. (Inre Med.), pp. 1-39.
The author examined the urine of eighty patients after intravenous
injection of salvarsan in order to determine if the subsequent
excretion of arsenic by the kidneys leads to any inflammation of
that organ. He found that this is almost always so, as large
quantities of casts are to be found in the urine, without, however,
bearing any definite relation to the actual amount of salvarsan
injected. The casts usually appear on the day following the
injection, and disappear from one to two weeks later. If the
treatment be combined with mercury the number is greatly
increased. He considers the condition is due to a pure toxic
nephritis.
He also experimented upon rabbits, and found that an intra¬
venous injection of 0*02 gr. of salvarsan per kilo, produced no
clinical or anatomical changes in the kidneys, unless the dose were
repeated when casts, but no albumen, appeared. 0*04 to 0*08 gr.
per kilo, produced both casts and albumen, with marked fatty
degeneration of the renal epithelium. A. Ninian Bruce.
CONCERNING AGGLUTININS FOR TREPONEMA PALLIDUM.
(403) John A. Kolmer, Journ. Exp. Med. t 1913, xviii., July, p. 18.
There is no demonstrable amount of agglutinin for Treponema
pallidum, (Noguchi) in normal human and normal rabbit serum
in dilutions as low as 1 : 20. Agglutinins for Treponema pallidum
448
ABSTRACTS
are readily produced in young rabbits by the administration of
pure cultures of living spirochetes. There is no appreciable amount
of agglutinin for Treponema pallidum culture used in the sera
of secondary and tertiary syphilis, or in the cerebro-spinal fluid of
tertiary syphilis in dilutions of 1 : 20 to 1 : 640.
A Ninian Bruce.
▲ STUDY OF THE ADDITION OF OHOLESTBBIN TO THE ALCO
(404) HOLIO EXTRACTS OF TISSUES USED FOR ANTIGENS IN
THE WASSERMANN REACTION. I. C. Walker and Hover
F. Swift, Joum. Exp. Med., 1913, xviii., July, p. 76.
The addition of cholesterin to an alcoholic extract of heart or
foetal liver increases the antigenic value of the extracts in the
Wassermann reaction. The optimum amount of cholesterin to
be added to heart extract or foetal liver extract was found to be
0*4 per cent. Cholesterin-heart extracts are superior to cholesterin-
liver extracts and to alcoholic extracts of syphilitic livers, as well
as to ether extracts of dried hearts. Cholesterin-heart extracts
prepared from different human hearts are practically equal in
anticomplementary antigenic value. Similar extracts prepared
from guinea pig hearts have the same antigenic value as those
prepared from human hearts. Both the human heart and the
guinea pig heart extracts are superior to beef heart extract when
the same amount of cholesterin is added to each of the extracts.
In testing blood serum for diagnostic purposes, it is not safe to use
more than one-fourth of the anticomplementary dose of the 0’4
per cent, cholesterin-heart extract. In the work here presented,
this consisted of a one in ten emulsions. In testing cerebro-spinal
fluids, one in ten emulsions give slightly better reactions with
smaller quantities of the fluid than do one in six emulsions. Because
of the simple preparation, the superior antigenic property, and the
constant antigen value of cholesterin-heart extracts prepared
from human hearts, the authors agree with M'Intosh and Fildes
that this form of extract fulfils the requirements of a standard
antigen. A Ninian Bruce.
A STUDY OF COMPLEMENT FIXATION IN SYPHILIS WITH
(406) TREPONEMA ANTIGENS. J. A. Kolmer, W. W. Williams,
and E. E. Laubauoh, Joum. Med. Research, 1913, xxviiL, July,
p. 346.
1. Serums of normal persons, and normal rabbits, and of
persons suffering from non-syphilitic diseases with negative
Wassermann reactions, do not contain substances capable of
ABSTRACTS
449
fixing complement with pallidum antigens. About 50 per cent,
of serums from persons in all stages of syphilis, and giving
positive Wassermann reactions and luetic histories reacted
negatively with the pallidum antigens. The reactions with the
pallidum antigens are weak and too inconstant to be of routine
practical value.
2. Serums of rabbits immunised with pure cultures of Treponema
pallidum yielded strong reactions with the pallidum antigens.
As controlled by the examination of one hundred normal rabbits,
these serums also give positive reactions with stock lipoidal extracts.
3. Many of the human serums and all the rabbit immune
serums were likewise tested with control antigens of sterile
culture media, pure washed cultures of typhoid and cholera
bacteria, as well as cultures of these organisms in the same culture
media as used in the cultivation of Treponema pallidum. With
the human serums a few doubtful reactions were obtained
with the antigens of sterile media, and more marked reactions with
the typhoid and cholera culture media antigens. The rabbit
immune serums not only reacted strongly with these antigens, but
likewise yielded weak reactions with antigens of washed typhoid
and cholera bacteria. From the fact that a lipoid was demon¬
strated in these antigens, it may be that the non-specific reactions
were due to the usual union of lipoid and lipoidophilie antibody,
although the authors are unable to explain at present why this is
especially true with the rabbit immune serums.
4. From the fact that the reactions with alcoholic extracts of
pure washed treponema were uniformly negative, it is apparent
that the antigenic principle of the treponema is not readily
abstractable in alcohol, the aqueous extracts being preferable in
complement fixation reactions. A. Ninian Bruce.
CONCERNING THE WASSERMANN REACTION WITH NORMAL
( 406 ) RABBIT SERUM. J. A Kolmbr and A. J. Casselman, Joum.
Med. Research, 1913, xxviii., July, p. 374.
A PERCENTAGE of serums of normal rabbits yielded positive com¬
plement fixation reactions with lipoidal extracts. With aqueous
and alcoholic extracts of pallidum as antigen fixation did not
occur. With acetone extracts of syphilitic liver no fixation was
found when using ’05 c.c. and 1 c.c. of serum; with ‘2 c.c. serum
fixation occurs in 10 per cent., and with ’4 c.c. in 311 per cent, of
normal rabbit serums. With alcoholic extracts of syphilitic liver
fixation did not occur with *05 c.c. serum; when using *1 c.c. fixa¬
tion occurred in 13 3 per cent.; with '2 c.c. in 20 per cent.; and
with *4 c.c. in 27'5 per cent, of normal serums. With extracts of
450
ABSTRACTS
the acetone insoluble lipoid fraction fixation did not occur with
•05 c.c. and - 1 c.c. of serum; with ’2 c.c. fixation occurred in 33*1
per cent., and with '4 c.c. in 557 per cent, of normal rabbit
serums. An alcoholic extract of beef, heart reinforced with
cholesterin, showed the highest per cent, of positive reactions.
With *05 c.c. serum fixation did not occur; with 1 c.c. fixation
occurred in 20 per cent.; with ’2 c.c. in 40 per cent.; and with
*4 c.c. in 56 8 per cent, of normal rabbit serums. The occurrence
of positive complement fixation reactions with normal rabbit
serums and lipoidal extracts bears no relation to coccidiosis.
While the cause of this phenomenon is as yet unexplained, it is
probably due to the presence in rabbit serum of a lipoidophilic
substance with affinity for certain lipoids or lipoidal substances.
A. Ninian Bbuce.
THE BLOOD AND THE CEBBBBO-8PINAL FLUID IN MUMPS.
(407) Anthony Fieling, Lancet , 1913, July 12, p. 71.
The author finds that in mumps the blood shows definitely a
slight increase in the total number of leucocytes, and a relative
and absolute lymphocytosis, which is present on the first day, and
persists for at least 14 days.
Also a lymphocytosis of the cerebro-spinal fluid occurs when
the disease is complicated by meningitis or by lesions affecting
the cranial nerves; and a lymphocytosis has also been found in
cases of mumps which have presented no clear clinical symptoms
of any organic lesion of the nervous system.
A. Ninian Bbuce.
THE GBOTALIN TREATMENT OF EPILEPSY. Ralph H. Spangles,
(408) Epilepria, 1913, iv., Juli, p. 307.
The crotalin solution used was made from the dried, yellowish,
crystal-like scales of the evaporated venom of the Crotalus horridus,
by dissolving the crystals in glycerine and sterile water with a few
drops of tricresol. The solution is then put into sterilised ampules
containing 1 c.c. of whatever strength is desired.
The author considers that the venom treatment is indicated in
many of the essential cases of epilepsy. Not only are the virulence
and number of epileptic fits favourably influenced, but the ex¬
citability of the nervous system is modified, and the general health
of the patients, their mental faculties and metabolism in every
respect, are considerably improved. The quality of the blood, and
possibly its chemical composition, seem to be affected by the
ABSTRACTS
451
injection of the venom. As to the exact effect it has on the
coagulability of the blood, further observation is necessary. There
is no danger in the use of crotalin if the usual precautions be
taken. A. Ninian Bruce.
A CASE OF TETANUS TREATED WITH INTRASPINAL INJEC-
(409) TIONS OF MAGNESIUM SULPHATE. H. Letheby Tidy, Brit.
Med. Joum., 1913, May 24, p. 1104.
A BOY, aged 8, developed tetanus three to four weeks after two
slight cuts to his head and chin. There was a marked risus
sardonicus, opisthotonus, and great pain. Ten c.c. of cerebro¬
spinal fluid were removed by lumbar puncture under great tension,
and 3 c.c. of sterilised 25 per cent, magnesium sulphate solution
injected. The spasms then ceased. The injection was repeated
after two days, and again four days still later, each time on
account of increase of the rigidity being noticed; 10 c.c. of anti-
tetanic serum were injected after other three days, and he made
a good recovery.
For an adult a dose of 6 c.c. of a 25 per cent, solution in
distilled water may be given. This contains about 1£ grams
(about 22 grains) of magnesium sulphate (c/. Review, 1912, x., p.
92). A Ninian Bruce.
POLYNEURITIS FOLLOWING A PHLEGMON OF* THE BIGHT
(410) INDEX. (Polynlvrlte consecutive & un phlegmon de l’indfc droit)
Saw and Mazel, Lyon mid., 1913, cxx., p. 1161.
A woman, aged 46, ran a splinter into her finger in March, and
developed a whitlow which was complicated by oedema of the right
upper arm. After a free incision the finger healed in three weeks,
but weakness of the limbs ensued. On admission to hospital in
May she had almost complete paralysis of all four limbs, paresis
of the dorso-lumbar muscles, difficulty in swallowing, and diplopia,
but no subjective disturbance of sensation, and no R.D. Cerebro¬
spinal fluid normal. Subsequently severe pain developed in the
limbs, but by September complete recovery took place. No
bacteriological examination had been made of the pus from the
finger, so the cause of the polyneuritis was uncertain.
The patient had had no sign of diphtheritic angina or coryza,
no specific antecedents nor any traces of diabetes, nor alcoholism.
(The possibility of the phlegmon being an instance of purely
cutaneous diphtheria is not mentioned.) J. D. Rolleston,
452
ABSTRACTS
▲ CASE OF EVULSION OF THE OPTIC NEEVE. (Bin Fall von
(411) Evulsio nervi optici.) A. Nat anson, Klin. Monatsbl.f. Augmheilk \
1912,1., August, S. 220.
A YOUNG man was struck on the left eye by the point of a stick.
There was severe pain at the time, soon followed by swelling. Two
weeks afterwards when the eye was examined, it was found to be
blind with the pupil dilated, and unresponding to light. The
media were clear, and in place of the usual appearance of the
optic disc there was an oval-shaped hole about 3 mm. deep. This
hole was surrounded by an oval area, devoid of retina and sur¬
rounded by haemorrhages, beyond which the retinal vessels could
be seen. The macular area exhibited a milky dimness.
The diagnosis was obviously rupture of the nerve in the
neighbourhood of the lamina cribrosa produced by the point of the
stick pushing the optic nerve backwards, while at the same time
forcing the eyeball to the front of the orbit.
H. M. Traquair.
CONTRIBUTION TO OUR KNOWLEDGE OF TUBERCULOUS
(412) CHANGES IN THE RETINA. (BeitrMge zur Kenntuis der
tuberkulosen Ver&nderungen der Retina.) Rados, Klin. Monatsbl.
f. Augmheilk. , 1912,1., 2, S. 330.
Tuberculous infection of the retina may begin in the iris and
ciliary body, and spread backwards or may spread forwards from
the optic nerve. The case under review occurred in a boy of 10
years, who died a year afterwards of tuberculous meningitis, and
belongs to the first group. A minute description of the micro¬
scopic appearances is given, special attention being drawn to the
unaffected condition of the choroid and the presence of at least
one typical tubercle as well as groups of small submiliary tubercles
in the nerve fibre layer of the retina. Bacilli were not found.
Tuberculous changes in the retina, especially with giant cells,
are extremely rare. The paper closes with an account of hitherto
described cases. H. M. Traquair.
PARESIS OF THE OCULOMOTOR NERVE WITH ABNORMAL
(413) CYCLIC INNERVATION OF THE INNER BRANCHES.
(Okulomotoriusl&hmung mit abnormal zyklischer Innervation der
inneren Aeste.) Salus, Klin. Monatsbl.f. Augmheilk , 1912, 1., 2,
S. 66.
In this case the right eye presented usually the ordinary
picture of third nerve paralysis. Suddenly, however, the upper
lid would begin to rise and the pupil to contract. After from ten
to thirty seconds the eye returned to its original state. The
ABSTRACTS
453
case is discussed at length by the author, who suggests in explana¬
tion of the phenomena an early or congenital lesion of the third
nerve near the peduncle, followed by regeneration in such a way
that the fibres for the outer muscles of the eye became continuous
with those for the intraocular muscles. Thus stimuli intended
for the external muscles reached the iris and ciliary muscle.
H. M. Traquair.
CLINICAL AND MICROSCOPICAL CONTRIBUTION TO SOLI-
(414) TART TUBERCLE OF THE OPTIC NERVE-HEAD. (Klini-
scher und mikroskopischer Beitrag zur Solit&rtnberkulSse der
Papilla nervi optici.) Jakobs, Klin. Monatsbl. f. Augenheilk,
1912,1., 2, S. 37.
This ocular condition, together with tuberculosis of the conjunctiva,
occurred in the left eye of a patient who had tuberculosis dacryo¬
cystitis in his right eye and also laryngeal tubercle. The region
of the optic disc was occupied by a greyish-white mass. The
paper contains a detailed description of the microscopic changes
found, special stress being laid on the presence of tuberculous foci
spreading back along the nerve. While an expectant attitude is
justifiable in solitary tubercle of other parts of the eyeball, an
exception should be made in the case of optic nerve-head affection
on account of the danger of backward extension, and the eye
should be removed without delay. The conjunctival tuberculosis
was cured by lactic acid. H. M. Traquair.
THE SOLUBILITY OF LEAD SALTS IN HUMAN GASTRIC JUICE
(415) AND ITS BEARING ON THE HYGIENE OF THE LEAD
INDUSTRIES. A. J. Carlson and A Woblfel, Joum. Amer.
Med. Atsoc., 1913, lxi., July 19, p. 181.
Lead may be absorbed by the skin, the lungs, and the digestive
tract. Under ordinary conditions absorption by the skin is very
slight. Lead poisoning occurs in industries in which no lead dusts
are produced. And since lead dust in the respired air increases
the chances of lead dust entering the stomach, it is clear that the
digestive tract is in some cases the sole, and probably in all cases,
the most important avenue of absorption of lead in industrial lead¬
poisoning. There is no evidence that leads salts can be absorbed,
or act locally on the mucosa, except in solution.
The authors tested the solubility of lead salts in human gastric
juice obtained from a case of gastric fistula in a man of sixteen
years’ standing. They found that the carbonate of lead is much
more soluble than the sulphate, and that the carbonate is also
much more toxic than the sulphate, although both salts produce
454
ABSTRACTS
acute lead poisoning when given in quantities of 0.1 gm. per kilo
body weight daily. When milk and gastric juice are mixed in the
proportions of 1: l, the hydrochloric acid of the gastric juice is so
completely fixed that the mixture has virtually no solvent action
on the lead salts. When gastric juice is present in excess the
lead goes into solution in proportion to the excess of the gastric
juice.
The authors therefore recommend that the state should aim at
the elimination of the use of the carbonate in all industries in
which this is possible, and that all lead workers should drink a
glass of milk between meals in order to diminish the chances of
any swallowed lead being dissolved by the free hydrochloric
acid present. A Ninian Bruce.
PSYCHIATRY.
THE MORRISON LECTURES, 1913 . GENERAL PARALYSIS OF
(416) THE INSANE. George M. Robertson, Joum. of Ment. Sc.,
1913, lix., April, p. 185.
In this lecture the author gives a full account of the signs and
symptoms, both mental and physical, .of general paralysis. The
uncertainty of diagnosis by clinical means is discussed, and a
detailed account is given of new laboratory methods of diagnosis.
These methods consist of six new serum and cerebro-spinal fluid
tests, namely, the Wassermann reaction in the serum, the Wasser-
mann reaction in the cerebro-spinal fluid, lymphocytosis, and the
presence of globulin, albumen, and plasma cells in the cerebro¬
spinal fluid.
By means of the Wassermann reaction in the cerebro-spinal
fluid, it is claimed that general paralysis can be differentiated
from every other condition which simulates it, with the exception
of tabes and syphilis of the nervous system. The other five tests
assist very little in the differential diagnosis of these three
conditions, which must therefore be made on clinical grounds.
Tabes with mental symptoms and cerebro-spinal syphilis with
mental symptoms are next discussed, and the possibility of
diagnosing early general paralysis before the onset of clinical
symptoms by means of the laboratory methods is mentioned.
The aetiology of the disease and its relations to syphilis are given
at some length, and reference is made to Ford Robertson’s
diphtheroid bacillus, which the author admits is present in the
blood or cerebro-spinal fluid in about 33 per cent, of cases of
general paralysis, but he is unable to agree with Ford Robertson
as to its significance. An account is given of the recent investiga¬
tions of Noguchi, who demonstrated the spirochseta pallida in the
brains of fourteen cases of general paralysis.
ABSTRACTS
455
In the treatment of syphilis salvarsan is mentioned, and great
stress is laid on the importance of obtaining a permanently
negative Wassermann reaction. Although sufficient time has not
yet elapsed to enable anyone to say that a complete cure of
syphilis by salvarsan, with a permanently negative Wassermann
reaction, will prevent the development of general paralysis, the
author’s opinion is that it is reasonable to think such might be
the case.
The form of treatment adopted for general paralysis was as
follows:—
1. Intra-venous Injection of Salvarsan. —0'3 to 0 6 grin, for a
man, 0’2 to 0*3 grm. for a woman. The injection was repeated
three or four times at intervals of a month.
2. Intra-spincU Injection of Anti-Syphilitic Scrum. —To obtain
this serum 20 or 30 c.c. of blood were withdrawn, with aseptic
precautions, from the aim of a syphilitic patient, who had been
treated three days previously with a full dose of salvarsan. This
was allowed to clot, and cultures were made from the serum. ’
The clotted blood was left on ice for twenty-four hours, and if the
serum was sterile it was poured into a sterile flask with other
sera, thus making a mixed serum. 10 to 15 c.c. of this
mixed serum, twenty-four to forty-eight hours old, was used for
an injection. Before the injection an amount of spinal fluid was
withdrawn, equal to that of the serum which it was intended to
inject. This serum is highly charged with syphilitic antibodies,
and was injected intra-spinously in order to bring the remedy near
the site of the disease.
3. Intra-spinal Injection of Salvarsan Serum. —This was obtained
by drawing off some of the patient’s own blood one hour after he
had received an intra-venous injection of salvarsan. This method
was only used on a few occasions, and was followed by a slight rise
of temperature.
4. Urotropine in doses of gr. x. t.d.s.
Calomel was given twice weekly.
The results of the treatment on the whole were disappointing,
but it seldom happened that the patient did not show slight
improvement after the first or second injection. Twelve cases
were treated. In five there was considerable excitement before
treatment, and all of these were benefited and became calmer.
Three recovered sufficiently to be discharged, one of these relapsing
after six months, another meeting with a fatal accident, while the
third remained well for a year. In more of the patients did the
Wassermann reaction become negative, but in a number there was
a distinct diminution of its intensity, which increased again later
on. In three of the cases there was marked and lasting decrease
456
ABSTRACTS
in the numlier of lymphocytes, and in three others it was slight
and of a temporary nature. There was no change in the amount
of globulin or albumen.
The author is of the opinion that the treatment was not
vigorous enough either as regards the amount of salvarsan
administered, the number of injections, or the rapidity with which
these succeeded one another. J. Stanley Hopwood.
THE TRANSMISSION OF TREPONEMA PALLIDUM FROM THE
(417) BRAINS OF PARETICS TO THE RABBIT. Hldeyo Noguchi,
Joum. Amer. Med. Assoc., 1913, lxL, July 12, p. 85.
Noguchi has now found the spirochetes in 36 of 130 additional
brains (v. Review, 1913, xi. p. 174), from which sections stained by
the modified Levaditi method were examined. Thus, in 200
cases of paresis so far studied, the pallidum was found in 48,
i.e., nearly 25 per cent. He has also found it in the posterior
columns of the cord in 1 of 12 cases of tabes dorsalis.
Forty-two rabbits were injected intratesticularly with an
emulsion of the fresh brain obtained from a paretic individual.
Two later developed syphilitic scleroses containing treponema
pallidum in their testes, the one taking 92 days to develop, and
the other 105. A. Ninian Bruce.
THE PRE-SENILE PSYCHOSES. W. L. Treadway, Joum. Nerv.
(418) and Ment. Dis ., 1913, xl., June, p. 375.
A somewhat hetereogeneous group of seven cases without autopsy
reports. D. K. Henderson.
THE PROBLEM OF THE ALIEN INSANE. S. L. Dowes, Amer.
(419) Joum. Med. Sc., 1913, cxlv., No. 5, May.
The inadequacy of the Federal laws, both as to the admission of
immigrants and the deportation of insane aliens, is considered.
D. K Henderson.
SOME CASES OF MENTAL DEFICIENCY. E. Bellingham Smith,
(420) Brit. Joum. Child. Dis., 1913, x., p. 241.
A clinical lecture illustrated by cases of sense deprivation,
cretinism, mongolism, microcephaly, paralytic idiocy, and simple
amentia. J. D. Rolleston.
REVIEW
457
A CASE OF ALZHEIMER’S DISEASE WITH UNUSUAL NEURO
(481) LOGICAL DISTURBANCES. A. M. Barrett, Joum. Nerv. and
Ment. Dm., 1913, zL, June, p. 361.
The case of a married woman who, at the age of 33, became
mentally confused. Two years later she showed an unsteady
gait, and a constant coarse tremor of both legs even when lying
quietly in bed. There were frequent jerking movements of the
legs and arms, and twitching movements of individual muscles.
The speech was indistinct, stammering, and at times explosive.
The tendon reflexes were much exaggerated, the right arm was
spastic, and Babinski’s sign was present on the right side.
She showed a variable emotional condition, laughing and crying
without reason. She wandered aimlessly about, and only rarely
comprehended what was said to her.
During her two years’ residence in the hospital she had a
number of convulsive seizures, accompanied by loss of conscious¬
ness, showed extreme atrophy of the leg muscles, and latterly the
Babinski reflex could not be elicited. She died on 31st October
1910.
Grossly the cerebrum and cerebellum were found to show
marked atrophy. Histologically all regions of the cortex showed
numerous plaques and the peculiar neuro-fibril alterations described
by Alzheimer and others as characteristic for this disease. A
very striking degeneration was also found in the pyramidal tract
traceable from the peduncles into the lower sacral regions of the
cord.
The interesting features in the case are the early age at which
the disease occurred, and the unusual and dominating character
of the neurological disturbances. The case shows that so far as
age is concerned Alzheimer’s disease is not confined to pre-senile
years. D. K. Henderson.
IRevtew.
ACROMEGALY. A Personal Experience. Leonard Portal Mark,
(422) M.D. Demy 8vo., pp. 160 with 11 plates. Baillifere, Tindall A Cox,
London. 1912. Price 7s. 6d. net.
The author of this book is a medical man, who himself suffered
from the disease, and its interest lies in the fact that we have
here a record of the feelings and thoughts and mode of life as
described by a sufferer who had the necessary medical knowledge
to understand and interpret the different symptoms as they arose.
458
BOOKS AND PAMPHLETS RECEIVED
A special chapter is devoted to each symptom which is discussed
in detail, and the book finishes with some notes on the skull by
Prof. Keith.
The author has suffered from the disease for about thirty-two
years, the first symptoms—“ queer feelings in his left ear ”—appear¬
ing when he was twenty-four years of age, and seven years before
the disease was first recognised by Pierre Marie. A year later he
developed photophobia and drowsiness. His general health then
became affected, and curious feverish attacks developed, followed
by severe headache and faceache, and inability to resist cold and
exposure. Then post-nasal catarrh and rhinorrhoea became
marked, and indigestion from the advancement of the lower jaw
preventing the “ bite ” of the teeth. Great sense of fatigue and
difficulty in balancing on cycling were also observed. Acromegaly
was diagnosed by his friends when he was 37 from the advance¬
ment of his lower jaw. The neuralgia, asthenopia, and nasal
catarrh all became worse, and the tongue and heart hypertrophied.
The queer feelings in his head became more persistent, and de¬
veloped into attacks of what he describes as “the acromegalic
state.” In spite of this he continued at work, and at the age
of 49 he was “ spotted ” in a crowd in Paris by Pierre Marie as
a “ typical acromegalic,” but it was not until the following year
that he himself suddenly discovered that his symptoms were due
to acromegaly, a fact which was later confirmed by Pierre Marie.
A. Ninian Bruce.
BOOKS AND PAMPHLETS RECEIVED.
Jones, Lewis. “Ionic Medication. The principles of the method, and
an account of the clinical results obtained,” cr. 8vo, pp. viii+151.
H. K. Lewis, London, 1913. Pr. 5s. net.
Maas, Otto. “Storung der Augenbewegungen durch Vestibularisrei-
zung” ( Neurol . Centralbl ., 1913. Nr. 10).
Maas, Otto. “Zur Bewertung der reflektorischen Pupillenstarre”
(tfenrol. Centralbl ., 1913. Nr. 15).
Mark, Leonard Portal. “ Acromegaly. A personal experience,” pp. viii
+ 160. Baillifere, Tindall & Cox, London, 1912. Pr.7s.6d.net
Vulpius Oskar. “The treatment of infantile paralysis,” translated by
Alan H. Todd, roy. 8vo, pp. x+318, 243 figs, in text Baillifere, Tin dall A
Cox, London, 1912. Pr. 10s. 6d. net.
White and Jellifife. “ Nervous and Mental Diseases,” by American and
British Authors > illust., 2 vols. Henry Kimpton, London. Pr. £3 net
■Review
of
IReurologs anb p8£cbiatn>
©rigfnal Brtfcles
REMARKS UPON THE IRREGULAR AND UN¬
USUAL TYPES OF FAMILIAL PERIODIC
PARALYSIS AND CONDITIONS SIMULATING
THE SAME, WITH A PRELIMINARY REPORT
UPON A NEW SUB-TYPE OF THIS PALSY . 1
By L. PIERCE CLARK, M.D., New York,
Neurologist, Randall’s Island Hospital; Consulting Neurologist, Manhattan
State Hospital; Chief Consultant, Letch worth Village.
In May of last year the author reported before the American
Neurological Association an instance of intermittent familial
paralysis which differed notably from the usual type.
Assuming that most physicians are familiar with the classical
type, we find indications, from studying individual cases, that the
differences within the classical limit are chiefly those of degree.
There are certain mild, abortive cases in which, for example, the
electrical phenomena are much less pronounced than in the
general run of cases. This variation is probably individual only,
not'familial, which leads us to state that sporadic cases must also
be included in seeking for analogies to our familial example. The
well-known family described by Holtzapple differs in a number of
respects from the classical type, but this difference does not show
much parallelism with our family. It is notably severe, some
cases having ended fatally; the familial incidence was a large one,
and a migrainous equivalent was very pronounced in the family.
1 Read at the Thirty-eighth Annual Meeting of the American Neurological
Association, 11th May 1912, Boston, Mass.
40
460
L. PIERCE CLARK
This leads us to the decision of briefly reviewing various anomalous
conditions reported from time to time, which, while no one would
place thorn outright beside familial periodic palsy as group
members of one disease, may at least have one or more components
in common with the latter . 1
1 Lest many are not so fully acquainted with Holtzapple’s important work
upon his sub-type as that of Goldflam’s, whioh may be called the classic type of
this affection, I shall undertake to give as briefly as possible the main facts in
Holtzapple’s publication (Jour. Amer . Med. Assoc., 1905).
Holtzapple has had twenty-two years* continuous experience studying a family
with periodic paralysis. Hitherto familial periodic paralysis was not regarded as
fatal (one doubtful case by Schachnowitsch, 1882, an exception); the author has
had six deaths in this family in the midst of an attack, one in Holtzapple’s
presence. Many members of this family have suffered from attacks of periodic
sick headache, which appears to be an equivalent and due to a common cause.
The paralysis is a flaccid motor one in type, and affects all voluntary muscles
save those of the face, eyes, tongue, speech and deglutition, and sphincters of
rectum and bladder. Periodicity is evident early in the disease, but after some
years the interval varies. Paralysis may be partial or complete, localised or
general, and many forms of fluctuation are seen—partial paralysis early in the
day, total paralysis at night; one side totally and the other partially paralysed,
Ac., &c.
There may be remissions, followed by more severe phenomena of paralysis.
In the most complete form the subject is quite helpless. It is in these severe
expressions that certain muscles may be dangerously involved, as those of
respiration and deglutition. The muscles first attacked are usually those of the
lower extremities, but at times the muscles of the upper extremities or neck may
lead. Ordinary sensorial disturbances are absent, save rarely formication and
numbness in the paralysed area. But there is a heaviness, a tired feeling, very
oppressive, and in which change of posture gives relief.
In complete paralysis reflexes and faradic excitability are abolished.
Some patients can foretell their attacks—the heavy, tired feeling, numbness
and formication, tendency to stretch. These symptoms usually appear toward
evening, and are often accompanied by a ravenous hunger. Over-indulgence in
rich food may itself be accused of causing the crisis. Dietetic excesses without
ravenous appetite also provoke attacks at times. Some patients may go to bed
in the best of health and awaken paralysed in part, the symptoms growing worse.
Abortive attacks are seen as follows : Patients waken heavy, tired, and drowsy.
There is a certain amount of weakness and ataxia, interfering with the finer
movements. These spells may last for several hours only, or up to three days.
They may pass off without a true attack, but they may be aggravated. Recovery
from paralytic attacks is usually very sudden. As soon as a toe or finger can
be moved the attack appears to be over. In some cases an attaok ends with
vomiting or diarrhoea. Some patients will have it that they hasten the departure
of their attacks by making exertions.
There are absolutely no psychic symptoms during an attack, nor any affection
of the cranial nerves or special senses. During a crisis the sphincters are not
disturbed, unless the bladder is already over-extended. As a rule patients have
no desire for food, and may even have nausea. They drink freely. The circula-
TYPES OF FAMILIAL PERIODIC PARALYSIS 461
Thus a condition has recently been described by Meyer-Betz 1
as a “ rare type of recurrent motor paralysis associated with hemo¬
globinuria.” It is not yet known whether or not the affection
occurs in familial incidence; but it is known to attack horses,
which would apparently eliminate a congenital factor, unless it
can be shown that the animals also may exhibit the disease in
families. Thus far no such transmission is apparent. At first
the occurrence of haemoglobin in the blood suggests paroxysmal
hsemoglobinuria, but the two affections have nothing more in
common than the mere condition of the urine.
Meyer-Betz’s patient was a myasthenic boy. A state of
.extreme weakness was succeeded by contractures. The muscles
are not themselves for some weeks, and in fact never do become
so, for the boy is not strong and tires readily. The crises reappear,
and the boy, who is now 13, has had many of them. The
condition suggests slightly progressive muscular dystrophy, but
he is thus far intact save for a slight contracture of the
right Achilles. The question of a dystrophic component came
up in connection with one of the author’s cases, and in one of
Bernhardt’s.
This boy was studied as to his metabolism, with especial
reference to the production of alimentary acetonuria. This would
tion is not disturbed as a rule—only onoe was there some evidence of respira¬
tory failure. This might have been due to obstructed air passages from a
cold, Ac.
The disease usually appeared about puberty, and, as a rule, the patients
remained in good health. The attacks of headache in the family did differ from
ordinary hemicrania. They began earlier, and one patient in a long life developed
no paralysis. A number had migraine up to 20 or 30 when it was replaced by
paralysis, and in some the two affections alternated.
The total number of patients with paralysis was 17; with migraine, 19.
5 showed both affections. 14 had only paralysis and 13 only migraine. Total
number of all cases, 32.
Of the 17 with periodic paralysis 7 have died, 1 with nephritis and 6 with
the disease itself. Holtzapple does not give details of the deaths. He regards
the affection as a possible degenerative affection of the anterior horns (two
patients became permanently paralysed ?). Aside from this, he regards it as a
vasomotor functional neurosis. The nearest disease in kinship is the combination
of migraine with certain hemipareses. The exciting cause he assumes to be a
toxin, and he examined 138 specimens of urine without coming to any conclusion.
He used bromides, chiefly on the assumption that there was a vasomotor spasm
of the anterior spinal arteries. This remedy seemed beyond doubt to give
considerable relief.
1 Deutsch. Archiv.fur Klin. Med., 1911, CL, p. 85.
462
L. PIERCE CLARK
amount to the production of acidosis. But while both acetone
and oxybutyric acid appeared freely in the urine no muscular
crisis supervened.
The association of motor inhibition with haemoglobinuria in
the horse is at least a strange coincidence. In the midst of health
and after standing for some days in a stall, while in the midst
of a short walk or trot, and even, it appears, without leaving the
stall, the hind limbs become rigid and then paralysed. The animal
falls, his limbs sweat and tremble. The crupper muscles are
slightly swollen and tender, but the muscular reactions are
normal. Hemoglobinuria is present. If the attack is mild the
horse recovers in three or four days, and becomes subject to
repeated attacks. There is, however, a severe and fatal type
of the creeping sort in which the affection spreads from one to
another group of muscles.
Since vasomotor spasm has been so frequently accused of
causing brief, transitory phenomena, occurring in succession, and
with a familial tendency, it seems strange that the systemic
muscles never seem to participate in vasomotor crises. W.
Russell, in an article on motor paralysis due to angiospasm, 1
brings up the subject, but not with any reference to forms of
myopathy. In feeble circulation the author has seen slight
paresis of the arm and leg which disappeared on treatment. The
paresis occurred in a series of crises, and the author accused con¬
traction or obstruction of the cerebral arteries. Another periodic
paresis, affecting the arm, is known to accompany migraine. Motor
paresis may accompany atheroma and arterio-sclerosis in the
aged, and occur in crises. The author also mentions transient
hemiparesis associated with high blood pressure, appearing when
the tension reached a certain point. As none of these conditions
given by Russell bear the slightest resemblance to familial periodic
paralysis, we may conclude that a vascular component does not
figure in the genesis of the latter.
Batten 2 mentions a familial palsy in five children of one
family. A periodicity is not present, and there is also a marked
cerebellar component. Despite the continuous character of the
muscular symptoms, there is no wasting and no dystrophy. There
is, in fact, no tendency to advance. The electric reactions of the
1 Lancet, 1912, ii., 1349.
a Trans. Clin. Soc. Loudon, 1902, xxxv., p. 205.
TYPES OF FAMILIAL PERIODIC PARALYSIS 463
muscles seem to be much like those in classic familial periodic
paralysis.
Lenoble of Brest, who has had an opportunity to study
numerous aberrant types of nervous affections, recently described
a case of transient familial paraplegia occurring in three adults
(father and two sons). All were attacked when young men. The
type was spastic to the extent that it was painful, with heightened
reflexes. Some atrophy resulted, but the affection appeared to be
self-limited, for the father had long years ago recovered, and one
son was improving. There were sensory disturbances.
An extraordinary type of momentary, repeated (or con¬
tinuously recurring) amyotonia is related by Gonzales, 1 who,
however, assigns to it a purely nervous mechanism, and calls it
an “inverted tic.” The muscular reactions were normal. The
child recovered suddenly within three years. The condition may
possibly be related to the most recent conceptions of narcolepsy. 2
In both cases the inhibition was almost continuous, but in Klien-
berger’s case it occurred as an intention phenomenon, and did not
appear when he was passive. The patient suffered attacks of
migraine.
We may now turn to two of the latest articles on familial
periodic paralysis, in reference to aberrant and simulating affec¬
tions. Bing 3 describes the type or classical form as follows:
While the muscles are usually flaccid, individual muscles may
show an increase of tonus. It is distinctly an “ aura ” affection,
at least in diurnal attacks, and begins with paresthesias, feeling
of fatigue, somnolence, and thirst. The attacks may be retarded
by active exertion (Couser). When the approach of one is per¬
ceived, forced walking or writing will postpone attacks in the legs
and arms respectively. It is known that rest exerts the opposite
effect. Non-motor elements may be present, although rarely—
acute dilatation of the heart, arrhythmia, bradycardia, defective
sensibility in the paralysed area, and profuse sweating. Under
differential diagnosis Bing mentions Lenoble’s transient spastic
paralysis already described, which has also been looked upon as
familial myotonia and paramyotonia. He also mentions periodic
hysterical paralyses, which need not detain us.
1 Chronica medico, Mexico, 1911, xiv., 169.
2 Klienberger, Berlin. Klin. Wochensch 1913, No. 6.
3 Mohr and Stiihelin’s Handbuch d. inn. Med., 1912, w, 733.
464
L. PIERCE CLARK
Other conditions of much greater interest include intermittent
malarial paralyses. Bing quotes only the cases of Hartwig and
Cavare, which were paraplegias of quotidian or tertian type,
sometimes with paralysis of the sphincters. As a rule the
paralysis accompanies the outbreak of chill and fever, and yields
with them to quinine. In intervals, however, indications of
paralysis are often seen. This condition has been studied much
nearer home, for in 1890 Browning of Brooklyn reported a long
series of cases, chiefly in children.
Another peculiar affection has been described as attacking
stable hands in Switzerland and also in Japan, the foci being
quite independent. Gerlier, in Switzerland, calls it “paralysing
vertigo,” while its Japanese name is “ Kubisagari.” It readily
disappears with change of occupation. In the midst of unimpaired
general health there appears periodically a flaccid paralysis,
attacking, perhaps, the entire musculature or else sparing the
limbs. The neck and eye muscles seem to be always involved,
and the clinical expression may be dysphagia, paralysis of masseters,
diplopia, and amblyopia. Vertigo also coexists. Activity exerts
a favourable influence, rest the reverse. This condition seems
too little known to compare it with familial periodic para¬
lysis, and Bing does not give the results of the full neurological
examination.
Jendrassik 1 terms the classic type “Paroxysmal Familial
Myoplegia,” and enumerates the following briefly of transition
forms with other heredo-degenerations. He only gives:—
1. Bernhardt’s case (father and son) of familial dystrophy,
plus paroxysmal paralysis.
2. Lenoble’s transitory spastic paraplegia.
3. Isolated non-familial forms.
There is no possibility of confusing hysteria, Meniere’s vertigo,
or myastenia, because in none of these is there loss of electric
excitability.
It is evident that transitional or imitative forms of familial
periodic paralysis should be linked together or differentiated from
one another by the presence or absence of certain components, in
addition to differences in clinical expression. For example, there
1 Lewandowsky’s Harvibuch d . Xturologie .
TYPES OF FAMILIAL PERIODIC PARALYSIS 465
are certain nervous affections which express themselves by periodic
crises, yet show no tendency to become worse. According to
Jendrassik family periodic paralysis belongs here, along with
migraine, certain tics, and perhaps myasthenia. But some cases
of the former (Holtzapple’s) have ended fatally, and the affection
in the horse quoted by Meyer-Betz has some mortality.
A condition, the most common expression of which is familial,
must be heredo-degenerative, according to some. Batten’s familial
myoplegia associated with Friedreich’s disease might be an instance
of a transition form. The fact that the paralysis does not seem to
have been intermittent might have been due to the cerebellar
element. Bernhardt’s case, showing the combination with familial
progressive muscular dystrophy, is likewise of interest. Lenoble’s
transient spastic paraplegia is mentioned as a transition form.
The favourable influence of motion and unfavourable effects of rest
are also seen in Thomsen’s disease, even more marked than in
familial periodic paralysis.
Of much more significance, and not excluding the possibility of
a heredo-degenerative state, are cases like those of Holtzapple.
The migrainous equivalent present here appears to solve the nature
of the condition for some authors. The "aura” factor, the
occasional sensory phenomena, &c., suggest to Jendrassik a
common psychoneurosis group brought about by a vasomotor
ischemia. Elsewhere we have shown that a vasomotor factor does
not harmonise with the clinical evidence. There is no doubt,
however, that such a factor may cause a hemiparesis, with aphasia,
an arm paresis, and ophthalmoplegia with migraine, &c. All these
phenomena seem unilateral. Thus the vaso-constriction is not
peripheral, but occurs only as a result of ischemia somewhere in
one cortex. Jendrassik, however, attempts to solve the problem
by making the ischemia occur in the anterior grey columns of the
cord. Such a view is modelled on that of Flatau and Bornstein;
the latter, however, speaks only of epilepsy in this connection, not
migraine. He bases his view that epilepsy has paretic equivalents
(although only mono- and hemiplegias) and upon the fact that he
has seen the two conditions in the same subject. He has seen
periodic paralysis succeeded by epilepsy and vice versa .
The vasomotor component stands in some relationship with the
autotoxic component. The occurrence of acetonuria and a peculiar
form of hemoglobinuria, in the Meyer-Betz’s syndrome, are some
466
L. PIERCE CLARK
of the data which point to a possible toxaemia. 1 However, these
are somewhat rare. It is stated that not a few patients try to
persuade themselves that their inferiority is the result of over¬
eating, and claim that fasting benefits them. This is not borne out
by neurologists. Jendrassik takes the view of Holtzapple, who
demonstrates the actual association with migraine, while the notion
of an epileptic affiliation is largely speculative.
1 Apropos of the therapeutic side of periodic paralysis, the report of Dr
H. Willoughby Gardner in Brain (Part iii., Vol. 35, Feb. 1913) is worthy of
mention. His patient was a big, hulking, country youth of 17, who came under
observation in the first instance in 1907, with a history of having been subject
for the previous two years to attacks of complete loss of power in the arms and
legs. There was no sign whatever of any disease. Nevertheless, the attacks
recurred, and I>r Gardner had the opportunity of observing the patient in one
of these in June 1907, which was as follows : The patient awoke with a headache
at 4 a.m., June 8, and found he was unable to move arms, legs, or head. When
examined later in the day, he was noted to be unable to move his head, exoept
very slightly from side to side, but the facial muscles were uninvolved. He was
just able to move his arms; the legs were completely immobile, except for a
feeble movement of the toes. There was no impairment of any form of sensibility.
The deep reflexes in the arms and legs were completely abolished. The muscles
of the limbs failed to react either to faradic or galvanic stimuli. The heart was
slightly dilated, and there was a soft systolic murmur most evident in the aortic
and pulmonary areas. The pulse rate was 42. As the patient was unable to
pass urine, a catheter was used. He was drowsy, and complained of pains in the
limbs. By eight o’clock the following morning the attack had already begun to
pass off, and by noon he had regained motor power in the arms and legs. The
reflexes and electrical reactions were brisk, and the next morning he walked five
miles home, apparently in perfect health. The attacks recurred with increasing
severity and frequency until the effects of treatment made themselves apparent,
and at present the patient is in full work as a collier, and is the father of a
healthy child of 2 years. Gardner’s comments on the case are instructive and
illuminating. It appears that in this instance the attacks of paralysis seem to
have replaced previous attacks of “bilious headache.” Latterly they became
associated with very violent attacks of vomiting. Either the attacks themselves
or the warnings, Gardner notes, nearly always began on a Sunday. They
certainly have been associated on not a few occasions with the patient'# playing
football on the Saturday previous. They always developed during sleep, the
patient waking up to find himself paralysed. The cause is unusual, however, in
that no hereditary element could be traced, although periodic paralysis is one of
the few truly hereditary diseases. Gardner believes that the essential condition
underlying the disease is a “congenital defect of metabolism.” It is easy to see
that the author takes essentially the position of Holtzapple, and that his type of
cases is similar to Holtzapple’s sub-type. Most observers of periodic paralysis
have carried out treatments similar or analogous to those which Gardner pursued,
but they have not had as good results as Gardner reports. It is therefore
obvious that there are radically different classes of cases grouped under the
one designation of family periodic paralysis.
TYPES OF FAMILIAL PERIODIC PARALYSIS 467
In setting up types of disease it is proper to follow only
examples of large familial incidence, in which the members all
or directly tend to show a common type. Thus far we have only
the original (Goldilam) type, the Holtzapple, and the author’s.
The other types are seen only in very small incidence, which is
not enough for the study of a familial disease (Batten’s might be
excepted, but is not periodic).
This has, of course, nothing to do with individual variation;
the familial element could be left out of account (i.e., occurrence in
repeated generations), and all of these expressions of periodic
paralysis analysed in respect to periodicity and otherwise.
Introduction to Report of Author’s Sub-Type .—While it is possible
for us to classify all types of transient familial palsies under the
broad designation of periodic palsy, it does not seem desirable to
do so when the palsy is too atypical in its manifestations and
course, and especially when a few cases of the periodic type
present a fairly well-established etio-pathology such as those
studied by Goldflam. When attempts are made to apply Gold-
flam’s interpretation to the whole group of periodic palsies, the
whole hypothesis of the nature of the periodic palsies falls to the
ground. These defects in observation, however, are not pertinent
to the type upon which I shall make preliminary report to-day,
inasmuch as the disorder is a sub-type of family periodic palsy, if
one follows the fairly definite criteria of periodic palsy as stated
by E. W. Taylor, namely, the disease or syndrome shows the
following symptoms: “ Periodicity, flaccid motor paralysis, loss of
electrical excitability; loss of deep reflexes, and, between attacks,
relatively perfect health.” None of the cases to which I shall
briefly refer show any of these marked symptoms.
My material is drawn from a known family stock of four
generations, of nineteen members, in which nine members have
shown the transient palsy described. The attacks, although
having no essential clinical resemblance to it, are called “ rheu¬
matic ” by the various members of the family afflicted, and as a
class they call themselves the “ stiff people,” although here, too,
no stiffness of muscles obtains. The grand attacks are charac¬
terised by a more or less complete and abrupt inability to move
any of the voluntary muscles. The disorder occurs at irregular
intervals of days, weeks, or months throughout the life of the
several members of the family. It might rather be termed as an
4G8
L. PIERCE CLARK
inhibition disorder than a palsy per se, as there are no electrical
changes, no alterations in the deep or superficial reflexes during
the attacks, and the muscle tonus does not seem to be altered
during any of the observed attacks. Sensibility is not demon¬
strably altered. There is at times in some cases involvement of
the muscles innervated by cranial nerves, notably the occular
muscles, the tongue, pharynx, the lips, and the respiratory
muscles (dyspnoea).
The earliest case known is that of the great-grandfather, and
followed in all the five female children of his family, the four
male members being exempt. The two female members of the
third fraternity, consisting of three members, have the disorder,
while the one male member is exempt In the fourth generation,
which is still in infancy, the oldest member being 5, the disorder
appears as yet in but one female member of the six children.
The fourth generation consists of two female and four male
children. While the disorder apparently originated in the great¬
grandfather, the disease transmitted by him has occurred
exclusively in the female members of the different fraternities
since. In this respect the disease follows the usual rule. The
male members, however, have not been without the suspicion of
a certain hereditary taint, as two have suffered from diabetes,
one dying in coma from the same. In the last two fraternities of
the fourth generation acetonuria and acetone poisoning have
occurred in four of the male children, one having died from acetone
poisoning. Other family peculiarities will be given in the brief
case history of each. It may be taken for granted, when various
symptoms and signs are not mentioned, that such neurological
inquiries have been of a negative character. The last two
generations have been under my observation for the last eight
years. The two female members of the third generation having
married physicians and trained neurologists, one may be sure that
no pains have been spared to unravel the real nature and signifi¬
cance of the affection. All our efforts in this direction so far
have been unavailing. The possibility of obtaining suggestions
as to further lines of research and investigation that may bear
fruit in the future is one of the main reasons for placing the
sub-type on record at this time.
The subject matter covering my new sub-type was submitted
to Prof. Charles B. Davenport, of the Carnegie Station for
TYPES OF FAMILIAL PERIODIC PARALYSIS 469
Experimental Evolution at Cold Spring Harbour, who made the
following pertinent comment, that the disorder appeared to him
like a sex character (female) except for its occurrence in Thos. J.
“ As the chart stands, it might very well be that of a dominant
trait. If, however, Thos. J. married a close relative, and if M. J.
in the second generation did the same, it would count equally
for the result even if it were recessive.” Prof. Davenport added
a criticism which applies equally to many another study of
familial disorder heredo-degenerative in character, that a great
fault of the charts prepared by medical men is that they assume
all traits are dominant, and, therefore, consider the ancestors along
one line.
But little is known of the great-grandfather (Thos. J.), the
apparent initiator of the disorder, except that he was a merchant
sea captain of industrious and sober habits, born in England, and
engaged in the coast trade of that country. He was married and
had nine children, two being born before he had his first attack of
the disease, which occurred at about the age of 28. The attack
of total inability to move his arms and legs occurred within a
few hours after a short period of rest, before which he had
suffered prolonged exposure to a severe wetting storm. In a few
hours the attack passed off, but apprehending he was soon to be
afflicted with a permanently disabling palsy, he soon retired from
active sea service. Attacks similar to the first one here noted
continued to appear at irregular intervals throughout the remainder
of his life. He died of an intercurrent affection of the kidneys
when between 60 and 70 years of age. The second generation
will be considered in the order of birth.
L Thomas J., Jun., was a lawyer and politician. He never had
anything the matter with him until he was about 28 years old,
at which time he was out one night delivering a speech and went
to bed apparently well, but the next morning he was found dead.
No autopsy was performed. He was married, but had no issue.
2. Mary J., mother of the third generation, died at 28 years
of age soon after the birth of her third child. During the
pregnancy she had evidence of Bright’s disease, and succumbed to
symptoms of the latter disorder. It is reported that she had
peculiar attacks of “ stiffness ” or so-called rheumatism all her life.
Her two daughters, my patients and also my informants, state
that minor and major attacks of inability to stir, lasting a few
470
L. PIERCE CLARK
hours every few days and weeks, were of fairly frequent occurrence
in their mother’s life. The attacks grew more frequent and
severe as the mother grew older. The attacks occurred after a
short rest, following severe and exhausting physical and mental
efforts. There never was any pain or physical discomfort other
than the embarrassment resulting from the sudden loss of power
of locomotion. Control of sphincters was never lost. In point of
fact, voiding urine in this patient, as in all the others, helped to
break up the disablement. Her disability often appeared without
her knowledge. She would be sitting at her work or in conversa¬
tion, and when she wished to rise or change her position would be
unable to move. All the relatives can detect the presence of an
attack in one of their number without being so informed, yet
nothing peculiar in the position or expression of the afflicted
member is obvious to a bystander. In minor attacks, when some
slow and feeble movements, in the legs especially, were still
possible, assisting the patient to walk up and down the room
might be the means of ridding the patient of the attack. At other
times such efforts made the condition worse. Various dramatic
yet highly embarrassing mishaps occurred in this patient as in the
others, such as being attacked and suddenly collapsing on railroad
tracks, hauled from in front of moving vehicles, and being carried
miles away beyond their railroad destinations, which latter mishap
frequently occurred both on account of physical inability and
diffidence in explaining to strangers their peculiar plight This
patient, as others in the group, often had an attack while stand¬
ing on the street kerb waiting for a car. In such instances
physical support in the standing posture would not be wanting,
and at such times even progression on the level could be slowly
undertaken, but the street car step would be too high for them
to reach, and once in the street several city blocks would be
traversed before a sufficiently low kerb would permit the patient
to step up on it, and thus return home or get to a place of safety
or rest while a carriage could be called. At times the disability
would be circumscribed to locomotion, and at others to a
generalised but incomplete weakness or defective use of the more
onerous or vigorous movements, especially in the thigh flexors.
This patient was a bright, intelligent, robust, and , handsome
woman, as are all the women members of the family. The mental
capacity of all members of the family is decidedly above the
TYPES OF FAMILIAL PERIODIC PARALYSIS 471
average. No insanity, hysteria, or psychoneurotic episodes are
known to have occurred in any of the families.
3. Sarah J. is still living, and is about 50 years of age. She
has always had the disability attacks as detailed in the preceding
case. The family thinks the attacks are less severe and frequent
as she grows older. The attacks were particularly frequent
between 25 and 30 years of age; at that period the patient suffered
a great deal from indigestion. Indigestion is indifferently present
and absent in the different members of the family afflicted,
without there being any particular relationship of cause and effect
in the occurrences. This patient, as well as all her living sisters,
reside in California. The third generation lives in New York
State.
4. Chrissie J. is about 48 years old, and although she is
very frequently and seriously affected with the locomotor dis¬
ability or palsy, she leads a very active life. She is described as
a bright, strong, handsome woman. Even though she drives, rides
horseback, and walks a good deal, her movements are not very
sprightly. Her speech or cranial nerves are never affected, and the
disability is largely confined to the lower extremities. As in all
the cases, the degree of disability is always bilateral, both legs are
synchronously involved and recover equally. The defect is always
most marked from below upward, and recovery usually in the
reverse order. The duration of the attacks is never determined by
the apparent degree of motor disability in the several attacks.
This patient has always claimed that frequent urination helps her
to stave off attacks, diminish their severity, or postpone actual
attacks. She has particularly noted this benefit to follow if she
can frequently void urine when taking long drives. If one desires
to consider this statement seriously, a number of physiological
principles may be invoked; but an unbiassed close observer has
failed to note the great benefit claimed by the afflicted people.
However, the alleviating expedient here recounted should not be
too readily cast aside.
Cases 5 and 6, Kate J. and Annie J., are not especially note¬
worthy, and are practically the same as the first two sisters in
the nature of their attacks.
7. Herbert J. died of diabetic coma at 31, which began at 26
years of age. The disease was typical and classic in every respect.
He never suffered from any motor disability.
472
L. TIERCE CLARK
8 and 0, tin.* remaining memlters of the second generation, died
in earliest infancy from diphtheria, and of course presented no
disorder of locomotor defect.
In the third generation we have to consider three individuals,
Mrs H. and Mrs F., both under my observation, and daughters of
Mary J. and Alex. G., the only issue of Sarah J., the other
sisters being unmarried or without issue. Mrs H. and Mrs F. J 1
are twins, and the manifestations of their disorder are quite , *
identical in all essential respects. I n
Alex. G. has never sutl'ered from the motor disability per sr. a
While he is a bright intelligent lad of 18, weighing about t
150 pounds, he is not strong. He has never been able to pass .J t
hi6 physical examination at school. He has no physical endurance, a
and is easily tired. It is thought he has a “ touch of diabetes.” 1
How accurate this statement may be it is impossible to determine, 1
as he lives in California, and is rather averse to giving details of t
himself. In a recent report it is stated he is growing slower in
his movements, and the muscle weakness is increasing. In his 1 t
photograph he looks well developed, and is a strikingly handsome j
boy. His general physical weakness has often been ascribed to < t
laziness. j
Mrs H. and Mrs F., both now 28 years old, may be treated j
in the matter of descriptive notes as one case. Both showed <
their disorder at an early age, one at 21 and the other before i
4 years of age. The one at 21 years, Mrs H., had her first i
attack after a long carriage drive with her father. She was s
allowed to remain in the carriage for an hour or so, as the '
father thought she could help herself out of the carriage if |
she only would. She was finally carried to the house, and the
attack gradually wore off in the course of the evening; the
exact time is not known. Her sister, Mrs F., had her first
attack at three or four years of age after sitting for some time '
on a porch bench. Both gradually developed the locomotor
disorder to a high degree until marriage at 19, at whioh time I
the attacks in both cases underwent some degree of betterment
for a short time. Pregnancies in both cases, however, made the
condition worse. They each have had three children. The oldest
of Mrs H/s children, a boy, died of acetone poisoning at 18 )
months of age; the second child, a girl, has violent attacks of the j
same affection, and is now 2£ years old. The youngest is 1 year |
TYPES OF FAMILIAL PERIODIC PARALYSIS 473
old, and while he has frequent attacks of indigestion, no acetone
attacks have developed.
Mrs F.’s children, three in number, show the following: The
first, a girl, is just beginning to show the affection. But last
week, after an auto ride, she began to cry and lagged behind the
others in entering the house, saying: “ Mamma, my legs are stiff;
I cannot walk. My legs won’t go right.” For some time she
walked slowly, stiffly, and awkwardly, and kept repeating: “ See,
mamma, they don’t go, and I cannot make them go.” The dis¬
ability passed off completely in a few minutes. At 10 months
neither this child nor the second one, a boy 2£ years old, was able
to turn over unassisted. The musculature in both children, while
apparently normal, is lacking in power of endurance in any pro¬
longed test. The boy has frightful acetone attacks, during which
he complains of not being able to lift his legs, and continually asks
to have them rubbed.
The obvious suggestion presented in this last statement has
been absolutely fruitless in searching the urine of the self-styled
“stiff people,” those afflicted with motor disability. The blood,
urine, and stool analyses so far reveal nothing in this affection.
To finish the case notes in the fourth generation: The knee
jerks in Mrs F.’s children are barely detectable by reinforcement,
and the oldest, the little girl, has a marked lordosis, so marked
that when she was taken to an orthopaedist recently for the
curvature, he inquired if any cases of dystrophy were known in
the family. On further examination, however, he became con¬
vinced, as we all have who have seen that no condition of
dystrophy was present, but that the muscle tonus is poor, that
the defect in general metabolism was responsible for the con¬
dition of relaxed vertebral spine. No defect in muscle tone like
that of this child holds good for any of the adults afflicted.
Before closing these brief notes of case histories I would say
that the attacks are shown in their severest degree and range of
muscle involvement in the case of Mrs F., the case about which
most is known. In many of her attacks, which last usually half
a day, and scarcely more than a day at the outside, the neck is
involved, the eyes are staring and are moved with difficulty;
there is an inability to use the muscles about the mouth; the
tongue is thick; swallowing difficult, and an oppressive dyspnoea
occurs, and inability to breathe deeply (diaphragmatic weakness)
474
L PIERCE CLARK
is often shown. Again, such severe attacks may come on so
abruptly that she is not aware they are upon her until she
attempts to move or rise. One day last week Mrs F. entered a
train for a short journey, feeling quite well. She sat still for half
an hour reading a magazine. On attempting to leave the train
all movement was impossible, and she had to be carried to a
carriage. She said, in writing me about these attacks: “I just
felt helpless; had no movements at all. I could just speak. It
wore off slowly, much more slowly than in my other attacks.
Independently of attacks, I fatigue quickly now. I do not walk too
much; over-exertion seems to snap something somewhere, and
then I have no power and am weak. My sister and I both get
very severe attacks of stomach indigestion, but they are always
independent of the attacks. The indigestion somehow makes for
attacks, and then some blood vessel or nerve spasm occurs some¬
where inside and causes the attack.” Of course, one may too
easily rely on a patient’s observations regarding the cause of
his own case, but clinicians may learn not a little from such
remarks.
I append a genealogical chart of the afflicted family for easy
reference.
ThObJ
ThpDii*JSr D*dof Br«|hr>
6 AtD • i
THOSJR MJ
Orfllh CauM’Unknown Bng|hf:>
S J
ThfDitfasf
Living
C J K J
ThpDiieusr
Living
□
i 6 A 6
A J HJ Drd m mfono of
ThfDiSflJb* Diphtheria
Living 0‘inlofDmbetfi
Mri F
ThrDueave
li vmq
Ehi 1
AG ,
Deficient muxlf power
Living
M rb H
[The Disease
Living
ini 6 66
K.F. RF U
The Dived!* PborfluyiibtarO K
Living Living Living
Th PH
Died of Acctouna Indigestion
Acetonuna Living Living
MYASTHENIA GRAVIS
475
In brief, then, we have here a hereditary family inhibition,
paralysis, or disability independent of a psychosis, without
electrical changes and without reflex alteration. The disabilities
are purely motor in character, involving voluntary and occasionally
involuntary muscles. The type, while nearest in clinical mani¬
festations to some of the recorded cases of periodic palsy, is
sufficiently to be differentiated from the Goldflam and Holtzapple
types to warrant us in leaving it unclassified and separate from
any of these known types.
MYASTHENIA GRAVIS WITH EXOPHTHALMIC
GOITRE.
By GEORGE E. RENNIE, M.D., F.R.C.P. (Lond.),
Senior Physician, Royal Prinoe Alfred Hospital, Sydney, and Lecturer in
Clinical Medicine, University of Sydney.
A married woman, 38 years of age, was admitted to the Royal
Prince Alfred Hospital under my care, complaining of weakness
and tiredness in arms and legs, difficulty in swallowing,
impediment in speech, with prominence of the eyeballs and
occasional diplopia of about twelve months’ duration. Her family
history was good. She had always lived in a healthy locality, and
was practically a teetotaller. She had had four children, the
youngest 5 years of age; no miscarriages, and nothing in her past
history to suggest syphilis. She had previously been a strong,
healthy, well-developed woman, but much domestic worry led to
considerable loss in weight and to the onset of the present symp¬
toms. So far as we were able to ascertain her first symptoms
were prominence of the eyeballs, especially the right, with some
chronic conjunctivitis. This appears to have been accompanied
by some general nervous weakness and depression, but nothing
very definite until about five months before admission. She then
noticed that her right hand and arm had become weak, so that she
was unable to scrub, or strike an octave on the piano. The left
hand at this time was not affected. She was treated with
massage and improved somewhat. Subsequently the weakness
returned, was more marked than before, and now extended to the
left arm and the legs.
4*
47G
GEORGE E. RENNIE
On examination on admission her temperature was normal,
her pulse 90, regular and of moderate tension, and respirations 25.
She was somewhat thin and wasted, facial expression rather sad.
She lay comfortably in bed. Skin was dry with the exception of
the palms of the hands which were cold and moist and covered
with a clammy perspiration. The thyroid gland was moderately
enlarged, more on the right side than the left.
Examination of Nervous System .—Her intelligence was good.
Her expression somewhat vacant and far away, and she was
somewhat emotional. She was not aphasic. On first beginning
to speak her articulation and voice were natural, but in a very
short time the voice became nasal in character and her articulation
so indistinct as to be almost unintelligible, reminding one of the
character of the speech in a case of bulbar paralysis. After a
short period of rest her speech would be almost normal again.
She had no fits.
Cranial Nerves .—Sense of smell normal. Sight normal; no
colour-blindness. There is some exophthalmos, more marked in the
right eye than in the left, with widening of the palpebral fissure.
There is more or less complete external ophthalmoplegia, which
varied, however, from day to day. No nystagmus. Pupils equal
and round, moderately dilated, react to light and convergence;
cilio-spinal reflex present. There is chronic conjunctivitis, and
the eyelids cannot be completely closed. There is no actual
paralysis of the muscles of the jaw, tongue, palate, or pharynx,
but these muscles rapidly become exhausted so that mastication
and deglutition become almost impossible, with tendency to
regurgitation of fluids through the nose. After a period of rest,
however, these muscles recover their power.
There is weakness in the muscles of the neck, so that she
cannot hold her head upright for any length of time. There is
weakness in both arms, more especially the right. Grip fairly
good in both hands; flexor power fair at elbows and wrists, and
stronger than the extensor at the same joints. The muscles were
poorly nourished, but no hypotonia. Co-ordination good. The
muscles of the arms became so rapidly exhausted that she was
unable to continue to feed herself. The muscles of the legs
showed similar condition of weakness and rapid exhaustion. Her
gait was unsteady, but no definite ataxy and no Rombergism. On
testing the muscles with electricity they responded at first briskly
MYASTHENIA GRAVIS 477
to both f&radic and galvanic current, but rapidly became exhausted
and ceased to respond altogether.
There was no parmsthesia, and no interference with the
conduction of normal sensations.
Reflexes .—Conjunctival on the right side modified, on left side
normal. Palatal present. Epigastric and abdominal absent on
both sides. Plantar reflex showed extensor response on both sides.
Jaw jerk absent; wrist jerk absent on both sides; elbow jerk
ditto; knee jerks active on both sides, which, however, rapidly
became exhausted; no ankle jerk or clonus was obtained. The
sphincters were normal.
The heart sounds were normal; the pulse rate was constantly
quickened, varying from 90 to 130. It was regular; blood
pressure 98 mm. of mercury. Examination of the blood showed
erythrocytes, 4,850,000; leucocytes, 6,000; haemoglobin, 93 per
cent.; colour index, *96; no marked change in morphology of blood
cells. The urine showed nothing abnormal.
Her condition remained practically the same, except for
gradual increase in muscular weakness and exhaustion. About
a month after admission she had a bad attack of dyspnoea which
lasted half an hour, and was relieved by the hypodermic injection
of ether and oxygen inhalation. Similar slight attacks recurred.
Finally, a very severe attack occurred, in which the intercostal
muscles and diaphragm both became inactive, and she died very
shortly.
The extract of pituitary gland was administered every other
day for a fortnight, but did not appear to produce any ameliora¬
tion of symptoms. Adrenalin chloride was equally ineffective.
Strychnine alone seemed to do any good.
The double extensor response of the plantar reflex in this case
is a feature which, so far as I can ascertain, has not been hitherto
observed in this disease. Farquhar Buzzard, in his article on
Myasthenia Gravis in Allbutt and Rolleston’s “System of Medicine,”
says: “ The superficial reflexes are generally preserved, and the
plantar response is of the flexor type.” In view of this statement,
which may be taken to represent the combined experience of
those who have written upon this disease, the presence of a double
extensor response and exaggerated knee jerks in this patient
might suggest the coexistence of some degeneration in the
pyramidal tracts; but the fact that the jerks were of the typical
478
ABSTRACTS
myasthenic type, being easily exhausted, together with the
absence of ankle clonus, any involvement of the sphincters, and
the absence of any history or sign of syphilitic infection, would
negative this view. The double extensor response means, of
course, some interference, temporary or permanent, with the
functions of the pyramidal tracts in brain or spinal cord, but there
was nothing observed in this patient to indicate the nature of that
interference. Possibly further observations on cases of this
disease may throw some light on this interesting point.
abstracts.
ANATOMY.
MOLLGAARD’S RETICULUM. Thomas J. Heldt, Joum. Comp.
(423) Neurol., 1913, xxiil, August, p. 315.
“ With a simplified smear method, both the Nisei's bodies and the
neurofibrilhe are found present in the spinal nerve cells of the
dog, fixed twenty-jive seconds after decapitation. There is no
evidence that they are artefacts due to post-mortem changes aa
described by Mollgaard.
“ Nissl’s bodies and neurofibrill® may also be demonstrated, in
a more or less modified condition, in frozen neural tissue. The
freezing causes the Nissl’s bodies and nuclear chromatin to assume
the form of a reticulum. This reticulum is identical with
Mollgaard’s reticulum, or ‘ glia-network.’
“ Mollgaard’s reticulum is produced during the process of freez¬
ing, and is due to the displacement incurred by the enlarging and
expanding ice-masses which form in the cell or tissue at the
reduced temperature.” A. Ninian Bruck.
PHYSIOLOGY.
ON THE OEREBRO-CEREBBLLAR TRACTS. (Ueber die serebro-
(424) zerebellaren Bahnen.) C. Besta, Arch.f. Psychiat., 1913, L, H. 2.
The author gives the results of careful experimental studies on
the cerebro-cerebellar tracts, using partly secondary degeneration
studied by Marchi’s method, and partly Gudden’s method of
studying cell atrophy in growing animals after lesions of distant
areas, supplemented by studies of recent changes in cell groups
ABSTRACTS
479
after similar lesions. The following are the author’s conclusions:
(1) The pedunculus cerebri consists exclusively of fibres coming
from the cortex, and contains two parts. The first comes from the
lobus fronto-sigmoideus, passes in the lateral part of the pedunculus,
and enters into relation with the cells of the peri-peduncular and
intra-peduncular lateral groups and of the ventro-lateral area.
The second part comes from the lobus temporo-parietalis. These
fibres occupy the median part of the pedunculus, and are connected
with the cells of the median peri-peduncular and intra-peduncular
groups, and with the cells of the para-median and ventro-median
area. (2) There are no fibres of cerebropetal course in the
pedunculi cerebri, and the author denies the existence of a cerebral
component in the ventral part of the pons, which is maintained by
von Monakow and others. It is true that after destruction of the
pedunculi cerebri in new-boni animals most of the cell groups of
the ventral aspect of the pons disappear; but he considers this
not as a Gudden degeneration, but as an atrophy of secondary
order due to want of functional stimuli. (3) The brachium pontis
is formed by cerebellofugal and cerebellopetal fibres. (4) The
cerebellopetal fibres of the brachium pontis go for the most part
to the opposite side of the cerebellum, but a small portion is
homolateral. (5) The cerebellofugal fibres spring from the cere¬
bellar hemisphere, and end in the ventral portion of the pons and
the tegmentum of the opposite side. The termination of those
fibres which go to the tegmentum is not established, but they do
not, even in part, go to the thalamus. (6) The brachium con-
junctivum consist exclusively of cerebellofugal fibres. (7) The
fibres of the brachium conjunctivum cross completely. (8) The
author does not consider it definitely established that the fibres
of the brachium conjunctivum come exclusively from the cells of
the nucleus dentatus. It is possible that a certain proportion
of them come from the cerebellar cortex. They enter into con¬
nection with the cells of the red nucleus, and with those of the
thalamus of the opposite side; a small number go to the nucleus
of the oculo-motor nerve. The author does not consider that his
investigations are of wider application than to the animals on
which he experimented, i.e., the dog and the cat.
C. Macfie Campbell.
THE CONTROL OF THE SUPRARENAL GLANDS B7 THE
(486) SPLANCHNIC NERVES. T. R. Elliot, Joum. of Physiol., 1912,
xliv., July 16, p. 374.
The author measured the amount of adrenalin that can be ex¬
tracted from the suprarenal glands of the cat by means of delicate
blood-pressure experiments, and found that the suprarenal glands
480
ABSTRACTS
contain almost equal amounts of adrenalin on each side. He
also found that the fright induced by morphia or B-tetrahydro-
naphthylamine exhausts the residual adrenalin, that all ordinary
conditions of anaesthesia, with ether, chloroform or urethane, as
well as excitation of afferent nerves (e.g., the sciatic), or direct
injury to the brain, are attended by exhaustion or loss of adrenalin.
The centre controlling such loss is close to the bulbar vaso-motor
centres. The efferent path is by the splanchnic sympathetic
nerves. Their section prevents this exhaustion, none of the
above causes, nor diphtheria toxin, having any direct exhausting
action on the suprarenals. Faradisation of the splanchnic nerves
discharges adrenalin into the blood, causing a characteristic drop
in the rising curve of blood pressure, and such phenomena as
paradoxical pupillo-dilation. It appears probable that the
suprarenal glands are played upon by the splanchnic nerves in
the emotional and vaso-motor reflexes with almost as delicate and
ever-changing an adjustment as are the muscles of the peripheral
tissues connected with the sympathetic nerves.
A. Ninian Bruce.
THE RELATION OF THE HYPOPHYSIS TO GROWTH, AND THE
(426) EFFECT OF FEEDING ANTERIOR AND POSTERIOR LOBE
Dean D. Lewis and Joseph L. Miller, Archive* Int. Med., 1913,
xii., August, p. 137.
Hypersecretion of the anterior lobe of the hypophysis causes
abnormal development of certain portions of the body, especially
the bony structures. In the Frohlich syndrome of adiposity and
failure of sexual development, it is thought by many that there is
lessened function of the posterior lobe; experimental evidence,
however, suggests lessened secretion of the anterior lobe. Studies
in metabolism in acromegaly are again inconclusive.
Partial removal of the anterior lobe in young animals modifies
growth and sexual development in such a manner as to resemble
closely Frohlich’s syndrome. Removal of the posterior lobe has
no effect. Feeding experiments have proved negative. (Cf. Review,
1912, x., pp. 373 and 567.) A. Ninian Bruce.
PATHOLOGY.
ON EPENDYMAL GLIOMATOSIS OF THE BRAIN VENTRICLES.
(427) (Ueber ependym&re Gliomatose der Himventrikel.) M. S.
Margulis, Arch.f. Psychiat., 1913,1., H. 3.
The author reports the result of the examination of seven cases
in which there was a marked gliomatous proliferation of the
ependyma of the ventricles. The anatomical picture consisted
ABSTRACTS
481
in a hyperplasia of the ventricular ependyma and in the develop¬
ment in the walls of the ventricles and in the neighbourhood of
the nucleus caudatus of peculiar foci of gliomatous proliferation.
In the cortex, too, a certain amount of neuroglia proliferation was
demonstrated. There were no inflammatory changes of the vessel
walls. The author considers the ependymal gliomatosis as a
focal manifestation of a general proliferative gliomatous process.
No clinical picture corresponded to the anatomical findings. The
cases were of variable diagnosis, and syphilis was denied in all;
epileptiform convulsions or apoplectiform attacks were mentioned
in several of the cases. The author comes to no conclusion with
regard to the etiology of the histo-pathological changes.
C. Macfie Campbell.
ON THE ABSENCE OF THE CORPUS CALLOSUM IN THE HUMAN
(428) BRAIN. (Ueber Balkenmangel im menschlichen Gehirn.) W.
Stoeckkr, Arch./. Psychiat ., 1913,1., H. 2.
The report of a case of an 18-year-old general paralytic at whose
autopsy the corpus callosum was found to be absent. In place of
the commissural system of the corpus callosum there was an
extensive system of longitudinal fibres reaching from the frontal
region to the occipital lobe; this formed the dorso-mesial limit of
the lateral ventricle, and in the occipital lobe the tapetum of the
ventricle. The pillars of the fornix did not unite to form one
body, but remained separate throughout. The septum lucidum
was absent. The gyrus fornicatus consisted of a broad mass of
convolution, which extended on both sides to the great longitudinal
fissure. The anterior commissure was normal. In addition, on
the median aspect, and on the convexity of the brain, the pattern
of convolutions and fissures showed certain deviations from the
normal C. Macfie Campbell.
HISTOLOGICAL FINDINGS IN A CASE OF JUVENILE GENERAL
(429) PARALYSIS. (Reperti istologici in un caso di paralisi generals
giovanile.) A. Rezza and A Vedrani, Riv. itaL di Newrop.
Psichiat. ed Elettroter., 1913, vi., p. 254.
Girl, aged 13, heredo-syphilitic.
Cerebrum .—Moderate degree of infiltration and hyperplasia of
the pia; considerable infiltration of the cerebral vessels of all
sizes, consisting chiefly of plasmocytes, most marked in certain
regions (cornu Ainmonis); absence of vascular proliferation, circum¬
volutions atrophied with reduction of the grey substance; various
changes in the nerve cells; changes in the neuroglia chiefly of a
progressive character.
482
ABSTRACTS
Cerebellum. —Meningeal and vascular changes as above.
Atrophy more marked, csj>ecially in certain regions, with reduc¬
tion of all the elements and almost entire disappearance of
Purkinjc’s cells. Purkinje’s cells with two nuclei not frequent
(2-3 in a section), characteristic changes in their dendrites, but
typical fusiform expansions of Straussber very rare. Perusini’s
dsavjicrig substances very abundant in the atrophic cells.
J. D. Rollbston.
MICROSCOPICAL INVESTIGATION OF THE NERVOUS SYSTEM
(430) IN THREE OASES OF SPONTANEOUS MYXCEDBMA R.
Brun and F. W. Mott, Proc. Roy. Soc. Med., 1913, vL, June (Sect,
of Psychiat.), p. 75.
“ The changes in the nervous system in myxoedema consist in
a general chromatolysis of the nerve cells of a subacute character,
and secondary to the disease.
“ These changes, though general, are not of the same intensity
throughout the different ganglionic structures, but they seem to
affect in a particularly grave manner the autonomous bulbar-
motor system (nuclei of the ninth and tenth nerves), and in second
line the eerebro-spinal motor neurons and the sympathetic system.
“ Clinically, the affection of the vago-glosso-pharyngeal system
can lead to severe vagal attacks, or, in advanced cases, to a fatal
acute bulbar paralysis." A. Ninian Bruce.
CLASSIFICATION OF TUMOURS OF THE PITUITARY BODY.
(431) Gkrhardt v. Bonin, Brit. Med. Joum ., 1913, May 3, p. 934.
The author proposes the following classification:—
I. Heterotopic tumours.
1. Tumours of the cranio-pharyngeal duct.
2. Teratomata.
II. Homoiotopic tumours.
1. Epithelial tumours :
(a) From anterior Cubic cell adenoma.
lobe {Round cell adenomo.
' (Combined | Carcinoma .
( b ) From pars intermedia J
2. Tumours developed from connective tissue:
(a) From anterior lobe and pars intermedia|sarcoma.
(b) From posterior lobe. Glioma.
3 Mixed tumours. Fibro-adenoma.
This is followed by a brief explanation of the above classification.
A. Ninian Bruce.
ABSTRACTS
483
CLINICAL NEUROLOGY
THE OCCURRENCE OF ANKLE-CLONUS WITHOUT OROS8
(432) DISEASES OF THE CENTRAL NERVOUS SYSTEM. W.
Tzleston, Amer. Joum. Med. Set., 1913, cxlvi., p. 1.
Tileston reviews the literature, and records four personal cases.
1. Girl, aged 14 years. Septicaemia following sinus thrombosis,
marked ankle- and jaw-clonus. Post mortem, no meningitis nor
gross lesions of central nervous system, moderate degenerative
changes in pons, and small foci of myelitis not involving pyramidal
tracts.
2. Girl, aged 8 years. Severe typhoid fever. Profuse intestinal
haemorrhage on twenty-fifth day, followed by marked ankle-clonus
lasting for five days.
3. Girl, aged 15, in last stage of phthisis, ankle-clonus five days
before death.
4. Girl, aged 17, in third stage of phthisis, ankle-clonus six weeks
before death.
Tileston’s conclusions are as follows:—
1. True ankle-clonus may be found in (a) acute infectious
diseases, especially typhoid. (6) Chronio infections, especially
pulmonary tuberculosis in the third stage. ( c ) Uraemia shortly
before and during the seizure, (d) Epilepsy immediately after
the convulsion, (e) Intoxication from certain drugs, eg., hyoscine,
ether, and chloroform. (/) Excessive fatigue, (g) Exceptional
cases of certain neuroses, viz., neurasthenia, hysteria, and paralysis
agitans. (A) Psychoses in the stage of excitement, (i) Chronic
articular rheumatism.
2. With the exception of joint disease, in which a constant
spinal irritation from the inflamed joints is the probable cause,
a toxic action on the nervous system is probably the underlying
factor in the production of clonus.
3. In two autopsies on cases of phthisis with clonus, no changes
were found in the central nervous system. In the writer’s case,
however, inflammatory exudate was found about the posterior
median artery in the posterior septum of the bulb.
4. Clonus due to a toxic state can usually be distinguished
from that due to organic disease by the absence of spasticity, and
of the Babinski and Oppenheim signs, except after the medicinal
use of hyoscine, and immediately after an epileptic attack, when
the Babinski and Oppenheim signs are present.
484
ABSTRACTS
5. The occurrence of ankle-clonus is of prognostic value in
uraemia, preceding at times the acute seizure ( v . Review, 1909,
vii., p. 783). Ankle-clonus usually disappears a few days before
death, otherwise its disappearance indicates improvement in the
patient’s condition. 3. D. Rolleston.
ACUTE ATAXIA WITH RAPID RECOVERY. (Sur un cas d’ataxie
(433) alguS avec guErison rapid©.) Rispal and Pujol (Toulouse), Gaz.
d. H6p., 1913, lxxxvi., p. 901.
A woman, aged 23, with a neuropathic heredity and personal
temperament, after an acute infection of uncertain nature, developed
marked ataxia of all four limbs, scanning and explosive speech,
and intention tremors. The intelligence and sphincters remained
intact. There was no disturbance of subjective sensibility, but
pressure of the muscles was painfuL Adiadocokinesis was present.
The knee jerks were exaggerated, and the abdominal and anal
reflexes lost. Sense organs normal. After lasting for about ten
days the symptoms rapidly improved. J. D. Rolleston.
THE REBOUNDING PUPIL. Frank R. Fry, Joum. New. and Menu
(434) Die., 1913, xL, July, p. 437.
A pupil which contracts to light, and promptly dilates or rebounds
to a position which is steadily maintained without alteration in
the light stimulus, has, along with other abnormal pupillary
reactions, a confirmatory value, and should always be noted.
D. K. Henderson.
ON THE VARIOUS CLINICAL EVOLUTIONS OF TOXIINFEC
(435) TIVE MYELITIS. (Sur les Evolutions cliniques diverges dee
myElites toxi-infectieuses.) Bernhkim, Rev. de mid., 1912, xxxii.,
p. 1.
Bernheim shows that the field of toxi-infective myelitis is much
larger than is supposed. The condition may be latent during life,
and only be revealed post mortem by histological examination of
the cord Sometimes it is manifested only by slight symptoms,
such as exaggeration of the reflexes, the presence of Babinski’s
sign, numbness, and weakness. In other cases the myelitis is
well marked, but abortive, and clears off rapidly. On the other
hand it may be prolonged, and take on the form of diffuse
myelitis, combined sclerosis, or disseminated sclerosis; but in
spite of these alarming symptoms which may persist for months
or years, recovery takes place either completely or with certain
residues. The course of the myelitis may be marked by acute
ABSTRACTS
435
attacks, separated from one another by intervals ranging from
weeks to years, and end in partial recovery or finally prove fatal.
Cerebral, cerebellar, or neuritic symptoms may be associated with
those of myelitis. This great variability in the evolution of the
various forms of myelitis is characteristic of toxi-infection.
Illustrative cases are given of typhoid fever, pneumonia,
influenza, miliary tuberculosis, and neurasthenia.
J. D. Rolleston.
ZOSTER OF THE INFERIOR MAXILLARY NERVE. (Zona de la
(436) 3* branche dn trijume&u (nerf maxillaire inWrieur).) H. K.
Sermaks£chian, Theses de Paris, 1912-13, No. 409.
The thesis contains references to twenty-six cases, including an
original one. The writer’s conclusions are as follows:—
1. Zoster of the inferior maxillary nerve is relatively rare, and *
may be observed at any age. (a) The inferior maxillary nerve
may be affected as a whole, or only in part. (5) Zoster of the
inferior maxillary nerve may form part of the herpes zoster of
the fifth nerve, when the latter is affected as a whole, (c) Zoster
of the inferior maxillary nerves may coexist with zoster affecting
the neighbouring nerves.
2. The principal causes appear to be trauma, intoxications, and
especially general infections, specific or otherwise.
3. The nerve changes may be situated in the brain, the cranial
ganglia and roots, or in the peripheral nerves.
4. The neuralgic pains, and especially the localisation of the
eruption with or without constitutional symptoms, are the principal
elements in diagnosis.
5. The most frequent complications are facial paralysis and
ear troubles (inflammation of the external auditory meatus, leading
to perforation of the drum and deafness), which may be transitory
or persistent. J. D. Rolleston.
BLOOD-VESSEL CHANGES CONSEQUENT ON NERVOUS LESIONS.
(437) T. Wingate Todd, Joum. Nerv. and MetU. Dis n 1913, xl., July,
p. 439.
In this article clinical and experimental evidence is brought
forward to prove that obliterative changes, occurring in blood vessels
by means of hypertrophy and hyperplasia of the several coats,
more especially the media and intima, are occasioned by a loss of
trophic control evidenced by a lesion of the vascular nerves. Such
changes in the blood vessels are the exciting cause of trophic lesions
of the skin and deeper tissues, and are seen in some cases of so-
called cervical rib (v. p. 431). I>. K. Henderson.
486
ABSTRACTS
DI80U88ION ON CERVICAL RIBS—
( 438 ) The Anatomy of Cervical Riba. F. W. Jones.
Surgical Treatment. W. Thorbubn.
Some Points in the Surgery of Cervical Ribs. P. Sargent.
The Results of Operative Treatment C. M. Hinds Howell.
Some Points in the Symptomatology of Cervical Ribs, with
especial Reference to Muscular Wasting. S. A Kirhise
Wilson.
Proc. Roy. Soc. Med. , 1913, vi., March (Clin. Sect.), pp. 95*141.
In the first paper it is pointed out that there seems to be an
antagonism between the formation of a nerve plexus for the supply
of the limb and the development of ribs in that region from which
the nerves are derived. This antagonism is manifested in the
bony elements by the pressure marks stamped by the nerves upon
the developing bone. The brachial plexus is subject to many
variations, but in a typical plexus a portion of the first thoracic
nerve ascends within the thorax to pass out over the first rib with
the brachial plexus, causing the sulcus sicbclavue. If this nerve be
large, the tension between the lowest cord and the first rib increases,
and may cause such symptoms as are usually ascribed to the
presence of a cervical rib. Should the second thoracic nerve be
added to the plexus, the antagonism between nerve and rib element
may lead to a curtailment of the first rib, which then presents
characters surprisingly like those seen in a case of developed
cervical rib. Just as varying grades of imperfection of development
of the first thoracic rib are the outcomes of varying degrees of
post-fixation of the plexus, so the varying grades of perfection in
the development of a cervical rib are the outcomes of varying
degrees of prefixation of the plexus. When the development
of the costal process is in excess of the plexus alteration, strain is
produced and the symptoms, motor, sensory, and vascular, are
developed, the result of pressure upon the lowest cord of the
plexus. As growth proceeds the shoulders drop back, especially
in women, and the greater the drop of the arm relative to the
highest rib, the greater the tension between the lowest cord of the
plexus and that rib, a symptom which will be relieved by a
deliberate elevation of the shoulder-girdle. A patient with
cervical ribs thus tends to select a position which will raise the
shoulder of the affected arm as far as possible, e.g., the shoulders
may be hunched up almost to the ears, and it is also to be noted
that the patient lies on the painful side, while in most other
painful conditions of the arm they lie on the sound side.
Mr Thorburn gave results of operation in 20 cases. Pain
was present in all; it was completely cured in 12, relieved in 3,
and 5 were lost sight of. Paralysis was noted in 12; it was cured
in 5, greatly relieved in 5, and 2 were not traced. Atrophy of the
ABSTKACTS
487
hand muscles was improved. Tactile anaesthesia could always be
cured. Sense of coldness was apt to remain. In two cases he pro¬
duced a transient paralysis of the brachial plexus of only a few
days’ duration. In 1 case the suprascapular nerve was injured,
but recovered in three months, and in 2 cases the pleura was
opened, causing symptoms for ten and fourteen days respectively.
Mr Sargent summarised 34 operations in 29 patients, 26 of
whom were females. The average age was 38.7 years. The first
symptom noticed was pain in 17, numbness in 5, clumsiness in the
fingers in 3, and swelling or coldness of the hand in 4. The
average length of time between the onset of symptoms and the
operation was over three years. The symptoms for which the
patient sought relief were: pain alone, 4; pain and wasting, 9;
pain and numbness, 6; wasting and numbness, 5; and wasting
alone, 5. In every case the abnormal ribs were bilateral, though
rarely symmetrical. The immediate result of operation had been
bad in 2 cases, one developing paralysis of the upper limb and
the other a hysterical monoplegia. A few showed a transient
numbness, the greater number being cured.
Dr Hinds Howell tabulates the results of 30 operations, and
concludes as follows: “In a large proportion of cases some
symptoms, such as pain and weakness in the arm, may be
expected to follow the operation, but not to last more than three
months or so. The vasomotor symptoms, which are present in
almost all the cases, will be certainly improved, and in the majority
of cases pain will be relieved or cured. With regard to muscular
weakness and atrophy, the expectation is that the operation, if it
is not too long delayed, will greatly improve this condition.
There is not, as a rule, complete restoration of the wasted muscles,
nor complete recovery from the vasomotor disturbance.”
Dr S. A. Kinnier Wilson discussed the symptomatology of
cervical rib, especially with regard to the motor and sensory
symptoms. Sensory symptoms may be classified as subjective
and objective. They consist of tingling, numbness, pins and
needles, usually unilateral, and referred mostly to the ulnar or
radial side of the hand rather than to all the fingers. Pain is
usually felt only in the forearm, hand, or fingers, and mostly
radiates downwards. Loss or diminution of sensibility never
exactly harmonises with a root supply. There are two main types
of muscular involvement. The first or “ median type ” is very
frequent. The abductor pollicis and opponens pollicis alone are
involved, all the other thenar muscles, including the flexor brevis
pollicis, being intact. All these three muscles are supplied by the
median nerve, and thus this condition strongly suggests that the
first two muscles get their root supply from the seventh cervical
and the flexor brevis from the eighth cervical. The wasting is
488
ABSTRACTS
often so profound in these two muscles that it is difficult to account
for it merely as an example of the special proclivity for abductor
muscles to be paralysed before adductor, as pointed out by Ferrier.
This condition is to l>e contrasted with the global atrophy in
progressive muscular atrophy. The other type of muscular atrophy
corresponds roughly to the ulnar distribution, i.e., general wasting
of the interossei and an approximation to the main en giiffe.
A. Ninian Bruce.
PARALYSIS OF THE 8ERRATU8 MAGNUS. R C. Hughes, Proc.
(439) Roy. Soc. Med., 1913, vL, March (Clin. Sect), p. 166.
A few notes on the case of a policeman who was assaulted by five
men and thrown against a gate, striking his right shoulder.
A. Ninlan Bruce.
DISCUSSION ON THE ./ETIOLOGY OF UNILATERAL (PARALYSIS
(440) OF THE RECURRENT LARYNGEAL NERVE Opened by
F. de Havilland Hall, Sib David Fbbbikb, and W. Pehmiwan,
Proc. Roy. Soc. Med., 1913, vi., June (Laryngol. Sect), p. 139.
Dr Hall gives the following table, compiled from all the cases of
unilateral laryngeal paralysis which he could find in the Proceed-
inf/s of the Laryngological Society from 1893 to 1907,52 in number,
together with a further series of 64 cases of unilateral re¬
current paralysis which he had observed himself:—
Right. Left.
Aneurysm of arch of aorta - 3 28
„ „ (subclavian) - 1 0
Mitral stenosis and enlarged left auricle * 0 4
Enlarged bronchial and other glands • 1 6
Disease of apex of lung - - -10
Malignant disease of lung • - -08
New growths in thorax - - 0 5
Malignant disease of oesophagus • -98
Thyroid tumours - - - 3 2
Influenza (vocal cord not stated, 1) .20
Diphtheria, lead (one each) - .02
Neuritis - - - - 4 2
Tabes, syringomyelia, disseminated
sclerosis, bulbar paralysis, general
paralysis of insane - - >36
In combination with other paralyses, as
hemiplegia, facial, palate, pharynx,
trapezius, and stemo-mastoid - .64
Doubtful cause • - - - 0 7
(Side not stated, 1)
33
82
Total 116
ABSTRACTS
489
Sir David Ferrier pointed out that the incomplete form of
recurrent laryngeal paralysis is by far the most frequent, and
that the greater vulnerability of the abductor fibres is only an
example of a more general law applicable to extensors in general,
and that he is inclined to adopt the view that the recurrent
laryngeal paralysis usually observable in tabes is of peripheral
origin.
Dr Permewan gives Avellis’ figures published in 1891 from an
analysis of 150 cases, and an analysis of 360 cases reviewed during
the past ten years, using StClair Thomson’s classification, as well
as 63 cases published by Guder and Dufour in 1910. Six cases have
been recorded by Casselberry of unilateral paralysis from cerebral
disease, in spite of the fact that the cerebral localisation of the
laryngeal muscles is bilateral.
Sir Felix Semon gravely doubted whether the laryngeal pheno¬
menon could be claimed as a simple example of Ferrier’s more
general law, although he fully admitted it seemed to fall into line
with it, since (1) while the antagonistic muscles of the limbs
served physiologically equivalent functions, those of the larynx
served two different functions (phonation and respiration), which
were differently represented in the cortex and in the medulla;
(2) after division of the adductor fibres of both recurrents, no
inhibition of the abductors follows stimulation of the cortex as in
genuine antagonistic muscles; and (3) organic progressive disease
always attacks the adductors first, or even alone, whilst in func¬
tional affections the adductors suffered similarly exclusively. He
also thought the question of the origin of tabetic laryngeal paresis
was still quite open. A Ninian Bruce.
ON DEGENERATIONS OF THE SPINAL COED IN PERNICIOUS
(441) ANiEMTA. (Ueber Rttckenmarksdegener&tionen bei pernMtfsar
An&mie.) R. O. Lenel, Arch.f. Psychiat 1913; L, H. 2.
Report of a case which caine to autopsy, with review of the
literature. C. Macpie Campbell.
SYPHILITIC INFECTION FOLLOWED BY LANDRY’S SYNDROME,
(442) AND LATER BY TABES DORSALIS- E. D. Macnamaba,
Lancet , 1913, August 9, p. 385.
The patient contracted syphilis in 1898, and apparently had been
thoroughly treated. In 1904 he developed a flaccid paralysis of
the legs, ascending a few days later to the arms and some of the
muscles supplied by certain cranial nerves. There were no sensory
490
ABSTRACTS
symptoms. The symptoms passed away in the same order as they
arose, and six months later he had practically recovered.
In 1907 he developed a paralysis of his sixth cranial nerve
with diplopia. This disappeared after treatment with pot. iod.
and mercury.
In 1911 he began to suffer from neuralgic pains. His gait was
ataxic, Romberg’s sign was present, the patellar and Achilles jerks
were absent, all forms of sensation in the legs were abolished, and
the pupils were immobile. In 1913 the Wassermann reaction was
found to be positive, and the cerebro-spinal fluid showed a slight
lymphocytosis. This sequence of events appears to be unique.
A. Ninian Bbuce.
SPINAL GLIOSIS AND SYRINGOMYELIA. MASKED INVOLVE-
(443) MENT OF THE CERVICAL CORD WITH DESTRUCTION OF
THE POSTERIOR ROOTS, BUT PRESERVED PUPILLARY
REACTION. GLIA TUFT ON THE FLOOR OF THE FOURTH
VENTRICLE (Gliosis spinalis und Syringomyelic. Starke
Beteiligung des Halsmarkes mit Zerstttnmg der HinterstrSoge
bei erhaltener Pupillenreaktion. Gliastift am Boden des vierten
Ventrikels.) E. Sikmkrlino, Arch, . /. Psychiat ., 1913, L, H. 2.
The clinical report of a case, with complete anatomical examina¬
tion. C. Macfie Campbell
HEREDITARY DEGENERATION AND POST-DIPHTHERITIC
(444) PARALYSIS. (Heredodegeneration und postdiphtherische
LKlunnng. ) H. Bxnkdict, Deut. ZeiUckr. /. Nervenheilh, 1913, xlvi.,
p. 492.
The patient was a boy, aged 16, who presented an enormous
congenital nmvus involving the right side of the thorax and right
upper limb. The area affected corresponded to the lower sixth
cervical and upper sixth dorsal skin segments. The mother had a
rudimentary right pinna and congenital right facial palsy, another
child who had died shortly after birth had had right club foot
and malformation of the spinal cord, and the maternal grandmother
had slight facial asymmetry and convergent right internal
strabismus.
After an ordinary attack of diphtheria the boy, in addition to
palatal and ocular palsies, developed motor and sensory monoplegia
of the right upper limb, which became swollen and cyanotic.
In the lower extremities the knee and ankle jerks were lost, but
there was no paralysis.
ABSTRACTS
491
I
as lirj
d n^f
f. i^
i
pm
,es vrt
ifci $
;ion ft
;; r l»
a4 ; «
j:;e.
SiiS >
[01#
ion or
0
Sait' ,
r/- 6 ,
.li^
t
This is the first case on record of a congenital defect of the
nervous system determining the localisation of diphtheritic paralysis.
J. D. Rolleston.
ENCEPHALO MYELITIS AFTER SMALLPOX, WITH REMARKS
(445) ON DISEASES OF GLANDS OF INTERNAL SECRETION.
(Encephalo myelitis nach Pocken (zugleich ein Beitrag zu den
Erkrankungen derDriisen mit inneren Sekretion).) O. Klienb-
BBRGER, Arch. f. Ptychiat ., 1913,1., S. 632.
The patient was a woman, aged 31, who had had a mild attack of
smallpox in childhood. Four weeks after the onset she had had
sudden paralysis of the right arm and left leg, accompanied by
aphasia. Within seventeen days the aphasia passed off, and there
was gradual improvement in the paralysis, but recovery was
not complete. Seven or eight years later tremors developed in
the right, and subsequently the left arm, leg, and trunk became
similarly affected. Gradual improvement took place. Some years
later the hands began to increase in size and thickness, and the
patient suffered from headache, giddiness, and tinnitus. She also
had a tendency to diarrhoea and sweating, and there was some
exophthalmus.
The paralysis and aphasia are attributed to encephalo-myelitis,
and the tremor and disturbance of growth to secondary hydro¬
cephalus, which, as Goldstein has shown, may produce symptoms of
pituitary disturbance (v. Review , 1911, ix., p. 203). The symptoms
of thyroid involvement were secondary to the pituitary lesions.
J. D. Rolleston.
ACUTE CEREBRO SPINAL MENINGITIS WITH CEREBELLAR
(446) SYNDROME. (Mdningite cdrdbro-spinale aiguS avec syndrome
cdrdbellenx.) Coyon and Joltrain, Paris med., 1912-13, ii., p. 212.
A man, aged 65, was admitted to hospital with cerebro-spinal
meningitis which had developed a week after an injury to the
occiput. Lumbar puncture showed the presence of meningococci.
Some improvement followed injections of anti-meningococcic
serum, but signs of cerebellar involvement set in, shown by vertigo,
titubation, slow and explosive utterance, nystagmus, and cerebellar
catalepsy. Post mortem a purulent exudation was found covering
the pons, inferior surface of the medulla, and the cerebellum.
Histological examination of the cerebellum showed considerable
thickening of the meninges, which were infiltrated with mono¬
nuclears, arteritis, and peri-arteritis, and areas of softening in the
nerve substance. A cerebellar form of cerebro-spinal meningitis
has not hitherto been recorded. J. D. Rolleston.
4^
402
ABSTRACTS
RECOVERY FROM TUBERCULAR MENINGITIS, WITH REPORT
( 447) OF CASES. 11. L. 1‘itkield, Amer. Journ. Med. Set., 1913, cilvi.,
p. 37.
A KKroiM) of u personal case in a man, aged 50, the subject of
pulmonary tuberculosis. Lumbar puncture gave issue to fluid
under pressure containing 3 acid-fust bacilli. No cyto-diagnosis
was made owing to admixture of tbe fluid with blood, and no
animal experiments were carried out. Rapid improvement
followed lumbar puncture, and within two years the patient was
able to resume his work of linen-draper.
Including the present case, Bitfield has collected 29 examples
of undoubted tubercular meningitis in which recovery took place,
and 8 others were doubtful. In 10 the autopsy confirmed the
early diagnosis. In 18 tubercle bacilli were found, and in 5
of these guinea-pig inoculation was positive. In 4 tubercles of
the choroid were seen. In 7 tuberculosis was found elsewhere.
J. D. Rolleston.
TYPHOID MENINGITIS. (Les meningitis dbdrthiennes.) J. Milhit,
(448) La mcdecine tnoderne, 1913, xxii., p. 12.
A fatal case of purulent meningitis in a girl of 8 years arising in
convalescence from typhoid fever. A pure culture of typhoid bacilli
was obtained from the turbid cerebro-spinal fluid during life.
Although more than 60 cases of typhoid meningitis are on
record, Milhit can find only 15 other cases in literature besides
his own in which a pure culture of typhoid bacilli was obtained
during life from the cerebro-spinal fluid. [To these may be
added tbe cases recorded by Lavenson, Henry and Rosenberger
(ILrinn, 1908, vi., p. 597). Schwartz (ib., 1911, ix., p. 31), David
and Speik (ib., 826), and O’t'arroll and Purser (ib., 1912, x., p.446).
—J. T). K.] The term typhoid meningitis should only be applied
to meningeal symptoms due to the typhoid bacillus or its toxins,
and therefore the cases published before the discovery of the
typhoid bacillus must be rejected. When the typhoid bacillus
was first discovered lumbar puncture was unknown, and the
diagnosis of meningitis was only made post mortem. Such cases
are open to criticism, owing to the readiness with which organisms
are diffused throughout the body after death.
Three varieties of typhoid meningitis may be distinguished—
1. Suppurative; 2. Serous; 3. Abortive.
The condition must be distinguished by lumbar puncture from
myelitis, to the occurrence of which in typhoid fever Milhit had
previously drawn attention (v. Review , 1909, vii., p. 661).
J. D. Rollkston.
ABSTRACTS
493
n bemb
iSil tit
I-i £"*
::i 3,
■MS
I
4
|i.i
V
i 1 *" 1
%
i
*
I
l
t
p
)
r J :
»
TRANSITORY CEREBELLO-SPASTIC SYNDROME IN CON-
(449) VALESCENCE FROM TYPHOID FEVER. (Syndrome c6t6-
bello-spasmodique transitoire dans la convalescence d’nne fifevre
typhoids.) E. Bari£ and J. Colombe, Bull, it mim. Soc. mid. Hop.
de Paru, 1913, xxxv., p. 1259.
A woman, aged 35, of nervous disposition, twenty-three days after
her temperature had become normal, presented symptoms of
cerebellar inco-ordination, characterised by intension tremor,
nystagmus, titubation, asynergy, and adiadocokinesis, without
modification of speech, and accompanied by the following spastic
symptoms: exaggeration of knee jerks, ankle-clonus, and peculiar
gait. The spastic phenomena persisted some time, while the
cerebellar symptoms disappeared in a few weeks.
This syndrome is rare, but occasionally occurs in convalescence
from acute infections, such as typhoid fever, pneumonia, diphtheria
(v. Review, 1909, vii., p. 664), measles, or malaria. It belongs to
the group of cases entitled acute ataxia, of which Leydon (1868)
and Westphal (1872) reported the first examples. Acute ataxia
bears a certain resemblance to multiple sclerosis, but improvement
and recovery occur within a few weeks or months. Possibly acute
ataxia may be the first stage of multiple sclerosis, but hitherto no
progressive case has been published. J. D. Rolleston.
MYELITIS FOLLOWING TYPHOID FEVER IN A CHILD. (Mytflite
(450) mltatyphique chez un enfant de quatre ans.) J. Renault and
P. P. L£vy, Bull, et mim. Soc. mid. H6p. de Paris , 1913, xxxvi.,
p. 80.
A boy, aged 4i, who had had typhoid fever a month previously,
was admitted to hospital with paraplegia. The various segments
of the lower limbs showed extreme contracture, the knee and ankle
jerks were exaggerated, Babinski’s sign was present, and there was
incontinence of urine and f races. No marked sensory disturbance.
Cerebro-spinal fluid normal. Wassermann negative. Under careful
nursing complete recovery took place within three months, though
typhoid bacilli were still present in the urine three months after
the onset of the infection. The possibility of subsequent spinal
cord sclerosis is mentioned (cf. Review, 1909, vii., p. 661).
J. D. Rolleston.
BULBAR PARALYSIS IN TYPHOID FEVER. R. Fitz, F. G.
(451) Brioham, and J. J. Minot, Boston Med. and Surg. Joum., 1913,
i., p. 957.
A previously healthy man, aged 40, was suddenly seized with
fever, difficulty in swallowing, and weakness of the legs. He died
i
494
ABSTRACTS
eight days from the onset with symptoms of bulbar palsy. The
course of the paralysis was diffuse, not typically ascending or
descending.
Post mortem typical lesions of early typhoid fever were found
in the small intestine, and typhoid bacilli were found in cultures
from the spleen. Sections of the brain and cord showed nothing
remarkable.
The literature shows that acute bulbar paralysis may occur as
a rare complication of typhoid fever. There are 12 such cases on
record occurring in adults. In 8 the symptoms developed at the
height of the disease, and in 4 after convalescence had begun. In
2 the disease started suddenly with a chill and various nervous
manifestations. Eight died.
Of 5 cases submitted to thorough histological and bacterio¬
logical study, 2 showed nothing abnormal in the brain or cord,
1 showed atrophic changes in various peripheral nerves, 1 had
microscopical haemorrhages at different levels of the medulla and
brain, 2 showed positive bacteriological findings. From the
brain and cord of one, typhoid bacilli were recovered; from the
other an unidentified coccus.
The condition may therefore exist without evident tissue
change in the nervous system, or be due to peripheral nerve
lesions or to a hemorrhagic encephalitis, or finally to the presence
of organisms in the brain, whether typhoid bacilli or secondary
invaders. J. D. Rolleston.
NEUROMA CUTIS (DOLOROSUM). M. L. Heidingsfeld, Joum.
(452) Amer. Med. Assoc., 1913, Ixi., August 9, p. 405.
A neuroma cutis implies some form of new growth in the skin,
multiple or single, situated intimately in the skin, and containing
new nerve elements. They are the seat of very severe paroxysmal
pain of both spontaneous and secondary character, and are to be
distinguished from amputation neuromas, neurofibromatosis, and
other growths arising from subcutaneous nerves.
Only two well-defined cases have l>een reported so far, one by
Duhring in 1873, involving the left arm and shoulder in a man
aged 70, aud one by Kosinski in 1874, involving the right thigh
and buttock in a man aged 30.
The case here reported occurred in a man aged 50, and
consisted of a small purplish-red nodule about the size of a split
pea on the inner side of the right thigh four inches above the
knee. It developed twenty-five years ago following a slight
injury. It soon became the seat of severe paroxysmal pain, later
almost inducing syncope.
ABSTRACTS
495
On microscopic examination the tumour was considered to be
a neuro-endothelioma of amyelinic type. Such cases are to be
carefully distinguished from myoma cutis, of which fourteen cases
have thus far been recorded. A. Ninian Bruce.
CEREBRAL COMPLICATIONS IN PNEUMONIA C. F. Withington,
(453) Boston Med. and Surg. Joum., 1913, i, p. 945.
Withington examined the records of 7,600 pneumonia cases at
the Boston City Hospital, and found the following cerebral com¬
plications : 21 cases of meningitis (of which 5 were confirmed by
autopsy and 2 by lumbar puncture), 4 of embolism, 2 of thrombosis,
1 of softening, 3 of abscess, 2 of oedema, 2 of hemiplegia, and 1 of
transient aphasia. The diagnosis of encephalitis had not been
made.
He also records a case of right hemiplegia with aphasia which
ended in complete recovery within two months, being probably of
toxic origin, with little or no destruction of brain tissue. A review
of the literature is given. J. D. Rolleston.
THE EARLY SYMPTOMS OF ARTERIO SCLEROTIC BRAIN DIS
(454) ORDER. (Die Friihsymptome der arteriosklerotischen Gehirner-
krankung.) Raecke, Arch . f . Psychiat ., 1913,1., H. 2.
The author calls attention to the early insomnia, headache,
dizziness, paresthesias, tremor, subjective sounds in the ears, tran¬
sitory focal symptoms, occasional heaviness of the limbs, and altera¬
tions in writing. The subjective complaint of memory defect is an
early symptom at a period when the defect cannot be objectively
determined. A definite diagnosis of early cerebral arterio-sclerosis
cannot be made on the ground of the mental changes alone. The
neurological picture is the only trustworthy criterion.
C. Macfie Campbell.
TWO CASES OF CIRCULATORY DISTURBANCE OF THE
(455) BRAIN. C. Eugene Riggs and E. M. Hammes, Jour. Atner. Med.
Assoc., 1913, lxi., July 26, p. 257.
The first case was one of thrombosis of the posterior inferior
cerebellar artery ( v. Review, 1913, xi., p. 441) in a man aged
47. His symptoms were severe occipital headache for four years,
more marked in the recumbent posture; sudden attack of vertigo
and diplopia, followed five days later by an attack of staggering,
496
ABSTRACTS
hoarseness, difficulty in swallowing, and impaired pain and
temperature sense over the right face and left extremities.
Wassermann reaction in blood negative, blood pressure 138 mm.,
and urine loaded with sugar. Six months later a mild similar
attack occurred. With rest in bed and potassium iodide he made
a practical recovery except for sensory involvement of right face,
a feeling of tightness in the throat, and persistent glycosuria.
The second case was a ruptured cerebral aneurism in a woman,
aged 44, who, without any previous symptoms, suddenly fell
downstairs, but with help was able to walk upstairs again. A
restless, delirious state developed, and she died six hours later
during the process of a lumbar puncture, where apparently pure
blood was drawn off. A small ruptured aneurism about the size
of a hazel nut was found near the bifurcation of the left posterior
cerebral and posterior communicating arteries.
An abstract of the discussion on these two cases follows.
A. Ninian Bruce.
A CASE OF “ IDIOPATHIC ” CEREBRAL ABSCESS. John
(466) Henderson, Lancet , 1913, May 31, p. 1625.
The patient was a healthy school boy, aged 13, who wakened one
morning complaining of severe headache. A convulsion lasting
thirty minutes followed this, seven others occurring during the
day. Next day he had another convulsion, and cerebro-spinal
meningitis was suspected, but next day he was perfectly well, and
lumbar puncture gave a negative result.
For the next six months he suffered off and on from headaches,
always frontal, and becoming steadily worse. Then fits of vomiting,
without definite food relation, occurred three or four times a day,
and he began to suffer from sleeplessness and constant headache.
The temperature was normal, but Kernig’s sign was present with
some rigidity of the neck muscles, retracted abdomen, and a well-
marked tache e^rdbrale, but he could understand all that was said
to him, and could recognise and speak to friends. He died
somewhat suddenly.
At the autopsy a large thin-walled cyst was found in the left
lower parietal region. This proved to be an abscess which had
extended inwards, and ruptured into the ventricle The middle
ears and all the internal organs were healthy.
As there was no evidence of the origin of infection, the case
is considered as “ idiopathic,” although it is suggested that it may
have been related to cerebro-spinal meningitis. Unfortunately
the identity of the organism does not appear to have been
established. A. Ninian Bruce.
ABSTRACTS
497
RECKLINGHAUSEN’S DISEASE AND THE SUPRARENALS.
(457) (Maladie de Recklinghausen et capsules surrtaales.) I. Bosquet,
' Echo mid. du Nord, 1913, xvii., p. 329-
A record of seven cases from literature in which symptoms of
suprarenal insufficiency occurred in Recklinghausen’s disease,
including the following personal case. Man, aged 4G. General
neurofibromatosis, bronze colour of skin resembling Addison’s
disease, low grade of intelligence, sexual frigidity, marked
anorexia, profound asthenia, and pains in limbs.
J. D. Rolleston.
MULTIPLE CONGENITAL OSTEOCHONDROMATA, WITH DE-
(458) GENERATION OF CRANIAL NERVES. T. R. Booos, Johns
Hopkins Med. Bull., 1913, xxiv., p. 210.
A report of a case in a man, aged 23, whose father had had
“ lumps in the legs.” Double optic atrophy was present, and the
acoustic nerves were completely degenerated, but the vestibular
nerves were intact. The thyroid was atrophied. The issue of
the case is not recorded. J. D. Rolleston.
INTRACRANIAL DIVISION OF THE AUDITORY NERVE FOR
(459) PERSISTENT TINNITUS. Charles H. Frazier, Joum. Amer.
Med. Assoc., 1913, lxi., August 2, p. 327.
Up to the present time surgical therapy has been applicable to the
treatment of functional disturbances in only three of the cranial
nerves—the trigeminal, facial, and auditory—and of these the last
is the latest to be brought within the scope of such treatment.
The above operation is indicated in cases of vertigo and tinnitus
combined, and especially in persistent and intractable tinnitus
which is so severe as to be the cause of serious mental disturbance.
The most promising cases are those with loss of air conduction and
preservation of bone conduction, with definite cochlear lesions in
which the tinnitus is low-pitched. The resulting deafness is not a
serious objection as the patient is usually already deaf on the
affected side.
A case is recorded in a man aged 34 who developed persistent
tinnitus, impairment of sensation in the distribution of the fifth
nerve, and complete loss of vision on the same side following a
fracture of the base of the skull, the result of his being struck on
the head by a falling limb of a tree. As his general health was
liecoming impaired by the tinnitus, his eighth nerve was divided
intraeranially, and he was completely cured. The steps of the
operation are briefly described. A. Ninian Bruce.
498
ABSTRACTS
FUNCTIONAL APHASIA. Hector Mackenzie, Proc. Roy. Soc. Afed .,
(460) 1913, vi., June (Clin. Sect), p. 220.
The patient was a woman, aged 35, who developed complete motor
aphasia a few days after her husband was seized with a right¬
sided hemiplegia and motor aphasia. She was able to speak
normally a few days later, when a second attack, also complete,
developed. This soon passed off. On eight or nine previous
occasions she had similarly been aphasic, but never for more than
a few hours at a time, and always occurring after some special
worry. The Wassermann reaction was not investigated, but she
had had three miscarriages. A. N inian Bruce.
OCCUPATIONAL BRASS POISONING: BRASS-FOUNDER S AGUR
(461) Emery R. Hayhurst, Amer. Joum. Med. Sc., 1913, cxlv., May.
Brass poisoning may be narrowed down to those exposed to
the inhalation of fumes arising from molten biass within the brass
foundry. It may be defined as an acute malaria-like syndrome of
chill, fever (sometimes), and sweat, appearing a few hours after
the inhalation, for a few minutes or longer, of the vapours or
fumes arising from molten brass, or from the fumes of pure zinc
alone, affecting only or mostly those unaccustomed to such ex¬
posure. The symptoms set in with a dry, parched throat, an
irritating and unproductive cough, a metallic taste, a feeling of
constriction in the chest, lassitude, more or less anorexia, followed
occasionally by nausea and sometimes emesis.
The chills rapidly increase into a distinct rigor which no
amount of external heat appears to lessen. The patient feels
deathly sick. These symptoms end almost by crisis, and are
followed at once by a most profuse perspiration.
The results of an investigation of the hygienic and working
conditions in eighty-nine brass foundries and three zinc smelters
in Chicago are reported. D. K. Henderson.
ABSENCE OF THE ABDOMINAL REFLEX IN CHRONIC
(462) ALCOHOLISM. (Fehlen der Bauchdeckenreflexe bei chronischen
Alkoholismus.) H. Sauer, Deut. Zcitschr. f. Nervenheilk., 1913,
xlvi., p. 229.
Sauer examined 132 patients in St George’s Hospital, Hamburg
—a town in which schnaps drinking Is prevalent—and found in
65 absence of one or more of the six abdominal reflexes (right and
left, upper, middle, and lower); 58 admitted more or less indulgence
in alcohol. In 46 chronic alcoholism could be regarded as the
cause of the absence of the reflexes, and in 19 other diseases were
responsible. In the alcoholic cases there was a constant absence
ABSTRACTS
499
of some or all the abdominal reflexes. Usually their condition
varied, sometimes one and sometimes another being absent.
After a long stay in hospital it was frequent to find that all the
reflexes had returned. In some cases, chiefly patients with
threatening delirium tremens, the reflexes were exaggerated. In
26 of the 48 cases there were other signs of chronic alcoholism,
e.g., neuralgia, tremor of hands and tongue, and hardness of the
calf muscles, but in all the rest there were no symptoms pointing
to alcoholism beyond the absence of the reflexes. Sauer, therefore,
regards the absence of the abdominal reflexes as an important
diagnostic sign of chronic alcoholism. J. D. Rolleston.
A CONTRIBUTION TO THE STUDY OF PELLAGRA IN ENGLAND.
(463) Gubth S. Blandy, Lancet , 1913, clxxxv., Sept. 6, p. 713.
Nine cases of pellagra are here described, all but one occurring
in females. With the exception of one (aged 74), all were in
early middle life, none had lived abroad, none were destitute, and
several had been in the Napsbury Asylum for years. The types
of insanity were: Confusional insanity (3), melancholia (2),
primary dementia (1), chronic mania (1), idiocy (1), and manio-
depressive insanity (1). The eruption was usually worst in July.
The paper concludes with short notes on two further cases.
A. Ninian Bruce.
NOTES OF A CASE OF PELLAGRA J. W. E. Cols, Lancet, 1913,
(464) clxxxv., Sept. 6, p. 717.
This case was that of a woman, aged 25, who developed a typical
rash on the face and hands a few days after her admission to
hospital. The mental state was one resembling katatonic stupor.
At the age of 19 she had an attack of mania, but at that time
exhibited no signs of pellagra. A. Ninian Bruce.
OBSERVATIONS ON THE INTESTINAL BACTERIA IN PELLA-
(465) GRA W. J. MacNeal, Amer. Journ. Med. Sci., 1913, cxlv., June.
Certain bacterial strains were subjected to agglutination tests,
using the blood serum from cases of pellagra, and from normal
individuals. Of 109 different sera from pellagrins, 743 per cent,
gave complete agglutination, 101 per cent, almost complete,
2 7 per cent, marked, 2 8 per cent, slight, and 101 per cent,
negative reactions. The 27 New York controls gave 6 complete
agglutinations, 3 almost complete, 10 marked, 1 slight, 7 negative
reactions. These results are held to be sufficiently important to
stimulate further work along this line. D. K. Henderson.
500
ABSTRACTS
CASE OF MONGOLISM. F. G. Cuookshank, Proc. Roy. Soc. Med.,
(4GG) 1913, vi., June (Sect. Dis. Child.), p. 133.
CASE OF MONGOLIAN IDIOCY. Edmund Cantley, Proc. Roy. Soc.
(4G7) Med., 1913, vi., June (Sect. Dis. Child.), p. 133.
Each author showed one ease, the second 1 K‘in^ characterised by
attacks of rapid breathing, the exact origin of which was uncertain.
The first case was shown to illustrate the point that quite a numlier
of European children, not idiots or imbeciles, exhibited Mongoloid
characteristics. There is a discussion as to how far it is justifiable
to use the term “ Mongoloid.” A. Ninian Bruce.
CARDINAL RICHELIEU’S DISEASE. (La maladie du cardinal
(4G8) Richelieu.) H. Cleu, Rev. de MM ., 1912, xxxii., p. 194.
In this interesting essay, which has been inspired by the paper of
1’oncet and Leriche on Calvin ( v. Review, 1908, vi., p. 437), the
writer shows that Richelieu was throughout life the subject of
tuberculous infection.
The condition w:is latent during childhood, hut iu adolescence
he suffered from prolonged febrile attacks, accompanied by headache
and melancholy, and later in life from Inemorrhoids, rectal fistula,
and chronic rheumatism, followed by an abscess of the arm.
Death took place from pleuro-pneumonia. J. D. Rollestox.
PSYCHIATRY.
ON THE FREQUENCY OF THE WASSERMANN REACTION IN
(469) THE CEREBRO SPINAL FLUID IN GENERAL PARALYSIS
(Zur Frage der H&ufigkeit der Wassermann-Reaktion im Liquor
cerebrospinalis bei Paralyse.) P. Kirchbkro, Arch. /. Psychiat.,
1913,1., H. 3.
The author reports the results of the examination of the blood
serum and cerebro-spinal fluid in 100 cases of general paralysis,
which he examined in the Ehrlich Institute for Experimental
Therapeutics. In 93 cases the blood serum, in 78 the cerebro¬
spinal fluid, was positive. Of the 22 cases with negative findings
in the cerebro-spinal fluid, 50 per cent, were eases of tabo-paresis.
Of the 24 cases of tabo-paresis, 46 per cent, gave a negative
Wasserinann in the cerebro-spinal fluid. Four cases of general
paralysis on the basis of congenital lues gave positive Wasser-
mann both in the blood and in the cerebro-spinal fluid with a
definite pleocytosis. C. Magpie Campbell.
ABSTRACTS
501
GENERAL PARALYSIS WITHOUT REACTION OF THE
(470) CEREBRO SPINAL FLUID. (Paralysie glnlrale sans reaction
du liquids c6phalo-rachidien.) Y. Demolk, Rev. m4d. de la Suisse
rom ., 1913, xzxiii., p. 555.
A well-marked case of general paralysis of six years’ duration
in a man, aged 44, in whom three successive lumbar punctures,
with a month’s interval between each, yielded a normal cell count.
Wassermann’s reaction was positive in the blood, but negative in
the cerebro-spinal fluid. Errors of technique could be excluded.
J. D. Rolleston.
THE SOURCE OF URINARY INDOL-ACETIO ACID IN TWO
(471) DEMENTIA PRJSOOX PATIENTS. Ellison L. Ross, Archives
Int. Med., 1913, xii., August, p. 231.
The author found indol-acetic acid in 21 per cent, of 91 urines
of healthy normal persons. Of 174 urines from dementia prrecox
patients, 48 per cent, contained indol-acetic acid.
The author found in two cases of dementia pnecox in women
that the indol-acetic acid output did not vary directly with any¬
thing, and appears to be more or less constant for each individual.
A. Ninian Bruce.
A PSYCHOSIS FOLLOWING CARBON-MONOXIDE POISONING
(472) WITH COMPLETE RECOVERY. Mary O’Malley, Amtr. Journ.
Med. Sci., 1913, cxlv., June.
A woman, 45 years, was admitted to the Government Hospital for
Insane, Washington, on 10th December 1910.
On 2nd November 1910 she was found in a deep coma, having
been exposed to an escape of illuminating gas. She was removed
to a general hospital, was unconscious for four days, and then
improved so rapidly that on 13th November 1910 she was
discharged as recovered.
A few weeks later, however, it was noticed that she became
dull and forgetful, would have outbursts of laughter without
provocation, lost herself on the streets, and generally behaved in
a very confused way.
On admission to the Government Hospital on 10th December
1910 she was in a semi-stuporous state, and her replies to
questions were usually incorrect and irrational. She was unable
to feed herself, and in addition was unable to carry out the
simplest orders.
Physically the deep reflexes were all exaggerated, a wrist
502
ABSTRACTS
clonus, and the sign of Bahinski were present on both sides.
During her hospital residence she laughed without reason,
she mistook the identity of those around her, and at times
confabulated.
Later, however, she began to show a marked improvement,
reacted normally to her environment, and acquired a good
realisation of her condition. D. K. HENDERSON.
CONTRIBUTIONS TO THE CLINICAL STUDY OF HYSTERICAL
(473) 8ITUATI0N-P8YCH08BS. (BeitrSge ztur intnik hysterischer
Situationspsychosen.) F. Steen, Archiv.f. Ptyckint., 1913, L, H. 3.
The author discusses on the basis of the clinical material of about
40 cases, 31 of which he gives in brief abstract, a group of
psychoses to which he has given the name of hysterical situation-
psychoses. The important factor is that these psychoses appear
to be the definite reaction to a painful situation, the reaction
having much in common with the hysterical mechanism. The
painful situation or difficulty to which the patients reacted con¬
sisted of imprisonment either under suspicion or lxffore or after
the sentence. A good deal of attention has already been given to
prison psychoses, many of which belong to the dementia pnecox
group of psychoses, while others arise on a less definite basis of
degeneracy. The psychoses described by Stern arose also on a
degenerative basis, the heredity of the patients being poor. The
psychoses were not merely to be considered the reaction to a
very emotional situation, because in some cases habitual offenders
showed no evidence of any strong effect. The most important
dynamic factor in the development of the psychoses was apparently
the wish to be sick, this wish having, of course, not to be taken as
a clear and purposeful one, but nevertheless as sufficiently strong
to precipitate the flight into the psychosis. An analysis of the
degenerative basis on which these psychoses arose did not disclose
specific hysterical features, which only occurred in comparatively
few cases. The constitutional basis was very varied. Notwith¬
standing the psychic anomalies of these individuals, it was a
striking fact that in only two had there been any psychosis apart
from a prison situation, and in the two exceptions there were
special etiological factors. From the symptomatic point of view
the psychoses consisted of attacks of excitement or stupor, showing
considerable variety. The diagnosis from catatonic conditions
was not always easy, but the complete absence of prodromal
symptoms is an important differential point. In the stupor of
the situation-psychoses, the patient on the whole has a more
comfortable adaptation than is usually the case in the catatonic.
ABSTRACTS
503
The Ganser symptom may be present in both, but is not quite
identical in the two cases. The transfer of the patient out of the
military or police environment into a civil hospital was of marked
benefit in the case of the hysterical psychosis. The prognosis in
these cases is, on the whole, very good so far as the attack is
concerned, and in none of the author’s cases did deterioration
ensue. The author sums up his conclusions as follows: (1) The
hysterical situation-psychoses frequently occur in persons on arrest
under suspicion. They must be thought of even though the
clinical picture appears to be that of catatonia or an epileptic
psychosis, and even if there have been epileptiform convulsions.
(2) These psychoses develop usually on the ground of a marked
psychopathic constitution. Hysterical antecedents can be com¬
pletely absent. (3) The wish to be sick is an important factor,
as well as the marked emotion associated with the situation.
(4) Symptomologically the most common conditions are the
conditions of stupor or confusion running an acute course; there
are all transitions from slight nan-owing to deep clouding of the
sensorium. Where the course is more protracted there is usually
a great variety in the clinical picture. (5) In the milder forms
an anxious effect is usually dominant. In the delirious forms
reminiscences may be the dominant feature. (6) There is some
amnesia with all except the mildest forms of the psychoses. (7)
In the differential diagnosis from catatonia one must emphasise
the acute attack, the favourable reaction to external surroundings,
the theatrical or affected colouring of the picture, the absence of
disorders of the general well-being, the maintenance of a some¬
what comfortable position even in the stupor. (8) Pure simula¬
tion is improbable even where we meet some rather suspicious
symptoms. A combination of genuine psychotic and simulated
disorders is frequent. The prognosis is extremely good.
C. Macfie Campbell.
THE PSYCHIC ACTION OF MESCALIN, WITH SPECIAL REFER-
(474) ENCE TO THE MECHANISM OF VISUAL HALLUCINATIONS.
A. Knauer and W. J. Maloney, Joum . Nerv . and Ment . Dis .,
1913, xl., July, p. 425.
The authors start from the view-point that to clarify the
symptomatology of psychiatry, psychiatrists should live through
some of the different psychoses, and they accordingly proceeded
to produce in themselves transitory psychoses by means of the
delusional Mexican drug—mescalin.
Altogether twenty-three experiments were made by injecting
the sulphate of mescalin subcutaneously. An intoxication was
usually markedly developed in an hour, and consciousness, during
.'04 ABSTRACTS
this intoxication, remained practically unclouded hut tremendously
limited.
The most remarkable feature of the intoxication was hallucina¬
tions, especially visual. Auditory hallucinations were occasionally
present; sometimes those in the muscular sense sphere were quite
astonishing.
The authors’ experiences have seemed to indicate to them that
live levels may be distinguished in passing from purely objective
imagery to purely objective realisation. They state that all their
hallucinations, no matter how weak, or how strong their imagina¬
tive force, no matter how feeble their development, remained
indubitable hallucinations, and never sank to be merely ideas, the
outcome of a vivid imagination.
They found no indication of the fundamental importance of
sexual experience in the content of their artificial hallucinations
and delusions, even when special means were taken to elicit it.
D. K. Henderson.
TREATMENT.
CASES OF EXOPHTHALMIC GOITRE TREATED BT X-RAYS.
(475) W. M. Kingsbury, Proc. Roy. Soc. Med., 1913, vi., June (Electro-
therap. Sect.), p. 158.
TREATMENT OF EXOPHTHALMIC GOITRE BY X-RAYS. W.
(476) Ironside Bruce, Proc. Roy. Soc. Med., 1913, vi., June (Electro-
therap. Sect.), p. 159.
The first author showed 5 cases which had been treated by
X-rays, all much improved. Two were men and 3 women.
Tachycardia was a prominent symptom in all 5 cases, and
completely passed away in all except 1 case, where it was
greatly reduced.
The second author gave an analysis of 18 cases. Six did
not appear for re-examination Of the remaining 12, 4 were
considered cured, 5—one of which had been operated upon
—were “greatly improved,” and 3 were “improved.” All the
patients expressed themselves as much better, and stated that
their weight had increased. All the cases were treated with the
X-ray tube at a distance of 18 to 12 in. from the skin, the
surrounding part being screened off by a 4-in. thickness of felt.
They had attended two or three times a week for periods varying
up to two years. A. Ninian Bruce.
REVIEWS 505
IRevuews.
IONIC MEDICATION. (The principles of the method and an account
(477) of the clinical results obtained.) H. Lewis Jones. Crown 8vo,
pp. viii. and 151. H. K. Lewis, London, 1913. Pr. 5s. net.
Now that “ionic medication” has taken a definite place in the
treatment of disease, we wish to know next in what conditions
we may expect benefit to result, and in what conditions no benefit
may be looked for. This the author has most successfully attempted
here, and he gives us records of many eases treated by himself
and by others, pointing out its suitability or unsuitability as the
case may be. As a general rule, the best results are got from
superficial affections, although deep-seated conditions may also
react favourably.
He begins by giving us a short description of the principle
of the treatment. This is followed by a chapter on the practical
details and method of applying the electrodes, &c. In general
a solution of a strength of 1 per cent, is suitable for all ionic
applications. The metallic ions mostly used are zinc, copper,
mercury, and silver, and of these the first is the best.
The treatment of neuralgia is discussed in Chapter V. Tri¬
geminal neuralgia yields best to the salicylic ion, although post¬
herpetic cases are less favourable, and are sometimes unaffected.
They may, however, benefit more by quinine ions. Brachial
neuritis usually responds well, but long sittings are required to
ensure a reasonable depth of penetration. The treatment of sciatica
is rendered difficult by the distance of the nerve trunk from the
surface. The best results have been obtained by the use of large
currents and long applications. Gouty neuritis and perineuritis
respond well to the salicylic ion, as also do acute and subacute
rheumatism. Rheumatoid arthritis does not react to this treat¬
ment, or if so, the relief is slight or temporary. Spondylitis
deformans appears to benefit from the salicylic ion, the rigidity
becoming less, and the movement actually returning. Lumbago
usually responds well. The treatment of facial paralysis by
salicylic ionisation is, according to the author, to be preferred to
the ordinary electrical treatment, improvement being more rapid.
The remaining chapters deal with the other conditions which
are suitable for treatment. There is a good index. We might
just refer to the fact that Dr Rows’ name has been accidentally
misspelt on p. 106.
The book is to be strongly recommended to all those interested
in ionic medication, as it gives a short and concise statement of
the main points requiring to be known by anyone who wishes to
understand this increasingly important line of treatment.
506
REVIEWS
PAPERS ON PSYCHO-ANALYSIS. Eknkst Junk.-, ML)., M.K.C.P.
(678) (Lond.), Associate Professor of Psychiatry, University of Toronto. 1
Pp. 432. Bailliere, Tindall, A Cox, Ijondun. l’r. 10s. 6d. net. f
UxriKK this title Professor .Tones has gathered together a book
from a number of papers, the majority of which have already
been published in various psychological journals. The papers, 1
which have been arranged in five groups, give a most interesting I
insight into this important branch of psychiatry, which has been I
largely neglected by British investigators. \
The author, who is one of the foremost exponents of psycho¬
analysis, produces considerable evidence which goes far to prove
how much can he done by careful investigation to elucidate the
nature of those complex mental conflicts in which psychoneuritic
symptoms take their origin.
The chapters on the investigation and treatment by psycho¬
analytical methods are full of interest, and the illustrations of
the way in which these investigations are carried out make the
volume exceedingly helpful in getting an accurate knowledge of
the procedure to adopt.
No work on such a subject would lie complete without
reference to Freud’s important and original investigations, and a
short account is given of that author’s important “Theory of
Sex,” and its application in the determination of neuroses. The
criticisms which have been advanced against Freud’s views are
well dealt with. Another chapter of considerable interest is that
in which the same author's “Theory of Dreams” is discussed.
All who have any interest in psycho-analysis, or who purpose
making a study of this subject, will be well advised to procure
Professor Jones’ book, which we can confidently recommend as a I
clear exposition of this rather complex subject.
BOOKS AND PAMPHLETS RECEIVED.
Dejerine and Gauckler. “ Psychoneuroses and Psychotherapy,” tmna*
lated by Smith Ely Jelliffe. J. B. Lippincott Co., London and Philadelphia,
1913. Pr. $4.00 net.
Lucien, M-, and Parisot, J. “ Glandes Surrdnales et Organes Chroma-
tlines,” 1913, pp. 453 and 100 figs. F. Gittler, Paris. Pr. fr. 14.
Nonne. “Syphilis and the Nervous System,” translated by Charles R
Ball. J. B. Lippincott Co., London and Philadelphia, 1913. Pr. 18s. net,
Pick, Arnold. “Die agrammatischen Sprachstoruogen. Studien xur
psycbologischen Grundlegung der Aphasielehre.” Teil I., 1913. Julius
Springer, Berlin. Pr. M. 14.
Villiger, Emil. “ Brain and Spinal Cord. A manual for the study of
the morphology and fibre-tracts of the central nervous system,” translated
by George A. Piersol from the third German edition. J. B. Lippincott Co.,
London and Philadelphia. Pr., 16s. net
IRevlew
of
IReurologs ant> fltescbtatrs
(Original Hrticles
DIRECT TROCHLEAR AND CROSSED
OCULOMOTOR FIBRES.
By LEONARD J. KIDD, M.D.
1. Preliminary; 2. Embryological Evidence ; 3. Anatomical Evidence;
4. Pathological Evidence; 5. Experimental Evidence; 6. The
Alleged Mechanism of Lateral Conjugate Eye-Movements ; 7. The
Meaning of Direct and Crosssd Fibres in the Fourth and the Third
Cranial Nerves; 8. The Neurology of the Sterno-Mastoid Muscle
in Associated Conjugate Contralateral Eye-Movements; 9. Needed
Experimental Procedures ; 10. Conclusions; 11. References.
1. Preliminary.
Practically all modern observers are agreed that some of the
fibres of the oculomotor nerve rise in cells of the opposite oculo¬
motor nucleus, and there is also incontrovertible evidence that
some fibres of the trochlearis nerve rise in the cells of the homo¬
lateral trochlearis nucleus. Conflicting accounts have been given
of the muscular destination of the crossed oculomotor fibres, none
of which, in my opinion, arrives at the whole truth. Of these
various schemata that of Bernheimer seems to have found most
favour, and it has even found its way into some text-books. But
I shall not waste time by discussing in detail any of these, because
our knowledge of the cortieo-nuclear path shows conclusively that
none of these schemata would be capable of working the various
conjugate eye-movements of mammals as we know them. It will
be best to begin with the embryological evidence which proves
43
LEONARD J. KIDD
no s
the existence of direct trochlear fibres, because the work of Paul
Martin gives us the clue to their understanding, and also to the
meaning of crossed oculomotor fibres. Martin’s work seems to
have entirely escaped the notice of all workers hitherto, with the
shining exception of the professional embryologists.
The view of Gaskell needs no detailed scrutiny: it is ingenious,
erroneous, and, if I may use an Irishism, it was disproved (by Martin
and by Froriep) before it was published. It is to be remembered that
Gaskell accepted the current teaching of his day that all trochlear
fibres are crossed. Professor Arthur Robinson, writing in Morris’
“Anatomy,” 3rd edition, 1902, p. 844, went so far as to write thus:—
“ Gaskell has shown (italics are mine) that this condition has probably
been brought about phylogenetically by the transference of the muscles
which have carried their nerves with them.” But I am glad to find
that Professor Irving Hardesty altex’s this in the 4th edition, Part 3,
p. 963, to the words, “Gaskell has suggested,” a very different
statement, and one which has the advantage of being correct.
2. Embryolooical Evidence.
So long ago as the year 1890 Paul Martin 1 found that in cat
embryos the trochlearis nidulus (embryonic nucleus) sends out its
neuroblasts on the same side, whereas its crossed neuroblasts are later
in appearance. What a comment this is on the erroneous and
really ludicrous dogmatism of the text-books! Not only have we
all been wrong in saying that all trochlear fibres are crossed, but
these crossed fibres are not the primitive ones, although in the
course of phylogenetic development they greatly preponderate in
numbers over the primitive, direct trochlear fibres. Martin found
also that the ventral position of the trochlearis nidulus, which His,
in 1888, described in human embryos, was not the primitive position
in the cat; the neuroblasts in the cat embryo lie at first higher
up the lateral wall of the neural tube, and later migrate to the
ventral position as described by His for the human embryo. The
significance of this fact will be obvious to those readers who are
widely read in the literature of the development of the trochlearis
and oculomotorius nerves. These facts, discovered by Martin in
cat embryos, are of more importance than may appear at the first
sight; for the cat presents in its ontogeny many traces of its
antiquity of origin. Practically all modern palaeontologists and
zoologists tell us that carnivores are descended directly from the
extinct Creodonta, which are known to have been of a very primitive
OCULOMOTOR FIBRES
509
mammalian type. Osborn * states that the creodonta appear first
in the lower (basal) eocene, i.e., just after the age of reptiles.
Soon after Martin made his ever-memorable discovery, Froriep 2
observed in young embryos (16 m.m.), of the elasmobranch, Toi'pedo
ocdlaia, that the trochlearis nerve receives fibres from both
trochlearis niduli.
We may then sum up the evidence, the importance of which
cannot be overrated, by saying that in two vertebrate forms, one
a very ancient one, the other a more modern one which shows,
however, traces in its ontogeny of its ancient origin, we have proof
of the existence of direct trochlear fibres, and of the fact that in
one of them the direct trochlear fibres are the primitive ones.
Although I shall have to refer presently to certain other embryo-
logical studies, it will be more convenient to include them in the
section dealing with anatomical evidence: this applies chiefly to
the third nerve, but also to the fourth. And let us remember that
no embryologist has ever found that crossed oculomotor fibres are
primary: it is as true of the oculomotor nerve as it is of the
trochlear nerve that the direct fibres are primary, the crossed are
secondary: there is, however, one exception to this, I believe, viz.,
in the case of the fibres which the oculomotor nerve sends to the
internal rectus muscle: I shall refer to this question in section 7
of this paper.
3. Anatomical Evidence.
Duval 8 mentions in his second paper, written in 1880, p. 296,
that the idea of a partial decussation of the oculomotor nerve is
an ancient one: thus, this opinion was held as long ago as the
year 1591 by Varolius, and was later supported by Riolan (1649),
Vieussens (1685), and Vicq d’Azyr (1805); but was denied by
Longet (1842). It was revived by Vulpian and Philippeaux(1853)
for mammals, including man. But Gratiolet (1857) failed to
confirm this, as also did von Kolliker in 1868 and Forel in 1877.
Duval and Laborde 4 state that, in 1877, in studying longitudinal
sections of the pons and bulb of a cat, they were struck by the
presence of some nerve-bundles which seemed to establish a crossed
connection between the nerve of the sixth pair with that of the
third pair. Duval concluded, from his studies in the chick and in
# “The Age of Mammals/’ by H. F. Osborn, New York, 1910 (the Macmillan
Company).
510
LEONARD J. KIDD
man, that the third nerve presents no decussation; yet he held
that it contains some crossed fibres which enter it from the contra¬
lateral sixth nucleus by way of the posterior longitudinal bundle.
Duval and Laborde described in the monkey fibres passing
from the sixth nucleus towards the third nerves, and also others
which go to the fourth nerves. But their work is not at all
convincing.
Perlia 6 (1889) found a partial crossing of the fibres of the
third nerve in all the mammals which he examined, viz., in calf,
pig, sheep, and mouse; also in chick and in frog.
von KOlliker 6 (1892) found a similar partial crossingin the
oculomotor nerve in a human embryo and also in the adult: these
crossed fibres come from the dorsal part of the opposite oculomotor
nucleus; but he could not exclude the possibility that some crossed
fibres may also come from the ventral part of that nucleus.
van Gehuciiten 7 (1892), working by the Golgi method in an
embryo of the duck of fourteen days’ incubation (he studied chick
embryos also), found some crossed fibres in the oculomotor nerves.
These are very clearly figured: they rise in both the ventral
and the dorsal parts of the opposite oculomotor nucleus, and pass
out chiefly in the median part of the oculomotor nerve.
Edinger 8 (1893) described crossed fibres in the human oculo¬
motor nerve, coming from the dorsal part of the hinder part of
the contralateral oculomotor nucleus.
Obersteiner • (1892) found essentially the same facts as
Edinger.
. von Bechterew 10 (1897) found a few crossed fibres in the
oculomotor nerve of a human embryo, coming from the dorsal
part of the caudal end of the opposite oculomotor nucleus.
Franz 11 (1911) found that in all the bony fishes which he
examined, amounting to a dozen or more varieties, the oculomotorins
root-bundles are partly crossed: in one only, Rromlus volitans, was
the crossed bundle very small.
We have, then, anatomical evidence of the existence of crossed
oculomotor fibres in fishes, amphibia, birds, and mammals up to
man; and it is important to note that these have been traced to
the contralateral oculomotor nucleus by von Kolliker, van
Gehuchten, Edinger, and Obersteiner.
Obersteiner® (1892) describes some fibres of the trochlearia
nerve as passing ventralwards in traversing the posterior longi-
OCULOMOTOR FIBRES
511
tudinal bundle: he thought that a certain number of these fibres
curve back to join the homolateral trochlearis nerve, whilst the
majority pass across the raphe. But von Bechterew 10 (1897)
failed to demonstrate the existence of any direct trochlear fibres,
as also did Cajal 12 (1900) in rat, rabbit, and cat; Bemheimer 18
also failed in a human embryo.
Franz 11 (1911) describes and figures both crossed and uncrossed
trochlearis roots in bony fishes.
McKibben 14 (1913) has carefully studied the eye-muscle nerves
of twenty-five adult specimens of the urodele Nedurus maculosus
by the inira vitam, methylene blue method: he found great varia¬
tions in the trochlearis nerve, even occasionally in a single specimen
on the two sides of the head: its root contains from sixteen to
twenty-four fibres ; out of these fibres from four to eight “ seem to
enter the nerve uncrossed; on careful examination under high
magnification these fibres seem to be larger than those which
make up the trochlear nerve, and to belong to the mesencephalic
root of the trigeminal nerve which lies here beneath the trochlear
nerve.” It seems to me that although these observations are in
some respects very puzzling, yet they may possibly mean that
nedurus has a relatively unusually large number of direct trochlear
fibres: but we cannot at present feel certain on this point. We
must wait for further observations on its trochlearis nerve and its
component fibres. It will be noted that McKibben writes through¬
out with great caution, as the passage quoted by me above shows:
we have to bear in mind also the great variations of the trochlearis
in this amphibian. One point, however, needs mention : we know
that Nedurus shows a very large number of ancient characteristics
in its neurology: one has only to point to the work of Kingsbury,
Julia Platt, Johnston, and many other American comparative
neurologists who have so thoroughly worked out a large part of
the anatomy and development of its nervous system. We should
expect, then, that this very ancient urodele should show a relatively
high proportion of direct trochlear fibres. McKibben points out
that its optic apparatus is poorly developed compared with that of
some other urodeles. On the whole, then, it seems to me to be a
fair provisional conclusion that Nedurus has retained the primitive,
ancestral conditions of its eye-muscle nerves, and represents an
ancient type of vertebrate which has not yet acquired a relatively
large number of crossed trochlear fibres.
512
LEONARD J. KIDD
4. Pathological Evidence.
Sie.merlj.no and Boedekkr 13 (1897) found evidence of the exist¬
ence of crossed oculomotor fibres coining from the ventral cells of
the contralateral oculomotor nucleus. They also found degener¬
ated cells in both trochlearis nuclei in a case where only one
superior oblique muscle of the eyeball was paralysed.
Siemekling and Westnial 1,1 (1891) described the trochlearis
nucleus as composed of two parts, (1) a distal part which alone
gives origin to fibres which cross in the valve of Vieussens, and
(2) a proximal part whose fibres cross the raphe and enter the
contralateral oculomotor nerve!
5. Exi’EUimental Evidence.
The chief experimentalists who have found evidence of the
existence of crossed oculomotor fibres are the following:—
von Gl’DDEN 17 (1881-85), using his own method in newly-born
rabbits, found that the crossed fibres of the oculomotor nerve
come from the cells of the dorsal part of the contralateral oculo¬
motor nucleus, and the direct fibres from the ventral part of the
homolateral oculomotor nucleus.
Si’iTZKA 18 (1885) found evidence of crossed oculomotor fibres
in the cat.
Berniieimei; 13 (1897) found, in the monkey, that crossed
oculomotor fibres come from the caudal part of the contralateral
oculomotor nucleus, and innervate the inferior oblique and the
inferior rectus muscles.
van Gehuchten 7 (1898, 1908) found evidence of crossed
oculomotor fibres in rabbits; in his 1903 paper he speaks of the
great difficulty of performing intra-orbital avulsion of one or other
of the three ocular nerves in the rabbit: he therefore enucleated
the globe of the eye with the soft parts in two rabbits: he found
that crossed oculomotor fibres come from the caudal three-fifths of
the contralateral oculomotor nucleus.
VAN Biervliet 19 (1899) found in rabbits that, after extirpation
of the globe of one eye, chromolysis of some of the cells of the
dorsal part of the caudal three-fifths of the contralateral oculo¬
motor nucleus occurred. He attempted also, in a series of rabbits,
to perform an isolated section of each muscular branch of the
oculomotor nerve on one side; he found that section of the branch
OCULOMOTOR FIBRES
513
to the inferior oblique muscle was very easy, but that of the three
other muscular branches of the oculomotor nerve was much more
difficult. (In the rabbit the branch to the superior rectus ap¬
parently supplies also the levator palpebree superioris muscle.)
His exact mode of operating is described on pp. 20-22 of his paper.
He concluded that the rectus inferior, rectus internus, and obliquus
inferior receive a few crossed fibres; and the superior and levator
palpebree superioris (“probably”) none but crossed fibres. He
mentions that several of his conclusions agree with the earlier
experimental findings of Bach. He also showed incidentally, as
van Gehuchten 7 did in 1898, that the intrinsic muscles of the
eyeball are innervated exclusively by direct fibres from the oculo¬
motor nucleus. In my opinion van Biervliet’s findings must be
regarded with great suspicion, for these reasons:—he says it is
very easy to divide the nerve-branch to the inferior oblique, and
impossible to perform isolated section of the branch to the inferior
rectus, on account of its close proximity to the branch to the
inferior oblique; he therefore contented himself with section of
the nerve-filaments destined for these two muscles. When he
performed this joint section, he found later five or six chromolysed
cells in the contralateral oculomotor nucleus; he had previously
found only one chromolysed cell in that nucleus after isolated
section of the branch to the inferior oblique. One would naturally
have concluded from these two separate findings that both the
inferior oblique and the inferior rectus receive some crossed fibres,
the larger number being received by the inferior rectus. But van
Biervliet writes the following astounding passage: — “ These
(chromolysed) cells appear to us to be exclusively connected with
the inferior oblique. It follows that the fibres which innervate
the rectus inferior are all direct.” I fail entirely to grasp the logic
of this statement, and it is actually contradicted by van Biervliet
himself in his list of conclusions (pp. 28, 29), where he states that
the rectus inferior, rectus internus, and obliquus inferior are in¬
nervated mainly by direct fibres, but apparently also by some
crossed fibres. In addition, as he admits that isolated section of
the nerve-filaments going to the internal, inferior, and superior
recti muscles is very difficult of performance in the rabbit, it seems
a great pity that he omits to say whether the fact of such isolated
section was in each case verified on autopsy.
Bach 20 (1906) performed avulsion of the ocular muscles in
514
LEONARD J. KIDD
rabbits, cats, and monkeys: after keeping his animals for seven
or eight months he found evidence that some of the fibres of the
oculomotor nerve come from the contralateral oculomotor nucleus,
(van Biervliet (1899) had previously objected to the avulsion
method as being liable to cause a lesion of neighbouring nerve-
filaments going to other muscles; and, in connection with Bach’s
earlier experiments, van Biervliet points out that Bach’s method
of dividing the muscle and extirpating only its peripheral part,
while its central part is left intact, is liable to fail to divide all the
nerve-fibres going to the muscle.)
van der Schueren 21 (1909) carried out a very thorough
experimental research on the ocular nerves of the rabbit: he
found that the oculomotor nerve contains some crossed fibres
which come from the caudal three-fifths of the dorsal part of the
contralateral oculomotor nucleus. But he did not experiment on
the question of the exact muscular destinations of these crossed
fibres. On summing up this question, then, we see that there is
a remarkable agreement among experimentalists that the crossed
fibres of the oculomotor nerve come from the dorsal part of the
caudal end of the contralateral oculomotor nucleus. And I shall
show in section 6 of this paper that we have experimental proof
of an overwhelmingly strong character that none of the crossed
fibres of the third nerve come from the cells of the contralateral
sixth nucleus.
Some six experimentalists have attacked the problem of the
exact nuclear origin of all the motor fibres of the fourth cranial
nerve. Two of these observers have established in the clearest
possible fashion the fact that it contains some direct fibres.
von Gudden 17 (1881) found that, after extirpation of the
three eye-muscle nerves of newly-born rabbits, there was complete
atrophy of the contralateral fourth nucleus. He concluded that
all the trochlear fibres are crossed, some of the oculomotor
crossed, and all of the abducens nerve direct.
Bregmann 22 (1892) failed to find evidence of the existence of
direct trochlear fibres.
Bernheimer 13 (1897) found, in the monkey, that all the troch¬
lear fibres are crossed.
van Gehuchten 7 (1898) found that, after section of the
rabbit’s fourth nerve, chromolysis occurred in a few cells of the
liomolateral fourth nucleus. He confirmed the existence of a few
OCULOMOTOR FIBRES 515
direct trochlear fibres in the rabbit in his later and fuller research
in the year 1903.
Bach 20 (1906) described in rabbit, cat, and monkey a certain
number of trochlear fibres as passing forward in the posterior
longitudinal bundle and joining the roots of the oculomotor nerve!
He thought this probably holds good for man as well!
VAN DER Schueren 21 (1909) found that, after rupture of one
trochlear nerve in rabbits, a few cells—a very careful count
showed a dozen—were chromolysed in the homolateral trochlear
nucleus; and a few noi*mal cells were found in the contralateral
trochlear nucleus. He found that the cells which give origin to
the direct trochlear fibres were distributed, without any apparent
order, throughout the whole extent of the trochlear nucleus. His
work, therefore, confirms the previous findings of van Gehuchten
(1898, 1903) that in the rabbit the trochlear nucleus sends a few
direct fibres into the homolateral trochlear nerve.
6. The Alleged Mechanism of Lateral Conjugate
Eye-Movements.
Before I attempt to discuss what I believe to be the meaning
of the presence in the fourth and in the third cranial nerves of
both direct and crossed fibres, it is essential to show that the
widely accepted teaching that lateral conjugate eye-movements
are carried out by virtue of fibres, which the sixth nucleus is
alleged to send to the contralateral third nucleus or root for the
innervation of the internal rectus muscle, is not only erroneous,
but that it has been proved to be erroneous by the sure test of
carefully planned and executed experimentation. The sixth
nucleus theory is at least fifty-five years old, if not more; but it
was brought into prominence by Duval and Laborde 4 in 1880:
they were led to adopt it partly by their own experiments—which
I will mention presently—and partly by Duval’s anatomical
studies mentioned by me in section 3 of this paper: in addition
they were much influenced by certain cases of paralysis of lateral
conjugate eye-movements, with preservation of the power of con¬
vergence. For convenience of description I shall speak of this
sixth nucleus hypothesis as the Duval-Laborde hypothesis.
F£r£ol 28 (1877) recorded a case of loss of lateral conjugate move¬
ments of the eyes to the right, with preservation of convergence.
516
LEONAKD J. KIDD
Autopsy showed a tuberculous focus near the origin of the right sixth
nerve. Fereol, therefore, concluded that “it is possible that the
internal rectus muscle receives its innervation from two sources,
from the third pair for isolated movements (of convergence), and
from the sixth pair of the opposite side for associated and synergic
movements.”
Hughes Bennett and Savill 54 (1889) recorded a case of permanent
conjugate deviation of the eyes and head. They called it “the result
of a lesion limited to the sixth nucleus.” A woman of 67 died three
months after the onset of her first symptoms, and one month after the
sudden onset of her ocular phenomena. On autopsy, a small patch of
softening, measuring about one-tenth of an inch, was found “occupying
the position of the left sixth nucleus and limited to it without apparently
involving the neighbouring structures, such as the facial fibres (Fig. 1).
Otherwise, to the naked eye, the appearances of the pons and medulla
were normal. These, with the cord and other nervous structures, were
reserved for subsequent and more complete examination, but, unfortun¬
ately, owing to a mishap, they were destroyed." . . . “The only
structures which were not lost were the two sixth nerves. Microscopi¬
cally, the right sixth nerve was perfectly healthy. The left, here and
there, showed slight traces of degenerative atrophy.” The worthlessness
of such an imperfect pathological study must be obvious to everyone:
it is the merest assumption on the part of the authors to say that the
lesion was limited to the sixth nucleus : we have no information as to
the presence or absence of degeneration in the posterior longitudinal
bundle. We now know that this bundle contains ascending vestibulo-
ocular fibres, all of which pass up close to the sixth nucleus and some
of them through it. A gross lesion, then, which involves the sixth
nucleus, involves also, of necessity, some of the ascending vestibule-
ocular fibres.
Gee and Tooth 25 (1898) published a case which was carefully
studied pathologically by the Marchi method. It was one of bilateral
loss of lateral conjugate eye-movements in a woman of 21, but loss of
convergence was also present, so that the case does not strictly come
within the category now under consideration. On autopsy, a haemorr¬
hagic focus was found in the pons at about the junction of its middle
and lower third. Almost the whole of the right sixth nucleus was
destroyed; the left sixth nucleus was “ only slightly, if at all, affected,
and probably only by pressure ”; both posterior longitudinal bundles
were degenerated, the right more than the left; “ the cells of the right
fourth nucleus natural, but it is pervaded with degenerated fibres, no
doubt derived from the posterior longitudinal bundle. The third
nucleus is full of degenerated fibres running in every direction.
Among the roots of the third nerve we find a fair number of degenerated
fibres, more on the left side than on the right.” Now this case
obviously lends no real support to the Duval-Laborde hypothesis, as
Gee and Tooth clearly recognised, I think ; thus, they wrote on p. 15:—
“ The connection between the symptoms and the condition of the sixth
nuclei presents certain difficulties. The practically complete destruction
OCULOMOTOR FIBRES
517
of the right sixth nucleus perfectly explains the loss of power of
conjugate deviation to the right. But the patient is noted to have
had equally complete conjugate paralysis of movement to the left,
while the left sixth nucleus is uninjured.” They suggested (in my
opinion quite rightly) that “it may be regarded as possible that a
lesion involving the division of the posterior longitudinal bundle on
both sides would result in paralysis of conjugate deviation on both
sides, even though the sixth nuclei were unaffected.”
Spitzer 26 (1899)* described a typical case of conjugate deviation
of the head and eyes as the result of a tuberculous focus developing
iu the dorsal part of the pons. The tumour occupied especially the
left side: it destroyed the dorsal part of the raphe and part of the
right posterior longitudinal bundle. On the left side it extended to
the nucleus of I)eiters, and ventrally to the superior olive. Above the
level of the tumour the degeneration occupied the ventral and median
part of the posterior longitudinal bundle: it can be followed to the
level of the fourth and the third nuclei: the root-fibres of these nerves
were intact. This case needs no comment, in view of the presence
of degeneration in the posterior longitudinal bundle.
Bruce 27 (1903) studied very carefully, clinically and pathologically,
a case of double paralysis of the lateral conjugate deviation of the eyes,
due to a pontine tumour which occupied the position of the two sixth
nuclei and the two seventh nerves: it extended to the nucleus of
Deiters, but did not destroy it. The tumour involved the left side
of the pons rather more than the right: ascending and descending
degenerations were found in the posterior longitudinal bundle, the
ascending degeneration being very well seen in both bundles. Bruce
concluded that “ it must be admitted as being beyond doubt that the
posterior longitudinal bundle does contain ascending fibres.” A
passage that follows almost immediately (p. 337) has been seriously
misunderstood, I think, by Van der Schueren (1909). Thus the
latter writer 21 quotes Bruce to the effect that:—“ It must be borne in
mind that any ascending degeneration within the upper part of the
posterior longitudinal bundle resulting (from a destructive lesion) t of
the sixth nucleus, must contain fibres which emanate from the nucleus
of Deiters as well as those which originate in the sixth nucleus itself.”
Van der Schueren then goes on to say (p. 151):—“ Bruce, then, seems
to admit that these fibres, rising in the sixth nucleus, terminate in the
cells of origin of the mesencephalic nerves, chiefly the oculomotor.”
But it is evident that Bruce did not blindly accept the Duval-Laborde
hypothesis, but on the contrary approached the problem with a clear
understanding of its nature. Thus he wrote, 27 p. 337, the following
passage in brackets:—“Indeed, a further investigation by means of
Nissl’s method of the condition of the cells of this nucleus (sixth)
after section of the posterior longitudinal bundle between it and the
third nucleus is necessary to determine with absolute certainty whether
* Cited by van der Schueren 21 (1909).
t The words in brackets are omitted by van der Schueren, doubtless by
a slip.
MS
LEONARD J. KIDD
they give rise to any ascending fibres.” I will show presently that
van der Sclmercn himself has performed this very experiment sug¬
gested by Bruce, and has succeeded in proving that the Duval-Laborde
hypothesis is erroneous, so far, at any rate, as the rabbit is concerned.
A very striking case, which I will now mention, proves that it is
erroneous for man also.
Sikmkruno and Bokdkkeb 15 (1897) denied the existence of a
lateral conjugate eve-movement centre in the sixth nucleus. They
recorded a case of bilateral degeneration of the sixth nuclei, in which,
during life, there had Ixx'n no paralysis whatever of the internal recti
muscles. We can no longer, then, hold that in man the sixth nucleus
sends any fibres to the contralateral third nucleus or root for the
conjugate inward movement of the internal rectus muscle in the
associated lateral eye-movements.
Duval and Lakokuk 4 (1880) performed stimulation and de¬
struction experiments in the region of the eminentia teres, chiefly
in dogs, hut also in cats and monkeys: they obtained by these
means various deviations of the eyes. But their experiments
cannot he taken seriously, for they actually believed that their
stimulation and destruction was limited to the sixth nucleus. We
know now, thanks to the labours of many experimenters up to
van der Sclmercn 21 (1918), that ascending vestihulo-ocular fibres
pass up in the posterior longitudinal bundle, some of which pass
through the sixth nucleus. Obviously, therefore, Duval and
Laborde's experimental procedures involved these ascending fibres
as well as the sixth nucleus.
van i*er SciiUEUEN 21 (1909) established the following facts in
rabbits:—(1) After section of the third, fourth, and sixth nerves
on one side he found, a few days later, that there was ehromolysis
of all the cells of the homolateral sixth nucleus, and none whatever
in the contralateral one: it is obvious that, if the sixth nucleus
sent any fibres to the contralateral third nucleus or root, he would
have found ehromolysis of some of the cells of the sixth nucleus
on the side, opposite to his section of the third nerve. (2) Section
of one sixth nerve was followed by ehromolysis of all the cells
of the homolateral sixth nucleus: therefore all the cells of the
sixth nucleus give origin to root-fibres of the homolateral sixth
nerve. (3) He also established the facts that, in the rabbit,
(a) the posterior longitudinal bundle in its course between the
level of the sixth nucleus and the fourth and third nerves contains
ascending fibres which are connected with the cells of the homo-
lateral fourth and third nuclei, and ( b ) that bundle does not contain
OCULOMOTOR FIBRES
519
any fibres which pass into the peripheral part of the fourth or
third nerve of either side, (c) the sixth nucleus sends no fibres
into the posterior longitudinal bundle, and (d) no neurones connect
the sixth nucleus with the fourth and third nuclei. In his recent
paper (1913) on the posterior longitudinal bundle he again proves
the falsehood of the Duval-Laborde hypothesis for the rabbit.
We may sum up the question thus:—(1) In all those cases of
loss of lateral conjugate eye-movement, accompanied by preserva¬
tion of the action* of the contralateral internal rectus muscle in
convergence, which have been carefully examined pathologically,
we find evidence of the presence of degenerated fibres in the
posterior longitudinal bundle; (2) the case of Siemerling and
Boedeker 15 directly negatives the Duval-Laborde hypothesis for
man; (3) experiments show that all the cells of the rabbit’s sixth
nucleus are radicular; it sends no fibres into the posterior longi¬
tudinal bundle to the contralateral oculomotor nucleus or root;
(4) whatever may be the mechanism of the lateral conjugate eye-
movements of man and the rabbit, so far as the brain-stem is
concerned, it is not by means of the Duval-Laborde fibres, for
such fibres have no existence. So long ago as the year 1892, van
Gehuchten 7 expressed the opinion that the posterior longitudinal
bundle seems to be sufficient to carry out the lateral conjugate
eye movements by means of the fibres which pass in that bundle to
the various ocular nuclei. Many other authors have held the
same opinion, and we can have no reasonable doubt that it is the
correct one.
We ought all to grasp the vitally important truth that there
are only two kinds of lesions which can cause effects anatomically
and functionally limited to the cells of the sixth nucleus, viz., (1)
a slow, primary degeneration of its cells, and (2) a retrograde,
secondary degeneration of its cells due to a lesion of the homolateral
sixth root or nerve. All gross lesions, such as tumour, softening,
hamiorrhage, etc., which involve one sixth nucleus, involve also of
necessity some of the ascending vestibulo-ocular fibres. A lesion,
then, which is strictly limited to the cells of one sixth nucleus,
gives exactly the same clinical picture as one which involves the
motor fibres of the sixth root or nerve; but a combined lesion of
the sixth nucleus and the posterior longitudinal bundle gives rise
to loss, or diminution, of lateral conjugate eye-movement to the
side of the involved sixth nucleus, with or without (most com-
520
LEONARD J. KIDD
monly with) preservation of the convergence action of the contra¬
lateral internal rectus muscle. And, finally, let us not forget that,
if the Duval-Laborde hypothesis were true, we should find in every
case of experimental section of one third nerve, and in at any rate
some cases of complete unilateral third nerve paralysis in man, that
autopsy would show the presence of chromolysis in some of the
cells of the contralateral sixth nucleus; but such changes have
never been seen by any experimentalist or pathologist.
«
7. The Meaning of Direct and Crossed Fibres in the
Fourth and the Third Cranial Nerves.
Hitherto the fundamental error has been made of comparing
the fourth nerve with the third nerve; and this, I believe, is the
reason why both nerves have been misunderstood. We can under¬
stand how this mistake came to be made:—Dissection seemed to
show that all the fibres of the third nerve are direct, and all those
of the fourth nerve crossed. Naturally, therefore, descriptive
anatomists seized on this apparent fact and taught that the fourth
cranial nerve differs from all other nerves in being composed
entirely of crossed fibres. Even when more exact methods proved
the existence of direct trochlear and crossed oculomotor fibres,
their meaning was quite misunderstood. Although Paul Martin’s
observations 1 gave all of us the hint twenty-three years ago, they
fell on barren ground, for two reasons:—(1) It is not the
function of the professional embryologist to worry out the clinical
and anatomical bearings of his discoveries; and (2) apparently
clinicians do not, for the most part at any rate, believe that the
study of the literature of comparative neuro-embryology is the
beginning of neurological wisdom. The true comparison is, I
believe, between the fourth nerve and that branch of the third
nerve which supplies the inferior oblique muscle. Probably
almost everyone to-day believes that, although the lateral eyes of
vertebrates are of vast antiquity, they were preceded in pre-
vertebrate ancestors by a series of appendages—about six or seven
—in the anterior region of the head; and the various muscles
innervated by the third nerve belonged originally to many separate
segments. And although I have chosen for this paper the title of
w direct trochlear and crossed oculomotor fibres,” yet for a proper
understanding of the question we need to compare the crossed
OCULOMOTOR FIBRES
521
fibres of the third nerve, not with the direct fibres of the fourth
nerve, but with its crossed fibres. So that the apparently excep¬
tional condition of the fourth nerve was arrived at originally in
ignorance of the fact that all nerve-fibres, with the single excep¬
tion of those to the internal rectus muscle of the eyeball, were
primitively direct.
In the year 1904 I stated 28 the elementary truism that in the
laterally placed lateral eyes of ancestral vertebrates the two
oblique muscles were primitively purely wheel-rotators, and the
upper and lower recti were purely vertical movers of the eyeball.
At a later stage—which may have come quickly—the obliques
and the two recti named received new fibres and new functions
with the rise of inward movements of the eyeballs (strictly of the
comeae, of course); in adduction, then, the obliques became vertical
movers and the two recti wheel-rotators. Now, primitively the
two eyes moved independently of each other, and originally, each
hemisphere governed the movements of the opposite eye: thus the
upper nerve-path was crossed, the lower direct. We must conceive
each separate field of fixation in this primitive animal as divided
at an early stage of its development into a right and left half of
the mid-line of vision of each eye. Probably the earliest possessors
of lateral eyes were relatively defenceless animals, which sought
safety in escape from their overtaking enemies. If that be admitted,
the earliest eye-movements were backward movements performed
by each posterior (external) rectus, aided for upward and back¬
ward movements by the superior rectus and inferior oblique, and
for downward and backward movements by the inferior rectus and
superior oblique. All this was performed by a crossed upper
and a direct lower path. It follows that, as in abduction, the
superior and inferior recti have much greater resistance to over¬
come in producing upward and downward movements than the
obliques have to meet in producing wheel-movements, the number
of direct fibres going to the two former muscles was of necessity
far greater than was needed in the case of the obliques: hence the
obliques received very few direct fibres, and the upper and lower
recti a very much larger number than the obliques. But things
were quite different when this primitive animal began to need
adduction movements of each eyeball: these movements were
really right-sided movements of the left eye and vice versd. It
will be convenient to speak of a muscle as a homonymous muscle
522
LEONARD .T. KIDD
when it carries out a movement on its own side, and heteronymous
when it performs a movement on the opposite side. The upper
nerve-path still remained a crossed one : therefore these adduction
movements of each eye were governed by the homolateral hemi¬
sphere: obviously, therefore, a crossed lower path had to be
evolved in order that these heteronymous muscular actions should
he capable of performance. A little reasoning will show that the
internal rectus muscle received crossed fibres, the two obliques a
very large* accession of crossed fibres, and the upper and lower
recti a very small accession of crossed fibres; the reason for this
was, of course, that in adduction the obliques have to contract
against marked muscular resistance and, therefore, need a large
numl»er of crossed nerve-fibres, whereas the superior and inferior
recti have very little resistance to overcome, and, therefore, need
very few crossed fibres. Of course we all recognise that it is not
easy to understand the exact stages by which the primitive inde¬
pendently acting eyeballs of lower vertebrates arrived at the
conjugated actions of higher forms. But one thing is clear. If
the upper path l>e entirely crossed, the lower path must be double
in the case of the two obliques, and the superior and inferior recti:
otherwise the eye-muscles would not be able to perform the various
eye-movements of mammals as we know them. If, on the other
hand, the upper path l>e double, a single nucleo-nmscular path to
these four muscles is sufficient. With regard to the internal
rectus muscle, we have evidence that it does not receive any
crossed fibres from the contralateral sixth nucleus. I feel con¬
vinced, however, that all its fibres are crossed; and that all its
motor fibres come from cells of the contralateral third nucleus;
my reason for this belief is, that it is entirely a heteronymous
muscle, not only in the action of conjugate lateral eye-movements
to the opposite side, but also in convergence. In the latter act
the left internal rectus performs a right-sided movement, t.«., it
acts as a heteronymous muscle. It is believed that in man the
eortico-nuclear path is entirely crossed: in the act of convergence
then, each hemisphere governs the action of the homolateral
internal rectus muscle by means of the crossed fibres which pass
from the contralateral third nucleus to the muscle just named.
The same thing happens in the actions of convergence below or
above the horizontal plane: in these actions each hemisphere acts
on the superior or the inferior oblique of its own side by means
OCULOMOTOR FIBRES
523
of the crossed fibres which pass to these muscles from the fourth
and the third nucleus respectively.
With regard to the levator palpebne superioris muscle, the
only reason I know of which suggests that it probably receives
some crossed fibres from the contralateral third nucleus is the fact
that electrical stimulation of a small area of the cerebral cortex
gives slight movements of the homolateral eyelids. [I reject van
Biervliet’s finding 10 that all, or nearly all, of the fibres received
by the levator palpebne superioris are crossed, as it seems to me to
amount to an absurdity].
If my reasoning in these matters be sound, the direct and
crossed fibres in the various muscular branches going to the
extrinsic muscles innervated by the third and fourth nerve would
be arranged as follows:—(1) The oblique muscles receive a small
minority of direct, a large majority of crossed fibres; (2) the
superior and inferior recti a large preponderance of direct, a small
minority of crossed fibres; (3) the internal rectus exclusively
crossed fibres from the contralateral third nucleus; (4) the levator
palpebne probably a relatively small number of crossed fibres from
the contralateral third nucleus. In the year 1910 I suggested'•“
that any muscle which receives both direct and crossed motor
nerve-fibres must receive also both direct and crossed muscle-
afferent nerve-fibres. In the case of the muscle-afferents of the
extrinsic muscles supplied by the third and fourth cranial nerves,
one cannot doubt that they are grouped in each nerve-branch in
exactly the same way as the motor fibres: thus, the muscle-
afferents of the obliques are mainly crossed, with a few direct;
those of the internal rectus all crossed; those of the external
rectus all direct, and so on.* Now, it is clear that my views here
offered as to the muscular destinations of the various crossed
fibres of the third nerve are contradicted by all experimenters who
have attempted to solve this difficult question. Yet I quite fail to
see how I can be wrong in this matter. If the upper nerve-path
to the ocular nuclei were double there would be no need—I would
even add no possible use—for any crossed trochlear or crossed
oculomotor fibres. And yet we have evidence of crossed trochlear
fibres even by the simple method of dissection, and of crossed
* At my private suggestion the question of the ganglionic origin of all the
eye-muscle afferente, both the postural and the algetic ones, is being most kindly
taken up experimentally by a physiologist.
44
524
LEONARD J. KIDD
oculomotor roots and fibres in fishes, amphibia, birds, and mammals
up to man. Indeed I feel sure that if a mechanical engineer were
shown a model of the muscular attachments of the eyeballs, and
were told that the upper nerve-path to the nuclei of these muscles
is entirely crossed, he would inevitably come to the conclusions
which I have here offered. I need hardly say that the active
movements of the eyes in the mid-line of vision are carried out
by the simultaneous active innervation of both cerebral hemi¬
spheres ; and, further, in such an act as that of looking downward
and outwards to the right side both hemispheres are acting in the
following way: the left performs the active movements of six
"prime movers” concerned, and the right cortex performs the
active—but less obtrusively active—movements of the six “co¬
operative steadiers.”* It would follow from this that that
cortex which is governing the active movements of the prime
movers does so by means of direct fibres of the contralateral eye,
and by crossed fibres of the homolateral eye. Exactly the opposite
arrangement holds goods for the co-operative steadiers.
I feel convinced that our ignorance of the exact muscular
destinations of the various crossed fibres of the third nerve, and
that ignorance of the fact that the fourth nerve contains some
direct fibres, often leads us astray in diagnosis. A few years ago
I heard a very distinguished ophthalmologist relate the case of a
man who showed an isolated complete paralysis of one superior
oblique muscle, which came on suddenly during a paroxysm of
coughing in pertussis. The surgeon diagnosed a hiemorrhage of
the opposite fourth nucleus. Now, a complete lesion of one fourth
nucleus would give a slight paresis of the homolateral superior
oblique, together with an almost complete paralysis of the contra¬
lateral muscle. There can be no reasonable doubt that in this
patient the hiemorrhage occurred within the sheath of the homo¬
lateral fourth nerve-trunk. I doubt whether there is any region
in the body in which so many erroneous diagnoses are made
as in the case of the ocular nerves and their nuclei. I have
specially noticed, in a long clinical experience, that very young
diagnosticians are very prone to diagnose nuclear lesions; but if
we exclude supra-nuclear lesions, I believe that the vast majority
* I prefer this term to that of “antagonists,” because even the biceps and
triceps cubiti muscles are never antagonistic, except in the case of the malingerer
or the hysterical patient.
OCULOMOTOR FIBRES
525
of ocular palsies are due to radicular or to radiculo-uuelear lesions,
and only a small minority to nuclear lesions. A lesion of one-
third nucleus, if it involves some, or all, of the cells of the dorsal
part of its caudal three-fifths, must of necessity give some crossed
ocular palsies. If we all did a great deal more anatomical thinking
in our clinical work, we should be less ready to diagnose glibly a
third nuclear lesion.
8. The Neurology of the Sterno-Mastoid Muscle in
Associated Conjugate Contralateral Eye-Movements.
In the year 1910 I stated 28 that there were reasons which
suggest that the stemo-mastoid muscle must receive both direct
and crossed nerve-fibres. Some eight or nine years ago I read
somewhere that it has been shown that the upper nerve-path for
this muscle is wholly crossed. If this be correct, it must then
receive some crossed fibres, because it is both a heteronymous
and a homonymous muscle. Thus, the left stemo-mastoid is a
homonymous muscle when it helps the other muscles of the left
side of the neck to incline the left ear to the left shoulder: this
action is performed by the right cerebral cortex acting by crossed
cortico-nuclear fibres on the cells of the left upper cervical cord-
segments, which, in their turn, act by the direct fibres which they
send to the left muscle. But the left muscle is a heteronymous
muscle when, either alone or in conjunction with eye-movements
to the right side, it turns the face to the right: and this action is
performed by the left cortex acting on the right side of the spinal
cord, which, in its turn, acts by means of the crossed motor fibres
which it presumably sends to the left sterno-mastoid muscle. If
the path just mentioned be denied, then we are logically driven
to the conclusion that the upper path for the muscle must be
double. It is difficult to say whether the muscle receives a large
majority of crossed fibres, because both of its actions are powerful
ones, as we can feel on ourselves digitally against resistance. On
the whole, however, it seems probable that it is mainly a heterony¬
mous muscle, and therefore receives a majority of crossed fibres.
In both respects it would, of course, resemble the two oblique eye-
muscles. So far as I know, no experimentalist has yet made a
careful study, by the retrograde chromolysis method, of the
question whether the muscle receives any crossed motor fibres.
526
LEONARD J. KIDD
And the fascinating question of the ganglionic origin of the
muscle-afierents of the sterno-mastoid muscle—and indeed of
other neek muscles also—is still an untouched field of inquiry
waiting for an enterprising physiologist.
Some observers, such as Edinger (1000) and Ohersteiner (1001),
have held that some spinal nerves contain crossed fibres. Hut van
Gehuchten 7 (1002) found that, after rupture of the eighth cervical
and first thoracic ventral and dorsal roots in the rabbit, he got no
evidence that any of their fibres are crossed; and again in JOOo
he mentions' that he obtained the same negative results by(l)
the Golgi method, (2) after amputations, (:») by his own indirect
Wallerian degeneration method: he thinks it is prohibit* that all
spinal nerves contain direct fibres only. Hut it seems to me clear
that the neurology of the stenio-mastoid musele is badly in need
of a carefully-planned experimental study.
!). Needed Experimental Procedures.
Although one would, for the sake of making assurance doubly
sure, welcome a renewed inquiry as to the destination of the
axons of all the cells of the trochlear and abducent nuclei, the
chief point we need light upon is the exact nuclear origin of the
motor fibres in the various muscular branches of the oculomotor
nerve, and their exact muscular destinations. 1 have said enough
on the neurology of the stenio-mastoid muscle in section 8 of
this paper. So far as the eye-muscle nerves are concerned, I
regard the rabbit as easily the worst of all laboratory animals for
such an experimental inquiry', for these reasons: it is a primi¬
tive, defenceless animal; it spends nearly all its life underground
(in the wild state) : it probably uses its ocular adduction mecha¬
nism much less than carnivora ; and its optic axes are amongst
the most divergent of all mammals. It will he remembered that
in 1001 G. Lindsay Johnson* showed that man and the true
simift alone have the power of convergence, and alone have parallel
vision; the domestic eat has a divergence of the optic axes of only
seven to nine degrees; dogs one of fifteen to twenty'; whereas the
hare has one of eighty-five degrees. (It is probable that the rabbit
closely resembles the hare in this respect.) I suggest, therefore,
that the best animals for the inquiry are the monkey, cat, and
* phiL Tram, Roy, Not., Vul. B. 104, p. 1. (.See especially Plate 30.)
OCULOMOTOR FIBRES
527
dog, in that order. The chief experimental procedures needed
seem to be Yon Gudden’s and the retrograde chromolysis methods.
It is of course vitally important that a most searching inquiry
should be made on autopsy to prove whether the lesion was entirely
confined to the nerve-branch which was cut at the time of opera¬
tion. (Unfortunately, the neuro-pathologist is seldom likely to
have an opportunity of adding substantially to our present imperfect
knowledge of this subject, as isolated lesions of single muscular
branches of the third nerve do not often come to autopsy.)
10. Conclusions.
1. We have embryological, experimental, and pathological
proof of the existence of direct (uncrossed) trochlearis fibres,
ranging from the ancestors of elasmobranch fishes up to man.
2. Direct trochlear fibres are few in number: the crossed have
increased enormously in the course of phylogenetic development.
In cat embryos direct trochlear neuroblasts are primary, the
crossed are secondary (Martin). 1
3. We have anatomical, experimental, and pathological proof
of the existence of crossed oculomotor roots and fibres in fishes,
amphibia, birds, and mammals up to man.
4. All the fibres in each muscular branch of the oculo¬
motor nerve — with the exception of that to the internal
rectus muscle — were primitively direct; their crossed fibres
are secondary.
5. The writer believes that the direct and the crossed fibres of
the oculomotor nerve are distributed as follows: the inferior
oblique receives a few direct and a large preponderance of crossed
fibres; the superior and the inferior recti mainly direct fibres, with
a few crossed; the internal rectus exclusively crossed fibres, all of
which come from the contralateral oculomotor nucleus; the levator
palpebne superioris probably a large majority of direct, and a
small minority of crossed fibres.
6. In all ocular nerves and nerve-branches the grouping of
the muscle-afferent nerve-fibres corresponds exactly with that
of the motor fibres in that nerve or branch: thus the obliques
have mainly crossed, the external rectus wholly direct, and the
internal rectus wholly crossed fibres, etc., etc.
7. There are no fibres in man or the rabbit going from the
528
LEONARD J. KIDD
abducens nucleus, via the posterior longitudinal bundle, to the
contralateral oculomotor nucleus or root.
8. The lower (infra-cortical) mechanism for the lateral con¬
jugate eye-movements depends on the ascending vestibulo-ocular
fibres of the posterior longitudinal bundle.
9. A lesion strictly limited to the cells of one abducens
nucleus gives exactly the same signs as one of the abducens
root or nerve, viz., a palsy of the homolateral external rectus
muscle.
10. A complete cellular lesion of one trochlearis nucleus gives
bilateral signs, viz., a slight paresis of the homolateral superior
oblique muscle, with an almost complete paralysis of the contra¬
lateral superior oblique.
11. Great caution is needed in diagnosing nuclear oculomotor
lesions on account of our gross ignorance of the exact muscular
destinations of the axons of all its cells.
12. The sterno-ma8toid muscle probably receives a majority
of crossed fibres, a minority of direct; this applies both to its
motor and its muscle-afferent fibres.
13. A renewed experimental study is needed in monkey, cat,
or dog: the rabbit should not be used.
14. As the upper path from the cortex cerebri to the nuclei
of the eye-muscle nerves and to the nuclei of the motor nerves of
the stemo-ma8toid muscle is believed to be wholly crossed, the
lower path has to be a double one to the two obliques and
the upper and lower recti muscles of the eyeball, and also to
the sterno-mastoid muscle. If it were not so, the eye-movements
could not be carried out in the way we know they are performed.
If, however, the upper path were double, a single lower path
would be sufficient, and there could then be no possible need for
any crossed fibres in either the oculomotor or the trochlearis
nerve.
11. References.
1 Martin, Paul,—
1890. Anal. Anzeiger, Vol. 5, p. 530.
“ Die neuroblasten den Oculomotorius und Trochlearis.”
2 Froriep, A.—
1891. “Verh. Anat. GeselL,” v. (Munchen), in Anat. Anzeiger, Vol. 6.,
p. 55.
“ Ueber die entwicklung des trochlearis bei Torpedo.”
OCULOMOTOR FIBRES
529
s Duval, M.—
1879. Joum. de V Anal. e. d. 1. Phynol. , Vol. 15, p. 492.
1880. Ibid., Vol. 16, p. 285.
4 Duval, M., and Labobdk, J. V.—
1880. Joum. de. VAncU. t. d. 1. Physiol., Vol. 16, p. 56.
8 Pkrlia—
1889. Arch, fur Ophthalmol., Vol. 35, p. 287.
• vox Kolliker, A.—
1892. Sitzungsb. d. Wiirzb. Phys. Med. Qesell., July 30.
7 vax Gehcchtex, A.—
1892. La Cellule, Vol. 8, p. 419.
1898. Joum. de Neurol., Vol. 3.
“ Travaux du Labor, de Neurol, de Louvain”
1902. Le Nivraxe, Vol. 4, p. 57.
1903. Ibid., Vol. 5, p. 265.
• Edinoer, L.—
1893. “Zwolf Vorlesungen,” Ac., Ac., Leipzig.
• Obkrsteiner—
1892. “ Anleitung beim Studium der Nervi isen Centralorgane,” p. 395.
10 vox Bechterew —
1897. Arch, fur Anal. u. Physiol.
11 Franz, V.—
1911. Anal. Anzeiger,Y ol. 38, p. 592.
12 Cajal, R. y.—
1900. “Textura,” Ac., Ac., Ac., F4.
15 Bernheimer—
Graefe-Saemiach’s “ Handbuch der Augenheilk,” 1 Teil, 6 Kap,
Anflage 2.
1897. Wien. Klin. Wochschr., Vol. 10, p. 322.
14 McKibben, Paul 8.—
1913. Joum. of Comp. Neurol., Vol. 23, p. 153.
“The eye-muscle nerves in Necturus.”
18 Siehkrlimo, £., and Boedekxr, J.—
1897. Arch, fdr Psychiatric.
14 Siemerlino and Westphal—
1891. Arch, fur Psychiatric.
17 von Gudden—
1881. TageU. d. Deutscher naturforsch. in Salzburg.
1885. Ibid.
18 Spjtzka—
1885. Philadelphia Neurol. Soc., Address.
18 VAX Biervliet, J.—
1899. La Cellule, Vol. 16, p. 1.
28 Bach, L.—
1906. Centralbl. f. Neri'enheilk. u. Ptychiat.
(a) January (Fourth Nerve).
(5) February (Third Nerve).
530
ABSTRACTS
21 VAN DER SciIUEREN, A. —
1909. LeXdrraxf Vol. 10, p. 117
1913. /Mtf., Vol. 13, p. 183.
- Bregmann—
1892. Oberstciner’s “ Arbeiten. a.r/. Utiiv Wien.
21 Fereol—
1877. Gaz. efcs Hopitanx, p. 738
* J4 Bennett, A. HroHES, and Savile, T. —
1889. Brain , Vol. 12, p. 102.
,Jf> Gee, S., and Tooth, H. H.—
1898. Brain , Vol. 21, p. 1.
Seitzer, A.—
1899. Obersteiner's “Arbeiten. Univ. Wien.,” Vol. 6
,JT Bruce, A.—
1903. Rev. XenroL and Psychiatry , Vol. 1, p.
Kidd, L. J.—
1904. Rev. Xeurol. and Psychiatry , Vol. 2, p. 99.
1910. Ibid ., Vol. 8:—
(«) Octol>er f p. 601.
(h) November, pp. 682, 683.
abstracts.
ANATOMY.
THE NEBVE SUPPLY OF THE DENTINE. J. Howard Mummery,
(479) Proc. Boy. Soc. Med 1913, v., July (OdontoL Sect), p. 166.
The nerves of the dental pulp lose their medullary sheath and
neurilemma just beneath the odontoblast layer, and are seen to
form an intricate plexus of neurofibrils in this situation, the plexus
of Raschkow; from this plexus they pass in approximately straight
lines between and around the odontoblast cells, and form another
much narrower plexus at the inner margin of the dentine, which
has been called the “ marginal plexus.” They very closely envelop
the cells and the dentinal fibril, and enter the dentine in company
with the latter. They can be traced as fine beaded fibrils all
along the tubes and their very numerous branches, and are seen
to terminate in the fine ramifications of the dentinal tubes beneath
the enamel and cementum. Whether they actually pass into the
enamel in places where the tubes penetrate this tissue cannot at
pi’esent be said, but in any case, their normal and principal final
ABSTRACTS
531
distribution is within the limits of the dentine. They are ap¬
parently very evenly distributed around the larger portion of the
pulp, becoming scattered, although not entirely absent, as they
approach the apex of the root. A. Ninian Bruce.
PHYSIOLOGY.
AN INVESTIGATION OF NERVE REGENERATION. Henry O.
(480) Feiss, Quart. Joum. Exp. Physiol ., 1913, vii., p. 31.
The author concludes that regeneration proceeds eentrifugally and
from a central source, but the neurilemma sheaths must be in
a proper condition both mechanically and nutritionally to receive
the newly regenerating fibres. There are two kinds of scars
obtainable by interruption of a nerve—the first a mere squeeze,
the second a complete division. The first type does not alter the
nerve pattern locally; the second does. Degeneration is the same
in both. Although regeneration is central in origin, its manifesta¬
tions are nevertheless often discontinuous, the scars forming regions
of obstruction to the outgrowing nerve fibres. As a result, the
nerve substance permeating through the compressed scar tissue
may be in greater evidence below the seal’s than in them. In
the segments between the scars the axis cylinders are laid down
in elongated strands and the myelin in small bits. The sheath
cells do not have adherent properties of neuroblasts. Nuclear
proliferation may have a protective influence against phagocytosis,
but it probably also has an important functional significance
indicating that the sheath cells provide the newly regenerating
fibres with nutriment. Fibres which have degenerated may show
regeneration in the anatomical sense, with good myelination, even
if they are prevented from making connection with peripheral
end organs. A. Ninian Bruce.
THE ACTION OF THE CEREBRO SPINAL FLUID, THE CHOROID
(481 ) PLEXUSES, AND SOME ORGANS AND SUBSTANCES|ON THE
ISOLATED HEART OF THE RABBIT. (L’azione del liquido
cephalo-rachidiano, dei plessi coroidei e di alcuni organi e
sostanze snl cuore isolato di coniglio.) N. del Priore. Riv. ital.
di Neurop. Psichiat . ed Elettroter., 1913, vi., p. 211.
As the result of his experiments the writer comes to the following
conclusions:—
1. The cerebro-spinal fluid of the ox added, in amounts varying
from 10-40 c.c. to 1000 c.c. of Ringer-Locke’s solution, may exercise
an exciting action upon the isolated heart of a rabbit. The
532
ABSTRACTS
cerebro-spinal fluid of the calf has the same action, perhaps even
more marked. Human cerebro-spiual fluid has also a certain
exciting action.
2. An extract of the choroid plexuses, in the proportion of 2-3
g. to 1000 of Ringer-Locke’s solution, produces an increase in the
height, and, though not invariably, in the frequency of the cardiac
contractions. An extract of the brain and cerebellum in the same
proportions has also an exciting action. Suprarenal extract has a
very markedly exciting action, but this action differs according as
the organs come from a foetus, a child, or an adult, as the action
of the foetal suprarenale is much less evident than that of the
suprarenals of a child or an adult.
3. Cholesterin added to Ringer-Locke’s solution in the pro¬
portion of 0*5-010 g. per 1000 does not produce a definite increase
in the number of contractions, but a rise in the tracing, which,
after one and a half minutes, falls and shows a diminution in the
frequency of the pulsations. Protein has the same action. Neurin
added in even the most dilute solution develops a depressing action,
which is shown by a fall of the cardiogram and a diminution in
the contractions. J. D. Rollkston.
VASODILATOR AXON-REFLEXES. A Ninian Bruce, Quart.
(482) Joum. Exp. Physiol., 1913, vi, p. 339.
This paper has already been abstracted (r. Review, 1911, ix.,
p. 117). Author’s Abstract.
ON THE REACTIONS OF THE SALIVARY CENTRES. F. R.
(483) Miller, Quart. Joum. Exp. Physiol., 1913, vi., p. 66.
“ I. The lingualis reflex.
1. Stimulation of the central end of the lingual nerve
(lingualis reflex) causes abundant secretion from the
ipsilateral submaxillary gland, and less secretion
from the ipsilateral parotid.
2. Slight secretion (about one drop) takes place from the
contralateral submaxillary and parotid glands.
3. The threshold of the reflex is very low (sec. coil about
30 cm.).
4. The threshold of the lingualis reflex is lower than that
of the peripheral chordo-lingual nerve.
5. The ipsilateral submaxillary latency is less than the
parotid latency. The ipsilateral submaxillary latency
is less than the contralateral submaxillary latency.
ABSTRACTS
533
II. The glossopharyngeus reflex.
1. Stimulation of the central end of the glossopharyngeal
nerve (glossopharyngeal reflex) causes abundant
secretion from the ipsilateral parotid gland, less
secretion from the ipsilateral submaxillary.
2. Slight contralateral effects are produced.
3. The ipsilateral parotid latency is less than the sub¬
maxillary latency.
III. The gastric vagus reflex.
1. Stimulation of the central end of the gastric vagus
(gastric vagus reflex) causes secretion from the
submaxillary and parotid glands.
2. The threshold is high.
IV. Stimulation of a sensory nerve (sciatic) causes a slight
submaxillary secretion.
V. The salivary reflexes are independent of the associated
muscular reflexes.
VI. Afferent fibres for the salivary reflex are contained in
the chorda tympani.
VII. The salivary secretion of curare poisoning is caused by
asphyxia.
VIII. Two points may be localised by unipolar faradisation of
the surface of the medulla oblongata. Stimulation of the one
causes parotid secretion; of the other, submaxillary secretion.
The stimulus threshold is very low (sec. coil at 80 cm.). The
results agree, in the main, with those of previous anatomical
work.” A. Ninian Bruce.
THE INFLUENCE OF MUSCULAR RIGIDITY ON THE OXYGEN
(484) INTAKE OF DECEREBRATE 0AT8. H. E. Roaf, Quart.
Joum. Exp. Physiol., 1913, vi., p. 393.
“During decerebrate rigidity the oxygen intake is only slightly
greater than when the muscles are flaccid.”
A. Ninian Bruce.
THE EFFECT OF THE REMOVAL OF THE HYPOPHYSIS IN THE
(485) DOG. Joshua Edwin Sweet and Alfred Reginald Allen,
Annals of Surgery, 1913, lvii., April, No. 4, p. 485.
The work upon which this report is based began over a year ago,
when the question of the essential characters of the hypophysis
was perhaps of more importance from the standpoint of experi¬
mental medicine than it is to-day. Hypophysectomy was per¬
formed upon twenty-two dog3. The method of approach was
through an incision about two inches in length, perpendicularly
534
ABSTRACTS
over the centre of the zygoma—the zygoma forming, as it were,
a base line with the vertical two-inch incision. The zygomatic
arch was removed, the coronoid process of the mandible resected,
and the base of the skull approached in a direct line. The skull
was trephined, and the opening enlarged: after opening the dura,
the brain was carefully elevated by a suitable retractor. The
hypophysis was removed by a special loop forceps, which enabled
the operator to remove the gland in two pieces, the anterior
lobe in one piece, and the posterior lobe separately. As regards
the post-operative results, seven dogs succumbed within ten days
from various causes, ten died during the second and third weeks,
five lived for months.
It was found to be exceedingly difficult to ensure a complete
physiological extirpation of the gland, as the cells of the pars
intermedia extend for a considerable distance forwards towards
the chiasma and backwards towards the corpora mammillaria. It
is, however, possible to remove the hypophysis physiologically,
that is, to remove enough so that certain characteristic changes
will follow.
The author considers that there are three well-marked changes
which follow hypophysectomy.
The first change concerns the pancreas. It has been noticed
to present a striking red coloration similar to that seen normally
at the height of digestion—microscopically there are no very
marked changes.
The second change, and second also in point of time, has been
an atrophy of the genital apparatus, particularly of the testicles.
Apparently the atrophy commences very early after the removal
of the hypophysis.
The third change noted has been an increase in weight. This
did not make its appearance until some time after operation, and
in the minds of the authors the question remained undecided as
to how far the tendency to obesity was due to a loss of the
hypophysis, or to a loss of some other function (testis) controlled
by the hypophysis. John Fraser.
PATHOLOGY.
BESTA’S METHOD FOB THE MYELIN SHEATH IN SECONDABY
(486) DEGENEBATIONS. (II Metodo di Besta per la guiana mielinica
nolle degenerazioni secondarie.) L. Lugiato, Riv. ital. di. Neurop.
Psichiat. td Elettroter., 1913, vi., p. 193.
The writer describes Besta’s method (v. Review, 1912, x., p. 564),
and comes to the following conclusions as the result of his
experience of the method.
ABSTRACTS
535
Besta’s method clearly shows an alveolo-reticular stroma, with
well-defined characters in the myelin sheath. This stroma
gradually disintegrates and disappears in secondary degenerative
processes of the nerve fibres. Besta’s method, like Weigert’s,
shows the degenerated /ones in a negative manner, but at a much
earlier period. It may also be of service when the methods of
Marchi and Donaggio are not available, because the lesions which
they might show are of too old a date. J. D. Rolleston.
ADDITIONAL STUDIES ON THE PRESENCE OF SPIROCHiETA
(487) PALLIDA IN GENERAL PARALYSIS AND TABES
DORSALIS. H. Noguchi, Joum. Cut. DU., 1913, xxxi, Aug., p. 543.
The technique used is as follows : “ From a specimen taken from
the gyri frontali, gyri recti, or any other region, and hardened
in 10 per cent, formalin, a slice of tissue measuring 5 to 7 mm. in
thickness and of variable dimension is taken and put into a
mixture containing 10 per cent, formalin, 10 per cent, pyridin,
25 per cent, acetone, 25 per cent, alcohol, and 30 per cent, aqua
distillata for a period of 5 days at room temperature. The tissue
is then thoroughly washed in distilled water for 24 horn's. Next
it is transferred to 96 per cent, alcohol for 3 days, and then
thoroughly washed in distilled water for 24 hours. After this,
the tissue undergoes the following treatment, which is carried out
in a dark bottle: (1) Bath in 15 per cent, silver nitrate solution
for 3 days at 37° C. (or 5 days at room temperature); (2) wash in
distilled water for several hours; (3) reduce in 4 per cent, pyrogallic
solution with the addition of 5 per cent, formalin for 24 hours at
room temperature; (4) wash thoroughly in distilled water; (5)
transfer to 80 per cent, alcohol for 24 hours, (6) then to 95 per
cent, alcohol for 3 days, (7) absolute alcohol for 2 days, (8) xylol,
xylol-paraffin, paraffin. The sections should be cut from various
strata of the tissue in order to ensure obtaining the best im¬
pregnated zone. The thickness of the section must depend upon the
degree of impregnation, which varies considerably according to
different specimens of the brain. It is my custom to cut to 3/x,
but it is often preferable to cut to 5/x, as one thereby increases the
chances of finding the pallida in a given area. It is highly
advisable to impregnate a syphilitic tissue containing numerous
pallidas, in order to control the staining of the brain tissue at the
same time.
“ When the staining is successful all the various tissues of the
brain appear in a colour varying from a pale yellow to a yellowish
brown, while the pallidas are pure black. The neuroglia fibres
sometimes stain distinctly, but when examined with artificial
536
ABSTKACTS
light they are found to be brownish, but never black. It is always
my rule in commencing my search for the pallida to start from the
palest area and proceed gradually towards the edge, which usually
takes on a deeper impregnation.
“ The above method iB also applicable to cases of tabes dorsalis.
It is best to cut the spinal cord 2 cm. long, and to make longi¬
tudinal sections.” A. Ninian Bruce.
THE PATHOLOGY OF THE CONDITION KNOWN AS PARA
(488) SYPHILIS. JAmes MTntosh and Paul Fildes, Lancet, 1913
clxxxv., Sept 27, p. 921.
The term “ parasyphilis ” was introduced by Fournier in 1894
to describe certain changes of an atrophic or degenerative nature
which might follow a syphilitic infection.
The authors, in a most interesting paper, consider that syphilis
of the central nervous svstem consists of two main divisions—
one largely or entirely confined to the lymph vascular tissues, and
the other largely or entirely confined to the brain substance. In
each of these two divisions varying numbers of spirocluetae, and,
even more so, varying sensitisation of the tissues, will occasion
lesions of varying clinical importance. In the vascular tissues
these will range from a slight meningitis to a gummatous process,
while in the brain from a slight meningo-encephalitis to tertiary
encephalitis (dementia paralytica). A. Ninian Bruce.
CEREBRAL SYMPTOMS IN A BULLDOG ASSOCIATED WITH
(489) LYMPHOCYTIC INFILTRATION OF THE VESSELS AND
MEMBRANE OF THE BRAIN AND SPINAL CORD. F. E.
Batten, Proc. Roy. Soc. J/«f„ 1913, vi., May (Neurol. Sect.), p. 114.
A bulldog, aged 16 months, a prize animal, began to suffer from
muco-gastro-enteritis with slight weakness in gait. The intestinal
symptoms improved but the nervous symptoms grew worse; the
eyesight became affected and the gait ataxic. He became very
drowsy and listless, and eventually blind. He was killed with
chloroform.
The intestine showed marked follicular ulceration. The root
of the penis had a curious warty appearance, which was said not
to be normal. A perivascular lymphocytosis was found both in
the brain and spinal cord similar to that seen in man in syphilitic,
trypanosomic, and polioinyelic infection. The interpretation in
this case is doubtful, but the possibility of its being venereal is
suggested. A. Ninian Bruce.
ABSTRACTS
537
CLINICAL NEUROLOGY.
THE r6LE OF SCARLET FEVER IN THE ./ETIOLOGY OF
(490) NERVOUS DISEASES. (Die Rolle des Sch&r lacks in der Atio-
logie der Nervenkrankheiten.) R. Neurath, Ergeb. d. inner.
Med. und Kinderheilk ., 1912, ix., pp. 103-156.
An exhaustive monograph, based on fifteen years’ study of nervous
diseases following acute infections, with a complete review of the
literature ( v. Review, 1912, x., p. 80). The paper contains the
histories of eight personal cases illustrative of hydrocephalus,
hemiplegia, and multiple sclerosis, following scarlet fever.
J. D. Rollestox.
SOME CLINICAL PHENOMENA OF THE TRANSVERSE LESIONS
(491) OF THE SPINAL CORD. S. V. Sewell, Australian Med. Joum.,
1913, ii., Aug. 23, p. 1178.
The author discusses the question of disorders of micturition
associated with transverse lesions of the spinal cord, and concludes
that the bladder mechanism is a reciprocal one, controlled by the
lumbar and sacral centres, which are connected together within
the cord by association fibres, and which are themselves under
voluntary control of the cerebral cortex, whose impulses pass to
these centres by way of tracts on either side of the anterior median
fissure of the spinal cord. A. Ninian Bruce.
TRANSMISSION TO MONKEYS OF VIRUS OBTAINED FROM
(492) ENGLISH CASES OF POLIOMYELITIS. James MTntosh and
Hubebt Turnbull, Lancet , 1913, clxxxiv., Feb. 22, p. 512.
Monkeys were inoculated intradurally as well as intraperitoneally
with emulsions of spinal cord from four cases of ijoliomyelitis,
which, with one exception, occurred in the London Hospital
district. Case I. was sporadic, and inoculation into monkeys
proved negative. Case II. also proved negative on inoculation
into monkeys, due probably to the fact that death resulted from
diphtheria, the patient having really recovered from his attack of
poliomyelitis. Cases III. and IV. both occurred in a mild epidemic,
and could be transmitted to monkeys, whose brain and spinal cord
exhibited the characteristic microscopical appearance of acute
anterior poliomyelitis. These results are in agreement with those
of other workers, who have found that it is extremely difficult to
transmit the virus from sporadic cases, whilst in epidemics trans¬
mission is successful in the great majority of instances.
The authors suggest that in sporadic cases the virus is feeble,
538
ABSTRACTS
and the occurrence of the disease is due to a hypersusceptibility
of the individual attacked, whilst an epidemic only results when
the virus has become exalted either by a series of passages through
susceptible individuals or from some other cause unknown.
A. Ninian Bruce.
TABES AND FACIAL PABALY81S. (Tabes et Paralysie fadale.)
(493) L. A. M. Jacques, Theses de Paris , 1912-13, No. 335.
The bulbar form of tabes may be accompanied by facial paralysis,
which may develop in the pre-ataxic stage, when it is generally
benign and of neuritic origin, or appears later when it is of nuclear
origin. In some cases it may be neuritic at first and later become
nuclear. J. D. Rolleston.
MA0R0GL08SIA CONGENITA NEUROFIBROMATOSA. (Makro-
(494) glossia congenita neurofibromatosa.) A. Hayashi, Pent. Zeitschr.
/. Chir., 1912, cxviii., p. 456.
The patient was a mentally defective boy, aged 3 years, whose
right half of the tongue had been noticed to be thicker than the
left since the first months of life. For a year it had been
increasing in size, and was always protruding from the mouth.
Under ether a wedge-shaped piece was removed, and the tongue
resumed its normal position. Histological examination showed
no new formation nor dilatation of lymph-vessels, and no muscular
hypertrophy. Most of the preparation was formed by nerves
encased in a hyperplastic perineurium of a myxomatous character.
There was no increase in the endoneurium, as in Abbott and
Shattock’s case. J. D. Rolleston.
RECOVERY FROM PNEUMOCOCCAL MENINGITIS. (M&iingites
(495) k pneumocoques gulries.) P. Savy and J. Gate, Lyon med~, 1913,
cxxi., p. 55.
A record of two cases: (1) Serous meningitis. The patient was
a man, aged 20, in whom the meuingeal symptoms were ill-marked.
The cerebro-spinal fluid was clear, and showed no micro-organisms
on direct examination of a film, but yielded a pure growth of
pneumococci on cultivation. Rapid improvement occurred in
three days. (2) Suppurative meningitis. A typical case of
meningitis with purulent cerebro-spinal fluid containing poly¬
morphs and pneumococci in a man, aged 25. Rapid improvement
took place after two lumbar punctures. Orchi-epididymitis,
probably of pneumococcal origin, occurred in convalescence. In
both cases the meningitis was primary, as neither had any
pneumonia, otitis, or rhinopharyngitis. J. D. Rolleston.
ABSTRACTS
539
A CASE SIMULATING MENINGITIS IN WHICH THE SYMPTOMS
(496) WERE CAUSED BY THE ESCAPE OF THREAD-WORMS
INTO THE PERITONEAL CAVITY THROUGH A PER¬
FORATED APPENDIX VERMIFORMIS. R. N. H. Anglin
Whitelocks, Brit. Jovm. Child. Bis., 1913, x., p. 296.
A GIBL, aged 5£ years, was admitted to hospital as a case of
tuberculous meningitis. An enlarged gland had been removed
from her neck a year previously. The symptoms on admission
were convergent strabismus, contracted pupils, photophobia, rest¬
lessness, and incontinence of mine. The right lower limb was
flexed and drawn up on the abdomen, while the left was moved
from time to time. Palpation of the abdomen showed marked
tenderness over the caecum, and rigidity over the right rectus
muscle. An exploratory incision was performed when the above
finding was made. Complete recovery followed removal of the
appendix, which was found full of thread-worms.
J. D. Rolleston.
A CASE OF. PURULENT MENINGITIS AFTER FRACTURE OF
(497) THE BASE TREATED WITH HEXAMETHYLENETETRA¬
MINE. RECOVERY. (Et Tilfaside af purulent Meningitis efter
Basisfractur behandlet med Hexamethylentetramin. Helbre-
delse.) Chikvitz, Hospitalstidende, 1913, lx., p. 929.
A MAN, aged 22, developed signs of meningitis in January 1912,
about a week after a fall from a height of 7 metres. The cerebro¬
spinal fluid was turbid, slightly blood-stained, and contained
pneumococci Hexamethylenetetramine, in doses of about 4
grammes daily, was given. Gradual improvement took place, but
deafness in the left ear and vertigo persisted, and were still
present when the man had resumed his work in the following
September. J. D. Rolleston.
TWO OASES OF RECOVERY FROM TUBERCULOUS MENINGITIS.
(498) (Fevri geheilte FElle von meningitis tuberculosa.) V. Reichmann
and F. Rauch, Miinch. med. Woch., 1913, lx., p. 1430.
Case 1. Child, aged 1| years, admitted to hospital in June 1912.
Condition on admission: Nuchal rigidity, Kernig’s sign, cutaneous
hyperalgesia, and hydrocephalic cry. Temperature normal. The
cerebro-spinal fluid was clear, showed lymphocytosis, excess of
albumin, and groups of tubercle bacilli (no animal inoculation
seems to have been made.—J. D. R.). Lumbar puncture was
performed five times in all, and marked improvement was noted
after the second puncture, though the pressure of the fluid
remained high for long. The child was last seen in October 1912,
45
ABSTRACTS
:>40
when it had made great progress, though it had not yet learned
to speak.
Case 2. Man, aged 21, admitted to hospital in November 1912,
with nuchal rigidity and violent headache. The cerebro-spinal
fluid was clear, and showed lymphocytosis. and tubercle bacilli
Inoculation of guinea pigs was negative, probably on account of
the small number of the bacilli, and because their virulence had
been weakened by the inoculation not having been made until
three days after the lumbar puncture. Recovery was slow, and
the patient was not discharged until 23rd January 1913.
The writers have collected from literature eighteen cases of
recovery from tuberculous meningitis. J. D. Rolleston.
A CASE OF OTOGENIC CEREBRAL ABSCESS. John Murphy and
(499) Albx. Lbwbbs, Australian Med. Joum., 1913, ii., Ang. 23, p. 1177.
A boy, aged 16, who had suffered from otorrhoea in his left ear for
four years, was admitted to hospital suffering from frontal head¬
ache, vomiting, dimness of vision, and transient paralysis of his
right arm and leg. The middle ear was found diseased, although
the inner ear was intact, and a polypoid mass of granulation tissue
was protruding through the upper part of the drum. This was
removed, the mastoid antrum opened, the meninges exposed, and
the dura opened. No pus was found. The condition of the patient
was little altered, so he was accordingly trephined in the temporal
region over the left ear, and pus was found on pushing a forceps
through the temporo-sphenoidal lobe to the region above the ear.
A hernia the size of an orange resulted, but later disappeared, and
recovery became complete. A. Ninian Bruce.
AN UNUSUAL CASE OF CEREBRAL ABSCESS. Harold S. Rbnton,
(500) Lancet , 1913, clxxxv., Sept. 27, p. 929.
A man, aged 41, was admitted to hospital in a comatose condition.
The limbs on the left side were more flaccid than on the right,
but the reflexes were normal and equal on both sides. There was
no squint or optic neuritis, the pupils were equal, of medium size,
and reacted slowly to light. The left side of the face showed
supranuclear palsy of the seventh nerve. The condition was at
first thought to be due to a right cerebral haemorrhage, but as
he had a hectic temperature and sweated profusely it became
evident he was really suffering from a purulent affection of the
brain. Shortly before death a greenish discharge “ came into the
mouth ” and required frequent removal.
At the autopsy a large abscess was found in the left temporal
ABSTRACTS
541
lobe communicating with the lateral ventricle. It was almost
empty, and communicated with the middle ear, and the pus had
apparently found its way into the mouth by way of the Eustachian
tube, as all the pharyngeal tissues were healthy. Over the motor
area of the right side of the brain there was extensive purulent
meningitis; the right ear was healthy, the base of the brain free
from pus, and the left cortex unaffected. A. Ninian Bruce.
A NEUROMA-MYOMA OF THE MESENTERY. Peter Paterson,
(501) Lancet, 1913, clxxxv., Oct. 4, p. 997.
A boy of 9 years, of poor mental development, was admitted to
hospital with pain, tenderness and rigidity in his right iliac fossa,
and a leucocytosis of 20,800. The appendix, on removal, was found
slightly congested, but otherwise normal. The pain and vomiting,
however, continued to recur every seven to ten days, usually
developing suddenly and lasting about twenty-four hours. As a
smooth oval tumour could be now felt in the middle line, just below
the umbilicus, it was removed. On section it was found to be
composed of a soft reddish centre, consisting of medullated nerve
fibres with a very few ganglion cells. Nearer the periphery plain
muscle fibres appeared amongst the nerve bundles, and these
gradually increased on passing outwards till, under the capsule,
the tissue was almost entirely muscle. A. Ninian Bruce.
CONGENITAL INTERNAL HYDROCEPHALUS: ITS TREATMENT
(502) BY DRAINAGE OF THE CISTERNA MAGNA INTO THE
CRANIAL SINUSES. Irving S. Haynes, Annals of Surgery, 1913,
lvii, April, No. 4, p. 449.
The author has contributed a most important memoir upon the
subject. He writes with the purpose of drawing attention to the
advantages of treating congenital internal hydrocephalus by
drainage of the cisterna magna into one of the cranial sinuses.
The cisterna magna is one of the cisterme subarachnoidales,
noticeable for its size, and situated at the interval between the
under surface of the cerebellum and the posterior surface of the
medulla oblongata.
The cistern communicates through the foramen of Majendie
with the ventricular system, and alterations in pressure of the
cerebro-spinal fluid in the cisterna magna is appreciated within the
ventricles.
Cerebro-spinal fluid is a true secretion produced by the gland¬
like cells of the ependyma, and in congenital hydrocephalus it
accumulates within the ventricles. Cushing believes that the
542
ABSTRACTS
cause of the accumulation is an obscure obstruction to the natural
flow of the fluid into the sinuses.
In the understanding of the operation suggested by Haynes
there are three important physiological points to be kept in mind:
(1) The pressure in the cerebro-spinal fluid is below that in the
arteries, but above that in the sinuses, and therefore the flow of
cerebro-spinal fluid will be into the sinuses.
(2) The specific gravity of the fluid (1005-1010) is below that
of the blood (1059), and as the current determined by difference
in the specific gravity of the two fluids is from that of the lesser
to that of the greater, the fluid flows into the blood stream.
(3) Cerebro-spinal fluid is isotonic with blood. And a mixture
does not produce coagulation.
Bearing these facts in mind, it is easy to follow the reasoning
which suggests a treatment consisting in an establishment of a
communication between the cisterna magna and the sinuses.
The steps of the operation may be summarised as follows:—
To expose the occipital bone by a mesial posterior incision. To
separate laterally the scalp, muscle, and periosteum. To trephine
over the mid-point between the foramen magnum and the external
occipital protruberance. To remove the bone upwards sufficiently
far to expose the termination of the superior longitudinal sinus.
To connect with rubber or silver tube the cisterna magna to the
torcular, occipital, or superior longitudinal sinuses.
The writer has submitted two cases to an operation of this type.
In Neither instance could the result be judged satisfactory.
The first case showed an improvement which lasted for about
six weeks: at the end of that time there was a relapse, and the
child succumbed to progressive hydrocephalus and marasmus.
The second case succumbed three days after operation, appar¬
ently from an excessive leakage of cerebro-spinal fluid through the
wound.
The value of the article is enhanced by a study of the physiology
of the normal intra-cranial circulation: and the formation and
deposition of cerebro-spinal fluid. There is a very complete
summary of the various methods which at one time or another
have been suggested as means of treatment of congenital cr
acquired hydrocephalus. John Fraser.
A CASE HAVING A BEARING ON THE LOCALISATION OF
(503) THE AUDITORY CENTRE. Wm. Bovd and J. Stanley
Hopwood, Lancet, 1913, June 14, p. 1661 [Ulustr.].
In this case a large cyst of the left temporal lobe of the cerebrum
was present without impairment of hearing. The destruction
involved the whole of the temporal lobe, with the exception of the
ABSTRACTS
543
third and anterior extremities of the second and first convolutions,
the last named bearing the anterior gyrus of Heschl on its upper
surface.
Campbell has laid stress on the importance from an auditory
standpoint of the gyrus of Heschl, and the present case helps to
confirm his views.
The cyst was probably of vascular origin.
Authors’ Abstract.
CONSECUTIVE DISPLACEMENT OF THE CEREBRAL HEMI
(504) SPHERE ON THE LOCALISATION AND REMOVAL OF
INTRA - CEREBRAL TUMOURS AND HAEMORRHAGES.
(APOPLECTIC HAEMORRHAGES AND CLOTS). William
H. Hudson, Annalt of Surgery, 1913, lvii., p. 492.
When operative measures are adopted for the exposure of a
•brain tumour, or the relief of secondary intra-cerebral pressure,
it frequently happens that the brain tension is so great that the
tumour cannot be satisfactorily palpated. In such a possibility
the presence of the tumour or haemorrhage may be overlooked.
To obviate the error the author recommends the exposure of the
dura through a laige osteoplastic flap. An omega-shaped temporal
Hap is raised, and this is reinforced by a second flap which extends
posteriorly or anteriorly according to the position of the tumour
or htemorrhage. Such a free removal of bone immediately affords
a great relief of tension and a satisfactory palpation is possible.
After removal of the tumour or blood clot, the osteoplastic flap is
replaced in position and drainage established through a trepliinic
opening.
Should the tumour be one the removal of which is impossible,
or should the cause of the compression not have been found, the
bone flap is adjusted in position by special expanding clips which
permit considerable displacement.
For the exact operation details, the original article must
be consulted, and also a contribution in Annals of Surgery,
May 1912.
The writer describes a series of instruments which he employs;
he claims for some of them a new mechanical principle, and to
their use he largely credits the success of the operation.
John Fraser.
REMARKS ON THE TREATMENT OF BRAIN TUMOUR. Charles
(505) A Ballance, Lancet, 1913, clxxxv., Sept. 13, p. 792.
The author points out that we must remember that the surgeon
cannot do more for tumour of the brain than for tumour situated
in any other organ. The removal of a single encapsulated tumour
544
ABSTRACTS
results in cure, with restoration of function in the brain as else¬
where. An infiltrating malignant tumour cannot be eradicated
without removing the organ in which it is growing.
Early diagnosis and early operation are the two important
points, and should be followed by operation before irreparable
damage to the eyesight has occurred. In an infiltrating tumour
of the brain, the right course to adopt is decompression, not
excision. Decompression relieves the symptoms which depend on
increased intracranial pressure, and as a rule it is from this that
the acute symptoms result, not from the local effects of the
tumour. An osteoplastic flap is a mistake, a large craniectomy is
required, and a cerebral protrusion is desirable. The dura must
be opened, otherwise the intracranial pressure will not be relieved.
Three cases are described in illustration of the above.
Except in cases in which a tumour is supposed to lie in the
anterior part of the vermis, or in which exploration of the fourth
ventricle is required, it is better not to divide the bone and dura
in the middle line, especially in malignant cases, because of the
loss of support thereby entailed. It is preferable to make two
craniectomy openings, one on each side of the middle line if the
diagnosis is in doubt. A complete removal of bone over one
cerebellar hemisphere gives an ample window, and if both sides
are thus treated the cerebellum can be displaced laterally to a
remarkable extent. Cushing’s suggestion of cutting through the
foramen magnum and of the arch of the atlas is also to be re¬
commended as a means of preventing respiratory failure.
A. Ninian Bruce.
CASE OF SUBCORTICAL CEREBRAL TUMOUR, TUBERCULOUS
(506) IN NATURE, REMOVED B7 OPERATION; RECOVERT.
Geobgb Hall and H. Brdnton Angus, Lancet , 1913, dxxxiv.
March 8, p. 678.
A miner was admitted to hospital on account of intense frontal
headache on the left side, and fits of tingling and jerking of his
right leg. These increased, his right arm and right face being
involved, and he occasionally lost consciousness. Slight weak¬
ness developed on his right side, and sensation became slightly
affected. Optic neuritis was present, most marked on the left
side. Anti-syphilitic treatment was of no avail, so it was decided
to trephine over the left sensori-motor area. The brain bulged
markedly, and he developed right hemiplegia with anarthria.
Later an encapsulated tumour If inches long was removed from
the wound, and proved to be tuberculous. The hemiplegia and
anarthria rapidly disappeared, and apart from a few fits he made
a good recovery. A. Ninian Bruce.
ABSTRACTS
545
A CASE OF ACROMEGALIA WITH AUTOPSY. Hermon C.
(507) Gobdinier and William Kirk, Albany Med. Annals, 1913, xxxiv.,
April, p. 189.
A cask in a woman, aged 39, with bitemporal hemianopia, drowsi¬
ness, slow cerebration, headache, palpitation, asthenia, and the
usual skeletal changes. At the autopsy the glandular portion of
the pituitary was found completely destroyed by a tumour.
A. Ninian Bruce.
CONTRIBUTION TO THE STUDY OF BITEMPORAL HEMIOPIA.
(508) H. M. Traquair, Edin. Med. Joum., 1913, xi., Sept., p. 197.
Only during recent years has detailed study of the nature of
bitemporal hemiopia been commenced. Special perimetric methods
are necessary to elicit the true conditions present.
Two types are prominent, one characterised by a scotoma at
or near the centre of the field, the other without this feature.
In the former type the scotoma usually begins in the apex of
the upper outer quadrant of the field, and spreads downwards to
the apex of the lower outer quadrant. About the same time the
periphery begins to fail, first along the outer side of the vertical
meridian above, forming a notching or depression of the upper
outer quadrant, then in the same position below, so that the
outer part of the temporal field becomes split off, forming an
island which in turn gradually disappears. The lower nasal
quadrant then becomes defective, centrally by the encroachment
of the scotoma at its apex, and peripherally along its mesial
border (vertical meridian), so that finally the upper inner quadrant
alone remains. The defect thus proceeds clockwise in the right
field, counter-clockwise in the left, the behaviour of the scotoma
resembling in its progress that of the field as a whole.
Two cases showing fields of this type are described with charts.
One was associated with acromegaly, the other with nasal sinus
disease. Tumour pressure is, therefore, unlikely to be the cause
of the features referred to, as they occur whether a tumour is
present or not. Reference to the literature' shows that such
scotomata are more common in cases of hypopituitarism in which
the tumour is of a relatively actively growing nature than in
acromegaly, where the tumour is usually relatively quiescent.
Moreover, when the scotomatous type of field does occur in
acromegaly the cases tend to be more rapid. The scotomatous
type of field, therefore, indicates relative activity of the disturb¬
ance, and is probably due to lymphatic or vascular congestion in
the chiasmal region, though other factors, such as pressure, are,
of course, not excluded, and probably various causes act together
with different degrees of importance in different cases.
546
ABSTRACTS
Other points, such as the recovery of affected parts of the field
and the relationship of the colour fields to those for white, are
illustrated by the cases described.
Four cases of acromegaly in which relative bitemporal hemiopia
without scotoma was present are also described. The condition
varied from slight depression of the upper outer quadrants only
elicited by a delicate test with Bjerrum’s method to hemiachrom-
atojtsia found on an ordinary perimeter. The loss of the temporal
field from above down was present here also, but the relation of
the colour fields to those for white indicated a less active process.
In all of several other cases showing indications of acromegaly
slight field changes were found. It is, therefore, likely that the
proportion of cases of acromegaly in which field changes are
present is very much greater than is indicated by present
statistics, and that the frequency of scotomata in cases of chiasmal
interference is also underestimated at present. Greater exactitude
and a standard method in examining and recording are required
to enable proper comparison of results. Author’s Abstract.
DID NAPOLEON BONAPARTE SUFFER FROM HYPOPITUITAR-
(509) ISM (DYSTROPHIA ADIPOSO GENITALIS) AT THE CLOSE
OF HIS LIFE ? Leonard Guthrie, Lancet , 1913, clxxxv., Sept 13,
p. 823.
The author shows that there is considerable evidence that
Napoleon, towards the close of his life, suffered from hypopitui¬
tarism of the anterior lobe in the shape of genital atrophy, sexual
alopecia, skeletal and tissue changes of feminine type, and lowered
temperature. Hypopituitarism of the posterior lobe was, perhaps,
indicated by obesity and lowered metabolism. In regard to
evidence of hyperpituitarism in Napoleon up to the zenith of his
career one is on less sure ground. One can only adduce the
habitual slowness of pulse, the life-long frequency of micturition,
“ the libido-sexualis,” and the anomalous cerebral attacks to which
he was liable, as evidence of some form of dyspituitarism.
The lesion is hardly likely to have been a tumour, as his vision
appears to have been in no way affected, and thus was probably
functional; but as the head was not opened after death, the condi¬
tion of the hypophysis cerebri must remain for ever unknown.
A. Ninian Bruce.
ON LOCALISED ATROPHY IN THE LATERAL GENICULATE
(510) BODY CAUSING QUADRANTIC HEMIANOPSIA OF BOTH
THE RIGHT LOWER FIELDS OF VISION. C. Winkler, Folia
Neuro-biologica , 1913, vii., August, p. 1.
As a result of the study of the brain of a woman, aged 37,
unmarried, who suffered during life from transitory sensory
ABSTRACTS
547
aphasia, alexia, and permanent quadrantic hemianopsia in the
lower right fields of vision, an incomplete atrophy of the cauda
of .the lateral geniculate body was found. The author concludes
that vision in the upper quadrants of the field of vision is possible,
notwithstanding the total loss of all the cells and fibres in the
medial (caput) division of the crossed lateral geniculate body, as
long as the cells and fibres of the cauda (origin of the ventral
geniculo-cortical radiation) are intact It is not sufficient that
the ventral occipital convolutions are destroyed to make all the
cells disappear out of the lateral (cauda) division of the geniculate
body. This only occurs when more proximally situated parts of
the gyrus occipito-temporalis are destroyed. The cortical area?
belonging to the lateral geniculate body are not only limited to
the cortex of the occipital lobe. A. Ninian Bruce.
DEATH FROM “606.” (La mort par le 606.) H. Miskdjian, Theses de
(611) Paris , 1912-13, No. 418
The author has collected 167 cases from literature in which death
followed the injection of “ 606,” or neosalvarsan. The cases are
classified as follows: Primary syphilis, 10 cases; secondary syphilis
— (a) active, 32 cases; ( b) latent, 3 cases; secundo-tertiary syphilis
— (a) active, 3 cases; ( b ) latent, 5 cases; tertiary syphilis— (a)
active, 36 cases; ( b ) latent, 4 cases; parasyphilis—tabes, 16 cases;
general paralysis, 15 cases; leucoplasia, 1 case; syphilis of un¬
certain period, 19 cases; inherited syphilis, 5 cases; haemorrhage
or thrombosis of cerebral arteries, 4 cases; non-syphilitic disease,
e.g., typhus, Hodgkin’s disease, malaria, recurrent fever, cancer, and
plague, 14 cases.
In 51 death was independent of “ 606,” being due to the
progress of the disease, whether syphilis or not, an intercurrent
disorder, or to the injection having been given in extremis. 19
were suffering from severe organic disease, such as uraemia, tuber¬
culosis, heart disease, or aneurysm. In 61, who were mostly
young and healthy persons, death was due to arsenical intoxication
either of the gastro-intestinal form (22 cases) or of the cerebro¬
spinal form (39 cases).
In 3 death was due to myelitis, in 5 to icterus gravis, and in
the remainder to faulty technique, except in 10, where no definite
cause could be ascertained.
The 29 eases in which an autopsy was obtained are divided
into two groups—(1) 22 cases of haemorrhagic encephalitis, with or
without renal, hepatic, or other lesions; (2) 7 cases in which
cerebral lesions were absent or unimportant, but various other
lesions were found, e.g., intense parenchymatous degeneration of
548
ABSTRACTS
the kidneys with hypersemia, congestion of the other organs, such
as the suprarenale, thyroid, etc., and acute pulmonary oedema.
J. D. Rolleston.
THE TREATMENT OF SYPHILITIC AFFECTIONS OF THE CEN-
(512) TEAL NERVOUS SYSTEM, WITH ESPECIAL REFERENCE
TO THE USE OF INTRASPINOUS INJECTIONS. Homer
F. Swift and Arthur W. M. Ellis, Joum. Ini. Med., 1913, xil,
Sept., p. 331.
The introduction of salvarsan directly into the cerebro-spinal
fluid in syphilis of the central nervous system suggests itself as
a means of intensifying the treatment, but subsequent examination
of the cerebro-spinal fluid after high injections of the drug in
monkey-serum intraspinously in monkeys showed that the drug
introduced in this form was too irritating to warrant its application
to patients. Neosalvarsan injected intraspinously into monkeys
was less irritating, but when injected into patients produced
symptoms too severe to warrant its continued use (v. infra).
Serum, on the other hand, can be repeatedly injected into the
subarachnoid space without demonstrable injury to the nervous
tissue. Serum of salvarsan-treated patients has a definite anti-
spirochetal effect, both in intro and in vivo. The technique of
such subarachnoid injections is here described, and its combination
with intensive intravenous treatment is indicated where specially
intensive treatment is required, as in rapidly advancing tabes
or paresis.
The treatment here adopted was to give 0'45 gm. to 0'5 gm.
every two weeks, and in addition intraspinous injections of 30 c.c.
of 40 per cent, serum until the cerebro-spinal fluid showed a normal
cell count and a negative Wassermann reaction.
A. Ninian Bruce.
THE TREATMENT OF SYPHILITIC DISEASES OF THE NERVOUS
(513) SYSTEM BY SUB ARACHNOID INJECTIONS OF NEO¬
SALVARSAN. (Behandlung syphilitischer Erkrankungen des
Nervensystems mittels intra - ar&chnoidealer Injektion von
Neosalvarsan. Q. Marinesco, Ztschr.f. Physik. u. diatet. Therap.
1913, xvii., p. 194.
Records are given of thirteen cases who were each given from
4 to 5 c.c. of a solution of neosalvarsan intraspinously. Except
for three cases, all the others bore the injection very badly, some
becoming very much worse, eight developing retention of urine,
and requiring catheritisation. One case, suffering from amblyopia,
became blind. A. Ninian Bruce.
ABSTRACTS
549
GUMMA CEREBRI: RESULTS OP TREATMENT: SOME HISTO-
(614) LOGICAL FEATURES. Howard H. Tooth, Proc, Roy. Soc.
Med., 1913, vi., May (Neurol. Sect), p. 87.
During the ten years 1902-11 there were under treatment in the
National Hospital, Queen Square, 71 cases of cerebral disease due
to syphilis. (Vascular lesions and cases exhibiting symptoms of
general paralysis have not been included.) Of these 31 gave
definite localising signs of intracranial growth, and 15 came to
operation; 16 were treated more or less successfully by anti-
syphilitic methods. In addition 9 were diagnosed as gumma
cerebri, and improved much on treatment. Forty cases are thus
here considered.
Many cases of gumma, or so-called pachymeningitis, arrive at
a stage in which treatment by ordinary medical methods is of no
avail. The growth must be treated as a tumour. Of 15 such
cases operated upon, 4 died (26 6 per cent.). In 12 the operation
was performed on the central region. Four of the remaining
cases were traced and were all alive several years afterwards.
Sixteen cases were treated medically only. They all presented
localising signs—4 frontal, 6 central, 1 temporo-sphenoidal, 3
cerebellum, 1 crus cerebri, 1 multiple gummata, 4 foci found post
mortem. Five died (31*2 per cent.), 9 may be said to have been
successfully treated (56’2 per cent.), and 2 derived no benefit.
Of 9 cases without localising signs, 5 (55*5 per cent.) apparently
completely recovered, 2 almost completely recovered, and 2
improved but little.
The medicinal treatment almost universally employed was
mercurial inunction and pot. iod. 10 gr. to 20 gr.
Of 31 cases of “ cerebral syphilis,” 13 were decidedly improved,
8 left hospital in much the same condition as on admission, and
3 have died. Of these 31 cases, 22 were males and 9 females.
Among the symptoms were: headache and vomiting in 9; mental
symptoms in 16, mostly dullness and slow cerebration; convulsions
in 9; cranial nerve lesions in 12, nearly all of third and sixth
nerves; optic neuritis in only 1; optic atrophy in 4; some degree
of paralysis in 9.
The excised masses were examined in 11 cases. The foci
usually develop in the pia-arachnoid. Masses of leucocytes are
thrown out widely, but mostly aggregated around the vessels and
tending to spread down into the cortex and white matter. Plasma
cells and fibroblasts then appear, and no doubt form the basis of
the fine supporting structure, and later of the scar-like tissue, of
the gumma. The changes in the vessels occur in the intima, the
intimal coat becoming invaded, usually at one side, and thickened
at the expense of the lumen, which may become obliterated. The
550
ABSTRACTS
reticular network then develops into thick fibres and the mass
becomes sclerosed. The underlying cortex may only suffer to a
very slight extent, or patches of inflammation or necrosis may be
found. An active proliferation of the pia may occur strongly
suggestive of some irritative cause, perhaps of an infective nature,
and strongly resembling a glioma. A. Ninian Bruce.
HEMIPLEGIA FOLLOWING SYPHILIS, WITH SPECIAL BEFEB
(515) ENCE TO A CASE OF DOUBLE HEMIPLEGIA AND P8BUDO-
BULBAB PARALYSIS. Murdoch Mackinnon, Lancet , 1913,
clxxxv., Oct. 4, p. 989.
A Chinese sailor, aged 39, was admitted to Greenwich Hospital
for Seamen on 3rd May 1910, with a healing chancre and a
roseolar rash. He was given benzoate of mercury, 4 gr. daily, and
pot. iod. 10 gr. t.i.d. He left hospital on 10th August apparently
quite well.
On 30th September he was readmitted with a history of having
lost the power of his right arm and leg four days previously.
He was given mercury and pot. iod., and was discharged much
improved on 19th December. On 2nd January 1911 he was
again admitted to hospital with complete left hemiplegia and
inability to talk. The tongue, soft palate, and lips were com¬
pletely paralysed, and there was great difficulty in swallowing
and in breathing. He was given mercury and pot iod., and later
0.6 grm. salvarsan. He was discharged on 16th June, when he
could walk and talk perfectly well, and showed very little evidence
of the successive attacks of paralysis.
Three other cases are also mentioned, the first in a man
aged 30, which occurred nine months after infection, the second
in a man aged 40, five years later, and the third in a man aged 30,
nine months later (cf. Review, 1913, xi., p. 257).
A. Ninian Bruce.
THE LUETIN TEST. Ferdinand Schmitter, Joum. Cut Die., 1913,
(516) xxxi, Aug., p. 549.
The author examined 150 cases with luetin prepared by Noguchi.
He considers that the luetin test, like the Wassermann reaction,
is a valuable diagnostic aid when interpreted properly, especially
in conjunction with the clinical findings ( v . Review, 1913, xi.,
p. 190). A. Ninian Bruce.
ABSTRACTS
551
A REPORT ON THE ANALYSIS OP THE 0ERBBR0-8PINAL
(617) FLUID. W. F. Schallxk, Joum. New. and MenL Du., 1913, xl.,
August, p. 489.
The material for this paper is taken from the records of 109 cases
of nervous affections. The cell count, globulin reaction, and
Wasserman reaction are especially considered. There is nothing
new in the paper. D. K. Henderson.
SOME ANATOMICAL CONSIDERATIONS OF THE DISPOSITION
( 518 ) OF THE SCIATIC NERVE AND FEMORAL ARTERY: with
suggestions as to their clinical significance. F. Wood-Jones,
Lancet, 1913, clxxxiv., March 15, p. 752.
The pressure of the lowest cord of the brachial plexus upon the
rib produces the sensory changes, the muscular wasting, and the
vascular symptoms in cases of “ cervical ribs.” In the arm both
vascular and nervous symptoms are produced by one pressure
point, and may be manifested together, although either symptom
may be predominant (v. Review, 1913, xl, p. 486).
These two symptoms are manifested separately in the leg and
under different circumstances, thrombo-angeitis of the leg with
intermittent claudication being accompanied by only trivial nervous
symptoms, and neuritic sciatica by no vascular changes. These
are explained by the fact that in the arm the limb artery accom¬
panies the main limb plexus, while in the leg they are situated on
opposite sides of the limb.
In the amphibia and reptilia the artery of the hind limb runs
along with the sciatic nerve on the caudal aspect of the limb. In
mammals the arteries lie on the flexor aspect of the limb so as to
avoid stretching in active limb movements, while the sciatic nerve
retains its primitive position on the extensor aspect. If the leg
be strained back the artery becomes stretched, if strained forward
the nerve is stretched. This latter condition will occur in those
who have to remain long in a sitting posture, and will produce
pressure or tension sciatica, while the former condition will be
found in those who have prolonged hours of standing, and will
lead to thrombo-angeitis with intermittent claudication.
A. Ninian Bruce.
A NOTE ON REMISSION IN A CASE OF EPILEPSY. D. W.
(519) Cabmalt Jones, Lancet, 1913, clxxxiv., Feb. 8, p. 384.
A girl, aged 4 years, who suffered from epileptic fits developed
pneumonia and was ill eight weeks. During this time the fits were
in abeyance. There was some recurrence when the pneumonia
was over, but after convalescence was established the fits com-
552
ABSTRACTS
pletely ceased. The case is of interest as being suggestive of the
infective nature of some kinds of epilepsy, and as being a possible
instance of an obscure process of immunity.
A. Ninian Bruce.
PIBLOKTO OB H78TBBIA AMONG PEAKY’S ESKIMOS. A A.
(520) Brill, Joum. Nero, and Ment. Dis ., 1913, xL, August, p. 514
Peary, in his book on “ The North Pole,” gives some interesting
particulars in regard to a disease which the Eskimos call piblokto,
and which he designates as hysteria. No child has ever been
known to have piblokto, but someone among the adult Eskimos
would have an attack every day or two. “It seems to be the
result of brooding over absent or dead relatives, or a fear of the
future.”
An attack has been described as follows:—“ A woman will be
heard softly singing and accompanying herself by striking the fist
of one hand with the palm of the second, making three sounds,
one long followed by two short ones. The rhythm and motion
continues to increase for some time, during which she tears off her
clothing, and ends in a fit of crying or screaming, in which the
woman may imitate the cry of some familiar animal or bird.
Some women drop down on their hands and knees and crawl
around barking like a dog. One woman used to lie on her back
on the snow and place ice on her breasts; another may jump into
the water and wade among the ice-cakes, all the time singing and
yelling.” The attacks last from one to one and a half hours,
usually end in sobbing or falling asleep, from which they awaken
in a perfectly normal state. The attacks are usually accompanied
by a certain loss of consciousness, but no typical gratui inal
seizure has been seen. Brill considers that piblokto is essentially
the same as hysteria, owing to its predominance in the female sex,
and owing to its psychogenetic origin. D. K. Henderson.
LATE SUPPURATIVE POST-TYPHOID THYROIDITIS AND
(521) SECONDARY GRAVES’ DISEASE. (Strumitis posttyphosa
apostematosa tarda, und sekund&re Basedowsche Krankheit.) G.
Gau, Dent. med. Woch., 1913, xxxix., p. 1302.
Man, aged 39. At the age of 16 he had been operated on for
goitre. For the next two years he had been in good health, and
noticed no swelling in his neck. In the third year he had an
attack of typhoid fever, in convalescence from which his neck
began to swell again, but the swelling soon subsided. The present
illness had started one month previously. Signs of an abscess in
the thyroid were accompanied by rapid loss of weight, sweating,
ABSTRACTS
553
tremor, tachycardia, exophthalmos, and von Graefe’s symptom.
Five months after evacuation of the abscess, which contained
typhoid bacilli, all the symptoms had disappeared.
The occurrence of Graves’ disease in infective thyroiditis is
well known, but in most cases the inflammation is non¬
suppurative. J. D. Rolleston.
TRIGEMINAL DURAL NEURALGIA Beverley R. Tucker, Journ.
(522) New. and Ment. Dis., 1913, xl., August, p. 521.
During the last five years the writer has observed a type of head
pain, neuralgic in character, yielding but slightly to the usual
analgesics, having more or less distinct manifestations, and due
to neuralgia in the dural branches of the fifth nerve, just as tic
douloureux, with which it is at times associated, is due to neuralgia
in its peripheral branches. For this condition the name trigeminal
dural neuralgia has been selected.
Nine cases are described in a short tabulated form.
D. K. Henderson.
HYOSOINE MORPHIA ANAESTHESIA FOR ALCOHOL INJECTION
(523) IN NEURALGIA Wilfred Harris, Lancet , 1913, clxxxiv.,
March 29, p. 881.
The injection of the trigeminal nerve for tic douloureux with
alcohol causes considerable pain. Nitrous oxide or gas and oxygen
are not suitable amesthetics on account of the muscular spasm
they produce. Under chloroform it is a difficult and slow process,
and it is necessary to allow the patient gradually to come round
to know if the nerve has been properly injected, as the only
satisfactory proof is anaesthesia of the skin and mucous membrane
in the distribution of the nerve. Eucaine solution does not
diminish the pain much.
The author now recommends that ^ gr. of morphia with gr.
of hyoscine be given hypodermically into the arm twenty minutes
before the time for the alcohol injection. The patient must now
lie down. When the needle is approaching the foramen ovale the
patient usually shows signs of sensitiveness, and a few drops of
3| per cent, eucaine solution may now be injected. The alcohol
may now be slowly injected in the usual manner. The addition
of tV gr. of atropine to the preliminary injection will diminish any
tendency to vomiting. A. Ninian Bruce.
5f>4
ABSTRACTS
80MB PELVIC DI80BDEB8 IK RELATION TO NEURASTHENIA.
(524) Carlton Oli> field, Practitioner, 1913, xci, Sept, p. 335.
A brief discussion of this subject, concluding with the opinion
that pelvic disorders have no specific action in causing neurasthenia.
Pelvic complaints, with the exception of disorders of menstruation,
are as often as not unassociated with physical signs, and due to a
general neurasthenia. Great care, however, is necessary before,
during, and especially after oj>eration, in order to prevent poet-
operative neurasthenia. A. Ninian Bruce
SHOULD A MAN WITH MINERS’ NYSTAGMUS WORK ? Stanley
(625) Riseley, Lancet , 1913, clxxxiv., March 1, p. 598.
When a man claims to be, and is admitted to be, incapacitated
by nystagmus, after a reasonable period, during which he has
been under constant observation, if his condition warrants his
being employed, lie should eventually resume work underground,
but as a commencement occupation above ground should be
provided. There is no doubt that a man with bad nystagmus
can work and do good work, and is no worse for doing it. The
attitude that a man with nystagmus should not be allowed to
work, and advised never to return to the pit, is not justified.
A. Ninian Bruce
THE EPIDEMIOLOGY OF PELLAGRA. J. F. Silks and P E.
(526) Garrison, Amer. Joum. Med. Sc., 1913, July, cxlvi.
This is the first part of an article which will be concluded in the
next miml>er.
The territory selected was Spartanburg county in South
Carolina. The total population of the county is 83,465, and it
contains 762 square miles.
From 1st June to October 1912, 282 cases of pellagra were
studied in detail. Definite knowledge waj also obtained in regard
to 94 additional cases, giving a ratio of 44 9 per 10,000 of popula¬
tion. The population may be divided into (1) rural, (2) mill-
village, (3) urban.
The cases of pellagra were found to be excessively prevalent
in the mill-villages where the population was congested.
In Spartanburg county the white race predominates numeri¬
cally over the black in the proportion of two to one, but there
were ten white pellagrins to one negro pellagrin. In considering
this racial comparison, it is interesting to note the practical
absence of negroes from the mill population.
In regard to sex distribution, pellagra appeared nearly three
times more frequently among females than among males.
ABSTRACTS
555
The age distribution showed that 56'4 per 10,000 occurred in
individuals twenty years and older, 15 - 5 per 10,000 in individuals
nineteen years and younger.
The distribution of cases in families is also considered.
D. K. Henderson.
PSYCHIATRY.
AN ADDRESS ON MIND AND MOTIVE: SOME NOTES ON
(527) CRIMINAL LUNACY. David Nicolson, Lancet , 1913, clxxxv.,
Sept. 13, p. 787.
The idea of crime on the one hand, and the idea of insanity on the
other, each in its way implies a deviation more or less important
from standards of conduct which bear the stamp of social sanction.
Insanity is a mental condition or a neurosis, and its heredity or
hereditary transmission is a fact in nature well established and
universally accepted. Now, crime is neither a mental condition
nor a neurosis, and is to be regarded in the main as an occupation
resulting from environment, and entered upon as a means of trying
to make a living. A peculiar interest thus attaches to the
question of insanity when raised in connection with a criminal
offence, especially if the offence be murder and the penalty death.
The broad guiding principles upon which medical opinion has to
be based are two in number:—(1) That no lunatic shall be hanged,
and (2) that no mere criminal shall, on the plea of insanity, be
allowed to escape the due punishment for his act of murder. In
the procedure by which a decision is arrived at as to whether a
prisoner is or is not a criminal lunatic, there are three stages
where the state of his mind may come up for consideration:
(1) The jury may be called upon to give their verdict as to his fit¬
ness to plead; (2) tho^trial itself; (3) the prerogative of mercy
exercised by the Home Secretary. A good rough-and-ready test
for use in a court of law, and the question is one which a medical
witness ought to be prepared to answer, ia—(1) If he can say the
prisoner did not know right from wrong; (2) if the prisoner did
know right from wrong, but that his self-control was in abeyance
or lost; (3) if the prisoner knew right from wrong absolutely.
At the trial of James Jefferson, at Leeds, in 1908, the jury found
him guilty although insane, as he knew he was doing wrong, and
he was sentenced to death; but the higher court set the verdict
aside and sent him to an asylum, showing that in the eye of the
law a knowledge of right and wrong is not incompatible with the
existence of insanity, carrying with it irresponsibility, in the
individual.
46
556
ABSTRACTS
Mental enfeeblement in some form is a precursor of the
insanity which leads up to murder in many cases, and must be
reckoned with, but it must be remembered that mental enfeeble¬
ment itself neither constitutes insanity in any form or implies
irresponsibility.
Questions of infidelity, alcoholic excess, delirium tremens,
drunkenness, epilepsy, and delusions, either in mania or melan¬
cholia, in their relation to criminal lunacy, are then discussed,
typical cases of each being given. The author states also that in
all his experience he has never been able to satisfy himself in any
case of drink or epilepsy, where murder has been committed, that
the whole of the circumstances of the act have been completely
obliterated from the memory. Confusion and incompleteness of
memory regarding some part may occur, or single and simple
automatic acts may be completely forgotten, but that is quite a
different matter.
Malingering, imposture, and feigned insanity usually expose
themselves, as the prisoner overacts the part.
A. Ninian Bruce.
THE THERAPEUTIC VALUE OF SODIUM NUCLEIN ATE IN
(528) GENERAL PARALYSIS AND DEMENTIA PRJECOX. (Sul
valore terapeutico del nucleinato di sodio nella parallel pro¬
gressiva e nella demenza precoce.) Antonio Morktti, Rauegna
di titudi Pnchiat.y 1913, iii., p. 269.
After briefly referring to the negative results obtained by this
method of treatment in cases of general paralysis in Florence, the
author describes three cases of dementia pnecox in which all the
symptoms upon which this diagnosis had been based completely
disappeared after a series of injections of sodium nucleinate. He
accordingly considers that this line of treatment is justifiable,
especially in early cases, where the diseased process may not have
yet produced any irreparable damage, as we know very little of
the etiology and pathology of this condition.
A. Ninian Bruce.
CONTRIBUTION TO THE STUDY OF THE MANIC-DEPRESSIVE
(529) PSYCHOSIS. (Contributo alio studio della psichosi maniaco-
depressiva.) G. Martini, Riv. ital. di Neurop . Psichiat. ed
Elettroter., 1913, vi., p. 297.
A case remarkable for the late development of the psychosis.
The patient was a woman, aged 58, in whom the menopause had
occurred two years previously. The exciting cause was a fright
caused by an explosion. Recovery took place in about eighteen
months. J. D. Rollrston.
ABSTRACTS
557
▲ CASE OF MANIC-DEPRESSIVE PSYCHOSIS IN AN ACHONDRO-
(630) PLASIAC. (Sn di un caso di psichosi maniaco-depressiva in
acondroplasico.) G. Zuccari, Riv. ital. di Neurop. Psichiat . ed
EletUroter.y 1913, vi., p. 289.
Male, aged 46, who had two maniacal attacks in the course of
three years. Though mental disturbances are not uncommon in
achondroplasia, this is only the third case on record of maniacal
attacks occurring in this condition. J. D. Rolleston.
*
FUNCTIONAL PSYCHOSES OF THE SENILE PERIOD. Albert C.
(531) Buckley, Pennsylvania Med. Joum., 1913, Feb.
From the experience of about one hundred patients whose
psychoses were observed the following conclusions may be drawn:
(1) True atrophic senile dementia is comparatively infrequent
among the mental disorders of senility; (2) senility is a relative
term, and the determination of its existence should be based upon
anatomico-pathological criteria rather than on any age limit;
(3) psychoses occur during the period of senility which are not, in
the strict sense of the expression, “senile psychoses”; (4) the
majority of mental disorders of old age are the result of arterio¬
sclerosis of the cerebral vessels and its effects; (5) functional
psychoses, such as occur in early life, are not infrequent among
senile individuals; (6) the functional psychoses which are seen in
old age are likely to be of (a) the confusional type, (b) the de¬
pressive (melancholic) type, or (c) the recurrent manic or melan¬
cholic (manic-depressive) type; (7) the confusional and depressive
types appear to be of toxic origin, probably due to systemic
vascular disease affecting the kidneys, liver, or intestines; (8) of
the functional psychoses 20 per cent, are recoverable.
A. Ninian Bruce.
THE INCIDENCE OF INHERITED SYPHILIS IN CONGENITAL
(632) MENTAL DEFICIENCY. J. Leslie Gordon, Lancet , 1913,
clxxxv., Sept. 20, p. 861.
The author applied the Wassermann reaction to the blood serum of
400 patients in the asylums of the Metropolitan Asylums Board who
were suffering from various forms of congenital mental deficiency,
and found that 66 (or 16 5 per cent.) gave a positive result.
Stigmata of syphilis could only be distinguished in 11 of these 66
cases, and in some were doubtful. An analysis of the various
types is given, and the conclusions are drawn that (1) a syphilitic
infection is associated with a considerable number of cases of
congenital mental defect, mostly the result of inherited syphilis;
ABSTRACTS
5o8
( 2 ) inherited syphilis, either ul< me or in conjunction with other
factors, plays ait important part in the causation of congcMiital
mental defect; (3) in very many cases syphilis can only he detected
hy means of the Wassermaiin ivacfion; (4)excepting hydrocephalus,
and certainly of the plegie forms, inherited syphilis is as likely to
cause a simple, uncomplicated form of congenital mental defect
as it is to cause any particular type; (a) the Mongolian and
epiloiac types are not commonly caused hy inherited syphilis.
A Xjman Bruce.
THE RECORDS OF FOUR UNUSUAL RECOVERIES IN CASES
:,Xi> OF MENTAL DISEASE. Lkwis C. Brock, Lancet, 1913, clxniv.,
April 12, p. 1022.
Cttw /. Male, aged .40, confirmed epileptic, and exhibiting mild
type of imbecility; seizures averaged at one time 200 to 300 per
month. 40 e.cs. of blood were drawn weekly for a period of six
weeks from his median basilic artery, i.c., 240 c.cs. in all, for test¬
ing, hut from the day of the first bleeding till now (a period of
eight years) he has had no further epileptic seizures.
Viise 11. Woman, aged 57, suffering from recurrent attacks of
fu/ir rirrn/niiY mania, with barely recognisable periods of depression.
Each of the attacks of excitement lasted about six weeks, and
was accompanied by a recurring leucocytosis of from 12,000 to
20,000, and by a specific agglutinin in her serum to a variety of
streptococcus isolated from the blood of a case of acute mania
Injections of this streptococcus failed to produce immunity, but
feeding her with living cultures of this organism grown in sterilised
broth for forty-eight hours at 37° C., 1 oz. thrice daily between
meals, resulted in recovery.
Case III. Woman, 32, melancholic, with fixed delusions;
nutrition miserable. Four years after onset of illness she
developed scarlet fever of a mild type, with little constitutional
disturbance (highest temperature being 101° F.). As she con¬
valesced from the fever a marked physical and mental improve¬
ment was noticed, and she ended by making a complete recovery.
C<w IV. Woman, aged 27, morose, impulsive, absolutely
intractable, with delusions of identity, and apt to suddenly attack
fellow patients. Suddenly one morning she was found in bed
unconscious with symptoms of right hemiplegia and aphasia
This was followed by three weeks of hyperpyrexia (temp. 104* F.).
after which the paralysis passed off and speech returned. She
finally made an excellent recovery, leaving the asylum to go into
service. ’ A. Ninian Bruce.
REVIEWS
559
TREATMENT.
STRYCHNINE IN HEART FAILURE. John Parkinson and R. A.
(534) Rowlands, Quart. Joum. Med., 1913, vii., October, p. 42.
The authors find no evidence that the subcutaneous injection of
a full dose of strychnine in cases of heart failure with a regular
rhythm produces any change in the blood pressure, rate of pulse,
rate of respiration, or general symptoms within the hour following
its administration. They conclude that strychnine has no effect
which justifies its employment as a rapid cardiac stimulant in
cases of heart failure. A. Ninian Bruce.
■Reviews.
TRAITS INTERNATIONAL DE PSYCHOLOOIE PATHOLOGIQUE.
(535) Directeur: Dr A Marie (de Villejnif). Tome troisifeme Psycho-
pathologic Appliqu6e, avec 338 gravures dans le texte. Paris,
Librairie Felix Alcan , 1912. Pp. 1076.
With the issue of this volume Dr Marie’s monumental work is
completed. The previous numbers, which dealt with the subjects
of “ General Psychopathology ” and “ Clinical Psychopathology ” re¬
spectively, have been reviewed in these pages. It may be stated
at the outset of this review that the present volume of “ Applied
Psychopathology” maintains the high standard of the treatise.
The several subjects are written by alienists of indisputable
authority, and there is a consistency of merit rarely attained in
the united labour of many authors.
Opening with a general survey of the physiopathology of that
part of the brain devoted to sensation and feeling, Bianchi has
little that is new to relate; he has, however, invested the subject
with interest, and realises fully the necessity for a thorough
understanding of it as the basis of all mental knowledge:—“Nihil
est in intelleetu quod non prius fuerit in sensu.” He traces
the evolution (individual and racial) of sensations, and their
development into perceptions and feelings, that is to say, into
successive notions and successive modifications of the Ego. The
whole of our present knowledge of sensation and its application
in mental disease is clearly and comprehensively stated.
An admirable introduction is thus given to one of the most
important monographs in the volume, that of the late Prof.
Sikorsky, “On mental disease from a psychological standpoint.”
This monograph is divided into two parts, one having reference
560
REVIEWS
to the manifestations of mental disease, the other to the psychology
of mental states. Sikorsky, in his study of the manifestations of
mental disease, confines himself to the transient features such as
mimicry, the acts and the attitudes seen in the several mental
conditions, normal and abnormal. The author draws largely from
the work of Duchenne, Boulogne, Charcot, Darwin, and others,
pioneers in this particular field, and the results of his own
researches are summarised and discussed. Of special interest
in this illuminating study are those parts on the variations of
mimicry according to race, age, sex, etc. In the second part of
the monograph Sikorsky is met with the difficulties which
surround the subject of psychology. This subject is one of the
weakest in our medical armoury, and recent psychological re¬
searches require to be amplified before much can be said in its
favour. The future of physiological and experimental psychology,
and especially the progress of neurology, have rendered indis¬
pensable the extension in every direction of clinical investigation
of both mental and bodily states considered in their mutual
relations. Such efforts must be singularly arduous, and the
guidance which is given to the manner in which these studies
ought to be conducted is of marked value. Practical papers on
pathological emotional conditions, and sexual psycho-pathogenesis,
are contributed by Dumas and Hellis.
The chapter on sexual mental affections is in the able hands
of Havelock Ellis, who groups all cases formerly described under
the headings of moral insanity, amorality, and moral idiocy, and
takes as the criterion of his study the abnormal reactions from
.morality which are associated with a basis of organic defect, con¬
genital or acquired, and generally linked to a certain degree of
mental defect.
A large part of the volume is devoted to comparative psycho¬
pathology. The introduction of this subject by A. Cullerre is
a painstaking and conscientious record, in which much that is
curious and of absorbing general interest is introduced. The
psychopathology of the several races forms the major portion of
the part; it is written by the Editor, and is well worthy of close
perusal. Originating as a scientific study in the school of Herbert,
our knowledge of comparative psychopathology has made great
progress, and the greater progress it makes, the clearer does it
become that mental affections, whether in history, in races, in the
human being, or in the lower animals, are governed everywhere
and at all times by the same laws of general unity. The sick
man is the neighbour of him who is normal, and physiology and
pathology onlv differ in degree and by insensible transitions. The
influence of climate and custom in modifying disease may here be
KE VIEWS
561
noticed. Syphilis, for instance, is very prevalent in Asia and
Africa, but it rarely acts on the nervous system; this is thought
to be due to the elimination of toxines by the sweat, and by a
simple life in the open air. A similar explanation applies to the
relative infrequency of nervous lesions in consequence of intemper¬
ance in the use of haschish and alcohol. Again, among the
Russians the lavish use of tea, of melon water, and of fruits, by
laving the intestinal tract, mitigates the effects of poisonous
substances. Bearing in mind the advocacy of castration, and the
removal of the ovaries in the treatment of sexual excess and
sexual perversion, the reference in this chapter to the prevalence
of erotic insanity among eunuchs must not be overlooked.
The wide range of study pursued by the Editor is further
emphasised by his collaboration with N. Bagenoff in what is
designated “The collective insanities,” conditions better known
in this country as “ Communicated insanities.” The history of
epidemic insanity in particular, with the deductions drawn from
the symptoms displayed during the epidemics, reveal the authors
at their best. Discussion of these subjects are usually entered
into in a biassed spirit, and it is to their credit that they have
so well maintained an unprejudiced attitude, and kept in view
the dictum of Renan in his “Vie de Jdsus”:—"Medicine has
names to express great departures from ordinary human nature,
and is prone to label what it cannot comprehend as pathological;
unmindful that in general one would prefer to be Pascal ill, than
an ordinary person—well”
The principal features of the mental conditions of animals,
apart from man, form the subject undertaken by Dexler (Prague).
Our knowledge of the mental states of the lower animals is still
in its infancy, and requires accurate and laborious experience on
which to base any satisfactory conclusions. Even when striped
of individual imagination and well controlled, a certain amount
of error cannot be avoided. The variety of animal organisation,
and the absence of speech relations between man and animals,
oblige one to analyse mental phenomena indirectly and in the
light of one’s own mental acts. Our knowledge of animal psy¬
chology is gained from experimental physiology or pathology.
Dexler’s work is largely based on the experiments of Mendel and
Gerdes on animal paralysis; on the mental alienation caused by
poisoning by morphine, cocaine, mercury, or autointoxications;
on Nissl’s work on the paralysis of dogs; and on symptoms of
mental degeneracy, mania, and other mental affections in horses, etc.
In the historical summary with which he introduces the
general etiology of mental troubles, and writing more particularly
of the influence of surroundings on mental states, the editor points
562
REVIEWS
out that the most ancient system of medicine known in the ancient
world—Sushrata Sanscrit—placed the air among the principal
causes of mental disease, and the influence on the brain of certain
divinities which probably correspond to the stars was indicated.
This system even made a distinction between certain forms of in¬
sanity according as they developed or became accentuated during the
different phases of the moon. The ideas thus referred to, though
slightly modified held sway in all civilised countries until recent
times, and even yet they mingle in the treatment of mental
disease, and will only be dissipated by further scientific study of
the influence of climate and surroundings on the mind. The
reader who wishes guidance on the most recent discoveries in
these matters cannot fail to profit largely by perusing the informa¬
tion afforded in this part of the treatise.
The final chapter of the volume is concerned with laboratory
work, and describes the numerous reaction time instruments and
varied clinical apparatus which have been adopted to amplify
our knowledge of mental disease. The volume is extensively and
beautifully illustrated, and is a storehouse of suggestion and
information. A detailed index to each volume, or to the completed
work, would be of much use to the reader.
Hamilton C. Mark.
BRAIN AND SPINAL CORD. A manual for the study of the
(536) morphology and fibre-tracts of the central nervous system. Emil
Villiger. Translated by Geobge A Piebsol from the third
German edition: with 232 illustrations. J. 6 . Lippincott, Co.
Philadelphia and London, 1912. Pr. 16s. net
The translation of this book into English places in the hands of
those who do not read German one of the best of the recent
works upon the anatomy of the central nervous system. It is a
book which may be confidently recommended to anyone wishing
a good text-book on this subject. The conciseness and brevity
which are so characteristic of the original have been carefully
preserved in this translation. The general appearance of the
book closely approximates to the German edition, the plates being
clearly reproduced, their value in many cases being greatly
increased by the introduction of two or three colours; in fact,
one would even wish that this had been more extensively used.
The book is divided into three parts. The first deals with the
morphology of the central nervous system. The development of
the different parts of the brain are clearly shown, the different
structures developing from the three primitive cerebral vesicles
being accurately explained. These are then described in detail, a
BE VIEWS
563
large amount of useful information being successfully compressed
into a small compass.
Part II. deals with the fibre tracts. It commences with a
short description of the different methods by which these tracts
have been studied. This is followed by a brief account of the
structure and appearance of the nerve cell. The layers of the
cerebral cortex are then considered, followed by a short section
on cerebral localisation. The association, commissural, and pro¬
jection fibres are then described, the diagrams illustrating the
different paths of these tracts being specially good and concise.
The cerebellar cortex and fibre tracts are next considered, followed
by the spinal cord and the medulla oblongata. The cranial nerves
are then discussed, and this part comes to an end with a summary
of the chief tracts.
Part III. consists of a number of figures illustrating two series
of serial sections of the brain stem of a four year old child. The
first series, of 28 figures, extends from the anterior end of the
corpus callosum to the quadrigeminal region; the second series, of
21 figures, is from the caudal end of the medulla oblongata to the
quadrigeminal region. A short description is given below each
figure, so that it is easy to identify the different structures.
No references to literature are anywhere given in the text, but
the translater has added a number of selected references. There
is a good index.
We have no hesitation in recommending this book to anyone
wishing a short and concise account of the anatomy of the central
nervous system. The type is good It is a book which may be
recommended both to the student and to the teacher. The
translation itself has been well done, the book being easy to read
and to understand. A. Ninian Bruce.
THE TREATMENT OF INFANTILE PARALYSIS. Oskar Vulpius.
(537) Translated by Allan H. Todd, with introduction by J. Jackson
Clarke. Pp. x. +318; 243 figs, in text London: Baillikre,Tindall
& Cox, 1912. Pr. 10s. 6d. net.
This work deals almost exclusively with the orthopedic treatment
of the sequelae of poliomyelitis, and is divided into two parts, the
first of which is confined to general treatment, and the second to
special treatment. There is a short introduction of twenty-five
pages dealing with symptomatology, aetiology, and pathological
anatomy.
The introduction is very brief, and it is a striking proof of the
rapidity of the advance of our knowledge of this subject that part
of it is already out of date.
The general treatment is discussed under the headings of (1)
564
BOOKS AND PAMPHLETS RECEIVED
general treatment in the acute stage and stage of repair during
the first year of illness, (2) orthopedic apparatus, and (3) the surgery
of paralysis, which is subdivided into (a) treatment of paralytic
contractures and deformities, (b) restoration of function by muscle
implantation, arthrodesis, tendon shortening, tendon transplanta¬
tion, and nerve transplantation.
The special part is devoted to the treatment of the various
parts—the neck, back and abdomen, shoulder, elbow-joint, hand
and fingers, foot, knee and hip; and the book closes with chapters
on the treatment of shortening, and on paralysis of extreme
severity. There is a good index, both of subjects and of names.
The book will specially prove of value to those interested in
the surgical treatment of infantile paralysis. We should like to
have seen more stress laid upon the prolonged and careful applica¬
tion of medical treatment, as we have seen many cases recover
under such conditions which had been considered as hopeless.
The illustrations are very numerous, and form such a complete
series that they alone add great value to the book. The translation
has been well done.
BOOKS AND PAMPHLETS RECEIVED.
Biedl, Prof. Dr Arthur. “ The Internal Secretory Organs: their
Physiology and Pathology,” translated by Linda Forster. John Bale, Sons
<k Danielsson, Ltd., London, 1913. Pr. 21s.
Brouwer, B. “ Uber das Kleinhirn der Vogel, nebst Bemerkungen
iiber das Lokalisations-problem im Kleinhirn” ( Folia Neuro-biologica,
1913, vii., Nr. 4/0, S. 349).
Buckley, Albert C. “Functional Psychoses of the Senile Period”
{Pennsylvania Med. Journ., 1913, Feb.).
Flatau, Edward, and Handelsman, Jdzef. “ Abcds de la moelle produits
par voie expdrinientale, Neuronophagie leucocytaire. Infiltration diffuse
dans le systeme nerveux central ” {Com/it. Haul, de la Soc. des Sciences de
Varsovie , 1913, vi., F. 1).
Kappers, C. U. Aricns. “ Cerebral Localisation and the Significance of
Sulci ” (XVIIth International Congress of Medicine, London, 1913).
Lange, S. J. de. “ Das Zwischenhirn und das Mittelhirn der Reptilien ”
{Folia Neuro-biologica, 1913, vii., Nr. 1/2, S. 67).
Lange, S. J. de. “ L’Evolution phylogdndtique du corps strid” {Le
Ntvraxe, 1913, xiv., p. 105).
Valkenburg, C. T. van. “ On the Occurrence of a Monkey-slit in Man ”
{Konink. Akad. van. Wetensch. te Amsterdam , 1913, Feb. 22).
Vries, I. de. “ Uber die Zytoarchitektonik der Grosshirnrinde der
Maus und fiber die Beziehungen der einzelnen Zellschichten zum Corpus
Callosum auf Grund von experimentellen Liisionen” {Folia Neuro-biologica ,
1912, vi., Nr. 4, S. 289).
“ Department of Neurology. Harvard Medical School.” Vol. v., 1912,
Boston, Mass., U.SA.
“Report of Het Centraal Nederlandsch Instituut voor Hersenonder-
zock,” 1912.
IReview
ot
neurology anb IPs^cbiatr^
©riginal articles
A CASE OF TOXIC EXHAUSTIVE INSANITY,
ASSOCIATED WITH CHRONIC SUPPURA¬
TIVE OTITIS MEDIA, LABYRINTHITIS, AND
EXTRA-DURAL ABSCESS.
By D. K. HENDERSON, M.D.,
Resident Physician, Phipps Psychiatry Clinic, Johns Hopkins Hospital,
Baltimore ; late Assistant Physician, Royal Edinburgh Asylum ;
AND
WINIFRED MUIRHEAD, L.R.C.P. (Edin.),
Late Pathologist, Royal Edinburgh Asylum ;
AND
J. 8. FRASER, M.B., F.R.C.S.,
Assistant Surgeon, Ear and Throat Department, Royal Infirmary, Edinburgh ;
Aural Surgeon, Leith Hospital.
(With Plates 28 to 31.)
The writers are indebted to Dr George M. Robertson, Physician
Superintendent, Royal Asylum, Edinburgh, for permission to
record the following case.
W. P., male, aged 42 years, labourer, married, was admitted
to the Royal Edinburgh Asylum, Momingside, on 29th May
1912.
The history of the development of the case obtained from the
patient’s wife was unsatisfactory, as she was of very low-grade
47
566 HENDERSON, MUIRHEAD, AND FRASER
mentality, and had not been especially observant She stated,
however, that the patient had always been a quiet, hard-working
man, and had earned 15s. per week as a worker in a flock-mill.
They had no children, and the informant denied ever having
had any miscarriages.
Six weeks previous to his admission to the Royal Edinburgh
Asylum the patient had to give up work owing to a failure of his
general physical health, and the doctor who attended him said
that he was suffering from consumption. Gradually he became
dull and apathetic, lay in bed all day long, had a very poor
appetite, and became too weak to walk. No account could be got
at this time in regard to the onset of a muoo-purulent discharge
from his left ear. Owing to his poor physical condition he was
sent to Seafield Hospital, Leith, but after a few days’ residence
there he was transferred to the Royal Edinburgh Asylum on
account of irritable, irrational behaviour. The medical certificates
stated that sometimes he answered when spoken to, but usually
took no notice of questions. He was described as rambling and
incoherent in his talk, as tearing his bed-clothes, and frequently
wetting himself.
On admission to the Royal Edinburgh Asylum (29th May 1912)
he was in a dull, confused, irritable, dishevelled condition. He
absolutely refused to co-operate in a mental examination, usually
refused to answer any questions at all, or else when he did so
replied in a flippant, irrelevant way, e.g ,:—
“ What is your address ? ” “ Trilby! see your way to let me
off this time. 0 God, help this sickness of mine."
“ Do you feel happy ? ’’ “ Yes.”
"Feel sad?" “Yes.”
“ Which is it ? ” “ The three of them.”
“ How long have you been sick ? ” “ Fourteen hundred and
eight.”
“ What do you mean ? ” “ Seven, seven, seven, seven.”
. He seemed to realise that he was in a hospital, but owing to
his attitude it was impossible to form any estimate of his memory
or orientation. No delusions or hallucinations could be demon¬
strated at that time.
Physically. —He was a white-faced, poorly nourished, de¬
generate man. His pulse was 72 per minute; temperature, 96*2;
height, 5 ft. 3 J in.; weight, 7 stone.
A CASE OF TOXIC EXHAUSTIVE INSANITY 667
He complained of headache and dizziness, showed a tendency
to fall backwards unless supported, and when supported walked
dragging his left foot, but his left arm was dependent and not in
wing position as is seen in complete hemiplegia.
His pupils were equal and regular; their reaction to light and
accommodation could not be determined owing to lack of co¬
operation. There was no paralysis of the external eye muscles,
and no nystagmus.
He had a purulent discharge from the left external auditory
meatus ; his hearing could not be definitely determined, again
owing to lack of co-operation, but it was not grossly disordered.
There was no disorder of the other cranial nerves, no special
tremors, and no disturbance of speech.
His tendon reflexes were exaggerated on both sides, but rather
more so on the left side; there was no ankle olonus, and no sign
of Babinski on either side. He showed numerous brownish scars
on both legs which seemed to be of a syphilitic nature, but both
he and his wife subsequently denied any syphilitic infection.
There was no disorder of the internal organs.
During the week following his admission he continued to
exhibit much the same condition. He was dull, irritable, and
cantankerous; he refused to co-operate satisfactorily in any
attempt to examine him, and when questioned buried his head in
the bed-clothes and refused to answer. He was cleanly in his
personal habits.
Gradually, however, under local treatment his ear condition
began to improve, and his general physical and mental condition
became so much better that on 18th June 1912 he was noted as
co-operating much better than at any time previously. He now
gave much the same account as that obtained from his wife in
regard to the onset of his sickness, but could not be got to
give any adequate explanation for his peculiar behaviour on
admission.
When some of the odd statements which he had made were
repeated to him he laughed, and said that he could not account for
them. He now, however, answered all questions correctly, had a
good appreciation of time, place, and person, and was able to give
a fair account of his life. He realised that he had passed through
an acute mental disturbance.
He was now able to be up and about the ward, assisted in
568 HENDERSON, MUIRHEAD, AND FRASER
some of the simple ward work, and did not show any special
abnormality of gait.
The examination of his cerebro-spinal fluid showed a negative
cell count of 2 cells per c.mm., negative globulin reaction, and
negative Wassermann reaction, both with the cerebro-spinal fluid
and blood-serum.
A qualitative examination of the cell-content of the cerebro¬
spinal fluid by means of Alzheimer’s method showed lymphocytes
62 per cent., large mononuclear cells 37 per cent., polymorpho¬
nuclear leucocytes 1 per cent.
No plasma, gitter, or macrophage cells were seen.
The patient continued to behave in a quiet way, and seemed
to have recovered from his mental condition, but on 12th July—
three days before death—he had a relapse, and suddenly became
confused and irritable. He tore his bed-clothes, struck another
patient without any provocation, either refused to answer any
questions, or else answered them irrelevantly, and at nights was
exceedingly restless and noisy. This condition lasted until the
time of his death on 15th July 1912.
Remarks .—Clinically the explanation of such a case was ex¬
ceedingly difficult. Owing to the old syphilitic (?) scars on the
patient’s legs, and the fact that he dragged his left leg in walking,
it was thought that he might have some syphilitic affection of his
nervous system. The entirely negative findings in the cerebro¬
spinal fluid and blood-serum made one feel justified, however, in
absolutely ruling out such a diagnosis.
The clearing up of the ear symptoms under local treatment
and the negative cerebro-spinal fluid findings also seemed to
conclusively rule out any cerebral or cerebellar involvement due
to abscess formation, so one was forced to make the more or
less symptomatic diagnosis of a confused, irritable mental state
developing on the basis of a low state of nutrition. The patho¬
logical and detailed examination of the left ear were, however,
instrumental in throwing more light on the case.
Autopsy Report. —The autopsy showed a poorly nourished
man with brownish scars on both legs. There was marked
thickening of the left mastoid process, and pus was seen in the
left auditory meatus.
Heart. —Weight, 10 oz. The heart muscle was pale and friable,
and showed some fatty infiltration. The tricuspid valve showed
[TY 569
Fit;. i.—N ormal Kk;ht Ear. No.
x. Ten.«ior tympani.
2. Apical coil of cochlea.
3. Middle coil.
4. Cochlear nerve in internal meatus.
5. Cranial end of aqueduct of cochlea (perilymph).
6. Lower part of basal coil of cochlea.
7. Carotid canal.
8 . Tubal portion of tympanic cavity.
I
Fir,. 2 .—Normal Right Ear. No.
> 1. Tensor tympani.
2. Helicotrema.
3. Canal for great superficial petrosal nerve.
I 4. Modiolus.
5. Facial nerve.
6. Cochlear aqueduct.
7. Line of junction of lamellor bone of carotid
cartilage bone of cochlear capsule.
8. Carotid canal.
9. Tubal air cells.
10. Tubal part of tympanic cavity.
iinmatory
e acutely
ditis; the
calcareous
Hus lung
liar focus,
te venous
no actual
process,
degree of
.t first to
animation
r the roof
with pus.
weighed
■f atrophy
3 granula-
t the base
iither the
D focus of
parietal,
roscopical
»llen, and
t seem to
isordered.
is stained
was seen,
ew vessel
•easonable
iue to an
etting up
les in the
"eptococcvs
568 H
some of t
abnormal i
The ex
cell count
negative "V
and blood-
A qual
spinal Hub
62 per cc:
nuclear le’
No pla
The pi
to have re
three days
confused i
patient w:
questions,
exceedingl
time of hii
Remar,
ceedingly
patient’s 1«
it was tho
nervous s;
spinal flub
absolutely
The cl
and the :
conclusive
to abscess
less symp'
developing
logical an
instrumen
Autop
man with
thickening
left auditc
Heart.-
and showi
A CASE OF TOXIC EXHAUSTIVE INSANITY 509
an acute endocarditis with, in addition, small inflammatory
haemorrhages on the cusps; the pulmonary cusps were acutely
inflamed; the mitral valve showed some chronic endocarditis: the
aortic valve showed no abnormality.
The first part of the thoracic aorta showed some calcareous
plaques.
Respiratory System .—Left lung: weight, 16£ oz. This lung
was emphysematous throughout. There was no tubercular focus,
and no congestion.
Right lung: weight, 25 oz. This lung showed an acute venous
congestion of the lower and middle lobes, but there was no actual
consolidation. There was no evidence of any tubercular process.
The kidneys, liver, and spleen all showed a slight degree of
chronic congestion.
Nervous System .—The dura mater did not seem at first to
present any abnormality, but a later and more detailed examination
showed that its outer surface was greatly thickened over the roof
and posterior surface of the left inner ear, and infiltrated with pus.
The pia arachnoid was slightly thickened. The brain weighed
42$ oz., and presented no gross abnormality in the way of atrophy
of the convolutions, foci of softening, &c. There were no granula¬
tions in the floor of the fourth ventricle. The vessels at the base
showed a slight degree of atheroma.
There was no evidence of any abscess formation in either the
cerebrum or cerebellum, and on section of the brain no focus of
infection was found.
Sections were taken from the frontal, precentral, parietal,
occipital, and temporo-sphenoidal regions. On microscopical
examination the nerve cells were found to be swollen, and
showed a fairly diffuse chromatolysis, but they did not seem to
be decreased in number, and their layering was not disordered.
In the large Betz cells in the motor region the nucleus stained
darkly, and a moderate degree of axonal reaction was seen.
There was no proliferation of the neuroglia, and no new vessel
formation.
Remarks .—In the light of the above findings it seems reasonable
to suppose that the sudden relapse of the patient was due to an
acute extension of the toxic process in the left ear setting up
an acute endocarditis, and secondary congestive processes in the
lungs, kidneys, liver, and spleen. A pure culture of Streptocoecvs
570 HENDERSON, MUIRHEAD, AND FRASER
pyogenes was obtained from the right lung, and it was unfortunate
that cultures were not also obtained from the heart and ear.
The nerve-cell changes seen in the cortex were quite typical
of those obtained in acute toxic-exhaustive states.
D.K.H.
W.M.
Examination of the Left Temporal Bone, and Left Middle
and Inner Ear.
(For purposes of comparison, photo-micrographs made from
sections obtained from the normal right ear of another patient
are reproduced alongside of those showing the condition of the
diseased left ear of the present case, W. P. The photo-micrographs
are made from the two ears at more or less corresponding points.
All the sections are cut vertically from before backwards, at right
angles to the long axis of the petrous pyramid, and are viewed as
they would appear to an observer standing in front of the patients;
thus the normal right ear is on the reader’s left, while the diseased
left ear is on the reader’s right.)
Naked Eye Appearances of Diseased Ear. —The dura mater in
the floor of the middle fossa is greatly thickened where it covers
the left tympanic cavity and labyrinth (pachymeningitis). On
the posterior surface of the petrous bone the dura is also thickened
above and behind the internal auditory meatus. The extra-dural
abscess above and behind the labyrinth has been opened iu
removing the brain, but still contains pus (Figs. 5a and z) which,
due to the formalin fixation, presents a putty-like character. The
saccus endolymphaticus appears normal, and, when opened, is
found to contain no pus. The left tympanic membrane is much
retracted, and the outline of the malleus can only be made out
with difficulty. The tympanic membrane does not give when
touched with the probe. There is slight thickening in the roof of
the jugular bulb, but there is apparently no general thrombosis of
the bulb itself.
Microscopic Examination of the Middle Ear.
Tubal Part of the Tympanic Cavity (Fig. la).—The superficial
epithelium presents an almost normal appearance. The submucous
tissue is greatly thickened, and shows areas of round cell infiltra-
TY 571
I 2 3
5 4
Fig. 3. —Normal Right Far. No. 175.
1. Ten>or tympani.
2 . Facial nerve passing above cochlea.
3. Vestibular ganglion.
4- Cochlear or perilymphatic aqueduct.
5. Jugular bulb.
6. Air cells in floor of tympanic cavity.
7. Tympanic cavity.
r contains
leep pink
on of the
ng of the
8 greatly
iner wall
Dy fibrous
:osa there
• This is
there are
e cochlea
contains a
r to that
.mount of
In the
ices filled
1 perfora-
•sterior to
Fig. 4.—Normal Right Far. No. 244)
1. Anterior part of epitympanic cavity.
2. Facial nerve.
3. Anterior part of utricle.
4. Cochlear opening of perilymphatic duct.
5. Jugular bulb.
6. Tympanic air cell.
7. Tympanic membrane.
8 . External meatus.
9. Tympanic cavity.
10. Sacculus.
n. Tensor tympani.
3 thicken-
:ic cavity
>d by the
(Figs. 4 a
t, but the
-a), and is
vascular
y of’the
»
processes,
ncus and
thickened
e appears
bra ovalis,
region are
570 HI
pyogenes we
that cultur
The nei
of those ob
Emvni.
(For p
sections ol
are reprod
diseased le
are made f
Ail the sec
angles to t
they wouk
thus the n
left ear is
Naked
the floor <
the left t
the poster
above and
abscess al
removing
due to the
saccus en
found to
retracted,
with diffi
touched v
the juguk
the bulb i
Tubal
cpitheliui
tissue is (
A CASE OF TOXIC EXHAUSTIVE INSANITY 571
tion. The lumen of the tubal part of the tympanic cavity contains
homogeneous or finely granular exudate, which stains deep pink
with eosin. The air cells in the floor of the tubal portion of the
tympanic cavity are greatly narrowed by fibrous thickening of the
submucosa.
Mao-Tympanic Cavity .—The tympanic membrane is greatly
thickened (Fig. 6a), and is in places adherent to the inner wall
of the tympanic cavity, which is greatly reduced in size by fibrous
thickening of the submucosa. In this thickened submucosa there
are areas of dense small cell infiltration (abscesses?).' This is
especially seen in the region of the promontory where there are
still the remains of a fistula into the basal coil of the cochlea
(figs. 3a and 4a). What is left of the tympanic cavity contains a
homogeneous or finely granular exudate (Fig. 6a) similar to that
seen in the Eustachian tube. There is a considerable amount of
new bone formation in the walls of the tympanum. In the
thickened submucous tissue there are numerous cystic spaces filled
with exudate (Figs. 4a and 7a). The remains of a small perfora¬
tion of the tympanic membrane can still be made out posterior to
and below the handle of the malleus (Fig. 5a).
Epi- Tympanic Cavity .—The attic is narrowed by fibrous thicken¬
ing of the submucous tissue (Fig. 6a).
Hypo-Tympanic Cavity .—The cellar, i.e., the tympanic cavity
below the level of the membrane, is entirely obliterated by the
marked fibrous thickening of the submucous tissue (Figs. 4a
and 6a).
Tympanic Ossicles and Muscles .—The malleus is present, but the
head shows extensive erosion of the joint surface (Fig. 6a), and is
adherent to the inner wall of the attic by means of vascular
fibrous tissue which has probably replaced the body of J the
incus.
The body of the incus, along with the short and long processes,
has entirely disappeared, but the joint between the incus and
stapes remains.
The stapes is present and, though embedded in thickened
mucosa, appears normal (Fig. 5a). The stapedius muscle appears
normal, but the tensor tympani is slightly atrophic.
Oval Window .—There is no perforation of the fenestra ovalis,
but the mucous membrane and submucous tissue of this region are
markedly thickened (Fig. 5a).
572 HENDERSON, MUIRHEAD, AND FRASER
Round Window .—The niche of the round window is entirely
filled up by fibrous thickening of the submucous tissue (Fig. 5a).
The secondary tympanic membrane is incorporated in the fibrous
tissue, which fills the scala tympani and the round window
niche.
Aditus and Antrum .—These spaces, like the tympanic cavity
itself, are almost entirely obliterated by fibrous thickening of the
submucous tissue (Fig. 7a).
Labyrinth Capsule .—The inter-globular space bone, which is
formed from the original cartilaginous capsule of the labyrinth,
is very irregular. This is well seen around the basal coil of the
cochlea, where the normal line of demarcation between the cartilage
bone and the lamellar bone is very indistinct and irregular
(perilabyrinthitis, Fig. la). In the posterior wall of the vestibule
the cartilage bone has been eaten through, so that the contents
of the vestibule are in contact with the extra-dural abscess described
below (Figs. 5a and 6a). The smooth end of the external semi¬
circular canal also shows some irregularity of its wall.
The lamellar bone which surrounds the cartilage bone is very
vascular, and is markedly thickened on the inner wall of the
tympanic cavity.
An extra-dural abscess is present in the floor of the middle
fossa, and also in the posterior fossa behind and above the internal
auditory meatus (Figs. 3 a, 4a, 5a, and 6a). In the middle fossa
the abscess extends forward above the cochlea and outwards to
reach the geniculate ganglion (Fig. 4a). Posteriorly the abscess
extends above the superior semicircular canal. The bony covering
of the cochlea, vestibule, and superior canal is markedly eroded
by this extra-dural abscess.
Posteriorly to the internal meatus there is a- track of fibrous
tissue leading from the extra-dural abscess of the middle and
posterior fossae downwards to the roof of the jugular bulb (Fig. z).
Pus formation can be seen in the labyrinth nucleus in the
region of the fossa subarcuata beneath the dome of the superior
canal
The Labyrinth.
Cochlea—Basal Coil .—The endosteum of the cochlea is greatly
thickened, and the outline of the endosteal bone, which lines the
cochlea, is rough and irregular on account of new bone formation
I
I
4
n
12
I I
to
Fic;. 5 .—Normal Right Ear. No. 295.
1. Tendon of tensor tympani.
2. Facial nerve.
3. Utricle.
4. Ampulla of superior membranous canal with crista.
5. Opening of crus commune.
6. Superior canal.
7. Sinus of posterior canal with crista quarta.
S. Niche of round window.
q. Jugular bulb.
10. Promontory,
ir. Kxternal meatus.
12. Handle of malleus attached to drumhead.
1 ^ and 14. Head and foot plate of stapes.
1.
2.
3 -
4 -
5 *
6 b
7 -
8 .
9 -
10.
11.
12.
x 3*
* 4 -
Fig. 6.—Normal Right Ear. No. 352.
External attic.
Head of malleus.
Facial nerve.
Two ends of external canal.
Superior canal.
Remains of fossa subarcuata in labyrinth nucleus.
Ductus endolymphaticu*.
Two ends of posterior canal.
Jugular bulb.
Hypotympanic cavity.
External meatus.
Tympanic membrane.
Stapes.
Prussac’s space.
573
»sue
t of
Y).
the
lere
wiic
>ani
*ous
and
•ack
rom
i to
ited
*ous
J0U3
coil
rely
aina
jahe
*OU3
Idle
are,
roin
ited
can
ling
ains
rery
aces
rous
vith
sent
new
tion
:ane
572
filler
The
tissu
nich
JL
itsel:
subn
1
form
is ve
coch]
bone
(peri
the <
of th<
belov
circa
T
vascu
tyrap
A
fossa,
audit*
the a
reach
exten
of th<
by th
P<
tissue
postei
Pi
region
canal.
Co
thicke
cochle
A CASE OF TOXIC EXHAUSTIVE INSANITY 573
(Fig. la). The basal coil of the cochlea is filled with fibrous tissue
in which much new bone has been deposited. The lower purt of
the basal coil is entirely replaced by new bone (Figs. 2 a and y).
The scala tympani shows more formation of new bone than the
scala vestibuli. Below and in front of the round window there
can still be seen the remains of an old fistula from the tympanic
cavity, which has opened into the scala vestibuli and scali tympani
of the basal coil (Figs. 3a and 4a). A slender process of fibrous
tissue can be seen extending from this region downwards and
inwards through the bone towards the jugular bulb (abscess track
along venous route ?). There is also a track of fibrous tissue from
the inner wall of the tympanic cavity and basal coil inwards to
the fundus of the internal meatus.
Middle Coil .—This has evidently been less severely affected
than the basal coil, for although it shows some new-formed fibrous
tissue and bone, the scale are mainly filled with homogeneous
material The cochlear duct is markedly dilated in this coil
(Fig. y) : Corti’s organ and the membrana tectoria have entirely
disappeared. The fibrous tissue in the scala tympani contains
many new-formed blood-vessels, and the outline of all the scale
are irregular at parts on account of the contraction of new fibrous
tissue and the formation of new bone.
Apical Coil .—This region is even less affected than the middle
coil, and there is no new bone formation. The three scale are,
however, filled with homogeneous exudate.
The Aqueduct of the Cochlea .—At the site of the opening from
the scala tympani the perilymphatic aqueduct is entirely obliterated
by new bone formation, although the outline of the opening can
still be seen (Fig. 4a). Lower down there is considerable thickening
of the lining membrane of the duct—the lumen of which contains
some pus cells. At the cranial end the fibrous thickening is very
marked (Fig. la).
Modiolus .—The central canal, spiral canal, and hollow spaces
of the bony spiral lamina are all filled with new-formed fibrous
tissue which replaces the nerves and ganglia (compare Fig. 2a with
Fig. 2), A considerable quantity of brownish pigment is present
in the hollow spaces of the modiolus and bony spiral lamina.
The Vestibule .—This cavity is almost entirely filled with new
fibrous tissue, in which there is very little new bone formation
(Figs. 5a and 6a). Just above the secondary tympanic membrane
574 HENDERSON, MUIRHEAD, AND FRASER
there is, however, a mass of new-formed bone (Fig. 5a). The
utricle and saccule have disappeared, and are replaced by fibrous
tissue. Here and there in this tissue small collections of round
cells (remains of abscesses) may be seen. On the inner wall of
the vestibule towards the roof the bone has disappeared, so that
the fibrous tissue filling the vestibule is in contact with the
extra-dural abscess in the floor of the middle fossa. This breaking'
through appears to have occurred in the region of the common
opening of the superior and posterior canals (crus commune)
(Fig. 5a). The smooth end of the external canal also shows some
erosion of bone. The aqueduct of the vestibule cannot be recognised
at the vestibular end. The lower part of the ductus endolymphaticus,
along with the saccus, appears to be normal.
Semicircular Canals .—The canals are less affected than the
other parts of the labyrinth (Fig. 7a), and in places the
membranous canals can still be seen. The perilymphatic space of
all canals contains pus and exudate, in which a little new-formed
fibrous tissue may be seen. There is some erosion of the bony
lining of the external semicircular canal at its non-ampullary
end.
Internal Auditory Meatus with Seventh and Eighth Nerves .—
The dura mater lining the internal meatus is greatly thickened,
and shows marked small cell infiltration as well as numerous
dilated blood-vessels (Figs, la and 2a). The bony floor of the
meatus is markedly eroded and presents a small abscess near its
cranial end. Towards the inner end the superior wall of the bony
meatus is perforated, so that the extra-dural abscess in the middle
fossa is in direct contact with the dura lining the upper wall of
the internal auditory canal. Numerous pus cells are present
between the thickened dura and the remains of the eighth nerve.
The two divisions of the eighth nerve can hardly be recognised, as
they are incorporated with the granulation and fibrous tissue
which fills the meatus. The vestibular nerve to the utricle is
replaced by fibrous tissue. Traces of the vestibular ganglion can
still be seen, and some fibres of the cochlear nerve can be traced
from the internal meatus to the modiolus. The facial nerve, on
the other hand, appears more normal, and in sections stained by
the iron hrematoxylin method (Fig. y) the nerve can be traced
through the meatus up to the geniculate ganglion. This latter
structure is in contact with the pus of the extra-dural abscess in
Kig. 7.—Normal Right Ear.
{ 1. Head of malleus.
2. Body of incus.
f 3 . Two ends of external canal.
■ 4 . Air cells behind labyrinth.
r 5 . Saccus endolymphaticus.
* 6. Two ends of posterior canal.
7. Jugular bulb.
Tympanic membrane.
2
987
Fu;. y.—Diseased Lkfi Iv\H
(Section stained by iron-hivmatojJ
1. Facial nerve well stained. Below am
cochlear nerve is not stained, and s|
2. Modiolus.
3. Dilated cochlear duct of middle coil.
4. Tensor tympani.
5. Tympanic cavity.
6. Carotid canal.
7. Basal coil of cochlea replaced by new 4
8. lugularbulb.
9. Aqueduct of cochlea.
riTY 575
al canal is
l above the
uhnston, of
>f the case,
je from his
lion he had
ival at the
and from
one or two
led of pain
side (left ?).
die time of
1 (29th May
ltly passing
ic purulent
iated in the
ulent laby-
ition of the
s been im-
ing the first
Functional
nging, how-
niination of
le years ago
to the con-
llucinations
l Edinburgh
one or both
1 retraction
er, tinnitus
nerve, or to
8 , of course,
n by means
bord. Such
st all of the
to establish
idoned.]
574 HE1
there is, hoi
utricle and a
tissue. Here
cells (remain
the vestibule
the fibrous 1
extra-dural al
through app€
opening of t
(Fig. 5a). Ti
erosion of bon
at the vestibu!
along with th
Semicircul
other parts
membranous •
all canals con
fibrous tissue
lining of the
end.
Internal j
The dura ma
and shows nc
dilated blood
meatus is ma
cranial end.
meatus is perl
fossa is in di)
the internal
between the t
The two divis
they are inc<
which fills th
replaced by fi
still be seen, t
from the inte
the other han
the iron hten
through the :
structure is ir
A CASE OF TOXIC EXHAUSTIVE INSANITY 575
the floor of the middle fossa. The lining of the facial canal is
greatly thickened in the region where the nerve passed above the
cochlea.
Remarks .—The writer is indebted to Dr G. M. Johnston, of
Seafield Hospital, Leith, for the following particulars of the case.
The patient had suffered from a foul-smelling discharge from his
left ear since boyhood. For some weeks before admission he had
been in bad health, and a day or two before his arrival at the
hospital he had suffered from severe pain in the ear, and from
marked giddiness which had caused him to fall on one or two
occasions. On admission (7th May 1912) he complained of pain
in the left ear and headache, and tended to fall to one side (left ?).
He also suffered from hallucinations of hearing. At the time of
the patient’s admission to the Royal Edinburgh Asylum (29th May
1912) the effects of the labyrinthine attack were evidently passing
off. Death occurred on 15th July 1912.
The case, therefore, was evidently one of chronic purulent
otitis media on the left side of long duration, complicated in the
beginning of May 1912 by an attack of acute purulent laby¬
rinthitis. It is unfortunate that no functional examination of the
ear was carried out, though it would probably have been im¬
possible to test the patient’s hearing, at any rate during the first
part of his residence at the Royal Edinburgh Asylum. Functional
examination of the vestibular apparatus by cold syringing, how¬
ever, could have been carried out.
[The difficulty of making an accurate functional examination of
the ear of insane patients will be obvious to all. Some years ago
the present writer (J. S. F.) attempted to inquire into the con¬
dition of the ears of insane patients suffering from hallucinations
of hearing, and examined twenty-two cases at the Royal Edinburgh
Asylum. Of these, five presented gross abnormality of one or both
tympanic membranes—perforations, scars, or marked retraction
and opacity. In the great majority of cases, however, tinnitus
aurium is due to a lesion of the cochlear ganglion and nerve, or to
otosclerosis. In order to detect these conditions it is, of course,
necessary to make an accurate functional examination by means
of tuning-forks, watch, voice, Gal ton whistle, or monochord. Such
an examination was quite out of the question in almost all of the
twenty-two cases mentioned above, and the attempt to establish
a pathological basis for the tinnitus was therefore abandoned.]
HENDERSON, MUIRHEAD, AND FRASER
r,7G
The character of the microscopic changes in the present case
would appear to indicate that the inner ear had been affected for
a period of about three months. The infection seems to have
spread from the tympanic cavity to the labyrinth by erosion of
the lower part of the basal coil of the cochlea. The usual sites
of fistula formation, namely, the oval and round windows and the
external canal, show no sign of perforation. The microscopic
changes are most marked in the lower part of the basal coil of
the cochlea and in the adjacent portions of the vestibule, as well
as in the remainder of the basal cochlear whorl. In the canals
the changes are less marked and less advanced than in the
vestibule and cochlea. From the vestibule the pus seems to have
spread to the sub-dural space by eroding the crus commune of
the superior and j>osterior canals, and thence to have extended
forwards and outwards over the cochlea and vestibule. The roof
of the internal meatus appears to have been eroded by the extra¬
dural pus burrowing downwards.
The inflammatory process also appeal's to have passed inwards
from the basal coil of the cochlea to the internal meatus in its
lower part.
As will be seen from the photo-micrographs, the extra-dural
abscess appears to be of much more recent date than the labyrinth¬
itis. If this be accepted, it goes to support the view suggested
by Drs Henderson and Muirhead, that the acute general infection
from which the patient died was due to an acute extension of the
septic process in the left ear.
In three similar cases of latent labyrinth suppuration, recently
examined by the present writer, a cerebellar abscess was present,
but in the case under consideration the brain appeared remarkably
healthy.
In conclusion, the writer wishes to acknowledge his indebted¬
ness to the Carnegie Trust for providing the illustrations.
J. S. F.
DESCRIPTIVE STUDY OF THE PERSONALITY 577
A GUIDE TO THE DESCRIPTIVE STUDY OF THE
PERSONALITY. WITH SPECIAL REFER¬
ENCE TO THE TAKING OF ANAMNESES OF
CASES WITH PSYCHOSES.
By Dr AUGUST HOCH,
Director of the Psychiatric Institute of the N. Y. State Hospitals, Professor
of Psychiatry, Cornell University Medical College ;
AND
Dr GEORGE S. AMSDEN,
Assistant Physician, Bloomingdale Hospital, White Plains, N.Y.
For some years we have been interested in the study of the
relation between personality and the psychoses. From the first
of it the inadequate general statements concerning the personal
constitution before the definite mental breakdown, set down even
in very good anamneses, emphasised to us the need of some
uniform way of collecting the data. The following guide repre¬
sents our endeavour to meet this need. It is the result of
many revisions and modifications suggested by the actual work.
Our endeavour, then, started from the practical demand, in cases
which come to the notice of the psychiatrist, for adequate
anamneses referring to the period of the patient’s life in which
the compensation, so to speak, had not yet started to break down,
i.e., to the so-called normal period of the lives of such individuals,
and not to the actual mental disorder in the stricter sense.
In this very period, however, there are frequently noted milder
traits of a defect of adaptation, which still require more careful
description and study than have hitherto been given them.
While we have developed the guide in connection with an
attempt descriptively to correlate the milder abnormalities and
the psychoses, we have had in mind also studies which aim at a
clearer clinical description of these milder traits, with special
reference to singling out reactions appearing in very early life,
which may serve as signals warning of future nervous or mental
ill health. We hope, therefore, that the guide may be of use in
the study of abnormal and nervous children. Those also who
578 AUGUST HOCH AND GEORGE S. AMSDEN
work on problems of inheritance of specific mental traits may
perhaps obtain some help from it, at least so far as the more
affective factors of the mental make-up are concerned.
We have now quite a number of intelligence tests which, if
correctly used, are of considerable importance in the characterisa¬
tion of deficient individuals, but we lack tests for the much more
difficult sizing up of the personality so far as the more affective
reactions are concerned. It will probably always be impossible
to devise tests of this sort, because the situations which call forth
such reactions are too complex and often too subtle to be repro¬
duced experimentally, or if anything like them were reproduced,
they would still be artificial and lack the real flavour after all.
Therefore, it is necessary to depend upon a collection of reactions
as they occur, habitually or episodically, under the various condi¬
tions of actual life. For this reason, some such guide as the one
we have here elaborated might be used in place of a test for the
more affective, and therefore, so far as the behaviour and the
balance of the individual are concerned, for the more important
and more dynamic reactions.
The question as to what should be taken up in such an
inquiry was at first not so simple to answer. Academic psychology
gave us no help, and we had to be guided entirely by our clinical
experience. The problem was to size up, as much as possible, the
habitual reactions of the individual—that is to say, the various
mechanisms of adjustment and adaptation brought into play in
the more specific affective responses, in other ways used by
the individual in dealing with situations, or in various ways of
escape. It is clear that all that which refers to the sexual instinct
had to be fully considered.
We did not at first consult any similar attempts of this
sort, and later in looking over some questionaires devised for
the collection of mental traits, we found relatively little help, not
because these did not contain much valuable material, which is
undoubtedly very useful for certain kinds of study, but rather
because we found little in them which was truly helpful for the
purpose in hand, namely, for the collection of traits which
influence the mental balance for better or worse. The chief
points which have been added later refer to factors upon which
psychoanalytic teaching has laid stress as being of considerable
importance, and which our own experience has taught us to value
DESCRIPTIVE STUDY OF THE PERSONALITY 579
as indispensable additions to the anamneses of psychoses, or for
that matter, for a characterisation of any personality.
With the final grouping of the questions it is probably not
difficult to find fault, and undoubtedly changes might be made.
Such matters can, however, not be grouped in the form of exclusive
categories, and where everything is so intimately interwoven, and
where it is often a question of shading off in different directions,
as it is here, it would seem absurd to follow anything like a
logical system, and much more to the point, to group the questions
about certain general topics without too much concern about
inconsistencies or even repetitions. The arrangements of the
groups are again the outcome of practical needs and practical ex¬
perience obtained in the actual work of establishing facts in the
anamneses of patients.
We have mentioned the fact that we were particularly interested
in the more affective reactions of the individual. It is important,
however, first to inquire into those traits which primarily refer
to the intelligence and the relative capacity for the output of
energy and activity. In both these fields we find, of course, that
affects may exert a very decided modifying influence. Neverthe¬
less, they represent the most easily accessible measures of native
endowment of the individual, and furnish in practical work a
valuable indication of the general level upon which the individual
stands. An inquiry into traits referring to this field should,
therefore, form a starting point in the sizing up of the personality.
We try to get an estimate of the capacity of the subject for
acquiring knowledge, of the traits referring to judgment, and of
indications which the standing in school, or later in life, the
efficiency in work, as well as the general sizing up of the individual’s
“ sense ” by his friends, &c., furnish us. The second section of the
guide refers to the habits of the individual in the output of
energy.
Before taking up the mood and the more specific adaptability
to environment, it has been found advisable to inquire first into
the subject’s estimate of himself as expressed in such traits as
self-reliance, self-depreciation, conceit, or self-pity, and the like.
In studying the habitual attitude towards the environment we
take up the more specific traits of the personality which stand as
coefficients for good or poor facility for adaptation: in the first
580 AUGUST HOCH AND GEORGE S. AMSDEN
place, the more striking and the more general characteristics
which, on their abnormal side, interfere in a definite manner
with contact with the outside world, such as a general tendency
to shun society. There are also traits which in a more specific but
less obvious way accomplish similar results. Such traits are
selfishness, suspiciousness, jealousy, &c. This leads over to traits
from which we gather to what extent the subject lays bare to
others his real self, that is, openness, reticence, and the like.
Then we have taken up traits, such as conscientiousness and
scrupulousness, which, in their normal development, are useful
qualities, but which, in their exaggerated form, work somewhat
in the same way as those just mentioned, or, at any rate,
interfere with efficiency. In this connection also we have studied
traits which indicate a tendency either to an active shaping of
circumstances, or to the reverse. Such traits are an inclination
to lead, courage, &c. Finally, it is important to consider the more
specific traits showing the attitude towards reality—such as a
tendency to be fantastic, to day-dreaming, &c.
The group concerning the mood, which stands next, aims at
determining the habitual or episodic reactions of elation or de¬
pression, and also at what may be called the more allopsychic
negative moods, such as irritability. To this are added somewhat
related mental traits, with, however, rather less active reactions as
a rule, such as sensitiveness, touchiness, and so on.
, The group following that descriptive of the mood deals
with the more instinctive demands of the individual Here
are included traits which are more or less clearly related to
the sexual instinct. Practical work has shown that it is wise
to begin with affections of a sort which, on the surface at least,
are not plainly sexual, such as friendship and affection for the
members of the family. Then the more plainly sexual life is
taken up—that is, the relation to the opposite sex, the character
and frequency of love affairs, the attitude towards the partner in
engagement and married life, the sexual demands proper, the
attitude toward sexuality in general, including such traits as
prudishness, and the like.
Finally we inquire into the subject’s general interests—that is,
his capacity for sublimation, his capacity for getting satisfaction
from altruistic or higher interests, which represent important
balancing factors in the mental economy.
DESCRIPTIVE STUDY OF THE PERSONALITY 581
These are the main directions in which we feel the inquiry
should run. We give in the following pages the guide in detail.
This should not be looked upon as a questionaire, but as a guide
to be modified in individual cases. In the use of it cross references
and many questions to check up the data should form an important
part.
We would like to insist, especially in reference to the mood,
and also in connection with such traits as reticence, stubbornness,
sensitiveness, jealousy, &c., that it is of the utmost importance to
inquire not only into the general type and characteristics of the
reactions, but also into the circumstances under which the reactions
occur, the causes, or at any rate the apparent causes, which seem
to call them forth, and to give illustrative instances of them.
I.—Traits Relating Essentially to the Intelligence, the
Capacity for Acquiring Knowledge, the Judgment, &c.
How easily did he learn—was it necessary for him to study
very hard to keep up in school ?
What was his standing in school ? (School records.)
Did he keep up with his classes ? If not, what was the
apparent reason ?
What did his teachers say about him ?
Was he proficient in some subjects, deficient in others ?
Is his education up to his opportunities ?
Is his power of attention and concentration good or bad ?
Does he observe well ?
How capable is he in positions ?
Is he considered to have good common sense ?
Is his advice sought by others ?
Is he quick, impulsive, or deliberate in his judgment ?
Is he definite or vague of purpose ?
Does he plan with good foresight ?
How practical is he ? Can he use tools well ?
II.— Traits Relating Essentially to the Output of Energy.
In childhood was he lively, active at work and play, or lazy
and sluggish ?
In his play as a child what did he prefer ? Did he exercise
much imagination in it ?
48
582 AUGUST HOCH AND GEORGE S. AMSDEN
Is he naturally talkative, or inclined to be silent ?
Is he energetic, or slow, or sluggish ?
Does he show a tendency to overactivity, to much push and
tension ?
Is he active or overactive by fits and starts ?
Does he spend his energy sensibly or in a desultory way ?
III.— Traits Relating Essentially to the Subject’s
Estimate of Himself.
Is he self-reliant or self-depreciative (feeling of inferiority) ?
How dependent is he for his comfort on the opinions which
others hold of him ?
Ib he conceited, egotistic, given to self-admiration ?
Is he vain, proud ?
Does he pay unusual attention to his dress, is he foppish ?
Is he honest with himself, does he emphasise his dislike for
sham ?
Does he seem to be genuine ?
Does he blame others for his faults ?
Is he inclined to pay much attention to his aches and pains—
inclined to self-pity ?
IV.— Adaptability towards the Environment.
(a) The more striking traits which, on their abnormal side, interfere
in a rather general and striking way with contact vnth the
environment.
Is he sociable, easy to get acquainted with, or does he hold
people off?
Does he make friends easily ?
If he prefers to be alone, how does he rationalise this ? Are
there special circumstances under which he goes away by himself
(e.g., when reprimanded, criticised, or when something is required
of him) ?
Is he bashful—at ease with strangers? Is there a marked
difference in behaviour in his intercourse with friends, family, or
strangers ?
When a child did he play freely with other children ?
!
DESCRIPTIVE STUDY OF THE PERSONALITY 583
(6) Traits which in a more specific, hut in a less obvious, way
interfere with contact with the environment.
Is he selfish or sympathetic, kind-hearted, altruistic ?
Is he generous or penurious ?
Has he genuine respect for the rights of others ?
Is he tactful or offensive ?
Is he quarrelsome, or easy to get along with ?
Can he co-operate with others ?
Does he want his own way ?
Was he obedient when a child ?
Is he inclined to criticise others much ?
Does he take advice well, or does he always think he is in the
right ?
Is he stubborn—set in his opinions ?
Does he allow his mistakes to be pointed out to him ?
Is he apt to blame others for his own mistakes ?
Is he trustful or suspicious ?
Is he resentful or forgiving ?
Does he hold grudges long ?
Is he easily offended ?
Does he see slights when none are intended ?
Is he jealous or envious ?
Does he think the world treats him ill ?
Does he feel satisfied with his environment—does he feel
above it ?
Does he readily adapt himself to new environments (as being
away from home, moving to new places, &c.) ?
(c) Traits which show to what extent the subject lays bare to
others his real self.
Is there much known of his inner life, his views, mental
attitudes ?
Is he frank and open ?
Has he or has he not a tendency to unburden himself to other
people, or special people ?
Is he demonstrative ?
If reticent, is he reticent generally or in relation to certain
topics ? Is he more frank to certain people ?
584 AUGUST HOCH AND GEORGE S. AMSDEN
(d) Traits which in normal proportions are useful qualities, hut in
ezeaggerated form interfere with efficiency.
Is he conscientious—has he a natural feeling of responsibility,
or is he unusually scrupulous ?
Is he easily blocked in his activity by scruples and doubts ?
Is he committed to a routine, or is he free and agile mentally ?
Is he finicky in his demands for precision, system, or order ?
Does he show an exaggerated demand for truthfulness and
justice ?
(e) Traits which show a tendency to active shaping of situations,
or the reverse.
Is he inclined to be a leader or led ?
Does he show much demand for self-assertion ?
Is he courageous or cowardly ?
Is he imitative—suggestible ?
(/) Traits showing the attitude towards reality.
Does he take things as they are, or as he wants them to be ?
Is he fantastic or over-imaginative ?
Is he inclined to build air-castles; how strong is the tendency,
and how much satisfaction does the subject get from day¬
dreaming ?
Is he truthful or apt to lie ?
V.—Mood.
Is he cheerful, light-hearted ?
Is he serious, or not inclined to take anything seriously ?
Is he enthusiastic ?
Is he jovial, bubbling ?
Has he good sense of humour ?
Is he optimistic, hopeful ?
When such traits are present, are they more or less habitual,
or do they come out only under certain circumstances ?
How does he react to pleasure, good news, success ? (Descrip¬
tion of reaction.)
Is he despondent—has he a tendency to look on the dark side,
brood ?
DESCRIPTIVE STUDY OF THE PERSONALITY 585
Does he get despondent without apparent reason ?
Are there any topics he is especially inclined to worry about ?
When such traits are present, are they more or less habitual,
or do they come out only under certain circumstances ?
How does he react to real trouble, such as bereavement, failure
or success, responsibility ? (Description of reaction.)
Does he make attempts to overcome his despondency or
worrying ?
Does he crave sympathy in his depression ?
Does he seem to enjoy his discomforts ?
Is he stable or variable in his mood, away up or away down ?
Does his mood change easily ?
Is he easily frightened ?
Has he a tendency to anxiousness, to forebodings ?
Are there special topics which bring out his anxiousness ?
When anxious, what is his reaction ?
Has his mood apparently been permanently influenced by any
special occurrence or circumstance ?
Is he irritable, quick-tempered ?
Are there special topics or circumstances which irritate him ?
How does he react when irritated ?
Does the irritation last long ?
Did he have tantrums when a child ?
Is he patient ?
Is he sensitive, touchy ?
Is he fault-finding ?
Is he phlegmatic, indifferent ? Has this existed since child¬
hood ?
VI.— Instinctive Demands, Traits which are More or Less
Clearly Related to the Sexual Instinct.
(a) Fi'icndship.
Is he affectionate, demonstrative, or is he cold ?
Does he have many friends, or is he whimsical in making
friends ?
Does he keep friends long, or does he give them up on slight
provocation ?
Is he sentimental in his friendship ?
What qualities in others attract him ?
o86 AUGUST HOCH AND GEORGE S. AMSDEN
(b) Attachment to members of the fa mily.
Does he resemble in his ways and characteristics other
members of the family ?
Does he show any marked preference for, or great dependence
on, any member of the family, or marked antagonism ? (Father,
mother, older or younger brother or sister.)
Has there been a change in this respect between childhood
and adult life ?
What was his reaction to the death of any member of the
family ?
(c) Attitvxle tovxirds the other sex.
1. General.
Is his personal attitude in harmony with his own sex ? (Tom¬
boy, mollycoddle, mother’s boy, mannish, effeminate.)
Is he natural and at ease with the opposite sex ?
Is he or is he not especially attracted by the opposite sex ?
Is he attracted by older or younger persons of the opposite
sex ?
Did he have many, few, or no love affairs ?
Did the love affairs go deep, or were they rather perfunctory ?
Is he sentimental ?
When love affairs were broken off, what was the reason ?
What was the reaction towards disappointments in love ?
Was he decided or wavering when the question of engagement
or marriage came up ?
In marriage or other similar relationships, what is the attitude
toward the partner ? Is he affectionate, kind; or dissatisfied,
irritable,fault-finding, jealous, over-anxious,indifferent, domineering
—or, on the other hand, very submissive ?
Is there, or is there not, a desire for children ?
2. Specific sexual demands.
Is the demand for sexual gratification great or small ? (Potency,
psychic impotence, ejaculatio prsecox, frigidity.)
Does the subject masturbate ? If not, has he never mastur¬
bated, or when did he stop ?
Are there any perversions ?
DESCRIPTIVE STUDY OF THE PERSONALITY 587
3. General traits derived from sexual instinct or reactions
against its assertion.
Was there much sexual curiosity ?
Does he talk much of sexual matters—tell suggestive stories ?
Does he indulge in gossip with a sexual colouring ?
Is he particularly innocent, modest, prudish ?
Does he show a special demand for nicety, neatness, cleanli¬
ness, moralising ?
Is he easily disgusted l
Are there any idiosyncrasies towards food or odours ?
Is there any special tendency to cruelty, plaguing, tantalising ?
VII.— General Interests.
Is he interested in his work—does he get satisfaction from it,
or from other pursuits ?
Is he ambitious, and in what direction-?
To what extent has he been able to satisfy his ambition ?
Is he interested in sports or other diversions ?
What are his hobbies ?
Has he any fads ?
Does he read much, and what is the character of his reading ?
Is he religious, does he get comfort from his religion, or is
his interest merely superficial ?
Does he show any vague gropings, such as spiritualism, occult¬
ism, theosophy, “ deep subjects ” ?
Is he superstitious ?
In what does he get his deepest satisfaction ?
VIII.— Pathological Traits.
Without going into the history of the disorder, it will often
be found useful to amplify the guide by statements concerning
more frankly pathological features,—such as criminal tendencies,
tendencies to hallucinate without definite psychosis, phobias,
disorders of appetite and sleep, night terrors and anxious dreams,,
nocturnal enuresis, tics, &c.
588
ABSTRACTS
abstracts.
ANATOMY.
THE CEPHALIC NERVES: SUGGESTIONS. Robert Bennett
(538) Bean, Anat. Record ', 1913, vii., July, p. 221.
The cranial nerves need a reclassification. There are only four
cerebral nerves proper. The olfactory bulb and tract is not
a nerve but an outgrowth of the brain. The optic nerve is also
not a nerve, but another outgrowth, the retina is a modified
cerebral cortex, there is an association tract and a decussation.
These nerves should thus be described with the olfactory apparatus
and the optic apparatus. The tenth and eleventh cranial nerves
should not be considered with the nerves of the head, because they
are distributed to the neck, shoulders, and trunk, and form an
intermediate stage between the cervical spinal nerves and cranial
(why not cephalic ?) nerves. The remaining eight nerves may be
divided into four groups, and the author proposes to alter the
terminology of the present so-called cranial nerves in the following
manner:—
1. Call the nerves distributed in the head the cephalic instead
of the cranial or cerebral nerves. The head includes the cranium
and face, with the orbital, nasal, and buccal cavities as a part of
the latter.
2. Omit the olfactory and optic nerves and describe them
under their proper apparatuses.
3. Omit the pneumogastric and spinal-accessory nerves from
the cephalic group because they belong to the spinal cord type,
or may be considered as transitory nerves between the spinal
cord and brain, and are not distributed to the head but to the
neck, shoulders, and trunk.
4. Add three nerves to the cephalic group: (a) Add the motor
root of the fifth and call it the masticator nerve; (6) add the
sensory part of the facial, including the intermediate, nerve of
Wrisberg, the geniculate ganglion containing the cells of origin
of this nerve, and the chorda tympani, with its distribution in
the tongue and palate; ( c ) add the nerve of the semicircular canals
calling it the vestibular and separating it from the auditory.
5. Omit the sympathetic ganglia of the head, especially the
ciliary, sphenopalatine, otic, and submaxillar)', and constitute them
ABSTRACTS
589
as a ganglionated cephalic plexus, including the sympathetic part
of the geniculate, petrous and jugular ganglia, the prolongation
upward of the cervical sympathetic system. The nerves as
rearranged may be enumerated as the cephalic nerves:—
Name .
Distribution , Nature.
Oculo-motor -
Trochlear or pathetic
Abduoens
Trigeminal or trifacial
Masticator
Facial
Auditory or acoustic
Vestibular
Glossopharyngeal
Glossopalatine -
Hypoglossal
}
}
\
i
eye muscle
face
•{
•{
motor.
f *
sensory.
motor.
M
internal ear
. 5
4
sensory.
tongue, palate, &c.
{
(mixed).
motor.
Diagrams are given to illustrate the course and distribution
of the masticator and glossopalatine nerves, and the ganglionated
cephalic plexus and its connections. A. Ninian Bruce.
THE NUCLEUS GABD1ACUS NERVI VAGI AND THE THREE
(539) DISTINCT TYPES OF NERVE CELLS WHICH INNER
VATE THE THREE DIFFERENT TYPES OF MUSCLE.
Edward F. Malone, Amer. Journ. Anat., 1913, xv., July, p. 121.
The histological character of a nerve cell is an indication of its
function. This is seen in the dorsal motor (sympathetic) nucleus
of the vagus, which contains centres for the control of both heart
and smooth muscle. The nucleus ambiguus give rise to fibres
which supply striated muscle. In the dorsal vagus nucleus two
different types of cells are found. In the lemur and in Macacu$
Rhesus, the oral portion of this nucleus consists exclusively of
small cells, and supplies smooth muscle. As one follows the
nucleus caudally, a second type of cell begins to appear. In the
lemur the large cells form a fairly compact group dorsal from
the small cells; in the monkey their relative position is reversed.
Proceeding further caudalwards, the small cells become fewer, and
finally disappear, although a few transitional types are seen here
and there. These larger cells supply the heart muscle. It is also
to be noted that these larger cells are intermediate in histological
structure between those supplying smooth muscle and those
supplying striated muscle, a fact of interest, as heart muscle is
histologically intermediate between the two other types of muscle.
Although not described in detail, coloured figures illustrating
these three types of cells are given. A. Ntnian Bruce.
590
ABSTRACTS
A CASE OF COMPLETE ABSENCE OF BOTH INTEBNAL
(540) CAROTID ARTERIES, WITH A PRELIMINARY NOTE ON
THE DEVELOPMENTAL HISTORY OF THE STAPEDIAL
ARTERY. A G. Timbrell Fisher, Joum. Anat. and Physiol-,
1913, xlviii., Oct, p. 37.
This case was discovered at the autopsy upon a man, aged 39, who
died from cerebral haemorrhage. There were no symptoms during
life. The brain weighed 1080 g. The external carotids were
large and tortuous, and gave off their usual branches. There was
no carotid canal in the petrous portion of either temporal bone.
The basilar artery was nearly double its normal calibre, and
ended at the upper border of the pons by dividing into the
posterior cerebrals. On each side, from the point of anastomosis
of the two posterior cerebrals, a slender artery proceeded forwards
and outwards, occupying the position of the posterior communi¬
cating artery in the normal brain. They were occluded by
concentric fibrosis. These slender arteries divided at the locus
perforatus anticus into anterior and middle cerebral arteries. The
latter are joined by the anterior communicating artery, which
thus completes the circle of Willis. It is probable that the
circulation in the anterior and middle cerebrals was mainly carried
on through the anastomoses of the posterior and middle cerebrals
through their temporal branches. The left temporal lobe presented
a general shrinking without any alteration in the configuration
of the convolutions, which were atrophied mainly at the expense
of the grey matter, and were firm and hard, with the arachnoid
and pia mater closely adherent.
The author thinks that the two internal carotids probably
developed, but at a very early stage (about the 5 mm. period)
they began to atrophy at about the point they divide into anterior
and posterior branches. A. Ninian Bruce.
PHYSIOLOGY.
THE PHYSIOLOGY OF THE POSTERIOR ROOTS IN THE LIGHT
(541) OF RECENT SURGICAL PROCEDURES. J. Strickland
Good all and H. Gastineau Earle, Archives of Middlesex Hasp
1913, xxix., p. 7.
The operation of posterior root section has been performed for the
relief of three conditions:—
1. Gastric crises of tabes.
2. Spastic paraplegia.
3. The pain of neuralgia and neuritis.
ABSTRACTS
591
The immediate results of section of any posterior root are:
(1) abolition of reflexes, (2) abolition of decerebrate rigidity (spastic
paraplegia), (3) abolition of all sensation, including pain (aptes-
thesia). If the section be central, degeneration of the posterior
root fibres takes place in the cord, and no regeneration occurs.
If the section be peripheral to the ganglion, there is no central
degeneration, only the peripheral fibres are affected, and if the cut
ends are sutured together, regeneration can occur. The chief
conclusions as to the present state of our knowledge of the
physiology of the posterior roots in general are given, and the
following points of importance to the surgeon pointed out:
Section of all the posterior roots supplying a limb renders the
limb quite useless. It not only destroys all sensation and all
reflex action, but renders co-ordinate voluntary action impossible,
while at the same time trophic disturbances also take place. On
the other hand, section of some only of the roots, while reducing
the total sensory innervation of the limb, will not render it useless
and may prevent those impulses which are producing the abnormal
condition from reaching the central nervous system.
The operation can be justified physiologically in the gastric crises
of tabes, and in peripheral pain. In spastic paraplegia section
merely substitutes a flaccid for a spastic paralysis, and all the roots
must not be divided or voluntary and reflex movement will cease.
A. Ninian Bruce.
REGENERATION OF AXIS CYLINDERS IN VITRO (Second Com-
(542) munic&tion). Ragnvald Ingebrigtsen, Joum. Exper. Med., 1913,
xviii., Oct, p. 412.
Pieces of cerebellum and of spinal ganglia were taken from
living etherised cats and guinea-pigs, and put directly into
Ringer’s solution, where they were cut, and from there transferred
to coagulated plasma. Nerve fibres were found to grow out from
those; they do not anastomose, and extend into the plasma un¬
accompanied by structures of any kind. The cultures were fixed
by Held’s pyridin method, and stained by Cajal’s silver nitrate
method. (Cp. Review, 1913, xi., p. 164). A. Ninian Bruce.
THE CEREBRO SPINAL FLUID.-I. SECRETION OF THE FLUID.
(543) W. E. Dixon and W. D. Halliburton, Joum. of Physiol., 1913,
xlvii., Nov., p. 215.
The principal new fact here described is that an intravenous
injection of an extract of choroid plexuses (choroid gland) produces
an increased excretion of cerebro-spinal fluid, as tested by the
592
ABSTRACTS
rate of outflow through a cannula. This is not due to deficient
absorption of the fluid, nor the results of alterations in respiration,
or altered vascular conditions. The increased flow is equally well
seen after the previous injection of atropine. Whether or not the
hormone originates in the metalx>lic activity of the central nervous
system, it is the case that extracts of brain produce the same
effect on respiration, blood pressure, and on the flow of cerebro¬
spinal fluid as are produced by the choroid extract. The substance
may be produced in the brain’s metabolism and pass into the
choroid plexus, or it may be produced primarily in the choroid
epithelium, and occur secondarily in the cerebral tissue. The first
is the more logical. The chemical nature of this substance, which
is found in brain extract, in choroid extract, and in cases of general
paralysis and brain softening where catabolic processes are
excessive, is probably the same. It has a high molecular weight
and resists boiling. Cholesterin is present in all the situations
just mentioned, but the results of injecting a colloidal solution of
cholesterin into the blood stream are not comparable with the
choroid injection. Whatever the exact nature of this substance
is, it appeal's to reach the choroid gland, to excite it to activity,
and to accumulate there, as it can be extracted from it in relatively
large quantities. It does not pass out into the secretion in
recognisable amounts under normal conditions.
A. Ninian Bruce.
CLINICAL NEUROLOGY
ON DISEASES OF THE SPINAL OORD IN SMALLPOX. (Uber
(544) Erkrankungen des Btickenmarkes bei Menschenpocken.) H.
Eichhorst, Deut. Arch . f . klin. Med.> 1913, cxi., p. 1.
Out of 904 cases of smallpox treated by Eichhorst between 1884
and 1912 only two presented diseases of the nervous system.
One was a woman who developed an acute psychosis, with de¬
lusions of persecution in convalescence, and recovered after
having been sent to an asylum. The other was the subject of
this paper. A man, aged 40, in the desiccation stage of severe
smallpox, developed symptoms of acute ascending myelitis, and
died in three days from the onset. Necropsy: Macroscopically
no change was found in the spinal cord, but microscopic ex¬
amination showed that the spinal cord was invaded by numerous
inflammatory foci irregularly distributed throughout its whole
length. The lesions were most marked in the lumbar region,
where the pia was also affected, and gradually diminished in the
cervical region. In all the sections the anterior horns were most
ABSTRACTS
593
affected, but the lesions were not confined to them, but involved
the white substance as well. The inflammatory foci consisted
almost exclusively of uninuclear round cells. Examination for
bacteria in the cord was negative. The toxin was probably con¬
veyed by the blood to the cord, and led to the inflammatory
changes, but it was impossible to say why this particular patient
was affected, and why the lumbar position of the cord was
principally involved. J. D. Rolleston.
HERPES FACIALIS IN DIPHTHERIA. (Ueber Herpes facialis bei
(545) Diphtheric.) F. Reiche, Med. Klinik , 1913, vi., p. 1407.
Of 4,830 diphtheria patients observed by Reiche in the course of
2£ years, 336 cases, or 6 96 per cent., showed herpes facialis. It
was not present in 99 patients under 1 year, or in 16 over 50.
138 of the herpes cases were males, and 198 females. In 40 - 3
per cent, it occurred on the third day of the disease. It was
slightly less frequent in the severe (6 24 per cent.) than in the
moderate (8*01 per cent.) or the mild cases (7 42 per cent.). Like
the abstracter ( v . Review, 1907, v., p. 906), Reiche does not attach
any prognostic significance to the eruption, nor associate it with
the injection of anti-toxin. J. D. Rolleston.
THE PATHOGENY AND CLINICAL ASPECTS OF POST DIPH
(546) THERITIC CEREBRAL PALSIES. (Zur Pathogenese und Klinik
der cerebr&len post-diphtheriachen Lfthmungen.) A. L. Dynkin,
Jahrb.f Kinderheilk ., 1913, lxxviii. (Erg.-Heft), p. 267.
Dynkin reviews the literature and records two personal cases.
1. Boy, aged 10 years. Severe faucial diphtheria, early cardiac
dilatation and vomiting, right hemiplegia and aphasia on 20th day,
palatal paralysis on 40th day. A relapse of diphtheria occurred
two weeks after the first attack, but without complications, and
without having any influence on the paralysis. On discharge
from hospital the child could walk alone, but had contracture of
the right hand.
2. Girl, aged 7 years. Severe faucial diphtheria, right hemi¬
plegia and aphasia, accompanied by repeated convulsions, occurred
on 17th day. Paralysis of soft palate on 24th day. Death from
acute pneumonia a month after the onset of hemiplegia. The
necropsy showed softening of part of the left parietal and occipital
lobes, and no changes in the heart. Dynkin thinks that embolism
was the probable cause of the hemiplegia in the first, anil
thrombosis in the second case. To the 69 cases of diphtheritic
hemiplegia collected by the reviewer in 1909 (v. Review, 1909,
594
ABSTRACTS
vii., p. 104), Dynkin adds 3 more from Russian literature.
These, with the 2 here described, and with 11 collected since
1909 by the reviewer, make a total of 85 cases ( v. Review, 1913,
xi., p. 280). J. D. Rollestox.
POST D I PHT HER ITIC BULBAR PARALYSIS. (Epidiphtherischa
(547) Bnlharllh wiling.) E. Troknek and A Jakob, Zeittchr. /. d. get.
Nevr. u. Ptych., 1913 (Orig.), xv., p. 18.
A girl, aged 8 years, six weeks after an attack of diphtheria,
developed bilateral facial palsy and ptosis, without R.D. A few
weeks later she had difficulty in swallowing and partial paralysis
of the soft palate. Finally, an attack of suffocation occurred,
followed by occasional rapid twitchings of the facial muscles and
extremities, paresis of the right oculo-motor nerve, cardiac weak¬
ness, and death from broncho-pneumonia.
Histological examination of the medulla, spinal cord, and some
of the peripheral nerves showed subacute inflammatory lesions
limited to the blood and lymph channels and the surrounding
parts. The changes in the bulb were more marked than in the
peripheral nerves, and the facial and vagus were more affected
than the vasculo-spinal.
The writers conclude that diphtheritic paralysis is due to
central as well as to peripheral lesions, sometimes the former
and sometimes the latter predominating. J. D. Rolleston. *
CHANGES IN THE HYPOPHYSIS IN DIPHTHERIA (ttber
(548) verlndenmgen in der Hypophysis cerebri bei Diphtheria.) H. Q.
Creutzfeldt and B. Koch, Virchow'» Arehiv , 1913, ccxiii., p. 123.
The writers summarise their paper as follows:—
1. In many cases of diphtheria the demonstrable changes in
the heart are not sufficient to explain the severe atony of the
vascular system.
2. The strongly hypertensive action of pituitrin in diphtheritic
hypotonus suggests a participation of the hypophysis in this
condition.
3. In seven out of nine cases who died of cardiac and vascular
paralysis the writers found the elements of the pars intermedia
severely affected.
4. In guinea-pigs infected with cultures of diphtheria bacilli
the same degenerative changes were found in the pars intermedia
as in the human subject.
ABSTRACTS
595
5. Treatment by pituitrin and adrenalin represents the specific
treatment for diphtheritic cardiac and vascular paralysis.
J. D. Rolleston.
TYPHOID MENINGITIS AND THE MENINGEAL MANIFEST A
(549) TIONS OF TYPHOID FEVER. (Lea mfaingites tfberthiennes et
lea manifestations mfaingles de la fidvre typhoids.) R. J.
Weissenbach, Gat. d. hdp., 1913, lxxxvi., p. 1631.
The author adopts the following classification:—
1. Typhoid meningitis, properly so called, with presence of
the typhoid bacillus in the cerebro-spinal fluid, and appearing
either at the onset or in the course of typhoid fever.
2. Meningeal states observed at the onset, or in the course
of typhoid fever, probably caused by the typhoid bacillus, but of
which the pathogeny is not elucidated.
3. Typhoid meningitis independent of enteric fever, and
occurring as the only or predominant lesion of typhoid septicaemia.
4. Meningitis in typhoid fever caused by other germs than
Eberth’s bacillus, e.g., staphylococcus, streptococcus, pneumococcus,
meningococcus, or tubercle bacillus.
Weissenbach mentions two peculiarities of the cerebro-spinal
fluid in typhoid meningitis. 1. It agglutinates the typhoid bacillus,
whereas in typhoid fever, uncomplicated by meningitis, the cerebro¬
spinal fluid contains no agglutinins, even when the blood serum
has a very high agglutinative power. 2. The presence of an
immune body (sensvbilisatrice) which appears earlier than the
agglutinins. J. D. Rolleston.
MENINGITIS IN AN INFANT CAUSED BY THE TYPHOID
(550) BACILLUS. H. W. Lyall, Joum. Med. Research, 1912-13, xxvii.,
p. 457
A female child, aged 4 months, was admitted to hospital with
signs of meningitis, and died a month later. The possibility of
typhoid fever was overlooked, and a provisional diagnosis of
tuberculous meningitis was made. Von Pirquet’s reaction, how¬
ever, was negative, and repeated lumbar punctures gave issue to
a clear, sterile, practically cell-free fluid, always under tension.
Only just before death did the fluid contain pus cells, and an
organism which in its morphological and cultural characters and
bio-chemical reactions corresponded to the Baoillus typhosus. The
same organism was obtained from the nose before death, and in
pure cultures from the brain, and spleen, and heart blood post
596
ABSTRACTS
mortem. A diffuse purulent meningitis was found at the autopsy,
but the characteristic lesions of typhoid fever were absent.
J. D. Rolleston.
A CASE OF INFLUENZAL MENINGITIS. Athole Ross and A.
(561) Eisdell Moore, Brit. Med. Jovm. ., 1913, Oct 26, p. 1056.
A child, aged 13 months, was admitted to hospital with rigidity,
marked retraction and head twisted to the left, Babinski extensor
and Kernig’s sign positive. The cerebro-spinal fluid was turbid,
under increased pressure, contained albumin, 85 per cent, of
polymorphs, and a short aerobic bacillus. Animal inoculations
were not performed. The bacillus was gram-negative, and in
direct film preparations from the cerebro-spinal fluid only short
bacilli within the limits of 1*5 p to 2 5 p were found, but on
cultivation, long thread-like bacilli were observed.
A. Nixian Bruce.
FATAL MENINGITIS FIFTEEN TEARS AFTER A BULLET
<552) WOUND OF THE BRAIN. W. Pasteur, Archives of Middlesex
Hosp.y 1913, xxix., Oct., p. 14.
A barber, aged 39, was admitted to hospital in a semi-comatose
state. Fifteen years previously he had tried to shoot himself with
a revolver in the middle of the forehead. The condition suggested
uraemia, and while the state of the kidneys was found post
mortem to be consistent with such a view, death was found to
have resulted from an extensive meningitis of the convexity of the
brain. The base was healthy except under the left frontal lobe,
and a small-bore bullet was found encapsulated in the under
surface of the left temporo-sphenoidal Iota.
A. Ninian Bruce.
EXPERIMENTS ON THE CULTIVATION OF THE MICRO-
(663) ORGANISM CAUSING EPIDEMIC POLIOMYELITIS. Simon
Flexner and Hideyo Noguchi, Joum. Exp. Med 1 , 1913, xviil,
Oct., p. 461.
The authors have succeeded, by using human ascitic fluid as the
culture medium, in isolating from the central nervous system of
human beings and monkeys suffering from epidemic poliomyelitis
a peculiar minute organism that has been caused to reproduce
the symptoms and lesions of experimental poliomyelitis. The
micro-organ ism consists of globoid bodies measuring from 015 p
to 0 3 p in diameter, and arranged in pairs, chains, and masses
ABSTRACTS
597
according to the conditions of growth and multiplication. The
chain formation takes place in a fluid medium, the other groupings
in both solid and fluid media. Within the tissues of infected
human beings and animals the chains do not appear.
The micro-organism passes through Berkefeld filters, and
the filtrates yield upon recultivation the particular organism
contained within the filtered culture. Also, Berkefeld filtrates
prepared from the nervous tissues of infected human beings and
monkeys yield in culture the identical micro-organism.
By employing a suitable staining method the micro-organism
has been detected in film preparations and sections prepared from
human nervous tissues, and from the corresponding tissues of
monkeys inoculated with the usual virus, or with cultures or
filtrates prepared from monkeys previously injected with cultures.
From all the infected materials mentioned, irrespective of the
manner of their origin, the micro-organism has been recovered
in cultures.
As this micro-organism exists in the infectious and diseased
organs, and is not associated with any other pathological condition;
as it is capable of reproducing, on inoculation, the experimental
disease in monkeys, from which animals it can be recovered in
pure culture, it fulfils the classical requirements, besides which
it withstands preservation and glyeerination, as does the ordinary
virus of poliomyelitis within the nervous organs. Its anaerobic
nature interposes no obstacle to its acceptance as the causative
agent, since the living tissues are devoid of free oxygen, and the
virus of poliomyelitis has not yet been detected in the circulating
blood or cerebro-spinal fluid of human beings, in which the oxygen
is less firmly bound.
Details of the method of cultivation and of staining the tissues
are given. A. Ninian Beuce.
THE POLYNEURITIC FORM OF POLIOMYELITIS: A CLINICAL
(654) AND PATHOLOGICAL STUDY. 8 . Leopold, Amer . Jowm. Med.
Sc., 1913, cxlvi., p. 406.
A previously healthy woman, aged 20, was suddenly seized with
vomiting, fever, and pain in the head and back, followed a few
days later by paralysis of the limbs and bladder. The left lower
limb was completely, and the right lower limb partially, paralysed.
Both showed areas of hyperaesthesia. The knee jerks were absent.
There was also marked tenderness on pressure over the nerve
trunks in the paralysed extremities, which persisted until death
two months after the onset.
Necropsy: Heart, lungs, spleen, and liver normal. Cloudy
swelling of kidneys. No exudation in cerebral or spinal meninges.
49
598
ABSTRACTS
The lumbar cord was somewhat softer thau the other portions,
and showed on section a reddish-grey area in both anterior horns.
Microscopically the anterior horns were found to be practically
destroyed. Intense inflammation was found in the meninges and
around the posterior roots. Only one peripheral nerve and part
of a muscle were examined, which were taken from the anterior
aspect of the right thigh near Poupart’s ligament. The nerve
showed no evidence of acute or subacute inflammation, and no
distinct evidence of degeneration. Except that the striations were
not sharply defined, the muscle was normal.
The pain in this case was caused by inflammation of the
meninges and the swelling of the posterior roots, due to the round-
celled exudation within them and the engorgement of their vessels.
J. D. Rolleston.
THREE INTERESTING BRAIN OASES. David McM. Offices,
(555) Australian Med. Joum., 1013, ii., Sept. 27, p. 1227.
Case I. Boy, aged 13, was hit on left side of head. He walked
home, went to lied, became very noisy, and later unconscious. On
trephining, a rupture of the posterior branch of the middle
meningeal artery was found with extravasation of blood into the
middle meningeal fossa. Artificial respiration had to be per¬
formed during the greater part of the operation, but he made
a good recovery.
Case II. A child, aged 9 months, fell out of bed. He seemed
stunned at the time, and developed in succession nystagmus,
twitching of right arm and leg, and paralysis of right side. At
the operation, a depressed fracture of the left occipital bone was
found. The bone itself was of almost papery thinness, and the
fragments were elevated, and one or two removed. There were no
fissures passing away from the depressed area to be seen.
Case III. A man, aged 37, suffered from Jacksonian epilepsy,
which had been getting progressively worse. As the right side
was affected, the left Rolandic area was exposed, but nothing
found. The bone was found extremely thick (f inch) and ivory¬
like. The fits stopped for about four months after the operation.
They then commenced again, and he died two months later.
A. Ninian Bruce.
A 0A8E OF PITUITARY TUMOUR J. Catarinich, Australian Med.
(666) Joum., 1913, ii., Sept 20, p. 1^20.
The patient was aged 44, a labourer, and suffered from time to
time from attacks of depression during which religious ideas
ABSTRACTS
599
became prominent. Later he developed occipital headache which
became extraordinarily severe. Mental confusion became marked,
which made an examination of the field of vision difficult. This
was followed by amentia; his pulse dropped to thirty-three, and
he died suddenly. There were no symptoms of acromegaly.
Post mortem there was found a small adenomatous tumour in
the region of the pituitary—undoubtedly an overgrowth from the
anterior part. It pressed on the optic chiasma, and indented the
floor of the third ventricle. A. Ninian Bruce.
ON FAILURE OF VISION AND ITS TREATMENT IN PITUITARY
(557) DISEASE. H. Campbell Thomson and William Lang, Archive *
of Middlesex Hotp., 1913, xxix., p. 17.
Four cases are here described with varying degrees of bitemporal
liemianopia. The treatment was the administration of thyroid,
and it was found that three markedly improved, while in the
fourth the progressive advance ceased.
This supports Cushing’s view that the primary atrophy more
often represents a physiological block to light impulses than an
actual destruction of the nerves. A. Ninian Bruce.
CASE OF HYPERACTIVITY OF ANTERIOR LOBE, COMBINED
(558) WITH DEFICIENT ACTION OF POSTERIOR LOBE. E. C.
Williams, Brit. Joum. Child. Die., 1913, x., p. 407.
The patient was a boy, aged 13 years, whose grandfather was said
to have been a very big man. Excessive growth began at the age
of 9 years, with increase in height (anterior lobe activity) and
adiposity of the feminine type (posterior lobe defect). Present
height, 5 ft. 2 in.; weight, 10 st. 7 lb.; chest measurement,
35 \ in.; umbilical measurement, 35 in. X-rays showed large size
of hands, and tufting of the terminal phalanges. The skiagram of
the sella turcica was indefinite. Extremities cold and blue; blood
pressure, 115 mm. Hg.; genitals ill-developed. No local signs; no
headache. Vision and fundi normal. J. D. Rolleston.
THE ETIOLOGY OF PERNICIOUS ANOSMIA J. T. Pilcher, Amer.
(559) Joum. Med. Sc., 1913, cxlvi, No. 2, August.
The development of pernicious anaemia seems to depend upon a
personal idiosyncrasy of certain individuals. It is thought that
we must revert to an embryonic tendency for the real etiological
factor. D. K. Henderson.
600
ABSTRACTS
POSTERIOR SPINAL NEURECTOMY FOR THE RELIEF OF PAIN
(56 j) IN CERTAIN OASES OF INCURABLE CANCER. Sir Alfred
Pearce Gould, Archives of Middlesex Hosp., 1913, xxix., Oct, p. 1.
Two cases are described in which malignant disease of the lower
cervical glands, secondary to cancer of the breast, was the cause
of severe pain referred to the whole of the upper limb due to
pressure on the brachial plexus. In both cases the cervical spinal
nerves were exposed within the theca spinalis and the posterior
roots of the nerves involved excised. In each case the pain, which
was very severe, was immediately relieved, and the patients were
grateful for the operation. A. Ninian Bruce.
NOTES OF A SUPPOSED CASE OF PELLAGRA. Robert Reid and
(561) William Calwell, Brit. Med. Joum ., 1913, Sept 27, p. 784.
A farmer, aged 66, residing five miles from Belfast, suffered from
a dermatitis during spring and autumn on the back of his hands
and chin and mouth. His memory had recently failed, and he
was somewhat nervous. There was a stream of water from some
marshy ground piped into his yard, and used for farming purposes.
A Ninian Bruce.
A NOTE ON A CASE OF PELLAGRA Emma M. Johnstone,
(562) Lancet , 1913, clxxxv., Oct. 18, p. 1114.
The case was that of a woman admitted into Holloway Sanatorium
for melancholia and delusions. She presented no definite physical
signs of disease. Her mental state varied from mild exaltation
to depression, and the delusions were mostly of an organic nature.
Towards the end of May she was out in the sunshine and developed
characteristic lesions of the face and hands. She had never been
abroad nor eaten maize.
Very short notes on two other cases are given.
A Ninian Bruce.
THE RdLE OF HYDROTHERAPY IN PELLAGRA George M.
(563) Niles, Amer. Joum. Med. Sc., 1913, cxlvi., No. 2, August
In pellagra there is a four-fold syndrome—gastro-intestinal, dermic,
nervous, and psychic.
The author believes that a great many of the symptoms in
all these fields may be benefited by some form of hydrotherapeutic
procedure. D. K. Henderson.
ABSTRACTS
601
THE EPIDEMIOLOGY OF PELLAGRA J. F. Siler and P. E.
(564) Garrison, Amer. Jovm. Med, Sc., 1913, cxlvL, No. 2, August.
This is the second and concluding part of this article, the first
part of which appeared in the July number.
The authors did not discover any evidence pointing to a spring
and fall recrudescence of the disease. If during the spring months
precipitation is high, temperature low, and number of rainy days
excessive, the appearance of acute symptoms in the skin iB
delayed.
In 83 per cent, of the cases the economic conditions were poor,
and the disease was most prevalent among people of insufficient
means.
In more than one-half of the cases the history was that of
good health. Among adult females, those most affected were
married women (86 per cent.), and 86 per cent, of the married
women had borne children.
The most unsanitary condition found in the county is the
absence of properly constructed privies. A second striking
unsanitary condition is the almost complete absence of effective
screening of dwellings. These two conditions present a situation
highly favourable to the transmission of disease organisms elimi¬
nated in the excreta, both by direct contamination of food and
person, and by insects.
Observations upon the use of the more common foodstuffs
failed to discover any points of difference between pellagrins and
non-pellagrins in the county, or any facts which would seem to
explain the strikingly greater prevalence of pellagra among
certain classes of the population. The limited use of fresh meats
was the most striking defect in the general dietary.
Investigation of the kind, quantity, and quality of com and
com products used in the county failed to bring to light any
epidemiological evidence pointing to the agency of corn as an
etiological factor in the disease. In two cases there was a definite
history of no consumption of corn for two years prior to the
onset of symptoms, and in several other cases, the amount of corn
eaten was so small that the authors feel that the evidence is
strongly against the hypothesis that com products alone are the
causative agents of the disease. D. K. Henderson.
THE ANALYSIS OF PELLAGRA AND THE MOSQUITO. S. R.
(566) Roberts, Amer. Jovm. Med. Sc., 1913, cxlvL, No. 2, August.
In regard to the nature and cause of pellagra, Sambon has said
that it is (1) an infectious disease, and (2) an insect-borne disease.
The author believes, however, that the third idea advanced by
602
ABSTRACTS
Sam bon, namely, that the simulium fly is the specific insect
carrier, is open to much doubt, and he further believes that it is
not nearly so apt to be the insect agent as is the mosquito.
Some of the objections advanced against the simulium theory
are as follows:—-
The disease appears in America chiefly in those who are not
field labourers, and who are little exposed to its bite; pellagra
occurs in sporadic cases in cities, among women who stay at home,
and in asylums, where the simulium neither comes nor bites; it
does not present the regularity of seasonal incidence, adults living
through the winter, the repeated broods during spring, summer,
and autumn in enormous numbers, as does the mosquito; it does
not move in swarms far from its stream home, and, therefore, does
not explain those cases arising at a distance from any running
stream ; it is more numerous in cold countries, and on the coast
of all continents, while pellagra avoids cold climates and seeks the
interior rather than the coast; as far as is known, the bite of the
simulium is poisonous rather than infectious, bearing toxins rather
than parasites.
On the other hand, analogies are drawn between pellagra and
the mosquito- borne diseases. I). K. Henderson'.
A CASE OF PRECOCIOUS ARTERIO SCLEROSIS. (Sopn un c mo
(666) d’arteriosclerosi precoce.) Vincenzo Scarpini, Rattegna di Studi
Pgichiatrici, 1913, iii., Sett-Ott., p. 372.
A description of a case in a man, aged 22, causing death four
years later from cerebral haemorrhage. The author discusses the
differential diagnosis from syphilitic endarteritis, and, from the j
autopsy findings, is inclined to lay great stress upon the significance ,
of a previous nephritis. A. Ninian Bruce
DIABETIC PARALYSIS OF THE EXTERNAL RECTUS. (Paralyne,
(567) diabdtique du motenr oculaire exteroe.) E Ginestocs, Gai. hebi
des Scu rried, de Bordeaux , 1913, xxxiv., p. 410.
A case of paralysis of the left external rectus in a man, aged 68,
in whom the diplopia caused thereby was the first indication of
diabetes. Under appropriate diet and antipyrin the glycosuria
and paralysis disappeared within a month.
According to Dieulafoy (1905) paralysis of the sixth nerve i
is the most frequent ocular palsy in diabetes, being three time 8 !
as common as paralysis of the third nerve, whereas in syphilis |
and tabes partial or complete paralysis of the third nerve, is
more frequent. J. D. Rolleston. j
ABSTRACTS
603
REPORT OF A CASE OF MONOCULAR PARALYSIS OF THE
(668) ACCOMMODATION DUE TO LUE8. J. W. Downey, Joum.
Amer. Med. Assoc., 1913, Ixi., Sept. 27, p. 1043.
A man who had syphilis five years previously, and been treated for
it for eighteen months, suddenly developed a paralysis of accom¬
modation of the left eye with a slight involvement of the sphincter
papillae. The Wassermann reaction was positive. He was given
an intravenous injection of salvarsan, and the condition completely
passed off, the Wassermann reaction becoming negative.
A. X in ian Bruce.
A STUDY OF THE SPIROCHjETICIDAL ACTION OF THE SERUM
569) OF PATIENTS TREATED WITH SALVARSAN. Homes F.
Swift &Dd Arthur W. M. Ellis, Joum. Exper. Med., 1913, xviii.,
Oct., p. 435.
The serum of rabbits treated intravenously with neosalvarsan,
and of syphilitic patients treated intravenously with salvarsan or
neosalvarsan, has a definite spirochieticidal action upon Spiro-
ctueta dwttoni (v. Review, 1913, xi., p. 548). A curative action of
the serum of neosalvarsan-treated rabbits is exercised on mice
infected with Spirochcetn duttoni. The spirochseticidal action of
the serum of salvarsan-treated rabbits and patients is markedly
increased by heating at 56 J C. for thirty minutes. The increased
spirochseticidal action produced by heating is due in part to the
destruction of some inhibitory substance contained in normal
serum, and in part to a direct effect of the heat upon the serum
and salvarsan mixture. Cerebro-spinal fluid does not contain the
inhibitory substance present in normal unheated serum.
A. Xinian Bruce.
THE EFFECT OF INTRA8PINOUS INJECTIONS OF SALVARSAN
(670) AND NEOSALVARSAN IN MONKEYS. Arthur W. M. Ellis
and Homer F. Swift, Joum. Exper. Med., 1913, xviii., p. 428.
The authors injected solutions of salvarsan and neosalvarsan in
serum intraspinously in monkeys, and studied the irritating
properties by the cell count in the spinal fluid. A count was
made before treatment, two days after treatment, and again alx>ut
a week later. The injection of even small quantities of salvarsan
is very irritating (v. Review, 1913, xi., p. 548); 3’2 mg. caused in
one monkey paralysis of the hind legs lasting for some months.
Injection of 1 mg. of salvarsan and over produced in every case
cell counts of over 1,000 per cm. The injections of neosalvarsan
were, on the whole, less irritating.
604
ABSTRACTS
Injections of neosalvaraan intraspinously are not to be recom¬
mended, but favourable effects may be obtained from the injection
of salvarsanised serum, tlie method being to bleed the patient
one hour after an intravenous injection of salvarsan, separate the
serum, and reinject this serum into the subarachnoid space.
A Ninian Bruce.
A NEOSALVARSAN FATALITY. M. E. Hagkrty, Joum. Am *.
(571) Med. Assoc , 1913, lxi., Oct 4, p. 1294.
A man, aged 20, with a history of a primary chancre about five
years before, was given mercury and pot. iod. for two years, after
which treatment ceased. He then developed vague mental
symptoms for which he was given 0*6 g. of neosalvaraan intra¬
venously. He hail no ill effects, and a second dose of 0 6 g. was
given aWmt six weeks later. There were no ill effects foralwut
fifteen minutes, when he started to walk to his hotel, returned
ten minutes later and collapsed on the floor. He died shortly
afterwards, and at the post mortem death was considered to be due
to acute arsenic poisoning. The author states that this is his first
fatality after six hundred injections. A. Ninian Bruce.
DEATH AFTER A SINGLE INJECTION OF NEOSALVASSAK.
(572) (Un cas de mort aprds tine settle injection de ndo-salv&rm)
Perrier, Joum. des Praticiens, 1913, xxvii., p. 456.
A man, aged 30, was admitted to hospital with right hemiplegia
with contractures and aphasia, which had developed suddenly a
fortnight previously. No history could be obtained, but Wasser-
mann’s reaction was positive. The heart, lungs, and brain were
normal. An intravenous injection of 0*40 g. salvaraan was
given. Death, preceded by fever, perspiration, and coma, took
place five days later. Post mortem no visceral lesions were
found except in the brain. On the outer part of the left hemi¬
sphere the pia was adherent in places to the Rolandic and Sylvian
fissures, and h;emorrhagic suffusion was noted all over the third
frontal convolution. A small area of red softening was found
in the upper part of the anterior limb of the internal capsule.
J. D. Rollkston.
HYSTERIA WITH FEVER AND ANKLE CLONUS. A. Mykkson,
(573) Boston Med. and Surg. Jowm., 1913, iL, p. 194.
Thk patient was an Irish girl, aged 22, whose symptoms of hysteria
were persistent vomiting, variable losses of consciousness, without
ABSTRACTS
605
epileptiform characteristics, hemiamesthesia, and mutism. The
temperature on admission to hospital ranged from 99 to 100‘2 by
rectum. On the second day she became very restless, vomited
continually, and the rectal temperature rose to 105 - 2. An hour
later it was 100 2, and gradually liecarae normal. On examination
a fortnight later persistent unilateral ankle clonus (right) was
found, in no way distinguishable from that found in organic
disease. No other evidence of organic disease was present.
Babinski, Gordon, and Oppenheim signs were negative. The
fundi and cerebro-spinal fluid were normal, and Wassermann in
the blood and cerebro-spinal fluid was negative. Recovery took
place in five weeks. J. D. Rolleston.
ON HTSTEBIA. (Ueber Hysterie.) E. Kkaepklin (of Munich),
(574) Zeitachr. f. d. ges. Neurol, u. Paychiat., 1913, xviii.
The subject of hysteria is here treated in an extremely formal
way, and the work of Freud and his school is discussed in a few
sentences. For Kraepelin the emotional expressions of the
hysterical represent an earlier stage in evolution—they are evidence
of lack uf development, and this fact explains their prominence in
the adolescent period before adult interests and self-control have
attained full development. Statistics show a great preponderance
of hysteria before the age of 25, and evidently the disorder
frequently disappears as the individual develops. Where the
symptoms persist and distort the personality, we have a more
serious condition. The author would therefore divide hysteria
into developmental hysteria and degenerative hysteria. The role
which alcohol plays as an etiological factor in the psychoses has
always been emphasised by Kraepelin, and where alcoholic abuse
is an etiological factor in the production of hysteria, he calls it
alcoholic hysteria. A passing reference is made to traumatic and
prison hysteria. A formal contribution of this nature with no
case histories is a good example of a rather barren variety of
psychiatry. C. Macfie Campbell.
HEREDITARY CONGENITAL WRY NECK. David M. Grkig, Brit.
(575) Joum. Child. Dis., 1913, x., p. 337.
A record of a family in which the maternal grandmother, mother,
second daughter, aged 7 years, and second son, aged 2 years, were
the subjects of left congenital wry-neck. The eldest daughter,
aged 10, and the eldest son, aged 5, were normal. Skiagrams of
the mother and the affected children showed no abnormality in
the bones. Unlike Golding-Bird, who held that congenital wry-
606
ABSTKACTS
nec k never affected the left side, Greig had observed twenty-four
cases of congenital torticollis in which eight were on the left,
fifteen on the right, and one in which both steruo-mastoids were
involved. Greig attributes the occurrence of his cases to a
maternal source, suggesting that some slight pelvic defect or
peculiarity might cause a malposition of the feet us in uftro.
J. D. Rollestos.
ACUTE THYROIDITIS AS A COMPLICATION OF ACUTE TON-
(676) SILITI8. C. F. Theisen, AU*iny Med. Annals, 1913, xnir.
p. 466.
A recoup of six cases of acute simple thyroiditis in women, aged
from 19 to 'Jit. Five occurred in connection with tonsilitis, and
one in the course of pneumonia. In all the gland had been
previously healthy. Two of the patients subsequently developed
well-marked goitre, and two others typical hyperthyroidism. A
review of the literature is given. J. D. Roi.l.ESTON.
HEREDITARY OPTIC NEURITIS. Eleven Cues in Three Genar*
(577) tions. A. S. Worton, Lancet., 1913, Oct 18, p. lilt
This affection, also known as Leber’s disease and as hereditary
optic atrophy, was first described by Leber in 1871. Both eyes
are usually affected. Rapid loss of central vision occurs, usually
lasting some considerable time, and followed in a certain proportion
of cases by' more or less spontaneous recovery of visual function.
A few cases go from bad to worse. The condition is essentially
one of inheritance, and although males are more liable, transmis¬
sion usually occurs through unaffected females. The pathology is
obscure. The ophthalmoscopic appearances diming the attack are
those simply of a mild neuritis, hypenemia of the discs, fluffiness
of the disc margins, and slight perivasculitis. The neuritis slowly
subsides, and the signs of atrophy supervene.
A chart is here given of an example of this condition. All the
eleven affected individuals were males. The age incidence varied
from 9 to 32 years. Of the four cases personally examined, two
had regained practically normal vision, but leaving some deficiency
in the light sense; one case is still under observation, and in one
the vision is reduced to hand movements close to the eyes. In all
the cases where visual power was completely' regained, or been
partially recovered, the age was below 20.
A. Ninian Bruce.
ABSTRACTS
607
PSYCHIATRY.
GENERAL PARALYSIS IN THE NEGRO. Francis M. Barnes,
(578) N. Y. Med. Joum.) 1913, xcviii., Oct 18, p. 767.
General paralysis, while rare in the full-blooded negro, is very
common in the coloured races where hybridisation has now occurred.
It is characterised in them by the greater frequency of the
occurrence of hallucinations, the predominance of the demential
type of the disease, and the greater frequency of paresis among
coloured females than among the whites of the same sex. Statistics
are given of 288 cases of paretics out of a total admission of 3,406
cases of mental disease. Of these, 74 were coloured, and 9 2 per
cent, were paretics, while the proportion among the whites was
7'4 per cent. 50 per cent, of all the cases were between 30 and 40
years. A. Ninian Bruce.
SAL VARS AN IN GENERAL PARALYSIS OF THE INSANE AND
(579) TABES. M. Fitzmaurice-Kelly, Joum. of Merit. Sci., 1913, July,
p. 498.
A discussion of the results of the treatment by the intravenous
injection of salvarean in eight cases of tabes and four cases of
general paralysis. Well marked relief of the lightning pains and
of the visceral crises occurred in the tabetic cases, but there was
no definite improvement in the general paralytics. One of the
latter developed signs of general paralysis after the successful
injection of salvarsan for tertiary syphilitic glossitis. The author
considers that the drug should only be used for the relief of
symptoms, and that there is some risk of acceleration of the
disease. W. D. Wilkins.
THE INFLUENCE OF TYPHOID FEVER ON EXISTING MENTAL
(580) DISEASE (Ueber den Einflnss des Abdominaltyphus auf
bestchende geistige Brkranknng.) W. H. Becker, AUg. Zeittchr.
/. P»ych. t 1912, lxix., p. 799.
The favourable influence of intercurrent typhoid fever upon
psychoses has often been observed by psychiatrists, including
Kraepelin and Ziehen. Becker, from his experience at the
Weilmunster Asylum, finds that this improvement depends on
three factors. 1. The character of the psychosis. 2. The age
of the patient. 3. The duration of the psychosis before the
attack of typhoid. Idiocy, epilepsy, general paralysis, and senile
mental disturbance are quite uninfluenced by the disease. Dementia
608
ABSTRACTS
pnecox, on the other hand, is very often improved, so that in
some eases the patient may lx* discharged. The effect of the
disease on manic-depressive insanity could not be determined,
owing to its circular and periodic character.
Improvement was more frequent in younger patients and in
those in whom the psychosis had not been of long duration.
J. D. Rolleston.
THE RELATIONS OF INTERNAL SECRETIONS TO MENTAL
(581) CONDITIONS. L. V. Frankl Hochwart, Amer. Joum. Med. Sc.,
1913, cxlvi., No. 2, August.
In this article a review is given of the effects of a number of the
internal secretions on mental conditions, and how the development
of the mind depends on these secretions.
In Basedow’s disease the predominance of maniac features
is emphasised. The individuals are often excited, though we
cannot exactly speak of a psychosis. They are talkative, inclined
to witticisms, and are given to sexual excesses.
A case is instanced in which a permanent cure resulted when
the Basedow symptoms disappeared.
In myxmdematous patients, on the other hand, the lack of
emotion is the striking feature.
In affections of the parathyroid glands tetany is common.
Individuals with tetany are excitable, timid, quarrelsome, and
inclined to outbreaks of temper.
In strumectomiscd animals, hallucinations, idiocy, and patho¬
logic motion phenomena occur.
In pituitary body tumours a peculiar indifference, euphoria,
and contentment are pronounced. The genital glands, the pineal
body, thymus, and suprarenal bodies are also referred to.
D. K. Henderson.
ON THE DEMONSTRATION OF DEFENCE-FERMENTS IN TEE
(582) BLOOD SERUM OF THE INSANE BY ABDEEBALDENS
DIALYSIS METHOD. (Ueber den N&chweis von Abwefcr
fermenten im Blutserum vomemlich Oeisteskranker dutch daa
Dialysierverf&hren nach Abderhalden.) V. Kafka (of Hamburg),
Zeittch./. d. get. Ne-urol. «. Ptyckiat ., 1913, xviii.
The author devotes a short introduction to the technique of the
method of Abderhalden for demonstrating the presence in the
blood serum of proteolytic ferments developed in reaction to
specific proteids introduced into or developed within the system.
. A.
ABSTRACTS
609
This method which Abderhalden developed, with a view to
determining the presence of pregnancy by demonstrating a proteo¬
lytic ferment specific for placenta, has been extended to a great
variety of different conditions.
Kafka gives the result of the investigation of an extensive
series, chiefly of cases of mental disorder. His most important
conclusions are as follows:—
1. The dialysis method is a simple means of determining
certain disorders in brain metabolism and in the activity of the
glands of internal secretion.
2. Defence-fermen ts in reaction to brain are formed if the
brain tissue itself is diseased (especially by syphilis), or if its
metabolism is permanently or suddenly and severely interfered
with. This does not mean that in every disease of the brain
defence-ferments can be demonstrated in the blood.
3. Defence-ferments in reaction to the sexual glands are
characteristic for dementia praecox; apart from this disorder they
seem to be found only in general paralysis or in the epileptic in
relation to attacks; idiocy and infantilism of dysgenital origin
must be investigated from this point of view.
4. Defence-ferments in reaction to adrenals are occasionally
found in dementia praecox; they appear to be of importance in the
investigation of idiocy and infantilism of glandular origin. The
technique of the preparation of the adrenals requires to be
improved.
5. Defence-ferments in reaction to thyroid are found in
dementia praecox and also in general paralysis; in epilepsy they
seem to be related to the attacks. Disorders of the thyroid
require further investigation; some forms of Basedow disease
only show a slight tendency to the formation of such defence-
ferments.
6. Defence-ferments in reaction to hypophysis were only
demonstrated in acromegaly and tumour of the hypophysis.
7. The presence of ferments in reaction to sexual glands seems
already to be of diagnostic and prognostic use in the dementia
preecox group. Also in the more severe disorders of the glands
of internal secretion the ferment investigations have already
practical value, although they are subordinate to the clinical
examination.
8. The above results encourage therapeutic experiments,
especially in the dementia prsecox group.
9. In the last-named group the ferment examination enables
one to make a provisional sub-group.
10. It is premature at present to discuss the specificity of
individual ferments. C. Macfie Campbell.
610
ABSTRACTS
RESEARCHES ON THE OPSONIC INDEX OP THE BLOOD SEBUM
(683) AND ON THE RESISTANCE OF , THE LEUCOCYTES DT
MENTAL DISEASE Nino Ramklla and Gdiskppb Zuccasj,
Rrutegna Ji Stu<li Peichiatrici, 1913, iii., Sett-Ott, p. 355.
The authors have examined the opsonic index for the StnphtjL)-
coo t's pyotjnif* aureus, the Streptococcus and the Bacillus coli, as
well as the resistance of the leucocytes, in 14 epileptics, 12 cases
of derntMitia pnecox, and 6 cases of pellagra. They found that
the opsonic index was highest in epileptics, being usually above one.
and most marked for the staphylococcus. In the dementia pnecox
and pellagra cases the index was usually below one, and usually
lowest of all for the streptococcus. The opsonic index in epileptics
did not differ if taken during fits or during the interval between
them.
The resistance of the leucocytes is closely related to the
opsonic index, l>eing highest amongst epileptics and lowest in the
dementia pnecox and pellagra cases. A. Ninian Bruce.
SOME SUGGESTIONS RESPECTING THE CARE OF THE FEEBLE
(584) MINDED UNDER THE MENTAL DEFICIENCY BILL, 1913.
A. R. Douglas, Joum. of Afent. Sci., 1913, July, p. 487.
A consideration' of the existing machinery for the care of the
various classes of defectives included in the provisions of the
alx>ve Bill. The author urges that the present voluntary institu¬
tions for the care and training of the feeble-minded should form
the nuclei of the future arrangements, but that idiots, as they
require more expensive treatment, should be dealt with separately
in mental hospitals. W. D. Wilkins.
MORAL INSANITY. Robert Hunter Steen, Joum. of Mental Sci.,
(585) 1913, July, p. 478.
A plea for the more accurate delimitation of a group of moral
defectives, characterised by a tendency to crime, the latter being
often unaccompanied by any apparent motive, and with little
attempt at concealment. The author believes that in these cases
the “moral sense centre” is congenitally absent, and considers
that they should be dealt with in the provisions of the Mental
Deficiency Bill. W. D. Wilkins.
THE INFLUENCE OF PHYSICAL ILLNESS ON THE MENTAL
( 586 ) STATE IN INSANITY. G. E. Peachell, Joum. <f Mental Sci.,
1913, July, p. 492.
The author gives the notes of six cases in which the mental Btate
materially improved with the incidence of physical illness, the
ABSTRACTS
611
latter being sulphonalism in two eases. The mechanism by which
this effect is produced is discussed, and suggestions made for its
intentional production, either by the empirical inoculation of
vaccines, or by the stimulation of leucocytosis.
W. D. Wilkins.
ON ATTEMPTED SUICIDE, WITH AN ANALY8I8 OF 1,000 CON
(587) 8E0UTIVE CA8E8. W. Norwood East, Jottm. of Ment. ISci.,
1913, p. 428.
An exhaustive analysis of the cases of attempted suicide received
into Brixton Prison in two and a half years, with valuable
statistical tables. After noting the benefit derived in many cases
from short terms of imprisonment, the author points out the
parallel between the number of would-be suicides and the amount
of unemployment. There is an interesting seasonal variation, at
present only tentatively explained, suicidal attempts being more
frequent in the summer.
The tendency to suicide increases as age advances, but this
would have been more clearly brought out if the cases had been
correlated with the number of persons living at each age.
Full tables are given of the methods employed, and interesting
differences are noted between those employed in actual suicides
and in successful attempts. Hanging heads the list of unsuccess¬
ful attempts with 27‘61 per cent., whereas only 8*40 per cent, of
the unsuccessful attempts were of this nature, an apparent proof
of the ease with which death can be produced in this way, and
probably of the suddenness with which unconsciousness ensues.
Poison, on the other hand, accounts for 3400 per cent, of un¬
successful attempts, whilst only 16 00 per cent, of the deaths
were due to this cause, an indication probably that the public
commonly under-estimates the lethal dose. This does not apply
to coal gas, to which the largest number of deaths by poison were
due, viz., 22 per cent., whilst only 6 00 per cent, of the unsuccess¬
ful attempts were under this heading.
The author attaches very great importance to the influence of
alcohol in the production of suicide, and ascribes 393 of the 1,000
cases to this cause—a startling proportion. Many of these cases
are true examples of alcoholic impulse with amnesia. Insanity
was present in 123 cases, chiefly melancholics, but other 82 cases
showed weakmindedness, neurasthenia, or epilepsy.
It need hardly be said that the author considers suicide is no
sign of insanity. W. D. Wilkins.
KE VIEWS
C12
TREATMENT.
EFFECTS OF CONTINUOUS ADMINISTRATION OF EXTRACT OF
(588) THE PITUITARY GLAND. John H. Mi'sner, Anur . Journ.
Med. tie., 1913, cxlvi., No. 2, August.
Tub preparation employed was the extract of the whole gland
made up in 0 2 g. tablets containing 0 00," g. of the dried gland,
equivalent to 0'26 g. of the fresh gland. The dosage at first
was two of these tablets twice a day, but no effect was noted
until the dose was increased to one tablet four times a day. All
patients took the tablets for at least a month, unless stopped
Itecause of untoward effects.
Of eighteen individuals, seventeen showed a rise in systolic
blood pressure, the greatest rise l>eing 27 mm. of mercury. A
corresponding rise in diastolic pressure occurred. An increase in
pulse rate was generally observed, though in two individuals the
rate was decidedly decreased.
The conclusion is that the gland exerts a distinct pressor effect
upon the peripheral vascular apparatus, which persists for an
appreciable time after discontinuation of the drug.
D. K. Henderson.
■Reviews.
THE PITUITARY BODY AND ITS DISORDERS. Clinical states
(589) produced by disorders of the hypophysis cerebri Habvkt
Cushing. Pp. x. aod 341; 319 illustrations. J. B. Lippincott Co.,
Philadelphia and London. Pr. 18s. net
No one interested in this subject can afford to neglect this book,
which presents to the reader in a clear and concise manner the
most important points in our present knowledge of pituitary
disease. There is every reason to believe, as Prof. Cushing states
in his preface, that cases of clinically recognisable pituitary disease
are at least as common as are cases of clinically recognisable
thyroid disease, and we find here an account of the pituitary
gland from the experimental, clinical, and surgical points of view.
The book is divided into three parts. The first deals very
briefly with the anatomy, physiology, pathology, and chemistry
of the pituitary gland. The second, and largest, part deals with
the clinical manifestations of disordered function, and a classifica¬
tion or grouping of cases is put forward as a provisional basis for
clinical use.
It is pointed out that a time is unquestionably approaching
REVIEWS
613
when the classification here employed will no longer be necessary,
but at the present stage of our knowledge it is the most practical.
Five types of pituitary disorder are here recognised: (1) Cases
in which both neighbourhood and glandular symptoms are out¬
spoken; of this there are three types, (a) hyperpituitarism,
(5) hypopituitarism, and (c) dyspituitarism; (2) cases with
pronounced neighbourhood but inconspicuous glandular symptoms;
(3) cases with pronounced glandular manifestations but incon¬
spicuous neighbourhood symptoms, with (a) past hyperpituitarism,
or (b) hypopituitarism as the striking feature; (4) cases of
hypophyseal disorder from remote intracranial lesions with hydro¬
cephalus, with (a) hyperpituitarism, or with (b) hypopituitarism ;
and lastly (5) cases showing a polyglandular syndrome. Part III.
deals with the incidence, symptomatology, and treatment of such
disorders.
The book itself has l>een particularly well reproduced. The
type is good and the illustrations remarkably clear. The records
of the cases are most valuable, and there is a good bibliography
and index. We have perfect confidence in recommending this
book to all those interested in this subject.
THE PSYCHONEUROSES AND THEIR TREATMENT BT
(590) PSYCHOTHERAPY. Prof. J. Dejerine and Dr E. Gaucxler.
Authorised translation by Smith Ely Jelliffe. J. B. Lippincott Co.,
Philadelphia and London. Pr. 18a net
This book, the French edition of which we have already reviewed
(fl. Review, 1912, x., p. 503), has been most successfully translated
into English, in fact it is one of the best translations we know.
The translator points out how he had been struck by the immense
number of minor psychic disturbances which render numerous
individuals unhappy, discontented, ill, and unable to hold their
own in their milieu, even making confirmed invalids of many.
The appearance of this volume, at a time when psychic problems
are beginning to receive such wide recognition, is most opportune,
and places in the hands of those who do not read French easily,
one of the most valuable of recent works on this subject. The
large number of cases recorded here form most instructive and
interesting reading, and it will be easily seen how many patients
may be treated and cured without a resort to the more detailed
analyses elaborated to meet more complex situations. The emphasis
laid upon the minor emotional factors in all the disorders under
discussion represent an important side which has been somewhat
neglected by former authors. Functional nervous disorders are
here treated by a master hand, and we are certain that no one who
may take up this book can fail to benefit greatly from its perusal.
5°
614
BOOKS AND PAMPHLETS RECEIVED
TIbe international Xeague against
Epilepsy.
The International Committees of the League met in London on
August 13th, at the conclusion of the International Medical
Congress. Dr Aklren Turner (London) presided. There were also
present:—Kocher (Berne), Anton (Halle), Donath (Buda-Pesth),
Moreira (Brazil), Krohn (Norway), Muskens (Holland), M'Dougall
(Manchester), Collins (London), and Crocket (Glasgow).
After a short opening address by the Chairman, communica¬
tions were read by Prof. Anton, Dr M'Dougall, and Dr Collins.
These will appear in full in the next number of Epilepsia.
At the conclusion of the meeting visits were paid to the
London County Council Epileptic Colony at Ewell, and to the
David Lewis Epileptic Colony at Alderly Lodge.
The next meeting of the League will be held in Berne, in
August 1914, on the occasion of the next International Congress
of Neurology and Psychiatry.
BOOKS AND PAMPHLETS RECEIVED.
“Alienist and Neurologist ,” 1913, xxxiv., Aug., No. 3.
Flexner, Simon, and Noguchi, Hideyo. “Experiments on the cultiva¬
tion of the micro-organism causing epidemic poliomyelitis” (Journ. Exp.
Med., 1913, xviiL).
Qresswell, Albert and George. “The Vital Balance,” pp. 136. Wm.
Rider <fe Son, London. Pr. 2s. net.
Lugaro, Ernesto. “ Modern Problems in Psychiatry,” translated by
David Orr and R. G. Rows; with a foreword by Sir T. S. Clouston.
Sherratt <fc Hughes, London, 1913. Pr. 7s. 6d. net.
“ Maladies des Meninges.” By Hutinel, Klippel,Claude, Voisin, andLevy-
Valensi, pp. 383, with 49 figs. J. Bailli&re et r ils, Paris, 1912. Pr. Fr. 8.
Noguchi, H. “Additional studies on the presence of Spirochceta pallida
in general paralysis and tabes dorsalis” ( Journ. Cut. Die., 1913, August).
Noguchi, H. “The transmission of Treponema pallidum from the
brains of paretics to the rabbit ” (Journ. Amer. Med. Assoc., 1913, lxi).
Oppenheim, H. “Weitere Beitrage zur Diagnose und Differential-
diagnose des Tumor medullae spinalis” (Monatsschr.f. Psychiat. u. Neurol.,
1913, xxxiii.).
Pick, A “Uber den Nachweis latenter aphasischer Erscheinungen
dure) Ermudung und die Moglichkeit seiner diagnostiachen Verwertung"
(Ptger Medii. Wchnschr., 1913, xxxviii.).
Salmon, A “Sul significato patologico della reazione miastenica nei
casi di nevrosi traumatica” (Riv. Crit. di Clin. Med., 1913, xiv.).
Sommer, R. “ Offentliche Ruhehallen ” ( Sammlung Hoche, 1913, x.).
Tuckey, C. Lloyd. “ Treatment by Hypnotism and Suggestion ” : Sixth
edition, revised and enlarged, pp. xxviii. + 431; 5 figs, in text. Demy
8vo. Baillifcre, Tindall <k Cox, London Pr. 10s. 6d. net.
“ The Training School,” 1913, x., October.
■Review
of
tfleurologv anb Ips^cbiatr^
(Mginal articles
THE DIRECT VENTRO-LATERAL PYRAMIDAL
TRACT.
By WILLIAM G. SPILLER, M.D.,
Professor of Neuropathology in the University of Pennsylvania.
(With Plate 32.)
This tract was first described by me at a meeting of the Phila¬
delphia Neurological Society, 28th November 1898. The case
in which it was discovered was one of haemorrhage in the external
capsule and lenticular nucleus. The degeneration of the fibres
evidently had its origin in this lesion. A little below the exit
of the fifth nerve from the pons a band of fibres became separated
from the outermost and lateral portion of the pyramidal tract.
Lower in the pons this band of fibres passed abruptly backward
and entered the trapezoid body. It took a position at the junction
of the medulla oblongata and pons lateral to the uppermost
portion of the inferior olive. As the olive increased in size the
bundle passed backward, and where the olive had its largest width
the bundle took a position on the posterior and lateral side of
the olive. The bundle was traced below the motor decussation,
and remained uncrossed throughout its entire length. It was
traced as far as the first cervical segment, but could not be traced
further as the spinal cord was not obtained.
The literature on this tract to the year 1913 is given in tf e
work on the anatomy of the central nervous system by Ziehen, 1
Spiller, Journal oj Nervous and Mental Distase y 1899, p. 178 ; Brain , 1899,
p. 563 ; Neurologisches Centralblatt } 1902, p. 534.
Ziehen, “Anatomie dee Centralnervensysteras,” II. Abteilung, Teil I.
(B&rdeleben’s “ Handbuch der Anatomie des Menechen”), 1913, p. 194.
5 1
616
WILLIAM G. SPILLER
and it would be useless to repeat it. The tract has been observed
by numerous investigators. It arises from the pyramidal tract
in the pons or medulla oblongata, and when arising in the latter
place it is described as passing backward with the anterior external
arcuate fibres, or a little interior to these, on the periphery of
the medulla oblongata. After reaching the region of Gowers’
tract the fibres of the direct ventro-lateral pyramidal tract bend
again downward, and pass in this region to the ventral periphery
of the lateral column into the thoracic region, or in one case
(Bumke) to the lumbar swelling. Ziehen speaks of the tract as
the aberrant ventro-lateral pyramidal tract.
In a case I have recently studied the separation of the direct
ventro-lateral pyramidal tract occurred in the medulla oblongata,
but in a different manner from that described in Ziehen’s summary
of the literature. The tract did not pass backward with or interior
to the anterior external arcuate fibres, but maintained through¬
out a longitudinal course. The case was one of haemorrhagic cyst
in the right lenticular nucleus and external capsule. The pyra¬
midal tract fibres extended around the lower olive in its upper
part, and spread out in a triangular shape immediately posterior
to the olive at the periphery of the medulla oblongata. They
were all cut transversely in a transverse section of the medulla
oblongata, and no rows of black dots were found in the anterior
external arcuate fibres indicative of a longitudinal course. The
outer portion of the anterior pyramid clearly was interrupted
by the development of the olive and the anterior external arcuate
fibres. The pyramidal fibres which, in the upper part of the
medulla oblongata, extended around the olive were gradually
completely divided by the olive and anterior external arcuate
fibres, so that a triangular zone posterior to the olive was formed
without connection with the anterior pyramid.
The direct ventro-lateral pyramidal tract was spread more
along the periphery of the cord at the sixth cervical segment than
at the seventh cervical segment; at the latter it was very distinct
and more triangular in shape. The direct pyramidal tract on
the same side of the cord was much degenerated, but was not
continuous with the direct ventro-lateral tract. The crossed
pyramidal tract of the opposite side was much degenerated, but
there was little or no degeneration in the crossed pyramidal tract
of the same side. The direct ventro-lateral tract was still distinct
lt>
$
"V
**
I***
&
■
K
0 m
f
S>
It
}
4
t
%
1
*1
l
I
1
4
Al
IsftiWB
ABSTRACTS
617
at the eighth cervical segment, and of much the same form as at
the seventh cervical segment, but was of smaller area. It was
not traced below the first thoracic segment.
Description of Figures.
Fig. 1. Showing the fibres of the anterior pyramid, B, extending well
around the olive, and united with the direot ventro-lateral pyramidal traet, A.
Fig. 2. The olive and anterior external arcuate fibres are beginning to
separate the direct ventro - lateral pyramidal tract, A, from the anterior
pyramid, B.
Fig. 3. The separation of the direct ventro-lateral pyramidal tract, A, from
the anterior pyramid, B is complete.
Fig. 4. Showing the position of the direct ventro-lateral pyramidal tract, A,
in the spinal cord. This section has been reversed in photographing it.
I am indebted to Dr A. J. Smith for the photographs. They have been
slightly retouohed.
abstracts.
ANATOMY.
THE NERVE SUPPLY TO THE PITUITARY BODY. Walter E.
(591) Dandy, Amer. Joum. Anat., 1913, xv., Nov., p. 333.
The nerve supply to the pituitary body is from the carotid plexus
of the sympathetic system. Numerous branches radiate to the
stalk along the hypophyseal vessels, and are immediately lost to
view in the substance of the anterior lobe. The posterior lobe
nerve supply is very scant, in marked contrast to the extensive
innervation of the anterior lobe. The pars intermedia receives
its nerves from the stalk. There is connection between the carotid
sympathetic system and the oculomotor and optic nerves. The
absolute differentiation between secretory and vasomotor nerves
is, of course, a matter of much dispute and is impossible. The
impression, however, from the character and course of the nerve
fibres, their greatly increased number in the region of the
hypophysis, the differences between the supply of the anterior and
posterior lobes, the connections established with the other cranial
nerves, leads us to regard them as secretory, in contradistinction
to vasomotor, the existence of which in the cranial chamber has
not been observed. The intra-vitam methylene blue method was
used to stain the nerves. A. Ninian Bruce.
ABSTRACTS
618
PSYCHOLOGY. |
THE OAEDIO CERVICAL CHROMAFFINE SYSTEM IN RBPTILB j
(592) (Le syst^me chromaffin cardiaco-cerrical ch«s 1 m uorieni) 0. I
Trinci, Arch. Ital. de Biol., 1913, lix., Sept. 15, p. 431.
Tuinci finds the following ohromaffine cell-groups in reptiles:—
(1) In the interior and along the walls of the large arteries, from
the cardiac region to the cervical region at the level of the
thymus; (Li) a certain number of cells occur constantly in the ,
cardiac arterial trunk: these he calls the cardiac paraganglion;
(8) others, also constant, near the area of bifurcation of the carotid,
“ the carotid paraganglion," to be regarded as homologous with the 1
mammalian carotid body; (4) others, serially interposed between
the former paraganglia, in direct or indirect relation with the
sympathetic and the largo arteries of this region. Trinci states
that he demonstrated (1007) the existence of a cardiac para¬
ganglion in mammals, confirmed for man by Busacchi (1912). J
Trinci believes that there are several varieties of chromafline
cells; thus, in some the chrome reaction is intense, in others it
may be absent. He. combats the hypothesis of Fedele (1910) that
these cardiac chromafline cells of reptiles are rather to be inter¬
preted as nerve ganglia, or at least as cells intermediate between
chromafline and nerve cells. Leonard J. Kidd. •
PATHOLOGY. ’
THE PRESENCE OF NEGRI'S BODIES IN THE NERVE GANGLIA
(593) OF THE SALIVARY GLANDS OF RABID ANIMALS. (Sat
l’existence des corpuscles de Negri dans les ganglions nerreu
des glandes salivaires ches les animaux r&biques.) Y.
Manou Elian, Compt. Rend, de FAcad. des Sciences, clvii,, No. 19,
1913, Nov. 10, p. 866. j
From an examination of the parotid and submaxillary glands of (
twenty rabid dogs, the author finds that Negri’s bodies are
almost constantly present in the cytoplasm of the nerve cells
of the ganglia which are constantly found in the interstitial tissue
of these glands; but there arc no Negri’s bodies in the gland
parenchyma, acini cells, or excretory ducts. He points out that
unskilled observers may mistake leucocyte corpuscles and debris
of glandular cells for Negri’s bodies. The intra-glandular ganglia >
are partly microscopic, partly visible to naked eye in coloured '
sections: all these ganglia are formed of cells of sympathetic
type. Negri’s bodies are also found in the sympathetic ganglia
and the cerebro-spinal ganglia. Further, the author finds that
in the nerve trunks accompanying the vessels of the salivary
glands there exist small masses of nerve cells, and even sometimes j
ABSTRACTS
619
a single nerve cell: Negri’s bodies are found in the cytoplasm
of these cells also. Leonard J. Kidd.
THE WEIGHT OF THE ADRENALS IN THE INSANE. (Recherches
(594) pondtoales sur les capsules surrlnales chez les alilnles.) C.
Parhon and Q. Zugravu, Arch. Intemat. de Neurol., 1913, xxxv.,
Nov., p. 273.
Pariion showed previously that the average weight of the thyroid
body is greatest in the affective psychoses—mania, melancholia,
manic-depressive—and least in epilepsy. The average weight of
the two adrenals in various psychoses the authors give as follows:
—it is greatest in G.P.I., 16 grin. 30; then follow epilepsy, 15*70;
dementia pnecox, 15*50; senile dementia, 14*44; alcoholism, 14*30;
pellagra, 13*83; mental confusion, 13*71; imbecility, 12*22; mental
debility, 10 grm.; and idiocy, 9*87. The low weight in idiocy is
partly explained by the early age of the patients. Usually the
adrenals are less heavy in the female sex. Testut gives 6 to
7 grm. as the average weight of each adrenal. Claude and
Schmiergeld found in ten female epileptics an average weight of
20 grm. *20 for the two adrenals, i.e., higher than normal. A.
Marie and Dide also found a high average for G.P.I. and epilepsy.
In connection with the low adrenal weight in pellagra, Parhon has
often seen an appearance of adrenal hypofunction: this is con¬
firmed by Garbini, who advises adrenal opotherapy in adynamic
confusion-psychoses. In G.P.I. Laignel-Lavastine notes a great
abundance of spongiocytes in the adrenals; Parhon has often seen
this. Sometimes, however, there is in G.P.I. a diminution of the
lipoids of the adrenal cortex. Stern connects the strong muscula¬
ture and hypertrichosis of G.P.I. with hyperadrenalism: he thinks
that the latter, with hyperpituitarism and hypofunction of genitals
and parathyroids, and thyroidal instability, predisposes to G.P.I.
Mention is made of Apert’s hirsutism, an adrenal syndrome.
Parhon has seen an adenomatous nodule in an adrenal of a fat
general paralytic; and he suggests that there may be an adrenal
element in the obesity of general paralytics lately described by
himself with Obregia and Urechia. The paper has a table of
adrenal weights in the psychoses. Leonard J. Kidd.
CLINICAL NEUROLOGY.
NOTE ON CONTRALATERAL OPPENHEIM AND GORDON
(595) REFLEXES, WITH OBSERVATIONS IN TWO OASES. A.
Myerson, Joum. Nerv. and Ment. Di$., 1913, xl., Sept, p. 574.
A coloured man, 50 years, in a delirious mental condition, had
retention of urine, paralysis of l>oth legs, and jerky twitchings of
620
ABSTRACTS
all four extremities. The tendon reflexes were more exaggerated
on the right side than on the left, and ankle clonus was present on
the right side, but there was no sign of Babinski on either side.
Stimulation of the right tibia (Oppenheim’s method) produced
homolateral and contralateral extension of the great toe; stimula¬
tion of the left tibia produced only homolateral extension of the
great toe. The same results were obtained by stimulation of the
tendo Achillis on either side.
Case No. 2.—Patient, male, 62 years, who showed symptoms
pointing unmistakably to cerebral arterial lesions, showed on the
right side homolateral and contralateral Babinski, Oppenheim and
Gordon signs, and on the left side homolateral Oppenheim and
Gordon signs, but no sign of Babinski. D. K. Henderson.
REFLEX FREQUENCY AND ITS CLINICAL VALUE. Walter B.
(696) Swift, Joum. of New. and Afent. DU ., 1913, xl., Sept, p. 586.
The author claims that this is the first scientific investigation of
relative reflex frequency. D. K. Henderson.
CERVICAL ZOSTER AND PARALYSIS. (Zona cervical et para
(597) lysie.) Lacroix, Jorum, de mid. de Bordeaux, 1913, Ixxxiv., p. 664.
A woman, aged 64, developed left facial paralysis of the peripheral
type a few days after the eruption of cervical zoster on the
same side. The existence of cerebro-spinal lymphocytosis sug¬
gested that a chronic meningitis involved both the posterior root
ganglia and the facial nerve in its intra-meningeal course. The
causal infection was not determined. There was no history of
syphilis, but Wassermann's reaction had not been performed. On
the other hand, a history of repeated attacks of bronchitis suggested
a tuberculous origin for the meningitis. J. D. Rolleston.
IONIC MEDICATION IN HERPES ZOSTER. Angus Macnab,
(598) Lancet, 1913, March 22, p. 821.
From the ophthalmic point of view herpes zoster can be divided
into two classes: (a) those in which there is no affection of the
cornea and iris, and ( b ) those in which there is iritis, and generally
an affection of the cornea. A case of each is described.
In the first case the whole of the forehead, the side of the
nose, and the upper lip on the left side were all affected. The
whole of the conjunctiva was congested. The surface of the
cornea was clear, and there were no signs of involvement of the
iris. An electrode of alxmt 15 sq. in. was applied to the affected
ABSTRACTS
621
area over three thicknesses of lint soaked in a solution of quinine
sulphate. A current of 15-20 milliamp£res was passed for
twenty minutes. Three days later the skin condition was greatly
improved, and there was a slight improvement in the condition
of the conjunctiva and the cornea. An electrode was prepared to
fit the conjunctiva, and after instilling cocaine this was applied
for four minutes, the forehead was again treated for fifteen
minutes. There was a severe reaction next day, which soon passed
off, and later, beyond a slight tendency to watering in the eye
affected, recovery appeared to be perfect.
The second case was seen fourteen weeks after the onset of
the attack. On the cornea were some four or five spots, the
remains of vesicles which apparently from the density of the
nebulce had pustulated. The pupil was semi-dilated, and reacted
very badly to light, and some exudate was present on the surface
of the iris and the anterior capsule of the lens. An electrode of
6 sq. in. was prepared, and a current of 4 milliamp&res passed
through a solution of quinine for twenty minutes. A fortnight
later the condition was much better, and a second application was
made through an electrode of 3 sq. in. of 5 milliamp&res for
fifteen minutes. A fortnight later the eye appeared to be com¬
pletely recovered. A. Ninian Bruce.
CHRONIC RHEUMATIC PERIARTHRITIS FOLLOWING ZOSTER,
(599) AND RESTRICTED TO THE AREA OF THE ERUPTION.
(Pdriarthrite rhumatismale chronique consecutive h un son* et
localises dans le territoire de Irruption.) G. Guillain and D.
Rournat, Bull, et mim. Soc. mid. H6p. de Parity 1913, xxxvi.,
p. 437.
A diabetic woman, aged 70, developed zoster of the left upper
limb. The vesicles covered the back of her hand and interdigital
clefts, and spread upwards on the dorsal aspect of the forearm to
the elbow. Pain in the finger-joints developed simultaneously
with the eruption, and was followed by persistent stiffness. For
two years there had been a very definite rheumatic periarthritis,
which was strictly limited to the left hand. X-rays showed an
absence of bone lesions. J. D. Rolleston.
THE TECHNIQUE OF EXCISION OF CERVICAL RIBS. A. S.
(600) Bluhdkll Bankart, Lancet , 1913, clxxxiv., April 5, p. 962.
The author recommends an incision about four inches long, parallel
to and about an inch from the spinous processes, with its centre
622
ABSTRACTS
opposite the seventh cervical vertebra. The trapezius is divided,
and the cervical rib at its origin from the seventh cervical vertebra
located. The rib is now divided close to the vertebra, and, being
then movable, can be dissected out from the soft parts with the
greatest ease.
The objection to the anterior and lateral operations is that
the rib is immovably fixed behind up to the very last stage of the
dissection, and thus all the soft parts have to be separated and
drawn away from the rib before it can be resected. This mani¬
pulation and retraction of important parts are responsible for
nearly all of the unfavourable sequelae which may follow these
operations.
A case is described of a woman, aged 33, who had a cervical
rib. The anterior operation seems to have resulted only in the
removal of the tip of the rib and aggravated the symptoms. The
posterior operation, however, resulted in a complete cure.
A. Ninian Bruce.
BLINDNESS AND TABES: AN INTRODUCTION TO A NEW
(601) METHOD OP CURING ATAXIA. W. J. M. A. Maloney,
Joum. of Nerv. and Ment. Dis ., 1913, xl., Sept., p. 553.
In this paper the literature is reviewed to ascertain, if possible,
whether or not the presence of optic atrophy or blindness exercise
any effect whatever upon the tabetic process in the spinal cord,
or upon the spinal symptoms.
Five incontrovertible cases, three of Schupfer’s, one of Leri’s,
and one of Abrahamson’s, have been culled from the literature,
which seem to prove that ataxia, occurring at or subsequent to the
onset of blindness, may be improved. The author’s main conclusion,
however, is: Neither the occurrence of optic atrophy nor of
blindness retards or influences the evolution of the structural
changes which accompany the tabetic process in the spinal cord
and elsewhere.
The absence of spinal implication in primary tabetic optic
atrophy is due to the accident of the localisation of the morbid
process, and not to any inhibitory influence arising from that
localisation.
The method of enhancing sensory perception in the cure of
ataxia has been used with success by the author. Blindfolded
tabetics can quickly be taught to appreciate their surviving
postural and muscular sense impressions to such a degree that
hopeless bedridden ataxies quickly learn to walk again.
D. K. Henderson.
ABSTRACTS
623
▲ CASE OF MULTIPLE NEUBOFIBBOMATOSI8 OF THE SKIN.
(602) (Ben Gev&l van multipele neurofibromatosis der Huid.) P. H.
Schoonhkid, Nederland. Tidjtchr. v. Geneesk., 1913, ii., p. 1639.
A typical case in a woman, aged 34, of nervous disposition, in
whom the lesions had first appeared at 13 with the onset of
puberty. Family history negative. Injection of cacodylic acid,
ovarian extract, and Fowler’s solution were all ineffectual. A
review of the literature is given including the case reported by
the abstracter and MacNaughtan (v. Review, 1912, x., p. 1).
J. D. Rolleston.
OPTIC NEURITIS IN NEUBOFIBBOMATOSIS. (Neuritis optici bei
(603) Neurofibromatosis.) F. Pincus, Med. Klinik , 1913, ix., p. 1158.
A case of bilateral optic neuritis in a man, aged 41, the subject
of von Recklinghausen’s disease. There were no other signs of
cerebral tumour, so that Pincus is inclined to regard the optic
nerves as affected by neurofibromata. J. D. Rolleston.
PSYCHICAL DISTURBANCES IN THE COURSE OF VON RECK-
(604) UNGHAUSENR DISEASE. A CUTANEOUS GASTRIC
AND PSYCHICAL COMPLEX, (ttber psychische Storungen im
Verlaufe der Recklinghausen'schen Krankheit. Kutanes, gas-
trisches und psychisches Symptomenbild.) L. Gatti, Neurol.
Centralbl., 1913, xxxii., p. 1027.
Man, aged 20. The remarkable feature of the case was that the
neuro-fibromatosis was much less marked than usual. The gastric
symptoms on the other hand were prominent, viz., dyspepsia,
absence of free HC1, presence of lactic acid, and the existence of
an abdominal tumour suggestive of a fibroma in the stomach wall.
The psychical symptoms were apathy and depression, and complete
sexual frigidity. Gatti does not know of any case of neuromata
or neurofibromata in the stomach. (He has overlooked the case
recently described by Leriche in which pyloric stenosis was caused by
neurofibromatosis (v. Review, 1912, x., p. 33).—J. D. R.)
J. D. Rolleston.
ON THE PATHOGENY OF POST-DIPHTHERITIC PARALYSIS OF
(605) ACCOMMODATION. (Zur Pathogenese der post-diphtheritischen
AkkommodationslShmung.) S. Auerbach, Deut. Zttchr. f. Nerven-
heilk ., 1913, xlix., p. 94.
Among 26 cases of post-diphtheritic accommodation which were
seen at an eye department during a period of fourteen years, there
624
ABSTRACTS
were 22 children aged from 6 to 14 years, 20 of whom were
hypermetropes and 2 emmetropes, and 4 adults aged from 18
to 22—all hypermetropes.
Auerbach concludes that post-diphtheritic paralysis of accom¬
modation is principally due to the physiological weakness of the
ciliary muscle peculiar to childhood. In addition to this, in almost
every case there is a physical factor, viz., hypermetropia. The
latter is always responsible for the isolated cases of paralysis of
accommodation which occur in adults, whether due to diphtheria
or to other causes. The practical outcome of this theory is that
hypermetropes should be forbidden reading or fine sewing in
convalescence from diphtheria (t.e., for about eight weeks).
J. D. Rolleston.
AFFECTION OF CONUS MEDULLABI8 FOLLOWING RACHIS-
(606) TOVAINI8ATION. (Affezione del cono midollare in seguito
a rachiostovaininsarione.) E. Aguqlia, Riv. ital di Neuropat,
Ptychiat. ed Elettroter., 1913, vi., p. 389.
A woman, aged 40, suffering from carcinoma of the cervix,
developed the following symptoms indicating injury to the conus
medullaris directly after rachistovainisation, which were still
present three months after the operation. Complete paralysis of
bladder and rectum; complete anaesthesia of the rectal, urethral,
and vaginal mucosae; loss of cutaneous reflexes of the sexual organs,
and of the visceral and rectal reflexes; total absence of the various
forms of sensibility in the clitoris, vulva, perineal and perianal
regions; “ riding-breeches ” anaesthesia; loss of the tendo Achillis
reflex on both sides, and numbness of the toes of the right foot,
especially of the little toe (cf. Review, 1912, x., p. 381).
J. D. Rolleston.
ON A CASE OF POTTS DISEASE. (A proposito di un caso di morbo
(607) di Pott.) Q. Bolzani, Riv. ital. di Newrop., Ptychiat. ed Elettroter.,
1913, vi., p. 346.
The patient was a man, aged 28, who had had two attacks of
Pott’s disease. The first, which occurred at 14, involved the
seventh cervical and first three dorsal vertebrae. He gradually
recovered, though cypho-scoliosis and atrophy of the small muscles
of the hands persisted. Nine years later he developed weakness
of the lower limbs, with atrophy of the muscles of the thigh and
leg, and cramps and twitchings in the leg. No painful spot was
found on examination of the vertebral column, but the X-rays
showed disease of the last dorsal vertebra. J. D. Rolleston.
ABSTRACTS
625
ON MENINGISM IN INFECTIOUS DISEASES. (Ueber Meningismus
(608) bei Infektionskrankheiten.) Kiechhiim and Schroder, Dent.
Arch./, klin. Med., 1912, ciiL, p. 218.
Kirchhkim and Schroder investigated the question as to whether
meningism really did exist without any microscopical changes.
They apply the term “meningism” to cases with well-marked
meningeal symptoms, but with a clear cerebro-spinal fluid without
increase of albumin or cell contents. In most of these cases the
tension was increased, but in many it was normal. Bacteriological
examination was negative in all.
Eight illustrative cases are recorded. The first three cases of
scarlet fever in children, aged 2, 3, and 6 years respectively, were
examples of clinical meningism, with positive evidence of meningitis
microscopically. The remaining five—cases of pneumonia in a
woman aged 42, and in a boy aged 5, and three cases of scarlet
fever in children aged 2, 6, and 7 respectively—were examples of
meningism in which the macroscopical and histological findings
were negative.
The writers attach special importance to the action of the
toxines, and hold that slight anatomical changes sometimes met
with in meningism are not enough to produce the meningeal
symptoms. They do not agree with Schottimiller (v. Review , 1910,
viii., p. 703), who holds that there is a gradual transition from
meningism to meningitis properly so-called. If this view were
correct, one would expect to find clinically spinal hypertension and
anatomically hypenemia and oedema of the meninges and brain in
every case of meningism, or as Schottmiiller calls it, “ Meningitis
disseminata acuta septica seu infectiosa.” Though these phenomena
are present in most cases, they do not occur in all.
J. D. Rolleston.
TUBERCULOUS MENINGITIS (BOVINE INFECTION) IN AN
(609) INFANT AGED 12 WEEKS. Geo. A Allan, Lancet, 1913,
clxxxv., Nov. 29, p. 1535.
A child, healthy at birth, appeared to thrive for about six weeks,
after which he made no further progress. Until this time he had
been entirely breast-fed, and now he was also given two feeds daily
of diluted cow’s milk. When he was eight weeks old, a cough
developed. The cow’s milk was stopped after a fortnight as the
mother had plenty of milk. When he was eleven weeks old his
condition began to cause serious concern, he was pale, irritable,
fed with difficulty, breathing irregularly, convulsions, squint
occasionally present, head retracted, and ultimately became
comatose and died.
626
ABSTRACTS
The spleen showed small tubercles. On culture it was found
that the bacillus was of the bovine type. The mother, father, and
only other child were all healthy. The infant was really breast¬
fed. Only after it had begun to show signs of malnutrition was
that augmented by cow’s milk and then only for a fortnight. There
seems no sufficient grounds for supposing the milk was the direct
source of infection. An adopted boy, however, had to have
tuberculous glands from his neck removed shortly after the death
of the child, and the author thinks this must be a case of direct
bovine infection through the oral cavity. A. Ninian Bruce.
FUSIFORM BACILLI ASSOCIATED WITH VARIOUS PATHO-
(610) LOGICAL PROCESSES. G. F. Dick, Jour. Inf. Die .. 1913, xil,
p. 191.
Fusiform bacilli were found in three cases of meningitis. In one
of them the infection probably arose from the middle ear, which
is connected with the naso-pharynx, in which these bacilli are
usually found. In the other two cases the infection probably
followed chronic bronchitis, as in cases reported by Ghon and
Mucha, and by Kaspar and Kern. The failure of attempts to
demonstrate the pathogenicity of the bacilli in animals suggests
that they were present only as secondary invaders, as other
organisms were present in every case. J. D. Rolleston.
THE BLOOD AND THE CEREBRO SPINAL FLUID IN MUMPS.
(611) A. Feiling, Lancet , 1913, ii., p. 71.
From examination of the blood of forty cases of mumps in patients
aged from 2 to 38 years, Feiling found (1) that there was a
slight increase in the total number of leucocytes; (2) that there
was an absolute and relative lymphocytosis; (3) that this
lymphocytosis was present on the first day of disease, and per¬
sisted for at least fourteen days. He records a case of meningitis
in a boy aged 5£ years, which occurred in the acute stage of
mumps. The cerebro-spinal fluid was colourless, slightly turbid,
and under slightly increased tension. Differential count: lym¬
phocytes, 96 per cent.; polymorphs, 2 per cent.; endothelial cells,
2 per cent. Bacteriological examination negative. A second
puncture, two days after the first, showed only twenty cells per
cubic millimetre, of which 90 per cent, were lymphocytes. Com¬
plete recovery took place. Feiling concludes from this and other
cases on record: (1) that cerebro-spinal lymphocytosis occurs
in mumps both when complicated by meningitis or lesions of the
ABSTRACTS
627
cranial nerves, and also when there are no clear clinical symptoms
of organic disease of the nervous system. J. D. Rolleston.
A STUDY OF THE CEREBRO SPINAL FLUID IN ACUTE
(612) POLIOMYELITIS. Francis R. Fraser, Joum. Exp. Med., 1913,
zviii, p. 241.
The spinal fluid in the cases of acute epidemic poliomyelitis
examined was usually clear, colourless, and did not appear to be
under any great increase of pressure. It showed changes in the
number of cells present, or in the globulin content, or in both,
in the majority of cases examined on the first few days after
onset of symptoms. The number of cells was usually highest
during the first week, in one case as much as 1,221 per cubic
millimetre. The globulin reaction was usually most marked during
the third week. The number of cells diminished rapidly, and
was above normal in only 32 per cent, of the cases in the third
week. The increase in the globulin reaction persisted to the fourth
week, and might be present for a considerably longer period. The
cell increase was due almost invariably to mononuclear cells of
various types. The lymphocytic type of cell was most common.
A high polymorphonuclear count was noted in the very early
stages. All the fluids reduced Fehling’s solution. The examina¬
tion of the spinal fluid may be of value in diagnosis in the
preparalytic stages and in abortive cases. It is not of value in
prognosis as to life or ultimate recovery.
A. Ninian Bruce.
EPIDEMIC POLIOMYELITIS. FOURTEENTH NOTE: PASSIVE
(613) HUMAN CARRIAGE OF THE VIRUS OF POLIOMYELITIS.
Simon Flexner, Paul F. Clark, and Francis R. Fraser, Joum .
Amer. Med. Assoc., 1913, lx., Jan. 18.
A girl, aged 4 years and 4 months, developed acute poliomyelitis.
Her father and mother, who were perfectly healthy, were sub¬
jected to a naso-pharyngeal irrigation with normal saline. About
150 c.c. of fluid were collected, shaken and pressed through a
Berkefeld filter. This fluid was introduced into a Macacus as
follows: about 15 c.c. were injected into the sheaths of each
sciatic nerve, and 140 c.c. into the peritoneal cavity. The animal
later developed a flaccid paralysis, and sections of the spinal cord
after death showed typical lesions of experimental poliomyelitis.
An emulsion of the glycerinated spinal cord of this monkey was
injected into each sciatic nerve and into the peritoneal cavity of
628
ABSTRACTS
two Martini ,s monkeys. Both later showed infiltrative lesions of
l>oliomyelitis uj*on sections of their spinal cords after death.
Although the parents of this case were evidently not suffering
from poliomyelitis, yet the washings from the naso-pharynx con¬
tained the virus of epidemic poliomyelitis, and thus affords an
experimental basis for the belief of the occurrence of passive human
carriers of the infection. A. N INI AX Brl’CI.
THE POLYNEURITIC FORM OF ACUTE POLIOMYELITIS: A
(614) Clinical and Pathologic Study. S. Leopold, Amer. Jovn. Med.
Sci., 1913, cxlvi., Sept., p. 406.
A young adult female, without any previous illness, was suddenly
seized with vomiting, fever, pain in the head and back, followed in
several days by pain and paralysis in the lower limbs, together
with paralysis of the bladder. The patellar tendon reflexes were
absent, there was an unsymmetrical paralysis of both lower limbs
with partial areas of hyperthesia, and there was marked tender¬
ness on pressure over the nerve trunks in the paralysed extremities,
which persisted until death, two mouths after the onset.
Microscopically, the anterior horns showed the characteristic
picture of the subacute stage of an acute poliomyelitis. The
peripheral nerve examined showed no evidence of a primary
neuritis. D. K. Henderson.
NOTE ON ▲ CASE OF CHRONIC INTERNAL HYDROCEPHALUS.
(615) James Rak, Lancet, 1913, clxxxiv., Feb. 15, p. 453.
The patient was a boy who was subject to convulsions during his
first year. He began to take notice and to talk at about the
usual age, and had measles and whooping-cough. Shortly before
his fourth birthday he seemed to become stupid, and at this time
his parents thought his head was enlarging. He was sent to
hospital. The chest had marked rickety deformities, the arms
were spastic, and the hands clenched. The frontal and right
angular veins were very prominent, and when the child cried the
external jugular veins became half an inch in diameter. Death
took place from pneumonia on the tenth day after admission.
At the necropsy it was found that the torcular herophili
contained a pyramidal blood clot lying with its apex towards the
straight sinus. The clot was 1£ in. high, and 1 in. across its
base. The association of this condition with hydrocephalus has
apparently not been previously recorded. A. Ninian Bruck.
ABSTRACTS
629
A CASE or HEMIPLEGIA AND HEMIANESTHESIA WITH
(616) MUSCULAR ATROPHY. (Su d'un caso di emiplegia ed
emianeatheaia con atrofla muscolare.) E. A. Sagrini, Riv. itai. di
Neuropat., Psychiat. ed Elettroter., 1913, vl, p. 337.
A man, aged 22, developed left hemiplegia with hemianaesthesia
and muBcular atrophy in convalescence from severe typhoid fever.
Some improvement took place in the motility of the left leg, but
none in the face, and the anaesthesia and muscular atrophy were
unchanged when the patient left hospital six months after the
onset of the paralysis.
The lesion was probably situated in the left internal capsule,
in which a portion of the posterior limb was involved, and also
in the pulvinar. The muscular atrophy is attributed to grave
and extensive lesions throughout the course of the pyramidal
tract. J. D. Rolleston.
SPINAL GLIOSIS OCCURRING IN THREE MEMBERS OF THE
(617) SAME FAMILY, SUGGESTING A FAMILIAL TYPE. George
E. Price, Amer. Joum. Med. Sci. , 1913, cxlvi., Sept., p. 386.
The cases reported occurred in two brothers and one sister, aged
13, 22, and 24 years respectively. The symptoms were practically
identical in all these patients.
One of the patients, when 8 years old, developed a sore on the
second toe of her right foot, which, after removal of a small spicule
of bone, rapidly healed. Two years later a similar condition
developed on the second finger of the right hand. The patient
stated that she had never been able to properly recognise touch,
pain, hot or cold on her hands and feet, but that she could
recognise these sensations readily on other parts of her body. An
objective examination showed that all forms of sensation were
lost in the affected areas. The fingers and toes of both hands and
both feet showed marked trophic changes both of the nature of
spontaneous amputation and arthropathies. Investigation of the
family history failed to disclose any possible etiological factor.
D. K. Henderson.
SYRINGOMYELIA; WITH PATHOLOGICAL FINDINGS. E. P.
(618) Brrnstein and S. Harwitt, Med. Record , 1913, lxxiv., Oct. 18,
p. 698.
A woman, aged 49, had suffered from attacks of pain over the
sacrum and left leg for nine years. Then both legs became
630
ABSTRACTS
involved, followed by flaccid paralysis, anesthesia, bedsores, and
death.
The spinal cord showed on section a longitudinal cavity of
irregular shape differing at different levels. The microscopic
appearance also differed at different levels, but the origin of all
the diverse lesions seemed to lie in neoplastic proliferation of glia
cells, resulting in the cauda equina in a gliomatous tumour mass.
A. Ninian Bruce.
MILD MANIFESTATIONS OF SYRINGOMYELIA. With Report of
(619) Three Cases. C. Burns Craig, 1913, lxxxiv., Oct. 25, p. 747.
Case I. —Man, aged 21, engineer and expert violinist, began to find
he could not use his left thumb and index finger well. Later,
slight numbness developed, and the first movement of the fingers
became inaccurate. The arm and forearm show a degree of
diminution in volume, which is just appreciable, and there is mild
atrophy of the thenar and hypothenar muscles. The left arm is
slightly ataxic. He is also completely anaesthesia to temperature
and pain from the crown of his head to the tenth dorsal vertebra,
and from his chin to the seventh rib, quite symmetrical and in¬
cluding both arms. The cerebro-spinal fluid was negative.
Case II. —Man, aged 28, clerk, complained of flattening of the
hand at the base of the left thumb. His first symptom was
failure to use his arms fully in swimming. The amestliesia con¬
sisted in absence of pain and temperature sense from the occiput
to the scapular spine on the left, and to the twelfth dorsal vertebra
on the right, and anteriorly from the chin to the third rib on the
left and below the umbilicus on the right. In addition certain
cardiac symptoms suggested involvement of the vagus nucleus.
Case III. —Man, aged 39, bookbinder, typhoid fever at 18,
began to notice numbness in the little finger ten years ago; then
numbness of all right arm, and later the right little finger began to
curl, then his ring finger did the same, and gradual loss of strength
occurred in his right arm. Amesthetic to head, cold and pin¬
prick was present from the occiput to just below the scapular
spine, and from the chin to the second intercostal space, with some
involvement of both arms. A. Nini an Bruce.
INFANTILE CEREBRO CEREBELLAR DIPLEGIA OF FLACCID
v620) ATONIC-ASTASIC TYPE. L. Piercb Clare, Amer. Joum. Di$.
Child., 1913, v., June, pp. 425-446.
This is a relatively rare disorder. The disease type is established
by pronounced ilaccidity, mutism and idiocy. Usually nothing
ABSTRACTS
631
abnormal in physical and mental make-up is noticed in the child
for the first few months after birth. The condition is usually first
seen at about one year, when the child attempts movements of its
own volition. It is then noticed it cannot sit up, hold up its head,
or even stand. There is no atrophy, but the whole musculature
is released. The electrical reactions are normal. The most
striking symptom is the enormously exaggerated mobility of the
joints. Later an ataxy of cerebellar type is superadded, and inco¬
ordination of all the extremities becomes marked. The positions
of the arms and legs are not fixed by proper muscle tone. If the
limbs arc left to themselves they follow the action of gravity, and
when let fall from a lifted position, they hang down in a lifeless
manner. Usually the mental deficit amounts to idiocy, or to a
low degree of imbecility. There is always a marked speech defect,
in most cases amounting to mutism.
The author considers that the condition is the result of an
intra-uterine disorder, either inflammatory, haemorrhagic, or an
agenetic disorder of the cerebellum, and a wide and extensive defect
of the fore-brain, especially the frontal, parietal, and possibly the
temporal cerebral lobes, as a result of which hypotonia, dysmetria,
ataxy, inco-ordination, mutism and idiocy result.
A. Ninian Bruce.
EXPERIMENTS ON INTRADURAL ANASTOMOSIS OF NERVES
(621) FOR THE CURE OF PARALYSES. W. B. Cadwaladeb and
J. E. Sweet, Med. Record, 1913, lxxxiv., Nov. 1, p. 800.
Anastomosis of peripheral nerves for the cure of paralysis has been
successful in certain cases of facial paralysis, but when applied to
nerves of the extremities the results have not been very encouraging.
If crossing the intraspinal motor roots of the spinal cord could be
proved to be practicable in man, for the Return of at least partial
function in paralysis of the bladder from injury to the lumbo-sacral
spine, &c., it might be a justifiable procedure in certain cases.
The authors divided intradurally the anterior nerve roots at
various levels, and performed cross anastomosis. The paralysis
resulting was in no case recovered from, as the cut ends became
involved in a great excess of scar tissue, and regeneration did not
occur. A Ninian Bruce.
DISEASE OF THE ULNAR NERVE AFTER TYPHOID FEVER.
(622) (Znr Kasuistik der Erkrankung des N. uln&ris nach Unterleibs-
typhus.) B. M. Dolgopol, ZciUckr. f . klin . Med., 1912, Ixxvi.,
p. 49a
Dolgopol reviews the literature and records a case of right ulnar
neuritis in a man, aged 22, in convalescence from severe typhoid
5 2
632
ABSTRACTS
fever. Complete recovery occurred in about six weeks. Dolgopol
rejects Bernhardt’s view that ulnar neuritis in typhoid is due
to mechanical damage from constantly lying on the side of the
nerve a flee ted, and regards a toxic origin as much more probable.
J. D. RoLLEsm
AGGLUTINATION OF THE TYPHOID BACILLUS BY THE
(623) CEREBRO SPINAL FLUID OF THE TYPHOID FATBHT.
(Agglutination do bacille d’Eberth par le liquids cdphAlo-nchidieB
dn typhique). R. Brandeis and C. Monooub, Cmpt. rend. See. it
Biol ., 1912, lxxiii., p. 140.
The presence of agglutinins in the cerebro-spinal fluid of persons
sutiering from microbial infections is so exceptional that the
present case is worthy of note. The patient was a woman who
had clinical evidence of typhoid fever, but an obstinate headache
of a month’s duration suggested the possibility of meningitis.
Widal’s reaction was positive. The cerebro-spinal fluid showed
no leucocytosis, and only a few red cells, but it agglutinated
typhoid bacilli, though in a somewhat lower dilution than in the
case of the blood serum—1 in 60 as compared with 1 in 80.
J. D. Rollkston.
SLOWLY DEVELOPING SUPRARENAL INSU FF IC I E N CY OF
(624) CEREBRAL FORM FOLLOWING TYPHOID FEVER (Inrafi*
ance surrdnale lente A forme cdrtfhnde consecutive i use Mvw
typholde.) R. Donnis, Arch, de mid. et de pharm. mil., 1913, In,
p. 667.
A soldier, aged 22, two months after a severe attack of typhoid
fever, developed signs of suprarenal insufficiency characterised
by circulatory troubles (hypotension and coldness of extremities),
digestive disorders (anorexia, constipation, and persistent vomiting),
nervous symptoms (lumbar and abdominal pain, headache, and pro¬
found neurasthenia), and general disturbance (anaemia, loss of
flesh, and hypothermia). In addition to these signs of suprarenal
insufficiency were some puzzling cerebral phenomena, viz., constant
melancholy, delusions, and nightmares. Progressive improvement
took place under the administration of adrenalin. The slow
development of the symptoms is attributed to a sclerotic change
in the suprarenals, following the acute inflammation produced by
typhoid fever (c/. Review, 1912, x., p. 243).
J. D. Rolleston.
ABSTRACTS
633
A VERT SUCCESSFUL NEW METHOD OF CURING HYSTERI-
(625) CAL APHASIA. (Un nuovo metodo molto efficace per guarire
l’afasia iaterica.) Pbof. Citelli, Riv. itaX. di Neuropat., Psychiat.
ed Elettroter., 1913, vi., p. 385.
In a paper read before the fifteenth section of the Seventeenth
International Congress of Medicine, Professor Citelli describes
the following method for curing hysterical aphasia. While engaged
in quiet conversation with the patient or his friends fix the back
of the patient’s neck with the left hand, and then suddenly grasp
with the index and thumb of the right hand the sides of the
thyroid and hyoid cartilages, and exercise upon them a pressure
which should rapidly be made strong and slightly painful. The
patient, alarmed by this procedure, tries to cry out, but should be
plied with a number of questions in rapid succession. He thus
escapes from the special state of consciousness which rendered
him aphasic, and replies in a clear voice. To avoid a relapse
compel the patient to continue speaking distinctly. Citelli has
successfully treated four cases by this method, two in men and
two in women, including an old maid of 60 who had been aphasic
for three years. J. D. Rolleston.
DEATH FROM SYPHILIS OCCURRING NINE DAYS AFTER IN-
(626) JECTION OF 8ALVARSAN. Capt J. H. Duguid and Lieut
W. T. Geaham, Jour. Roy. Army Med. Corps, 1913, xxi., p. 582.
A man, aged 28, who had contracted syphilis eighteen months
previously, was given an intravenous injection of 06 gm.
salvarsan. The primary lesion had rapidly yielded to injections
of mercury, and at the time of injection of salvarsan he had
no signs of active disease, and did not complain of anything.
Six days after the injection he had headache, malaise, and rise
of temperature, and the following days a series of epileptic fits,
which continued till death. Post mortem a gumma was found
4 cm. in diameter just external to the anterior horn of the right
lateral ventricle. In addition to the usual caseous material, the
gumma contained a considerable amount of fluid blood, pointing
to haemorrhage of some days’ duration. The writers think that
salvarsan caused a local reaction in the gumma, and thus produced
symptoms which might have remained in abeyance.
J. D. Rolleston.
A REPORT OF SEVEN OASES OF SYPHILIS APPARENTLY
(627) CURED WITH ONE INJECTION OF SALVARSAN. A. L.
Wolbarst, New York Med. Jowm ., 1913, ii., p. 747.
The patients received no other treatment beyond a single intra¬
muscular injection of salvarsan. They all became and remained
634
ABSTRACTS
perfectly well. Tlie period of observation since the injection
ranged from two years and ten months to two years and one
month. In four cases Wassermann’s reaction was taken, and was
persistently negative. Two of the patients were in the primary,
two in the secondary, and three in the tertiary stage at the time
of in jection. J. D. RoLLBTOh'.
THE PREVENTION OF BPILBP8T. L. Pikrce Clark, New York
(628) Med. Joum., 1912, Dec. 14
After a brief discussion of this subject, the author points out
that the prevention of epilepsy is closely bound up with: (1) a
more precise and intensive study of family stock from which the
disease is recruited; (2) birth injuries and accidents must be still
further eliminated; (3) the rearing of neuropathic individuals
must l*e given more definite and painstaking attention; and (4)
proper metabolism in potentially epileptic individuals must be
still more energetically safeguarded. A. NntlAN BbucI
PSYCHIC EPILEPSY WITHOUT OTHER PHENOMENA Gsobgi
629) E. Price, Journ. Nerv. and Ment. Dit., 1913, xL, Sept, p. 580.
The case of a man, 42 years, who had always been irritable, and
who in September 1912 was suddenly found in a confused condition
and entertaining the delusion that a man was in the room, whom
he was apparently trying to shoot by snapping an empty revolver.
In less than an hour his mind cleared, and he had no recollection
of what had occurred. He then complained of headache, and
wanted to sleep. Seven such attacks occurred during the following
five weeks. He would always be found in a confused, hallucinatory,
and delusional state, always believing a strange man was in the
room, and entertaining in a more or less vague way the delusion
of marital infidelity. The attacks lasted from fifteen minuteeto
one hour, and were always followed by headache.
The physical examination was negative; there were no
hysterical stigmata.
Under rest and bromide treatment the attacks disappeared for
a period of three months, but subsequently returned.
D. K. HEHDKB80N.
ABSTRACTS
635
THEBE OASES OF “FITS.” Robert A. Fleming, Clin. Joum., 1913,
(630) xliL, Aug. 13, p. 800.
The author classifies fits as follows:—
Cerebral fits -
/
Organic”
or epileptic
form
\ Functional -
' I. Trueor idiopathic epilepsy— 1
(1) Grand mad.
(2 ) Petit mal .-
TL-
(1) Toxic, e.g. 9 uraemic con- j
vulfliona
(2) Infective, e.g. 9 scarlet
fever, acute poliomyelitis,
III. Organic—
(1) Tumour—Dependent on site.
(2) Sclerosis - - - - \
(3) Haemorrhage
(4) Embolism
(5) Hydrocephalus-
(6) Meningitis
IV. Infantile convulsions—
(1) Due to any of above groups
(2) Reflex, e.g. 9 teething
V. General paralysis oi the
insane
Jacksonian
epilepsy.
Hysteria.
A. Ninian Bruce.
TRAUMATIC) NEURASTHENIA. H. Campbell Thomson, Joum. of
(631) Mental Sei., 1913, Oct., p. 682.
The author discusses the limitations of the term traumatic
neurasthenia, and considers that it should include all cases of
neurosis resulting from shock to the mind in connection with an
accident, even though there may be no physical injury. It is
the fear of trauma, rather than the trauma itself, that leads to
the neurosis, the amount of shock being often disproportionate
to the degree of danger experienced. Indeed, the trauma may
affect one person and the neurasthenia another.
The latent period in genuine cases is not usually longer than
a week or two, and cases in which the symptoms are delayed
much longer than this should be looked upon with suspicion.
The author believes that the symptoms are due to the in¬
hibition of the action of those cortical cells which control the
thalamic centres, the latter being intimately related to the
emotions, and forming part of Langley’s autonomic system.
Treatment of sixty cases resulted in thirty-nine resuming
work, nine are permanently disabled, three have become insane,
and in nine the results are uncertain. W. D. Wilkins.
ABSTRACTS
6:;g
DELIRIUM TREMENS? DUE TO STRAMONIUM POISONING
if, 32 / (Un cas do deliriom tremens? dd k intoxication par Is datnn
stramonium.) Boghassian, Arch. Internal, de Neurol ., 1913, nn,
Nov., p. 2!*0.
The author reports the case of a woman of 43 in whom bizarre
effects of stramonium poisoning lasted so long as seventeen days.
Bazil states, after a long experience in India, that the mental
effects of stramonium last f«>r only five or six days. Paehagan
observed a whole Armenian family thus poisoned, with a duration
of mental symptoms for only four or five days. The author
attributes the long duration in his own case to the heredity of the
patient: the father was alcoholic and of irritable character, and
died delirious in pneumonia; the mother showed of late symptoms
of organic dementia; a maternal aunt had an attack of acute
mania with perfect recovery: another maternal aunt showed
paranoia since age of 15, and is now under the author’s care.
There was also plenty of insanity in more distant relatives.
There was no consanguinity of the patient’s parents. A graphic
description is given of the patient’s terrifying visual and aural
hallucinations. Leonard J. Kidd.
AN INTENSIVE STUDY OF INSECTS AS A POSSIBLE ETIOLOGIC
(633) FACTOR IN PELLAGRA. A. H. Jennings and W. V. Kmc,
Amer. Joum. Med. Sci., 1913, cxlvi., Sept, p. 411.
A SUMMARY of the results obtained is given; Ticks, lice, bed¬
bugs, cockroaches, horse-flies, mosquitoes, buffalo-gnats (Simulium),
house-flies, and stable-flies (Stomoxys) were under consideration.
Horse-flies have nothing, and cockroaches little, to support them.
Most of the other insects are ruled out for various reasons, but it is
stated that the stable-fly (Stomoxi/s calcitrant) displays certain
salient characteristics which seem to qualify it for the role of a
transmitter of pellagra. The characteristics mentioned are not
convincing. D. K. Henderson.
A CASE OF TETANUS TREATED BY INTRAVENOUS INJECTIONS
(634) OF PARALDEHYDE AND COPIOUS INJECTIONS OF
NORMAL SALINE RESULTING IN CURE Ouvkb Atket,
Lancet , 1913, clxxxiv., Jan. 18, p. 468.
A BOY, aged 19, was admitted to Khartoum Civil Hospital for
septic tuberculous sinuses of the neck. Two days later he
developed tetanus. The neck was very rigid, and opisthotonos
was marked during the spasms. He was given a large number
ABSTRACTS
G37
of doses of paraldehyde and ether intravenously in normal saline
solution. This produced deep anaesthesia immediately, and acted
not only as an anaesthetic but as a hypnotic, and thus preserved
the patient from the rapid exhaustion entailed by the muscular
contractions and pain, while the body was given time to eliminate
the tetanus toxin. At the same time the sinuses were laid freely
open and the activity of the bowels attended to. In this case the
strength and nutrition of the patient was well maintained during
the eight days he was suffering from tetanic symptoms, and he
was ultimately discharged quite well. A. Nini an Bruce.
ON A CASE OF ADDISON’S DISEASE IN A BOY AGED 10 YEABS.
(636) Frederick Langmead, Lancet , 1913, clxxxiv., Feb. 16, p. 449.
A boy, aged 10 years, was admitted to the Royal Free Hospital
on 17th September 1912, and died four hours later. On the
evening before, vomiting had started abruptly, accompanied by
restlessness and followed by loss of consciousness. The pulse was
rapid and weak, and the temperature subnormal. Frequent con¬
vulsions occurred until death. The urine and cerebro-spinal fluid
showed nothing abnormal. A slight diffuse brownness of the skin
was noticed, which the mother had noticed to have gradually
deepened for about twelve months.
The suprarenal glands were fibro-caseous almost throughout,
merely a narrow margin of healthy gland tissue being discernible
in a few areas. The sympathetic ganglia were not recognised.
Tubercular foci were found in the lungs and elsewhere.
A. Ninian Bruce.
PSYCHIATRY.
THE BACTERIOLOGICAL EXAMINATION OF THE URINE IN
(636) SOME OASES OF GENERAL PARALYSIS. E. Barton White,
Joum. of Mental Sci. t 1913, Oct., p. 596.
An examination of the urine was made before and after treat¬
ment by hexamethylenetetramine. Before treatment the urine
contained micro-organisms in every case, variously the Bacillus
coli comrminis, a diphtheroid bacillus, a staphylococcus, a strepto¬
coccus, and in one case a diplococcus. These all disappeared after
treatment, except in the case of the diplococcus, this being also
the only one in which formaldehyde was not found in the urine.
The author considers that the treatment had a favourable
effect in clearing up secondary infections, and in thus delaying
the onset of the third stage. W. D. Wilkins.
ABSTRACTS
G38
THE WASSERMANN REACTION AMONG THE NEOBO INSANE
(637) OF ALABAMA. R. R. Ivey, Med. Record, 1913, il, p. 711
Ivey examined the blood of 706 patients. The total number of
males examined was 357, of whom 95, or 25 per cent., were
positive. 349 females were examined, of whom 102, or 29 per
cent., were positive. There was nothing characteristic in the
mental condition of the positive or negative cases, save one feature,
viz., 17 cases of general paresis, 15 in men and 2 in women, all
gave a positive reaction. Among the 90 males, 48 gave clinical
signs of syphilis, such as adenopathy, pigmentation of skin, and
exostoses, and among the females 49 gave similar evidence,
J. D. Rollsston.
THE BOLE OF SYPHILIS IN MENTAL DEFICIENCY AND
(638) EPILEPSY : A REVIEW OF 206 OASES Kate Fkasks and
H. Ferguson Watson, Joum. of Mental Set., 1913, Oct, p. 640.
These investigators conducted their researches independently no
comparison being made until the investigations were complete.
The blood sera of mentally defective and epileptic children wat
examined for the Wassermann reaction, and in many cases the
relatives of the patients were examined in the same way.
Dr Fraser obtained a positive reaction in 44*90 per cent of a
group of 89 mentally defective children, and this percentage was
raised to 57*70 per cent, when those cases were included in which
a positive reaction was obtained in some other member of the
family, but not in the patient. The number of positive reactions
was almost the same in the epileptic children as in those without
epilepsy.
Dr Watson examined 105 defectives, and obtained a positive
Wassermann in 48 50 per cent., a percentage which was raised to
5810 per cent, when the relatives were included, so that the
results obtained by the two observers were very similar, and show
that a syphilitic taint is present in a large proportion of weak-
minded and epileptic children. W. D. Wilkins.
ICHTHYOSIS WITH MENTAL DEFICIENCY. (Note swr on cas
(639) d'ichthyoM avec ddbilitd mentals.) C. Pabhon and C. Dak,
Bull. Soe. Set. mid. dt Bucarett , 1911-12, p. 62.
A case of mental debility dating from childhood in a man,
aged 31, accompanied by almost generalised ichthyosis, slow pulse,
marked mononucleosis, and an impalpable thyroid. The condition
was attributed to thyroid insufficiency with which disturbance
of other glands of internal secretion was possibly associated.
J. D. Rollkston.
ABSTRACTS
639
DYSENTERY, PAST AND PRESENT. H. S. Gettings, Joum. of
(640) Mental Sci., 1913, Oct, p. 605.
An interesting account of the history of dysentery in England, first
as a general epidemic disease, and later as an asylum infection,
exemplified more especially in the annals of Wakefield Asylum.
The author has traced cases in almost every year since 1818, the
date the asylum opened, but shows that there have been six
epidemics, each having approximately a ten year cycle, with a
gradual rise and fall. At the end of each epidemic the authorities
claimed that the reduction in the number of cases was due to the
measures they had undertaken. W. D. Wilkins.
ON THE BACTERIOLOGY OF ASYLUM DYSENTERY IN
(641) ENGLAND. D. M‘Kinley Reid, Jour n. of Mental Sci., 1913,
Oct, p. 621.
This important essay has been awarded the Bronze Medal of the
Medico-Psychological Association. It is the account of some
careful and elaborate researches having the object of deciding
which type of B. dysenteries is the cause of asylum dysentery.
Thirty-five cases were investigated, many both before and
after death, and in twenty-eight of these cases organisms of the
Flexner type were isolated, no bacilli of this type being obtained
from twenty control cases, and the Shiga type not being found
at all. It was shown that the earlier in the course of the disease
the faeces were examined, the greater was the likelihood of the
bacilli being isolated.
The author has further been able to group the bacilli he
found into six distinct strains, differing distinctly from each
other in cultural characters, but all being mannite-fermenting,
and therefore akin to the Flexner type. He has been able to
identify these strains, more or less closely, with those described
by various observers in other epidemics.
Further tests were made of the agglutinating properties of
the seruto from these cases, and the presence of the Flexner
bacillus was confirmed. Intravenous inoculation of the cultures
was found by Dr Macalister to be fatal to rabbits, and the post¬
mortem appearances closely resembled those in early dysentery
in the human subject. Feeding experiments were carried out on
rabbits by Dr J. Walter Macleod for the author, but, strangely
enough, the results were negative in all cases.
The author considers that serum treatment offers the greatest
hopes for the future, and is well worth further investigation.
W. D. Wilkins.
53
640
REVIEWS
A DIFFICULT DIAGNOSIS IN AN IN8ANB PERSON. Robsbt
v*>42) Jones, Brit . Med. Joum ., 1913, Aug. 30, p. 633.
A man, aged 48, blind from double cataract, had been in Claybury
Asylum for about sixteen years suffering from maniacal excite¬
ment, with delusions of persecution; he was also a case of con¬
genital weak-mindedness. He was taken suddenly ill on 21st
May, and died on 23rd May. He complained of pain in the upper
part of the abdomen, which did not move during respiration.
The pulse was over 130. He vomited some “coffee-ground"
matter, became weaker, and sank into a semi-conscious condition.
A perforated duodenal ulcer was found at the autopsy.
A Ninian Bruce.
"Reviews.
AU8 DBM 8BBLBNLBBEN DB8 KINDS. Dr H. Von Hug Hbuxcth,
(643) 1913. Pp. 170. Deuticke, Vienna. Pr. M. 6.
An attempt is here made systematically to describe the develop¬
ment of the child by the help of the increased knowledge of this
period of life that has resulted from psycho-analytic investigations.
The book is divided into two parts, one dealing with the infantile
period, the other with the later “ play ” period. The chaptere of
the first are entitled—1. The functions of sense in the service of
feeling; 2. The first manifestations of the will; 3. The first signs
of the development of understanding; 4. The beginnings of speech;
5. The sources of ethical feelings; 6. Dreams. Of the second—
1. The body and its functions in the service of the play instinct:
2. The development of understanding; 3. Memory; 4. Phantasy:
5. Reason; 6. Speech; 7. Emotional life; 8. Art in the life of
the child; 9. Dreams. A study of the classical observations
of Compayrd, Scupin, Preyer, Stern, &c., is given, but the greater
part of the book is taken up with the author’s own observations.
The main purpose of the work is to investigate the aspects of
childhood life to which Freud has called special attention, such as
the importance of the early emotional life, of mental conflicts, of
repression, and of the childhood form of sexuality. The other
aspects that are more usually considered are by no means neglected,
though they are chiefly studied in relation to these.
The value of the book resides in the material added to that
already published, which goes to show that the conclusions on
childhood life, drawn by Freud from psycho-analysis of the adult,
REVIEWS
641
can be fully confirmed by direct observation of the child itself, if
only precautions are taken not to overlook or underestimate them
in the way usually done. Ernest Jones (London).
MENTAL DISEASES. By Dr R. H. Cole. University of London Press,
(644) 1913. Pp. 343. Pr. 10s. 6d.
This is a new text-book of psychiatry, evidently designed for
students. The first chapter, which in the reviewer’s opinion is
the best in the book, deals in a very interesting manner with the
history of insanity and its treatment. Then follow four clearly
written chapters on normal psychology; these, together with the
chapter on the neuroses, have been reviewed elsewhere by the
present writer (in the Journal of Abnormal Psychology), so that
attention will be confined here to the clinical and pathological
sides.
It is plain that a great amount of work has been put into
the book, which is on the whole a very creditable production.
The best features of it are the general clearness of exposition,
with a vivid and easy style of writing, the clinical descriptions,
the section on the legal aspects of insanity, and the well-repro¬
duced photographs and beautiful coloured illustrations. Much
of the content, however, is less satisfying than the form. The
impression of modernity that one gets, for instance, from seeing
references to Mendel, and even casual ones to Freud, is not
altogether maintained by closer inspection. One dare hardly say,
for example, ten years after the work of Apathy and Bethe, that
“ the neurone theory is practically accepted by neurologists ” (p.
22). In the section on general paralysis no mention is made of
the Wassermann reaction; it is true that this is referred to in the
chapter on pathology, but only in a brief sentence that gives the
reader no idea of the diagnostic value, the pathological significance,
or even the nature of it.
A few points in the book may be selected for comment. In
sensory aphasia the mental defect is one of apperception, not of
perception (p. 36). We read (p. 95) that “ the sexual nature can
be repressed with safety, provided, &c.,” where the writer prob¬
ably meant “ suppressed,” an alteration which would bring the
statement nearer the truth, without, however, making it true.
That mental shock “ produces about 1 to 2 per cent, of cases
of insanity ” (p. 98) is a dangerous remark to insert in a text¬
book, as it conveys an obviously false impression of simplicity and
accuracy. The misleading term, “ maniacal-depressive insanity,”
is used (p. 105); Kraepelin did not, as the author states, introduce
this term, for, in common with most other psychiatrists, he speaks
642
REVIEWS
of manic-depressive insanity. Stupor is still considered to be a
type of insanity, instead of, as with all modern writers, merely a
symptom, and the term “ amentia ” is deflected from its ordinaiy
connotation of the psychosis described by Wernicke to signify a
primary mental deficiency.
The gravest error in the book, in the writer’s opinion, is that
concerning the attitude adopted towards dementia pnecox. This
is considered in the same chapter as, and thus on a level with, the
terminal states of alcoholic, presbyophrenic, and epileptic psychoses,
and of others with gross organic disease. Now, without going
into the vexed question of the histopathological changes found in
this condition, it is quite certain that it differs fundamentally in
nature from the “ dementias ’’ accompanying gross organic disease.
To take one point alone, it is now known that no dementia,
properly speaking, ever occurs in the disease, which psychological
investigations have shewn to 1>e characterised by the most pro¬
ductive and significant mental activity. No hint is given to the
student that the name of the disease is merely of historic interest,
and it is grouped together with conditions that may well come
under the definition of dementia given by the author (p. 132), as
a state “ exhibiting an absence of mental functions due to organic
destruction of nerve cells, and without hope of recovery.” This
accords with the author’s treatment of the pathology of dementia
pnecox, by which he means only morbid anatomy, not a single word
being said of all the extensive and fruitful work of recent years
on the psychopathology of the condition. The difficult and im¬
portant question of the diagnosis between it and manic-depressive
insanity is practically ignored, for in the chapter on the latter
condition we find only that “ dementia pnecox may be excluded
by the gradual onset (what about the acute outbursts of catatonic
excitement ?), together with the weak-mindedness and mannerisms
accompanying it ” (p. 120). By the way, one is astonished to
read (p. 156) that the term dementia pnecox was first applied by
Pick in 1898 ; it was coined by Morel half a century ago, and has
enjoyed a wide circulation ever since, though it is only a couple
of years since it has come into use amongst English psychiatrists.
On the whole the book may be regarded as a fairly presentable
account of the subject, written very conventionally, and with a
pronounced cautiousness towards any new or original ideas, and of
unequal value. Some of the good and bad features have been
pointed out above, and similar criticisms could be applied to
almost every section; for instance, the chapter on morbid anatomy
is very good so far as macroscopic work is concerned, but fails to
give any adequate conception of the more important histopatho¬
logical side, on which so much work has been done in recent years.
BOOKS AND PAMPHLETS RECEIVED
643
In the second edition, which we may anticipate with confidence,
we hope to find evidence of a thorough revision, when one will
then, no doubt, be able to recommend it more cordially to students
of the subject. Ernest Jones (London).
INTERNATIONALE ZEITSOHRIFT FttR ARZTLIOHE PSYCHO
(645) ANALYSE. Jahrgang I., Heft I., January 1913. Heller, Vienna.
Pr. M. 18 yearly.
This new journal, which replaces the Zentralblatt as the official
organ of the International Psycho-Analytic Association, is directed
by Professor Freud, and edited by Drs. Ferenczi and Rank (now
also by the reviewer). It appears every other month, alternately
with Imago, the psycho-analytic journal devoted to non-medical
investigations, each number containing about 120 pages.
The first number is divided into eight parts: I. Original Articles.
There are five of these, as follows: Freud, “ Further Advice on the
Technique of Psycho-Analysis.” This is one of a series of papers
that Freud has for some time been publishing on the subject of
technique. Ernest Jones, “The Relation between the Anxiety
Neurosis and Anxiety Hysteria.” Seif, “ The Psychopathology of
Morbid Anxiety.” Fedem, “Contributions to the Analysis of Sadism
and Masochiem.” Rank, “ The Matron of Ephesus.” II. Shorter
Communications. These are grouped according to subject, e.g.,
infantile life, dream interpretation, &c. III. Criticisms and
Reviews. IV. Reports of Societies and Meetings. V. Correspondence.
VI. Various. Quotations from writers, &c. VII. Bibliography.
A bibliography of the works published on this subject and on
allied ones is printed in every number. VIII. Korrespondenzblatt
of the International Association. Reports of the constituent
societies, &c. The journal is printed mainly in German, but
papers can also be published in English and French.
This is not the place to offer a detailed criticism of the new
journal, which would obviously involve one of psycho-analysis
itself. One need only point out that to those working at, or
seriously interested in the subject, this journal is literally
indispensable. Ernest Jones (London).
BOOKS AND PAMPHLETS RECEIVED.
Clark, L. Pierce. “Newer Aspects of the Treatment of Epilepsy”
{Med. Record , 1913, Aug. 2).
Clark, L. Pierce. “The Prevention of Epilepsy” {New York Med.
Joum., 1912, Dec. 14).
Clark, L. Pierce. “Remarks upon Psychogenetic Convulsions and
Genuine Epilepsy” {Med. Record, 1912, Oct. 5).
54
G44 BOOKS ANT) PAMPHLETS RECEIVED
Clark, L. Pierce. “ A Case of Myoclonia occurring only after Rest or
Sleep ” (Jour*. Anter. Med. Ateoc., 1912, lviii., pp. 1660-1668).
Clark, L. Pierce. “ Some Considerations of Psychopathic Children ”
( Women’s Med. Joum., 1913, July).
Clark, L. Pierce. “ Infantile cerebro-cerebellar Diplegia, of flaccid,
atonic-astasic type ” (Amer. Joum. Die. Child., 1913, v., pp. 426-446).
Cole, R H. “ Mental Diseases. A text-book of psychiatry for medical
students and practitioners,” pp. X.+343; 52 illustrations and {dates.
University of London Press, Hodder <fc Stoughton, London, 1913. Pr.
10a 6d. net
Flexner, Simon, Clark, Paul F., and Fraser, Francis R “Epidemic
Poliomyelitis. Fourteenth note: passive human carnage of the virus of
poliomyelitis” {Joum. Amer. Med. Assoc., 1913, lx., Jan. 18).
Fraser, Francis R "A Study of the Cerebrospinal Fluid in Acute
Poliomyelitis ” {Joum. Exp. Med., 1913, xviii., p. 242).
Schaefer, F. “Die Alkohol-Geistesstorungen” {Jurietiech-peychiat.
Grenzfragen, 1913, ix. Pr. M. 1.50).
Sommer, Robert “Klinik f. psychische und nervdee Krankheiten,”
1913, viil H. 2/3. Pr. M. 3.
Taylor, Jamea “Vascular and other retinal changes associated with
general disease” {Ophthalmol. Soc. Trane., 1913, xxriii.).
Taylor, James, and Holmes, Gordon M. “ Two families, with several
members in each suffering from optic atrophy ” {Ophthalmol. Soc. Trane n
1913, xxxiii., p. 95).
Taylor, James, and Holmes, Gordon M. “ Nervous symptoms associated
with optic atrophy of the familial type ” {Ophthalmol. Soc. Trane., 1913,
xxxiii., p. 116).
White, William A “Bulletin No. 5.” Government Hospital for the
Insane, Washington, 1913.
“ The Training School ,” 1913, x., November.
33ibliO0tapb\>
ANATOMY.
KUBIK, J. Uber die Darstellung des Glaskftrpergeriistes und peripherer markloser
Nervenfasern nach S. Mayen Methods. Arch.J. mikr. Anat ., Bd. 81, H. 2, Nov.
15,1912, ». 74.
AUERBACH, L. Die Beziehungen zwischen dem Strukturbilde dee Aohsenxylinders
der markbaltigen Nerven der Wirbeltiere und den physikalischen Bedingungen der
Fixation. Arch. /. mikr. Anat., Bd. 81, H. 2, Nov. 15, 1912, 8. 151.
SIMPSON, S. The pyramidal tract in the Canadian porcupine (Erethizon dorsatus,
Linn.). Proc. Soc. Exp. Biol, and Med., YoL x., No. 1, Oct. 16, 1912, p. 4.
JOHNSTON, J. B. On the teleoetean forebrain. Anat . Rec., Vol. 6, No. 11, Nov. 20,
1912, p. 423.
SHIMADA, K. Uber die Segmentierung dee eigenttimliohen Rtickenmarksbandes und
die “ Hoffmann’schen Kerne” (Kolliker) dee Riickenmarkee von einigen Schlangen
(Trigimoccphalus ; Tropidonotus tigrinus ). Anat. Anzeig., Bd. 42, No. 17/18, Nov.
29, 1912, p. 417.
TODD, W. The tonic and respiratory action of the trapezius. Anat. Anzeig., Bd. 42,
No. 17/18, Nov. 29, 1912, p. 438.
STOCKARD and CRAIG. An experimental study of the influence of alcohol on the
germ cells and the developing embryos of mammals. Archiv/. Enlwicklungsmech.
d. Organismen, Bd. xxxv., H. 3, Dez. 17, 1912, s. 569.
PATZELT, V., and KUBIK, J. Azidophile Zellen in der Nebenniere von Rana
esevdenla. Arch. f. mikr. Anat., Bd. 81, H. 2, Nov. 15, 1912, s. 82.
PHYSIOLOGY.
MARINESCO and MINE A. Croissanoe dee fibres nerveuses dans le milieu de culture
in vitro des ganglions spinaux. Compt. Rend. d. 1. Soc. de Biol., T. lxxiii., No. 37,
D4c. 20,1912, p. 668.
BESTA, CARLO. Ueber die zerebro-zerebellaren Bahnen. Experimented Unter-
suchungen. Archiv J. Psychiat. u. Nervtnkrank., Bd. L, H. 2, 1912, s. 323.
ADRIAN, E. D. On the conduction of subnormal disturbances in normal nerve.
Journ. Physiol., Vol. xlv., No. 5, Dec. 9, 1912, p. 389.
BAGLIONI, S. Sui rifiessi cutanei degli anfibi e sui fattori che li condizionano.
Ztschr.f. allg. Physiol., Bd. xiv., H. 2, 1912, s. 160.
PORTER, E. L. Thresholds of electrical stimulation in the spinal oat, determined by
the Martin method. Amer. Journ. Physiol., YoL xxxi., No. iii., Dec. 2, 1912,
p. 141.
SNYDER, C. D. Concerning some reoent experiments on the temperature coefficient
of nerve conduction and cardiac rhythmioity. (4 figs, in text.) Ztschr. f. allg.
Physiol, Bd. xv., H. 2, 1912, s. 263.
NAGEOTTE, J. Image normals, image paradoxale et mensuration de la gains de
mylline. Compt. Rend. d. 1. Soc. de Biol., T. lxxiii., No. 37, D4c. 27, 1912, p. 725.
AMANTEA, G. A proposito dell’ arione del curaro applicato direttamente sui centri
nervosi. Riposta al prof. G. Pagano. Rir. di Palol. nerv. e ment., Vol. xvii.,
F. 11, Die. 6, 1912, p. 696.
PAGANO, G. Replica al dott. G. Amantea. Riv. di Palol. nerv. t ment., Vol. xvii.,
F. 11, Die. 6, 1912, p. 700.
YERKES, R. M. Habit and its relations to the nervous system in the earth worm.
n X Ct. _ XT* r».• I J l/.J TT^l — -KT_ 1 1 0 1 Al O _ 1C
PAGANO, G. II meccanismo fisiologioo dalle emozioni Riv. di Palol. nerv. e ment.,
VoL xvii., F. 11, Die. 1912, p. 687.
CLAUDE, H., and BAUDOUIN, A. Glycosuria hypophysaire et glycosurie adr^nalique.
Compt. Rend, d . 1. Soc. de Biol., T. lxxiii., No. 37, f)6c. 27, 1912, p. 732.
a
i*
mm.IOGRAPHY
0*
rOHN, A. K. On the dilhTencos in the effect* of stimulation of the two va^u* nerves
cm rate' ;m«l cmi lm tnm of the (h>g s heart. Proc. .Vo*. Exp. Biol, aiui Med., Vol. l,
No. 1, Oct. 16, 1912. p. 8.
LE PLAY. Stir lea rapport* entre la thyronle ot leg para thy ro ides. Thrroidectanie
apron parat by rtndccloinie. ComjU. Rend. d. 1. Soc. de Biol T. lxxiii., No. 37, Dec-
2*», 1912, p. 626.
KONVE, A. H. On the Croatia-splitting enzyme of the parathyroids and the adrenftli
Amer. Journ. Physiol., Vol. xxxi., No. iii., Dec. 2, 1912, p. 169.
DIXON, \V. K., ami RANSOM, F. Broncho-dilator nerve*. Journ. Ph>isid Vol.
xlv., No. 6, Dec. 9, 1912, |>. 413.
TRIBE, E. M. Effect of adrenalin on tho pulmonary circulation (Proc. Phyiiol. Soc.,
Oct. 19, 1912). Journ. Physiol., Vol. xlv., No. 5, Dec. 9, 1912, p. xx.
v. ANKKl\ G. On tho part played hy the suprarenal* in the normal vascular reactions
of the body. Journ. Physiol. % Vol. xlv., No. 5, Deo. 9, 1912, p. 307.
v. ANKER, G. On local vascular reactions and their interpretation. Journ. Pkpwi.*
Vol. xlv., No. 5, Dec. SI, 1912, p. 318.
MULON, P. 1a corticale surrcnalo du chien. Compt. Rend . <L L Soc . de BioL, T,
lxxiii., No. 37, Doc. 27, 1912, p. 714.
COTT E N TOT, MU LON, a nd Z IM M E RN. Action des rayon* X gar la oorticale surrenale
Compt. licnd. d. 1. Soc. de Biol. % T. lxxiii., No. 87, D4c. 27, 1912, p. 717.
PSYCHOLOGY.
IiEYMANS, G. In Sachen de* pgychischen Moniamu*. Ztsckr. /, Psychol., Bd. 63,
H. 4 und 5, 1912, 8. 241.
v. LIE BERM ANN, P., and REVESZ, GEZA. Experimen telle Beitnge wr Ortho-
gym phonic und zum Falschhoren. Ztschr. /. Psychol Bd. 63, H. I und 5,1912,
g. 286.
v. LIEBKRMANN, P., and REVESZ, GEZA. Tiber eine besondere Form de* Falich*
horetis in tiefen Lagen. Ztschr. /. Psychol Bd. 63, H. 4 und 5, 1912, a 325.
MOLL, A. Physiologischcs und Psychologiaches uber Liebe und Freundicbafi %*hr.
f. Psychotfier. u. med. Psychol ., Bd. iv., H. 5, 1912, s, 257.
DUBOIS, P. Die Dialektik im Dienste der Psyohotherapie. Ztschr. f\ Psychother. a.
mod. Psychol ., Bd. iv., H. 5, 1912, s. 278.
STERNBERG, W. Das SattigungsgefiihL Ztichr. j. Psychother. a. nud. Psyckoi,
Bd. iv., H. 5, 1912, s. 288.
CORNING, J. L. The Psychology of the Gambling Habit. A Study of Soipencein
Gaming, the Drama and the Experimental Scienoes. Med. Record, VoL 82, No. ft
Nov. 30, 1912, p. 971.
WEBER, R. Zur Psychologie des Y&gabundentums. Ztschr. f. Medinnalbmtf*
J. 25, Nr. 22, Nov. 20, 1912, *. 851.
PATHOLOGY.
PAG ANO, G. Osservazioni su alcuni oani senxa cervello. Riv. di Patol . nerv. e i**L
Vol. xvii., F. 10, Nov. 11, 1912, p. 576.
FEDER1CI, O. Contribute clinico ed anatomo-patelojjioo alio studio dell* portnoskb*
nei bambini. Riv. di Patol. nerv . e menl., vol. xvii., F. 11, Die. 6,1912, p. 64L
HORAND, RENE. Alteration du ganglion de Gasser dan* un caa de n4n*to«
rebelle du trigumeau (etude anatemo-pathologique faite une demi-heure *j»^ »
gasserectomie grace A la congelation par l’aoide carbonique). (5 Fig.) Rev. Neurd,
Ann. xx., No. 22, Nov. 30, 1912, p. 543.
BIANCHI, V. Alterazioni istologiche della corteoci* oerebrale in teguito a focoln
distruttivi ed a lesioni speriment&li Annali di ATetroL, Anno xxx., F. 1L 1W>
p. 61.
KRAMER, B. The r61e of lipoid* and particularly lecithin in narooeii. Pros. Soc.
Exp. Biol’ and Med., Vol. x., No. l f Oct. 16, 1912, p. 15.
LIBERT, LUCIEN. Valour semeiologique du syndrome interpretation en pathoktf®
mentale. (Rev. gen.) LEncephaU, Ann. vii., No, 12, Dec. 10,1912, p. 449.
MASSONE, MARCELLO. Della contrattilith elettrica dei musooli ftriati dogo nwrto
(eooitabilitfc diretta) come segno di morte. Annali di Frcniat., VoL xxii, F* **
Sept. 1912, p. 230.
BIBLIOGRAPHY
3*
CLINICAL NEUROLOGY.
GEJfERAL—
RAECKB. Die Frtihsymptome der arteriosklerotischen Gehirnerkrankung. Archxv
f. Psycktat. u. Nervenkrank., Bd. L., H. 2, 1912, s. 476.
GOULD, G. M. Acute reflex disorders caused by the cinematograph. Joum.
Amer. Med. Assoc., Vol. lix., No. 25, Dec. 21,1912, p. 2254.
DAVENPORT, 0. B. Heredity in nervous disease and its social bearing. Journ.
Amer. Med. Assoc., Vol. lix., No. 24, Dec. 14,1912, p. 2141.
ROSE, FELIX. Le eigne d*Argyll Robertson dans les affections non syphilitiques
(Rev. crit.). Sem. mid., Ann. 32, No. 49, Dec. 4, 1912, p. 577.
HINDS HOWELL, C. M. Lectures on Neurology.—I. Examination of cases of
nervous disease. II. Motor disturbances. Clin. Joum., Nos. 1051 and 1052,
Dec. 18 and 25, 1912, pp. 167 and 177.
If ESTES—
FRAZIER, C. H., and BOLLS, C. K. Intradural root anastomosis for the relief of
paralysis of the bladder and the application of the same method in other paralytic
affections. Joum. Amer. Med. Assoc., VoL lix., No. 25, Dec. 21, 1912, p. 2202.
DELAVAN, D. B. Paralysis of the right recurrent laryngeal nerve from accidental
trauma. Med. Record, Vol. 82, No. 23, Dec. 7, 1912, p. 1028.
WOLFSTEIN, D. I. Temporary paralysis of the right vocal cord with sensory
disturbance on the left side of the body. Joum. Nerv. and Ment. Dit., VoL 39,
No. 12, Dec. 1912, p. 793.
MTBCIiRS—
CLUZET, FROMENT, and MAZET. A propos dun cas de maladie de Thomsen.
Lyon Mid., Ann. xliv., T. cxix., No. 52, Dec. 29,1912, p. 1117.
FRATTIN, J. Beitrag zur Kenntnis der Myositis ossificans progressiva. Fortsch.
a. d. Oeb. d. Rontgenstrahlen, Bd. xix., H. 4, Nov. 29,1912, s. 272.
MINGAZZINT, G. Dystrophie musculaire progressive h4milat4rale (type facio¬
scapulohumeral). (2 PI.) Nouv. Icon. d. 1. Salpit., Ann. 25, No. 4, Juiflet-Aodt
1912, p. 320.
LONG, E. Atrophia musculaire progressive (type Aran-Duchenne) de nature
nlvritique. Second cas suivi d’autopsie. (2 PL, o Figs.) Nouv. Icon, d . 1. Salpit.,
Ann. 25, No. 4, Juillet-Aofit 1912, p. 281.
TAYLOR, JAMES. ? Peroneal atrophy. Proc. Roy. Soc. Med., Vol. vi., No. 2,
Dec. 1912 (Neurol. Sect.), p. 50.
BATTEN, F. E. Atrophy of distal muscles in all four extremities. ? Cause. Proc.
Roy. Soc. Med., Vol. vL, No. 2, Deo. 1912 (Neurol. Sect.), p. 62.
STEWART, PURVES. Family myoclonus. Proc. Roy. Soc. Med., VoL vi., No.
2, Deo. 1912 (NeuroL Sect.), p. 58.
9PITAl< CORD—
General. —SOUQUES, A. Le ph4nom&ne des doigts. Rev. Neurol ., Ann. xx.,
No. 22, Nov. 30, 1912, p. 649.
D&JERINE. Les compressions lentes de la moelle 4pini&re. Joum. des Prat.,
Ann. 26, No. 61, Die. 21, 1912, p. 817.
MONDIO, G. Lesioni oombinate dei eordoni posteriori e lateralL Riv. xtal. di
Neuropatol., Psichiat. ed Elettroter., Vol. v., F. 12, Dec. 1912, p. 629.
STOFFEL. Die Technik meiner Operation zur Beseitigung der spastisohen
Lehman gen (Illustr.) Munch. Med. Wchnschr., J. 59, Nos. 52 und 63, Deo.
24 und 31, 1912, s. 2860 und 2916.
PINELE3, F. Zur Pathogenese der osteomalaoisohen Lfthmungen. Neurol.
Centralbl., Nr. 23, Dez. 1, 1912, s. 1474.
LENEL, R. O. Ueber Riickenmarksdegenerationen bei pernizioser Anlmie.
Archxv f. Psychiat. u. Nervenkrank., Bd. L, H. 2, 1912, s. 517.
BURR, C. W. Spinal ataxia in the aged. N. Y. Med. Joum., Vol. xevi., No.
23, Dec. 7,1912, p. 1159.
Praetnre, Dislocation, dte. —McKENZIE, B. E. The treatment of roto lateral
curvature of the spine. Canad. Med. Assoc. Joum., Vol. ii., No. 12, Dec. 1912,
p. 1067.
4*
BIBLIOGRAPHY
Tab** Nntlli.-RIOOS, O. S. Boom atypical forms of tabes and paresis con¬
sidered in the light of serodiagnosis. Joum. Nerv. and MenL Du., VoL 39,
No. 12, Doc. 1912, p. 824.
BUNOART, J. Bin Beitrag sur Frage dor Behandlung gastrointestinaler Krtsen
bei Tabes dorsalis (lurch Resektion hinterer Dorsalworzeln (Forsterscbe opera¬
tion). Mitteil. a. d. Grtmgeb . d. Med. u. Chir. , Bd. xxv., H. 4 V 1912, s. 702.
NOUKT, HENRI. Association dn tabes, de la paralysie gdn&rale et de la malarii*
de Basedow. L'Enciphale , Ann. vii., No. 12, Dec. 10, 1912, p. 444.
CLAUDB, HENRI. La m4ningo-eno4phalite syphilitique aigu* des tabdtiquec.
LEnciphalt, Ana. vii., No. 12, Dec. 10, 1912, p. 417.
Poliomyelitis Anterior Aenta.— FLRXNER, 8., and CLARK, P. F. A note on
the mode of infection In epidemic poliomyelitis. Proc. of Soc. for Exp . Biol,
and Med., Vol. x., No. 1, Oct. 16, 1912, p. 1.
WIENER, A. Report upon a case of aoute bulbar palsy, with autopsy and
histological findings: type, anterior poliomyelitis. Med. Record, Vol. 82, No.
23, Dec. 7, 1912, p. 1029.
Brtwn Heqssrd Hymp tom-€omplex. —OUILLAIN. G. Syndrome de Brown-
S4quard. (2 Fig.) Rev. Neurol ., Ann. xx., No. 23, Dec. 15, 1912, p. 625.
Syringomyelia.— SIEMERLING, E. Gliosis spinalis und syringomvelie. Starke
Beteiligung des Halsmarkes mit ZerstOrung der Hinterstrange bei erhaltener
PupiUenreaktion. Gliastift am Boden des vierten Ventrikels. Arehw f.
Psych iat. u. Nen>enkrank ., Bd. L, H. 2, 1912, s. 449.
Tnmonrs.— HARRIS, W., and BANKART, A. 8. B. Spinal tumour and scoliosis;
recovery after operation. Proc . Roy. Soc . Med., Vol. tL, No. 2, Dec. 1912
(Neurol. Sect.), p. 67.
Meningocele.— NORBURT, L. E. C. Spina bifida (meningo-myelooele ulcerated)
in a ohild treated by operation. Proc . Roy. Soc. Med., VoL vi., No. 2, Dec.
1912 (Sect. Dis. Child.), p. 30.
MBAHV—
General. —SUTHERLAND, G. A. Cerebral Non-development. Proc . Roy. Soc .
Med.. Vol. vi., No. 2, Dec. 1912 (Sect. Dis. Child.), p. 37.
BARANY, R. Lokalisation in der Rinde der Kleinhirnhemisphkren des Mensehen.
Wien. Klin. Wchnschr., J. xxv., Nr. 52, De*. 26, 1912, a 2033.
STOECKER, W. Ueber Balkenmangel im menschlichen Gehirn. Archir . /.
Psychiat. u. Nervenkrank., Bd. L., U. 2, 1912, s. 643.
KIDD, L. J. The Pineal Body: a Review. Med. Ohron., Vol. IviL, No. 339,
Deo. 1912, p. 154.
fiknll, Injury, Ac. — HOLBECK. Ueber die Indikationen sur prim&r-operativen
Behandlung der SchadelschUsse im Frieden und Kriege. St Petersburger Med.
Ztschr., J. 37, No. 23, D6z. 1912, s. 339.
RAWLING, BATHE L. Two lectures on oranio-oerebral surgery. Clin. Joum.,
No. 1049, Dec. 4, 1912, p. 129.
Friedreich's Ataxia.—NAUM ANN, A. G. Uber die Friedreioh’sehe Krankheit.
Neurol. Centralbl., Nr. 23, Des. 1, 1912, a 1488.
ELLIOTT, T. R. ? Unilateral Friedreich's disease. Proc. Roy. Soc . Med.,
Vol. vi., No. 2, Dec. 1912 (Neurol. Sect.), p. 66.
Memlplegta.—CAD1VALADER, W. B.—Unilateral optic atrophy and contra¬
lateral hemiplegia consequent on ooclusion of the cerebral vessela Joum.
Amer. Med. Assoc., VoL lix„ No. 25, Dec. 21, 1912, p. 2248.
Diplegia. —BUZZARD, E. F. Post-encephalitic diplegia with involuntary move¬
ments. Proc. Roy. Soc. Med., Vol. vi., No. 2, Dec. 1912 (Neurol. Sect.), p. 6L
Embolism.— GJESSING, H. G. A. Kin Fall von einseitiger Amaurose unter dem
Bilde einer Embolia arteriae centralis retinae im Ansohluss an einen Kriminellen
Abort mit auff&Uig guter Wiederkehr des Sehvermogens und Gesichtsfeldea
Klin. Monatsbl. f. Augenheilk., J. L., Nov. 1912, s. 695.
Cerebellum. —DAVIS, H. J. Cerebellar Hernia following cerebellar abscess in a
boy aged 8. Proc. Roy. Soc. Med., Vol. vi., No. 2, Dec. 1912 (Otol. Sect.), p. 30.
Cerebellar Ataxia.—WILLIAMSON, O. K. Cerebellar ataxia. Proc, Roy. Soc.
Med., Vol. vi., No. 2, Dec. 1912 (Scot. Dis. Child.), p. 41.
GUTHRIE, L. Congenital oerebellar ataxy. Proc. Roy. Soc. Med., Vol. vl,
No. 2, Dec. 1912 (Neurol. Sect.), p. 61.
BIBLIOGRAPHY
5*
Meningitis. —KLINQBE, R. Ueber einige Fxlle you “Influenza” Meningitis.
Correspondenz-Bl. f. Sehtoeizer Aerzte, J. xlii. f No. 34, Dez. 1, 1912, s. 1289.
KOTZ. Zur Frage der Heilb&rkeit der otogenen Meningitis. Milnch. Med.
Wchnschr ., J. 59, No. 52, Dez. 24, 1912, s. 2863.
KOCH. H. Entstehungsbedingungen der Meningitis tuberculosa. ZUchr . /.
Kinderheilk. (Orig.), Bd. v., H. v., Nov. 30, 1912, s. 355.
MANWARINO, W. H. Effects on meningeal tuberculosis of the local injection
of foreign leuoooytes. Proc. Soc. Exp. Biol. and Med., Vol. x., No. 1, Oct. 16,
1912, p. 2.
BABINSKI. Mdningite ohronique spdoifique conjugate. Joum. dee Prat., Ann.
xxvi., No. 50, D4c. 14,1912, p. 804.
ANDRE-THOMAS and JUMENTI^, J. M6ningo-my41ite de IMpicone avec
lipomatose secondaire. (4 PL, 3 Fig.) Nouv. Icon. d. 1. Salpit ., Ann. 25,
No. 4, Juillet-Ao&t 1912, p. 309.
Hydrocephalus. —PUSSEP, L. M. Operative Behandlung des Hydrocephalus
internus bei Kindern. Archiv J. Kinderheilk ., Bd. fix., H. iii./iv., 1912,
s. 172.
Abscess. —VOORHEES, I. W. Labyrinthitis and cerebellar abscess. N. Y. Med.
Joum., Vol. xcvi., No. 24, Dec. 14, 1912, p. 1212.
Tumours. —SIMONELLI, G. Contribute alia oonosoenza dei disturbi psiohioi nei
tumori cerebralL Riv. di Patol. nerv. e ment., Vol. xvii., F. 11, Dio. 6,
1912, p. 672.
McCONNELL, a. a. A Case of Cerebellar Tumour. Dub. Joum. Med. Set.,
No. 492, Deo. 1912, p. 413.
MoGUIRE, E. R. A new operation for decompression. N.Y. Med. Joum.,
Vol. xcvi., No. 25, Dec. 21, 1912, p. 1265.
BOUCHri, GEORGES. La oraniectomie decompressive (suite). Joum. de
Neurol., Ann. 17, No. 19, Oct. 5, 1912, p. 361.
Pituitary Tumours, Ac.—v. EISELSBERG, F. Zur Operation der Hypophysis-
geschwlilste. Archiv f. Klin. Chir., Bd. c., H. 11, 1912, s. 8.
THOMSON, H. C. ? Pituitary tumour. Proc. Bop. Soc. Med., Vol. vi., No. 2,
Dec. 1912 (Neurol. Sect.), p. 49.
Diabetes Insipidus.— STOEWER, P. Neuritis und Iridozyklitis bei Diabetes
Insipidus. Klin. Monatsbl. /. Augenheilk., J. L., 1912, s. 624.
ELLERN. Bin Beitrag zum Itiologischen Studium des Diabetes insipidus.
Deut. Archiv f. Klin. Med., Bd. 109, H. 1 und 2, 1912, s. 85.
Pellagra.— STIEFLER, G. Das Fazialisphanomen in der Symptomatology der
Pellagra. Neurol. Centralbl., Nr. 23, Dez. 1, 1912, s. 1483.
Apbasla, Ac.—SCHAPIRO, M. Ein eigenartiger Fall von aphasischapraktischen
Stdrungen. Neurol. Centralbl., Nr. 23, Dez. 1, 1912, s. 1477.
gypbllls.— LEREDDE. Les rfegles du traitement de la syphilis nerveuse. Joum.
des Prat., Ann. xxvi., No. 49 et 50, D4c. 7 et 14,1912, pp. 785 et 802.
BECK, KARL. Untersuohungen zur Frage nach der Entstehung von Taub-
stummheit durch die Syphilis. Ztschr. f. Bekdmpf. d. Oeschlechtskr., Bd. xiv.,
H. 4,1912, s. 113.
POWER, D’ARCY. Recent progress in connection with syphilis. Brit. Med.
Joum., Dec. 7, 1912, p. 1603.
RIBTSCHEL, H. Die “ Vererbung der Syphilis.” Ztschr. f. Kinderheilk. (Ref.),
Bd. iii., H. 9, Nov. 15, 1912, s. 677.
BALLENGER, E. G., and ELDER, O. F. The after treatment of syphilis.
Med. Record, Vol. 82, No. 23, Dec. 7, 1912, p. 1024.
GOLDBERG, L. Uber die Entstehung von Herzklappenfehlem und Aorten-
aneurysmen durch Syphilis. Dermatol. Wchnschr., Bd. lv., Nr. 51a, Dez. 21,
1912, a. 1539.
LIPPMANN and QUIRING. Die Rdntgenuntersuchung der Aortenerkrankungen
mit Bpezieller Berticksichtigung der Aorten-Lues. Fortsch. a. d. Oeb. d. Rdnt -
genstrahlen , Bd. xix., H. 4, Nov. 29, 1912, s. 253.
DUBOIS, P. Einige Versuche Uber die Wirkung der Antimonsalze auf die
Kaninohensyphilis. Ztschr. f. Chemother., Bd. i., H f 3 (Teil i.; Orig.), 1912,
s. 203.
6 *
BIBLIOGRAPHY
ROSS. E. H. An btrtaellnltf ptmite derelopbf into spiroohntea Brit.
Med. Joum., Dec. 14, 1912, p. Ifefil.
JENNINGS, E. The parasites recently found in syphilis. Brit. Med . Joum.,
Dec. 14, 1912, p. 1655.
MOOLGAVKAH, S. R. On certain bodies found in syphilitic lesions demon¬
strated by the jelly method. Brit. Med. Joum. , Dec. 14, 1912, p. 1655.
STINER, OTTO. Weitere Erfahrungen iiber Verwendung von Asetonextrakten
bei der Seruindiagnostik der Syphilis. Deut. Med. Wcknsckr., J. 38, Nr. 49,
De*. 5, 1912, b. 2300.
•alvarsa*.—LEREDDE, M. La ftevre du salvarsan dans les affections syphil-
itiques du systfeme nerveux. Bull. d. L Soc. franc. cL Derm. e. d. Syphil.,
Ann. 22, No. 8, Nov. 1912, p. 411.
GRIGNOLO, F. Zur Frags der toxischen Wirkung des Salvanana Zlschr . /.
Chemother ., Bd. I, H. 3 (Teil i.; Orig.), 1912, s. 353.
WECHSELMANN. Etat actuel de la salvarsanoth4rapie de la syphilis. Bull,
gin. de Therapy T. clxiv., Liv. 23®, D4c. 23, 1912, p. 881.
HOBHOUSE, E. Salvarsan in pernicious amemia. Brit. Med. Joum., Dec. 14,
1912, p. 1659.
ROSENTHAL, M. Chancre developing four days after salvarsan injection.
Joum. Amer. Med. Assoe., Vol. lix., No. 25, Dec. 21, 1912, p. 2255.
FREUND. Ueber Abortivkuren mit Salvarsan. Miinch. Med. Wchruchr., J. 59,
No. 51, Dex. 17, 1912, s. 2813.
EICHLER. Schwere Arsenikvergiftung nach Salvarsaninfusion. Munch. Med.
Wchnschr. , J. 59, No. 52, Dex. 24, 1912, a 2871.
KUGGLES, E. W. Salvarsan versus mercury. N. Y. Med. Joum., YoL xevi,
No. 26, Dec. 28, 1912, p. 1313.
Neesalvarsaa. —CASTELLI, G. Uber Neosalvarsan. Ztschr. f. Chcmotker ., Bd. L,
H. 3 (Teil i.; Orig.), 1912, a 321.
LEREDDE, M. Les accidents du Neosalvarsan. Technique et dosage des
injections. Bull . d. 1. Soc. franc, d. Derm. e. d. Syphil., Ann. 22, No. 8, Nov.
1912, p. 422.
DARIER, J. Deux oas de mort apr&s des injections de Neosalvarsan avec
enqudto sommaire sur les cas analogues. Bull. d. 1. Soc. franc. <L Derm. e. d.
Syphil., Ann. 22, No. 8, Nov. 1912, p. 437.
LIiIVY-BING, M. Sur la necessity de l’emploi d’une eau chimiquement pure
pour les injections de Neosalvarsan. Butt. d. 1. Soc. franc, d. Derm. e. d.
Syphil ., Ann. 22, No. 8, Nov. 1912, p. 462.
BUNCH, J. L. Congenital Syphilitic Infant treated by Intravenous Injection of
Neo-Salvarsan. Proc. Boy. Soc. Med., YoL vL, No. 2, Deo. 1912 (Sect. Dia
Child.), p. 27.
MAURICE and BERNAY. Le neosalvarsan dans la tuberculosa et les 6tats
an^miques. Joum. de Mid. dt Paris, Ann. 32, No. 51, Die. 21, 1912, p. 975.
Wtuensaii Reaction.—NICOLAS, J. and CHARLET, L. Variations de la
reaction de Wassermann faite en series chex les syphilitiques traitea Annal.
d. Derm, et d. Syphil., T. iiL, No. 11, Nov. 1912, s. 605.
BRAUN and BODINEAU. De la mesure du pouvoir hemolytiqus global des
milieux de la reaction de Wassermann. Utilite de cette mesure. Prog. Mid.,
Ann. 40, No. 49, Dtk>. 7, 1912, p. 612.
Cerebro-Splnal Fluid. —KAFKA, Y. Die CerebrospinalflUssigkeit (Fortxetsung
and Schluss). Ztschr. f. d. get. Neurol, u. Psychiat. (Ref. u. Ergeb.), Bd. vi,
H. 6, 1912, S. 449.
CAMP, CARL D. Note on the examination of the cerebrospinal fluid for arsenic
following the administration of salvarsan. Joum. Nerv. and Ment. Dts.,
Vol. 39, No. 12, Dec. 1912, p. 807.
REICH, J. Ueber Gelbfarbung der CerebrospinalflUssigkeit. Mitteil. a. d.
Orenzgeh. d. Med. u. Chirurg ., Bd. xxv., H. 4, 1912, a 72L
DANIELOPOLU, D. Action des rayons ultra-violets sur le liquide e4phalo~
raohidien. Compt. Bend. d. 1. Soc. de Biol., T. lxxiii., No. 36, D4o. 20, 1912,
p. 666.
BIBLIOGRAPHY
7*
omnui amo NNcnMu muami-
Bpllcp«7 .—Berioht fiber die dritte Tagung der internationalen Liga zur
BekAmpfung and Erforsehang der Epilepsie. Epilepsia , VoL iv., F. 1,
Dez. 1912, s. 1.
CLARK, L. PIERCE. The prevention of epilepsy. N.Y. Med. Jou m., VoL
xcvi., No. 24, Deo. 14, 1912, p. 1205.
JONES, ROBERT. The relation of epilepsy to insanity, and its treatment.
Practitioner , Vol. lxxxix., No. 6, Deo. 1912, p. 772.
WALSHE, F. M. R. Jacksonian Attacks. Proc . Boy. Soc. Med., Vol. vi., No.
2, Dec. 1912 (Neurol. Sect.), p. 68.
YAWGER, N. S. Paranoid type of insanity with Jacksonian convulsions:
syphilitic cerebral pachymeningitis; the microscopic findings. Joum. Amer.
Med. Assoc., Vol. bx., No. 25, Dec. 21, 1912, p. 2243.
CAREY, H. M. Compulsory segregation and sterilization of the feeble-minded
and epileptio. Epilepsia , Vol. iv., F. 1, Dez. 1912, s. 86.
JACKSON, J. B. The relation of convulsions in ohildren to dietary errors.
Pediatrics, VoL xxiv., No. 11, Nov. 1912, p. 689.
CRANDALL, F. M. The Etiology of Convulsions in Early Life. Archives of
Pediat.. VoL xxix., No. 11, Nov. 1912, p. 803.
Hysteria.— WILLIAMS, TOM A. The practical import of recent work on hysteria.
Joum. Amer. Med. Assoc., VoL lix., No. 25, Dec. 21, 1912, p. 2224.
VOSS, G. Neuere Ansohauungen fiber das Wesen der Hysteric. Bert. Klinik,
J. 24, H. 294, Dez. 1912, s. 1.
ANDRE-COLLIN. Le champ inoulte de l'hyst4rie. Gaz. des H6p., Ann. 85,
No. 144, D4c. 17, 1912, p. 2033.
CAPEZZUOU, C. Di un caso non comune di sonne isterico. Riv. crit. di clin.
med. 9 Anno xiiL, Nos. 50 and 51, Die. 14 and 21, 1912, pp. 794 and 805.
Chorea. —GRENET, H., and LOUBET, P. Signes organiaues de la choree de
Sydenham. Rev. Neurol ., Ann. xx., No. 23, Dec. 15, 1912, p. 632.
Athetosis.— BUZZARD, E. F. An obscure case of athetosis, with abolition of
tendon reflexes. Proc. Roy. Soc. Med., VoL vi., No. 2, Dec. 1912 (NeuroL
Sect.), p. 60.
Myasthenia.— PURSER, F. C. Clinical lecture on bulbar and pseudo-bulbar
paralysis. Med. Press , No. 3841, Deo. 18, 1912, p. 652.
Neuritis. —STIEFLER, G. Ueber einen Fall von primttrer symmetrischer
Brachialplexusneuritis als Symptom einer Spatsyphilis. Wien. Klin.
Wehnschr., J. xxv., Nr. 52, Dez. 26, 1912, s. 2038.
HARTEL, F. Dio Leitungsan&sthesie und Injectionsbehandlung des ganglion
Gasseri und der Trigeminusstamme. Archiv f. Klin. Chir., Bd. c., H. 11,
1912, s. 193.
BRUNN. Zur Beurteilung der Ischias bei Unfallvcrletzten. Miinch. Med.
Wehnschr ., J. 59, No. fiO/Des. 10, 1912, i. 2725.
Neuralgia. —SOMERVILLE, W. F. High-frequency ourrents in trigeminal
neuralgia. Brit. Med. Joum., Deo. 21,1912, p. 1706.
Alcoholism, die.—HARE, FRANCIS. On alcoholism; its clinical aspects and
treatment. J. A A. Churchill, London, 1912.
FURER. Zur Frage der sogenannten Abstinenzdelirien der chronischen
Alkoholisten. Miinch . Med. Wehnschr ., J. 59, No. 51, Dez. 17, 1912, s. 2802.
NEFF, I. H. The problem of drunkenness. Boston Med . and Surg. Joum.,
Vol. clxvii., No. 26, Dec. 26,1912, p. 911.
Exophthalmic Goitre, Cretinism, dtc.— KOLB. Ueber Intestinalerscheinungen
bei BaBedowscher Krankheit und die Schwierigkeiten der Diagnose. Miinch.
Med. Wehnschr., J. 59, No. 49, Dez. 3, 1912, s. 2669.
ZANDER, P. Zur Histologie der Basedowstruma. Mitteil. a. d. Grenzgeb . <L
Med. u. Chirurg ., Bd. xxv., H. 4, 1912, s. 682.
PERN, S. The necessity of lime in the system and its relation to goitre.
Australian Med. Joum., Vol. 1, No. 69, Nov. 9, 1912, p. 765.
LEOPOLD-LEVI. Effets rapides et non thdrapeutiques du traitement thyroidien.
Compt. Rend. d. 1. Soc. de Biol., T. lxxiiL, No. 36, Ddc. 20, 1912, p. 644.
8*
BIBLIOGRAPHY
MARKOR, J. W., and WING, L. A. The thyroid and Re relatlen to pregnancy
and the puerperal state. Bull, of Lying-in Ho*p. of City of New York ,
Vol. viii., No. 4, Nov. 1912, p. 153.
DAVIS, E. P. Thyroid disease complicating pregnancy and parturition. Butt,
of Lying-in Hasp, of City of New York, Vol. viiL, No. 4, Nov. 1912, p. 176.
Paralysis Agltans.—MAILLARD, G. Dee troubles d'apparenoe myotonique
dans la maladie de Parkinson. L' Enctpkalc, Ann. viL, No. 12, Dec. 10, 1912,
p 433.
COLLIER, J. Unilateral tremor resembling that of paralysis agitana in a
child. Proc. Roy . Soe. Med., VoL vi., No. 2, Dec. 1912 (Neurol. Sect.), p. 64.
Addison’s Disease. —PHILLIPS, J. G. PORTER. Nervous and mental symptoms
in a case of Addison’s Disease. Brit. Med. Joum ., Dec. 21, 1912, p. 1706.
Tetaaas.—FEARNSIDES, R. G. Tetanus; ohloretone poisoning; recovery;
followed by polyneuritis. Proc. Roy. Soc . Med., Vol. vi., No. 2, Dec. 1912
(NeuroL Sect.), p. 54.
SPECIAL MENSES AND CRANIAL NERVES—
CAMPBELL, HARRY. The neurology of the visual system. Med. Pros, Dec.
11, 18, 25, 1912, and Jan. 1,1913.
ESKUCHKN. Ueber die Geneae der Sehnervenatrophie bei Oxyaephalen.
Munch. Med. Wcknschr ., J. 59, No. 50, Des. 10, 1912, s. 2722.
BIKTTI, A. Glaukomatoao Exkavation der Papille und Neuritis optici. Klin .
Monatfibl. f. Augcnhcilk., J. 1., Nov. 1912, s. 5o2.
TERRIKN, F. L’hemianopsia bitemporale. Prog. Med., Ann. 40, No. 50,
Due. 14, 1912, p. 623.
HOG YES, A. Uber den Nerve nmeohanism us der assoiizerten Augenbewe-
gungen (Fortactzung). Monatuchr. /. Okrenhcilk. u. Laryngo-Rhinol ., J. xlvi.,
H. 11, 1912, s. 1353.
GREEVES, R. A. Partial oculomotor paralysis, with synchronous clonic con¬
tractions of muscles supplied by the third cranial nerve. Proc. Roy. Soc. Med.,
Vol. vi., No. 2, Dec. 1912 (Ophthal. Sect.), p. 23.
GREEVES, R. A. Partial third nerve paralysis with rhythmio movements of
the pupil. Proc. Roy. Soc. Med., VoL vi, No. 2 , Deo. 1912 (NeuroL Sect.),
p. 68.
FEARNSIDES, E. G. Nystagmoid movements of palate and lids, lateral and
rotatory nystagmus, cerebellar incoordination. Proc. Roy. Soc. Med., Voi vi.,
No. 2, Dec. 1912 (Neurol. Sect.), p. 53.
LAKE, RICHARD. Aural Vertigo (non-sunpurative): a clinical and thera¬
peutical study. Lancet , Dec. 14, 1912, p. 1638.
STUCKY, J. A. Progressive deafness. N.Y. Med. Joum., Voi xevi., No. 26,
Dec. 28, 1912, p. 1328.
GOBEL, O. Uber die Tatigkeit des mensohliohen Hbrorgans. Archiv f.
Okrenheilk., Bd. 90, H. 1 und 2, 1912, s. 134.
MMCELLANEOCM SYMPTOMS AND CASES—
STEPHEN SON, 8. On cases of eye-strain simulating grave organic disease of
the central nervous system. Practitioner, Vol. lxxxix., No. 6, Deo. 1912,
p. 817.
COLLIER, JAMES. Two members of a family in which visual defects and loss
of knee-jerk have occurred during three generations. Proc. Roy. Soc. Med.,
Vol. vi., No. 2, Dec. 1912 (Neurol. Sect.), p. 64.
GLIBERT, M. D. Contribution k la prophylaxie du 41 mal des caissons.' 9 Bull
d. VAcad. Roy. de M6d. de Belg., Sdr. iv., Tom. xxvi., No. 9, Oct. 26, 1912,
p. 640.
MASSALONGO, R. Sullo 44 Jaw-Winking phenomen.” Riv. di Patol. nerr. c
went., Vol. xvii., F. 10, Nov. 11, 1912, p. 612.
CUNNINGHAM, W. Psoriasis-a neurosis. Med. Record, Vol. 82, No. 23,
Dec. 7, 1912, p. 1031.
LERI and LEGROS. Traumatism® et syndrome de Paget. (1 PI.) Nouv. Icon,
d . 1. SalpH., Ann. 25, No. 4, Juillet-Aout 1912, p. 334.
BIBLIOGRAPHY
9*
PINCUSSOHN, L. Untersuchungen ttber die Seekrankheit. Ztschr. /. Exp .
PatA u. Ther ., Bd. xii., H. 1,1912, s. 155.
KOTTGKN. Nervenhygiene und Betriebssicherheit im Automobil-und Eisen-
b&hnverkehr. Ztschr . /. MedizinalbcamU, J. 25, Nr. 23, Dez. 5, 1912, a. 875.
MARRO, ANTONIO. L’ “Eugenica” ossia la scienza della coltura della razza
nel prirao Congresso Internazionale di Londra. Annali di Freniat. , VoL xxiL,
F. 3, Sept. 1912, p. 193.
PSYCHIATRY.
GENERAL PARALYSIS—
TSIMINAKIS, C. Nukleins&urebehandlung der progression Paralyse. Wien.
Klin . Wchnschr., J. xxv,, Nr. 49, Dez. 5,1912, s. 1939.
NAVILLE, F. De la paralysis g<$n6rale chez l’enfant. Rev. mid. d. I. Suisse
Rom., Ann. xxxii., No. 11, Nov. 20,1912, p. 742.
HORAND, R., PUILLET, P., and MOREL, L. Deux nouveaux cas de parotidite
suppur4e chez des paralytiques gendraux. Oaz. des B6p., Ann. 85, No. 139,
Vic. 5, 1912, p. 1953.
THABIUS and BARBE, A. Etude physico-chimique du liquide cephalo-
rachidien dans la paralysis g6n4rale. Rev. Neurol., Ann. xx., No. 22, Nov.
30, 1912, p. 533.
CULLERRE, A. Un cas de paralysis gln^rale au xviii* si&cle. Annal. Med.-
Psychol ., Ann, lxx., No. 6, V6o. 1912, p. 480.
DEMENTIA FBECOX-
DUNTON, W. R. Predementia prascox. Joum. Amer. Med. Assoc., VoL lix.,
No. 25, Dec. 21,1912, p. 2206.
CORNELL, W. B. Cyanosis in Dementia prwcox. Joum. Amer. Med. Assoc.,
VoL lix., No. 25, Deo. 21, 1912, p. 2208.
SINGER, H. D. Dementia pnsoox. Joum . Nerv. and Ment. Dis., VoL 39,
No. 12, Deo. 1912, p. 812.
GENERAL—
WTGERT, V. “Serie-vis” upptradande sjukdomsanfall i manisk depressiv
psykos. Upsala Lakarefor. FbrhandL , Nov. 28, 1912, p. 45.
PIANETTA, C. Frenosi maniaoo depressive in gemelle. Riv. itaL di Neuro-
patol., Psichiai. ed EleUroter ., VoL v., F. 12, Dec. 1912, p. 635.
SMITH, PHILIP. Psychoses occurring in twins. N. Y. Med. Joum., VoL xovL,
No. 25, Dec. 21,1912, p. 1268.
ROUBINOWITCH. Mecanisme et diagnostic des hallucinations. Joum. des
Prat., Ann. xxvi., No. 49, D4c. 7, 1912, p. 789.
BENON and FROGER. Du dllire chez les enfants. Nouv. Icon. d. L Salpit.,
Ann. 25, No. 4, Juillet-Aodt 1912, p. 343.
PRTRO, FRANCESCO. Mitomania e simulazione di reato specialmente con*
siderate negli adolesoentL Annali di Freniat., VoL xxiL, F. 3, Sept. 1912,
p. 251.
t* i
REVESZ, BELA. Psyohiatrische Fiirsorge auf dem Kriegsschauplatze. Wien.
Klin. Wchnschr., J. xxv., Nr. 50, Dez. 12,1912, s. 1965.
ALLERS, R. Die Anwendung und Bedeutuug der Immunitats-forschung in der
Psyohiatrie (Sammelbericht). Ztschr. f. Chcmother., J. 1, H. 10 und 11
(Toil. H., Ref.), 1912, s. 986.
METER. Zur Frage des ktinstlichen Abortes bei psyohischen Storungen.
Milnch. Med. Wchnschr., J. 59, No. 51, Dez. 17,1912, s. 2801.
BULLARD, W. N. The insanity of the feeble-minded. Boston Med. and Surg.
Joum., Vol. clxvii., No. 25, Dec. 19, 1912, p. 873.
EMERSON, C. Glycosuria among the insane. Joum. Amer. Med. Assoc.,
Vol. lix., No. 25, Dec. 21,1912, p. 2245.
BOSSI, L. M. Malattie utero-ovariohe e psicopatie. Annali di Freniat.,
Vol. xxiL, F. 3, Sept. 1912, p. 275.
MATHES. Psychiatric in der Gynkkologie. Milnch. Med. Wchnschr., J. 59,
No. 50, Dez. 10,1912, s. 2735.
b
1
BIBLIOGRAPHY
t»wARTNER O. Die weisacn Blutkorperchen beim Jugendirrteein. dretir /.
Psuchiat. u. Ncrvenkrank., Bd. 1., H. 2, 1912, ». 674.
m a vi OR R G Thyroid Feeding in Mental Disease. Australian Med. Jour*.,
Vol t , No.' 70. Nov. 10,1912. p. 775. . n k
va^TAN M. Der Adrenalingehalt des Blutes bei etnigen Psychosen. Artk tr
f! Psyehiat. u. Ncrvcnkrank., Bd. L, H. 2. 1912, *. 655.
«aNOI'INETI. L. R. L’insonnia dei peioopaticL—L Ricerche quantitative ml
S ^mbio delle soitauM puriniche. At-, di Fatal, ntrv. e ment., VoL m,
F. 10 Nov. 11* 1912, p. G2S.
mowriT VITIGE. L’osteodiagnoai dell* etfc della mortc (Nota 2*). Anwuidi
ol. iiu., F. 3, Sept. 1912, p. 217.
a \u 'HAND L. Lea accea melancoliques d«» obaedda douteur*. AnnaL Jfett
Psychol. , Ann. lx*., No. G, Dec. 1912, p. 488.
p aukiVR S Le crime de Roussillon efc l’otat mental de see troll auteur*
° Uuite tin.V ‘ AnnaL Mcd.-Psyr.hoL, Ann. ixx., No. 6, Dec. 1912, p. 504.
a KT v fPerel. Divorce et alienation mentale. Replique k M. le Dt
P Tr^nel ’ M*d.-P,yckol., Ann. la., No. 6, Ddo. 1912, p. 619.
TREATMENT.*
TrWES H L. Ionic: medication. Arch, of Roentgen Ray, No. 149, Dec. 1919, p. 254.
,.Zr\ a T Reflex stimulation of the Tagus centre in the treatment of di*w.
BR £S’ Prrtt; No. 3840, Dec. 11. 1912, p. 631.
” ,u p E thik und Psychotherapie. Corretpondem-BL f. Sckveizer Aerie,
DU J xlU.; No. 35, De*. 10, 1912, s. 132i.
. a number of reference, to paper* on Treatment are included loth* BlbUopsphy tudet
Individual dlseaeo*.
i
Bibliography
ANATOMY.
SINN, R. Beitrag zur Kenntnia der Medulla oblongata der Vogel. Afonatsschr. f.
Psychiat. u. Neurol., Bd. xxxiii., H. 1, Jan. 1913, S. 1.
SHIINO, K. Beitrag zur Kenntnia der Gehirnnerven der Schildkrdten. Anat. Hcftc.
H. 141, 1912, S. 1.
PHYSIOLOGY.
CIACCIO, C., and SCAGLIONE, S. Beitrag zur cellularen Physiopathologiu der
Plexus chorioidei. Beitriige z. pith. Anat. u. z. ally . Path., Bii. Iv., H. 1, 1912,
S. 131.
FEISS, H. O. The effect of nerve-fusion on the patterns of nerves containing
degenerated fibres. Quart. Journ. Exp. Physiol., Vol. v., No. 4, Nov. 1912, p. 399.
LAIGNEL-LAVASTINE and JONNESCO, V. Hecherches histologiques sur lea lipoides
de la moelle epinit;re. Compt. Rani. d . 1. Soc. dc Biol T. lxxiv,, No. 1. Jan. 10.
1913, p. 12.
LAPICQUE. Action de la cafeine sur rexcitabilite de la moelle. Compt, Bend. d. 1.
Soc. dc BioLy T. lxxiv., No. 1, Jan. 10, 1912, p. 32.
FAHKENKAMP, KARL. Uber die Aktionsatrbme des Wannblutcrmuskels im
Strychnintetanus. Ztschr. f. Biol., Bd. 59, H. 9, 1912, S. 420.
PORTER, E. L. Variations in irritability of the reflex arc.—(I.) Variations under
asphyxial conditions, with blood-gas determinations. Amcr . Journ . Physiol .,
Vol. xxxi., Nov. iv., Jan. 1913, p. 223.
v. LEHMANN. Studien uber rctiektorische Darmbewegungen beim Hunde. PtUigcr's
Archiv , Bd. cxlv., H. 6, 7, und 8, 1912, S. 413.
GSTETTNER, M. Ein Beitrag zur Kcnntnis des Blinzelreflexes. Pjl tiger's Archiv,
Bd. cxlv., H. 6, 7, und 8, 1912, S. 407.
FROHLICH-PICK. Die Folgen der Vergiftung durch Adrenalin, Histamiu, Pituitrin,
Pepton, sowie der anaphylaktischen Vergiftung in Bezug auf das vegetative
Nervensystem (mit 3 Kurven). Arch, f, exp. Path, u . Pharmak ., Bd. 71, H. 1,
1912, S. 23.
MOREL, L. Les relations fonctionnelles entre le foie et les parathyroides. Compt.
Bend. d. L Soc. de Biol., T. Lxxiv., No. 1, Jan. 10, 1913, p. 28.
TATUM, A. L. On the Destruction of Epinephrin and Constrictor Substances of
Serum by Oxygenation in the Presence of Blood Vessel Walls. Journ . Pharmacol,
and Exp. Therap., Vol. iv., No. 2, Nov. 1912, p. 151.
MATTIROLO, G., and G AMNA, C. La midriasi adrenalinica in rapporto alia sindrome
oculosimpatica di Claude Bernard-Horner. Biv. di Patol. new. t meat., Vol. xvii.,
F. 12, Gennaio 1913, p. 728.
PSYCHOLOGY.
DECROLY. La Psychologie du Dessin. Journ. de Neurol ., Ann. 17, No. 22, Nov. 20,
1912, p. 421.
SIDIS, BORIS. The theory of the subconscious. Proc . Soc. for Psychical Research ,
Part lxvL, Vol. xxvi., Nov. 1912, p. 319.
HALDANE, J. S. The Relation of Mind and Body. Science Progress, No. 20, Oct.
1912, p. 292.
LADD, G. T. Rationalism and Empiricism. Mind , No. 85, Jan. 1913, p. 1.
ALEXANDER, S. Collective Willing and Truth. Mind , No. 85, Jan. 1913, p. 14.
MUIR, M. M. P. Alchemy and the Absolute. Mind , No. 85, Jan. 1913, p. 48.
LANGLEY, G. H. The Metaphysical Method of Herbart. Mind , No. 85, Jan. 1913,
p. 62.
12*
BIBLIOGRAPHY
MEYER, ADOLF. Conditions for a home of psychology in the medical curriculum.
Journ. Abnorm. Psychol., Vol. vii., No. 5, Dec.-Jan. 1912-1913, p. 313.
SOUTHARD, E. E. On the somatic source* of somatic delusions. Journ . Abnoru.
Psychol ., Vol. vii., No. 5, Dec.-Jan. 1912-1913, p. 326.
BURROW, T. Psychoanalysis and Society. Journ. Abnorm, Psychol., Vol. vii.. No.
5, Dec.-Jan. 1912-1913, p. 340.
TAYLOR, G. H. A note on the colour sense in relation to the emotion of sex. Journ.
Abnorm, Psychol ., Vol. vii., No. 6, Dec.-Jan. 1912-1913, p. 347.
PATHOLOGY.
LAIGNEL-LAVASTINE and JONNESCO, VICTOR. Recherohes histologioues sur
l’hypophyse des psychopathe*. ISEnctphaU, Ann. viii, No. 1, Jan. 10, 191o, p. 25.
WATSON, E. M. The Negri bodies in rabies. Journ, Exp. Med., Vol. xvii.. No. 1,
Jan. 1913, p. 29.
FREY, E. Hirnpathologische Beitrage. III. Uber den Verlauf des vorderea
Pyrainidenbundels. (54 Text fig.) Ztschr . /. d . ges. Neurol, u. Psychiat. (Orig.h
Bd. xiv., H. i., Des. 31, 1912, S. 1.
FREY, E. Hirnpathologische Beitrage. IV. Uber klinische Formen, Symptoma¬
tology und V erlauf tier Tabes auf Grund von 850 Fallen. (3 Text fig.) Ztschr.
/. d. get. Neurol . u . Psychiat. (Orig.), Bd. xiv., H. 1, Dex. 31, 1912, S. 21.
MIODOWSKI. Die Lymphscheiden des Olfaktorius ala Infcktionsweg bei rhinogenen
Hirnkomplikationen. Ztschr. f. Larnngol ., Rhinol . w. Orenzgeb., Bd. ▼. H. 5,
Dez. 1912, S. 943.
CIUCA and DANIELOPOLU. Recherohes sur la perm^abilite des meninges aux
albumines hetcrologues et aux precipitines. Compt. Rend. d. 1. Soc. de Biol., T.
lxxiv., No. 2, Jan. 17, 1913, p. 115.
OKER-BLOM, M. Ueber den Einfiuas der chronischen Quecksilber-. Blei- und Alkohol-
vergiftung auf die naturlichen Abwehrvorrichtungen des Tierkdrpers. Ztschr. f.
Immunitatsf. u. exp . Therap Bd. xvi., H. 1, 1912, S. 102.
CLINICAL NEUROLOGY.
GENERAL—
WHITING, A. J. The associations of tuberculosis with disorders of the
nervous system. Practitioner , Vol. xc.. No. 1, Jan. 1913, p. 269.
CAMPBELL, HARRY. The neurology of the visual system. Med. Press , Nos.
3,843, 3,844 and 3,845, Jan. 1, 8 and 15, 1913, pp. 8, 36 and 65.
HOWELL, C. M. HINDS. Lectures on Neurology. III. Sensory Disturbances.
IV. (a) Electrical Testing of Muscles: (6) Lumbar Puncture. Clin. Journ.,
Nos. 1,054 and 1,055, Jan. 8 and 15, 1913, pp. 218 and 236.
SERVES—
KEPPLER, W. Die An&sthesirung der unteren Extremit&t mittels Injection auf
dio grossen Nervenstamme. Archiv f. Klin. Chir ., Bd. c., H. 2, 1912, S. 501.
SCHWARTZMANN, J. Troubles circulatoires aigus par hypertonie brusque du
nerf vague. Sem. Med., Ann. 33, No. 4, Jan. 22, 1913, p. 37.
CHALIER. Sur un nouveau mode'de traitement de la dysphagie douloureuse dans la
tuberculose et le cancer du larynx par la resection de la branche interne du nerf
laryngtS superieur. Prog. Med., Ann. 41, No. 1, Jan. 4, 1913, p. 8.
MUSCLE*—
STEVENS, W. E. Myositis ossificans traumatica. Journ. Amer. Med. Assoc.,
Vol. lx., No. 3, Jan. 18, 1913, p. 203.
SPINAL CORD—
General.—SARBO. Klinisch reiner Fall von spastischer Spinalparalyse (Erb) als
Unfallfolge. Bent. Ztschr . /. Ncrvcnheilk ., Bd. 46, H. 1, 19127s. 43.
HA§KO VEC, LAD. Zur Symptomatology und Diagnose der Storungen der Cauda
equina und des Conus medullaris. Wien. Med. Wchnschr J. 63, Nr. 1, Jan.
1, 1913, S. 29.
Fractare, Dislocation, Ac.—WOOD-JONES, F. The ideal lesion produeed by
judicial hanging. Lancet, Jan. 4,1913, p. 53.
BIBLIOGRAPHY
13*
DOERR, R. Beitrag zur statischen Skoliosenfrage. Ztschr. /. Orthopdd. Ckir .,
Bd. xxxi., H. 1/2, 1912, S. 1.
KAUFFMANN, F. Zur Kasuistik der kongenitalen Skoliose. Ztschr. f.
Orthopdd. Chir. t Bd. xxxi, H. 1/2, 1912, S. 81.
Cerrical Mb.—TODD, T. W. The arterial lesion in cases of “ Cervical” rib.
Joum. Anal. and Physiol ., Vol. xlvii, Jan. 1913, p. 250.
Herpes Zoster.—KUNZ, HANS. Herpes zoster im Wochenbett. Zentralbl. f.
Gynakol ., Nr. 4, Jan. 25,1913, S. 122.
Tabes Dorsalis.—LORTAT-JACOB, L. Traitement du tabes. Joum. de Mid.
de Paris , Ann. 33, Nos. 1 et 2, Jan. 4 et 11, 1913, pp. 7 et 27.
GRAND-CLEMENT. Possibility de gu^rir le tabes h ses ddbuts. Symptomes
oculaires qui permettent de le reconnaitre & ce moment. Joum. de Mid . de
Paris , Ann. 33, No. 3, Jan. 18, 1913, p. 58.
FOERSTER, O. Die analytische Methode der korapensatorischen Uebungsbe-
handlung bei der Tabes dorsalis. Klinischer Vortrag. Deut. Med. Wehnschr .,
J. 39, Nr. 1, 2 und 3, Jan. 2, 9 und 16, 1913, S. 1, 49 und 97.
FRAZIER, C. H. The relief of gastric crises in tabes dorsalis by rhizotomy.
Amer. Joum. Med. Sci ., Vol. cxlv., No. 1, Jan. 1913, p. 116.
FRENKEL and SAINT-MARTIN. Complications oculaires de randvrisme de
l’aorte. An^vrisme de 1‘aorte et tabes. Rev. Neurol ., Ann. xx., No. 24, Deo.
30, 1912, p. 689.
PeUomyelllls Anterior Aenta.— KLING, CARL. Die Aetiologie der Kinder-
l&hmung. Wien. Klin . Wehnschr ., J. xxvi., Nr. 2, Jan. 9, 1913, S. 41.
KUNG, C., WERNSTEDT, W., and PETTERSSON, A. Recherches sur le
mode de propagation de la paralysie infantile ypidyrnique (maladie de Heine-
Medin). Quatrieme m^moire. Ztschr. f. Immunitdtsf. u. exp. Ther. (Teil l,
Orig.), Bd. xvi, H. 1, 1912, S. 17.
JOSEFSON. Experimentelle Untersuchungen liber die Mfiglichkeit einer Ueber-
tragung der Kinderlahmung durch tote Gegenstiindo und durch Fliegen.
Milnch . Med. Wehnschr ., J. 60, No. 2, Jan. 14, 1913, S. 69.
FLEXNER, SIMON, CLARK, P. F., and FRASER, F. R. Epidemic Polio¬
myelitis. Fourteenth Note : Passive Homan Carriage of the Virus of
Poliomyelitis. Joum. Amer. Med. Assoc. 9 Vol. lx., No. 3, Jan. 18, 1913,
p. 201.
Landry’s Paralysis. —FLEISCHMANN, R. Uber einen Fall von Landryscher
Paralyse bedingt durch Salvarsan-Intoxikation. (1 Text fig.) Ztschr. /. c l. yes.
Neurol, u. Psychiat. (Orig.), Bd. xiv., H. 1, Dez. 31, 1912, S. 125.
Disseminated Sclerosis.—ROPER, E. Zur Aetiologie der multiplen Sklerose.
Monatsschr. f. Psychiat. u. Neurol Bd. xxxiii., H. 1, Jan. 1913, S. 56.
BONNE and WIMMER. Akute disseminierte Sklerose. Deut. Ztschr. f.
Nervenhcilk ., Bd. 46, H. 1, 1912, S. 56.
FRAENKEL, MAX. Erfahrungen fiber Behandlung der multiplen Sklerose mit
Fibrolysin. Neurol. Centralbl., Nr. 1, Jan. 2, 1913, S. 25.
Byrlagoinyella.—BUNDSCHUH and EDUARD. Uber warzige Hyperplasien der
Gehirnoberflache in Form von Mtniaturwiudungen des normal gefurchten
Grosahirns bei einem Fall* von Syringomyelic. Bcitrdge z. path. Anat. u. z.
ally. Path ., Bd. lv., H. 1,1912, S. 91.
Tnmonrs—EBERS, PAUL. Fall von operiortem Riickenmarkstumor. Deut. Med.
Wehnschr ., J. 39, Nr. 2, Jan. 9, 1913, S. 70.
BHA1N—
General.—WEBER, L. W. HimerschUtterung oder Vergiftung als Todesursache.
Vierteljahrssch. f. gericht. Med., F. iii., Bd. xlv., H. 1, Jan. 1913, S. 61.
MARGULIS. Die pathologisch-nnatomisclien Veranderungen bei Cysticerken des
Grosshirns. Deut. Ztschr. f. Nervenhcilk ., Bd. 46, H. 1, 1912, S. 1.
TYLOR, C. The paths of encephalic infection in otitis. Brain, Vol. xxxv.,
Partii., 1912, p. 109.
DECROLY. Le d6veloppement de Taptitude graphique. Joum . de Neurol .,
Ann. 17, No. 23, D6c. 5, 1912, p. 441.
14 *
BIBLIOGRAPHY
PM«4fMk«r Paralysis. — CHASLIN, M. f and DELAGE, Mm. ANNA.
Paralysie pseudo-bulbaire oong6nitale avec diplegie che* une enfant arrieree,
infantile et 6pileptique. (Soc. de Psychiat. de Paris.) L'Bnctphcde, Ann. viii..
No. 1, Jan. 10, 1913, p. 73.
ABeartsm. — LANGBEIN. Kasuistischer Beitrag zur Diagnose perforierender
Aneurysmen der Hirnarterien. Alii tick. Med. BVArwcAr., J. 60, No. 1, Jan. 7,
1913, S. 22.
Thrombosis. — WEBER, F. PARKES. Non-syphilitic arteritis obliterans
(“Thrombo-Angeitis” of Leo Buerger), with intermittent claudication of the
left lower extremity. Lancet, Jan. 18, 1913, p. 169.
■tBsJplegla. —LOEB, S. Hemicanitiea bei Hemiplegic. Devi. Med. Wchnschr
J. 39, Nr. 3, Jan. 16, 1913, 8. 116.
D&T&RINE. Infantile cerebral hemiplegia. Monde M6d., Ann. xxiL, No. 325,
Nov. 1912, p. 321.
MARIE, PIERRE, and FOIX, CH. H&nisyndrome c^nibelleux d’origine syphili-
tique: hdmipl^gie cerebelleuse syphilitique. Sem. Med., Ann. 33, No. 2,
Jan. 8, 1913, p. 13.
NOICA. A pronos de l’article de M. W. Sterling, sur 1’adduction syncin^tique
du bras malado dans l a h4miplegie organique. Rev. Neurol ., Ann. xx., No. 24
Dec. 30, 1912, p. 696.
Abscess.—HAYMANN Zur Pathologic und Klinik der otogenen Groeshirnabs-
zesse. Miinch. Med. Wchnschr ., J. 60, No. 2 und 3, Jan. 14 und 21, 1913,
S. 66 und 135.
Meaftaglt Is. —MORICHAU-BEAUCHANT, R., LB BLAYE, and DELAGE.
M^ningite c4r6bro-Bpinale suraigue k cocco-bacille ind^terminA Prog. Mid.,
Ann. 41, No. 2, Jan. 11, 1913, p. 14.
SCHAEFFER, S. Tuberculous meningitis. N. Y. Med. Journ., VoL xcvii..
No. 2, Jan. 11, 1913, p. 77.
MANWARING, W. H. The effects of subdural injections of leucocytes on the
development and course of experimental tuberculous meningitis. (Second
paper.) Journ. Exp. Med., Yol. xvii., No. 1, Jan. 1913, p. 1.
FREW, R. S. t and GARROD, A. E. Glycosuria in Tuberculous Meningitis.
Lancet , Jan. 4, 1913, p. 15.
VOISIN, R., and STE VENTN, H. La m^ningite k pnenmocoques. Gaz. des H6p. 9
Nos. 1 et 4, Jan. 4 et 11, 1913, pp. 6 et 53.
STOCKDALE, E. M. Serous otitic meningitis, with septic thrombosis of the
left lateral sinus and internal jugular vein, successfully treated by operation.
Journ. Laryngol. , Rhinol. and Otol. , Vol. xxviii., No. 1, Jan. 1913, p. 1.
CHARTIER, M. Mdningite localisee post-appendiculaire avec compression des
racines lombo-sacr^es. L Ena'phale, Ann. viii., No. 1, Jan. 10, 1912, p. 44.
PAILLARD and FONTBONNE. Los reactions mdningtSes dans les intoxications
(dtude clinique et cyto-diagnostic). Gaz. des H6p No. 7, Jan. 18, 1913, p. 101.
Hydrocephalus.—DUNCAN, R. B. Hydrocephalus in a female child one year
and ten months old: operation—recovery. Australian Med. Journ., Vol. 1,
No. 75, Dec. 21, 1912, p. 825.
COUTO, M. Uber einen Fall von Hydrocephalus idiopathioos" outer der
Maske des 44 Weber’echen Symptomenkomplexes.” Sofortige Heilung durch
Lumbalpunktion. Neurol. Centralbl ., Nr. 1, Jan. 2, 1913, S. 20.
Tamoars.—RANDOLPH, B. M. Sarcoma of left frontal lobe of brain without
definite symptoms until shortly before death. Journ. Amer. Med. Assoc..
Yol. lx., No. 1, Jan. 4, 1913, p. 30.
CIUFFINI, P. Contributo clinico ed anatomo-patologico alio studio dei tumori
del lobo parietale. Riv. di Paid. new. c ment., Vol. xvii., F. 12, Gennaio 1913*
p. 705.
BOND, F. D., and PEABODY, A. H. Brain Tumor. Operation. Autopsy.
Findings. Boston Med. and Sure). Journ., Vol. clxviii., No. 3, Jan. 16, 1913,
p. 90.
HALL, A. Two cases of colloid tumour of the third ventricle, causing death.
Lancet , Jan. 11, 1913, p. 89.
BIBLIOGRAPHY
15 *
TOOTH, HOWARD H. Some observations on the growth and survival-period
of intracranial tumours, based on the records of 500 cases, with special reference
to the pathology of the gliomata. Brain , Vol. xxxv., Part ii, 1912, p. 61.
BA RAN Y, R. Nouvelles recherches et observations concernant les relations
existent entre lappareil vestibulaire et le systeme nerveux central. Symptdmes
cerdbelleux et vestibulaire k distance provoques par des tumours c4r6brales.
Rev. Neurol., Ann. xxi., No. 1, Jan. 15, 1913, p. 1.
OPPENHEIM, H. Uber klinische Eigenttimlichkeiten kongenitaler Hirngesoh-
wulste. Neurol. Ccnirafbl ., Nr. 1, Jan. 2, 1913, S. 3.
Diabetes Insipidus. — SIMMONDS. Hypophysis und Diabetes insipidus.
Miinch. Med. Wchnschr., J. 60, No. 3, Jan. 21, 1913, S. 127.
BONIN, G. von. Study of a case of dyspituitarism. Quart. Journ. Med., Yol.
6, No. 22, Jan. 1913, p. 125.
Infknttllsni.—McCRUDDEN, F. H., and FALES, H. L. The nature and
origin of the nitrogenous compounds in the feces in infantilism. Joum. Exp.
Med., Vol. xvii., No. 1, Jan. 1913, p. 20.
McCRUDDEN, F. H., and FALES, H. L. The cause of the excessive oaldum
excretion through the feces in infantilism. Joum. Exp. Med., Vol. xvii., No.
1, Jan. 1913, p. 24.
Aphaula, df. —GORDON, A. A contribution to the study of aphasia. N.Y.
Med. Journ., Vol. xcvii., No. 1, Jan. 4, 1913, p. 9.
Pellagra. —DEVOTO, L. Atiologie und Klinik der Pellagra. M ini. Med.
Wchnschr., J. 63, Nr. 1, Jan. 1, 1913, S. 20.
ROBBINS, F. C. Report of a case of pellagra. Med. Record, Vol. 83, No. 2,
Jan. 11, 1913, p. 55.
NILES, G. M. The treatment of pellagra. N. Y. Med. Joum., Vol. xovii.,
No. 3, Jan. 18,1913, p. 116.
Syphilis. —WILSON, A. R. Some rarer manifestations of parasyphilis of the
nervous system. Brain, Vol. xxxv., Part II., 1912, p. 153.
RICHTER, P. Welcho Bedeutung hat der ‘ ‘ mal franzoso ” in Italien in der ersten
Halfte des 15 Jahrhunderts fiir die Ansicht vom amerikanischen Ursprung der
Syphilis? Dermatol. Ztschr., Bd. xx., H. 1, Jan. 1913, S. 34.
KLAUSNER. Die Behandlung der Syphilis mit Kontraluesin (Richter) einem
molekular zerstiiubten Quecksilber. Miinch. Med. Wchnschr., J. 60, No. 2,
Jan. 14, 1913, S. 62.
HOFFMANN, E. Dauer der Kontagiositat der Syphilis und Ehckonsens im
Lichte der neuen Forschung. Dent. Med. Wchnschr., J. 39, Nr. 1, Jan. 2,
1913, S. 14.
NEISSER. Die Prinzipien der modernen Syphilistherapie. Bcrl. Klin.
Wchnschr., J. 50, Nr. 2, Jan. 13, 1913, S. 49.
FISCHER, O., and KLAUSNER, E. Kin Beitrag zur Kutanreaktion der
Syphilis. Wien. Klin. Wchnschr., J. xxvi., Nr. 2, Jan. 9, 1913, S. 49.
LAUNOY and LEVADITI. Nouvelles recherches sur la th6rapeutique
mercurielle des spirilloses (sp. des poules et syphilis du lapin). Com.pl. Rend,
d. 1. Soc. d. Biol., T. Ixxiv., No. 1, Jan. 10, 19i3, p. 18.
McDONAGH, J. E. R. The complete life-history of the organism of syphilis.
Brit. Joum. Dermatol., Vol. xxv., No. 1, Jan. 1913, p. 1.
Balvarsan. —LUBE, F. Uber epileptiforme Anfiille nach Salvarsan. Dermatol.
Ztschr., Bd. xx., H. 1, Jan. 1913, S. 8.
RIMINI, E. Uebor den Einfluss des Salvarsans auf das Gehororgan. Dent.
Med. Wchnschr., J. 39, Nr. 2, Jan. 9, 1913, S. 71.
KREN, O. Schlussbericht liber unsere Er^ahrungen mit Salvarsan. Wien. Klin.
Wchnschr., J. xxvi., Nr. 4, Jan. 23, 1913, S. 133.
RIECKE. Ueber den gegenw&rtigen Stand der Salvarsantherapie bei Syphilis-
unter Berlicksichtigung eigener Erfahrungen. Fortschr. d. Med., J. 31, Nr. 1,
Jan. 2, 1913, S. 1.
MAYNARD, E. F. Salvarsan in Pernicious Amentia. Brit. Med. Joum., Jan.
11, 1913, p. 71.
LOEB, H. Heilung der Verrucae planae durch Salvarsan. Deut. Med.
Wchnschr ., J. 39, Nr. 4, Jan. 23, 1913, S. 168.
16*
BIBLIOGRAPHY
yeasalTanaa.— ALMKVI8T, J. Uber bei Bedeutung des Salvarsans urd
Neoeal variant bei der Behaudlung der Syphilis. DermaXoL Wchnschr.., Bd. 5*'».
Nr. 2, Jan. 11, 1913, S. 41.
SWIFT, H. F. The absorption of arsenic folio wing intramuscular injections of
aalv&rsau and neosalvarsan. Joum. Exp. Med., VoL xviL, No. 1, Jan. 1913.
p. 83.
ARZT, L., and KERL, W. Zur Kenntnia der parasitotropen Wirkung de*
Atoxyls und Neosalvarsans. Wien, Klin, Wchnschr., J. xxvL, Nr. J, Jan. 2,
1913, S. 12.
BACHSTEZ, EL I T ebor lokale Behandlung der Keratitis parenchymatosa mit
Nooaalvarsan. Wien, Klin, Wchnschr., J. xxvi.. Nr. 3, Jan. 16, 1913, S. 101.
HOEHL. Zur Kenntnia der Neosalvarsanwirkung bei Keratitis parenchymatosa.
Miinch. Med. Wchnschr., J. 60, No. 2, Jan. 14, 1913, S. 72.
Wasserauuui BesetIon.— BUYS, L. R. us. A study of the Wassermann Reaction
in connection with Hereditary Syphilis. Atncr, Journ, Du. of Child., VoL v.,
No. 1, Jan. 1913, p. 6T».
KLIEN, H. Uber das Verhaltnis zwischen Wassermann- und Eiweiss-Reaktionen
in der Cerebrospinalflussigkeit der Paralytiker. Ztschr. f. d. ge$. NcunA. u.
Psychiat. (Grig.), Bd. xiv., H. 1, Dez. 31, 1912, S. 97.
SARATEANU and VELICAN. Die W&ssermann’sche Reaktion in der Schwang-
erschaft der Frauen und bei den Wochnerinnen. Monatsschr. f. Geburts. u.
Gyndkol ., Bd. xxxviL. H. 1, Jan. 1913, S. 89.
Orebro-Bplmal Fluid.—GEISSLER. Ueber Blut in der Spinalfhiesigkeit.
MUnch . Med. Wchnschr ., J. 60, No. 3, Jan. 21, 1913, S. 121.
DANIELOPOLU. Sar la fragility des hematics du chien et sur Taction h&noly-
tique du serum et du liquide cephalo-rachidien. Canpt. Rend. d. 1. Soc. d .
T. lxxiv., No. 2, Jan. 17, 1913, p. 113.
OEMEK1L AMH FUMtTIOMAl D18EA&K8—
Epilepsy.—WOODRUFF, J. B. Crotalin in the treatment of epilepsy and nerve
disorders. N. Y. Med. Joum., Vol. xcvii., No. 2, Jan. 11* 1913, p. 71.
MEYER, E. Epileptoide Zustande bei Alkoholintoxikation. Med. Kltnik , J. ix.,
Nr. 3, Jan. 19, 1913, S. 83.
CLAUDE, H. Le traitement operatoir© de Tdpilepsie. Rev. dt Psychiat., Ser.
8*, Ann. 16, T. xvi., No. 11, Nov. 1912, p. 442.
Hysteria.— MAIRET, A., and MARGAROT, J. D4g4n4rescenoe mentale et hystdrie.
VEnctphale, Ann. viii., No. 1, Jan. 10, 1913, p. 1.
MITCHELL, T. W. A study in hysteria and multiple personality, with report
of a case. Proe. Soc. for Psychical Research , Part lxvi., VoL xxvi, Not. 1912;
p. 286.
MegHas.— CAESAR, G. Der migrfcnose Anfall, seine Kennxeichen, seine Ursaohen
und sein Wesen unter besondercr Beriicksichtigung der Wechselwirknng zwischen
Migrane und Sexualleben. Med. Klinik , J. ix., Nr. 2, Jan. 12, 1913, S. 49.
Xewralgla.—ALEXANDER. W., and UNGER, E. Zur Behandlung sohwerer
Gesichtsneuralgien. Alkoholinjektion ins Ganglion Gasseri. Reri. Klin.
Wchnschr ., J. 60, Nr. 4, Jan. 27, 1913, S. 167.
SICARD, M. J. On the treatment of facial neuralgia and facial hemispasm.
Med. Press , No. 3,846, Jan. 22, 1912, p. 88.
Mewritls.—FOERSTER, O. Die arteriosklerotische Neuritis. Wien. Med.
Wchnschr J. 63, Nr. 6, Jan. 25, 1913, 8. 313.
DOINIKOW. Zur Histopathologie der Neuritis mit besonderer BertteMehtigung
der Regenerationsvorg&nge. Deut. Ztschr. f. Nervenheilk Bd. 46, H. 1, 1912,
8. 20.
CRAMER, E. Neuritis retrobulbaris mit achtttigiger Amaurose und sohwersten
Gehirnerschcinungen als Folge von infektioser multipier Neuritis. Klin.
Monatsbl. f. Augenheilk., J. li., Jan. 1913, 8. 58.
NOORDEN, CARL von. Ueber enterogene Intoxikationen, besonders uber
enterotoxisohe Polyueuritis. Berl. Klin . Wchnschr., J. 50, Nr. 2, Jan. 13,1913,
8. 51.
BIERMANN. Ueber metapneumonisohe Brachialplexusneuritis und -polyneuritis.
Deut. Med . Wchnschr ., J. 39, Nr. 4, Jan. 23, 1913, 8. 166.
BIBLIOGRAPHY
17*
LANGBEIN, B. Beitrag zur Bebandlung dor Ischias mit cuiduralen Injek-
tionen. Deut. Med. Wchnschr ., J. 89, Nr. 1, Jan. 9, 1913, 8. 90.
Keimei. — BEHRENROTH, E. Die sexuelle psyohogene Herzneurose
(Phrenokardie). Deut. Med. Wchnschr ., J. 39, Nr. o, Jan. 16,1918, 8. 106.
BENON. Enervement, anxiety periodiques et ndvroses de l’estomao. Gaz. des
E6p. y No. 8, Jan. 21, 1913, p. 120.
RUMPF. Bemerkung liber die Begutachtung von Unfallkranken. Deut. Ztschr .
/. NervenhcilL , Bd. 46, H. 1. 1912, S. 109.
Alcoholism, Ac. —LISSAUBR, MAX. Experimen telle Leberzhrhose naoh
chronischer Alkoholvergiftnng. Deut. Med. Wchnschr ., J. 39, Nr. 1, Jan. 2,
1913, 8. 18.
Exophthalmic Goitre, Cretinism, Ac.—CRILE, G. W. The kinetic theory of
Graves' disease. Airier. Joum. Med. Sci.> Vol. cxlv., No. 1, Jan. 1913, p. 28.
GROBER. Ueber Selbetheilung von Basedowscher Krankheil Miinch. Med.
Wchnschr ., J. 60, No. 1, Jan. 7, 1913, 8. 8.
SCHLESINGER, A. Zur chirurgischen Behandlung dee Morbus Basedowii.
Bert. Klin. Wchnschr ., J. 50, Nr. 2, Jan. 13, 1913, 8. 57.
WHITE, W. HALE. Clinical lecture on Myxoedema. Lancet , Jan. 18, 1913,
p. 154.
McCARRISON, R. The Etiology of Endemic goitre. (Milroy Lectures.)
Lancet , Jan. 18,1913, p. 147.
CLAUDE and SEZARY. Adipose douloureuse avec astbdnie. Action
remarquable de l’opoth6rapie thyroidienne. Gaz. des H6p No. 5, Jan. 14,
1913, p. 69.
Paralysis Agltans.—BURR, O. W. Paralysis Agitaus in Negroes. Joum. Amer.
Med. Assoc., Vol. lx., No. 1, Jan. 4, 1913, p. 43.
Tetamns.—ATKEY, O. A case of tetanus treated by intravenous injections of
paraldehyde and copious injections of normal saline resulting in cure. Lancet ,
Jan. 18, 1913, p. 168.
YAGI, 8. Uber die antitetanische Wirkung der Kalziumsalze. A rchives internal,
de Pkarmacodyn. et de Thirap ., Vol. xxii., F. iii.-iv., 1912, p. 259.
SPECIAL SENSES AND CRANIAL NERVES—
BE RIEL, L. Etude anatomique d’un cas d'h^mianesthesie avec l&ion en foyer
des parties anterieures de la couche optique. (8 fig.) Rev. Neurol ., Ann. xxi.,
No. 1, Jan. 15,1913, p. 6.
BEHR. Die Bedeutung der Pupillenstorungen fiir die Herddiagnose der homony-
men Hemianopsie und ilire Beziehungen zur Theorie der rupillenbewegung.
Deut. Ztschr. f. NervenhcilL , Bd. 46, H. 1,1912, 8. 88.
SCHIECK, F. Die Bedeutung der Stauungspapille. Deut. Med. Wchnschr .,
J. 39, Nr. 1, Jan. 2, 1913, 8. 10.
SCHLESINGER, ERICH. Ueber den Schwellenwert der Pupillenreaktion und
die Ausdehnung des pupillomotorischen Bezirkes der Retina. Deut. Med.
Wchnschr ., J. 39, Nr. 4, Jan. 23, 1913, 8. 163.
CZYHLARZ, E. v. Ueber Nystagmus bei fieberhaften Krankheiten. Bert. Klin.
Wchnschr ., J. 50, Nr. 3, Jan. 20, 1913, 8. 112.
THOMSON, E. Ocular Myoclonus. Lancet, Jan. 18, 1913, p. 167.
GREENE, J. 8. Diseases of the labyrinth. With special reference to the
methods of examining the labyrinth in the Continental Clinics. Med. Record,
Vol. 83, No. 2, Jan. 11, 1913, p. 56.
M1SCELLANEOUS SYMPTOMS AND CASES—
BEYER, W. Beweist der Aufsatz von Kleinschmidt (im Heft vom 3. Juli dieaer
Zeitschrift) etwas “Zur Frage der Wirksamkeit des Diphtherieserums bei
Beteiligung des Nervensystems an der Erkrankung ” ? Jahrb.f. KinderheUk .,
Jan. 2, 1913, 8. 65.
KLEINSCHMIDT, H. Erwidening auf die vorstehenden Bemerkungen des
Herrn Dr W. Beyer. Jahrb. f. KinderheilL, Jan. 2, 1913, 8. 69.
SATO, 8. Ueber das cavernose Angiom des peripherischen Nervensystems.
Archiv f. Klin. Chir., Bd. c., H. 2, 1912, 8, 553.
OBERHOLZER, EMIL. Einige Beobachtungen Uber das psychogene Moment
beim Keuchhusten. Correspondsnz-Bl. J. Schweiz. Aerzte , J. xlii.. Nr. 36,
1912, Dez. 20,1912, 8.136L
18 *
BIBLIOGRAPHY
NEUSTAEDTER, M. Observations of the atypical children in Dr Groezman’*
School from the Standpoint of the Neurologist. Med. Record, VoL 83, No. 3,
Jan. 18, 1913, p. 106.
HOLLIS, W. AINSLIE. Facial Crinkles and Emotional Grimace. (Ill us t.)
Lancet , Jan. 4, 1913, p. 23.
EISENSTAEDT, J. S. Three cases of family dystrophy of the hair and nails.
Joum . Amer. Mid. Assoc., Vol. lx., No. 1, Jan. 4, 1913, p. 27.
BARANY, R. Ueber einen Fall von vollst&ndiger Wiederherstellung des Gehors
nach Kompletter, nahezu ein Jahr dauernder Taubheit bei dem von Bariny
beschriebenen Syinptomenkomplex. Wien. Klin. Wchnschr. % J. xxvi-, Nr. 4,
Jan. 23, 1913, S. 138.
PSYCHIATRY.
GENERAL PARALYSIS—
HASSMANN, O., and ZINGERLE, H. Beitrag zur Kenntnis der Verlaufeformen
der progreiwiven Paralyse. Neurol. Centralbl ., Nr. 1, Jan. 2, 1913, S. 10.
HARTUNG, E. Fall von Dementia paralytica and Geburt. Deut. Med .
Wchnschr., J. 39, Nr. 2, Jan. 9, 1913, S. 72.
DEMENTIA PRiECOA—
KRUEGER, H. Uber die Uytologie des Blutes bei Dementia praecox. Zlschr. f.
d. yes. Neurol, ti. Psyehiat. (Orig.), Bd. xiv., H. 1, Dez. 31, 1912, S. 101.
BENEDEK, L., and DEAK, S. Unterschiedc zwischen dem Blutseram bei
Paralyse uiul Dementia praecox in bezug auf die Auslosung von Immun-
hamolyscn. Deut. Med. Wchnschr ., J. 39, Nr. 1, Jan. 2, 1913, S. 24.
ASCHAFFENBURG, G. Degenerationspsychosen und Dementia praecox bei
Kriminellen. Ztsrhr. f. d. yes. Neurol, u. Psyckial. (Orig.), Bd. xiv., H. 1,
Dez. 31, 1912, S. 83.
GENERAL—
LUCANGELI, G. L. Uu singolare caso clmico di delirio acutd. Patho/oyica,
Anno iv., N. 99, Die. 15, 1912, p. 741.
COURBON, P. Integrity de la memoire et demence. Rev. de Psyehiat. , Ser. 8*
Ann. 16, T. xvi., No. 11, Nov. 1912, p. 448.
PAT1NI, E. Osservazioni sul mocc&nismo della dissociazione ptdchica in un
demente afasico. Annuli di Ncvrol. , Anno xxx., F. iii., 1912, p. 117.
KUTZINSKI, A. Ueber die Beeinflussung des Vorstellungsablanfes lurch
Geschichtskomplexe bei Gcisteskranken. Monatsschr. f. Psyehiat. u. Neurol .,
Bd. xxxiii., H. 1, Jan. 1913, S. 78.
SCHONHALS, P. l T eber einige Fallc von induziertem Irresein. Monatsschr. f.
Psyehiat . u. Neurol ., Bd. xxxiii., H. 1, Jan. 1913, S. 40.
BOSSI. Psychiatric und Gynakologie. Munch. Med. Wchnschr ., J. 60, No. 3,
Jan. 21, 1913, S. 134.
MITCHELL, T. W. Some types of multiple personality. Proc . Soc. jor
Psychical Research , Part Ixvi., Vol. xxvi., Nov. 1912, p. 257.
DANA, C. L. Mental Tests. Med . Record , Vol. 83, No. 1, Jan. 4, 1913, p. 1.
HARDY, IRA M. Schools for the Feeble-minded—The States Best Insurance,
Policy. Pediatrics , Vol. xxiv., No. 12, Dec. 1912, p. 732.
VINCHON, JEAN. “ L’Hdpital des fols incurables” de Thomas Garsoni. Rev.
de Psychiat Ser. 8 # , Ann. 16, T. xvi., No. 11, Nov. 1912, p. 455.
TREATMENT.*
GOLDSCHEIDER. Die Anwendung der physikalischen Heilmethoden «ur Be d a nhlun g
von zentralen Erkrankungon. Ztschr. f. Physical, u. Dial. Therap. t Bd. rvii.,
H. 1, Jan. 1913, S. 1.
HARTENBERG, P. La strychnine h dose intensive. Mdthode et indications. Prcsse
Mid., No. 8, Jan. 25, 1913, p. 71.
FISCHER, OSKAR. Das Problem der Paralysetherapie. Prayer Med. Wchnschr .,
J. xxxviii., Nr. 2 und 3, Jan. 9 und 16, 1913, S. 15 und 27.
FREUD, SIGM. A note on the unconscious in psycho-analysis. Proc. Soc, for
Psychical Research , Part lxvi., VoL xxvi., Nov. 1912, p. 312.
* A number of references to papers on Treatment are included in the Bibliography under
individual diseases.
Bibliography
ANATOMY.
MILLER, M. M. Prenatal growth of the human spinal cord. Journ. Comp . Neurol .,
Vol. 23, No. 1, Feb. 15, 1913, p. 39.
HARVEY, R. W. A preliminary report on the asymmetry of the basal ganglia. Aunt.
Record , Vol. vii., No. 1, Jan. 20, 1913. p. 17.
SMITH, E. V. Histology of the sensory ganglia of birds. Amer. Journ. Anat. y Vol.
14, No. 2, Jan. 15, 1913, p. 251.
VAN FALKENBURG, C. T. Zur Lokalisation innerhalb der bulbaren Pyramide des
Menschen. Ztschr . /. d. get. Neurol . u. Psych iat. (Orig.), Bd. xiv., H. 3, Feb. 11,
1913, S. 304.
BIONDI, J. I nuolei d’origine e terminali del nervo trigemiuo nel polio. Riv. ital. di
Nevropatol ., Psichiat. ed Elettrotcr , Vol. vi., F. 2, Feb. 1913, p. 49.
LEGENDRE, R. A propos du pigment des cellules nerveuses d’Helix pomatia. Compt .
Rend. d. 1. Soc . de Biol. y T. lxxiv., No. 6, Fev. 14, 1913, p. 262.
HALLER, B. Die Intelligenzspharen des Molluskengehirns. Ein Beitrag zur stufen-
weisen Entfaltung dieser bei den Achordaten. Arch. j. Mikr. Anal., Bd. 81, H. 3,
Jan. 25,1913, S. 233.
J0HN80N, C. E. The development of the prootic head somites and eye muscles in
chelydra serpentina. Amer. Journ. Anal ., Vol. 14, No. 2, Jan. 15, 1913, p. 119.
SCHAEFFER, J. P. On two muscle anomalies of the lower extremities. Anal. Rcc.,
Vol. vii., No. 1, Jan. 20, 1913, p. 1.
LANDAU, MAX. Zur Entwicklung der Nebennierenrinde. Dent. Med. Wchnschr .,
J. xxxix., Nr. 7, Feb. 13, 1913, S. 300.
ONODI, LADISLAUS. Ueber einige chirurgisch wichtige Formverhaltnisse der
Stirnhohle, fiber den Recessus cristae galli, Torus olfactorius und Recessus
paracribrosus. Archiv f. Laryngol. u. Rhinol. , Bd. xxvii., H. 1, 1913, S. 126.
PHYSIOLOGY.
INGEBRIGTSEN, RAGNVALD, Studies of the Degeneration and Regeneration of
Axil Cylinders in vitro. Journ. Ezpcr. Med. y Vol. xvii., No. 2, Feb. 1,1913, p. 182.
MARINESCO and MINEA. Sur le rajeunissement des cultures de ganglions spinaux.
Compt. Rend. d. 1. Soc. de Biol. y T. lxxiv , No. 6, F^v. 14, 1913, p. 299.
ROTHMANN, MAX. Zur Kleinhirnlokalisation. Bcrl. Klin. Wchnschr. , J. 1., No. 8,
Feb. 24, 1913, S. 336.
GRAHAM BROWN, T. Studies in the physiology of the nervous system. XII.
Rhythmic responses in the simple reflex-progression-scratch. Quart. Journ. Exp.
Physiol. , Vol. vi., No. 1, Feb. 15, 1913, p. 25.
HEUBNER-LOEWE. Uber die zentral lahmende Strychninwiikung. Archiv f. exp.
Path. u. Pharm. y Bd. Ixxi., H. 3, Feb. 1913, S. 174.
DOZZI, L. Studi suirazione del piombo. Azionc del piombo sulla eccitabilita dci nervi
motori. Lo Sjtcrimcntalc , Anno lxvi., F. vi., Gennaio 1913, p. 666.
GRUBER, C. M. A comparison of naturally and artificially aroused impulses under
the influence of nerve block. Quart. Journ. Exp. Phusiol ., Vol. vi., No. 1,
Feb. 15, 1913, p. 21.
NIKIFOROWSKY, P. M. On depressor nerve fibres in the vagus of the frog. Journ .
Physiol ., Vol. xlv., No. 6, Feb. 5, 1913, p. 459.
d
is*
20 *
BIBLIOGRAPHY
EPIFANIO. G. Variations de lexcitabilite du centre du vague dans lea deux phases de
la respiration. Arch. \taL de Biot,, T. lviii., F. iL, Dec. 31, 1912, p. 306.
HYDE, SPRAY, and HOWAT. The influence of alcohol upon reflex action in the frog.
Amer. Journ. Physiol. , Vol. xxxi.. No. v., Feb. 1, 1918, p, 309.
FAURE, CH. y and LOU LA, C. Etude de la proteolyse de la substance nerveuse.
Relations entre la proteolyse et la chromatolyse fonctionnelles des centres dans la
fatigue. (Note pnliminaire.) Compt, Rend, d, L Soc, de Bid. % T. budv., No. 7,
Feb. 21, 1913, p. 350.
BERGER, H. T T eber die Folgen einer vorubergehenden Unterbrechung der Blutxufuhr
ftir das Zentralnervensystem des Menachen. Monatsschr. f, PsychiaL u, Neurol ..
Bd. xxxiii., H. 2, Feb. 1913, S. 111.
HERRING, P. T. Further observations upon the comparative anatomy and physiology
of the pituitary body. Quart, Journ, Exp, Physiol, % VoL vi. t No. I, Feb. IS,
1913, p. 73.
WEED, L. H., CUSHING, H., and JACOBSON, C. Further studies on the idle of
the hypophysis in the metabolism of carbohydrates. The autonomic ooutrol of the
pituitary gland. Bullet. Johns Hopkins Ho$p, t Vol. xxiv., Feb. 1913, p. 40.
SCHAFER, E. A. On the effect of pituitary and oorpus lutmun extracts on the
mammary gland in the human subject. Quart, Journ, Exp, PhyoioL , VoL vL,
No, 1, Feb. 16, 1913, p. 17.
CLAUDE and PORAK. Sur Faction cardio-vasculaire de eertains extraits d'hypophyse.
Compt. Rend. d. 1. Soc, de Biol., T. Ixxiv., No. 5, F4v. 7, 1918, p. 205.
HERZBERG, S. Klinische Versuche mit den isolierten wirksamen Snbstanxea der
Hypophysen. Dent, Med. Wchnsehr,, J. L., Nr. 5, Jan. 30, 1913, S. 207.
CARLSON, A. J. Contributions to the physiology of the stomach.—IV. The influence
of the contractions of the empty stomach in man on the vasomotor oeatre. on the
rate of the heart beat, and on the reflex excitability of the spinal oord. Amer .
Journ. Physiol Vol. xxxi., No. v., Feb. 1, 1913, p. 318.
FUNK CAS1MIR. Further experimental studies on beri-beri. The action of oertain
purine- and pyramidine-derivatives. Journ, Physiol Vol. xlv., No. 6, Feb. 5,
1913, p. 489.
WHALE, H. The late vasomotor paresis due to adrenalin. Brit, Med. Journ.,
Feb. 8, 1913, p. 273.
MATTIROLO, G., and GAMNA, C. L arione combinata della eoeaina e dell* adrenalina
sulla pupilla. Riv, crit. di clin. med.. Anno xiv., Nos. 6 und 7, Feb. 1913, pp. 81
and 97.
PARHON, M. Sur Is teneur en glycogens du foie et des muscles chez les animaux
traites par des preparations thyroidiennes. Journ. de Physiol, et de Path, pen.,
T. xv., No. 1, Jan. 16, 1913, p. 75.
MYERS, V. C., and FINE, M. S. The creatine content of muscle under normal
conditions. Its relation to the urinary ersatinine. Journ, Biol, Chen ., VoL xiv.,
No. 1, Feb. 1913, p. 9.
MARIE, A. Glandes surrenales et toxi-infections (Troiaifcme note). Compt, Bend, d, l.
Soc. dc Biol T. Ixxiv., No. 5, F<$v. 7, 1913, p. 221.
MUNZER, A. Innere Sekretion und Nervensystem. Bert. Klin, Wehmohr ., J. L.,
Nos. 7 und 8, Feb. 17 und 24, 1913, S. 302 und 349.
MANGOLD, E. Zur tierischen Hypnose. PjlugtPi Archiv, % Bd. cl., H. 1 und 2,1913»
S. 46.
FREDERICQ, H. L'excitabilite du vague caidiaque et ses modifications sous l'influenoe
de la cafeine (1 fig.). Arch, internal de Physiol., Vol. xiiL, F. 1, Jan. 31* 1913,
p. 107.
GREGOR, A., and SCH1LDER, P. l>e it rage zur Ksnntnis der Physiologic und
Pathologie der Muskelinnervation (64 Textfig.). Zteehr, J, cL ffe$, Neurol, u.
Psychiat. (Orig.), Bd. xiv., H. 3, Feb. 11, 1913, S. 359.
KATSCH, G. Psychische Beeinflusaung der Darmmotilitfct. Ztsckr. f. Exp, Polk, u,
Therap. , Bd. xii., H. 2. 1913, S. 200.
BIBLIOGRAPHY
21*
PSYCHOLOGY.
DODGE, R. The refractory phase of the protective-wink reflex. Amer. Joum.
Psychol ., Vol. xxiv., No. 1, Jan. 1913, p. 1.
FINKENBINDER, E. O. The carve of forgetting. Amer. Joum. Psychol ., Vol. xxiv.,
No. 1, Jan. 1913, p. 8.
MARTIN, L. J. The electrical supply and certain additions to the laboratory equip¬
ment in the Stanford University laboratory. Amer. Joum. Psychol Vol. xxiv.,
No. 1, Jan. 1913, p. 33.
WELLS, F. L. Practice and the work-curve. Amer. Joum. Psychol ., Vol. xxiv.,
No. 1, Jan. 1913, p. 35.
SMITH, T. L. Paramnesia in daily life. Amer. Joum. Psychol ., Vol. xxiv., No. 1,
Jan. 1913, p. 52.
STRONG, E. K. A comparison between experimental data and clinical results in
m a nic depressive insanity. Amer. Joum. Psychol Vol. xxiv.. No. 1, Jan. 1913,
p. 66.
BUCKNICH, 0. A. The use of the term function in English text-books of psychology.
Amer. Joum. Psychd. % VoL xxiv. No. 1, Jan. 1913, p. 99.
TITCHENER, E. B. Prof. Martin on the Perky Experiments. Amer. Joum. Psychol .,
Vol. xxiv., No. 1, Jan. 1913, p. 124.
GRUHLE, H. W. Ergographische Studien. Psychol. Arbeiten, Bd. vi., H. 3, 1912,
S. 339.
FRANKFURTHER, W. Arbeitsversuche an der Schreibmaschine. Psychol. Arbeiten ,
Bd. vi., H. 3,1912, S. 419.
MIKULSK1, A. Auffassungs-und Merkversuche an Gesunden und Kranken mit
beeonderer Beriicksichtigung des Gefuhls der Sicherheit. Psychol. Arbeiten , Bd.
vi., H. 3, 1912, S. 451.
ORSZULOK, P. Untersuchungen ttber die Muskelarbeit des Menschen. II. Teil.
Untersuohungen beim Gesunden. Psychol. Arbeiten, Bd. vi., H. 3,1912, S. 494.
HETMANS, G. In Sachen des psyohischen Monismus. (Zweiter Artikel). Ztschr. f.
Psychol ., Bd. lxiv., H. 1 und 2, 1913, S. 1.
MEYER, PAULA. Uber die Reproduktion eingepragter Figuren und ihrer raumlichen
Stellungen bei Kindern und Erwachsenen. Ztschr. f. Psychol. , Bd. lxiv., H 1 und
2,1913, S. 34.
KOHLER, W. Akustische Untersuchungen HI. und IV. Ztschr. f. Psychol. , Bd.
lxiv., H. 1 und 2, 1913, S. 92.
HOLUNGWORTH, H. L Experimental psychology and medicine. Med. Record ,
Vol. 83, No. 6, Feb. 8, 1913, p. 237.
DIDB, M. Les id&distes passionals et leurs actions antisociales. Joum. de Neurol .,
Aim. 18, No. 2, Jan. 20,1913, p. 22.
COURTNEY, J. W. On the nature of the feeling of unreality. Boston Med. and
Burg. Joum,, Vol. olxviii., No. 6, Feb. 6, 1913, p. 198.
PATHOLOGY.
D’ABUNDO. Su d’una partioolare microgiria parriale simmetrica negli emisferi
cerebrali, e sui oonsecutivi probabili effetti oompensativi. Rir. ital. di Neuropat.,
Psichiat. ed Elettroteir. , Vol. vi., F. 1, Gennaio 1913, p. 1.
FEISS, H. O., and CRAMER, W. Contributions to the histo-chemistrv of nerve: on
the nature of Wallerian degeneration. Proc. Roy. Soc ., Ser. B., Vol. 86, Jan. 7,
1913, p. 119.
BARRATT, J. O. W. Changes in ohondriosomes occurring in pathological
Quart. Joum. Micios. Sci ., Vol. 58, Part 3, Jan. 1913, p. 553.
conditions.
SHUNDA, A. Technique microseopique, impregnation rapide (Bieltchowsld simplify)
et m4thode regressive dans l’impregnation. Rev. Neurol Ann. xxi., No. 4, F^v. 28,
1913, p. 204.
99 *
BIBLIOGRAPHY
ADLER, H. M. Unsaturated Fatty Acid as a Neurolytic Agent. Archives of Int. Med .,
Vol. ii., No. 2, Feb. 15, 1913, p. 187.
LEWANDOWSKY, M. Stand uud Aufgabeu der allgemeinen Physiologic mid
Pathologie des aym|aithiHclien Systems. Ztschr, /. d. get . AfauroL u.
(Orig.), Ed. xiv., H. 3, Feb. 11, 1913, S. 281.
PAPAZOLT, MME. ALKX. Sur la production des substances biuretiaues dans lea
centres nerveux maladea (epilepsie, demence precoce, paralysie gent* rale) et dans le
oorpa thvroide (goitre), le thymus et l ovaire des basedowiens, par le serum des
individus atteints de ces memos maladies. Compt . Rend, d, l. Soc. de Biol., T.
lxxiv., No. 6, Ft-v. 14, 1913, p. 302.
MARINESCO. Rernarquea h propos de la note de Mme. Papazolu. Cornpt. Rend. d. i.
Soc. de Biol., T. lxxiv., No. G, Fev. 14, 1913, p. 304.
PECHSTEIN, H. Zur Frage des experimentellen Diabetes. I. Mittheilung: Zucker-
inobiiiaation durch Adrenalin in Leberdurchblutungsversuchen. Ztschr. f. Exp.
Bath. u. Then, Ed. xiL, H. 2, 1913, S. 380.
CLINICAL NEUROLOGY.
GENERAL—
TOMLINSON, H. A. The rflle of the nervous system as affecting the symptom¬
atology of disease, and the influence of disturbance of its functions on morbidity.
Amer. Journ. Insanity , Vol. lxix.. No. 3, Jan. 1913, p. 531.
WARRINGTON, W. B. A review of recent work in neurology. Liverpool Med.-
Chir. Journ., No. 63, Jan. 1913, p. 69.
THOMSON, H. C. Review of recent literature on nervous and mental diseases.
Practitioner , Vol. xc., No. 2, Feb. 1913, p. 484.
CAMPBELL, HARRY. The neurology of the visual system. Med . Press f Jan. 29
and Feb 5, 1913, pp. 122 and 144.
POMEROY, J. L. Pulmonary tuberculosis and peripheral nervous system. N. Y.
Med. Journ., Vol. xcvii., No. 5, Feb. 1, 1913, p. 235.
LOVETT, R. W. The work of the Massachusetts State Board of Health in the
investigation of paralysis. Bouton Med. and Burg. Journ., Vol. dxviii., No. 4.
Jan. 23, 1913, p. 109.
NERVE*—
JONES, H. LEWIS. Paralysis of the trapezius from injury of spinal acoessory
nerve, and recovery. Proc. Roy. Soc. Med., Vol. vi. f No. 8, Jan. 1913 (Electro-
ther. Sect.), p. 37.
BEHRENL). Kin Fall von isolierter traumatischer Lahmung des Nervus supra-
scapularis. Berl. Klin. Wchnschr., J. L., No. 6, Feb. 10, 1913, S. 249.
GLEITSMANN, J. W. Paralysis of the recurrent nerve due to circulatory lesions,
with remarks on recent therapeutic measures. Med. Record, VoL 83, No. 8, Feb.
22, 1913, p. 336.
DAVIS, H. J. Paresis of the left recurrent laryngeal nerve in a woman, aged 35.
Proc. Roy. Soc. Med., Vol. vi., No. 3, Jan. 1913 (Laryngol. Sect.), p. 45.
STOFFEL. Beitrage zu einer rationellen Nervenchirurgie (Illustr.). Munch. Med .
Wchnschr., J. lx., No. 4, Jan. 28, 1913, S. 175.
JACOB, O. Des rapports de la hranche motrice du nerf radial avec l’articulation
radio-humerale, envisages au point de vue de la chirurgic operatoire du coude
(2 fig.). Rev. dc Chir., Ann. xxxiii., No. 2, Fev. 10, 1913, p. 137.
NEIL, W. F., and CROOKS, F. Supraclavicular anesthetization of the brachial
plexus. Brit. Med. Journ., Feb. 22, 1913, p. 388.
COSTE. Nervennaht, Nervenanastomosen und Neurolyse. Ztschr. f. d. yes. Neurol,
u. Psychiat., Bd. vi., H. 8 (Ref.), 1913, S. 849.
MUaCLE*—
GOTO, S. Pathologisch-anatomische und klinische Studien iiber die sogen.
Myositis ossificans progressiva multiplex. (Hyperplasia fascialis ossificans pro¬
gressiva). Archiv. f. Klin. Chir., Bd. c., H. iii., 1913, S. 730.
BIBLIOGRAPHY
23*
TIXIER, L. , and RCEDERER, C. Bur une dystrophie osteo-musculaire avec nanisme,
r4cemment d^crite par M. Hutinel. Etude chnique de quelques nouveaux cas.
Presse Mid., No. 10, F6v. 1, 1013, p. 95.
SPINAL COIN-
Gfieral. —BEER, EDWIN. The relief of intractable and persistent pain due to
metastases pressing on nerve plexuses by section of the opposite anterolateral
column of the spinal cord, above the entrance of the involved nerves. Journ .
Amer. Med. Assoc,, Vol. lx., No. 4, Jan. 25, 1913, p. 207.
EICHHORST. Bleivergiftuug und Ruckenmarkskrankheiten. Med. Klinik .,
J. ix., Nr. 6, Feb. 0, 1913, B. 201.
AUER, E. M. Spastic paraplegia with the cutaneous reflex of defense occurring
in Pott’s disease. Journ, Amer. Med. Assoc., Vol. lx., No. 4, Jan. 25, 1913,
p. 269.
D&JERINE. Monoplegie dissociee. Journ. des Prat., Ann. xxvii., No. 2,
Jan. 11, 1913, p. 20.
SEVER, J. W. The relation of scoliosis to school seating. N. Y. Med. Journ.,
Vol. xcvii., Nos. 6 and 7, Feb. 8 and 15,1913, pp. 273 and 337.
Cervical Rib.— WEBER, F. PARKES. Bilateral cervical ribs with unilateral
(right-sided) atrophy of hand muscles. Proc. Roy. Soc. Med., Vol. vi., No. 3,
Jan. 1913 (Clin. Sect.), p. 52.
WEBER, F. PARKES. Cervical ribs with atrophy of hand muscles. Proc. Roy.
Soc. Med., Vol. vi., No. 3, Jan. 1913 (Clin. Sect.), p. 55.
Meningocele. —KISCH, H. A. Meningocele in the nasopharynx. Proc. Roy. Soc.
Med., Vol. vi.. No. 3, Jan. 1913 (Laryngol. Sect.), p. 41.
Tabes Dorsalis.— HAMILTON, A. M‘L. The diagnostic significance of pain in
tabes. N. Y. Med. Journ., Vol. xcvii., No. 8, Feb. 22, 1913, p. 373.
ROCHON-DUVIGNEAUD, A., and HEITZ, JEAN. De Involution des troubles
pupillaires chez les tabetiques k la ptSriode d’etat. Rev. Neurol., Ann. xxi.,
No. 3, Fev. 13, 1913, p. 151.
PUJOL. Prurit tab^tique et ars^nobenzol. Prog. Mid., Ann. 41, No. 8, F«$v.
22, 1913, p. 100.
Poliomyelitis Anterior Acuta. —MACKENKIE, WM. Epidemic poliomyelitis.
Australian Med. Journ., Vol. ii., No. 80, Jan, 25, 1913, p. 875.
JOHANNESSEN, AXEL. Poliomyelitis acuta in Norwegen. Monatsschr. f.
Kinderheilk., Bd. xi., Nr. 9, 1912, p. 424.
KLING and LEVADITI. Etudes sur la poliomyelite aigue dpidemique. Compt.
Rend. d. 1. Soc. de Biol., T. lxxiv., No. 7, Feb. 21, 1913, p. 316.
RIVET, L. La conception actuelle de la paralysie infantile au point de vue
clinique et th^rapeutique. La maladie de Heine-Medin. Bull. gin. de Therap.,
T. clxv, F6v. 23 and 28, 1913, pp. 241 and 277.
ECKSTEIN, G. Quadrizepsplastik bei spinaler Kinderlahmung. Prag. Med.
Wchnschr., J. xxxviii., Nr. 8, Feb. 20, 1913, S. 97.
M‘INTOSH, J., and TURNBULL, H. Transmission to monkeys of virus
obtained from English cases of poliomyelitis. Lancet, Feb. 22, 1913, p. 512.
FLEXNER, SIMON, and NOGUCHI, HIDEYO. Experiments on the cultiva¬
tion of the virus of poliomyelitis. Fifteenth Note. Journ. Amer. Med. Assoc.,
Vol. lx., No. 5, Feb. 1, 1913, p. 362.
Friedreich’s Ataxia. —LAMBRIOR, A.-A. Un nouveau cas de maladie Friedreich
avec autopsie (7 fig.). Rev. Neurol., Ann. xxi., No. 2, Jan. 30, 1913, p. 58.
Pseudo-Bulbar Paralysis.— PIC and BLANC-PERDUCAT. Un cas de myas-
th^nie grave progressive bulbo-spimele. Lvon med., Ann. xlv., No. 8, Fev . 13
1913, p. 380.
Hiematomyella. — BERNHARDT, M. Weiterer Beitrsg zur Lehre von der
Hamatomyeliii traumatica. Nturol. CintralU ., J. xxxii., Nr. 3, Feb. 1, 1913,
S. 147.
24*
BIBLIOGRAPHY
BBilM-
Ceneral. — YOKOYAMA, YUGO, and FISCHER. WALTHSE. Tiber cine
eigenartige Form knotiger Hyperplasie der Leber kombiniert mit Gebirn-
veranderungen. Firchow's Archiv ., Bd. 211, H. 2, 1913, S. 305.
GOLDTUWAIT, J. E. An anatomic explanation of many of the cases of
weak or painful backs, aa well as of many of the leg paralyses. Boston Med .
and Savy. Joum ., Vol. clxviii., No. 4, Jan. 23, 1913, p. 128.
HAUPTMANN, A. Untersuchungen liber das Wesen des Hirndrucks. Ztsehr.
f. d . get. Neurol, u. Psychiat. (Orig.), Bd. xiv.. H. 3, Feb. 11, 1913, S. 313.
D^J^RINE. Lesion oorticale. Joum . d . Prof., Ann. xxvii., No. 5, F^v. 1,
1913, p. 69.
Fraclnre, DliloeatUs, etc. —KOSMAK, G. W. Immediate treatment of de-
E rested fractures of the skull in the new-born. Amer . Joum. Obstet VoL
tvii., No. 2, Feb. 1913, p. 264.
Encephalitis. —KRUMHHOLZ, SIGMUND. Localised encephalitis of the left
motor cortical region with epilepsia continua. Joum. Nerv. and Ment. Dis
VoL xl., No. 1, Jan. 1913, p. 17.
Meningitis*—SLATAPER, F. J. Epidemic meningitis. N. 7. Med. Joum .,
Yol. xcvii., No. 7, Feb. 15, 1913, p. 347.
BRELET, M. M. Mdningites aigues et reactions mening^es des poliomyElites.
Ocu. des H6p.. No. 20, F4v. 18, 1913, p. 313.
MILLIGAN, WM. The treatment of meningitis of otitic origin. Lancet, Jan. 25,
1913, p. 226.
KELLY. R. E., and GLYNN, E. A second unusual case of pneumoooocal roenin
gitis following trauma. Liverpool Med.-Chir. Joum., No. 63. Jan. 1913,
p. 162.
KOCH, H. Entstehungsbedingungen der Meningitis tuberculosa. Wien. Klin .
Wchnschr ., J. xxvi., Nr. 7, Feb. 13, 1913, S. 247.
CRACE-CALVERT, G. A. Tuberculous meningitis in adults. Liverpool Med.-
Chir. Joum., No. 63, Jan. 1913, p. 117.
BABINSKI. La mcSningite sp&rifique h^rdditaire familiale et oongdnitale. Jour,
des Prat., Ann, xxvii., No. 1, Jau. 4, 1913, p. 1.
BOIDIN. Etat mt$niug<$ au debut d’une fifcvre parityphoide B grave et prolonged.
Oaz. des H6p. t No. 15, Fev. 6, 1913, p. 229.
Hydraeephalns.—RAE, JAMES. Note on a case of chronie internal hydro¬
cephalus. Lancet , Feb. 15, 1913, p. 453.
Hmnorrhage.— VORPAHL, F. Uber Sinusthrombose und ihre Bedehung xu
Gehim-und Piablutungen. Beitrage. z. path. Anal . u. z. allg. Path., Bd. lv.,
H. 2, Jan, 1913, S. 322.
BYCHOWSKI, Z. Uber zwei Fklle von subduralem Hama tom. Ztschr. /. d .
ges. Neurol, u. Psychiat. (Orig.), Bd. xiv., H. 3, Feb. 11, 1913, S. 340.
EASTMAN, A. C. Intraventricular hemorrhage of the new-born. Boston Med.
and Surg. Joum., VoL clxviii., No. 5, Jan. 30, 1913, p. 165.
ABELS, HANS. Zur Oenese und Symptomatology injrakranieller Blutnngen
beim Neugeborenen. Archiv f. Qynaekol ., Bd. 99, H. 1, 1913, S. 1.
Hemiplegia.—HERTZ, A. F. Organic hemiplegia following typhoid fever, in
which the plantar reflex is flexor, but Babinski's “second sign '"—combined
movement of the trunk and pelvis—is present. Proc. Roy. Soe. Med., Vol. vi. t
No. 3, Jan. 1913 (Clin. Sect.), p. 63.
Paelal Paralysis.— WOLFF, 8. Postdiphtherische FacialislJthmung. Jakrb. f.
Kinderheilk., Feb. 1, 1913, S. 194.
CASTRO, ALOYSIO DE. Sur le signe de Negri dans la paralysis faciale
p<$riph4rique (3 photogr.). Rev. Neurol. , Ann. xxi., No. 3, F4v. 15, 1913,
p. 149.
BIBLIOGRAPHY
25*
Cerebellar A lax la.—WEBER, F. PARKES. Family cerebellar ataxia in two
half-sisters. Proc. Roy. Soc. Med., Vol. vi., No. 3, Jan. 1913 (Clin. Sect.),
p. 50.
A pha s i a , Ac.—SWIFT, W. B. Studies in speech disorder. Boston Med . and
Surg. Journey Vol. olxviii., No. 5, Jan. 30,1913, p. 160.
Tusoars. —BROCA, A. Disjunction des sutures craniennes par tumeur enobphalique
chez l’enfant. Prtsst Mtd., No. 11, Fbv. 5, 1913, p. 10L
OPPENHEIM and KRAUSE. Partielle Entfernung des Worms wegeu
Geschwulstbildung unter breiter Eroffnung des vierten Ventrikels. Berl.
Klin. Wchnschr.y J. L., No. 8, Feb. 24, 1913, S. 333.
MATHIES, A. Vier familiar© Falle multipier Neuromyxofibrosarkomatose.
Ztschr.f. Klin. Med., Bd. lxxvii., H. 1 und 2, 1913, S. 50.
MEYER, W. R. Zur Kasuistik der epidermoidalen Cholesteatome des Gehirns.
Virchow's Arckiv.y Bd. 211, H. 2, 1913, S. 161.
SYMMERS, D. A recurrent neuroblastoma of the soapular region. Journ.
Amer. Med. Assoc. , Vol. lx., No. 5, Feb. 1, 1913, p. 337.
BONNEL. Sarcome de la dure-mbre. BuU. et mbit, de la Soc. anat. de Paris ,
Ann. lxxxvii., Ser. 6, T. xiv., No. 9, Nov. 1912, p. 381.
RUHLAND, G. C. Ganglionic glioneuroma of the optic nerve. Journ. Amer.
Med. Assoc. , Vol. lx., No. 5, Fab. 1, 1913, p. 363.
HILDEBRAND, OTTO. Beitrag zur chirurgie der hinteren Schadelgrube auf
Grand von 51 Operationen. Archiv. f. Klin. Chir.y Bd. c., H. iii., 1913,
S. 597.
LYNCH, J. M. A preliminary report of operations under extradural anesthesia.
Med. Recordy Vol. 83, No. 6, Fab. 8, 1913, p. 235.
Pltaltary Taasemrs, Ac. —VALENTIN, F. Die Technik der Hypophysenopera-
tion. (Sammelreferat). Internal. Zentralbl. f. Ohrenheilk., Bd. xi., H. 1,
1913. S. 2.
FRAZIER, C. H. An approaoh to the hypophysis through the anterior oranial
fossa. Annals of Surgery, Part 242, Feb. 1913, p. 145.
iBfbatlllsns.—M'CRUDDEN, F. H., and FALES, H. L. Intestinal Absorption
in Infantilism. Journ. Exper. Med ., Vol. xvii., No. 2, Feb. 1, 1913, p. 199.
M'CRUDDBN, F. H., and FALES, H. L. The Cause of the Failure to Develop
in Infantilism. Journ. Exper. Med.y Vol. xvii., No. 2, Feb. 1, 1913, p. 202.
Acheadreplasla.—TAUSSIG, F. J. Cesarean section in an aohondroplasio dwarf.
Amer. Journ. Obstct ., Vol. lxvii., No. 2, Feb. 1913, p. 248.
Syphilis.—M‘DONAGH, J. E. R. The complete life-history of the organism of
syphilis. Pros. Roy. Soc. Med ., Vol. vi., No. 3, Jan. 1913 (Path. Scot.), p. 85.
BAESLACK, F. W. On the cultivation of the treponema pallidum. Journ.
Infect. Dis.y Vol. 12, No. 1, Jan. 1913, S. 7, p. 55.
WILSON, F. P. Some present-day views of syphilis. Liverpool Mcd.-Chir.
Journ., No. 63, Jan. 1913, p. 225.
MXJARTHY, H. L. The diagnosis of congenital syphilis. Practitioner , Vol. xc.,
No. 3, March 1913, p. 624.
ALMKVIST, J. Uber Syphilis mit verstecktem Primaraffekt. Derm. Wchnschr .,
Bd. 56, Nr. 7, Feb. 15, 1913, S. 190.
SCHILLING. Zur Frage der neuen Rosschen Entwicklung des Syphiliserregers.
Munch . Med. Wchnschr ., J. lx., No. 4, Jan. 28, 1913.
SCHULMAN, M. Syphilis of Sternum. Journ. Amer. Med. Assoc. , Vol. lx.,
No. 7, Feb. 15, 1913, p. 515.
LUDERS, C. Die Byphilitische Mittelohrentzundung. Deut. Med. Wchnschr .,
J. 39, Nr. 5, Jan. 30,1913, S. 225.
LOVE, J. K. Sporadic congenital deafness, and deafness from syphilis. (Jlasyow
Med. Journ., Vol. lxxix., No. 2, Feb. 1913, p. 81.
26 *
BIBLIOGRAPHY
SUDHOFF, K. Anfange tier Syphilisbeobachtung uiid Syphilisprophylaie zu
Frankfurt a. M., 1496-1502. Derm. Ztschr., Bd. xx., H* 2, Feb. 1913, S. 95.
THOMSON, OLVF, and BOAS. HARALD. Untcrsuchungen fiber Ausflockungs-
reaktionen bei Syphilis mit besomlerer Berucksichtigung der von Herman and
Perutz ausgearbeiteten Modifikation der Methode von Elias-Neubauer-Porge*
und Salomon. Ztsekr. f. Jmmunitatsf. u. exp, Thcrap ., Teil L (Orig.), Bd.
xvi., H. iv., 1913, S. 391.
Sal Vartan.—LJASS, S. Salvarsan bei syphilitischen und metasyphilitischen
Brkrankungen des Nervensvstcms. Neurol. Centralbl. , J. xxxii.. Nr. 4.
Feb. 15, 1913. S. 217.
PINKUS, F. Zur Kenntnis der syphilitischen Hirnreaktion nach der zweiten
Salvarsaninjektion. 1>< rm. Wchnsrkr., Bd. lvi., Nr. 7, Feb. 15, 1913, S. 196.
MITCHELL, A. P. Treatment of syphilis by salvarsan. Edin. Med . Joum..
Vol. x., No. 2, Feb. 1913, p. 137.
KILROY, L. The treatment of syphilis with salvarsan : first 1,000 oases treated
at the Roval Naval Hospital at Plymouth. Lancet , No. 4666, Feb. 1, 1913,
p. 302.
MOREL, MOURIQITAND, and POLICARD. Recherches but les agents chimio-
therapiques. Action du “606” a doses therapeutiques sur le foie et le rein et
les prmcipaux organos. Journ. dc Physiol, et dc Path, gen., T. xv., No. 1,
.Tan. 15, 1913, p. 141.
MTLLKR. Dauererfolge der Salvarsanabortivkuren der Jahre 1910-1911.
Munch. Mid. Wckn 9 e.hr ., J. lx., No. 8, Feb. 25, 1913, S. 408.
STUMPKE, G. Kombinierte (Salvarsan- Quecksilber) Behandlung der Lues.
Dent. Med. \Vchnsrhr. % J. xxxix.. Nr. 9, Feb. 27, 1913, S. 407.
LANG, J. Zur Salvarsanfrage in der Otiatrie. Dent. Med. Wchnschr ., J. xxxix..
Nr. 9, Feb. 27, 1913, S. 409.
HEINDL, A. Uher die Syphilis des Stirnbeines und der Stirnbohlen. MonaUsch.
/. Ohrcnhcilk , u. Laryrujo-Rhmol ., S. xlvii., H. 2, 1913, S. 197.
ULLMANN, K. Zur Frage der Parasitotropie und Toxizitat des Salvarsan*
(NeowalvarHans). Wien. Kim. Wchnschr ., J. xxvi., Nr. 6 und 6, Jan. 30 und
Feb. 6, 1913, S. 161 und 216.
JEANSELME. Du traitement par le Salvarsan des femmes syphilitiques en etat
de gestation. Annul, dc Hyrncol. et d'Obstet ., Ann. xl., Jan. 1913, p. 27.
SAUVAGE. De l’emploi du salvarsan chez les femmes enceintes syphilitiques.
Annal. de (iynerol, ct d'Obstet., Ann. xl., Jan. 1913, p. 49.
Jfeoaalvanuin.—GENNERICH, W. Sammelreferat der Arbeiten fiber Salvarsan
und Neosalvarsan, die in der Zeit vom 1 Juli bis 1 November 1912 erschiencn
sind. Ztschr. /. V hr mot her J. II., H. 1, Teil. II., Ref. 1913, S. 13.
ELLIS, W. M. Review of American Literature on Salvarsan, appearing October
1911 to October 1912. Ztsrhr. /. Chcmnther., J. II., H. 1, Teil. II., Ref. 1913,
S. 40.
MTNTOSH, JAMES. Salvarsan Therapy in England. Ztschr. f. Chemothrr .,
J. II., H. 1, Teil. II., Ref. 1913, S. 62.
JANET and LEVY-BING. Traitement de la blennorragic et de ses complications
par le neosalvarsan. Uaz. des Hop., No. 21, Fev. 20, 1913, p. 326.
WAHLE. Zwei Falle von Neosalvarsanvcrgiftiing. Munch . Med. Wchnschr.,
J. lx., No. 7, Feb. 18, 1913, S. 351.
KSCANDE, F. Etat meningo-encephalique au cours d'une syphilis secondaire
traitee par le neosalvarsan. Oaz. des Hop., No. 12, Jan. 31, 1913, p. 184.
GRAY, A. M. H. Seventh and eighth nerve paralysis after neo-salvarsan injec¬
tion. Proc , Roy. Sue. Med., Vol. vi., No. 3, Jan. 1913(Dermatol. Sect.), p. 79.
WuMmann Reaction.—STRATHY, G. S. The results of treatment of syphilis
as shown by the Wassermann reaction. Canad. Med. Assoc. Joum., Vol. iii.,
No. 1, Jan. 1913, p. 32.
MILNE, LINDSAY 8. The present value of the Wassermann reaction. Amcr.
Joum. Med. Sci., Vol. cxlv., No. 2, Feb. 1913, p. 197.
BIBLIOGKAPHY 27*
WOLBARST, ABR. L. Contradictory findings in the Wassermann test. N. Y.
Med. Joum ., VoL xoviL, No. 8, Feb. 22, 1913, p. 378.
THIELE, F. EL, and EMBLETON, D. Some observations on the Waasermann’s
Reaction. Zischr. f. Immunitatsf. u. exp. Therapic., Teil I. (Orig.), Bd. xvi.,
H. 4, Feb. 1913, S. 430.
CRAIG, G. F. The interpretation of the results of the Wassermann Test.
Joum. Amer. Med. Assoc., Vol. lx., No. 8, Feb. 22,1913, p. 565.
RUHL, KARL. Uber die diagnostisohe Wertlosigkeit der negativen Wassermann
Reaktion. Derm. Wchnschr., Bd. Ivi., Nr. 6, Feb. 8, 1913, S. 159.
STERN, CARL. Uber “ eigenlosende ” Eigenschaften des Meersohweinschen-
seroms and daduroh bedingte Fehlerquellen der Wa. R. Deut. Med. Wchnschr.,
J. xxxix., Nr. 9, Feb. 27,1913, S. 405.
Cerebro-Spinal Flald.—BISGAARD, A. Die Eiweissuntersuchung der Oerebro-
spinalflussigkeit, duroh 234 Falle beleuchtet. Neurol. Centralbl., Bd. xiv., H.
3* Feb. 11,1913, S. 329.
HEKTOEN, L. On the ooourrenoe of an isolated antibody in the cerebrospinal
fluid. Joum. Infect. Dis ., Vol. xii., No. 1, Jan. 1913, p. 1.
VORKASTNER and NEUE. Uber den Naohweis von Alkohol in der Spinal-
fiiissigkeit von S&ufern. Ztschr. f. d. ges. Neurol, u. Psychiat. (Orig.), Bd.
xiv., H. 3, Feb. 11,1913, S. 324.
ailVEKlL AMD FUNCTIONAL DIB EASES—
Epilepsy. —ALEXANDER, W. Necessity of a better classification of epileptics.
Lancet, Jan. 25, 1913, p. 263.
FLOOD, E., and COLLINS, M. A study of heredity in epilepsy. Amer. Joum.
Insanity , VoL lxix., No. 3, Jan. 1913. p. 585.
METER, MAX. Zur Frage therapeutischer Massnahmen bei genuiner Epilepsie.
Neurol. Centralbl ., J. xxxii., Nr. 3 and 4, Feb. 1 and 15, 1913, S. 152 and 227. .
BOLTON, G. C. Pathogenese und Therapie der Epilepsie. Monatsschr. f.
Psychiat. u. Neurol ., Bd. xxxiii., H. 2, Feb. 1913, S. 119.
MARCHAND, L. Du r61e de l’alcoolisme dans la pathog4nie de Tdpilepsie.
Rev. de Psychiat ., T. xvii., No. 1, Jan. 1913, p. 1.
WYSS, H. v. Die pharmakologischen Grundlagen der Bromtherapie bei der
genuinen Epilepsie. Deut. Med . Wchnschr., J. xxxix., Nr. 8, Feb. 20, 1913,
S. 345.
JONES, C. A note on remission in a case of epilepsy. Lancet , Feb. 8, 1913,
p. 384.
Cfcerea.—HARTEL. Salvarsan bei Chorea gravidarum. Munch. Med. Wchnschr .,
J. lx., No. 4, Jan. 28,1913, S. 184.
Pellagra*—Report of the Pellagra Commission of the State of Illinois, Nov. 1911.
Illinois State Journal Co., 1912.
JENNINGS, A. H. One of the possible factors in the causation of pellagra.
Joum. Amer. Med. Assoc., Vol. lx., No. 4, Jan. 25, 1913, p. 271.
Mearasthenla. — DEJ^RINE and GAUCKLER. Comprehension de la neuras¬
thenic. Presse Mid., No. 17, Fdv. 26, 1913, p. 157.
LEVY, PAUL-EMILE. Les principes du traitement r&kluoateur dans la
neurasth6nie et les nevroses. Joum. de Neurol ., Ann. 17, No. 24, Deo. 20,
1912, p. 461.
Psyehastheala.—WILLIAMS, TOM A. Multiple professional cramps in a
psychasthenic. N. Y. Med. Joum., Vol. xoviL, No. 7, Feb. 15, 1913, p. 333.
Mearases.—VERGER, H. Les conceptions nouvelles des nevroses traumatiques et
leur retentissement medico legal. Arch. d'Anthropol. Crim., Ann. 28, Jan. 15,
1913, p. 15.
GARRBTSON, W. V. P. Functional nervous conditions. N. Y. Med. Joum.,
VoL xovii., No. 8, Feb. 22, 1913, p. 388.
e
28*
BIBLIOGRAPHY
Alcoholism, Ac.—COOPER, J. W. ASTLEY. The combined treatment of
aloohol inebriety. Practitioner, Vol. xc., No. 2, Feb. 1913, p. 493.
Keeralfla,—RETHI. Die elektrolytische Behandlung der Trigemin usneuralgien.
Munch. Med. Wchnschr., J. lx., No. 6, Feb. 11, 1913, S. 296.
Nmitfls. —DUHOT, PIERRET, and VERHAEGHE. Ndvrites pdripheriques par
ischemie. L'Encephale , Ann. viii., No. 2, Fthr. 10, 1913, p. 137.
DEJERINK. N^vrite post-grippale. Tic d’origine Emotive. Joum. des Prat.,
Ann. xxvii., No. 3, Jan. 18, 1913, p. 39.
SIMPSON, E. S. A case of methsemoglobinuria followed by multiple neuritis.
Joum. MetU. Set., Vol. lix., No. 244, Jan. 1913, p. 81.
SMITH, F., and HASTINGS, A. E. F. Multiple neuritia among soldiers in
Calcutta and vicinity—an endemic, epidemic, seasonal disease resembling beri-
beri. Joum. Roy. Army Med. Corps, Vol. xx., No. 2, Feb. 1913, p. 208.
ABADIE, PKTGKS, and DESQUEYROUX. Polyndvrite sensitive-motrice avec
troubles psychiqucs k la suite d’une injection intra-veineuse de salvaraan.
Annul. dr Dermatol, u. Syphil. % T. iv., No. 1, Jan. 1913, p. 17.
FLEMING, R. A. Acute Toxic Polyneuritis. Ed in. Med. Joum., VoL x., No.
3, March 1913, p. 289.
Bay sand's Bf sense.— SEMON, H. C. Raynaud’s disease. Proc. Boy. 8oc. Med.,
Vol. vi., No. 3, Jan. 1913 (Dermatol. Sect.), p. 82.
Addison’s Disease.— LANGMEAD, F. On a case of Addison's disease in a boy
aged ten years. Lancet, Feb. 15, 1913, p. 449.
Tetanas.— BOGEPvT. The scrum treatment of tetanus after symptoms have
developed. Joum. Amcr. Med. Assoc., Vol. lx., No. 5, Feb. 1, 1913, p. 363.
KOCHER, THEODOR. Weitere Beobachtungen iiber die Heilung des Tetanus
mit MagneHiuiriHulfat. Corrtspondenz - Rl. /. Schwtizer Atrzit, xliiL, No. 4,
Jan. 25, 1913, S. 97.
ARND, C. Die Magnesiumbehandlung des Tetanus. Correspondenz-Bl. f.
Schwcizcr Aerzte , xliii., No. 4, Jan. 25, 1913, S. 105.
Exophthalmic Goitre, Cretinism, Ac.—KINGSBURY, W. N. The treatment
of exophthalmic goitre. Proc. Roy . Soc. Med., Vol. vi., No. 8, Jan. 1913
(Electro-ther. Sect.), p. 41.
BRUCE, H. A. Surgical treatment of exophthalmio goitre. Canad. Med.
Assoc. Joum., Vol. iii., No. 1., Jan. 1913, p. 1.
CRILE, G. W. Present day conceptions on the pathologic physiology of Graves’
Disease from the Surgeon’s Viewpoint. Cleveland Med. Joum., VoL xil.,
Jan. 1913, p. 15.
MARINE, D. Some remarks on the thyroid gland in its relation to Basedow’s
Syndrome. Cleveland Med. Joum., Vol. xil., Jan. 1913, p. 21.
DEROVE, A. Goitre exophthalmique et asystolic. Joum. des Prat Ann.
xxvii., No. 5, F«$v. 1, 1913, p. 65.
DUTOIT, A. Die Beziehungen des Morbus Basedowii xur Thymuahyperplasia
(Sammelreferat). Dent. Med. Wchnschr., J. xxxix., Nr. 6, Feb. 6, 191a, S. 272.
McKISACK, H. L. Remarks on atypical exophthalmic goitre. Brit. Med .
Joum., Feb. 1, 1913, p. 208.
PERN, S. The treatment of nineteen cases of goitre with thyrotoxio symptoms.
Australian Med. Joum., Vol. ii., No. 78, Jan. 11,1913, p. 856.
MARTINI, E. Sur les alterations du corps thyroide dans diffdrents 4tats
exp6rimentaux et cliniques (4 fig.). Rev . de Chir Ann. xxxiii., No. 2, F4v. 16,
1913, p. 171.
OSKAR, MEYER. Thyreoiditis chronica maligna. (Eigenarti^es aus eosino*
philen und Plasmazellen zusammengesetztes, vom rechten Schilddrtisenlappen
ausgehendes Granulom). Frankfurter Ztschr . /. Path., Bd. xiL, H. 1, 1913,
S. 116.
MORI, T. Uber das Auftreten thyreotoxisoher Symptoms bei Qesohwulst-
metastasen in der Schilddrtise. Frankfurter Ztschr . /. Path., Bd, xii., H. 1,
1913,8.2.
BIBLIOGRAPHY
29*
DUTOIT, A. Die Schilddriisentuberkulose (Sammelreferat). Deut. Med.
Wchnschr., J. 39, Nr. 6, Jan. 30, 1913, 8. 327.
SAATHOFF. Thyreoee und Tuber kuloee. Munch. Med. Wchnschr ., J. lx.,
No. 5, Feb. 6, 1913, 8. 230.
MARINE, DAVID. Benign epithelial tumors of the thyroid gland. Joum.
Med. Research, Vol. xxvii., No. 3, Jan. 1913, p. 229.
METER, ADOLF. The nature of metastatio tumours of the thyroid. Amer.
Joum. Insanity , Vol. Ixix., No. 3, Jan. 1913, p. 543.
RUSSELL and KENNEDY. “Teratoma of the thyroid in a foetus.” Joum.
Obstet . and Oynascol. , Vol. xxiii., No. 2, Feb. 1913, p. 109.
McCARRISON, R. The Milroy Lectures on the Etiology of Endemio Goitre.
(Lect. II., III., and IV.. Illust.) Lancet , Jan. 18, 25, *eb. 8, 1913, pp. 147,
219 and 365.
SPECIAL SENSES AND CRANIAL NERVES—
AUGSTEIN, C. Ein bemerkenswerter Fall von akuter doppelseitiger retro-
bulb&rer Neuritis mit Erblindung beiderseits und Ausgang in Heilung, links
nach 33 tagiger Amaurosis. Klin. Monatshl. f. Augenhexlk ., J. li., Feb. 1913,
8. 181.
WERTHEIM, ED. Ueber die Beziehungen der Neuritis optiea retrobulbaris zu
den Nebenhohlenerkrankungen der Naae. Archiv f. Laryngol. u. RhinoL,
Bd. xxvii., H. 1, 1913, S. 162.
SZILY, A. ▼. Von dem blinden Fleck ausgehendes Ringskotom (sog. Bjerrum-
sches Zeichen) bei cerebraler Stauungspapille. Klin. Monats . /. Augenheilk.,
J. li., Feb. 1913, S. 196.
JESS, A. Hemianopic pupillary paralysis and the hemiopio prism phenomenon.
Archives of Ophthal ., VoL xliL, No. 1, Jan. 1913, p. 51.
BATTLER, R. Short clinical accounts with mioroeoope demonstrations of two
cases of tumour of the optio nerve. Archives of Ophthal VoL xlii., No. 1,
Jan. 1913, p. 25.
HIRSCH, 0. Sympnthischer Nystagmus bei Erysipel. Deut. Med. Wchnschr.,
J. xxxix., Nr. 7, Feb. 13, 1913, sT315.
HARBRIDGE, D. F. Concomitant convergent squint. N. Y. Med. Joum.,
Vol. xcvii., No. 4, Jan. 25,1913, p. 187.
UDVARHELYI, KARL. Veetibulare Nerven-Verbindungen. Ztschr. f. Ohren-
heilk ., Bd. Ixvii., H. 1 und 2, Jan. 1913, 8. 136.
MISCELLANEOUS SYMPTOMS AND CASES—
WILDENBKRG. Deux interventions sur les sinus frontaux et le lobe frontal.
Monatssch.f. Ohrenheilk. u. Laryngo-RhinoL, J. xlviL, H. 2, 1913, 8. 361.
BYCHOWSKI, Z. Benediktsches Syndrom nach einem Trauma. Ztschr. f. d.
ges. Neurol, u. Psychiat. (Orig.), Bd. xiv., H. 3, Feb. 11, 1913, 8. 353.
DAVID, I. La diphtdrie paralysante. Archives de Mid. des Znf., T. xvL, No.
2, F4v. 1913, p. 116.
BRAMWELL, BYROM. On malingering (Discussion). JMin. Med. Joum.,
Vol. x., No. 2, Feb. 1913, p. 102.
S&ZARY, A. Les syndromes surrdno-muaculaires. Sent. Mid ., Ann. 33, No. 6,
Fdv. 5, 1913, p. 61.
LAFFORGUE. La notion d’insuffisanoe surrinale; quelquos applications
diniques. Prog. Mid., Ann. xli., No. 6, F6v. 8,1913, p. 69.
AUSTREGESILO, PINHEIRO, and MARQUES. 8ur nn oas de syndrome pluri-
glandulaire endoerinique. L'Enciphale , Ann. vML, No. 2, F4v. 10,1913, p. 150.
8AVINI, B. Le type constitutionuel sympathique ou vaeotnoteur. Prog. Mid.,
Ann. 41, No. 7, F4v. 15, 1913, p. 82.
FROMBNT. J., and MONOD, O. Existe-t-il k prominent parlor des images
motrices a’articulation ? Rev. NeuroL, Ann. xxi., No. 4, F4v. 28,1913, p. 197.
30*
BIBLIOGRAPHY
ROSSI, E. Nature della anormalitt della oondotta e possibili messi di cure e
di eduoaxione. Riv. ital. di NeuropatoL Psiekiatr . ed KleUroter., VoL vi., F.
2, Feb. 1913, p. 58.
STEFANELLI, A. La piastre motrioe seoondo le veochie a le nuove volute ©on
oeaervazioni originali. Annali di Nevrol ., Anno xxx., F. i? M 1913, p. 161.
THOMAS, J. J. Retardation and constitutional inferiority in connection with
education and crime. Journ . New. and Ment. Di*., Vol. xL, No. 1, Jan. 1913,
p. 1.
DWYER, P. J. Morphino-mania with suggested visual hallucinations. Journ.
Ment . Sci., Vol. lix., No. 244, Jan. 1913, p. 87.
PEARSON, C. B. A plea for greater consideration for the opium addict. Med.
Record , Vol. 83, No. 8, Feb. 22, 1913, p. 342.
SEQUEIRA, J. H. Congenital absence of both thumbs. Lancet, Feb. 8,1913,
p. 385.
WILLIAMS, TOM A. Nervousness in ohildren—how to prevent it. Arehve*
of Pediatrics, VoL xxx., No. 1, Jan. 1913, p. 13.
NEU, C. F. Nervousness in children—its cause and prevention. Pediatrics,
Vol. xxv., No. 1, Jan. 1913, p. 35.
DERCUM, F. X. The nervous phenomena of prostatio disease and their relation
to treatment. Thcrap. Gaz. % Feb. 15, 1913, p. 77.
MEES, R. Kleinhirnexstirpation bei einen Fall von angeborener Hydrencepha
locele occipitalis. Beitrdgc z. Geburtshilfe u. Gyneekol ., Bd. xviii, H. 1,1913,
S. 1.
PSYCHIATRY.
GSERIAL PARALYSIS—
NOGUCHI, HIDEYO, and MOORE, J. W. A demonstration of Treponema
pallidum in the brain in cases of general paralysis. Journ. Bxper. Med., Vol.
xvii., No. 2, Feb. 1, 1913, p. 232.
NOGUCHI, HIDEYO. DtScouverte du trepon&m© pile dans les cerveaux de
paralytiques g^n^raux. Compt. Rend. d. 1. Soc. de Biol., T. lxxiv., No. 7, Feb.
21, 1913, p. m
GORDON, A. Early paresis. Importance of its recognition; differential
diagnosis; medico-legal considerations. Journ. Amer. Med. Assoc ., VoL lx..
No. 5, Feb. 1, 1913, p. 352.
TROWBRIDGE, E. H. Salvarsan in General Paresis. Journ. Amer. Med.
Assoc., Vol. lx., No. 6, Feb. 8, 1913, p. 429.
CHILD, H. T. Ocular Symptoms in General Paralysis of the Insane. Amer.
Journ. Insanity , Vol. Ixix., No. 3, Jan. 1913, p. 625.
JOLOWICZ, ERNST. Uber Behandlungsversuche mit Natrium nuoleiuicum
und Salvarsan bei progressiver Paralyse, unter besonderer Beriicksichtigung dec
Veranderungen dea Liquor cerebrospinalis. Neurol. Centralbl., J. xxxiL, Nr.
4, 1913, S. 210.
BAIRD, H. Urethritis in general paralysis, with remarks on the exhibition of
hexamethylene-tetramine. Journ. Ment. Sci., Vol. lix., No. 244, Jan. 1913*
p. 75.
PHILLIPS, J. G. PORTER. Maniacal-depressive insanity (resembling general
paralysis). Proc . Roy. Soc. Med., Vol. vi., No. 3, Jan. 1913 (Sect, of
Psychiat), p. 18.
Dementia Prsecox.—STRANSKY, E. Ueber Schizophrenia (Dementia Pnsoox).
Med. Klinik., J. ix., Nr. 7 and 8, Feb. 16 and 23,1913, 8. 241 and 283.
OBREGIA, PARHON, and URECHIA. Recherehes sur les glandes g^nitalas,
testicules et ovaires dans la demence prtScoce. L'Enc&pKalc , Ann. viiL,
No. 2, F6v. 10, 1913, p. 109.
STODDART, W. H. B. Presenile katatonia (? dementia preoox). Proc. Roy.
Soc. Med., Vol. vi., No. 3, Jan. 1913 (Sect, of Psychiat.), p. 16.
STODDART, W. H. B. (Edema of the thighs in a katatoniac. Proc . Roy. Soc.
Med., Vol. vi., No. 3, Jan. 1913 (Sect, of Psychiat.), p. 15.
BIBLIOGRAPHY
31 *
CeaeraL— STODDART, W. H. B. Presbysphrenia (Alzheimer’s disease). Proa.
Bay. Soc. Med., Vol. vi., No. 3, Jan. 1913 (Sect, of Psychiat.), p. 13.
BESSI^RE, RENE. La maladie d’Alzheimer. Rev. de Psychiat., T. xvii.,
No. 1, Jan. 1913, p. 15.
PHILLIPS, J. O. PORTER. Senile dementia with apraxia. Proe. Bay. Sac.
Med., VoL vL, No. 3, Jan. 1913 (Sect, of Psychiat.), p. 18.
M‘GAFFIN, C. G. A study of the forms of mental disease in oases showing no
gross lesions in the brain at autopsy. Amer. Joum. Insanity , Vol. lxix., No. 3 r
Jan. 1913, p. 605.
REID, EVA G. Literary genius and manic-depressive insanity. With special
reference to the alleged oase of Dean Swift. Med. Record, Vol. 83, No. 6,
Feb. 8, 1913, p. 245.
LEROY, A. and GENIL-PERRIN, G. Ironie et imitation chez un oatatonique.
Annal. M6L-Psychol., Ann. lxxL, No. 1, Jan. 1913, p. 5.
BALLET, G. Un eas de confusion men tale, hallucination prolong©©. Joum.
des Prat., Ann. xxvii., No. 6, F6v. 8, 1913, p. 81.
CLARKE, G. The form of mental disorder occurring in connection with child¬
bearing. Joum. Ment. Sci., VoL lix., No. 244, Jan. 1913. p. 67.
BROWN, RALPH. Acute confusion in a child, aged 12. Proc. Boy. Soc. Med.,
Vol. vi., No. 3, Jan. 1913 (Sect, of Psyohiat.), p. 19.
KARPAS, M. J. Analysis of psychosexual anaesthesia in a oase of psychopathic
personality. Amer. Joum. Insanity , Vol. lxix., No. 3, Jan. 1913, p. 559.
MASSELON, RENE. Psychoses constitutionnelles et psyohoBes associfos.
Les associations de la psychose m&niaque-depressive et de la paranoia. L'Enet-
phale, Ann. viiL, No. 2, F4v. 10, 1913, p. 118.
CARLISLE, C. L. The relation of certain psychoses to the neuroses. Amer.
Joum. Insanity, VoL lxix., No. 3, Jan. 1913, p. 497.
KALMUS, E. Zur Prophylaxe der Psyohosen. Prog. Med. Wchnschr., J.
xxxviii., Nr. 7, Feb. 13,1913, S. 83.
WITTE, MAX E. Some psychological observations in the insane. Amer. Joum .
Insanity, Vol. lxix., No. 3, Jan. 1913, p. 511.
HAVILAND, C. F. Occupation for the insane. Amer. Joum. Insanity, Vol.
lxix., No. 3, Jan. 1913, p. 483.
CASTELLI, E. Public protection acainst mental defectives in Paris—the working
of the special infirmary connected with the police department. Med. Record ,
Vol. 83, No. 7, Feb. 15, 1913, p. 287.
WILSON, J. G. The diagnosis of feeble-mindedness among immigrants. Boston
Med. and Surg. Joum., Vol. clxviiL, No. 7, Feb. 13, 1913, p. 226.
NEFF, M. L. Mental symptoms associated with renal insufficiency. Boston Med .
and Surg. Joum., Vol. clxviii., No. 8, Feb. 20, 1913, p. 272.
CLOUSTON, Sir THOMAS. “ The argument for the large state insane hospital. *’
Boston Med. and Surg. Joum., VoL clxviiL, No. 9, Feb 27, 1913, p. 297.
CLARK, L. PIERCE, and STOWELL, W. L. A study of mortality in four
thousand feebleminded and idiots. N. Y. Med. Joum., Vol. xcviL, No. 8, Feb.
22, 1913, p. 376.
SCRIPTURE, E. W. The care of speech defectives. Med. Record, Vol. 83, No. 8,
Feb. 22, 1913, p. 339.
DEWEY, R. The jury law for commitment of the insane in Illinois (1867-1893),
and Mrs E. P. W. Packard, its author, also later developments in lunaoy legis¬
lation in Illinois. Amer. Joum. Insanity, Vol. lxix., No. 3, Jan. 1913, p. 571.
COUPLAND, SIDNEY. Remarks on death certification and registration.
Joum. Ment. Sci., Vol. lix., No. 244, Jan. 1913, p. 27.
AUBREY, C. K. Medical certificates of lunacy. Practitioner, Vol. xc., No. 3,
March 1913, p. 628.
WTLUGE, H, Bericht fiber die xviii. Versammlung mitteldeutscher Psychiater
und Neurologen in Halle a. S. am 26 Oktober 1912. Monatsschr. f. Psychiat.
u. Neurol ., Bd. xxxiii., H. 2, Feb. 1913, S. 179.
32*
BIBLIOGRAPHY
KUTZIN8KL A. Ueber die Beeinflussung det Votttellungmblasfe* durek
(ieacluchtskomplexe bei Ueiateskranken. Monatsschr. /. Pryehusi, % Neurol.,
lid. xxiiii., H. 2, Feb. 1913, S. 159.
HURI), II. M. Three-quarters of a century of institutional flaw of the man* in
the United States. Amcr. Journ. Insantty, VoL lxix., No. 3, Jilt 1913,
p. 469.
MUIKHHAD, WINIFRED. The care of the defective in America. Jwra.
ACrnf. Set., Vol. lix., No. 244, Jan. 1913, p. 53.
DOHERTY, C. E. Treatment of the Insane in British Columbia. Aw
Journ. Insanity, Vol. lxix., No. 3, Jan. 1913, p. G09.
HUMMER, H. R. Insanity among the Indiana. Anar. Journ, Imnti
Vol. lxix., No. 3, Jan. 1913, p. 615.
FASTURKL and CARR AS. L’idfolisme passionnd chez StendhaL Ret. it
Psychtat., T. xvii., No. 1, Jan. 1913, p. 21.
MIONOT and JUijDKLIKR. A propoa dee internementa ditc abuaifci Rer,
dt Psyrhmt., T. xvii., No. 1, Jan. 1913, p. 24.
VINCHON. A propo* de la Tanatophilie dea Hababourg. Re r. dt Pty&uL,
T. xvii , No. 1, Jan. 1913, p. 27.
l.ORDK and BINET. I* psychiatric au theatre: leg “Invisible!.” Ret. it
J’suchiat., T. xvii., No. 1, Jan- 1913, p. 29.
TREATMENT.*
aRFRCROMBIE, R. The treatment of muscular pareeia by means of eccentric mo«*
ments. Bnil Med. Journ.. Feb. 8, 1913, p. 277.
nTCTFRMANN, H. Zur Hydrotheraphie dcr nervbsen Soblafloeigkeii MUckr. /.
Phynkal. u . Dial. Tkcrap Bd. xvii., H. 2, Feb. 1, 1913, 8 . 85.
in ilCK Contribution k l’utude de Faction du nucldinate de sonde on mddectne amide.
Journ . de Xcurol., Ann. 18, No. 1, Jan. 5, 1913, p. 1.
KRAFT F de. High frequency currants in medicine. AT. F. Med . Journ,, Vol mil,
^No. 6, Feb. 8, 1913, p. 285.
SCHURIGh Zur tberapeutischen Verwendung der Hoohfrequenatr&me. DeuL MA
Wchnsckr ., J. xxxix., Nr. 6, Feb. 6, 1913, S. 271.
x»nvT> WM Leuoocytoeis produced by the injection of normal saline aolitioa. Journ.
Mint.sk, Vol. lix., No. 244, Jan. 1913, p. 86.
xr vac AN H. C. The legitimate use of psychic influences in the treatment of the nek.
Journ. I inanity, VoL lxix., So. 3, Jan. 1913, p. 521,
HAMBURGER, F. Ueber peychb^e Beh*ndlw»g m Kindewlter. Witn. JR*
Wtkntehr. nrL, J., Nr. 8, Feb. 80,1918, 8. 981,
• A number ef reterenoee to pepen oa Treatment we lnaMed i# th, BlbBofraptj tffldu
intfTtdnel dieewee.
JSibltograpb?
ANATOMY.
STERZI, G. Intorno alle meningi midollari ed al legamento denticblafco degli ofidi.
Anal. Anzeig ., Bd. xliii., No. 8/9, Feb. 28,1913, S. 220.
JOSEPH, BARNET. A new technique in the fixation and staining of nerve tissue.
Anal. Rec., Vol. vii., No. 2, Feb. 20, 1913, p. 63.
STAUFFER, PIERRE. Un cas de defect partiel congenital de la colonne vertebral© ©t
de la moelle bpinifere, avec fente thoraoo-abdommo-pelvienne. Rev. mid. d. 1.
Suisse Rom ., Ann. xxxiii., No. 2, F^v. 20, 1913, p. 97.
POLVANI, F. Studio anatomioo della glandola pineale umana. Rassegna di Studi
Psichiat, Vol. iii., F. 1, Gennaio-Febbraio 1913, p. 3.
DELMAS and VALLOIS. Un oas d’hdmimrflie longitudinals externe du membre
superieur. Bibliogr. Anal., T. xxiii., F. 1, 1913, p. 22.
SPUTTSTOSSER, PAUL. Zur Morphologie des Nervensy stems von Anodontaoellensis
Schrot. (19 Fig.) Ztschr. f. Wissensckaft. Zool., Bd. civ., H. 3, 1913, 8. 388.
KRBIBICH, K. Farbung der Marklosen Hautnerven beirn Menschen. Bcrl. Klin.
Wchnschr ., J. 60, Nr. 12, Marx 24, 1913, S. 646.
WENIG, J. Untersuchungen fiber die Entwicklung der Gehororgane der Anamnia.
Gegenbaurs Morph. Jahrb., Bd. xlv., H. 2,1913, S. 296.
WOOD-JONES, F. Some anatomical considerations of the disposition of the sciatic
nerve and femoral artery: with suggestions as to their clinioal significance. Lancet,
March 16, 1913, p. 752.
GLAESMEB, E. Zur Phylogenie des Flexor digitorum brevis pedis. Gegenbaurs
Morph. Jahrb., Bd. xlv., H. 2, 1913, S. 199.
BALDWIN, W. M. The Relation of Musole Fibrillae to Tendon Fibrillae in voluntary
striped Muscles of Vertebrates. Gegenbaurs Morph. Jahrb ., Bd. xlv., H. 2, 1913,
S. 249.
SOHUCK, C. Beitr&ge xur Myologie der Primaten.—I. Der M. latissimus dorsi und der
M. latissimo-trioipitalis. Gegenbaurs Morph. Jahrb., Bd. xlv., H. 2, 1913, S. 267.
PHYSIOLOGY.
BRUCKE and SATAKE. Beitrage zur Physiologic der autonom innerviertem
Muskulatur.—VI. Uber die Aktionsstrome des Kaninchenosophagus w&hrend des
Ablaufes einer Schluckwelle. PflugtrArchiv , Bd. cl., H. 3, 4 und 6, 1913, S. 208.
BRUNACCI, B., and CORRADO, T. Su la conoentnudone molecolare di aloune parti
del nevrasse (cervello-cervelletto-midollo spinale). Archivio di Fisiol ., Vol. xL,
F. 1, Nov. 1,1912, p. 67.
NOVI, L Le calcium et le magnesium du oerveau dans les diffbrents iges. Arch. ital.
de Biol., T. lviii., F. iii., 1912, p. 333.
RENNER. Uber die Innervation dor Niere. Devi. Archiv /. Klin. Med., Bd. cx.,
H. 1 und 2, 1913, S. 101.
BOOCI, B. Die mit der komplexen Morphologie des Corti’schen Organs am moisten im
Einklang stehende Theone des Gehors. PJiiigtrArchiv, Bd. oL, H. 3, 4 und 5,
1913, S. 111.
DANEO, L., and FERRARI, MANLIO. Di alcune ricerohe emo-citologiohe e fisio-
ehimiohe in scorbutici alienati. Rassegna di Studi Psichiat., Vol. iiL, F. 1,
Gennaio-Febbraio 1913, p. 6.
f
34*
BIBLIOGRAPHY
M'GUIGAN and MOSTROM. Epinephrine. Jour*. Pkarhiacol. and Exp. Tkemp.,
VoL ir., No. 4, March 1913, p. 277.
GUNN, J. A., and CHAVASSE, F. B. The action of adrenin on reins. Proe . Boy.
Soc., Bor. B., VoL 86, No. B586, March 6, 1913, p. 192.
CANNON, W. B. f and LYMAN, H. The depressor effect of adrenalin on arterial
pressure. Amer. Jour* . Physiol ., VoL un., No. rL, March 1913, p. 376.
CLAUDE, BAUDOUIN, and PORAX. La glyoosurie hjpophrsaire ches rhomme et
l’animal tuberculeux. Compt. Bend. <L L Soc . A 2ta£, T. Ixxir., No. 10, Mars 14,
1913, p. 529.
ACHARD and DESBOUIS. L’insuffisanoe glyoolytiqu* proeoqude par 1’extmit
d'hypophyse et par Tadrenaline. Compt. Bend. d. L Soc. a. Biol., T. Ixxir., No. 9,
Man 7, 1913, p. 467.
WILENKO. Uber die Ursache des Adrenalindiabetes. Arch. /. exp. Path. u. Pkarmakol
BA 71, H. 4, Feb. 27, 1913, 8. 263.
COSTA, C. DA Recherche* sur lliisto-phriiologie dee glandes surr^nales. Archives de
Biol. , T. xxriii, F. 1,1913, p. 11L
PSYCHOLOGY.
HOFMANN, H. Untenuchungen fiber den Bmpfindungsbegriff. Arehiv /. d. get.
Psychol. , BA xxri, H. 1 und 2,1913, 8. 1.
KEHR, T. Bergson und das Problem eon Zeit und Daner. Arehiv f. A get. Psychol.,
Bd. xxri., H. 1 und 2, 1913, 8. 137.
MOEDE, W. Die psychische KausaliUt und ihre Gegner. Arehiv f. A ges. Psychol
Bd. xxri., H. 1 und 2, 1913, 8. 156.
HOMUTH, PAUL. Beitrage zur Kenntnis der NaohbQdenoheinungen. —I. TeO: Lfcnger-
danernde Raise: “Da* abklingen der Farben,” Versuohe, Ossehichte und Tboocie.
Arehiv f. d . get. Psychol ., BA xxri, H. 1 und 2, 1913* 8- 13L
PATHOLOGY.
AUDENTNO, E. Degenerazione marjpnale di fibre nerroee in fate ini riale nel midollo
dimostrata col metodo di Donaggio per le degenerasUmL Biv. di PatoL nerv. t
merit., Vol. xriii., F. 1, Feb. 5, 1913, p. 1.
BERIEL, L. Sur les modifications histologiques de Tdooroe o4r4be!leuee dans eertaines
lesions aoquises. La oouche dite “ oouene exteme des grains." Lyon Mid., Ann.
xle., No. 13, Man 30, 1913, p. 711.
GREY, E. C. The fatty acids of the human brain. Biochem. Jour*., VoL eiL, No. 2,
March 1913, p. 148.
SOULA Des rapports entre l’anaphylaxie et l’autoprotdolyse des centres nerreux.
Compt. Bend. d. 1. Soc . d. Bid., T. Ixxir., No. 11, Man 21,1913* p. 592.
CLINICAL NEUROLOGY.
GENERAL—
BEYER, W, Zur Frage der Wirksamkeit des Diphtherie-seruxns bei Beteiligung
des Nereensystems, etc. Entgegnung auf die Bemerkungen eon H. Ekhndunidt
in Heft. 1. Jahrb. /. KindcrheilL, BA 77, H. 3, M*rz 1913, 8. 356.
CASAMAJOR, L. An unusual form of mineral poisoning affecting the nervous
system; manganese? Jour*. Amer. Med. Assoc., YoL lx.. No. 9, March 1,
1913, p. 646.
MUNZBR, A Inner* Sekretion und Nervensyatem. BerL JUin. Wehnsohr., J. 50,
Nr. 9, Man 3, 1913, S. 396.
NERVES—
COLLBDGE, L. Two cases of laryngeal palsy due to nuclear lesions of the Tagus.
Proc . Boy. Soc. Med., VoL ri, iSo. 4, Feb. 1913 (LaryngoL Sect.), p. 65.
GARRELON, LANGLOI8, and POY. Pneumogastriques et TinljTindss Compt.
Bend. d. 1. Soc. d. Biol., T. Ixxir., No. 10, Man 14, 1913, {i 647.
BIBLIOGRAPHY
35*
MMOUft—
JOHNSTON, O. Paralysis of right lower and middle trapezius. Proc. Roy. Soe.
Med., VoL vi., No. 4, Feb. 1913 (Neurol. Sect.), p. 85.
BUZZARD, E. FARQUHAR, Muscular atrophy of left upper limb. Proc. Roy.
Soe. Med., VoL vi., No. 4, Feb. 1913 (NeuroL Sect.), p. 84.
STEWART, PURVES. Progressiver Myotonus bei einer myoklonischen Kranken.
Neurol Centralbl., Nr. 6, Mars 1,1913, S. 288.
SrEVAJL COED—
Ceiml-PASTINE, C. Le phdnomfcne de l’extension doe doigta normal et
pathologique. (3 fig.) Rev. Neurol., Ann. xxi., No. 5, Mars 15, 1913, p. 289.
HAjSkOVEO, L. Laterals Deviation der Finger der Hand. Neurol . Centralbl.,
Nr. 6, Mars 1,1913, S. 274.
ROGERS, M. H. Pathology of typhoid spine. Boston Med. and Surg. Joum.,
VoL. clxviii., No. 12, March 20, 1913, p. 348.
L^RI, A. Un ph4nora&ne rlflexe du membre tupdrieur: le signs de l’avant-bras.
(2 fig.) Rev. NeuroL, Ann. xxi., No. 5, Mars 15, 1913, p. 277.
NOIGA and PAULIAN. Un signe organique: la flexion du genou. (1 fig.) Rev.
Neurol Ann. xxi., No. 5, Mars 15, 1913, p. 288.
SOUZA, OSCAR, de and CASTRO, AL07SI0 de. Le ph6nom&ne de Textension
du gros orteil associ^e aux efforts musoulaires. V Enctphale, Ann. viiL, No. 3,
Mars 10,1913, p. 219.
ROTHMANN, MAX. Gegenwart und Zukunft der Rttckenmarkschirurgie. Berl.
Klin. Wchnschr., J. 50, No. 13, Mars 31,1913, S. 698.
MtJLLER, V. J. Zur Kenntnis der Leitungsbahnen des psyohogalvanisehen
Reflex-phanomens. Monatssch. f. Psychiat. u. Neurol., Bd. xxxiiL, H. 3,
Mars 1913, S. 235.
FEARNS1DES, B. G. Athetosis of left hand with tremor of right hand. Proe .
Roy. Soe . Med., Vol. vi. No. 4, Feb. 1913 (Neurol. Sect.), p. 81.
TURNER, ALDREN. Tremor of uncertain origin. Proc. Roy. Soc. Med., VoL
vi. No. 5, Feb. 1913 (NeuroL Sect.), p. 70.
COLLIER, JAMES. Two sisters presenting a similar right-sided hemiparesis
and stunting of growth dating from birth. Proe. Roy. Soc. Med., VoL vi.,
No. 4, Feb. 1913 (NeuroL Sect.), p. 72.
CAMPBELL, HARRY. Trophic changes of obscure origin. Proc. Roy. Soe.
Med., Vol. vi., No. 4, Feb. 1913 (NeuroL Sect.), p. 71.
WEBER, F. PARKE3. Non-syphilitic arteritis obliterans (“ thrombo-angeitis "
of Les Buerger) with intermittent claudication of the left lower extremity.
Proe. Roy. Soc. Med., VoL vi, No. 4. Feb. 1913 (Clin. Sect), p. 72.
FISCHER, L. Lumbar puncture, an aid to diagnosis. Archives of Ped., Vol.
xxx., No. 2, Feb. 1913, p. 131.
Eerpe* So*ter.— MONTGOMERY, D. W. The oourse the vims of herpes roster
takes to reach the nerve ganglion. Joum. Cut. Die., VoL xxxi.. No. 3, March
1913, p. 156.
MACNAB, ANGUS. Ionic medication in herpes zoster. Lancet, March 22,1913,
p. 821.
Tabes Borsalfs.— BARKAN, HANS. Zur Frage der infantilen und juvenilen
Tabes. Wien. Klin. Wchnschr. J. xxvi. Nr. 11, M*rz 13, 1913, S. 417.
CHENEY, W. F. Gastric disturbances in tabes dorsalis. Amcr. Joum. Med.
Sci ., VoL oxlv., No. 3, March 1913, p. 328.
LERICHE. Elongation du plexus solaire pour crises gastriques tab£tiques.
Lyon M4d., Ann. xlv., No. 12, Mars 23, 1913, p. 624.
MOORHEAD, T. G. A case of juvenile tabes. Dublin Joum. Med. Sci.,
Ser. I1L, No. 495, Maroh 1913, p. 167.
Poliomyelitis Anterior AcnUu— COLLIVER, J. A. A new preparalytic symptom
of poliomyelitis. Joum. Amer. Med. Assoc., Vol. lx., No. 11, March 15,1913,
p. 813.
36*
BIBLIOGRAPHY
BIBHLER, M. ▼. Bin Beitrag snr Bpidemie der Heine-Medin'schen Kmnkhoit
im Konigreich Polen im Jahre 191L Jakrb. f. KinderkeUt., Bd. 77, H. 3,
Mkrz 1913, S. 348.
Myelitis.— HERTZ, A. F., and JOHNSON, W. Polio-enoephalo-myelitis associated
with optio neuritis, nephritis, and myocarditis. Proc. Roy, Soc. Med., VoL vi. t
No. 4, Feb. 1913 (Clin. Sect.), p. 90.
Syringomyelia.—ELLIOTT, T. R. Shoulder-joint lesions in syringomyelia. Proc.
Roy. Soc. Med., Vol. vi., No. 4, Feb. 1913 (Neurol. Sect), p. 77.
■sematomyclla.—SILVAN, C. Studio clinioo ed anatomo-patologioo sopra nn
caso di ematomielia. Riv. di Paid. nerv. c mcrU ., VoL xriiL, F. 2, Mario 24,
1913, p. 06.
HBNNEBERG and WBSTENHOFER. Ueber asymmetrisohe Diastematomyelie
▼om Typus der u Vorderhornabschniirung.” Monatsschr. f. Psychiat a.
Neurd., Bd. xxxiii., H. 3, Mars 1913, S. 205.
Mssmerrhage.—HUTINEL. Les h6morragiea mdning&s dans l'enfanoe. Joum.
des Prat, Ann. xxvii., No. 9, Mars 1, 1913, p. 130.
Spina BlSda.— EDINGTON, GEO. H. Two unusual forms of spina bifida.
Glasgow Med. Joum., Vol. lxxix., March 1913, p. 161.
Aneurism.— MAGAUDDA, P. Contribute alio studio delle siudromi nervosa
determinate dagli aneurismi dell* arteria suoclavia. Riv. di Paid. nerv. c merit,
Vol. xviii., F. 2, Marzo 24, 1913, p. 83.
Tnmenrs. —MERZBACHER and CASTEX. Uber ein sehr grosses multilobulares
Fibrom ira Cervikalmark. Deui. Ztschr. f. Nervenheilk. , Bd. 46, H. 2, 1913,
S. 146.
Paraplegte.— FINKELNBURG. Partielle Rindenatrophie und intakte Pyramiden-
bahn in einem Fall von kongenitaer spastischer Paraplegia (Little). DetU.
Ztschr. /. Nervenheilk., Bd. 46, H. 2, 1913, S. 163.
D^J^RINE.—La paraplegia syphilitique. Proc. Mid., Ann. 41, No. 10, Mars 8,
1913, p. 124.
BRAIN—
General.— MODENA. Totales Fehlen dee Gehiras und des Rtiokenmarks. Deut
Ztschr. /. Nervenheilk ., Bd. 46, H. 2,1913, S. 158.
SUTHERLAND, J. A., and PERKINS, H. W. Specimen of non-development of
oerebrum. Proc. Roy. Soc. Med., VoL vi, No. 4, Feb. 1913 (Sect Dis. of
Child.), p. 118.
ZAUN. An Argyll Robertson pupil becoming normal after mercury and salvarsan.
Joum. Amer. Med. Assoc., Vol. lx., No. 9, Biarch 1,1913, p. 664.
Amyotrophic Lateral Sclerosis. — STRASBLANN, R. Sehr seltene Form
amyotrophischer Lateral-sklerose. Neurd. Centralbl., Nr. 6, Mkrs 1, 1913,
S. 285.
Disseminated Sclerosis. —BECK. Multiple Skleroee, Schwangersohaft und
Geburt. Deut. Ztschr. f. Nervenheilk., Bd. 46, H. 2, 1913, S. 127.
COLLIER, JAMES. Case for diagnosis? Cerebellar ataxy presenting typical
symptoms of disseminated sclerosis in an undersized boy, aged 13. Proc. Roy.
Soc. Med., Vol. vi., No. 4, Feb. 1913 (NeuroL Sect.), p. 75.
Meningitis. —WESSON, MILEY B. Epidemic cerebrospinal meningitis. N.Y.
Med. Joum., Vol. xcvii., No. 12, March 22, 1913, p. 607.
PARMELEE, ARTHUR H. Epidemic cerebrospinal meningitis. Joum. Amer.
Med. Assoc., Vol. lx., No. 9, March 1, 1913, p. 659.
GREEN, GEORGE R Sporadic cerebrospinal meningitis: reoovery. Joum.
Amer. Med. Assoc., Vol. lx., No. 9, March 1, 1913, p. 664.
DUBOIS, P. L. Differential diagnosis and treatment of epidemic cerebrospinal
meningitis. Joum. Amer. Med. Assoc., VoL lx., No. 11, March 15, 1913,
p. 820.
ROSENTHAL, G. Enc^phalo-m^ningite k cocco-bacille de Pfeiffer. Joum. de
Mid. de Paris , Ann. 33, No. 12, Mars 22, 1913, p. 244.
BIBLIOGRAPHY
37*
ROSENBLATH. Bin F*U von Cystioerkenmeningitu mitvorwiegender Botoilignng
dea Rtiokenmarks. Dent. Zttchr. f. NervenheUh Bd. 46, H. 2,1913, S. 113.
HAYNES, I. S. The treatment of meningitis by drainage of the oisterna magna.
Archive s of Ped., Vol. xxx., No. 2, Feb. 1913, p. 84.
HIRSCH, D. I. Irrigation of the spinal canal as a preliminary to introduction of
Flexner’s antimeningitio serum. Joum. Amer. Med. Assoc.. Yol. lx., No. 11.
Maroh 15, 1913, p. 828.
MILLIGAN, \VM. A discussion on the treatment of meningitis of otitio origin.
Proc . Roy . Soc. Med., VoL vL, No. 4, Feb. 1913 (Otol. Sect.), p. 41.
MARIE, PIERRE, and GOUGEROT, H. Ramollissement c4r4bral et 4panohement
mdningd puriforme aseptique k polynucl Zaires in tacts. Qaz. des H6p. % Ann. 86,
No. 29, Mar B 11, 1913, p. 453.
DESNEUX, DUJARDIN, and WEILL. La syphilis m4ning4e. Joum. de
Neurol., Ann. 18, No. 3 et 4, F4v. 5 et 20, 1913, pp. 41 et 61.
Abscess.— LUBBERS, KARL. Himabszess, Osteomyelitis des Stirnbeines; Stirn-
hohlenempyem. Archiv f. Ohrtnheilk., Bd. 90, H. 3,1912, S. 172.
Hemiplegia. —GENT1LI, G. Un caso di emiplegia in pneumonioo. Riv. crii . di
Clin . Med., Anno xiv., No. 10, Marzo 8, 1913, p. 145.
ROLLESTON, J. D. Diphtheritic hemiplegia. Proc. Roy . Soc. Med., YoL vi. t
No. 4, Feb. 1913 (Clin. Sect.), p. 69.
FUSSELL, M. H., and LEOPOLD, S. Gradually developing hemiplegia due to a
cerebral neoplasm. Med. Rec., Yol. 83, No. 12, March 22,1913, p. 527.
MARIE, PIERRE, and FOIX, CH. Formes cliniaues et diagnostic de rh4mipl4gie
c^rebelleuse syphilitique. Sent. mid. , Ann. 33, No. 13, Mars 26,1913, p. 145.
Hflplegla. —KUNNE, BRUNO. Die Little’ache Krankheit. Berl. klin. Wchnschr .*
J. 50, No. 13, Marz 31, 1913, S. 603.
Acbondraplasla.— BERTOLOTTI. Contribution k l’4tude de l’aohondroplasie.
Nanisme familial par aplasie chondrale systematises. Mesomelia et brachymeiie
metapodiale symetrique. Press Mid., No. 18, Mars 1, 1913, p. 165.
Pellagra.— TIZZONI, G., and ANGELIS, G. DE. Studi intorno alia biologia e alia
morfologia dello streptobacillo pleomorfo della pellagra. Pathologica, N. 106,
Anno v., Marzo 15,1913, p. 173.
YOLPINO, G. Ricerche sulla pellagra. Pathologica , N. 105, Anno v., Marzo 15,
1913, p. 174.
MARTIN, E. H. The specific treatment of pellagra. N.Y. Med. Joum.,
VoL xcviL, No. 11, March 15,1913, p. 547.
Tumours.— HALL, GEORGE, and ANGUS, H. B. Case of subcortical cerebral
tumour, tuberculous in nature, removed by operation: recovery. Lancet,
Maroh 8, 1913, p. 678.
LANGE. Labyrinthver&nderungen bei Tumoren des Kleinhirns und Kleinhirn-
brtickenwinkels. Archiv. f. Ohrenheilk , Bd. 90, H. 3,1913, S. 180.
MOSNY and MOUTIER. Sur un cas de saroomatose diffuse aigu8 (lymphocyto-
matose atypique) des visceres abdominaux (estomac, intestin, rein, Ac.) et des
meninges. Arch, de Mid. exp. et d'Anat. Path., T. xxv., No. 2, Mars 1,1913,
p. 194.
Pltmltary Tumours, Ac.—CUSHING, HARYEY. Concerning the symptomatic
differentiation between disorders of the two lobes of the pituitary body: with
notes on a syndrome accredited to hyperplasia of the anterior and secretory
stasis or insufficiency of the posterior lobe. Amer. Joum. Med. Sci ., Yol. cxlv.,
No. 8, March 1913, p. 313.
GRAHAM, C. I. Cyst of the pituitary foBsa: operation by the nasal route.
Proc. Roy. Soc. Med., Vol. vi., No. 4, Feb. 1913 (Laryngol. Sect.), p. 61.
Diabetes Insipidus.— LEWIS, DEAN, and MATTHEWS, S. A The pars inter¬
media; its relation to diabetes insipidus. Trans. Chicago Path. Soc., Yol. ix.,
No. 1, Feb. 1913, p. 16.
Apbasla, *c.—FROMENT and PILLON. A propos de deux cas d’aphasie motrice
pure. Lyon Mid., Ann. xlv., No. 13, Mars 30, 1913, p. 690.
38 *
BIBLIOGRAPHY
GOLDSTEIN, L Uber Aphid* and apraxie. (Zu^mmenstellang tot Arbaten
aus dem jAhreo 1906-1911.) Schmidts Juhrbiick. d. in.* %. ausdand. pes. Md,
Bd. 317, H. 2, Feb. 1913, S. 106.
ARCHAMBAULT, LA S. Report of two cam exhibiting lesions of special
interest for the localisation of AphAsio disorder* A/6any Mid. Annals, VoL
xxxv., No. 3, MArch 1913, p. 125.
MACMAHON, CORTLANDT. Functional aphonia; a method of OVAtive and
preventive treatment. Lancet , MArch 1, 1913, p. 632.
•ypMtlla.—TOUTON. Die jetzigen Heilmittel der Syphilis and ihre Anwendung in
der Praxis. BerL Klin. Wchnschr,, J. 50, No. 13, M*rz 31, 1913, 8.573.
LOMEK. GO. Heilversuche bei xwei Fallen von luischer Snatform. AUg.ZUthr,
/. Psychiat., Bd. 70, H. 1, Feb. 22, 1913, S. 135.
DEMJANOWITSCH, M. Uber eine seltene Form vor sekondarer Loss (Syphilis
outaneA verruouea}. Derm. Ztsehr., Bd. xx., H. 3. Min 1913.
PICKER, R. Ein FaII von Syphilis der BIas*. Ztschr. f. Urolog., Bd. vit, H. 5,
1913, p. 192.
JEANSELME, M. E. Syphilis et nourrisson, Joum. de Mid. c it Paris, Ann
33, No. 10, Mars 8, 1913, p. 199.
RYTINA, A. G. The luetin skin test in the diagnosis of syphilis. Md Ret
Vol. 68, No. 9, March l, 1913, p. 384.
FINDLAY, L. Eczema oris as a manifestAtion of oongenitAi syphilis, lancet,
March 29, 1913, p. 875.
CECIL, R. L., And LAMB, A. R. Observations on the complement fixation tot
for syphilis with cadaver serum. Arch, of Ini. Med VoL II, No. 3, March 15,
1913, p. 249.
BRONFENBRENNER and NOGUCHI. On the resistance of various spiro¬
chetes in cultures to the action of chemical and physical agents. Joum.
Pharmacol, and Exp. Thernp ., VoL iv., No. 4, March 1913, p, 333.
PERELMAN, A. Contribution & 1’dtude du s^ro-diagnostic de la syphilis par le
proctor!de Sabraz^s-Eckenstein et de sea applications en olinique infantile.
Rev. Mid. d. L Suisse Ram., Ann. xxxiil, No. 2, Fdv. 20,1913, p. 131
LOVE, J. KERR. Sporadic congenital deafness and deafness from syphilis
(concluded). Glasgow Med. Joum., VoL ixxix., March 1913, p, 172.
ftal varan ■—ABRAMOVITZ, MORRIS. A combined gravity and syringe method
for the intravenous injection of salvarsan. Joum. Amer. Med. Assoc., Vol lx.,
No. II, March 15, 1913, p. 824.
JEANSELME, E. De la prophylaxie antisyphilitique rdalisde par lesalvamn.
Bull. de. la Soc. de Path. Exotique, T. vi, No. 2, 1913, p. 102.
FROST, A. F. Treatment of syphilis by salvarsnn. Joum. State Med., Vol
xxL, No. 3, March 1913, p. 167.
CLAPP, C. A. Deafness following the use of salvarsan. Joum. Amer. Md
Assoc., Vol. lx., No. 10, March 8, 1913, p. 742.
MATZENAUER, R. Durch Alkaliabgabe des Glases bedingte toxische Neben*
wirkungen nach intravenosen Salvarsaninjektiooen. Wien. Klin, Wcknsckr .,
J. xx vi., Nr. 11, Marz 13, 1913, S. 406.
RINDFLEISCH, W. Status thymolymphaticus and Salvarsan. Berl. Kid
Wchnschr., J. 50, Nr. 12, Marz 24, 1913, S. 542.
SAUVAGE. De l’emploi du salvarsan chez les femmes enceintes ayphilitiqaee.
Annalcs de Gynicol. cd d'Obstii., Ann, xl., S4r. IL, T. x., F4v. 1913, p. 91.
tfeetalvarsan.—RAVAUT, PAUL. Nouveau prooddd d’injection intrareineose
du ndo-Salvarsan. Prtsse Mid., No. 18, Mars 1, 1913, p. 171.
LIER. W. Erfahrungen tiber Neosalvarsan. Wien. Klin. Wcknsckr., J. ml,
Nr. 11, M*rz 1913, S. 410.
FREUND, EMANUEL. Erfahrungen mit Salvarsan und Neosalvarsan in der
Privatpraxia. Prag. Med. Wchnschr ., J. xxxviii., Nr. 12, Man 20,1913,3.151.
KAUFMAN, J. Experience! with Neosalvarsan. N. Y. Med. Joum, , Vol
xcvii., No. 12, Marcn 22, 1913, p. 598,
BIBLIOGRAPHY
39*
GUTMANN, C. Ueber Parallelversuche mit Alt- und Neosalvarsan. Berl. Klin.
Wehnschr., J. 50, No. 13, Marz 31, 1913, S. 581.
SCHRAMM, R Ueber Aqua destillata zur Salvarsanbereitung. Berl. Klin.
Wehnschr ., J. 50, Nr. 10, Marz 10, 1913, S. 446.
NIXON, J. A. The intravenous administration of Neosalvarsan in syphilis.
Bristol Afed.-Chir. Joum ., VoL xxxi., No. 119, March 1913, p. 24.
TOUTON. Darf Neosalvarsan auch ambulant angewandt werden? Berl. Klin.
Wehnschr., J. 50, Nr. 11, Marz 17, 1913, S. 484.
LEMELAND and BRISSON. Etude but les rEsultats observes 4 la clinique
Tarnier par l’emploi du salvarsan et du neo salvarsan ohes les femmes enoeintes,
chez les femmes en couches et chez l’enfant nouveau-nE. Arch. Mensuel.
d'ObsUt. et de Gynecol., Ann. 2, No. 2, Fev. 1913, p. 113.
Wassernsamn Reaction. —HERMAN and D’HOLLANDBR. La rEaotion de
Wassermann et l’alie nation mental©. Bulletin de VAcad. Roy. de Mid., Ser.
iv., T. xxvi., No. 11, Deo. 1912, p. 793.
GOSS, W. J. Eine neue Methode zur Gewinnung des Antigens ftir die Wasser-
mannsche Reaktion. Ztschr. f. ImmunitaUforsckung. , Teil I. (Orig.), Bd. xvii.,
H. 1,1913, S. 99.
LESSER, F. Zur Verfeinerung der Washerman nsoheu Reaktion und Vermeidung
divergenter Resultate. Derm. Ztschr ., Bd. xx., H. 3, Marz 1913, S. 193.
PIPER, J. E. Results of the Wassermann test as applied to a random series of
patients admitted to the Women’s Hospital, Melbourne. Australian Med.
Joum., Vol. ii., No. 84, Feb. 22, 1913, p. 916.
UCKE, A. Ueber die Wassermann’sohe Reaktion. St Petersburg Med . Ztschr .,
J. 38, No. 5, Marz 1913, S. 57.
MULLER, R., and STEIN, R. O. Die Hautreaktion bei Lues und ihre Bexiehung
zur Wassermannschen Reaktion. Wien. Klin. Wehnschr ., J. xxvi., Nr. ii.,
Marz 13, 1913, S. 408.
Cerebre-gptmal Fluid.—HANNS and JACQUOT. Phagoovtose du bacille de
Kooh dans le liquid© cephalo-rachidien. Compt. Rend. a. 1. Soc. d. Biol., T.
lxxiv., No. 9, Mars 7, 1913, p. 490.
THOMAS, P. Recherche et dosage de l’ammoniaque dans le liquids cephalo-
rachidien. Compt. Rend. d. 1. Soc. d. Biol ., T. lxxiv., No. 11, Mars 21, 1913,
p. 621.
BLATTEIS, S. R., and LEDERER, MAX. An analysis of four hundred and
twenty-six cerebro-spinal fluids from various pathologic conditions. Journ.
Amer. Med. Assoc., Vol. lx„ No. 11, March 16,1913, p. 811.
GKIUUI AND FUNCTIONAL DISEASES—
Epilepsy.—HOWELL, C. M. HINDS. Jacksonian epilepsy. Proc. Roy. Soc.
Med., Vol. vi., No. 4, Feb. 1913 (NeuroL Sect.), p. 78.
MOUISSET and FOLLIET. De l’Epilepsie dans le oours de la fievre typhoids.
Lyon Mid., Ann. xlv.. No. 13, Mars 30, 1913, p. 665.
CLAUDE, HENRI. Epilepsie fruste et fugues. Joum. des Prat., Ann. xxvii.,
No* 11, Mars 15, 1913, p. 161.
CROUZON, O. Etat vermoulu du oerveau et Epilepsie senile. Lyon Mid., Ann.
xlv., No. 10, Mars 9, 1913, p. 516.
DUMAS, ANTOINE. Accidents nerveux de nature synoopale ou Epileptiform©
au oours des troubles du rythme cardiaque (Rev. gEn.). Rev. de Mid., Ann.
xxxiiL, No. 2, FEv. 10, 1913, p. 149.
JACQUIN, G., and MARCHAND, L. Myoolonie Epileptique progressive (Type
Unverricht Lundborg). L'Enclphale, Ann. viii., No. 3, Mars 10, 1913, p. 205.
Hysteria.—BLANC, J. LTiystErie au Maroo et en particular au tabor de police
franco-marocaine, no. 9. Les idEes actuelles sur cette nEvrose. Annales
d'Hygiene Publique, SEr. 4, T. xix., Mars 1913, p. 272.
TUCKER, W. C. A oaae of (hysterical) sudden monocular real blindness with
recovery. Cleveland Med. Joum., VoL xiL, No. 2, Feb. 1913, p. 127.
40 *
BIBLIOGRAPHY
SHKAHAN. Anuria—perhaps hysteric. Joum. Amer. Med. Assoc., VoL lx..
No. 11, March 15, 1913, p. 826.
Cltreft.—MARKLEY, P. H. Chorea. N.Y. Med. Joum., VoL xcviL, No. 9,
Mar oh 1, 1913, p. 453.
Myasthenia. —TAYLOR, JAMES. Myasthenia gravis. Proe . Roy. 5oc. Med.,
Vol. vi.. No. 4, Feb. 1913 (Neurol. Soot.), p. 69.
BUZZARD, E. FARQUHAR. Myasthenia gravis. Proe. Roy . 56c. lied., VoL
vL, No. 4, Feb. 1913 (Neurol. Sect.), p. 85.
COLLIER, JAMES. Case for diagnosis: slowly on-coming cerebellar ataxia, with
facies resembling that of myasthenia gravis. Proe. Roy . Soe . Med., VoL vi.,
No. 4, Feb. 1913 (NeuroL Sect.), p. 74.
Nearest he a la.—CASTE X, A. Bourdonnements dans la neurasthenia. Joum.
de Prat ., Ann. xxvii., No. 13, Mars 29, 1913, p. 193.
LEVY, P. E. Lee principes du traitement reeducateur dans la neurasthenia et
les nevroses. Joum. de Med. de Paris , Ann. 33, No. 11, Mars 15, 1913, p. 221.
MACNAUGHTON-JONES, H. The relation of puberty and the menopause to
neurasthenia. Lancet , March 29, 1913, p. 879.
Neuroses.—WILLIAMS, TOM A. Occupation neuroses. Their true nature and
treatment. Med. Rec ., VoL 83, No. 11, Biarch 15, 1913, p. 464.
BAILEY, PEARCE. The traumatic neurosis: a retrospect and a forecast.
Cleveland Med . Joum., Vol. xii., No. 2, Feb. 1913, p. 89.
GOODIIART, S. P. Jung's modification of the Freudian theory of the neuroses.
Med. Rec., Vol. 83, No. 9, Biarch 1, 1913, p. 375.
MOTT, F. W. The neuropathic inheritance. Proe. Roy. Soc. Med., VoL vi.
No. 4, Feb. 1913 (Sect, of Psychi&t.), p. 23.
Neuralgia.—CORSY, M. F. Considerations anatomiques sur les injections neuro-
lytiques dans la neuralgic faciale. (5 figs.) Gaz. des ffdp., No. 27, Mars 6, 1913,
p. 421.
HARRIS, WILFRED. Hyoscine-morphia anaesthesia for aloehol injection in
neuralgia. Lancet, March 29, 1913, p. 881.
CATES, B. B. A method of dealing with the peripheral branches of the fifth
cranial nerve in tic douloureaux. Boston Med. and Surg . Joum. % VoL olxviii.,
No. 12, March 20, 1913, p. 384.
Neuritis.—ANGL AD A and FABRE. Polynduritcs par ingestion d’un vin ooatenant
de l’arsenic. Annales d'Hygtine Publique, S^r. 4, T. xix., Biars 1913, p. 193.
Paralysis Agf taut.—SAINTON, PAUL. La maladie de Parkinson et sa pathogenic.
Joum . des Prat., Ann. xxvii.. No. 12, Mars 22, 1913, p. 177.
Tetanus.—80ULA. Influence de la toxine t^tanique et de la toxine diphtdriqus
sur la proteolyse et Taminogen^se des centres nerveux. Compt. Rend. d. L Soe.
d. Biol., T. lxxiv., No. 9, Biars 7, 1913, p. 476.
Exopfcthalmle Goitre, Cretlnisus, de. — RUB I NO, A. Behandlung der
Basedowischen Krankheit. Berl. Klin. Wchnschr ., J. 50, Nr. 12, Mare 24,
1913, 8. 525.
LEWI, W. G. Exophthalmic goitre and perverted thyroid secretion; and their
treatment with high frequency electricity. Albany Med. Annals , VoL xxxv.
No. 2, Feb. 1913, p. 63.
BERRY, JAMES. The surgery of the thyroid gland, with special reference to
exophthalmic goitre. [Lettsomian lectures.] (lllust.) Lancet, March 1, 8 and
15, 1913, pp. 583, 608 and 737.
CARINI, A. Contributo sperimentale alia eziologia del cretinismo. Pathdogica ,
Anno v., N. 105, Marzo 15, 1913, p, 172.
PERN, S. A few cases of thyroid insufficiency and the relationship to the
metabolism of lime. Australian Med. Joum., Vol. 11, No. 83, Feb. 15,1913,
p. 906.
MARINE, D., and JOHNSON, A. A. Experimental observations on the effects
of the administration of iodin in three cases of thyroid oareinoma (two human
and one canine). Arch . of Int. Med., Vol. 11, No. 3, March 15, 1913, p. 288.
BIBLIOGRAPHY
41*
PUJOL. Sur on ou de syphilis tertiaire du corps thyroide et da ooo. Prop.
Mid,, Ann. 41, No. 13, Mars 29,1913, p. 168.
fts|Bsad's Bhesie.—WEBER, F. PARKES. Chronio Raynaud’s symptoms,
probably on a syphilitic basis, associated with Livedo reticulata. Remarks on
Livedo reticulata (Livedo annularis, Livedo figurata, or Cutis inamorata).
British Joum. Dermatol., Vol. xxv., No. 3, March 1913, p. 81.
Aleekollsm, Ac.—GORDON, ALFRED. A study of fourteen cases of aleoholism
in children apparently free from morbid heredity. Med . Rec., Vol. 83, No. 10,
March 8, 1913, p. 433.
CROTHERS, T. D. Some facts concerning the periodicity of inebriety. Albany
Med . Annals, Vol. xxxv.. No. 3, March 1913, p. 140.
LAGRIFFE, LUCIEN. Le hilan de quatre-vingts ans d’alooolisme en Basse-
Bretagne (Rev. crit.). Archives d'AnthropoidOrim., T. xxviii., Ann. 28, F4v.
16, 1913, p. 126.
SfICUl gnitBg AMD CBAMUL MERTBS—
GRUENING, E. The optic disks in purulent otitio disease and its complications.
Archives of Ophthalmol., Vol. xliL, No. 2, March 1913, p. 163.
BURR, C. W. Unusual duration of mental symptoms in a case of atropine
poisoning. Archives of Ophthalmol ., Vol. xlii., No. 2, March 1913, p. 136.
EITELBERG, A. GUnstige Beeinflussung nervdser Zustande duroh Heilung
der chronischen eitrigeu Mittelohrentsilndung, nebst einigen oto-therapeutisohen
Bemerkungen. Wien. Med . Wchnschr., J. 63, Nr. 13, MArs 22, 1913, 8. 816.
M0CILUMBOU8 SYMPTOMS AMD CASKS—
HERTZ, A. Fj. and JOHNSON, W. Bilateral atrophy of the face. Proc. Boy.
Soc. Med., vol. vi., No. 4, Feb. 1913 (Clin. Sect.), p. 92.
BI8ELEY, STANLEY. Should a man with miner's nystagmus work? Lancet,
March 1, 1913, p. 698.
MORETTI, A. Due oasi di idiozia mongoloide. Riv. di Patol. new. e merit.,
VoL xviii., F. 1, Feb. 6, 1913, p. 12.
WEBER, F. PARKES. Chronio acholuric jaundice, with anemia, slight spleno¬
megaly, and nervous disorder. Proc . Roy. Soc. Med., Vol. vi., No. 4, Feb.
1913 (Clin. Sect.), p. 79.
v NICOSIA, S. Sur l’anesthMe medullaire et sur auelques problftmes qui s’y
rattachent. Arch. ital. de Biol., T. lxvii., No. 2, March 1913, p. 393.
GOT, CHARLES, and DUPIN. Insnffisance glandulaire et anormaux pasrifs dans
l’armta. L'Enciphale, Ann. vili., No. 3, Mars 10, 1913, p. 223.
GOLDBLADT. Ein nerves Reflexometer. Dent. Ztschr.f \ Nervenheilk., Bd. 46,
H. 2, 1913, S. 171.
GATTI, STEFANO. Oxioefalia ed esoftalmo. Rassegna di Studi Psichiat., Vol.
iiL, F. 1, Gennaio-Febbraio 1913, p. 14.
PSYCHIATRY.
fiimAl PARALYSIS—
HBSNARD. Un cas de paralysis gdndrale progressive post-insolatoire. Arch, de
Mid. et Pharmacie Nav ., Jan. 1913, p. 60.
BBLLETRUD and FROISSARD. Meurtre, tentative de meurtre et tentative de
suicide. Paralysis g^ndrale ohez un d6g4n£r4 k ascendanoe 6pileptique. Annal.
Mid.-Psychol., Ann. lxxL, No. 2, F4v. 1913, p. 170.
DKMBMT1A FBACOX-
DERCUM, F. X. Essential features of symptomatology and prognosis in dement ia
prsecox. N. Y. Med. Journ., Vol xcviL, No. 9, March 1, 1913, p. 426.
FILHO, PERNAMBUCO and MORAES VIEIRA. Notas sobre um caso de syn¬
drome pluriglandular endocrinioo e demencia preooce. Arch. Brasil . de Med.,
Anno it., N. 6, Dez. 1912, p. 671.
SCARPINI, VINCENZO. Rioerche istologiche std centri nervosi in un caso di
dsmensa preooce catalonioa. Rassegna di Studi Psichiat., VoL ii. F. 1,
Gennaio-Febbraio 1912, p. 1.
42*
BIBLIOGRAPHY
CKBTEKAL—
DAWSON, W. R. The Mental Deficiency Bill and its propoeed extension to
Ireland. Med. Press , No. 3,852, March 5, 1913, p. 251; Dublin Joum. Med.
Sci Ber. iiL, No. 495, March 1913, p. 161.
VALABREGA, G. Alcune osservazioni sulla preeeione sangnigna in dementia
senili e presenili e un saggio di terapia oolla teohromina. Annali di Freniat
Vol. xxu. y F. 4, Die. 1912, p. 289.
KLE1ST. Die involutionsparanoia. Allg. ZUckr. /. Psychial., Bd. 70, H. 1,
Feb. 22, 1913, S. 1.
KUTZ IN SKI, A. Ueber die Beeinfiussung des V orstellungsablaufea darch
Geschichtekompleze bei Geisteskranken. Monatssch. f. Psychiat. u. Neurol
Bd. xxxiii., H. 8, Mirz 1913, 8. 254.
JOLLY, PH. Ueber Heredit&t bei Geistesgesonden and Geisteskranken. Med .
Klinik, J. ix., Nr. 10, Mars 9,1913, a 364.
VINTON, MARIA M. State care for mental defectives. Med. Bee., VoL 83,
No. 12, March 22, 1913, p. 52a
LADAME, CH. La loi de Fint^zAt momentand et la loi de l’intdrfit dloigne.
Annal. Med.-Psychol., Ann. bud., No. 2, Fdv. 1913, p. 129.
L^VEQUB. De la fugue ehes lee ddsiquilibrde et dans un oas de ddmenee
primitive de Delasiauve, ddmenoe prdcoce de Kraepelin. Annal. MStL-Ptychol..
Ann. lxxi., No. 2, Fdv. 1913, p. 140.
ADAM, FR. Aocfes confusionnels chez un persdeutd persdeuteur. Annal. M4d.-
Psyehol ., Ann. lxxi., No. 1, Fdv. 1913, p. 150.
VOIVENEL, P. L’homicide en pathologic mentale (Rev. crit.). Annal. Mtd.
Psychol ., Ann. lxxi., No. 2, Fdv. 1913, p. 179.
OOLIN, H. Le quartier de silretd de Villejuif (alienee criminek, vkieux, diffieOee,
habitues des asiles) (suite et fin). Annal. M6d.-PsychoL , Ann. lxxi.. No. 2,
Fev. 1913, p. 170.
MARTINOTTI, 0. Bull’ ipoplasia dell’ aorta e del siatema arterioso in alcune
forme di malattie men tali. Annali di Freniat ., YoL xxii., F. 4, Die. 1912,
p. 364.
MIGNOT, ROGER, and UBSE, F. Troubles mentaux observes chez un sujet
morphinomano et cbloralomane. L'Enctphale, Ann. viiL, No. 3, Man 10,
1913, p. 235.
BENIGNI, P. F. La reazione meiostagminioa sul sangue di alcuni malati di
mente. Riv. de Patol. new. e ment ., Vol. xviii., F. 2, Mario 24, 1913, p. 92.
TREATMENT.*
RENSSELAER, H. VAN. The high frequency ourrent in the treatment of high blood
pressure. Albany Med. Annals , Vol. xxxv., No. 2, Feb. 1913, p. 77.
TOBIAS, ERNST. Ueber die praktische Bedeutung der Hochfrequenz-behandlung
(d’Arson valuation)—insbesondere bei inueren und Nervenkrankheiten. BcrL
Klin. Wchnschr ., J. 60, Nr. 12, Marz 24, 1913, S. 538.
BERKELEY-HILL, O. Two cases treated successfully by psycho-therapy. Indian
Med. Gaz ., Vol. xlviii., No. 3, March 1913, p. 97.
BARNES, F. H. The necessity of early institutional treatment in mental and nervous
diseases. Med. Rec. % Vol. 83, No. 10, March 8, 1913, p. 435.
KNOX, H. A. Some practical psychotherapy. Joum. Amer. Med . Asjoc., VoL lx.,
No. 9, March 1, 1913, p. 657.
GRULEE, C. G. Dietetic treatment of convulsions and allied conditions oocurring in
infants. Amer. Journ. Dis. Child., Vol. v., No. 3, March 1913, p. 205.
VALLON, C., and BESSIERE, R. Le vdronalisme. (Rev. gdn.) L'Enctphalt , Ann.
viii., No. 3, Mars 10, 1913, p. 245.
* A number of references to papers on Treatment are included in the Bibliography under
individual diseases.
Bibliography
ANATOMY.
GEMELLI, AG. Sulla origine delle radioi posteriori del midollo spinale del mammiferi.
Anat. Arneig ., Bd. 43, No. 16, April 3, 1913, pp. 400-410.
GEMELLI, AG. Contributo alia conoscenza d*lla fine struttura del midollo spinale.
Anat . Anteig., Bd. 43, No. 16, April 3, 1913, pp. 410-422.
KUNTZ, ALBERT. The development of the cranial sympathetic ganglia in the pig.
Journ. Comp. AruU ., Vol. 23, No. 2, April 1913, p. 71.
BOEKE, J. Tiber die Regenerationserscheinungen bei der Verheilung von motorisohen
mit sensiblen Nerventasem. Anat. Anzeig ., Bd. 43, No. 14/15, Marz 27, 1913, pp.
366-378.
BIONDI, GIOSUE. I nuclei d’origine e terminali del nervo trigemino del polio. Riv.
Hal. di Neuropatd., Prichiat. ed Elettroter ., Vol. vi., F. 3, Marzo 1913, p. 117.
LEY. Le “cinquifeme ventricule” cerebral. Journ. de Neurol ., Ann. 18, No. 7, Avril
5, 1913, p. 121.
COG HILL, G. E. The primary ventral roots and somatic motor column of Ambly stoma.
Journ. Comp. Neurol ., Vol. 23, No. 2, April 1913, S. 121.
HOOGKAMER. Die Nerven der Gebarmutter. Archiv f. Gynackol ., Bd. 99, H. ii.,
1913, S. 231.
JOHNSTON, J. B. Nervus terminalis in reptiles and mammals. Journ. Comp . Neurol .,
Vol. 23, No. 2, April 1913, p. 97.
M'COTTER, R. E. The nervus terminalis in the adult dog and cat. Journ. Comp.
Neurol., Vol. 23, No. 2, April 1913, p. 145.
WOERDEMAN, M. V. Tiber einen Zusammenhang der Chorda dorsalis mit der Hypo-
physenanlage. Anat. Anzeig., Bd. 43, No. 14/15, Marz 27, 1913, pp. 378-388.
PHILLIPS, W. F. R. Innervation of an axillary arch muscle. Anat. Record , Vol. 7,
No. 4. April 20, 1913, p. 131.
BERTOLOTTI, M. Une vert^brale lombaire surnum^raire complete chez une momie
egyptiennede la XI* dynastie. Trouvaille radiographique. (1 pi.) Nouv. Icon. d. 1.
Salpit ., Ann. 26, No. 1, Fev. 1913, p. 63.
SMITH, CARROLL. The congenital absence of ribs: report of case with complete
absence of the left seventh and eighth ribs. Journ. Amer. Med. Assoc., Vol. lx.,
No. 12, March 22, 1913, p. 895.
PHYSIOLOGY.
ZELIONY, G. P. Observations sur des chiens auxquels on a enlev3 les hemispheres
cerebraux. Compt. Rend. d. 1. Soc. de Biol., T. lxxiv., No. 12, Avril 11, 1913, p.
707.
EPIFANIO, G. La fisiopatologia della circolazione cerebralo. Riv. di Paid. nerv. e
ment., Vol. xviii., F. 3, Aprile 16, 1913, p. 170.
LEIDLER, R. Experimentelle Untcrsuchungen liber das Endigungsgebiet des Nervus
vestibularis. Monatssck. /. Ohrenhetlk. u. Laryngo-Rhinol., J. xlvii., H. 3,1913,
S. 389.
SHERRINGTON, C. S. Reciprocal innervation and symmetrical muscles. Proe . Roy.
Soc., Ser. B., Vol. 86, April 7,1913, p. 219.
h **
44 *
BIBLIOGRAPHY
SHERRINGTON, C. S. Nervous rhythm arising from rivalry of antagonistic reflexes : I
reflex stepping as outcome of double reciprocal innervation. Proc. Boy. Soc., Ser. (
B., Vol. 86, April 7,1918, p. 283.
CAMUS, JEAN. Paralysie experimental® des centres respiratoires. Compt. Rend. d. I
L Soc. de Biol., T. lxxiv., Avril 26, 1913, p. 761.
ARTHUS, M., and MARTIN, Mllk. F. Note sure le oentre vaso-tonique bulbaire. f
Compt. Rend. d. I. Soc. dt Biol., T. lxxiv., Avril 25,1913, p. 744. '
FREDERICQ, H. Les fonctions des nerfs accel^rateurs du ooeur et lee modifications [
qu’elles eprouvent sous l’influence de divers agents therapeutiquee. (2 fig.) Arch. .
interned, de Physiol., VoL xiii., F. 11, Mars 31, 1913, p. 116. f
SOULA. Relations entre l'activitl fonctionnelle des oentres nerveux et la protdolyse
de la substanoe nerveux. Joum. de Physiol, et de Path, gin., T. xv., No. 2, i
Mars 15, 1913, p. 267. (
ROBINSON, G. C. The influenoe of the vagus nerves on the faradised auricles in the
dog’s heart. Joum. Exp. Med., VoL xvu., No. 4, April 1, 1913, p. 429. I
WEIL, A. Die chemie des Gehirns. (Sammelrefemt.) Ztschr. /. d. get. Neurol, u. {
Psychiat. (Ref.), Bd. 7. H. 1, April 1913, S. 1.
MATHILDE, L. KOCH. Contributions to the ehemioal differentiation of the oantral j
nervous system. I. A comparison of the brain of the albino rat at birth with that I
of the fetal pig. Joum. Biol. Chem ., Vol. xiv., No. 8, April 1913, p. 267. '
KOCH, W., and KOCH, M. L. Contributions to the chemical differentiation of the /
central nervous system. II. A comparison of two methods of preserving nerve *
tissue for subsequent chemical examination. Joum. Biol. Chem., VoL xiv., No. 3, .
April 1913, p. 281. f
SWEET, J. E., and ALLEN, A. R. The effect of the removal of the hypophysis in the
dog. Annals of Surgtry. Part 244, April 1913, p. 485. k
DUBOIS and BOULET. Action des extraits de prostate but les circulations oerdbrale
et r^nale. Compt. Rend. d. 1. Soc. de Biol., T. lxxiv., Avril 25, 1918, p. 811.
*
MARIE, A. Glandee surr^nales et toxi-infections. Ztschr. f. Immunitdtsforsch , /
Teil 1 (Orig.), Bd. xvii., H. 4, 1913, S. 420.
SCHMIDT, P. J. La catalepsie des Phasmides. Compt. Rend. d. 1. Soc. de Biol.,
T. lxxiv., No. 12, Avril 11, 1913, p. 705.
PSYCHOLOGY.
CAMPBELL, HARRY. The integration and disintegration of the personality. Med.
Press, No. 3860, April 30,1913, p. 469.
BIRK, W. Uber den Einfluss psychiscber Vorgange auf den Ernahrungserfolg be
Sauglingen. Monatssch. f. Kindcrheilk. (Orig.), Bd. xii., Nr. 1,1918, 8. 1.
BORING, E. G. Introspection in Dementia Precox. Amer. Joum. Psychol., Vol.
xxiv., No. 2, April 1913, p. 145.
GEISSLER, L. R. Experiments on Color Saturation. Amer. Joum. Psychol., VoL
xxiv., No. 2, April 1913, p. 171.
SWINDLE, P. F. On the Inheritance of Rhythm. Amer. Joum. Psychol., Vol. xxiv.,
No. 2, April 1913, p. 180.
DEARBORN, G. V. N. Kinesthesia and the Intelligent Will. Amer. Joum. Psychol.,
Vol. xxiv., No. 2, April 1913, p. 204.
KRUEGER, F. Magical Factors in the First Development of Human Labor. Amer.
Joum. Psychol., Vol. xxiv., No. 2, April 1913, p. 256,
ANGEU, F., and ROOT, W. T. Size and Distance of Projection of an Afterimage on
the Field of the Closed Eyes. Amer. Joum. Psychol., Vol. xxiv., No. 2, April 1913,
p. 262.
POWELSON, I., and WASHBURN, M. F. The Effect of Verbal Suggestion on
Judgments of the Affective Value of Colors. Amer . Joum. Psychol., vol. xxiv.,
No. 2, April 1913, p. 267.
BIBLIOGRAPHY
45*
URBAN, F. M. Professor Dodge’s Recent Discussion of Mental Work. Amer. Joum.
Psychol., Vol. xxiv., No. 2, April 1913, p. 270.
HELLPACH, W. Vom Ausdruck der Verlegenheit. Ein Versuch zur Sozialpsychologie
der Gemtitsbewegungen. Arehivf. d. ges. Psychol ., Bd. xxvii., H. 1 und 2,1913,
S. 1.
HAERING, TH. Untersuohungen zur Psycholoeie der Wertung (auf expenmenteller
Grundlage) rait besonderer Berlicksichtigung der methodologischen Fr&gen. II. Teil:
Die Ergebnisse. Archiv f. d. get. Psychol ., Bd. xxvii., H. 1 und 2,1913, S. 63.
FRIEDMANN, R. Vorwort zur Oharakterologie. Archiv f. d. ges. Psychol ., Bd.
xxvii., H. 1 und 2, 1913, S. 196.
SCHMITT, H. Psychologic und Logik in ihrem Verh<nis zur Spraohe und zur Methods
sprachlioherUntersuchung. Arehivf. d. ges. Psychol ., Bd. xxvii., H. 1 und2,1913,
S. 204.
URBAN, F. M. Ein Apparat zur Erzeugung schwacher Schalbreize. Archiv f. d. ges.
Psychol ., Bd. xxvii., H. 1 und 2, 1913, S. 232.
KOHLER, P. Ein Beitrag zur Traumpsychologie. Archiv f. d. ges. Psychol., Bd.
xxvii, H. 1 und 2,1913, S. 235.
MARX, E. Untersuchungen liber Fixation unter verschiedenen Bedingungen. Ztschr.
f. Sinnesphysiol ., Bd. 47, H. 2 und 3, 1913, S. 79.
HERMANN, IMRE. Uber die F&higkeit des weissen Liohtes die Wirkung farbiger
Liohtreize zu schw&ohen. Ztschr. f. Sinnesphysiol ., Bd. 47, H. 2 und 3, 1913, S.
97.
ZIMMER, A. Die Ursachen der Inversionen mehrdeutiger stereometrischer Konturen-
zeiohnungen. Ztschr. f. Sinnesphysiol ., Bd. 47, H. 2 und 3,1913, 8. 106.
LANGENBECK, K. Die akustisch-chromatischen Synopsien. Ztschr. f. Sinnesphysiol. $
Bd. 47, H. 2 und 3, 1913, S. 159.
PASCHEN, H. Physiologisohe Ersoheinungen bei der Ubereinanderlagerung von
Halbsohatten. Ztschr. f. Sinnesphysiol., Bd. 47, H. 2 und 3,1913, S. 182.
FRANKFURTHER, W., and THIELE, RUD. Experimen telle Untersuchungen zur
Bezold’schen sprachsext. Ztschr. f. Sinnesphysiol.. Bd. 47, H. 2 und 3, 1913, 9.
192.
ALEXANDER, S. Collective willing and truth. Mind, No. 86, April 1913, p. 161.
MACKENZIE, J. S. A sketch of a philosophy of order. Mind, No. 86, April 1918,
p. 190.
QUICK. O. Bergson’s “Creative Evolution ” and the individual* Mind , No. 86, April
1913, p. 217.
KNOX, H. Y. William James and his Philosophy. Mind , No. 86, April 1913, p. 231.
PATHOLOGY.
FOSCARINI, RODOLFO. Sulle degenerazioni primarie spinali sperimentali. Riv.
Sper. di Frtn ., 1913, VoL xxxix., pp. 18*57.
PARSONS, L. Diffuse sarcomatosis of the brain and spinal oord. Proc. Roy. Soc .
Med., Vol. vL, No. 6, April 1913 (Sect. Dis. Child), p. 168.
SCHNITZLER, J. G. Zur Technik der Marksoheidenftrbung. Neurol. Centralbl.,
Nr. 7, April 1, 1913, S. 403.
SOULA, L. C. Des rapports entre l’anaphylaxie, l’immunit4 et Tautoprot^olyse des
centres nerveux. Compt. Rend. d. 1. Soc. de Biol., T. lxxiv., No. 12, Avril 11,1913,
p. 692.
ACHARD, CH., and FLANDIN, CH. Toxioit4 du oerveau dans le oboe peptonique et
dans le choo anaphylactique. Compt. Rend. d. 1. Soc. de Biol., T. lxxiv., No. 12,
Avril 11, 1913, p. 660.
46 #
BIBLIOGRAPHY
CLINICAL NEUROLOGY.
UE^EiiL-
CALL1GARIS. U1L T SEPPE. Nuov# ricerche sulle line* cutanee iporsitakhe
Htr. S}*r <i» Fren., 1U13. Vol. mix , pp 58*97.
STEWART. G N., and LAFFER. W. B. A study of vasomotor rentes eliciteibj
heat ami cold from region* devoid of temperature aetmibility (in an unuju&l cue
of posttyphoidal neuritis) ArcVmrj Int. Mfd ., Vol ii. . No. 4. April 1913
p. 31 ia.
STEWART, G. N , and WALKER, O. C. Vasomotor reflexes elicited by heat a^l
cold from areas deprived of temperature sensibility by a traumatic lesion.
Arthurs Int. Med .. Vol. ii., No 4, April 1913, p. 383.
9EBVES—
BERNHARDT. M. Beitrag tur Lebre von den Verletxungen des N. radialis am
Unterarm. Neurol. Centralbl ., Nr. 6, 1913, Mari 16, S. 339.
MUSCLES—
PARSONS, L. Sections from a case of progressive spinal muscular atrophy of
infants. (Wcrdnig-Hoffraann type.) Froc. Roy. Soc. Med., VoL vi., No.6, April
1913 (Sect. Dia. Child), p. 164.
HERTZ, A. F., and JOHNSON, W. Progressive muscular atrophy associated with j
primary muscular dystrophy in the second degeneration. Proc. Roy . Soc. J Id
Vol. vi., No. 0, April 1913 (Clin. Sect ), p. 177.
DL T CROQL T ET, C. Faralysie totale des muscles da membre inferieur.
Med., No. 33, Avril 23, 1913, p. 325.
POTTENGER, F. M. Spasm of the lumbar muscles. Journ. Amrr. Md
Assoc., Vol. lx.. No. 13, March 29, 1913, p. 980.
ALLISON, N. Muskelgruppenisolierung cur Beseitigung spaitiacher Uhmunpu*
Ztsehr.f. Orthopad. Chir ., Bd. xxxi., H. 3/4, 1913, SL 444.
MANN, L. Die Elektrotherapie der Lahmungen und Muskslatrophien. &*kr.
/. Physxkal. u. Didt. Therap Bd. xvii., H. iv., April 1913, S, 313.
PLICQUE. Les sels de magnesium an injections locales oontre lea eontractnrw
et lea spasmes musculairea. Bull . Med., Ann. 27, No. 30, Avril 16, 191ft
p. 364.
GRUND, G. Uber die cbemlsche Zustammensetcnng atrophischer Muihto.
Neurol . Centralbl ., Nr. 8, April 16, 1913, S. 486.
IIPIMAL COMD—
geaeral.—WOLFSOHN, J. M. A new lumbar-puncture needle. Joum. Amer.
Med. Assoc., Vol. lx.. No. 16, April 19, 1913, p. 1204.
LBULLIER. La douleur lombo-sacrde. Sa valour dans le diagnostic dtiologique*
Indications physio fcb&apiques. Joum. de Med. de Paris, No. 16, Avril 1ft
1913, p. 319.
THOMAS, T. T. Stiff and painful shoulders with loss of power in the appa
extremity from injuries or inflammations of the shoulder-joint. Thersf
Gazette , April 16, 1913, p. 229.
ANDR^-THOMAS and LEBON. Troubles trophiques d’origine trsamthqu,
atrophie de la main avec d ^calcification des os, consecutive k une fracture de 1 a
premiere phalange du petit doigt Rev. Neurol Ann. xxL, No, 6, Man 3ft
1913, p. 357.
Fracture, Dislocation, Ac.—VITAL-BADIN. Mesure et representation da
oourbures dans les deviations de la oolonne vertdbrale. Arch. yin. de MB.,
Ann. 92, Mars 1913, p. 197.
GOURDON, M. J. Les troubles nerveux d'byperexcitabiliW observes dan*
certains cas de luxation cong<£nitale de la hanche. Leur influence an oouri du
traiteznent de la luxation. Gas. des H6p., Ann. 86, No. 46, Avril 23, 1913,
p. 741.
c
BIBLIOGRAPHY
47*
Cervical Bib.— BANKART, A. S. B. The technique of excision of cervioal ribs.
Lancet , April 5, 1913, p. 962.
WEBER, F. PARKES. Congenital eversion of the great toe and other
abnormalities. Bony process, on the left side of the neck, liable to be mistaken
for a cervical rib. Proc . Roy. Soc. Med ., Yol. vi. f No, 6, April 1913 (Sect.
Dis. Child.), p. 160.
Tabes Dorsalis.—WILLIAMS, TOM A. Tabes dorsalis without lymphocytosis.
Med . Press, No. 3856, April 2, 1913, p. 361; N. Y. Med. Joum., Yol. xcvii.,
April 5,1913, p. 705.
M‘WALTER, J. C. Tabes dorsalis in the blind. Med. Press, No. 3859,
April 23, 1913, p. 444.
DUVOIR, M. Le tabes traumatique. Anna/. d'Hyg. Pull., S4r. 4*, T. xix,,
Avril 1913, p. 305.
BLENCKE. Bin Beitrag zur Frage der tabischen Arthropathien und Spontan-
frakturen. Fortsch. d. Med., Nr. 12, Marz 20,1913, S. 309.
BOUCHi). Tabfes et salvarsan. Joum. de Neurol., Ann. 18, No. 7, Avril 5,
1913, p. 124.
LEREDDE. Le traitement du tabes par le salvarsan. La methods, see r&ultats
et ses dangers. Joum . des Prat., Ann. xxvii., No. 14, Avril 5, 1913, p. 209.
JAWORSKI. Un nouveau traitemont du tabes. Joum. dee Prat., Ann. xxvii.,
No. 16, Avril 19, 1913, p. 247.
FREUND, ERNST and KRISER, ARTUR. Uber die Behandlung der Ischias,
Tabes und chronischer Gelenkkrankheiten mit Mesothorschlamm. Therap.
Monatshefte , J. xxvii., H. 4, April 1913, p. 282.
Poliomyelitis Anterior Acuta. —HAYWOOD, H. B. Acute anterior poliomyelitis.
N.Y. Med. Joum., Vol. xcvii., April 12, 1913, p, 771.
JEWESBURY, R. C. Acute poliomyelitis affecting the muscles of both hands.
Proc. Roy. Soc. Med., Vol. vi., No. 6, April 1913 (Sect. Dis. Child.), p. 159.
PROESCHER, F. Poliomyelitis and variola. N.Y. Med. Joum., Yol. xcvii.,
April 12, 1913, p. 741.
NEU8TAEDTER, M. Poliomyelitis in guinea-pigs. Joum. Amer. Med. Assoc.,
VoL lx., No. 13, March 29,1913, p. 982.
Friedreich’s Ataxia.— THOMAS, H. M. Case of Friedreich’s ataxia. (Johns
Hopkins Hosp. Med. Soc.) Bullet. Johns Hopkins Hosp., Yol. xxiv., No. 266,
April 1913, p. 121.
ANGELO, PIAZZA. Paicosi maniaco-depresaiva, morbo di Basedow e atassia
tipo Marie; malattia di Friedreich. Riv. iial. di Neuropat., Pitchiat. ed
Elettroter ., Vol. vi., F. 3, Maroh 1913, p. 97.
Myelitis.— b£riEL, L., and DELACHANAL. Etude anatomique d’un cas de
sclerose multiloculaire par my41ite diss6minde syphilitique. L'Enctphale, Ann.
vUi., No. 4, Avril 10,1913, p. 301.
Tmmonrt.— ROTSTADT, J. Traitement ohirurgioal des tumeurs de la moelle.
Nouv. Icon. d. 1. SalpSt., Ann. 26, No. 1, F4v. 1913, p. 37.
Paraplegia.— KAUFMAN, L., and BRETON, P. lb. A case of spastic paraplegia,
with dorsal root section for pain and spasticity. Joum. Amer. Med . Assoc.,
Vol. lx., No. 13, March 29, 1913, p. 982.
BBAnr—
Cteaeral.—LANGMEAD, FRED. Congenital deficiency of the oranial vault.
Proc. Roy. Soc. Med., Vol. vi., No. 6, April 1913 (Sect. DU. Child.), p. 151.
Amyotrophic Lateral heterosis.— SANO, F. SoUrose latlrale amyotrophiqne
et syringomyllie. Joum. de Neurol., Ann. 18, No. 6, Mars 20, 1913, p. 104.
48 *
BII’.LTOGEAPHY
Microcephaly.— RIVA, EMILIO. L’ idiota microcefalo Battista. Rir. Sper. di
Fren., 1913, Vol. xxxix., pp. 125-176.
Poreaccphaly.— BABONNEIX and DARR£. Sur un cas de porenc^phalie. Lyon
mtd., Ann. xlv., T. cxx., No. 18, Mai 4, 1913, p. 945.
■femorrhage.— RAUZIER and ROGER. Hernia tronhie, dmipar&ie et hemi-
bypoesthesie linguale gauche avec deviation de la luette par n&robiose on
dmorrngie hulbaire. Hcmiparesie concomitante de la xnoitie droite du corps,
predominant a la face, par legion cerebrale. (1 pi.) Aouv. Icon, d . I. Sa?pH.,
Ann. 20, No. 1, Fev. 1913, p. 28.
MAB1LLE, H., and PITRES, A. Sur un cas damnesie de fixation post-
apoplectique ayant persists pendant vingt-trois ans. Rev. dc Med., Ann.
xxxiii., No. 4, Avril 10, 1913, p. 257.
Aphasia, Ac.— ARCH AMBAULT, LA SALLE. Contribution k Fetude des
localisations de l’aphasie. (2 fig., 1 pi.) Nouv. Icon, d . L Salptt. , Ann. 26,
No. 1, Fev. 1913, p. 20.
FROMENT and MONOD. Etude anatomique et clinique d’un cas d’aphaaie
totale. Lpon med ., Ann. xlv., T. cxx., No. 17, Avril 27, 1913, p. 881.
FROMENT, PILLON, and DUPASQUIER. Aphasie et gliomes cer^braux.
Lyon mid., Ann. xlv., T. cxx., No. 17, Avril 27, 1913, p. 848.
GOLDSTEIN, L. Uber Aphasie und Apraxie. Schmidts Jahrbiicher der in •
und auslund. yes. Med., Bd. 317, H. 3, Marz 1913, p. 218.
CHANCE, B. Developmental Alexia. N. Y. Med . Journ ., Vol. xcvii., April 5,
1913, p. 697.
Periodic Paralysis. —GARDNER, H. W. A case of periodic paralysis. Brain,
Vol. xxxv., Part iii., 1913, p. 243.
Meningitis.— SANO, F. Considerations cliniques sur la m^ningite cer£brospinale
(Spidemique. Journ. de Neurol Ann. 18, S r o. 4, Mars 20, 1913, p. 101.
RAWITSCH, N. A. Ein Fall von epidemischer Zerebrospinalmeningitis, geheilt
durch Antidiphtherieserurn. ZcntralLl. f. inn . Med., Nr. 16, 1913, April 19,
1913, S. 393.
DUCASTAING, M. R. Sur un cas beuin de meningite & pneumocoques clinique-
ment primitive. Rev. Neurol. , Ann. xxi., No. 6, Mars 30, 1913, p. 361.
BRADY, J. M. Report of a case of pneumococcus meningitis with normal
cerebrospinal fluid. Journ. Amer. Mtd. Assoc., Vol. lx., No. 13, March 29,
1913, p. 972.
BREGMAN and KRUKOWSKI. Beitrage zur Meningitis serosa. Monatsseh.
f. Psychiat. u. Neurol., Bd. xxxiii., H. 4, April 1913, S. 283.
NORBURY, L. E. C. Circumscribed serous meningitis. Proc. Roy. Soc. Med.,
Vol. vi., No. 6, April 1913 (Sect. Dis. Child.), p. 157.
KOPETZKY, S. J. Untersuchungen iiber die Beziehungen gewisser Gewebcreak-
tionen zur Frubdiagnose und chirurgischen Behandlungsweise der Meningitis.
Ztschr. f. Okrcnheilk Bd. 08, H. 1, 1913, S. 1.
LISSAUER, MAX. Experimented Leptomeningitis bei chronischer Alkohol-
vergiftung. CcntrnlU. f. ally. Path. u. Path. Anat., Bd. xxiv., No. 8, April
30, 1913, p. 337.
BABINSKI, JUMENTIE, and JARKOWSKI. Meningite cervical® hyper-
trophique. (3 pi., 1 schema.) Nouv. Icon. d. 1. Salptt Ann. 26, No. 1, F4v.
1913, p. 10.
RAUZIER, G., and ROGER, H. Monopl^gie crurale douloureux en flexion avec
anestbesie d’apparence radiculaire. Diagnostic clinique: compression de In
iv« racine lombaire par pachymeningite rachidienne secondaire k un nctaplasme
uterin. Autopaie : nevrite du crural englobe par un volumineux cancer latent
du ccecum. Rev. Neurol Ann. xxi., No. 7, Avril 15, 1913, p. 445.
BIBLIOGRAPHY
49 *
Hydrocephalus. —HAYNES, I. S. Congenital internal hydrocephalus. Annals
of Surgery, Part 244, April 1913, p. 449.
Spondylitis. —FAVRE and BOVIER. Sur un cas de spondylite typhique. Lyon
med., Ann. xlv., T. ©xx., No. 15, Avril 13, 1913, p. 777.
Amaurotic Family Idiocy. — BERGER, H. Uber zwei Falle dor juvenilen Form
der familiaren amaurotischen Idiotie. Ztschr. f. d. ges. Neurol, u. Psychiat.
(Orig.), Bd. xv., H. iv., April 1913, S. 435.
Progressive Lenticular Degeneration. —SAWYER, J. E. H. A case of pro¬
gressive lenticular degeneration. Brain , Vol. xxxv., Part iii., 1913, p. 222.
HOMEN. Einige Wort© zu dem Aufsatz des Herrn Lhermitte : “ Die familiar©
juvenile Hepatitis rascher Entwicklung mit Entartung des Corpus striatum :
Progressive Linsenkern-Entartung ” (Wilson). Fortsch. d. Med., Nr. 11, Marz
13, 1913, S. 284.
Cerebellum.— WERSILOW, W. Zur Frage liber die sogen. “ serosen” Zysten des
Kleinhims. Neurol. Centralbl ., Nr. 6, Marz 16, 1913, S. 350.
MAAS, OTTO. Storung der Schwereempfindung bei Kleiuhirnerkrankung.
Neurol. Centralbl ., Nr. 7, April 1, 1913, S. 405.
GEERTS. Syndrome cerebelleux grave gueri spontanement. Journ. de Neurol .,
Ann. 18, No. 6, Mar B 20, 1913, p. 106.
POGGIO, E. Sintomi clinici da lesione cerebellare e dati sperimentali. Riv.
Crit. di Clin. Med., Anno xiv., No. 17, Aprile 26, 1913, p. 259.
Tmmonrs. —HUDSON, WM. H. Consecutive displacement of the cerebral hemi¬
sphere in the localisation and removal of intracerebral tumours and hemorrhages
(apoplectic hemorrhages and clots). Annals of Surgery, Part 244, April 1913,
p. 492.
PAINE, F. Cerebral tumour, illustrating the value of the operation of decom¬
pression. Proc. Boy . Soc\ Med., Vol. vi., No. 6, April 1913 (Sect. Psyohiat.),
p. 73.
PALLASSE, E. Deux cas de tumeurs de Tangle ponto-cer^beileux. Lyon mdd.,
Ann. xlv., T. cxx., No. 16, Avril 20, 1913, p. 825.
GUTTMANN, A. Die chirurgische Behandlung der Kleinhimbrucken-winkel-
tumoren. (Sammelreferat.) Internal. Zcntralbl. f. Ohrenhcilk. u. Rhino-
Laryngol ., Bd. 11, Nr. 4, 1913, S. 121.
BERLSTEIN, J., and NOWICKI. Zur Kenntnis der Acusticustumoren. Mo-
natssch . /. Ohrcnheilk. u. Laryngo-Rhinol. , J. xlvii., H. 3, 1913, S. 415.
CROOM, Sir HALLIDAY. Pseudo-eclampsia, with two illustrative cases : I.
Cerebral Tumour; II. Meningitis. Journ. Obstct. and Oynacol. , Vol. xxiii..
No. 4, April 1913, p. 213.
Pituitary Tumours, Ac.— M'KENZIE, DAN. Brain, with large pituitary
tumour, from patient who died from haemorrhage after partial removal of floor
of Bella turcica. Proc. Roy. Soc. Med., Vol. vi., No. 6, April 1913 (Laryngol.
Sect.), p. 103.
GRAHAM, C. I. Pituitary tumour. Proc. Roy. Soc. Med., Vol. vi., No. 6,
April 1913 (Laryngol. Sect.), p. 106.
GRAHAM, C. I. Specimen of cerebral tumour which involved pituitary fossa;
microscopical section. Proc. Roy. Soc. Med., Vol. vi., No. 6, April 1913
(Laryngol. Sect.), p. 107.
Acromegaly.— MULLALLY, E. J. Three cases of acromegaly with one autopsy.
Canadian Med. Assoc. Journ., Vol. iii., No. 4, April 1913, p. 269.
GORDINIER, H. C., and KIRK, WM. A case of acromegaly with autopsy.
Albany Med. Annals, Vol. xxxiv., No. 4, April 1913, p. 189.
Diabetes Insipidus. —FORSCHBACH. Zur Frage des Konzentriervermogens der
Niere beim Diabetes insipidus. Ztschr. f. Klin. Med., Bd. 77, H. 3 und 4, 1913,
S. 153.
50 *
BIBLIOGRAPHY
AcfcOM4r*ptA%i*.— BANKART. A. S, B. Case of achondroplasia. Prce. Rot
8oc. Med., VoL vi., No. 6, ApriJ 1913 (Soot Dis. Child.), p. i55,
Pcllafra.—ADLER, R M. The experimental production of lesions rosmbliv
pellagra. Boston Med . and Surg. Joum., VoL clxviii,, No. 13, March I?, 191$
p. 454.
CARBONE, D.. and CAZZAMALU, F. Studi sulk aiologia della pellagra.
Btv. S per. di Frcn 1913, Vol. mix., pp. 177*231.
MILLS, H. P. Pellagra: pathology of gaatro-inteninal tract Joum. Aw.
Med. Assof\ t Vol. lx., No. 12, Maroh 22,1913, p. 889.
HTLLMANN, O. S. Some hematological finding! in pellagra, Anter. Joum.
Med. Sri., April 1913, p. 507.
TIZZONI, G., and ANGELI8, G. dx. Sul oiolo evolutivo dello etreptobadllo
della pellagra. Pathologies Anno v„ N. 107, April© 15,1913, p. 225.
SypMlie.— SCHOENBORN, S. Die operative therapie der Lue§ dei CentralMrw
systems. CentralhL /. d. Orenzgeb. d. Med . u. Chir., Bd. xvi., Nr. 4, April
1913, S. 425.
DBSNEPX and WEILL, La eyphiii* mdniogee. Joum, de Neurol., Ann. 1A
No. 7, Mara 5, 1913, p. 81.
GRAVES, WM. W. Remark* on the Scaphoid Scapuk and its Syndrom*: the
Connection with Syphilis in the Ascendants. Joum. Cut. Z>i>., April 1913,
p. 241.
COSTA, S. M. pe. Infectio secunda syphilitica. Nederlandseh Tijdtch, t.
Geneesk., No. 18, Mei 3, 1913, p. 1207.
THEVENOT, L. Figure neutrophile sanguine d’Arneth dans la irphilii. Pw
Mid., Ann. 41, No. 16, Avril 19, 1913, p. 302.
WATSON, H. F. Unusual fertility in syphilitic parents, associated with
anomalous involvement of the children. Brit. Med, Joum., April 26, 1913,
p. 877. •
DETWILER, A. K. The recently described parasite of syphilis, Joum. Amtr
Med. Assoc., Vol. lx., No. 18, April 19,1913, p. 1225.
GLUCK, A. Die Serodiagnose der Syphilis. (Sammelreferat uber die Arheiten
des letzten Jahres.) Arckiv /. Dermatol, u. St/phihs (Ref.), Bd. cxv.,Rrii,,
1913, S. 721.
IIIDAKA, S. Zur Frage der Beziehungen zwischen Syphilis* and Recurred*
Immunitat. Ztsehr . /. Immunities for sc h. t Teil 1 (Ong.), Bd. xvii., H. n.,
1913, S. 443.
galvarsan.— DIND. Considerations sur lea resultats acquis dans le traitement de
la syphilis par la medication d’Ehrlich—Des neurorecidives. Bev, mid. d . L
Suisse Bom., Ann. xxxiii., No. 3, Mars 20, 1913, p. 177.
BALZER, F. La technique des injections intramusculaires huileusei d’wwno'
benzol dans le traitement de la syphilis. Pressemdd ., No. 27, Avril 1913,p.261.
PINKUS, FELIX. Uber den Stand unserer Kenntnisse vom 8alvarsan. Bcikftt
zur Med . Klinik, J* ix., H. 4,1913, S. 97*
ORMSBY, R. The injection of salvarsan. N.Y. Med. Joum., VoL xcvii..
April 12, 1913, p. 772.
SCHESTOPAL, J. Zur Frage der Todesfalle nacb Salvarsan. Berliner Klind.
J. 25, H. 298, April 1913.
TOMASCZEWSKI, E. Ueber die Todesfalle naob intravenosen Injektionen von
Salvarsan und Neosalvarsan. Dermatol, Ztsehr ., Bd, xx., H. 4, April 19U
S. 283.
STEPHENS, G. A. Distilled water versus salvarsan in the treatment of syphilis
Brit. Med . Joum., April 5, 1913, p. 706.
ASSMY and KYRITZ. Uber Salvarsanbebandlung geschwitrixsr Prc
welche durch die Vinoentscbe Symbiote veranlasst sind. Arckiv /. Schtfl¬
unk Tropen-lTygicne, Bd. 17, Nr. 7,1913, S. 217.
BIBLIOGRAPHY
51*
GLASGOW, L. E. Salvarsan in asthma. N.Y. Med. Joum., Vol. icvii.,
March 29, 1913, p. 663.
Neosalvarsan. —MARINESCO, G. Behandlung syphilitischer Erkrankungen des
Nervensy stems mittels intra-arachnoidealer Injektion von Neosalvarsan.
Ztschr. /. Pkysikal . u. Dxat. Therap ., Bd. xvii., H. iv., April 1913, S. 194.
NIXON, J. A. The intravenous administration of Neosalvarsan in Syphilis.
Bristol Med.-Chir. Joum ., Vol. xxxi., No. 119, March 1913, p. 24.
RAVAUT, P. La pratique des injections intraveineuses de n^o-Salvarsan en
solutions concentrdes. Preset mtd. y No. 27, Avril 2, 1913, p. 262.
PFEIFFER. Zur Lokal behandlung mit “Neosalvarsan.” Archiv /. LaryngoL
u. Bhinol., Bd. xxvii., H. 2, 1913, S. 337.
Wataermamn Reaction.—PAINE, H. L. Results of the Wassermann in two
hundred consecutive admissions to the Danvers State Hospital. Boston Med.
and Surg. Joum., Vol. clxviii., No. 14, April 3, 1913, p. 601.
PISANI, S. Adenopatie superficial! e reazione di Wassermann. Biv . crit. di .
c tin. med ., Anno xiv., No. 16, Aprile 19, 1913, p. 247.
TEISSONNlfeRE, M. Contrdle de l’inactivation des scrums en experience dans
la reaction de Wassermann. Compt. Rend. d. 1. Soc. de Biol. y T. lxxiv.,
Avril 25, 1913, p. 821
RICHARDS, J. H. The Wassermann reaction in diabetes mellitus with special
reference to acidosis. Joum. Amer. Med. Assoc., VoL lx., No. 15, April 12,
1913, p. 1139.
Cerebro-Splnal Fluid. —KAFKA, V. Untersuchungen zur Frage der Entstehung,
Zirkulation und Funktion der Cerebrospinalflussigkeit. Ztschr. f. d. ges.
Neurol, u. Psychiat. (Orig.), Bd. xv., H. 4, April 1913, S. 482.
OHAUVET, S. Methods of counting leucocytes in the cerebro-spinal fluid.
Monde M4d. y Ann. xxiii., No. 328, March 1913, p. 73.
SCHLUCHTERER, B. Eine bequeme Methode zur Darstellung der Zellen des
Liquor cerebrospinalis. Neurol. Centralbl. , Nr. 7, April 1, 1913, S. 420.
ROGER, H. Le liquide cdphalo-rachidien dans la syphilis et la parasypbilis
nerveuses. Preset Med ., No. 31, Avril 16, 1913, p. 305.
GAUJOUX, EM. Que faut-il Denser des pr^tendues “erreurs de formule
oytologique ” du liquide c^phalo-rachidien dans les affections mdning^es ?
(Rev. crit.) SemainenUd., Ann. 33, No. 14, Avril 2, 1913, p. 157.
GENERAL AND FUNCTIONAL DISEASES—
Epilepsy. —M'KINNISS, C. R. Epilepsy. Med . Record , Vol. 83, No. 17, April
26, 1913, p. 749.
SHANAHAN, W. T. A plea for a moderate conservatism in the care and treat¬
ment of epileptics. Epilepsia, Vol. iv., F. 2, April 1913, p. 119.
KATZENELLENBOGEN, E. W. A critical essay on mental tests in their
relation to epilepsy. Epilepsia, Vol. iv., F. 2, April 1913, p. 130.
MUSKENS, L. J. J. Myoklonische Refiexe in der Tierreihe. Epilepsia , Vol. iv.,
F. 2, April 1913, p. 174.
FLEURY, MAURICE DE. Traitement des crises d’epilepsie commune par la
desinfection intestinal©. Epilepsia , Vol. iv., F. 2, April 1913, p. 178.
ORZECHOWSKI, K., and MEISELS, E. Untersuchungen liber das Verhalten
des Vegetativen Nervensystems in der Epilepsie. Epilepsia , Vol. iv., F. 2,
April, 1913, p. 181.
CHIRIE, J. L. Recherchessur Teclampsie puerperal©. Epilepsia, Vol. iv., F. 2,
April 1913, p. 194.
t
BIBLIOGRAPHY
VRIES, ERNST i>k. Uber einen Fall von Epilepsiaalteraan*. Neurol Ct nfroJV.,
Nr. 6, Marx lb, 1913, S. 341.
<;<)UKIKKI, A. Hamatologischc Untersuchungen uber die Epilepaie, Ztrkr.j.
d. <ye*. XeuriU. u. Psyckiat. (Grig ), lid. xv., H. 4 f April M3, 8. 443.
KIKBES, W. Pie farblosen Blutzellen bei der Epilepda AUg. hukr, f,
Psyehieit. % Bd. 70, H. 2, 1913, S. 283.
HAKTENBEPO, M. P. La therap<‘utique de Tepilepaie, Journ. de M& h
Pa rts, No. 17, Avril 2b, HU3, p, 343.
SPANGLER, K. H. The treatment of epilepsy with hypodermicinjeetioniof
crotalm. N. P Mrd. Journ., Vol. xcvii., April 6, 1913, p. 699.
MAYS, T. J. The action and administration of orotalin in pulmonary consump¬
tion and in epilepsy. Mid. Record, Vol. 83, No. 13, March 29, 1913, p. j6L
FLEUR Y, M. pk. Notes on the Dietetic and Bacteriotherapeutic treatment of
common epilepsy. Journ. Pract . Diet, and Bact.-Tkerap., Vol. v M No. 2,
April 1913, p. 24.
HUGER, H. Epileptiform© Lahmungwinfalle ohne Krarapf tmdapoplektifonoe
lltMnitonen ohne Lahmung. (1 Textfig.) Ztsckr. f. d. get, Neml.
Psychnd. (Grig ), Bd. xv., H. iv., April 1913, 8. 427.
Bysterta.—WILLIAMS. TOM A. Hysterical Phobia in a Child; the Principle!of
Treatment. Brit. Journ. Child . 2)ii, 1913, x. f p. 156.
Bnlbar Parslydi.—FREYSTADTL, BELA. Kehlkopfllbmungen bed ihter
Bulbarpaialyse nebst Bernerkung*'n rum Semonschen Onsets. drriir /.
LarywjoL u. Rhinal ., Bd. xxvii., H. 2, 1913, S. 204.
M ear I m.— LEVI, L. Migraine ophtalmique et instability thyroidieone. BM
gen. de Tkerap T. clxv., Avril 8, 1913, p. 496.
ROMAONA-MANOJA. A. Ueber cephalalgische und hemtkranischePsychona
Monutssch. /. Psychiat. u. Neurol., Bd. xxxiii., H. 4, April 1913, S. 294.
Neurasthenia.— RUSSELL, J. RISIEN. The diagnosis, prognosis and bestead
of neurasthenia. Med. Press, No. 3856, April 2,1913, p. 357.
COBB, I. G. The diagnosis of neurasthenia. Practitioner , VoL xa, April 1913,
p. 745.
PAUL, BONCOUR. L’asthynie psycho-mot rice oonstitationnslls infantile.
Asth6nie et neurasthenic chez Tenrant. Prog, rrUd., Ann. 41, No. 16, Avril 12,
1913. p. 190.
Neuralgia.—M‘CONNELL, G. The pathology of neuralgia. NY. Nd
Journ., Vol. xcvii., April 12, 1913, p. 747.
ALEXANDER, W. Die Fortsohritte der physikaliachen Therapie bei Trigeroi
nuaueuralgie, einschliesslieh der Injektions-methoden Ztschr. f. PkgsM
u. Dud. Tlurap., Bd. xvii., H. iv., April 1913, 8. 234.
Neorftl*.—WALLFIELD, J. M. Multiple neuritis in a child. NT, Md
Journ.) Vol. xcvii., April 5, 1913, p. 713.
ESPOSKL, F. Nevrites tuberculosa*. Arch . Brasil de Med Anno iii., N. 1,
Fev. 1913, p. 129.
Addison's Disease.—ANDERSON, K. A case of Addison's disease without
pigmentation. Norsk Mag. f. Large videnskaben, 1912, 5 R, x., 1039.
LOWY. Zur Kenntnis des Morbus Addiaonii. Deutsch. Archie f. KlinMtL
Bd. cx., H. 3 u. 4, 1913, S. 373.
Tetanus.—FRIEDMAN. L. J. Tetanus successfully treated with antitetank
serum. N. Y. Med. Journ., Vol. xcvii., April 5, 1913, p. 716.
CHAUFFARD. Sur un c&s de tdtanoe. Journ , des Prat,, Ann. xxvii., No. 14
Avril 5, 1913, p. 211.
Tetany.—HUGHES, B. Tetany in acute suppurative appendicitis in an adult.
Brit. Mfd. Journ., April 26, 1913, p. 879.
BIBLIOGRAPHY
53 *
KEHRER Die geburtsbUflioh-gynakologische Bedeutung der Tetanie, Archiv
/. Qynaekol ., Bd. 99, H. it., 1913, S. 372.
Exophthalmic Mire, Cretinism, Ac.—BERARD. A propoa da traitement de la
maladie de Basedow ohez les enfant*. Lyon mtd., Ann. xlv., T. cxx., No. 18,
Mai 4, 1913, p. 985.
GBAZIADEI, B. La febbre nel morbo di Basedow e nelle aortiti. Riv. crit. di .
din . med. 9 Anno xiv., No. 13, 14, and 15, Marzo and Aprile 1913, pp. 193, 209,
and 225.
SABOURAUD, R. Pelade et goitre exophtalmique. Animal . de Dermatol . et de
Syphil ., T. iv., No. 3, Mars 1913, S. 140.
SODERBERGH, G. Symptfimes odr^belleux dans le myxoed&me. Nord. Med .
Arkiv [Afd. 11, Inre Med.], Bd. 45, H. 3, Nr. 11, 1912, p. 1.
LANGMEAD, FRED. Nervous cretinism. Proe . Roy . Soc. Med . (Sect. Dis.
Child.), Vol. tL, No. 6, April 1913, p. 149.
ALAMARTINE, H. La technique actuelle des operations pour goitres. Rev. de
Chir. 9 Ann. xxxiiL, No. 4, Avril 10,1913, p. 512.
GILBRIDE, J. T. Ten cases of goitre. AT. F. Med. Joum., Vol. xcvii., March 29,
.1913, p. 662.
Isrnaid’i Disease. —NEWHAM, H. B. A case of Raynaud's disease with exten-
■ivejguigrene. Joum. London School Trap. Med. % VoL iL, Part 2, April 1913,
Aleohollsm, Ac.—LET. Delirium tremens et traumatisms oranien. Joum. de
Neurol ., Ann. 18, No. 7, Avril 5, 1913, p. 122.
SPECIAL SEMES AMD CEAM1AL MERVE*—
GIESE, H. Uber die Schein-Entriindung (Pseudoneuritis) des Sehnerven,
speziell bei Geisteskrauken. Ally. ZUchr. f. Ptychtal., Bd. 70, H. 2, 1913,
5. 237.
SPEYR, TH. V. Ein experiment zum Akkomodationsreflex. Correspondenz-Bl.
J. Schxoeizer Aerzte 9 J. xliii., No. 10, Marz 8, 1913, S. 298.
GINZBURG, J. Zur Kasuistik der Ptosis congenita mit oollateraler Vererbung.
Klin. Monatsbl. /. AugtnheUk ., J. 4, 1913, S. 455.
DUTOIT, A. Der traumatische Enophthalmias. Correspojvdenz-BL /. Schweizer
Aerzte , J. xliii, Nr. 13, Marx 29, 1913, S. 398.
GRANT, J. D. A man, aged 27, with paralysis of the right vocal cord and of
the right half of the palate (the facial, auditory, glosso-pharyngeal and
accessory portion of the vagus involved). Proc. Roy. Soc . Mtd. y Vol. vi., No.
6, April 1913 (Laryngol. Sect.), p. 118.
MlSCELLAMROITg &YMPTOM8 AMD CAIE8-
CHAGAS. Les formes nerveuses d’une nouvelle trypanosomiase ( Trypanosoma
Cruzi inocul<$ par Triatoma magista). (5 pi., 2 fig.) Nouv. Icon, de la Salpit .,
Ann. 26, No. 1, Fdv. 1913, p. 1.
GREGOR, A., and SCHILDER, P. Uber reflektorisohe Gegenspannung beim
Normalen. Neurol. Ccntralbl., Nr. 8, April 16, 1913, S. 482.
ECKERT. Die pharmakologische Priifung des vegetativen Nervensystems im
Kindesalter. Ztschr. f. Ktnderheilk ., Bd. vii., H. 1 und 2, April 1913, S. 41.
ALTER. Ein Fall von Selbstbeschuldigung. Ztschr . /. d. yes. Neurol, u.
Psychiat. (Orig.), Bd. xv., H. iv., April 1913, S. 470.
LAMPE, C. Arterioeklerose, Spat paralyse und UnfalL Monatsschr. /. Psychiat.
u. Neurol. , Bd. xxxiii., H. 4, April 1913, S. 335.
AYALA, G. Le trophoedeme chronique et le syst^me endocrinosympathique.
L'Xntfpkale, Ann. viii, No. 4, Avril 10,1913, p. 319.
54 *
BIBLIOGRAPHY
CHASE, R. G. A one of chronio plumbum in which multiple aneurysms
occurred. Brit. Med. Joum., April 26, 1913, p. 376.
MARTINET, A. Syndrome hyposphyxique et insuffisanoe pluriglandulair*.
Presse Mid. , No. 34, Avril 26, 1913, p. 339.
HEISE, W. Uber Versuche mit Opsonogen. Allg. Etsckr. /. Psychiat., Bd. 70.
H. 2, 1913, S. 291.
LUGARO, E. Un principio biogenetioo: la moltiplioaxione degli effetti utQi
indiretti. (A propoeito aei “ cavalli pensanti.”) Riv. di Patol., nerv. e men*.,
VoL xviii., F. 3, April© 16, 1913, p. 129.
LESZTNSKY, WM. M. Sexual disorders associated with disease of the nervous
system ; and remarks on present-day sexual problems. Med. Record , VoL 83,
No. 15, April 12, 1913, p. 661.
MAVERICK, A. Blunders made by nature ; the part played by nature in eausing
disease of the digestive and nervous systems. Med. Recoil VoL 63, No. 14,
April 5,1913, p. 613.
DEGENKOLB, KARL. Die Raumanachauung und das Raumumgaagsfeld.
Neurol . CentraWl ., Nr. 7 und 8, April 1 und 16,1913, S. 409 und 49L
BOYLE, S. B. Beri-berL N.Y. Med. Joum., VoL xcviL, April 19, 1913,
p. 828.
FUNK, OASIMIR. Studies on beri-beri. Further facts concerning the chemistry
of the vitamine-fraction from yeast. Brit. Med. Joum., April 19,1913, p. 814.
PSYCHIATRY.
SIVKKIL PARALYSIS—
HOFFMANN. Ueber den Naohweis von Syphilisspirooh4ten in der Himrinde bei
Dementia paralytica duroh H. Noguchi. Dermatol. Ztschr., Bd. xx., H. 4,
April 1913, 8. 375.
MARIE, A., LEVADITI, C., and BANKOWSKL Presencedu TreponemapaUidum
dans le oerveau des paralytiques g4n4raux. Compt. Rend. d. 1. Soc. de BioL ,
T. lxxiv., Avril 25, 1913, p. 791.
MARINESCO and MINEA. Presence du trdpon&me pile dans le oerveau dee
paralytiques g4n4raux. Compt. Rend. d. 1. Soc. de Biol., T. lxxiv., Avril 25^
1913, p. 749.
MARINESCO and MINEA. Association de mlningite syphilitique et de paralysie
g4n6rale ; presence de Trepon&mes dans lea meninges. Compt. Rend. a. L Soc.
de BioL , T. lxxiv., Avril 11, 1913, p. 709.
PAINE, F. Organic disease of the nervous system, presenting some features of
general paralysis of the insane. Proe. Roy. Soc. Med., VoL vi, No. 6, April
1913 (Sect. Psyohiat.), p. 72.
CARBONE, D., and PIGHINT, G. Rieerohe sulla oostiturione ohimica del oer-
vello nella paralisi progressiva. Riv. Sper. di Fren., Vol. xxxix., 1913, pp. 1-17.
BISGAARD, A. Eiweiss- und Wassermann-Reaktionen in der Cerebrospinalfltis*
sigkeit der Paralytiker. Ztschr. f. d. gee. Neurol., Psychiat. (Orig.), Bd. xv. f
H. iv., April 1913, S. 608.
ROBERTSON, GEORGE M. General paralysis of the insane: I. and IL
Edin. Med. Joum., April and May 1913, pp. 293 and 428.
ROBERTSON, GEORGE M. Clinical lecture on the early diagnosis of general
paralysis. Med. Press, Nos. 3857 and 3858, April 9 and 16,1913, pp. 382 and
408.
DAMAYE, H. Les associations men tales du syndrome physique paralyse gdnlrale.
Prog. Mid., Ann. 41, No. 16, Avril 19, 1913, p. 204.
CHARPENTIER, J. Quatre oas de paralysis gdndrale conjugate. (Soc. de
Psyohiat. de Paris.) VEneiphale, Ann. viii., No. 4, Avril 10, 1913, p. 399.
BIBLIOGRAPHY
55 *
DEMENTIA PRJSCOX—
CAZZAMALLI, F. Contribute alio studio della “ dementia praeoox.” Riv.
Sper. di Fren ., Vol. xxxix., 1913, pp. 98-124.
SAVOUREUX, H. ls. Quelques mots d’historique sur la d&nenee pr6ooce. Rev.
de Psyckiat ., 1913, F4v., No. 2, Ann. 17®, T. xvii., p. 72.
BORING, B. G. Introspection in dementia preoox. Amer. Joum. Psychol .,
Vol. xxiv., No. 2, April 1913, p. 145.
REPOND, ANDRE. Uber Storungen der musikaliscben Reproduktion bei der
Schizophrenic. AUg. Ztsckr. /. Psyckiat ., Bd. 70, H. 2, 1913, S. 261.
GENERAL—
LIDBETTER, E. J., and NETTLESHIP, E. On a pedigree showing both
insanity and complicated eye disease: anticipation of the mental disease in
successive generations. Brain, Vol. xxxv., Part iii., 1913, p. 195.
BRUCE, LEWIS C. The records of four unusual recoveries in oases of mental
disease. Lancet , April 12, 1913, p. 1022.
JONES, ROBERT. 41 Responsibility ” in regard to oertain forms of uhsoundnees
of mind. Practitioner , Vol. x©., April 1913, p. 053.
SAVAGE, Sir G. H. Automatism. Practitioner , Vol. xc., April 1913, p. 645.
BONHOEFFER, K. Ueber die Beziehun$ der Zwangsvorstellungen sum
Manisch-Depressiven. Monatssck. /. Psyckiat. u. Neurol ., Bd. xxxiu., H. 4,
April 1913, S. 354.
ROSENFELD, M. Uber die Beziehungen des manisch-depressiven Irreseins su
korperlichen Erkrankungen. AUg. Ztschr. f. Psyckiat ., Bd. 70, H. 2, 1913,
5. 186.
EWART, C. T. Katatonio Stupor. Proc. Roy. Soe. Med., VoL vL, No. 6,
April 1913 (Sect. Psychiat.), p. 70.
HEILBRONNER, K. Cooainpsychos© ? Als Beitrag zur Borutaohtung Utio-
logischer Zusammenh&nge. Ztsckr. f. d. gcs. Neurol, u. Psyckiat. (Orig.),
Bd. xv., H. iv., April 1913, S. 416.
DANEO, LUIGI. Sulla psico-patologia dell' emozione durante la guerra.
Rasstgna di Studi Psickiat. f Vol. iii., F. 2, Marzo-April© 1913, p. 96.
EWART, C. T. 14 Washing Mania.” Proc . Roy. Soe. Med., VoL vL, No.
6, April 1913 (Sect. Psychiat.), p. 67.
PARHON, 0., MATBESCO, Mllr. EUG., and TUPA, A. Essais sur Paction
du s4rum des maniaques dans la m<$lancolie et du sdrum des mdlanooliquee dans
la manie. Rev. Neurol ., Ann. xxi., No. 7, Avril 15, 1913, p. 450.
DIDE and LKVEQUE. Psychos© k base d'interprdtation passionnde. Un idealist©
passionn4 de la justice et de la bontd. (1 pi.) Nouv. Icon. d. 1. Salptt .,
Ann. 26, No. 1, F 6v. 1913, p. 56.
LAUMONIER, M. J. La psychiatric. Qaz. des H6p., Ann. 86, No. 38, Avril 3,
1913, p. 615.
BURR, 0. W. The teaching of psyohiatry. Joum. Amer. Med. Assoc..
VoL lx., No. 14, April 5, 1913, p. 1054.
DKRCUM, F. X. The teaching of insanity. Joum. Amer . Med. Assoc.,
VoL lx., No. 14, April 5, 1913, p. 1057.
SCHWAB, S. I. General consideration and classification of the mentally de*
feotive child. Pediatrics , Vol. xxv., No. 3, March 1913, p. 154.
WILLIAMS, E. H., and BROWN, J. S. The menace of the 44 recovered” insane.
Med. Record, VoL 83, No. 13, March 29,1913, p. 565.
DAMATE, HENRI. Associations de la confusion mental©: la confusion inter*
mittente. Rev. de Psyckiat ., 1918, F4v., No. 2, Ann. 17®, T. xvU., p. 62.
k
5ft*
BIBLIOGRAPHY
GENIL-PERRIN, G. L’idee dc dt*generescenc« on medecine mentals. Rev. dt
Piyrhuit., 1913, Fov., No. 2, Ann. 17«, T. xvii., p. 45-
JVQVELIKR, P. % and FILASSIER, A. Le manage ct U vie conjugate demiile
alienee part»den§. JUv. dc Ptychtat., 1913, Fev., No. 2, Ann. 17®, T. x?iL, p-77.
MEN DEI* K. Ueber den Selbetmord bei Unfallverletxten. Monatuch /.
Psychtat. u. JW^roL, lid. xxxni., H. 4, April 1913, S. 310.
GANTER, R. Uber Degenerationsrcichen (von In*, Ohr, Zahnen oiw.) bd
tionundcn, Geisteskrankcn, Epileptikern und Idioten. Aliy. Ztsckr.f. Pfvciiat,
Ed. 70 , H 2, 1213. S. 2*0,
STRAUSS, PAUL. La nouvelle loi »ur le regime ilea alienes. Bcr. dePtmtat,,
Ann. 17, T. xvii.. No. 3, Mara 1913, p. 89.
CHARPENTIER, RENE. Alienation men tale et criminality. Statiatique medioo-
legale des infraction* aux loi* ayant determine I’internemeut d'alieno* danr le
d«*partement de la Seine pendant une jw-riode de cinq aunees (1905-1910|.
L Kncephaic, Ann. viii., No. 4, Avril 10, 1913, p. 341.
LIBERT. LUC1EN. Ix>* alienes en Orient (Grfcce, Empire Ottoman, Egyp^)*
L'Encephale. , Ann. viii., No. 4, Avril 25, 1913, p, 129.
TREATMENT.*
SCRIPTURE, E. W. What it psyohanalysia ? Med. Record , VoL 83, No. 17, April 96,
1913, p. 737.
VOGT, H. Psychotherapie. Tkerap. Monatekelfe, J. xxvii., H. 4, April 1913, p- 257.
WERTHEIMER, H. O. Dreaming and dreams. N. 7. Med. Joum VoL xcrii.,
March 29, 1913, p. 657.
BROWN, WM. Freud s Theory of Dreams. Lancet, April 19 and N, 1913, pp. 1114
and 1182.
REGIS, E., and HESNARD, A. La doctrine de Freud et de son 4oole. (Ber.fM-l
VKnctphalt. Ann. viii., No. 4, Avril 10, 1913, p. 356.
ELFER. UbeT die Wirkung des Extraktes am dem Infundibularteil d«r Glandula
nituitaria unter pathologischen Verhaltniasen. DeuUch. Archiv f. KUn.
fed. ox., H. 3 und 4, 1913, S. 260.
AIRMAN, J. Extract of the suprarenal glands. N.Y. Med. Joum., VoL xcrii,
March 29,1913, p. 649.
• A number of references to papers on Treatment are included in the Bibliofnpbj under
individual d i sease s.
Bibliography
ANATOMY.
SYMINGTON and CRYMBLE. The central fissure of the cerebrum. Joum. Anat.
and Physiol ., Vol. xlvii., April 1913, p. 321.
GRAY, A. A. On the occurrence of a ganglion in the human temporal bone not
hitherto described. (Plate.) Proc. Boy. Soc ., Ser. B., Vol. 86, May 22, 1913,
p. 323.
JALIFIBR, A. Le ganglion sous-maxillaire chez Homme et son rameau pharyngA
Bibliograph. Anat., T. xxiii., F. 2, 1913, p. 83.
TESCH, J. J. Das Nervensystem der Heteropoden. Ztschr. f. Wissenseh. Zool.,
Bd. cv., H. 2,1913, S. 243.
DUCKWORTH, W. L. H. Note on a human foetal skull, apparently the subject of
cephalocele. Joum. Anat. and Physiol ., Vol. xlvii., April 1913, p. 343.
MUNSON, J. P. Chelonian brain-membranes, brain-bladder, metapore and metaplexus.
(9 Figs.) Anat . Record , Vol. 7, No. 5, May 20, 1913, p. 169.
GERARD, G. Contribution k l’4tude morphologique des arthres des capsules surrenales
de l’homme. (16 Figs.) Joum. de l 9 Anat., Ann. xlix., No. 3, Mai-Juin 1913, p. 269.
PHYSIOLOGY.
EDINGER, LUDWIG. Zur Funktion des Kleinhirns. ,(Mit 3 Abbild.) Deut. Med.
Wchnschr. , J. 39, Nr. 14, April 3, 1913, 8. 633.
bArAnY, ROBERT. Lokalisation in der Rinde der Kleinhirnhemisphfcren.
(Funktionsprufung und Theorie.) (Mit 3 Abbild.) Dent. Med. Wchnschr., J. 39,
Nr. 14, April 3,1913, S. 637.
AMANTEA, G. Azione della stricnina e del fenolo sulle zone non eccitabili della
oorteccia cerebral© del cane. Archivo di Pistol ., Vol. xi., F. 11, Gennaio 1913,
p. 112.
KRAUSS, E. Die Wirkung der Nitrite auf die Korpertemperatur des normalen und
des durch Gehirnreizung hyperthermisch gemachten Kaninohens. Archiv f. Exp.
Path. u. Pharmakol , Bd. 72, H. 2, Mai 6, 1913, S. 97.
WALBAUM, H. Ein Beitrag zur Klarstellung des Mechanismus der Warmeregulation
beim normalen und durch Gehirnreizung (Wfcrmestich) hypertherm isch gemachten
Kaninchen. Archiv f. Exp. Path. u. Pharmakol., Bd. 72, H. 2, Mai 6,1913, S. 153.
BIANCHI, V. Alterations histologiques de l’dcoroe cerebrale h la suite de foyers
destructifs et de ldsions experimental©*. Arch. ital. de Biol., T. lix., F. 1, Mai
1913, p. 87.
DANA, C. L., and BERKELEY, W. N. The functions of the pineal gland. With
reports of feeding experiments by H. H. Goddard and W. S. Corwell. Med. Record,
Vol. 83, No. 197»Iay 10, 1913, p. 835.
BOEKE, J. Die Regenerationserscheinungcn bei der Verheilung yon motorischen und
rezeptoriachen Nervenfasern. Pfliigers Archiv, Bd. 161, H. 1, 2, und 3, April 21,
1913, S. 57.
CLEMENTI, A. Contribution i Tdtude des fonctions autonomes de la moelle 4pinifcre.
(Recherches exp4rimentales sur la moelle lombaire dee oiseaux.) Arch. ital. de
Biol., T. lix., F. 1, Mai 1913, p. 15.
BKRITOFF, J. 8. Zur Kenntnis der epinalen Koordination der rhythmischen Reflex©
Tom Ortsbewegungstypus. PJluger's Archiv, Bd. cli., H. 4, 5, und 6, 1913, 8. 171.
I 87 *
58 *
BIBLIOGRAPHY
TURNER, A. H. Remarks on the origin of the phrenie nerve in the rabbit, cat, and
dog. Amur, Journ. Physiol., VoL xxxii., No. 1, May 191% p. 65.
AUER, J. t and MELTZER, 8. J. Der afferente Splanchnikm ale Dep r e—or. ZentralU.
f. Physiol. , Bd. xxvi., Nr. 26, Mar* 22, 1913, 8. 1316.
TROLAND, L. T. A definite physico-chemical hypothesis to explain visual response.
Amer. Journ. Physiol Vol. xxxii., No. 1, May 1913, p. 8.
CLEMENTI, A. Sur les mecanismes nerveux qui r&glent la coordination dee mouve-
ments locomoteurs ohe* lee Diplopodes. Arch. Hal. de Biol., T. lix., F. 1, Mai 1913,
p. 1.
PIERON, H A propos de la oatalepeie dee Phasmides. Compi. Rend. d. 1. Soc. de
Biol., T. lxxiv., No. 19, Mai 30, 1913, p. 1079.
WEILER, FRITZ. Die anatomischen Verfcnderungen bei der Sublimatvergiftung des
Kaninchens in ihrer Abhangigkeit vom Geffcssnervensystem. Virchow's Archi r,
Bd. 212, 11. 2. Mai 15, 1913, S. 200.
FUHNER, H. Ueber die isolierten wirksamen Sabetanxen der Hypophyse. (Mit 1 TafeL)
Dent. Med. Wchnschr ., J. 39, Nr. 11, Mar* 13,1913, 8. 491.
HOSKINS and MEANS. The relation of vascular conditions to pituitrin diuresis.
Journ. Pharmacol, and Exp. Ther ., Vol. iv., No. 5, May 1913, p. 435.
GARRELON, LANGLOIS, and POY. La polypn^e thermique: pneumogaetrique,
adrenaline. Journ. die Physiol, et de Path . gen ., T. xv., No. 3, Mai 15, 1913,
p. 564.
MARIE, A. Glandes surr^nales et toxi-infection. Annales de Vlnstitut Pasteur , Ann.
xxvii., T. xxvii.. No. 4, Avril 1913, p. 294.
CANNON and NICE. The effect of adrenal secretion on muscular fatigue. Amur .
Journ. Physiol ., Vol. xxxii., No. 1, May 1913, p. 44.
MEYER, FELIX. Zur Frage der Adrenalinwirkung auf den Coronarkreislauf. Bert.
Klin. Wchnschr ., J. 50, Nr. 20, Mai 19, 1913, 8. 920.
ADLER, LEO. Zur Adrenalinbeetimmung im Bint. Berl. Klin. Wchnschr ., J. 50,
Nr. 21, Mai 26, 1913, 8. 969.
GREENWALD, ISIDOR. Further metabolism experiments upon parathyroidectomised
dogs. Journ. Biol. Chem ., VoL xiv., No. 4, May 1913, p. 363.
GREENWALD, ISIDOR. On the phosphorus content of the blood of normal and
parathyroidectomised dogs. Journ. Biol. Chem., Vol. xiv., No. 4, May 1913, p. 369.
FENGER, FRED. On the iodine and phosphorus oontents, sire and physiological
activity of the fetal thyroid gland. Journ. Biol. Chcm. % VoL xiv., No. 4, May
1913, p. 397.
PSYCHOLOGY.
FROMENT and MONOD. Du lansage artioulrf che* l’homme normal and chez
l’aphasique. Arch, de Psychol ., T. xiii., No. 49, Avril 1913, p. 1.
DESCOEUDRES, A. Les enfants anormaux sont-ils des amoraux ? Arch, de Psychol.,
T. xiii., No. 49, Avril 1913, p. 20.
FLOURNOY, H. Epilepsia dmotionnelle. Arch, de Psychol ., T. xiii., No. 49, Avril
1913, p. 49.
CLAPAREDE, ED. Existe-il des images verbo-motrioes? Arch . de Psychol ., T. xiii..
No. 49, Avril 1913, p. 93.
ALETRINO, A. Der Liebesprozess beim Mensohen. Ztschr. f. Psychotkcrap. u . med.
Psychol ., Bd. v., H. 1, 1913, 8. 1.
ALRUTZ, S. Zum Probleme der Hypnose. Ztschr. f. Psychotkcrap. u. med. Psychol..
Bd. v., H. 1, 1913, 8. 31.
WYRUBOW, N. Zur Psychoanalyse des Hasses. Ztschr. f. Psychotkcrap. u. med.
Psychol. , Bd. v., H. 1, 1913, 8. 42.
IdAIER, H. W. Jahressitzung des internationalen Vereins fiir medizinische Psychologic
und Pgyohotherapie. Ztschr. /. Psychotkcrap. u. med. Psychol ., Bd. v., H. 1 , 1913,
S. 47.
BIBLIOGRAPHY
59*
FREUD, S. Weitere Ratschlage zur Teohnik der Psychoanalyse. I. Zur Einleitung
der Behandlung. Internal. Ztsehr. j. Arztlich. Psychoanalyse , J. i., H. 1, Jan,
1913, S. 1.
JONES, ERNEST. Die Beziehung zwieohen Angstneurose und Angsthysterie.
Internal. Ztsehr. /. Arztlich. Psychoanalyse, J. i., H. 1, Jan. 1913, S. 11.
SEIF, L. Zur Psychopathologie der Angst. Internal. Ztsehr. /. Arztlich. Psycho¬
analyse, J. i., H. 1, Jan. 1913, S. 18.
FEDERN, PAUL. Beitrage zur Analyse des Sadismus und Masochismus. I. Die
Quellen des mannlichen Sadismus. Internal. Ztsehr. f. Arztlich. Psychoanalyse ,
J. i., H. 1, Jan. 1913, S. 28.
RANK, OTTO. 41 Die Matrone von Ephesus.” Ein Deutungsversuch der Fabel von
der treulosen Witwe. Internal . Ztsehr. J. Arztlich. Psychoanalyse , J. i., H. 1,
Jan. 1913, S. 50.
BERGER. Zur Psychologic der falschen Literaturangaben. Munch. Med. Wchnsehr.,
J. 60, No. 12, M&rz 25, 1913, S. 652.
CAMPBELL, HARRY. The integration and disintegration of the personality. Med.
Press , Nos. 3860 and 3861, April 30 and May 7,1913, pp. 469 ana 497.
BONNIGER. Magenfunktion und Psyche. Deut. Med. Wchnsehr ., J. 39, Nr. 19,
Mai 8, 1913, S. 890.
NORMAN, H. J. Emanuel Swedenborg: a study in morbid psychology. Journ.
Ment. Set., Vol. lix., April 1913, p. 286.
WILLIAMS, TOM A. Psychogenic disorders in childhood. Journ. Abnorm. Psychol.
Feb.-March 1913, p. 407.
JONES, EARNEST. Relation between the anxiety neurosis and anxiety-hysteria,
Journ. Abnorm. Psychol ., Vol. viii., No. 1, April-May 1913, p. 1.
TAIT, WM. D. The effect of psychophysical attitudes on memory. Journ. Abnorm.
Psychol ., Vol. viii., No. 1, April-May 1913, p. 10.
CORIAT, I. H. A case of synesthesia* Journ. Abnorm. Psychol ., Vol. viii., No. 1,
April-May 1913, p. 38.
PATHOLOGY.
TODD, T. WINGATE. Indications of nerve lesion in certain pathological conditions of
blood-vessels. Lancet , May 17,1913, p. 1371.
OBERSTEINER, H. Ueber pathologische Veranlagung am Zentralnervensystem.
Wien. Klin. Wchnsehr ., J. xxvi. Nr. 14, April 3, 1913, S. 521.
STEINER, G. Histopathologischo Befunde am Zentralnervensystem syphilitischer
K&ninchen. Deut. Med. Wchnsehr ., J. 39, Nr. 21, Mai 22, 1913, S. 984.
ORTON, S. T. A study of the brain in a case of oatatonic Hirntod. Amer. Journ.
Insanity , Vol. lxix., No. 4, April 1913, p. 669.
BERIEL, L. Lee donn6es de l’anatomie pathologique et le problems de la sclerose en
plaques. Lyon M6d., Ann. xlv., No. 21, Mai 25, 1913, p. 1117.
DUFOUR and THIERS. Sur un syndrome mlningitique de la sclerose en plaques.
L'Enctphale, Ann. viii., No. 5, Mai 25, 1913, p. 204.
BAUER, J., and SKUTETZKY, K. Zur Pathologie der Blutlipoide mit besonderer
Beriicksichtigung der Syphilis. I. Mitteilung. Wien. Klin. Wchnsehr ., J. xxvi..
Nr. 21, Mai 22, 1913, S. 830.
MUHLMANN, M. Lipoides Nervenzellpigment und die Altersfrage. (4 Textfig.)
Virchov/s Arehiv\ Ed. 212, H. 2, Mai 15, 1913, S. 235.
COLLIN, R. Les granulations lipoides de la substanoe grise chez l’homme. Compt.
Bend. d. I. Soc. de Biol., T. Ixxiv., No. 19, Mai 30, 1913, p. 1121.
COLLIN, R. Les mitochondries des cellules ndvrogliqucs k expansions longues dans la
substance blanche de la moclle chez l'homme. Compt. Rend. d. 1. Soc . de Biol..
T. Ixxiv., No. 19, Mai 30, 1913, p. 1123.
TINEL and LEROIDE. Rccherches sur la permeability k l’arsenio des meninges
normales et pathologiques. Compt. Rend. d. 1. Soe. de Biol. % T. Ixxiv., No. 18,
Mai 23, 1913, p. 1073.
60*
BIBLIOGRAPHY
ZALOZIECKL Zur Fvage der “ Permeabilittt der Meuingen," iMbeiond^ Immun-
stoffen gegenuber. /Arut. JUeAr. /. NeroenkeiUL, Bd. 46* EL 3, 1916, S. 195.
CLINICAL NEUROLOGY.
6imilr-
HEAD, HENRY. 8ix clinical lectures on the diagnostic value of sensory changes
In diseases of th# nervous s y s t em. Lecture YL Clm. Joum.. VoL zE, No. 3,
April 16, 1913, p. 93.
FABRITIUS and V. BERMANN. Zur Kenntnia dor Heat- and TiefeneensibQitat,
untersucht mittels der AbeehntLrungsmethode. Archiv, Bd- cli-, H- 4,
5, und 6. 1913, 8. 126.
PIOTROWSKI. Ueber einan neuen antagon istisohsn Reflex. BerL Klim.
Wehn$ckr. % J. 60, Nr. 16, April 21,1913, 8. 726.
SHAW, B. H. The internearonie ijnapee in dismss, Bril. Med. Joum.. May 10,
1913, p. 989.
WYNKOOP, B. J. A plea for the more frequent nee of lumbar puncture. Arch,
of Fed., VoL xxx., No. 5, May 1913, p. 368.
LADE. Anwendung der Hermann-Perutmehen Reaktlon bei der Prttfung eon
Lumbalpunktaten. Munch. Mod. Wchnechr., J. 60, No. 11, Min 18, 1913,
8. 690.
BKVERS, EDMUND. A case of fado-hypoglomal anastomosis. Lancet, May 24,
1918, p. 1450.
MIGIN1AC, M. G. Section traumatique du nerf cubital i la face posterieure du
brae: suture immediate; retabliseement de la function quarante-huit heures
aprfcs la suture; persistence partielle de lanesth4sle; atrophic seoondaire des
interosseux et de Teminenoe hypoth4nar; inUgrite des fl&hisseurs; rdsultat
fonotionnel satisfaisant. Oat. du H6p., No. 54, Mai 16, 1913, p. 869. r
JABOULAY. Nrfvrom* du cubital. Prog. Mod., Ann. 44, No. 20, Mai 17, 1913,
p. 259.
DORKNDORF, H. Bin Beitrag sur Frags des Zustandekommens linkseeitiger
Recurrenslihmung bei Mitralstenoee. BerL KUn. Wchneohr., J. 60, Nr. 20,
Mai 19,1913, 8. 912.
BABITZKI, PAUL Zur Anasthesierung des Plexus braehiaUs naeh Kulonkampff.
Deut. Med . Wchnechr ., J. 39, Nr. 14, April 3,1913, 8. 652.
NBUMANN-KNEUCKER, A. Kilteleitungsanisthesie am Nerms mentalis.
Wein. Klin. Wchnechr ., J. xxri., Nr. 17, April 24, 1913, 8. 670.
8CHEFFLER Lee mod^rateurs rdfllxes. Joum. de MM. de Parte, Ann- 33,
No. 20, Mai 17,1913, p. 403.
MU6CLE6—
FLATAU and STERLING. Uber sym pto m ati s o h e Myokknie bei organiachen
Affektionen des sentralen Nerrensystems bei Rindorn. Zleehr. f. d. gee. Neurol
u. Ptychiat. (Orig.), Bd. xvi., H. 1 und 3, 1913, S. 143.
FOOT, N. C. Report of a oase of amyotonia oongenita (myatonia oongenita—
Oppenheim) with autopsy. Amer. Joum. Die. of Children , Vol. No. 5, May
1913, p. 359.
STAUDE, C. Ueber Peroneuslahmung post partum. MonaUech . f. Oeburtehulfe
u. Qyndkol ., Bd. xxxYii., H- 6, Mai 1913, p. 611.
HAUSHALTER, P. Myopathic primitive progressive ehes deux frtaes aoec
autopsie. Rev. Neurol ., Ann. xxi, No. 9, Mai 15, 1913, p. 687.
JACOB. Beitrag zur Kenntnis der Myositis, MUneh. Med. Wekneehr ., J. 60
No. 20, Mai 20, 1913, 8. 1089.
EATON, E. M. Tick-bite followed by transitory muscular paralysis. Auelrolaeian
Med. a*., Vol, xxxiiL, No. 17, April 26,1913, p. 391.
BIBLIOGRAPHY
61*
SAUERBRUCH. Die Beetofluasung you Lungenerkraukungen duroh ktinstliehe
L&hmung dee Zwerehfells. [Phrenikotoroiel [II lust.] Miineh. Med. Wehneehr .,
J. 60, Nr. 12 and 19, Mars 25 mul Mai 13, 1913, S. 625 und 1011.
SPINAL €619-
OcieraL—NEWTON, ALAN. A preliminary note upon an experimental invest iga-
tion of ooneussion of the spinal oord and allied conditions. Brit. Med. Joum.,
May 24, 1918, p. 1101.
HIR8CHFELD, R., and LEWANDOWSKY, M. Der Eigenreflex der groesen
Zehe. Ztechr. /. d. yet. Neurol, u. Ptychiat. (Orig.), Bd. xvi, H. 182, 1913,
S. 232.
OBERMILLER. Ueber Arsenlfchmungen. Berl. klin. Wehneehr., J. 50, Nr. 21,
Mai 26, 1913, 8. 966.
B1ESALSK1, K. Die spastisohe Lahmung im Kindesalter und ihre Behandlung.
Deut. Med. Wehneehr. t J. 39. Nr. 16, April, 10, 1913, 8. 699.
BOGDANOW1TSCH. Entbindung bei vollst&ndiger Lahmnng dee Rumpfes.
Zentralbl. f. Oyndkol., Nr. 22, Mai 31. 1913, 8. 809.
Fracture, Dislocation, Ac.—GILLESPIE, E. The diagnosis and treatment of
scoliosis. Clin. Joum ., YoL xlii, No. 4, April 30, 1913, p. 60.
SPITZ Y. Zur Ausniitsung der respiratorischen Krafte in der Skoliosenbehandlung.
Miineh. Med. Wehneehr ., J. 60, No. 11, Man 18,1913, S. 577.
LEWY, J. Angeborene Skoliosen. (Mit 4 Abbild.) Deut. Med. Wehneehr.,
J. 39, Nr. 12, Marx 20, 1913, 8. 558.
SCHANZ, A. Zur Abbott’sehen Behandlung der Skolioee. Berl. Klin. Wehneehr .,
J. 50, No. 22, June 2, 1913, 8. 1019.
VULPIUS, O. Die neue Yerbandbehandlung der Skoliose naoh Abbott. Deut.
Med. Wehneehr., J. 39, Nr. 15, April 10, 1913, 8. 695.
Cervical Dlb.— MENDEL, KURT. Uber Halsrippen. Neurol. Centralbl ., Nr. 9,
Mai 1.1913, S. 556.
Herpes Zoster.—SUNDE, ANTON. Herpes sot ter frontalis mit Bakterienbefund
im Ganglion Gasseri. (Mit 2 Abbild.) Deut. Med. Wehneehr., J. 39, Nr. 18,
Mai 1, 1913, 8. 849.
Tabes Dorsalis.—MARI NEBCO, G., and NOiCA. Deux eaa de tabes compliqul
d’h4mipl4gie. L'Enetphalc , Ann* viii., No. 5, Mai 10,1913, p. 413.
PURSER, F. C. A ease of tabes dorsalis (?) with spinal lesion. Dublin Joum.
Med. Sei., No. 497, May 1913, p. 321.
HIRSCH. Zur Behandlung der Tabes, besonders der Schroerzen u. Parfcstheeien.
MUnch. Med. Wehneehr ., J. 60, No. 19, Mai 13, 1913, S. 1036.
NOBTHE. Die Behandlung der Tabes, speriell ihrer rudimenUren Form und
deren Beziehungen zu psychopathisohen Storungen. Deut. Med. Wehneehr.,
J. 39. Nr. 21, Mai 22, 1913, 8. 999.
SCHUSTER, PAUL. Die abortiven Formen der Tabes dorsalis und der iibrigen
■yghilogem Nervenkrankheiten. Med. Klinik , J. ix., Nr. 18, Mai 4, 1913, 8.
CASTELLI. E., and PINEL, T. The pathogenesis of the gastrio crises of tabes.
Med. Record, , Vol. 83, No. 18, May 3, 1913, p. 783.
CZYHLARZ, E. v., and SELKA, A. Das rftntgenologische Verhalten des Magens
bei gastrischen Krisen und beim Brechakte. Wien . klin. Wehneehr ., J. xxvi.,
Nr. 21 und 22, Mai 22 und 29, 1913, S. 842 und 892.
SCHLEINZER, J. Zwei Falls seltener tabischer KnochenbrUcbe. Wien . Med.
Wehneehr ., J. 63, Nr. 21, Mai 17, 1913. 8. 1287.
D0LLKEN. Ueber Heilung tabischer Erscheinungen durch Arsen und duroh
Bakterienpriparate. Berl. klin. Wehneehr., J. 60, Nr. 21, Mai 26, 1913, 8.
962.
Folloasyclltfls Anterior Acata.— SCHOUG, CARL. Dio Llnge der Inkubations-
zeit bei der akuten Kinderlahmung (Heine-Medinsche Krankheit). Deut. Med.
Wehneehr., J. 39, Nr. 11, Mfcrs 13,1913, 8. 493.
62 *
BIBLIOGRAPHY
TRUMPP. Brkrankung Ton Gesehwistern an Heine-Medinscher Krankheit.
Milnch. Med. Wchnschr., J. 60, No. 19, Mai 13, 1913, S. 1029,
SHARP, E. A. The aborted forma and pre-paralytic stage of acute poliomyelitis
aa observed in the Buffalo epidemio. Joum. Amer. Med . Assoc., VoL 40, No.
5, May 1913, p. 289.
CAMPBELL, B. P. Causation and treatment of deformities following anterior
poliomyelitis. 1. Edin. Med. Joum., May 1913, p. 390.
BARTOW, B. Shoulder and arm paralysis of poliomyelitis (with eleven illustra¬
tions.) N. Y. Med. Joum ., Vol. xcvii., No. 18, May 3, 1913, p. 910.
LUCAS, W. P., and OSGOOD, R. B. Transmission experiments with the
virus of poliomyelitis. Finding the virus in the nasal secretion of a human
carrier four months after the acute stage of a second attack of poliomyelitis.
Joum. Amer. Med. Assoc., Vol. lx., No. 21, May 24, 1913, p. 1611.
ROSENAU, M. J. The mode of transmission of poliomyelitis. Joum. Amer.
Med. Assoc., VoL lx., No. 21, May 24, 1913, p. 1612.
Tsaosn.—MITCHELL, CLARKE, and MORTON, C. A. Removal of intrathecal
tumour from lumbar region of spinal cord. Brit. Med. Joum., May 3, 1913,
p. 932.
JANCKE. Beitrag zur Diagnostik der RUckenmarkstumoren. Munch. Med
Wchnschr., J. 60, No. 19, Mai 13, 1913, S. 1033.
WOLBACH, S. B., and MILLETT, J. A. P. Suffuse sub-dural lipomatosis of
the spinal cord in an infant. Boston Med. and Surg. Joum., VoL olxviiL, No.
19, May 8, 1913, p. 681.
POTEL and VEAUDEAU. La chirurgie des tumeurs du rachis et de la moelle.
Rev. de Chirurgie, Ann. xxxiii., No. 5, Mai 10, 1913, p. 713.
Syringomyelia.— SOUQUES, A., and MIGNOT. Syndrome de Brown-Slquard
avec dissociation syringomyelique de la sensibilite (voies de la sensibility dans la
moelle ypinifcre). (3 fig.) Rev. Neurol., Ann. xxi., No. 8, Avril 30,1913, p. 509.
NANTi^ A., and DUCUING, P. Sur un oas d’hydro-syringomyyiie avec troubles
tropbiques cutanea. (2 planches.) LEnciphale, Ann. viii., No. 5, Mai 10, 1913,
p. 425.
Myelitis.—LERI and LEROUGE. Lea atrophies musculairea syphilitiques pro¬
gressives. La “mydlite syphiiitique amyotrophique.” Qaz. des H6p., No. 65,
Mai 17, 1913, p. 88o.
Progressive Muscular Atrophy. —HUBER. Uber die RUckenmarksver&nderungen
bei spinaler progressiver Muskelatrophie. Deut. Med. Wchnschr ., J. 39, Nr. 14,
April 3, 1913, S. 649.
Paraplegia.—MARINESCO, G., and NOlCA. Sur les reactions des membres
inf<£rieurs aux excitations exterieures chez l’homme normal et ches le para-
pl^gique spasmodique. Mouvements de defense normaux, mouvementa de
defense pathologiques. Rev. Neurol., Ann. xxi., No. 8, Avril 1913, p. 516.
Ischaemic Paralysis.— SWIETOCHOWSKI, G. dk. A case of Volkmann’s
ischsemic contracture of the hand. (IUustr.) Lancet, May 17, 1913, p. 1380.
MAIN—
General—BE RIEL, L. Etude sur coupes s^ri^es d’une lesion thalamique sans
troubles de la sensibilite. Lyon Mid., Ann. xlv., No. 21, Mai 25, 1913, p. 1148.
BYCHOWSKI, Z. Beitrage zur Diagnose und chirurgischen Therapie einiger
Gehirnkrankheiten. Neurol. CeiUrcUbl., Nr. 10, Mai 16, 1913, S. 613.
BADOLLE. Un cas de commotion c^brale. Lyon Mid., Ann. xlv., No. 19,
Mai 11, 1913, p. 1011.
WILLIAMS, E. M. Punctiform hemorrhagic pigmentation of the cerebral pia
mater. Journ. Nerv. and Ment. Dis., Vol. 40, No. 4, April 1913, p. 217.
UNGER and BETTMANN. Experiments zur Bekampfung der Atheml&hmung
bei Gehirnoperationen mittels Meltzer’s Insufflation. Archiv f. Klin. Ckir.,
Bd. c., H. 1, 1913, S. 118.
BIBLIOGRAPHY
63 *
Disseminated Sclerosis.—SCHUSTER, PAUL. Anatomischer Befund einee mit
der Forstersohen Operation behandelten Falles yon multipler Skleroae nebst
Bemerknngen stir Histologic der multiplen Skleroae. Mona tuck. f. Psychiat.
u. Neurol ., Bd. xxxiii,, H. 5, Mai 1913, S. 384.
Anemrlsm. — ORTH. Ueber einen Fall von ruptnriertem Aneurysma einer
Himarterie durch Trauma. Munch. Med . Wchnschr., J. 60, No. 19, Mai 13,
1913, S. 1038.
Haemorrhage.—BIGELOW, O. P. The diagnosis of cerebral hemorrhage by means
of lumbar puncture. Cleveland Med. Journ., Vol. xii., No. 4, April 1913,
p. 265.
HAUCK. Spontane todliche Gehimblutung bei einem Hamophilen. Munch. Med.
Wchnschr., J. 60, No. 21, Mai 27,1913. S. 1147.
Hemiplegia. — ROLLESTON, J. D. Diphtheritic hemiplegia. Clin. Journ.,
Vol. xlii., No. 1, April 9,1913, p. 12.
SAVY, P., and FAYRE, M. H4mipl4gie au oours de la scarlatine. Lyon Mid.
Ann. xly., No. 21, Mai 25,1913, p. 1142.
LEEDE, W. H. Die Hemiplegia postdiphtherioa. Ztschr. f. Kinderheilk.
(Orig), Bd. viii., H. 1, Mai 26, 1913, S. 88.
Meningitis.—BLACK. J. H. Prophylactic yaocination against epidemic meningitis.
Journ . Amer. Med. Assoc ., Yol. lx., No. 17, April 26, 1913, p. 1289.
KRAMER, S. P. A possible souroe of danger in the use of antimeningitis serum
in young children. Journ. Amer. Med. Assoc., Vol. lx., No. 18, May 3, 1913,
p. 1348.
SCHWARTZ. Uber die Meningitis serosa. Petersburg. Med. Ztschr ., J. 38,
No. 6, Marz 1913, S. 67.
SATTERTHWAITE, T. E. Recovery in a oase of influenzal meningitis compli¬
cated by pneumonia. N.Y. Med. Journ., Yol. xovii., No. 21, May 24, 1913,
p. 1065.
COURMONT, SAYY and FLORENCE. Mlningite aseptique k polynucl^aires
chez un tuberculeux. Lyon Med., Ann. xlv., No. 19, Mai 11, 1913, p. 1049.
VILLARET and DESCOMPS, P. A propos d’un oas de m&iingite tuberculeuse
hlmorragique. Oaz. des H6p., No. 59, Mai 27, 1913, p. 961.
ROGER, HENRI. Le liquide clphalo-rachidien de la m^ningite tuberculeuse.
Prog. Med., Ann. 44, No. 21, Mai 24, 1913, p. 271.
TINEL, J., and PAPADATO. Etude clinique et diagnostique de la pachy-
mlningite oervicale hypertrophique. Prog. Med., Ann. 44, No. 20, Mai 17,1913,
p. 253.
KAYSER, CURT. Meningismus (Uebersiohtsreferat). Berl. klin. Wchnschr.,
J. 50, No. 22, Juni 2,1913, S. 1021.
ROGER, HENRI. Les accidents neuro-m4ning6s pr&ooes et tardifs du 606.
M4ningo-neuro - r4cidives ou mlningo - neuro - rechutes syphilitiques th^ra-
peutiques. Oaz. dee H6p., No. 58, Mai 24, 1913, p. 933.
Abscess.—HENDERSON, JOHN. A oase of “idiopathic” cerebral abscess.
Lancet , May 31, 1913, p, 1525.
LANNOIS, DURAND, and RENDU. Trepanation de labyrinthite suppur^e.
Abc&s du cervelet. Intervention. Mort. Lyon Med., Ann. xlv., No. 19, Mai
11,1913, p. 1039.
Tsmonn.-WHITNEY, R. L. Report of a case of a large endothelioma of the
frontal region of the brain. Amer. Journ. Insanity , Yol. lxix., No. 4, April
1913, p. 705.
BARRETT, A. M. Diffuse glioma of the pia mater. Amer. Journ. Insanity,
Vol. lxix., No. 4, April 1913, p. 643.
B^RIEL, L. Sur la transformation kystique des gliomes o4r4braux. Arch, de
Mid. Ezpir., T. xxv., No. 3, Mai 1913, p. 355.
MORRISON, E. E. Report of a case of brain tumour. Journ. Amer. Med.
Assoc., Vol. lx., No. 17, April 26, 1913, p. 1280.
64
BIBLIOGRAPHY
MAILHOUSB, M. t and VERDI, W. F. Cerebellar tutor, glioma, operation,
recovery. Journ. Nerv. and Ment. Du., VoL 40, No. 4, April 1913, p. M
MARX, H. Zur chirurgie der Kleinhirnbruckenwinkoltumoren. Mittal a. i
Urennjtb. d. Mai. u. Ckir. t Bd. xxvi,, H. 1, 1913, p. 117.
ANDREK. Exstirpation eines kleinfaustgrossen Hirnhauttumow in Lokaknu-
thcsie. Mufich. Mai. Wchnschr., J. GO, No. 10, Mari 11,1913, S. 528
EICHHOKN, F. Bin Fall von heterotopem chorionepitheliom in Grhirn and
Lungeii. Mtschr. J. Krebijorschung, lid. xiii., H. 1, 1913, S. 42.
rUslUirj Tantin, die.— MVLLALLY, K- J. A case of infantilism aa«ociat#d
with pituitary neoplasm. Archives JtU. Bled., Vol. xi., No. 5, Msv ISli
p. 6-3.
BONIN, GKRHARDT v. Classification of tumours of the pituitary bodr. Bni
Med. Journ., May 3. 1913, p. 934.
MEYER, ADOLF. New formation of nerve cell* in an isolated part of the
nervous jn>rtion of the hypophysis-tumor in a case of acromegaly with diabetes,
with discussion of hypophysis tumors found so far. Amer. Journ. lam ify,
Vol. lxia., No. 4, April 1913, p. 653.
Ft’NKE, JOHN. Carcinoma of a hyperplastic hypophysis, N . Y. Mtd. Journ,
Vol. xcvii., No. 19, May 10, 1913, p. 976.
PKRITZ, GEORG Hypophysensrkrankungeo. Monatuckr. /. Psychiat. a
Neurol ., Bd. xxxiii., H. 6. Mai 1913, S. 404.
Aeraaaegaly. —POINDECKER, HANS. Ein Beitrag rur Kaauistik der Hypophy*
enverauderungen bei Akromegalie. Wien. klin. Wchnsckr., J. xxri., Nr. W,
Mai 8, 1913, S. 745.
GOLDSTEIN. Ein Fall von Akromegalie nach Kastration bei finer erwachienen
Frau. Munch. Med . Wchnschr ., J. 60, No, 14, April 8,1913, S. 757.
Pellagra.—GRIMM, R. M. Pellagra: some facts in its epidemiology. Jom-
Amer. Mtd . Assoc., Vol. lx., No. 19, May 10, 1913, p. 1423.
TIZZONI, G., and ANGELIS, G. dm. Sfcudien iiber die Biologie uud
Morphologic des pleomorphen Streptobacillus der Pellagra. Central#, f. Bail-
dr., Abt. 1. (Orig.), Bd. 69, H. 1/2, Mai 1913, S. 5.
MYERS, V. C., and FINE, M. S. Metabolism in pellagra. Amer. Journ. Mtd.
Sei Vol. cxlv., No. 5, May 1913, p. 705.
VALTORTA. Di alcuni caratteri della funzionalita gaitrica in pellagrosi. B
Manicomio, Anno xxvii., N. 2-3, 1912, p. 241.
Mongolism.—KELLNER. Die mongoloide Idiotie. (Illuitr.) Munch. Mtd
Wchnschr ., J. 60, No. 14, April 8, 1913, S. 746.
RKICHER, MICHAEL. Untersuchungen iiber die Schkdelform der ripening
ischen und mongolischen Brachycephalen. II. Vergleich der alpenlandischen
brachycephalen Schadel mit den mongoloiden. Zlschr . /. Morpkd.
Anthropol Bd. xvi., H. 1, Mai 1913, S. 1.
Achondroplasia.-—JANSEN, MURK. The causation of the condition known a
achondroplasia. Journ. Anal . and Physiol ., Vol. xlvii., April 1913, p. 360.
Aphasia, Me.—FROMENT and MONOD. Du language articuld chex ITaomnof
normal et chez l’aphasique. Arch, de Psychol ,, T. xiii., No. 49, Anil 1913,p L
GLASCOCK, A. The present knowledge of the status of apraxia with the study
of a case. Journ. Nerv . and Ment. bis., Vol. 40, No. 4, April 1913, p. 223.
FORSYTH, DAVID. A post-graduate lecture on disorders of speech as evidence
of nervouB disease. Clin. Journ., Vol. xiii.. No, 8, May 28,1913, p, 118.
anhUli.— FISCHER, O. Gibt es eine Lues nervosa ? Zlschr . /. d . get. Jftvrd, *•
Psychiat. (Orig.), Bd. xvi., H. 1 und 2,1913, S. 120.
SCHOENBORN, S., and CTJNTZ, WM. Zur Frage der “Pa^*yphilil. ,, m
Med. Wchnsckr., J. 39, No. 12, Mkrx 20, 1913, a 542.
POLLITZER, S. Das Bnde der Parasyphilis. Dermatol. Wchnsckr ., Bd. 56,
Nr. 19, Mai 10, 1913, S. 526.
BIBLIOGRAPHY
65*
POLLITZKR, S. The passing of paraaypMU*" Mod. Record, VoL 83, No. 18,
Hoy 3,1913, p. 797.
SUTHERLAND, W. D. The sero-di&gnoais of syphilis. Indian Med. Oat.,
Vol. xlviii., No. 6, May 1913, p. 169.
OBERNDORFER. Die syphilitiacbe Aortenerkrankung. Milnch. Med.
Wchnschr. , J. 60, No. 10, Mar* 11, 1913, S. 605.
DENEKE, TH. Uber die syphilifcische Aortenerkrankung. (Mit 1 Tabelle.) Deut.
Med. Wchnschr., J. 39, Nr. 10, Marx 0, 1913, S. 541.
LADE, FRITZ. Erfahrungen mit der Hermann-Perutzachen Syphilisreaktion an
600 Fallen. Deut. Med. Wchnschr ., J. 39, Nr. 15, April 10, 1913, S. 693.
TSUZUKI. Antiluetin, ein neuea Mittel der Kombinationatherapie. Deut. Med.
Wchnschr ., J. 39, Nr. 21, Mai 22, 1913, S. 985.
TSUZUKI, ICHIBAGASE, HAGASHI, and HTANO. Die iberapeutiacbe
Wirkung dea Antiluetin. Deut. Med. Wchnschr. , J. 39, Nr. 21, Mai 22, 1913,
S. 988.
NAKANO, H. Ueber Teilungaformen der reingezUohteten Syphiliaapirocbaten.
Deut. Med. Wehnschr., J. 39, Nr. 22, Mai 29,1913, S. 1031.
FLESCH, J. Die Metaluea in veraicherungsarztlicher diagnostisch-prognoatiacher
Hinaioht. Wien. Med. Wchnschr ., J. 63, Nr. 17, April 19, 1913, S. 1061.
ARNOLD. Ueber ortbotiaebe Albuminurie und ibre Beziehungen xur Tuber-
kuloae naob Unterauobungen bei Hautkranken, inabeaondere bei Hauttuber-
kuloae und Sypbilia. Munch. Med. Wchnschr ., J. 60, No. 9, Mari 4, 1913,
S. 458.
UHLENHUTH and MULZER Weitere Mitteilungen Uber die Infektioeitit dea
Blutea und anderer KorperflUssigkeiten syphifitischer Menscben fUr das
Kanineben. Berl. klin. Wchnschr. , J. 50, Nr. 17, April 28, 1913, S. 769.
COLE, H. N. Recent advances in tbe treatment of luea. Cleveland Med. Joum.,
Vol. xii., No. 4, April 1913, p. 249.
NAKANO, H. Experimentelle und kliniache Studien Uber Kutireaktion und
Anaphylaxie bei Sypbilia. Archiv f. Derm. i*. Syphilis (Orig.), Bd. oxvl, H. 2,
1913, S. 281.
8alvarsan. —MATTAUSCHBK, EMIL. Salvaraan und Nervenayatem. Med.
Klinik, J. ix.. Nr. 14, April 6, 1913, S. 626.
EDDY, N. B. Recovery in brain sypbilia after tbe uae of aalvaraan. Joum.
Amer. Med. Assoc., Vol. lx., No. 17, April 26, 1913, p. 1296.
ARMOUR, R. G. Salvaraan in the treatment of syphilitic diseases of the oentral
nervous system. Canad. Med. Assoc. Joum. t Vol. iii., No. 5, May 1913, p. 364.
MULLER. 44 Vasooommotio cerebri,” ein neuer Symptomenkomplex von Gebirn-
erscheinungen aobwerster Art naob Salvarsaninfusionen, eine mittelbare Folge
des Waaserfeblera. Milnch. Med. Wchnschr. , J. 60, No. 15, April 15, 1913,
S. 805.
LEVIS, H. J. An eye lesion following two intravenous injections of salvaraan
but relieved by its further use. Joum. Amer. Med. Assoc. , VoL lx., No. 18.
May 3, 1913, p. 1369.
HAZEN, H. H. Oily injections of salvaraan—a warning. Joum. Amer. Med.
Assoc., Vol. lx., No. 21, May 24, 1913, p. 1618.
ZIMMERN. Infusion oder Iujektion dea Salvaraan* Milnch. Med. Wchnschr .,
J. 60, No. 20, Mai 20, 1913, S. 1087.
MOKRZEOKI. Zur Salvaraanbehandlung dea Milabrand. Milnch. Med.
Wchnschr., J, 60, No. 20, Mai 20, 1913, S. 1089.
HOLTH, MARIE. S&lv&rsanbehandelte Mutter und ibre Kinder. Deut. Med.
Wchnschr., J. 39, Nr. 10, Marz 6, 1913, S. 462.
DOINIKOW. Ueber daa Verhalten dea Nervenaystems geaunder Kanineben au
boben Salvaraandoaen. Milnch. Med. Wchnschr ., J. 60, No. 15, April 15,
1913, S. 796.
KALL. Die praktisebe Ver wend bar keit der provozierenden Wirkung dea
Salvaraana. Milnch. Med. Wehnschr ., J. 60, No. 15, April 15,1918, S. 803.
66 *
BIBLIOGRAPHY
ANTONI. 7 Falle Yon Reinfectio syphilitica and Betrachtungen iiber schwere
Salvaraanintoxikationen. Deut. Med. Wchnsckr. 9 J. 39, Nr. 11, Man 13,
1913, S. 506.
MIEDRK1CH, FR. Klinische und tiers experimenteller Beitrmg zur Toxik-
ologie des Salvartans. Derm. Ztschr. 9 Bd. xx., H. 5, Mai 1913, S. 393.
BAYLY, H. W. The dangers and complications of aabraraan treatment.
Lancet , May 24, 1913, p. 1443.
JORDAN, A. Ein Todesfall doroh Salrarsan. Dermatol. Wchnschr. 9 Bd. Iri.,
Nr. 20, Mai 17, 1913, S. 567.
FINGER, B. Quecksilber und Salrarsan. Bemerknngen zur Syphilistherapie
nnd rur Wirkung der gebrauchlichsten Antisyphilitika. Wien. khn.
Wchnschr. 9 J. xxvi., Nr. 15, April 10, 1913, S. 561.
Waftierausi Reaction.—QUADFLIEG, LEO. Beitrag zur Modification der
Wassermann-Neisser-Brucksehen Reaktion nach M. Stern. Dent. Med.
Wchnschr ., J. 39, Nr. 18, Mai 1,1913, S. 847.
MULLER, R., and STEIN, O. Die Hautreaktion bei Lnes und ihre Beziehung
xnr Wassermannschen Reaktion. Wien. klin. Wcknschr. 9 J. xxvi., Nr. 21, Mai
22, 1913, S. 825.
THOMPSON, L. O. A modified Waasermann. Archives Ini. Med., Vol. xL,
No. 6, May 1913, p. 612.
GRAETZ, FR. Studien xnr Frage der Yerfeinerung der Wasaermannschen Re¬
aktion mit hesonderer Berticksichtigung der aog. “ paradoxen Sera. 11 Dermatol.
Ztschr., Bd lvi., Nr. 20, 21, und 22, Mai 1913, S. 667, 684, u. 616.
STILLIANS, A. IV. Some details in Waasermann technique. Joum. Cut. Dis. y
Vol. xxxi., No. 5. May 1913, p. 316.
BOAS, H. Die Bedeutung der Waesermannechen Reaktion mit Leichenblut
aosgefuhrt. Archiv /. Derm. u. Syphilis (Orig.), Bd. cxvi, H. 2,1913, S- 313.
GIBSON, J. L. The Waasermann reaction in lead poisoning. Australasian
Med. Gaz. % Vol. xxxiii., No. 14, April 6, 1913, p. 300.
WYETH, GEORGE A. What the practitioner should know of the Waesennann
reaction. N. Y. Med. Joum. 9 Vol. xcvii., No. 19, May 10, 1913, p. 964.
ZALOZIECKI, ALEX. Ueber *' eigenlosende 99 Eigenschaften des Meerschwein-
chenaeruma und dadurch bedingte Fehlerquellen der Wa. R. Deut. Med.
Wchnschr ., J. 39. Nr. 17, April 24, 1913, S. 797.
JOLOWICZ, E. Notiz xu vorstehender Arbeit. Deut. Med. Wchnschr J. 39,
Nr. 17, April 24, 1913, S. 798.
Cerebrospinal FI a Id.—JAEGER and GOLDSTEIN. Goldsolreaktion in liquor
cerebrospinalis. (4 Textfig.) Ztschr. f. d. gcs. Neurol, u. Psychiat. (Orig.),
Bd. xvi., H. 1 und 2, 1913, S. 219.
GRUND. Uber Eosinophilie im Liquor cerebrospinalis bei Rautengruben-
Cysticercus. Deut. Ztschr. f. NcrvenheUk ., Bd. 46, H. 3, 1913, S. 236.
REICHMANN. Zur Druckbestimmung des Liquor cerebrospinalis. Miinck.
Med. Wchnschr J. 60, No. 17, April 29, 1913, S. 926.
KAPLAN, D. M. Analyse der Spinalfittssigkeit und des Blntserums in ihrer
Bedentung fur die Neurologic. Deut. Med. Wchnschr ., J. 39, Nr. 22, Mai 29,
1913, S. 1035.
ALTMANN and DREYFUS. Salvarsan und Liquor cerebrospinalis bei
Fnihayphilis, nebst erganzenden Liquoruntersuchungen in der Latenxzeit.
Miinch. Med. Wchnschr ., J. 60, No. 9 und 10, M&rz 4 und 11, 1913, S. 464
und 531. |
SCHUMM and FLEISCHMANN. Untersuchungen liber den Alkoholgehalt der
Spinalflussigkeit bei Alkoholisten und Deliranten. (6 Abbild.) Deut. Ztschr.
/. NcrvenheUk Bd. 46, H. 3, 1913, S. 275.
Bfeotal Tartan.—SUGGETT, O. L. Neos&lvarsan (with one illustration). N. Y
Med. Journ ., Vol. xovii., No. 20, May 17, 1913, p. 1035.
BIBLIOGRAPHY
67*
DUHOT. Bine neue Spritze zur Injektion yon konzentrierter, unter Luft&bsehluas
hergeetellter Neosalvaraanlttsung. (Illustr.) Milnch . Med. Wchmchr ., J. 60
No. 20, Mai 20,1913, p. 1088.
WOLFF, A., and MULZER, P. Darf daa Neoealvaraan ambulant angewendet
werden? Berl. Klin. Wchmchr., J. 50, Nr. 19, Mai 12,1913, S. 879.
DREYFUS. Neoealvaraan. MUnch. Med. Wchmchr ., J. 60, No. 12, M*rz 25,
1913, S. 630.
GERBER. Die bizherigen Erfahmngen mit der Salvarajtn—und Neosalvaraan—
behandlung der lokalen Spirooh&toeen. Milnch. Med. Wchmchr ., J. 60,
No. 12, Mftrz 25,1913, S. 634.
STERN. Die Anwendungaart dea Salvaraana und Neoaalvaraana, Infnaion oder
Injektion ? Milnch. Med. Wchmchr ., J. 60, No. 13, April 1,1913, S. 691.
EMERY, E. R4f6rat anr l’emploi dn aalvaraan et da n6osalvarsan, en France, da
1" aoOt aa 1" ftvrier 1913. Ztschr. f. Chemother , Toil II. (Ref.), H. 3 a. 4,
1913, S. 387.
IYERSEN, JUL. Sammelreferat der roaaiaohen Arbeiten aber Salyarsan and
Neoealvaraan yon Oktober 1911 bia Januar 1913. ZUchr. /. Chemother ., Tail II.
(Ref.), H. 3 a. 4,1913, S. 415.
TOMASCZEWSKI, E. Ueber die Todesf&lle naoh intravenoeen Injektionen yon
Salvaraan and Neoealvaraan (Sehloaa). Derm. ZUchr.. Bd. xx., H. 5, Mai
1913, S. 411.
ALWENS. Experimentelle Studien Uber den Einfloaa dea Salyaraana und
Neoealvaraana aof den Kriealauf and die Nieren gesunder and kranker Tiere.
Archiv. J. Exp. Path. u. Pharmakol ., Bd. 72, H. 3,1913, S. 177.
RAVAUT, PAUL, and SCHEIKEVITCH. Etude but on nouveau proc4d£
d’injection du n£osalvaraan en aolutiona concentr&ea. Technique et reactions.
Annates de Derm . et de Syphl ., T. iv., No. 4, Avril 1913, p. 206.
tiINCKIL AMD FUMCTIOMAL DISEASES—
Epilepsy.—OBERHOLZER, E, Erbgang and .Regeneration in einer Epileptiker-
familie. (1 Textfig.) ZUchr. /. a. get. Neurol, u. Psychiat. (Orig.), Ba. xvi.,
H. 1 and 2, 1913, S. 105.
LOEWE, S. Zur Frageatellang in der Epilepsieforschung. ForUch. d. Med.,
J xiii., Nr. 20, Biai 15,1913, S. 533.
YAURGER, N. S. The mental manifeetationa of epilepsy. Joum. Abnorm.
Psychol., VoL yii., Feb.'March 1913, p. 420.
SORIBNER, E. V. A oaae of epilepsy. Amer. Joum. Insanity , Yol. lxix.,
No. 4, April 1913, p. 723.
LEUBUSCHER, PAUL. Therapeutiaohe Versuche mit Phosphor bei Epllep-
tikern. Dent. Med. Wchmchr ., J. 39, Nr. 11, M&rz 13, 1913, S. 494.
ERLENMEYER, A. Ueber Epilepsiebehandlong. Berl. Klin. Wchmchr .,
J. 50, Nr. 18, Mai 5, 1913, S. 813.
FLOURNOY, H. Epilepsie Imotionnelle. Arch, de Psychol ., T. xiii., No. 49,
Avril 1913, p. 49.
BALINT, R. Die Koohaalzentziehung in der Behandlung der Epilepsie. Neurol.
Centralbl ., Nr. 9, Mai 1,1913, S. 547.
Hysteria.—COURTNEY, J. W. The views of Plato and Freud on the etiology
and treatment of hysteria: a comparison and critical study. Boston Med. and
Surg. Joum., Vol. clxviii., No. 18, May 1,1913, p. 649.
HINRICHSEN, O. Uber daa “ Abreagieren ” beim Normalen und bei den
Hyateriachen. ZUchr. f. d. get. Neurol, u. Psychiat. (Orig.), Bd. xvi., H. 1
and 2, 1913, S. 199.
GATTI, L. II fenomeno di auto-imitazione nolle aasociazioni istero-organische.
Riv. Ital. di. Neuropatol. Psichiat. ed. Elettroter ., Vol. vi., F. 4, Avril 1913,
p. 159.
EMERSON, L. E. A psychoanalytic study of a severe case of hysteria. Joum.
Abnorm. Psychol Vola. vii. and viii., Feb.-March and April-May 1913,
pp. 385 and 44.
68*
BIBLIOGRAPHY
Mtar Hralyiii,- SIEBERT. Zu Kaseistik der bnlbftren Brkraakungmi.
Petersburger Med. Ztsckr., J. 88, No. 9, Mai 1918, 8. 106.
MurtlfU -GRINKER, J. A new method of treating neuralgia of the trigeminus
by the injection of alcohol into the Gaseerian Ganglion. Joum. Amer. Med.
Assoc ., Vol. lx., No. 18, May 3, 1913, p. 1364.
OFFEKHAUS, H. K. Mii n erraringen omtrent de Behandleling nrn Trigeminus-
neur&lgicen met Alcohol-inspuitingen. Nederlandsck Tijdsck. voor Genettk.,
No. 21, H. 1, Mai 24, 1913, p. 1447.
LOEVY, A. Ein Beitrag zur Behandlnng eohwerer Formen von Trigeminus*
neuralgic mit Alkoholinjektionen ins Ganglion Ginfiri, BerL kiin. Wchnschr.,
J. 50, Nr. 17* April 28, 1913, S. 784.
JHenrltla.—CLAUDE, HENRI. Existe-t-il one polynlrrite par intoxication
oxycarbonee? Prog. Med. t Ann. 44, No. 81, Mai 24, 1918, p. 866.
SAVY and MAZEL. Polyn^urite consecutive k nn phlegmon de Pindex droit.
Lyon Mid., Ann. xiv., No. 21, Mai 26, 1913, p. 1161.
HANDY, W. C. Polyneuritic delirium—Korsakoff* psychosis. Amer. Joum.
Insanity, Vol. lxix., No. 4, April 1913, p. 739.
EIJKMANN, C. Uber die Natur und W irkungsweise der gegen ex penmen telle
Polyneuritis wirksamen Substanzen. Archiv /. Sehiffs - tm5 Tropen-Hygiene,
Bd. 17, H. 10, 1913, S. 328.
FAVRE, M., and TOURNADE, A. Sur one varitft* d’adipoee douloureuae
localises aux membres interieur* attaints de seiatiqne. Lyon mid., Ann. xlr..
No. 19, Mai 11, 1913, p. 1006.
Aleehellsm, Ac.—SAUER. Fehlen der Banohdeokenreflexe bei ohronischem
Alkoholismus. Deut. Ztachr. /. Nervenheilk ., Bd. 46, H. 3, 1913, S. 829.
Addlsea’s •Uemse —TESCHEMACHER. Bin Fall von geheiltem (?) Morbus
Addison. Dent. Med. Wchnschr., J. 39, Nr. 10, M&rx 6, 1913, S. 462.
Exophthalmic Goitre, Cretinism, Ac. — TOU8EY. SINCLAIR. Case of
exophthalmic goitre cured by X-raye. Med. Record , Vol. 83, No. 19, May 10,
1913, p. 849.
LEDOUX and TISSERAND. Le Baeedowisme iodique. Prog, mid., Ann. 41,
No. 16, Avril 12 1913, p. 186.
SCHNEE, ADOLPH. Neues zur Therapie des Morbus Baeedowii. - Eentrolbl. f.
Jinnere Med., Nr. 19, Mai 10, 1913, S. 473.
MACLAURIN, C. Exophthalmic goitre. A study of last year’s work. Austral.
Med. Gaz., Vol. xxxiii., No. 15, April 12,1913, p. 326.
HOWLE, W. C. Endemic goitre. Austral. Med. Gaz., VoL xxxiii.. No. 15,
April 12, 1913, p. 327.
BAUER, JULIUS. Fortechritte in der Kliuik der Schilddrtteenerkraukungen.
Btihtflt z. Med. Klinik ., J. ix., H. 5,1913, S. 129.
GORDON, M. B. Thyroid medication in children. N.Y. Med. Joum., Vol.
xcvii., No. 17, April 26, 1913, p. 870.
MARINE, DAVID. The evolution of the thyroid gland. (Illustr.) Bullet. Johns
Hopkins Hosp., Vol. xxiv., No. 267, May 1913, p. 136.
LUBLINSKI, W. Die akute nicht eitrige Thyreoiditis. (Bine Uebereicht.)
BerL Klin. Wchnschr., J. 60, Nr. 18, Mai 6, 1913, S. 834.
TATUM, A. L. Morphological studies in experimental cretinism. Joum. Exp.
Med., Vol. xvii., No. 6, June 1, 1913, p. 636.
BRUSH, E. N., and CORNELL, W. B. A case of myxedema, with recovery, and
seven years' after care. Notes. Archives Ini. Med., VoL xi., No. 6, May 1913,
p. 530.
LANG MEAD, FRED. The relationship of the thyroid gland to alimentary
toxsemia. Lancet , May 17, 1913, p. 1370.
CRIBE, G. W. The identity of oause of aseptic wound fever and so-called post¬
operative hyperthyroidism and their prevention. Annals of Surgery, Part
245, May 1913, p. 048.
BIBLIOGRAPHY
69*
VALTORTA. Rioerehe ematologiche ed urologiche in frenasteniei oon sindrome
ipotiroidea. U Manioomio , Ann. xxrii., N. 2-3, 11)12, p. 249.
Tetany.—SEITZ. Ueber galran. Nerrenmuskelerregbarkeit in der Schwanger-
shaft nnd liber Sehwangersohaftstetanie. Munch . Med . Wchnschr., J. 60,
No. 16, April 22,1913, S. 849.
Tetanai.—DUTOIT, A. Die Magnesiombehandlung dec Tetanus traumaticus.
Dtut. Med. Wchnschr ., J. 39, Nr. 12, Marc 20, 1913, S. 561.
TIDY, LETHEBY. A case of tetanus treated with intraspinal injections of
magnesium sulphate. Brit. Med. Joum., May 24, 1913, p. 1104.
KOLB and LAUBENHEIMER. Zur Beurteilung der prophylaktisohen Serum-
therapie des Tetanus. MUnch. Med. Wchnschr ., J. 60, No. 9, Mara 4, 1913,
EYMER, H. First der Tetanusbacillus grampositir. Centralbl. f. Bakt ., Ac.,
Abt. 1 (Orig.), Bd. 69, H. 1/2, Mai 1913, S. L
SPECIAL SENSES AND CRANIAL NERVES—
BARNES, STANLEY. On Ocular Paralysis. Birmingham Med. Review, Vol.
lxxiii., May 15, 1913, p. 232.
LAUBER, HANS. Bin Fall ron zyklischer Okulomotoriuslahmung. Wien.
Klin. Wchnschr ., J. xxri., Nr. 18, Mai 1, 1913, S. 707.
ABRAHAMS, A. The analysis of nystagmus. (Illustr.) Lancet, May 31,1913,
p. 1522.
KOPETZKY, S. J. The Meniere symptom complex. N. Y. Med. Joum.,
Vol. xcvii., No. 21, May 24, 1913, p. 1070.
LANNOIS and RENDU. Necrose du rocher avec paralyse faciale et sequestra¬
tion du vestibule et des canaux semi-circulaires. Operation. Guerison. Lyon
Med., Ann. xlv., No. 19, 11 Mai 1913, p. 1037.
MALONEY, W. J. W. A. The enhancing of auditory acuity by psychological
methods. N. Y. Med . Joum, VoL xcvii., No. 21, May 24, 1913, p. 1077.
REED, A. O. Vertigo. Joum. Amer. Med. Assoc., VoL lx., No. 20, May 17,
1913, p. 1514.
HINSBERG. Ueber die funktionelle Untersuchung des Ohrlabyrinthes. Berl.
Klin. Wchnschr ., J. 50, Nr. 19, Mai 12,1913, S. 876.
MAAS, OTTO. Storung der Augenbewegungen durch Vestibularisreixung.
Neurol . CcntratbL, Nr. 10, Mai 16, 1913, S. 621.
BALLIN, M. J. A case of total deafness following a dose of quinine. N. Y.
Med. Joum., VoL xevii., No. 21, May 24, 1913, p. 1088.
MISCELLANEOUS SYMPTOMS AND CASES—
TEMME, WALTER. Experimental studies on the nervous mechanism in the
production of hyperplasia. Joum. Nerv. and Ment. Dis., Vol. 40, No. 5,
May 1913, p. 311.
CLAUDE, HENRI. Paralysie saturnine avec participation du median et du
cubital. Joum. des Prat., Ann. xxrii., No. 19, Mai i0,1913, p. 289.
RISPAL and PUJOL. Sur un oas d ataxie aiguft avec gu4rison rapide. Qaz. des
H6p., No. 56, Mai 20,1913, p. 901.
BABINSKI. Suggestion and simulation. Joum. des Prat., Ann. xxrii., No. 21,
Mai 24, 1913, p. 327.
DYNAN, N. J. Psychogenic pyschosis. N.Y. Med. Joum., Vol. xorii.,
No. 19, May 10, 1913, p. 966.
DEUTSCH, FELIX. Untersuchungen liber das Verhalten des vegetativen
Nervensystems bei tuberkulosen Erkrankungen der Lunge. Wien. Klin .
Wchnschr., J. xxri, Nr. 15, April 10, 1913, 8. 569.
PRIBRAM, O. Ueber Seekrenkheit. Wien. Klin. Wchnschr ., J. xxri., No. 22,
Mai 29,1913, S. 888.
70 *
BIBLIOGRAPHY
FROESCH. Ueber cine Komplementbindungsreaktion bei angebornem Schwach-
feinn unJ anderen degeuerativen Zustanden dea Zentralnervensystema. Munch.
Med . Wchnschr ., J. 60, No. 17, April 29, 1913, 8. 911.
SCHUFFNER 1st die Beriberi eine auch in Eoropa beimiaehe Krankheit?
Munch Med . Wchnschr., J. 60, No. 12, Marz 25, 1913, 8, 642.
DEGENKOLB, KARL. Die Raumanschauung und dae BaumnmgangrfelcL
(Fortaetzung.) Neurol. CentralU ., Nr. 9 and 10, Mai 1 and 16, 1913, 8. 560
und 626.
SITTIG, OTTO. Zur Kasuistik der Dysmegalopeie. Monatssehr. /. PsychiaL u.
Neurol. , Bd. xzxiii., H. 5, Mai 1913, 8. 361.
HAENISCH, G. Zur diagnostischen Bedeutung dea Ganaerscben symptoms.
Monatssehr. f. Psychial. u. Neurol. , Bd. xzxiii., H. 5, Mai 1913, S, 439.
BOND, E. D. The personality and outcome in two hundred consecutive cases.
Amer. Journ. Insanity, Vol. lxix., No. 4, April 1913, p. 731.
BURR, C. W., and CROW, C. B. Mirror writing and other associated move¬
ments occurring without palsy. Journ. Nerv . and Menl. Die., VoL 40, No. 5,
May 1913, p. 300.
V. HOESSLIN. Ueber Lymphozytose bei Asthenikern und Neuropathen und deren
klinische Bedeutung. Munch . Med. Wchnschr., J. 60, No. 21, Mai 27, 1913,
8. 1121L
ROSENIIAUPT, H. Die medikamentose Bebandlung dea nervoeen Erbreohena
im fruhen Kindeaalter. Deut. Med . Wchnschr ., J. 39, Nr. 16, April 17, 1913,
S. 752.
BRAUN, L. Therapie der Psychoneuroaen nach Dubois. Wien. Med. Wchnschr.,
J. 63, Nr. 22, Mai 24, 1913, S. 1364.
GREGOR and GORN. Zur psychopathologiachen und klinischen Bedeutung dea
psychogalvanischen Phanomens. (45 textfig.). Ztschr. f. d. gts. Neurol, u.
Psychuit. (Orig.), Bd. xvi., H. 1 und 2, Mai 3, 1913, 8. 1.
SCHALLER, W. F. Spasmodic torticollis. Notes on the etiology in two oaaea.
Journ. Amer. Med. Assoc., Vol. lx., No. 19, May 10, 1913, p. 1421.
D*ABUNDO. Sulle manifestazioni di vitality nei trapianti del teasuto nerroeo.
Pit’. I ted. di NcuropaUl ., Psichiat. ed EUttroUr , Vol. ri., F. 4, April 1913,
p. 145.
PSYCHIATRY.
fcKHEBAL PAJRALYAI8—
MOORE, J. W. Uber das Vorbandenaein dea Treponema pallidum im Gebirn der
progressiven Paralyse. (1 Tafel.) Ztsckr /. d. ges. Neurol, u. Psychial. (Orig.), i
Bd. xvi., H. 1 und 2, 1913, S. 227.
MARINESCO and MINEA. Presence du treponema pallidum dans un caa de K
m^ningite syphilitique associ^e k la paralyaie gen&ale et dans la paralyaie
g^nerale. (2 fig.) Rev. Neurol ., Ann. xxi., No. 9, Mai 15, 1913, p. 581. (
NOGUCHI. Studien fiber den Nachweis der Spiroch&ts pallida im Zentral- f
nervensystem bei der progressiven Paralyse und bei Tabes dorsalis. Munch. [
Med. Wchnschr., J. 60, No. 14, April 8, 1913, 8. 737.
GEISSLER, W. Unter welchen Vorausaetzungen darf man die Nicbterkennung f
der progressiven Paralyse als einen krztlichen Kiinatfehler bezeiohnen ? Ztschr. \
f. MedizinalheanUe , Nr. 9, Mai 5, 1913, S. 337. f
ROBERTSON, GEORGE M. The Morison Lectures, 1913.—General paralysis of
the insane. Journ. Mental Sci., Vol. lix., April 1913, p. 185.
PFLUGER. Ein Beit rag zur Differentialdiagnose zwiaohen den ayphilogenen
Erkrankungcn progressive Paralyse und Tabes doaalia und dem Alkoholtsnms {
chronicus mit besonderer Beriiokaiahtigung der 4 ‘ 4 Reaktionen.” Deut.
Ztschr. /. Ncrvenhtilk, Bd. 46, H. 3, 1913, 8. 242.
PAINE, H. L. A statistical study of remissions in general paralysis. Boston
Med. and Surg. Journ., Vol. olxviiL, No. 19, May 8, 1913, p. 684. '
BIBLIOGRAPHY
71 *
WESTPHAL, A. Ueber die Bchandlung der progreuiven Paralyse. Berliner
klin. Wchnschr ., J. 50, Nr. 15, April 14, 1913, S. 669.
AUDRY, CH. Pourquoi Ton doit traitor lea paralytiques g^neraux. Annales de
Derm, et de Syph. 9 T. iv., No. 5, Mai 1913, 8. 289.
DEMENTIA PRACOX-
VALABREGA, G. Arteriosclerosi, pressione sanguigna e demenza precoce.
Annali di Frcniat ., VoL xxiii., F. 1, Marzo 1913, p. 48.
COURBON, PAUL. D&nence precoce et psychose maniaque-depreasive ; Con¬
tribution k l^tude dea psychoses aaaocieea. VEncephale , Ann. viii., No. 5,
Mai 10, 1913, p. 434.
GENERAL—
MOTT. F. W. The neuropathic inheritance. Journ. Mental Sci. 9 Vol. lix.,
April 1913, p. 222.
HALBERTSTADT. Un caa de psychose degenerative poat-emotionnelle. Rev.
de Psychiat ., T. xvii., No. 4, Avril 1913, p, 150.
PORTEUS, C. A. A brief report of two interesting cases of melancholia. Amer.
Journ. Insanity , Yol. lxix., No. 4, April 1913, p. 755.
ALLAMAN. Folie k deux. Deux aoeura persecutes posse dees. Hallucinations
de la vue et de l'ouie. Hallucinations paycho-motrices et de la aenaibilite
generale. Prog . M6d. 9 Ann. 44, No. 22, Mai 31, 1913, p. 281.
SOUTHARD, E. E. A aeries of normal looking brains in psychopathic subjects
Amer. Journ. Insanity , Vol. lxix., No. 4, April 1913, p. o8§.
FAUSER. Zur Frage dea Vorhandenseins spezifischer Schutzfermente im Serum
von Geisteskranken. Munch. Med. Wchnschr. 9 J. 60, No. 11, Mai 18, 1913,
S. 584.
CHAMPION, J. Dea injections aaaocieea d’iodure de sodium et de cacodylate de
aoude, en particulier, dans lea etats meiancoliquea. Presse M4d. 9 No. 42,
Mai 21, 1913, p. 418.
CYRIAX, E. F. Medical gymnastics considered as a prelude to physical education
in the treatment of mentally deficient children. Med. Press , No. 3862, May
14, 1913, p. 523.
STONER, G. W. Insane and mentally defective aliens arriving at the port of
New York. N.Y. Med. Journ. , Vol. xcvii., No. 19, May 10, 1913, p. 957.
CLOUSTON, Sib THOMAS. “The argument for the large State insane
hospital.” Med. Press , No. 3864, May 28, 1913, p. 573.
VORKASTNER. Payohiatrie und Presse. Berl. klin. Wchnschr., J. 50, Nr. 21,
Mai 26, 1913, 8. 971.
SAGRINI, E. A. La pressione aanguigna negli alienati di mente. Riv. Ital. di
Neuropatol. 9 Psichiat. ed Elettrotcr. % Vol. vi., F. 4, April 1913, p. 169.
WINSLOW, L. F. Mental suggestion by transference. Practitioner. Vol. xc.,
May 1913, p. 870.
SUTTON, H. Education of the feeble-minded in Victoria. Austral. Med.
Journ. 9 Vol. 11, No. 86, March 8,1913, p. 936.
PICK, A. Uber eine nicht unbedenkliohe Erscheinung in der Entwicklung der
deutachen Payohiatrie. Neurol. Centralbl. 9 Nr. 10, Mai 16, 1913, S. 611.
NOBLE, A. I. The curability of insanity. Amer. Journ. Insanity , Vol. lxix..
No. 4, April 1913, p. 715.
CHRISTIAN, F. L. The defective delinquent. Albany Med. Annals , Vol. xxxiv.,
No. 5, May 1913, p. 276.
MARRO, A., and SOCRATE, R. Relazione di perizia psichiatrica aullo stato
men talc di Maggi Francesco, imputato di omicidio premeditato. Annali di
Freniat. 9 Vol. xxiii., F. 1, Marzo 1913, p. 1.
DAWES, S. L. The problem of the alien insane. Amer. Journ. Med. Sci. 9
Vol. cxlv., No. 5, May 1913, p. 671.
72*
BIBLIOGRAPHY
DEMAY. G. L’hdreditd vdeanique eimilaire. Reu. <U PtythvxL, Ann. 17.
T. xvii„ No. 4, April 1918, p. 138.
KISATH, G. Die Fortschritte dm ineaarstliehae Heflvsrfahriss usd die
Geaetxgehung in Osterreich. EUtkr. /. d. pa. IfeuroL u, Ptychiat. (Orif ),
Bd. xvl. f H. 1 und 2, 1913, S. 175.
SPENSLET, F. O. A brief account of Darenth and its system of indwtrol
training. Journ. Ment. Sci., VoL lix., April 1913, p. 305.
WOOLLEY, J. E Suicide among Indian oonrkte under transportation. Journ
Meni. Sci. f VoL lix., April 1913, p. 335.
SMITH, M. H. Notes on one hundred men tall? defective prisoner* si Stafford.
Journ. Ment. Sci. % Vol. lix., April 1913, p. 826.
STURKOCK, J. P. The mentally defective criminal Jours. MenL Sri,
Vol. lix., April 1913, p. 314.
BOND, C. H. After-care in cases of mental disorder, and the desirability of its
more extended scope. Journ. Ment. Sci., VoL lix., April 1913, p. 271
PARIAN!, C. Nuove rioerche sui rapporti dell’ Arte • della Panin. Air. di
Paid., nerv. e ment., Vol xviii., F. 4, Maggio 31, 1913, p. 209.
FROND A. L'otnoeessualitt nella donna. U Manieomw , Anno xxril, K. 24,
1912, p. 123.
VIDONI. A propoeito di an oaso di sindattilia. II Maniwmo, Anno xrvii,,
N. 2-3, 1912, p. 115.
BIANCHINI, LEVI. Oseerrasioni snl rioambio e sulla medkadoas fosfonta in
alcuni stati di esaurimento nelle psiooei acute e oroniche. H Memcmu),
Anno xxvii.. N. 2-3, 1912, p. 135.
VIDONI, GATTE e. Rilievi antropologid su 500 aliened a 50 alienate della
provincia di Treviso. II Mameomio , Anno xxvii., N. 2-3, 1913, p 195.
GRECO. DEL. La mentality degli anonnali psiohia. II Maniwnio, Anno
xxvii., N. 2-3, 1912, p. 227.
PAGE, C. W. Dr Eli Todd and the Hartford Retreat Amer. Journ. Inanity,
Vol. Ixix., No. 4, April 1913, p. 761.
CAMPBELL, HARRY. Man’s mental evolution, past and future. L, R, 2ZL,
and IV. Lancet, May 1,10,17, and 24, 1913, pp. 1260, 1833, 1408. and 1473.
TREATMENT.*
WATSON, L. Abolishing pain after operation! with nerve blook A distance. Annals of
Surgery , Part 245, May 1913, p. 73 0.
HISS, CARL. Hypertension und ihre Bebandlung mit Hochfrequenzstrdmen. JMir.
/. Physical, u. Dtat. Tkerap Bd. xvii., H. v., Mai 1913, p. 277.
BRANTH, J. H. High tension high frequency currents. (With one illustration-1
If. Y, Med. Journ., Vol. xcvil, No. 19, May 10,1918, p. 961.
WALLER, H. E. Influence of the thyroid gland upon blood-pressure. Practitioner,
Vol. xc., May 1913. p. 881.
DOSIO, ENRICO. II “Luminal” come ipnotico. AnndU di Preniat.. Vol. xxiiL,
F. 1, Marso 1913. p. 84.
• A number of references to papers on Trasimeat are included in the Bthlfegmpty onto
individual diseases.
Bibliography
*
ANATOMY.
SCHUEREN, VAN DER. Etude anatomique du f&isceau longitudinal post^rieur. Le
N6vraxe , Vol. viii., F. 2 et 3, Avril 1913, p. 183.
KANKELEIT, O. Zur vergleichenden Morphologic der unteren Saugetierolive (mit
Bemerkungen Uber Kerne in der Olivenperipherie). Arch. f. A not, u. Physiol
1913 (Anat. Abt), H. i., ii., und iii., Mai, S. 1.
NORRIS, H. W. The cranial nerves of Siren lacertina. Joum. Morphol., 1913, xxiv.,
June, p. 245.
BOSS, K. Studien uber die Entwickelung des Gehims bei Fringilla canaria und
Chelydra serpentina. Gcgenbaut*s Morphol. Jahrb., 1913, xlv., H. 3, S. 337.
OGUSHI, K. Zur Anatomic der Hirnnerven und des Kopfsympathicus von Trionyx
japonicus nebst einigen kritischen Bemerkungen. Gtgenbaur's Morphol. Jahrb.,
1913, xlv., H. 3, S. 441.
FRETS, F. P. Uber die Entwioklung des Geruchorganes. Gegenbaur** Morphol .
Jahrb., 1913, xlv., H. 3, S. 481.
BURNE, R H. The comparative anatomy of the internal ear of vertebrates (Dlust.).
Science Progress, 1913, No. 28, April, p. 574.
M'KIBBEN, PAUL S. The eye-muscle nerves of Necturus. Joum, Comp. Neurol .,
1913, xxiii., June 15, p. 153.
BLACK, D. DAVIDSON. The central nervous system in a case of cyclopia in homo.
Journ. Comp . Neurol ., 1913, xxiii., June 15, p. 193.
SCHUMACHER Nochmals die Frage der kollateralen Innervation. Anat. Anxeig .,
1913, xliv., No. 1/2, Mai 24, S. 14-23.
SABUSSOW, N. B. Zur Frage nach der Innervation des Schlundkopfes und der
Speiserbhre der Saugetiere. Anat Arneig ., 1913, xliv., No. 3/4, Juni 3, S. 64-69.
HACKER, F. Beobachtungen an einer Hautstelle mit dissozlierter Empfmdungslah-
mung. Ztschr. f. Biol., 1913, lxi., S. 231.
KREIBICH, K. Farbung der marklosen Hautnerven beim Menschen. Archiv /.
Dermatol, u. Syphilis (Ref.), 1913, cxv., H. 9, S. 993.
ABEL, W., and MTLROY. The arrangement and distribution of the nerves in certain
mammalian ovaries. Proc. Roy. Soc. Med., 1913, vi., May (Obstet. and Gyn.
Sect.), p. 240.
PHYSIOLOGY.
ROSSI, ENRICO. II maggior fenomeno delle oorteccia cerebrale. Lt Nevraxc , Vol.
viii., F. 2 et 3, Avril 1913, p. 161.
DEBAISIEUX, V. G. Recherches anatomiques et experimentales but l*innervation do
la vessie. Le Nivraxe , Vol. xiii., F. 2 et 3, Avril 1913, p. 119.
WALTER, F. K. Be it rage zur Histologic der menschlichen Zirbeldriise (2 Tafeln).
Ztschr. f. d. ges. Neurol, u. Psychiat. (Orig.), 1913, xvii., June, S. 65.
RODIO, G. Contributo alia Questions della rigenerazione del nervi nei mammiferi.
Annali di Neurologies, 191o, xxx., p. 262.
BERITOFF, J. S. Uber die reflektorisehe Naohwirkung der Skelettmuskeln des
Rttckenmarksfroscbe*. Archiv. /. Anat. u. Physiol. (Physiol. Abtlg.), 1913, H. I.
n. II., S. 1.
m
73 *
74*
BIBLIOGRAPHY
HOFFMANN. PAUL. Ueber die Aktionsstrome der Augenmuskdn bei Ruhe da
Tieres und beim Nystagmus. Artktv. /. Anal . u. PhysioL (Physiol. 1913,
H. I. u. II., S. 23.
FILEHNK, WILH. Die Gehorsempfindung bei isolierter, willkurlicher Zuswnmen-
ziehung dee Steigbugclmuskels. Arehtr. f. Anal. u. Physiol, [PhttsioL Abilg\
1913, H. I. u. II., 8. 100.
LANGLEY, J. N. The nomenclature of the sympathetic and of the related system of
nerves. Zfnlralbl . /. Physiol., 1913, nviL, Mai, p. 160.
LAIGNEL LAVASTINE. Definition du sympathique. Qaz . da ffdp ., 1913, Ini.
Juiu 24, p. 1167.
DALE, H. H. On the action of ergotoxine; with special reference to the existence of
sympathetic vasodilators. Journ. Physiol,, 1913, xlvi, No. 3, p. 291.
GKAHAM BROWN, T. Studies in the physiology of the nervous system —XIII.
The compounding of stimuli in temporal succession. Quart. Journ. Exp. Phwd.,
11*13, vi., June, p. 209.
SHERRINGTON, C. S. Reflex inhibition as a factor in the oo-ordiuation of move¬
ments and postures, Quart. Journ, Exp, Physiol., 1913, vi, June, p. 251.
DALE, D.. and MINES, G. R. The influence of vagus and sympathetic on the
electrical and mechanical responses of the frogs heart (Prelim, note). (Proc. Phyiid.
Soc., May 17, 1913). Journ, Physiol 1913, xlvi., No. 3, p. xxviil
LUCAS, KEITH. Electrodes for preventing current-spread in the stimulation of
nerve. ( Proc. Pkysxol. Soc., May 17, 1913). Journ, Physiol., 1913, xlvi, No. 3,
p. xxxii.
CAR DOT and LAUGIER. Loi polaire da Pfluger et dlectrodiagnostic. Pmt. mid,,
1913, xlvi., Juin 4, p. 459.
ZELIONY, G. Ueber die Abhsngigkeit der negativen und positives Schwaubng des
Nervenstromes vom Sauers toff. Ztsehr. f. aUg, Physiol 1913, xv., 8. 23.
MANSFELD, G., and UPTAK. P. Der Kinflusa daa Nervenayetems euf die Mobr
lisierung von Fetfc. Ein Beitrag zur Physiologic der Fettwanderung. PJUpr*
Archiv., 1913, clii., H. 1, 2 und 3, Jum, S. 61.
MANSFIELD, G., and LIPTAK, P. Die quantitative Anderung der Hirnlipoide
wahrend der extrauterinen Ent wick lung. Zuglcich ein Beitrag xur Tbeorie der
Narkose. Pfinger's Archiv 1913, clii., H. 1, 2 und 3, Juni, S. 68.
FUNK, CASIM1R. Studies on beri-beri.—VII. Chemistry of the vitamine-frwtion
from yeast and rice-polishings. Journ. Physiol., 1913, xlvi, No. 3, p. 173,
HENKEL, H. Rhythmishe Entladungen der Nervenxentra. Ztschr.f. ally. Physiol*
1913, xv., S. 1.
FREDERJCQ, H. Resistance comparee des nerfs et dot muscles de grenouillt i h
compression m^canique. (2 fig.) Arch, internal, de Pkysxol, 1913, xiil, Mai,
p. 311.
LEROY, A. Apnde et dyspnde dans la circulation odphalique croiaee. (1 fig.) 4^
internal, de Physiol., 1913, xiii,, Mai, p. 322.
DELL* ERBA, A. Contributo alia fisiologia delle pereexioni visive. Annali di NerroL
1913, xxx., p. 269.
POPIELSKI, L. Hypophysis und ihre Praparate in Verbindung mit ihreo wirbtmw
Substanzen. Perl. Klin. Wchnschr., 1913,1., Juni 23, 8. 1166.
ELLIOTT, T. R. The innervation of the adrenal glands. Journ. Physiol 1915,
xlvi., No. 3, p. 285.
BIERRY, H. Capsules surrtnales et glyodrine. Prase vtfd., 1913, xlvii., Juin g
p. 468.
HOSKINS, R. G., and M'PEEK, C. The effects of adrenal massage on blood-preowre.
Journ. Amer . Med. Assoc., Vol. lx., No. 23, June 7, 1913, p. 1777.
ELIAS, H. Wfcrmestich und Nebenniere. Zentrclbl. f. Physiol. , 1913, Mai, S. 152.
M ANSFF.LD, G. Blutbildnng und Schilddrttse. Beitrag xur Physiologie der Scbild-
druse: II. Mitteiluug. Pfluger s Archiv 1913, clii., H. 1, 2 und 3, Juni, S. 23.
BIBLIOGRAPHY
75*
MANSFELD, G., and HAMBURGER, E. Uber die Ursache der pr&mortalen Eiweisa-
zersetzung. Beitrfcge zur Physiologic der Schilddrfise. III. Mitteilung. Pflilgcr's
Archiv ., 1913, clii., H. 1, 2, und 8, Juni, S. 50.
HAMBURGER, 0. Uber die Wirknng ohlorierter Narkotica auf den Eiweissumsatz.
Beitrage zur Physiologic der Schilddrfise. IV. Mitteilung. Pfliiger's Archiv .,
1913, clii., H. 1, 2 und 3, Juni, S. 56.
PSYCHOLOGY.
HIOKS, G. DAWES. The nature and development of attention. Brit. Joum.
Psychol ., 1913, vi, June, p. 1.
WATT, HENRY J. The psychology of visual motion. Brit. Joum. Psychol ., 1913,
vi, June, p. 26.
READ, CARVETH. The comparative method in psychology. Brit. Joum. Psychol .,
1913, vi., June, p. 44.
FLUGEL, J. C. Some observations on local fatigue in illusions of reversible per¬
spective. Brit. Joum. PsychoL , 1913, vi., June, p. 60.
DAWSON, SHEPHERD. Binocular and uniocular discrimination of brightness.
(6 figs.) Brit. Joum. Psychol ., 1913, vi., June, p. 78.
WYATT, STANLEY. The quantitative investigation of higher mental processes.
(4 figs.) Brit. Joum. Psychol ., 1913, vi., June, p. 109.
BLECTLER, E. Zur Theorie der Sekundiirempfindungen. Ztschr. f. Psychol ., 1913,
lxv., H. 1 u. 2, S. 1.
MEYER, SEMI. Die Lehre von den Bewegungsvorstellungen. Ztschr. /. Psychol .,
1913, lxv., H. 1 u. 2, S. 40.
GROOS, KARL. Liohterscheinungen bei Erdbeben. Ztschr. f. Psychol ., 1913, lxv.,
H. 1 u. 2, S. 100.
JAENSCH, E. R. Die Natur der menschliohen Spraehlaute. Ztschr. f. Sinnes -
physiol ., 1913, xlvii., H. 4 u. 5, S. 219.
BLACHOWSKI, STEFAN. Studien fiber den Binnenkontrast. Ztschr. f. Sinnes -
physiol ., 1913, xlvii., H. 4 u. 5, S. 291.
BABAk, EDWARD. Uber den Farbeneinn des Frosohes, vermittels Atemreaktion
untersucht. Ztschr. f. Sinnesphysiol. 9 1913, xlvii., H. 4 u. 5, S. 331.
POPP, HEINRICH. Die Wirkung von Wkrme und K<e auf die einzelnen Ampullen
des Ohrlabyrinths der Taube, festgestellt mit Hilfe neuer Methoden. Ztschr. f.
Sinnesphysiol ., 1913, xlvii, H. 4 u. 5, S. 352.
BECHTEREW, W. v. Ueber die individuelle Entwicklung der neuropsychischen
Sphere naoh psycho-reflexologisohen Befunden. Ztschr. f. Psychothcr. u. med.
Psychol ., 1913, v., Juni, S. 65.
ADLER, A. Neuropeychologische Bemerkungen zu Freiherr Alfred von Bergers
“ Hofrat Eyseali4rdt. n Ztschr . /. Psychothcr. u. med. Psychol 1913, v„ Juni,
S. 77.
ALETRINO, A. Der Liebesprozess beim Menschen (Scbluss). Ztschr. f. Psychothcr.
u. med. Psychol ., 1913, v., Juni, S. 89.
KARP AS, M. J. The principles of Freud’s Psychology. N.Y. Med. Joum., 1913,
xovii., June 14,1913, p. 1231.
SCHLESINGER, E. Das psychisohe Verhalten der sohwachbegabten Sohulkinder und
ihre Charakterentwicklung. Ztschr. f. d. ges. Neurol . u. Psychiat. (Orig.), 1913,
xvii., Juni, S. 10.
BLOCK, E. Uber Intelligenxprfifungen (naoh der Methods von Binet und Simon) an
normalen Yolkssohulkindern und Hilfssohulkindem. Ztschr. f. cL ges Neurol, u.
Psychiat. (Orig.), 1913, xvii, Juni, S. 23.
SOLOMON, MEYER. The analysis and interpretation of dreams based on various
motives. Joum. Abnorm , PsychoL , 1913, viii, Junt-July, p. 73.
BIBLIOGRAPHY
76*
JONES, ERNEST. A simple phobia. Joum. Abnorm. Psychol., 1913, ful, June*
July, p. m.
COR1AT, ISADOR H. An unusual type of synesthesia. Joum. Abnorm. PsyM,
1913, viii., June-July, p. 109.
OTIS, MARGARET. A perversion not oommonly noted. Joum. Abnorn. Piychd.,
191.'I, viii., June-July, p. 113.
SOUTHARD, K. K., anil STEARNS, A. W. How far is environment responsible/or
delusions? Joum . Abnorm. Psychol. , 1913, viii., June-July, p. 117.
PATHOLOGY.
LUGIATO, LUIGI. II metodo di Besta per la guaina mielinka nelle degeneraziom
secomiarie. Riv . ital . di Neurtrpatol., Psichiat. td Klettroter., 1913> vi., p. 193,
PRIORK, N. DEL. L'arione del liquido oefalo-rachidieno, dei plewi coroidei « di alcuni
organi e sostanze tul cuore isolato di eoniglio. Riv. Ital. di Rcurojiatol., Pstchisl
ed Klettroter., 1913, vi., p. 211.
MALESPINR, M. E. Note but Ies processus de disintegration des tissui nemui et
sur le rule des leucocytes. Lyon Altd 1913, Ann. xlv., No. 25, Join 22, p. 1340.
BATTEN, E. K. Cerebral symptoms in a bulldog associated with lymphocytic infiltra¬
tion of the vessels and membrane of the brain and spinal cord. Proc. Roy. Soc.
Med., 1913, vi., May (Neurol. Sect), p. 11A
MARKUS, OTTO. Kin Fall von diffuser Sarkomatose der Pia mater. Arehir. f.
Psyi huit. u. Nervenkrankh , 1913, 1L, S. 322.
SCHOPPKR. Uber primhre Melanosarkomatoee der Pia mater. Frankfurter ftschr.
f. Path., 1913, xiii., S. 77.
SPIKSS, PAUL. Zur Lehre der von Sehnensoheiden und Aponeoroeen suigehe&deo
Riesenzellensarkoroe (“Tumours mydloides” and “Myotome* der Autoren).
Frankfurter . Ztschr. /. Path.,, 1913, xiiL, 8. 1.
PETERS, H. Zur Kenntnis der Ganglioneuroma. Frankfurter Ztschr. /. Path, 1913,
xiii., S. 114.
HERZOG, GEORG. Uber einen Bautengrubencystieenms. Bin Beitrag zur Histologie
der Ependymverhnderungen. Beitrdge z. path. Anal. u. z. aUg. Path., 1913, lvi,
S. 215.
RUFFER and CRENDIROPOULO. Sur la guerison du tetanos experimental, chezle
cobaye. Compt. Rend. d. 1. Soc. de Biol., 1913, lxxiv., Juin 20, p. 1277.
WIEDEMANN. Beitrag sur Frage der traumatischen RUckenmarkg-degenerstion (im
Anschluss an einen Fall von stiftformiger Nekrose des Rtickenmarkes nsch Frsktor
der Halswirbelaaule). Frankfurter Ztschr . /. Path., 1913, xiii., 8.16i
FREUND. Uber die Bedeutung der Vagi fUr die W&rmeregulation. (4 Kurnn.) Arehir.
/. Rjp. Path. u. Pharmakol. , 1913, lxxii., S, 295.
OSWALD, AD. Die Schilddrttse und ihre Rolle in der Platbologie. Correspond. Bl. /.
Schweizer Aerzte, 1913, xliii., Mai 31, 8. 675.
WELTMANN, O. Uber das doppeltbreohende Lipoid der Nebenniere. Beitrdgc
path. Anat. u. z. ally. Path., 1913, Ivi., S, 278.
CLINICAL NEUROLOGY.
glMNEBAL—
WILSON, S. A. KINNIER, The clinical importance of the sympathetic nervous
system. Brit. Med. Joum., 1913, June 14, p. 1257.
BOURGUIGNON, G. Electrodes impolarisables pour l’excitatton des nerfs et
muscles de lTiomme. Compt. Rend. d. 1. Soc. de Biol., 1913* lxxiv., Join 20,
p. 1250.
HIRSCHBERG, R. Die Uebungstherapie bei den motorischen Storungen einiger
organiseber und funktioneller Erkrankungeu des Nervensyatems. Ztschr. f
Physikal. u. Didt. Therapie , 1913, xvi., Juni, S. 333.
COLLINS, J. The possible relationship of organic diseases of the nervoui system
to Riggs disease. Joum. Amer. Med. Assoc., Vo h lx., No. 23, June 7, 1913,
p. 1779.
BOHM, F. Bin Beitrag zur tubertieen Skleroee. Proper Med. Wchnschr 1913,
xxxvtfL, Jnni 12 undid, S. 329 and 360.
BIBLIOGRAPHY
77*
HEEVEft—
HBZBL, O. Bine Verletzung dee N. radialis am Unterarm. Neurol. Centralbl .,
1913, xxxii, Juni l f S. 686.
BAB1NSKI. Section et suture dee nerfa. Joum. dee Prat., 1913, xzrii., Join 7,
p. 358.
LOEPER end SCHULMANN. Lea lotions dn pneumo-gastrique et le syndrome
de In petite oonrbure. Prog. Med., 1913, xliv., June 7, p. 293.
MUSCLES—
HUGHES, E. C. Paralysis of the serratua magnus. Proc. Roy. Soc. Med., 1913,
vi., March (Clin. Sect.), p. 165.
ROASBNDA and ANGELA. A proposito deile atrofle muscolari di origins cere¬
brals. Due oaei clinioi e relativ oonsiderarioni patogenetiche. Riv. erit. di din.
Med., 1913, xiv., Maggio and Guigno, pp. 337 and 353.
COTTERILL, DENIS. A case of amyotonia congenita. Bdin. Med. Joum., 1913,
Vol. x., June, p. 519.
COLLIER, JAMBS, and WILSON, S. A. KINNIER. The olinical history and
morbid anatomy of a case of generalised solerodermia with severe muscular
atrophy. Proc. Roy. Soc. Med., 1913, vi., May (Neurol. Sect.), p. 119.
SPINAL COED—
Oeaeral — MANNING, J. V. V. A study of the flaccid spinal paralysis which
attacked Louis Pasteur in early maturity, and its similarity to an attack of
acute epidemic poliomyelitis. Together with a study of the silkworm as a
possible mediary host of the same disease. Med. Record, 1913, lxxxiii,, May
81, p. 976.
GEHUCHTEN, A. VAN, and LAMBOTTB, A. La laminectomie dans la com¬
pression m&lullaire—Treize interventions ohez ouze maladee—Un cat de
gu^rison complete. Le Nevraxe, Vol. xiii., F. 2 et 3, Avril 1913, p. 311.
RAIMISTE, J. M. Contribution k la symptomatologie de la paralysie organique
d’origine centrale du membre supdrieur. (2 fig.) Rev. Neurol., 1913, xxi., Mai
30, p. 652.
FOERSTER, O. Das phylogenetische Moment in der spastiscben L&hmung.
Berl. Klin. Wchntchr., 1913, 1., Juni 30, 8. 1217-
Praetare, Dislocation, Ac.— CALOT. Le traitement des scolioses hautea. Joum.
dee Prat., 1913, xxvii., Mai 31, p. 337.
Tsnssrs. —HARRIS, WILFRED, and BANKART, A. 1 S. B. A case of spinal
tumour with scoliosis. Operation. Lancet, 1913, olxxxiv., June 21, p. 1730.
Cervical Elb. —Discussion on cervical ribs. Demonstration of cases of cervical
rib. Proc. Ran. Soc. Med., 1913, vi., March (Clin. Sect.), pp. 95-133, and pp.
142-154.
Herpes Easier.— SALOMON, ERICH. Herpes Zoster. Ztschr. f. d. gee. Neurol,
u. Psychiat., 1913, vii. (Ref.), Juni, S. 345-394.
LITCHFIELD, L. Acute posterior ganglionitis simulating surgical conditions in
the abdomen. Joum. Atner. Med. Assoc., Vol. lx., No. 22, May 31, 1913, p.
1691.
MONTGOMERY, D. W., and CULVER, G. D. A comparison between zoster of
the face and that of the leg. as shown in two cases recently observed. Joum.
Amer. Med. Assoc., Vol. lx., No. 22, May 3^ 1913, p. 1692.
Tabes Dorsalis.— BOKELMANN. Erfahrungen tiber die Wirkung der Spinal-
narkoae bei tabischen Visceralkrisen. Ztschr. f. d. ges. Neurol, u. Psychiat.
(Orig.), 1913, xvii., Juni, S. 1.
Poliomyelitis Anterior Aenta.—CAMPBELL, B. P. Causation and treatment
of deformities following anterior poliomyelitis. II. Ed in . Med. Joum., 1913,
x., June, p. 501.
Progressive Masealar Atrophy.— CADWALADER, W. B., and CORSON-
WHITE, E. P. The relation of syphilis to progressive muscular dystrophy.
Med. Record, 1913, lxxxiii., June 7, p. 1033.
3EAIN—
fteEcral.—ARCHIBALD, E. Puncture of the corpus callosum. Canadian Med.
Assoc . Joum., 1913, iii., June p., 451.
78*
BIBLIOGRAPHY
SCUCTTK. Kin Fall von gleichreitiger Krkrankung des Gehirns und dar Leber.
Arrhir. /. Psychtat. u. Nerrenkrankh^ 1913, li., S. 334.
K KTKdKK. H. Hirngewicht und Schadclkai>azitat b^ipjiychischenErknnhngen
(24 Tcxttig.) Ztschr. /. d. yes. Neurol, u. PtychuU. (Orig.), 1913, xviL, Juni,
S. SO.
WKSTPHAL. A. Beitrag zur Ixdire von der Paeudoakleroee (WestphalStrumpelll,
iortbeHondore ut>er ihre Bexiehungen zu dem eigenartigen durch Pigmeutieronsen,
Ijeherzirrhoee, payehinohe und nervnse Storungen aiu»gezeickneten Krsnkbeitt-
bilde (Fleischer). Archir. f. Psych tat. u. Nerrenkrankh 1913, li. t S. 1.
Diplegia*- TIKRTZELL, CARL. Uebungsbehandlung bei Little’ seber Krankheit
mit Hilfe ciner neuen Gehstutze. Perl. Klin . Wchnschr 1913, L, Juni 9,
S.
CLARK, L. PIERCE. Infantile cerebrocerebellar diplegia, of flaccid, atonic*
astatic type. Amer. Journ. Du. Child, 1913, v., June, p. 425.
Abaccas. —ANDRE-THOM AS. Abc^s du lobe parietal Hdmianestbesie. Drametrie
et brad vkim^ie, Asynergie, apraxie. Perturbation des fonctions d’arret. (5fig.)
Rrv. Nrurol., 1913, xxi.. Mai 30, p. 637.
HealiiKlIla. — SITTIG, OTTO. F.in Fall von Meningitis ohne makroskopisebeo
Refund. Pray. Med. Wchnschr ., 1913, x xxviii., Juni 12, S. 333.
LESAOK. Meningite tuberculeuse & forma ebrieuse. ArcA. dc Mtd.daEnf.,
1913, xvi., Juin, p. 452.
CHARLES, J. R. Some recent cane* of epidemic cerebrospinal meningitis.
Jlristfd Med.-Chir. Journ., 1913, xxxi., June, p. 142.
KOl'Lllv, H. Meningitis of the epidemic type in children below two years of
age. Journ. Anar. Med. Assoc., Vol. lx., No. 23, June 7» 1913, p. 1755.
DAVIS, H. J, Progressive bilateral deafness following epidemic cerebro-spiuxl
meningitis. Proc. Roy. Soc. Med., 1913, vi., March (Otol. Sect.), p. 68.
WHITKLOCKE, R. H. A. A case simulating meningitis, in which the symptoms
were caused by the escape of threadworms into the peritoneal cavity through a
E erforatt d appendix vermifornus. Proc. Roy. Soc. Med 1913, vi.,Mav(Sect.
ha. of Child), p. 192.
Hydroreplialua.—USENER, W. Uber die Verteilungs- und Anascheidungmr'
halfcnisse des Urotropin im menschlichen Korper und deren Verwendung nw
DifferentiaIdiagnose ties Hydrocephalus (naoh Ibrahim). Ztschr. f. Kinder-
hnlk. , 1913, viii., H. 2, Juni 6, S. ill.
Twinovr*.—LUEKE, A. W. Tumors of the cerebellopontine angle. Cleveland
Med. Jonni., 1913, xii., May, p. 325.
PltalUry Tumours, Ac.—Demonstration of cases of disease of the pituitary body.
Proc. Roy. Soc. Med., 1913, vi., May [Sections of Neurol and Ophthalmol.
(Combined Meeting)], pp. i.-xxxiv.
SCHAFER, Sir E. A. The structure and functions of the pituitary body.
(Discussion.) Proc. Roy . Soc. Med., 1913* vi., May (Sect, of NeoroL and
Ophthalmol.), p. xxxiv.
LAWFORD, J. B. Disease in the pituitary region. Proc . Roy\ Soc. lfai.,191S,
vi., March (Sect, of Ophthalmol.), p. 58.
BROECKAERT, JULES. A contribution to the surgery of the hypophynt
(translated by Chichele Nourse). Journ. LaryngolRhinol., and Otol., 1913,
xxviii., p. 340.
Acrowegaly.—HOLMES, GORDON. A pituitary tumour with early acromegaly
Proc. Roy. Soc. Med., 1913, vi., May (Sect. Neurol, and Ophthalmol), p. x.
WILSON, S. A. KINNIER. A typical case of acromegaly with signs of regression.
Proc. Roy. Soc. Med., 1913, vi., May (Sect. Neurol, and Ophthalmol), p. nii*
WILLCOX, W. H. Case of acromegaly. Proc. Roy. Soc. Med. , 1913, fi,
May (Sect. Neurol, and Ophthalmol.), p. xxvi.
DOYNE, R. W. Acromegaly : pituitary tumour showing failure of the fields for
colour before the failure of the white field. Proc. Roy. Soc. Med.. 1913, vl,
May (Sect. Neurol, and Ophthalmol), p. xxviii.
pellagra* —SINGER, H. D., and POLLOCK, L. J. The histopathology of the
nervous system in pellagra. Archives IrU. Med,, 1913> xl, Jane, p. 565,
BOX, C. R- Pellagra. Practitioner, 1913* xo., June, p. 940,
BIBLIOGRAPHY
79*
M#ac*lUm.—CROOKS HANK, F. G. Case of mongolism. Proc. Roy. Soc. Med,,
1913, vi., March (Seot. Dis. Child.), p. 133.
CAUTLEY, E. Mongolian idiocy. Proc. Roy. Soc. Med., 1913, vi., March
(Sect. Dis. Child.), p. 133.
Achondroplasia.—HART, D. BERRY. On the pressure experienced by the foetus
in utcro during pregnancy; with special reference to achondroplasia. Edin.
Med. Joum., 1913, x. f June, p. 496.
Aphasia, Ac.—LONG, ED. Un cas d’aphasie par lesion de l'hemisphhre gauche
chez un gaucher. (Aphasie croiseo et aphasie disaociee.) LEnciphale, 1913,
viii. , Juin, p. 520.
EBSTEIN, E. Goethes Anteil an der Lehre von der Aphasie. Ztschr. /. d. git.
Neurol . u. Psychiat. (Orig.), 1913, xvii., Juni, S. 58.
GUTZMANN, H. Versuch eiuer synoptischen Gliederung der Sprachstorungen
auf der Grundlage ihrer kliniachen Symptome. Berl. Klin. Wchntthr., 1913,
L, Juni 30, S. 1193.
MINGAZZINI, G, Ueber den Verlauf einiger Hirnbahnen und besonders der
motorischen Sprachbahnen, Arckiv. f. Psychiat. u. Nervenkrankh., 1913, li.,
S. 256.
BOYD, WM., and HOP WOOD, J. S. A case having a bearing on the localisa¬
tion of the auditory centre, (lllustr.) Lancet , 1913, clxxxiv., June 14, p. 1661.
Syphilis. —TOOTH, HOWARD H. Gumma cerebri: results of treatment. Some '
histological features. Proc. Roy. Soc. Med., 1913, vi., May (Neurol. Sect.),
p. 87.
SCHWINN, G. S. Prognosis and therapy of cerebral syphilis. Joum. Amtr.
Med. Assoc., Vol. lx., No. 24, June 14, 1913, p. 1852.
SORMANI, B. P. De waarde van den luetischen index (2-1) bij lues en
paralues. Nederlaixd. Tigdsch. v. Oencesk, 1913, xxiv., Juni 14, p. 1711.
SAMELSON, S. Uber die Dungernsche Sypbilisreaktion bei Lues congenita.
Ztschr. f. Kindcrhcilk., 1913, viii., H. 2, Juni 5, S. 155.
WOLFSOHN, J. M. The cutaneous reaction in syphilis. Joum Amer. Med.
Assoc., Vol. lx., No. 24, June 14, 1913, p. 1855.
GLASER, F. Syphilis und Fieber. Berl. Klin. Wchnschr ., 1913, 1., Juni 30,
S. 1215.
KLAUSER, E. Uber eine klinisch verwendbare Kutanreaktin auf tertiare
Syphilis. II. Mitteilung. Wien. Klin. Wchnschr ., 1913, xxvi., Juni 12,
S. 973.
PICK, W. Der gegenwartige Stand der Sypbilistherapie. Med. Klinik ., 1913,
ix. , Juni 8, S. 899.
GOTTHEIL, W. S. Changes in the treatment of syphilis. N.Y. Med. Joum.,
1913, xcvii., June 7, p. 1170.
PAROUNAGIAN, M. B. The old method of treatment of syphilis versus the
new. N. Y. Med. Joum., 1913, xcvii., May 31, p. 1134.
BERN ART, W. F. Is the rapid cure of syphilis possible ? N.Y. Med. Joum.,
1913, xcvii., June 21, p. 1285.
ROBIN, A. Le traitement de la tuberculosa chez les syphilitiqueB. Joum. des
Prat., 1913, xxvii., Mai 31, p. 340.
telvarsan.— SPIETSCHKA, T. Meine Erfahrungen uber Salvarsan. Wien.
Klin. Wchnschr., 1913, xxvi., Juni 12, S. 974.
ULLMANN, K. Zur Organotropic der Salvarsanpraparate (Schluss). Wien.
Klin. Wchnschr ., 1913, xxvi., Juni 5 und 12, S. 929 und 978.
KAHN, A. Notes on the deleterious effects of salvarsan from an otological stand¬
point. N. Y. Med. Joum., 19L3, xcvii., June 7, p. 1188.
LUITHLEN, F., and MUCHA, V. Die expcrimentelle und klinische Analyse
des ‘ 4 Salvarsanfiebers.’* Wien. Klin. Wchnschr., 1913, xxvi., Juni 5, S. 924.
CARY, G. F. S. New and simple apparatus for salvarsan administration.
Joum. Amer , Med. Assoc., Vol. lx., No. 23, June 7,1913, p. 1782.
MORGENROTH, J., and TUGENDREICH, J. Aethylhydrocuprein und Sali ;
cylsfcure als Adjuvantien des Salvarsan. Berl. Klin. Wchnschr., 1913,1., Juni
30, S. 1207.
80*
BIBLIOGRAPHY
KemlTtma—RAVAUT, PAUL. Deax cm de syphilis nerve use trades per lei
injections intrarachidiennes ds mere arc et de neosalvman. 0<tz. da Rbp. }
1913, lxv., Juin 10, p. 1061.
BUNCH, J. L. Two cases of hereditary syphilis treated by intravenous injections
of salvarsan and neo-salvarsan. Proc. Roy . Soe. Mei., 1913, vi, May (Sect.
Die. of Child.), p. 173.
BR AM WELL, BYROM. Discussion on the use of salvanan and neo-selvaran is
diseases other than syphilis. Proc. Roy . Soc. Med., 1913, vl, M»y(Tb«ap.
and Pharmacol. Sect.), p. 131.
WassermaBB BearUon.—KAPLAN, D. M. A quantitative chemical reaction for
the control of positive Wassermann results. N . Y. Med. Joum., 1913. xcvii.,
June 7, p. 1172.
HECHT, HUGO. Die Wassermannsche Reaktion als Indikator bei der Thenpie
der Syphilis. Proper Med. Wchnschr ., 1913, xxxviii., Juni 5, S. 318.
FOEKSTKR, O. H. Negative Wassermann reaction in untreated tertiary syphilis
of the skin and mucous membranes. Jotirn. Cut. Dis , 1913, ml, June, p 393,
MAJOR, R. H. The Wassermann reaction in ths Johns Hopkins hospital
BulUt. Johns Hopkins Hosp., 1913, xxiv., June, p. 175.
<;EMEEAL AMD rtJMCTIOMAL MI9KA8D-
Epilepsy. —CHAUFFARD. Epilepsie. Joum . des Prat, 1913, xxvii, Juin 14,
p. 374.
BOLTEN, G. C. Pathogenese en therapie van “ genuine ” epileptic. Nederland.
Tijdsch. v. Geneesk., 1913. No. 25, H. 1, Juni 25, p. 1791.
DKMOLK, V. Realisation pratique du traitement dechlorurd de Tepilepsie pax
le sedobrol. Rev. Med. d. I . Suisse Rom., 1913, xxxiii., Mai, p. 403.
PAUL-BONCOUR. Epilepsie et syphilis cerebrale henkiitaire tardive, Guerison
par liodotherapie. Prop. Med., 1913, xliv., Juin 14, p. 315.
LOMBARDO, R. Hul paramioclono epilettico. Annali di Nevrot., 1913, xxx.,
p. 225.
8IOLI, FR. Ueber histologischen Refund bei familikrer Myoklomw-Epilepsie.
Archivf. Psyehiat . u. Ncrvenkrankh 1913, li., S. 30.
WHITELOCKE, R. H. A. A successful case of cerebral decompression for con*
vulsions, Jacksonian in type, in a child, aged 4 years. Proc. Roy. Soc. Med.,
1913, vi., May (Sect. Dis. of Child), p. 176.
Chorea,—LANGMEAD, FRED. Varieties and treatment of chorea. Brit. Med.
Joum., 1913, June 14, p. 1261.
GRENET, H. Recent researches on Sydenham’s chorea. Monde mid., 1913.
xxiii., June-July, p. 161.
NIESSL-MAYENDORF, B. v. Hirnpathologische Ergebnisee bei Chores
chronica und vom choreatischem Fhanomen uberhauph Archiv f. Psyehiat.
u. Nervenkrankh., 1913, li. v S. 40.
MeBreaes.—BRILL, A. A. The unconscious factors in the neuroses. N.Y.Med.
Joum., 1913, xcvii., June 7, p. 1165.
TURAN, F. Uber einige objektive Symptome bei Herzneurosen. Wie* Med.
Wchnschr ., 1913, lxiii., Juni 14, S. 1546.
OPITZ, B. Einiges uber Beziehungen von Entztindungen des Dickdsnm xn den
weiblichen Gesohlechtsteilen und su funktionellen Neuroses. ZUchr. /.
Geburtshiilfe u. Gyndkol ., 1913, lxxiii., H. 2, S. 362.
MevnistlieiKtB.—UNDERHILL, A. J. Sexual neurasthenia in men. Joum.
Amcr. Med. Assoc., Vol. lx., No. 24, June 14,1913, p. 1869.
NeuralfflA.—CAMPBELL, HARRY. Treatment of neuralgia and facial spawn by
nerve-injections. Practitioner , 1913, xc., June, p. 991.
LAPINSKY, M. N. Die Bedeutung der Head’scben hyperasthetischen Zonen fa
die Diagnostik der symptomatischeu Gesichtsneuralgie und fiir die Behsndlanf
derselben bei gynakologischen AfFektionen. N enrol. CentralU ., 1913, xxxiL,
Juni 1, S. 676.
ZIMMERN, COTTENOT, and DARIAUX. La radiothdrapie radiculsire dsn* le
traitement des ndvralgies (sciatique, ndvralgie du plexus brachial, du trigumew,
4tc,). Presse mid., 1913, lii., Juin 25, p. 518.
BIBLIOGRAPHY
81 *
Newrltls.—MESS A, G. E. Contribute* alio studio delle neuriti traumatiche
puerperali. La Oinecologia, 1912, ix., Die. 15, p. 689.
Addison’* Disease. —MILNE, L. S. A case of Addison's disease with severe
abdominal symptoms. Med. Record, 1918, lxxxiii., May 31, p. 974.
Exepbtkalmle Goitre, Cretinism, Ac. —SCHLOFFER, H. Uber die operative
Behandlung der Basedowschen Krankheit. Pragcr Med . Wchnschr., 1913,
xxxviii., Juni 5, S. 313.
FUNKE, R. v. Uber akuten Basedow. Pragcr Med. Wchnschr., 1913, xxzviii.,
Juni 5, S. 320.
WEIDLER, W. B. Exophthalmic goitre; hyperthyroidism. N. Y. Med. Joum.,
1913, xcvii., June 21, p. 1293.
DAVIS, H. J. Deafness in a ease of myzoedema. Proc. Roy. Soe. Med., 1913,
vL, March (Otol. Sect.), p. 71.
FLETCHER, H. MORLEY. Operative myzoedema—cachexia strumipriva.
Proc. Roy. Soc. Med., 1913, vi.. May (Soct. Dis. of Child.), p. 181.
Tetany.— PITFIELD, R. L. Pylorospasm with gastric tetany. N.Y. Med.
Joum., 1913, xcvii, May 31, p. 1129.
GRUNFELDER, BENNO. Bromkalxium in der Behandlung des Laryngospas-
mus und der Tetanie. Therap. Monatskefte, 1913, xxvii., Juni, S. 41o.
SPECIAL SENSES AND CRANIAL NERVES—
KOYANAGI, Y. Zur pathologischen Anatomie der Netzhaut nach der Exstiroa-
tion eines Sehnerventumors. Klin. Monatsbl. f. AugenheUk., 1913, li., Mai,
S. 623.
SEGI, M. Ueber einen Fall von Myxosarkom des Sehnerven. Klin. Monatsbl.
f. AugenheUk., 1913, li., Mai, S. 630.
MYLIUS, W. Ein Fall von Gumma der Optikuspapille. Klin. Monatsbl. f.
AugenheUk., 1913, li., Mai, S. 648.
NYDEGGER, J. A. The importance of adopting a more aoourate method of
examination for color-blindness. Med. Record, 1913, lxxxiii., June 14, p. 1068.
HAYMANN, H. Der galvanische Lichtreflex unter psyohopathologischen
Verhaltniasen. Ztschr. /. d. get. Neurol, u. Psychiat. (Orig.), 1913, xvii.,
Juni, S. 134.
BEUNOFF, 8. Zur Atiologie der Recurrensl&hmung. (Ein Fall von Schlacht-
felde.) Monatsschr.'f. Ohrenheilk. u. Laryngo-Rhinol ., 1913, xlvii., H. 5, 8. 717.
WISCBLLANEOCS SYMPTOMS AND CASES—
FORSTER, O. Ubungsbehandlung bei Nervenerkrankungen mit oder obne
voraufgegangene operationen. Ztschr. f. Physikal. u. Duit. Therapie, 1913,
xvi., Juni, 8. 321.
ALEXANDER, W. Beitrag zur Uebungsbehandlung bei LShmungen. Ztschr.
f. Physikal. u. Diat. Therapie , 1913, xvi., Juni, 8. 343.
LLEWELLYN, T. L. A lecture on miner’s nystagmus. Brit. Med. Joum.,
1913, June 28, p. 1359.
BUYS. Beitrag zum Studium des Drehnystagmus. Monatsschr. f. Ohrenheilk.
u. Laryngo-Rhinol., 1913, xlvii., H. 5, 8. 675.
HOLMES, GORDON. Headaches of organic origin and their treatment.
Practitioner, 1913, xc., June, p. 968.
BABINSKI. Diagnostic des 4tats organiques. Joum. des Prat., 1913, xxvii.,
Juin 14, p. 374.
ALDABALDE, VALLE r. Piralisis de la degluci6n. Rev. de Med. y Cir.
Prdct., 1913, xxxvii., May 7, p. 195.
DANIEL, GASTON. Anthropologic oongolaise. Joum. de Neurol., 1913, xviii.
Mai 5, p. 161.
ROCK, H. Beitrag zur Kenntnis der Alopecia neurotica. Dermatol. Wchnschr.
1913, lvi., Juni 14, 8. 661.
FOSSIER, A. E. Brythromelalgia. N.Y. Med. Joum., 1913, xcvii., June 14,
1913, p. 1238.
n
82 *
BIBLIOGRAPHY
DIDE, M. Die Noeologi© des “ passionierten IdealismtH." Neurul. CentralU.,
1913, nxii., Juni l, S. 6S8.
DKGENKOLB, KARL. Die Raumanschaming and da* Reuranmgwipfeii
Neurol. Centrum., 1913, xxxiL, Juni 1, S. 691.
PSYCHIATRY.
4iKMEBiL PARALTIIS-
MARINESCO, O., and MINE A, J. A propos de la presence du Treponema,
pallulum dene le oerveau dee paralytiques geniraux. Bet. Neurol., 1913. uL,
Mai 30, p. 661.
ALBES, A. De quelquea particularity* observes dan* un dtat hallnematoiit
chez un p&rmlytique general. Annal . Med.-Psychol 1913, lxxi., Men, p. 285,
VERESS, F. v., and SZABO, JOSEF. Wert und BedeutungderKaronentthen
Reaktion fur die Diagnoee der Syphilis und der progressive!! Paralyse. Archiv
/. PtuchuU. u. Nervenkrankk 1913, li,, S. 233.
BENEDEK, LAD, and DEAK, STEFAN. Unterechiede nrischen dem Blot*
eerum von Paralytikern und Praeooxen in Bezug auf die Auslosung von Irnrnun-
himolysinen. Archiv f. Psyehiat. u. Nen'tnkrankh 1913, li., S. 209.
»EMEYUA PMCdl-
ORUHLE, H. W. Bleulere Schizophrenic und Kraepelina Demtntie praoox.
Ztsehr. /. d. get. Neurol, u . Psyehiat. (Orig.), 1913, xvil, Juni, S. 114.
SOUKHANOFF, S. Ddmenoe prdooce et alooolisme. Annal . Mid.-Psychol-,
1913, lxxi., Mare, p. 277.
CENEKAL—
STODDART. Puerperal insanity. Clin. Joum ,, 1913, xlil, June 25, p. 189.
TREADWAY, W. L. The preeenile ptychoeee. Joum. Ntrv. and Menl. Dii
1913, xl., June, p. 376.
SCHEKR, W. M. v. n. Osteomalacic und Psyoboee (Sobluss). Archiv /.
Psyehiat. u. Nerrenkrankh., 1913, li., S. 79.
BARRETT, A. M. A case of Alzheimer's disease with unusual neurologic*! dis¬
turbances. Joum. Nerv. and Ment. 1913, xL, June, p. 361,
BALLET, GILBERT. La peychose hallucinatoire chronique et la ddMgr4g*tk>fi
de le pereonnalitd. L Enc&phale, 1913, viii., Juni 10, p. 601.
BERNHEIM. Dee hallucinations physiologiquee et pathologiques, VKncdpkale,
1913, viii., Juin, p. 609.
DIDE, M., and CARRAS, G. Psychos© pdriodique complete. Ddlire dlnterori-
tation, peychose excito-ddpreesive, obsessions et impulsions. Annal . Afw.*
Psychol ., 1913, viii., Mars, p. 257.
CRAWFORD, A. W. An unusual oase of amentia. Brit. Med. Joum., 1913,
June 28, p. 1369.
SMITH, BELLINGHAM. Some oases of mental deficiency. Brit. Joum.
Child. Die., 1913, x., No. 114, p. 241.
DAMAYE, H. La psyohiatrie aetuelle et la thdrapeutique dec affections
curable*. Annal. M6d.-Psychol., 1913, viii., Mars, p. 290.
BURR and DRRCUM. The teaching of psyohiatry. Joum. Amer. Med. An or.,
Vol. lx., No. 24, June 14, 1913, p. 1874.
TREATMENT.*
HATSCHEK, H. Zur Praxis der Psyobotherapie. Wien. Klin. Wchnschr., 1913,
xxvi., Juni 19, S. 1015.
* A number of retsrtaoes to papers on Treatment are Included in tbs Bibliography under
individual diseases
Bibliography
ANATOMY.
JEFFERSON, GEOFFREY. The morphology of the sulcus interparietalia. Journ.
Anal . and Physiol., 1913, xlvii., July, p. 365.
DERRY, DOUGLAS E. A case of hydrocephalus in an Egyptian of the Roman period.
Journ . Anal, and Physiol ., 1913, xlvii., July, p. 436.
BEAN, R. B. The cephalio nerves: Suggestions. Anal . Record, 1913, vii., July,
p. 221.
NORRIS, H. W. The cranial nerves of Siren lacertina . Journ . Morphol ., 1913, xxiv.,
June, p. 245.
MALONE. E. F. The nuoleus cardiacus f nervi vagi and the three distinct types of
nerve cells which innervate the three different types of muscle. (3 figs.) Amer.
Journ . Anal ., 1913, xv., July, p. 121.
LUNA, E. I condriosomi nelle cellule nervoee. Anat. Anztig ., 1913, xliv., No. 6 7,
Juni 28, S. 142-144.
MENSA, ATTIUO. Arterie meningee encefaliche nella serie dei Mammiferi. Studio
morfologico e descrittivo. Oegenbaurs Morph . Jahrb ., 1913, xlvi., H. 1 und 2, S. 1.
STENDELL, W. Zur vergleichenden Anatomic und Histologic der Hypophysis cerebri.
Arch. /. miter. Anal ., 1913, lxxxii., H. 3, S. 289.
GRAY, A. A. Notes on the comparative anatomy of the middle ear. Journ. Anat.
and Physiol ., 1913, xlvii., July, p. 391.
NETCHAEWA-DIAKONOWA, A. K. Sur l’adaptation des groupes musculaires aux
conditions statiques anormales. (1 fig.) Journ dt VAnat 1913, xlix., Juillet-Aout.,
p. 421.
PERN, S. Some oongenital abnormalities of the thyroid gland. Austral. Med. Journ.,
1913, ii., June 21, p. 1087.
PHYSIOLOGY.
NAGEOTTE, J. Note sur la presence de fibres ndvrogliques dans les nerfs p^riph^riques
d4g4n4r4s. Compt. Rend . de la Soc . de Biol., 1913, lxxv., Juillet 25, p. 122.
CRAMER, W., FEISS, H. O., and BULLOCK, W. E. The significance of the March i
reaction in nerve dogeneration, and its application as a specific stain for unsaturated
ordinary fats. (Prelim, com.) ( Proc . Physiol. Soc., June 7.) Journ . Physiol .,
1913, xlvi., Nos. 4 and 5, p. 1L
CLEMENTI, A. Sui caratteri e sul significato teleologico di una nuova categoria di
riflean nervosi di difesa. Archivio di Ftsiol. , 1913, xi., Marzo, p. 210.
FANO, G. Appunti sintetici.— I. Sulla trasmissione di eccitamenti per vie umorali e
nervoee. Archivio di Fisiol., 1913, xi., Marzo, p. 203.
VERZAr, FRITZ. Die Anderung der Polarisierbarkeit des Nerven duroh die Erregung.
Pfluger's Archiv, 1913, clii, H. 4, 5, und 6, S. 279.
ADRIAN, E. D. Wedensky inhibition in relation to the “ all or none * principle in
nerve. Journ . Physiol 1913, xlvi., Nos. 4 and 5, p. 384.
DALE and MINES. The infiuenoe of nerve stimulation on the electrocardiagram.
Journ. Physiol 1913, xlvi., Nos. 4 and 6, p. 319.
84*
BIBLIOGRAPHY
BRANDT, A. Arbeitshypotheee liber Rechte- and Iinkshiindigkeit. Biol. Centralhl. 9
1913, xxxiii., Juni 20, S. 361.
TSCHUGUNOFF. Uber die Verfcnderung dee Auges bei Leptodora Kindtii (Focke)
unter dem Einfluee von Nahrungsentziehung. Biol. Centralbl., 1913, xxxiii., Juni
20, S. 351.
MULLER end GLASER Uber die Innervation der Gefieee. Deal. JBtschr. /.
NervtnheUk. % 1913, xlvi., H. 4 u. 5, S. 325.
GOLLA, F. L., and SYMBS, W. L. The innervation of the tracheal muscle. (Prelim,
oom.) (Proc. Physiol. Soc. 9 June 7, 1913.) Joum. Physiol ., 1913* xlvi., Noe. 4
and 5, p. xxxviii.
GOLLA, F. L., and SYMES, W. L. The double aotion of adrenaline on the bronehiolee.
(Prelira, oom.) (Proc. Phtteiol. Soc. f June 7, 1913.) Joum. Phytiol. 9 1913* xlvi.
Noe. 4 and 5, p. xxxviii.
CAMPBELL, DOUGLAS, HALDANE, and HOBSON. The reeponae of the respiratory
oentre to oarbonic acid, oxygen, and hydrogen ion oonoentration. Joum. Physiol .,
1913, xlvi., Noe. 4 and 5, p. 301.
ORR and WATSON. Study of the respiratory meohaniem in the duok. Joum.
Physiol., 1913, xlvi., Noe. 4 and 5, p. 337.
DUNAN, F. Rapports de l*hypophyse avec lee entree glandee h adoration interne.
Gaz. dcs H6p. f 1913, lxxxvi., Juillet 24, p. 1351.
BABINSKI, J., atd WEILL, G. A. Mouvemente rlaotiounels d’origine veetibulaire et
mouvements contrerdaotionnels. Compt. Rend, de la Soe . de Biol. 9 1913, Ixxt.,
Juillet 25, p. 98.
KOOH, W. F. Toxic basee in the urine of parathyroidectomieed doge. Joum. Biol.
Chan., 1913, xt., July, p. 43.
GRADINESCU, A. V. Der Einfluee der Nebennieren auf den Blutkreislauf und den
StoffwechseL Pflilger's Archiv , 1913, oliL, H. 4, 6, und 3, S. 187.
BRIAULT and GAUTRELET. Contribution h l’4tude dee phtaom&nes cireulatoiree
dans Tanaphylaxie adrdnalique. (Deuxitme note.) Compt. Rend, de la Soc. de Biol..
1913, lxxv., Juillet 25, p. 106.
PSYCHOLOGY.
RUCKMICH, C. A. The R51e of Kina&stheeie in the Perception of Rhythm. Amer.
Joum. Psychol ., 1913, xxiv., July, p. 305.
SMITH, P. Luther's Early Development in the Light of Psycho-Analysis. Amer.
Joum. Psychol ., 1913, xxiv., July, p. 360.
FERREE, C. E. The Fluctuation of Liminal Visual Stimuli of Point Area. Amer.
Joum. Psychol ., 1913, xxiv., July, p. 378.
FROST, E. P. The Characteristic Form assumed by Dreams. Amer. Joum. Psychol .,
1913, xxiv., July, p. 410.
HAGGERTY and KEMPF. Suppression and Substitution as a Factor in Sex
Differences. Amer. Joum. Psychcl. % 1913, xxiv., July, p. 414.
DONOVAN and THORNDIKE. Improvement in a Practice Experiment under Sohool
Conditions. Amer. Joum. Psychol ., 1913, xxiv., July, p. 42o.
TITCHENER, E. B. The Method of Examination. Amer. Joum. Psychol ., 1918, xxiv.,
July, p. 429.
ERISMANN, TH. Untersuchung Uber das Substrat der Bewegimgsempfindungen und
die abhangigbeit der aubjektiven Bewegungsgrosee vom Zustand der Muskulatur.
Archiv / d. ges. Psychol ., 1913, xxviii., S. 1.
ROSE, HEINRICH. Der Einfluas der Unlustgefuhle auf den motoriechen Effektder
Willenahandlungen. Archiv f. d. ges. Psychol ., 1913, xxviii., S. 94.
TRUSCHEL, L. Experimentelle Untersuchungen Uber Kraftempflndungen bei Feder-
spannung und Gewichtshebungen. Archiv /. d. ges. Psychol ., 1913, xxviii., 8. 183.
DECROLY, O., and DEG AND, J. Observations relatives au dlveloppement de la
notion du temps chez une petite fille de la naissance a 5 ans 4. Archiv. de Psychol.
1913, xiii., Juni, p. 113.
BIBLIOGRAPHY
85*
DBMOLE, V. Uncas de conviction spontande. (1 fig.) Arcktr. de. Psychol., 1913, xiii,
Juni, p. 162.
JONES, ERNEST. Dor Gottmenuoh-Komplex.. Intemat. Zttchr. f. Arztliche Psy¬
choanalyse , 1913, i., Juli, S. 313.
BURROW, T. Die psyohologische Analyse der aog. Nenrasthenie and verwandter
Zustknde. Internal. Zttchr. f. Arztliche Psychoanalyte, 1913, L, Juli, S. 330.
MARCINOWKI, J. Die moralischen Wertechatzungsurteile als Hindernis in der
psyohischen Beh andlnng . Intemat. Zttchr. f. Arztliche Psychoanalyse, 1913, i.,
Juli, S. 344.
SADOER, J. Uber Gesksserotik. •Intemat. /. Arztliche Psychoanalyse, 1913,1., Juli,
S. 361.
FORSTERLING, W. Persdnlichkeitsbewnsstaein nnd Organgeftthle. Monatttch. f.
Ptychiat. u. Neurol., 1913, xxxiv., Juli, S. 87.
HOWARD, F. E. Psychological differences between children and adults. Pedagog.
Sem., 1913, xx., Jane, p. 236.
WILSBR, L. Bin Beitrag sum Verstandnis der Tierseele. Allg. Zttchr. /. Ptychiat.,
1913, lxx., S. 474.
ETNON, W. C. The mental measurement of four hundred juvenile delinquents by the
Binet-Simon System. (1 chart.) N. 7. Med. Jou m., 1913, xcviii., July 26, p. 175.
CANESTRINI, SILVIO. Uber das Sinnesleben dee Neugeborenen (naoh physlologisehen
experimenten). Monograph, a. d. Gcsamtgcb, d. Neurol. «. Ptychuii., 1918, H. 6,
■Tillius Springer, Berlin. Pr. M. 6.
PLANT, FELIX. Uber Halluxinoeen der Syphilitiker. Monograph, a. d. Getamtgeb.
d. Neurol, u. Ptychiat., 1913, H. 6. Julius Springer, Berlin. Pr. M. 5,60.
PATHOLOGY.
TODD, T. WINGATE. Blood vessel changes consequent on nervous lesions. Journ.
Nerv. and Meat. Dit., 1913, xL, July, p. 439.
LUBE Vertinderungen des Zentralnervensystems bei pernizihser Anfcmie. Deut.
Zttchr. f. Nervenheilk., 1913, xlvi., H. 4 u. 6. S. 299.
MIOHAILOW. SERGIUS. Pathologisch-anatomische Untersuchungen der fdineren
Struktur der Gehirarinde, der Rinde des Kleinhirns, des verlkngerten und des
Rttckenmarks des Ifenschen bei a si astischer cholera. Arcktv. f. Ptychiat. u.
Nervenkr., 1913, li., S. 687.
BRUN, E, and MOTT, F.W. Microsoopical investigation of the nervous system in
three cases of spontaneous myxcedema. Proe. Boy. Soc. Med., 1913, vi., June (Sect,
of Psyohiat.), p. 75.
WEIL and KAFKA. Zur Frage der Permeabilitkt der Meningen. Deut. Zttchr. /.
Nervenheilk., 1913, xlvi., H. 4 u. 5, S. 402.
ZALOZIECKI. Zur Frage der Permeabilit&t der Meningen. Deut. Zttchr. J. Nerven¬
heilk., 1913, xlvi., H. 4 u. 6, 8. 409.
BIONDI, GlOSUt. Sul oosidetto “pigmento giallo” del oentri nervoet. Riv. ital.
di. Neuropatol., Ptichiat. Xlettroter., 1913, vi., p. 241.
CLAUDE, H., and LOYEZ, M. Les voies de propagation du cancer seoondaire du
oervean. (4 planches.) ISEnctphale, 1913, vui., Juillet, p. 6.
MAA8S, S. Ueber diffuse Karzinomatose der weiehen Hirrnhkute. Archivf. Ptychiat.
v. Nervenkr., 1913, li., S. 359.
HEBOLD, OTTO. Haemangiom der weiehen Hirnhaut bei Naevus vasculosus des
Gesiehts. Arehiv f. Ptychiat. u. Nervenkr., 1913, li., S. 445.
NAVILLE and FROMBERO. Les embolies graisseuses; l’embolie graisseuse du oerveau.
Arch, de Mid. Kxpir. et d’Anat. Path., 1913, xxv., Juillet, p. 406.
MASSAGLIA, A. Tetanic infolge experimenteller Parathyreoidinsuffisens wkhrond
der Sehwangerschaft und Eklampsie. Centralbl. f. Allg. Path. u. Pathol. Anat.,
1918, xxiv., S. 577.
BIBLIOGRAPHY
SC*
CLINICAL NEUROLOGY.
•UOAIr-
TILESTON. W. The occurrence of ankle-clonus without gross disease of tb
central nervous system. Amer. Joum. Mid. Set., 1913, cdvi, July, p. 1.
PALMER, F. S. Clinical lecture on reflexes and their significance. Mid. Pm
1913, July 23, p. 84.
MAL Y. Klinische Beitrage *ur Kenntnio der elektriaehen Unfilla Devi, ttidr.
f, Ntrvtnkeilk ., 1913, xlvi., H. 4 u. 6, 8. 366.
FORSTER, O. Uebungsbehandlung bei Nervenerkrankungen nit odn ohoe
voraufgegangene Operationen. (Schluaa.) JRtehr. /. pkytiml .«. dial. Thmp.,
1913, xvii., S. 403.
SUTHERLAND, O. A. Graphic record* of respiratory paralyiii. Lancet, 1913 ,
July 12, p. 75.
m«-
HALL, F. PR H. Dieouuion on the aetiology of unila teral paralyiii of tb
recurrent laryngeal nerve. Proe. Boy. Sac. Mid., 1913, vl, Jose (Iarrapl
Sect.), p. 139.
POLLAK, E. Ueber einen Fall von angeborener, einaattiger Hatoympathitas-
lahmung. Wien, kl in. Wckniekr., 1913, xxvi, Juli 17, 8.1210.
TUTTLE, H. K. Expoanre of the bracial plexus with nerve transplantation.
Joum. Amer. Med. Auo c„ 1913, IxL, July 5, p. 15.
GUIBAL. P. Contribution k la chirurgio du oou. La rdseetioa unilateral* dob
jugulaire interne et du pneumogastrique est-elld inoffensive? Rn. it Ckir.,
1913, xxxiii., Juillet, p. 96.
FISCHER. Seekrankheit und Vngotouie. Miinck. Mid. reAnielr., 1913, It,
Juli 29, 8. 1649.
COHN, MAX. Rontgenuntersuchung einer Fran, welcher der Magennndbeide
Nervi vagi resewert worden Bind. Berl. Klin. Wckmekr., 191$ 1., Jnli 28,
8. 1393.
IIIKLK8—
PALMER, F. S. Primary progreaaive myopathy; Faofo-Mapulo-hanwnl
(Landouxy-Ddjdrine type); advanoed stage. Proe. Soy. Soe. Med, 1913, u,
June (Neurol. Sect.), p. 136.
BOGGS, T. R. Multiple oongenital osteochondromata with draeiation d
cranial nerves and muscular dystrophy. (Illustr.) Bullet. JokniBopHntBop.,
1913, xxiv., p. 210.
REINER, HANS. Ueber Myatonla congenita. Berl. klin. JPcAnieAr., 1913,
1., Jnli 14, S. 1306.
GREGOR, A., and 8CHILDER, P. Zur Theorie der Myotonia (10 Textfig l
Zttckr. f. d. get. Neurol, u. Piychiat. (Orig.), 1913, xviL, S. 206.
BRAMWELL, B., and ADDIS, W.R. Myotonia atrophica. Kdin.Md.Mn.,
1913, xi., July, p. 21.
MONIZ, E. Myoclonies essentielles. (1 pi.) Jfouv. Icon. d. I. SalpH, 1913, mi,
Man-Avril, p. 85.
BOSCHI, GAETANO. Ataxie hdrdditaire avec paramyoclonus multiplei
Joum. de Neurol., 1913, xviii., April 20, p. 131.
BYLOFF, C. Zur Frage der Bestimmung des ZwercbfeUstandee und der
Zwerchfellfunktion. Wien. klin. Wckntckr., 1913, xxvi. Juli 31,8.1265.
srnu co«»—
fiemeral.— MEYER, L Verknticherungder Aohillessehna Berl. Bin. Wehntdr.,
1913,(1., Juli.14, S. 1304.
FRANKFURTHER, VP. Bemerkung tu der Arbeit von L. Haskovec. Iatcrsle
Deviation der Finger der Hand. Neurol. Centralbl. 1913, xxxil, Juli 1, S 908.
BIBLIOGRAPHY
87*
HASKOVEC, LADISLAUS. Laterale Deviation der Handfinger. Neurol .
CentraJUbl., 1913, xxxii, Juli 1., S. 809.
NOICA. Sur lei reflexes tendineux et p^rioetiquee oontralaUraax et lee mauve-
mente assoeies spasmodiquee. Rev. Neurol., 1913, xxi., Juillet 15, p. 6.
RIOCA, SILVIO. Inversion du r^flexe du radius par lesion traumatiaue de la
VI e racine oervioale. (1 fig.) Rev. Neurol., 1918, xxi., Juin 15, p. 735.
ROLLESTON, J. D. Diphtheritic paralysis. Arch, of Ped., 1913, xxx. v p. 335.
HARRIS, H. E. The end results of operative treatment in 33 oases of spastio
paralysis. Boston Med. and Surg. Joum., 1913, clxix., July 17, p. 82.
FOERSTER, O. Das phylogenetische Moment in der spaBtischen Lahmung.
(Schluss.) Bert. klin. Wchnschr 1913, 1., Juli 13, S. 1255.
Fraetmre* Dislocation, Ac.—BROCA, A. Pseudoarthrose du perond droit.
Scoliose par in6galit4 des membres inflrieurs. Prtsst Mid., 1913, No. 54,
Juillet 2, p. 540.
Tabes Dorsalis. —TSCHIRJEW, S. Tabes atactica und Behandluns der post-
syphilitischen Erkrankungen des Nervensystems mit Quecksilber und Salvarean.
Archivf. Psychiat. u. Nervenkr 1913, li., S. 467.
Poliomyelitis Anterior Acata.—HAZEN, C. M. Anterior poliomyelitis; infantile
spinal paralysis; polio-encephalomyelitis; acute central infectious paralysis.
N . y. Med. Joum., 1913, xoviii, July 12, p. 81.
ROTH, P. B. The treatment of infantile paralysis. Med. Press, 1913, July 23,
p. 91.
Amerikanische Literatur liber Poliomyelitis, 1912. II. Semester. Sammelreferat.
Monatsschr. f. Kindcrheilk. (Ref.), 1913, xii., Juni, S. 193.
Tmsaonrs. —CA8TELU, E. Methods of localisation of spinal tumours with
reference to their medical and surgical treatment. Med. Record, 1913,
July 5, p. 1.
Syringomyelia.—BABINSKI. Diagnostic et traitement de la syringomyelic. *
Joum. des Prat., 1913, xxvii., Juillet 12, p. 439.
Friedreich’s Ataxia.—TAYLOR, JAMES. Friedreich’s ataxia in an undersized
girl, aged 10. Proe. Roy. Soc. Med., 1913, vi., June (Neurol. Sect.), p. 141.
Spondylitis.—BADE. Zur Behandlung der spondylitischen Lahmungen. Miinch.
Med. Wchnschr., 1913, lx., Juli 1, S. 1432.
Myelitis.—ANGELA, C. Paraplegia flacoida ed esaltxione dei rifiessi tendinei
nella mielite traaversa. Riv. di Patol. nerv. e ment., 1913, xviii., Luglio, p. 281.
Cerebellar Ataxia.—FRANKEL, H., and DIDE, M. R4tinite pigmentaire aveo
atrophie papillaire et ataxie cere belle use familialee. Rev. Neurol ., 1913, xxi.,
Juin 15, p. 729.
BBAJMf—
General. —CRESPIGNY, C. T. C. de. Intracranial disease. Austral. Med. Gaz.,
1913, xxxiiL, May 31, p. 507.
BABINSKI. Phenombnea d'hypertension intra-cr&nienne et ponction lombaire.
Joum. des Prat., 1913, xxvii, Juin 28, p. 405.
KASTAN, MAX. Ueber die Berichungen von Hirnrindenschadiaung zur
Erhohung der Krampfpradisposition. Archiv f. Psychiat. u. Nervenkr., 1913,
Ii., S. 694.
JACOBSOHN, L. Uber Paraffinseriensohnitte duroh das Gehirn. Neurol.
Centralbl., 1913, xxxii, Juli 1, S. 802.
ZINGEELE, H. Ueber Storungen der Wahrnehmung dee eigenen Korpers bei
organischen Gehirnerkrankungen. Monalssch. f. Psychiat . u. Neurol., 1913,
xxxiv., Juli, S. 13.
EXNER, A., and KARPLUS, J. P. Extraction eines Projektiles aus dem dritten
GehirnventrikeL Exitus. Wien. klin. Wchnschr, 1913, xxvi., Juli 10, S. 1152.
FOURNIE, J. Un cae de procidenoe mastoidienne de la dure-m&re de la foese
c4r4brale moyenne. Gaz. des H6p., 1913, lxxxvi, Juillet 19, p. 1311.
88*
BIBLIOGRAPHY
Hkmll, lajirr, DENNIS, C. B. The value of radiography u an wd to
diagnosis in suspected fractures of the skull. Austral. Med. Joum., 1013, ii.,
June 21, p. 1090.
Meningitis.—SAV7 end GATE. Meningites 4 pueumocoques gueritt. Ip
Med., 1913, T. cxxi., Ann. xlv., Juillet 13, p. 55.
PIT FT ELD, R. L. Recovery from tubercular meningitis, with report of cues
Amir, Joum, Med, Sci., 1913, exlvi, July, p. 37.
CRACE-CALVERT, GEO. A. Tuberculous meningitis in adults, Md Pm,
1913, July 9, p. 37.
VILLARKT, M., end PORAK, R. A propos de quelques oas de mdningiie tabs-
euleuse de I’adult*. Rev. de la Tubercul., 1913, Ser xil, T. x., Join, p, 300.
REICHMANN end RAUCH. Zwei geheilte Falls von Meningitis tabercukse
Munch. Med, Wchnschr., 1913, lx., JuH 1, S. 1430.
TINEL, J.. end PAPADATO. Etude anatomo-petholcgique de Is pschy
meningite cervicele hypertrophique. Prog, Med., 1913, xliv., Joillet 19, p. 37 <.
FLEXNKR, SIMON. Accidents following ths subdural injection of tbe infc-
meningitis serum. Joum* Artur, Med,, Assoc., 1913, lx., June 21, p. 1937.
HUTINEL. Lee meningitss syphilitiques. Joum. da Prat,, 1913, ixrii,
Juillet 12, p. 437.
WHITELOCK. R. N. H. A. A oese simulating meningitis in which the lytnptomi
were oeused by the esoape of threadworms into the peritoneal cavity through
e perforated appendix vermiformis. Brit, Joum. Child Die, 1913, x. f July,
p. 296.
EneepkallUe. —BARTOLOTTL Uber purulsnte disssminierte Enoepbslitii nsch
Pan ophthal mite. Dent. Ztschr. J. Nervenheilk 1913, xbt, H. 4 u. 5, S. 397.
A kites*.—DAVIS, H. J.— 1 Temporo-sphenoidal abscess following mastoid disewe
and aural polypus. Proc . Roy. Soc. Med., 1913, rl, June (OtoL Sect), p. 102.
COUTEAUD, M.— Abohs mdtastatiques de 1‘encdphale en rapport svec lei sup¬
purations hdpato-pulmonaires. Rev. de Chir. t 1913, xxxiii., Juillet, p. 56.
Mplegfn.—KUGELGEN, LEO VON. Kin unaufgeklhrter Nervenfsll mit dem
Svmptomsnkomplex der Little’schen Krankheit. Petersburger, Med. &tckr. }
1913, xxxviii., Juni, S. 145.
■emlplefls*—CASTRO, ALOYSIO DE—Note but la demarche latdrale dim
Themipldgie organique. Mouv, loon. d. L Salpit., 1913, xxvl, Mars-Anil, p. 81.
Thronboili.—BBRTLICH. Thrombose des Sinus cavemosus bei ewetn 5 Monst
alten Skugling. Miinck . Med. Wchnschr 1913, lx., Juli 1, S. 1435.
ROBINSON, G. W. Occlusion of the posterior inferior cerebellar artery. Joum.
Amer. Med. Assoc., 1913, lxi., July 19, p. 179.
RIGGS, C. E., and HAMMES, E. A. Two eases of circulatory diiturbsooe of the
brain. Joum. Amer. Med Assoc*, 1913, lxi, July 26, p. 257,
Angiospasm. —WILLIAMSON, O. K. Arterial spasm. Practitioner, 1913, id,
July, p. 33.
Myastkanlm.—SALMON, A. Sul signiflcato patologioo della reariono militaries
nei oasi di Nevrod traumatica. Riv* crit. di Clin* Med., 1913, sir., Luglio,
p. 433.
Ammnrellc Family Idisey.—CORIAT, I. H. Amaurotic family idiocy. Artkiw
o/Ped 1913* xxx., p. 404.
Cerekellnm.—ADAMS, S. S. Tumour of the oerebellum. Archives of Pd., 1913,
xxx., p. 465.
BROUWER, B. Ueber Hemiatrophia nsooerebellaria Archie /. Ptgckiai w.
Ncrvtnkr*, 1913, li., S. 539.
ANDRE-THOMAS and DURUPT, A. Reohsrches experimental^ m la
fonotions odrdbeIleuses. Dysmdtris et localisations. L'Bnctphak, 1913, viii,
Juillet, p* 21*
BIBLIOGRAPHY
89*
Tamo art.—PELZ, A. Ueber einen im Wochenbett unter dem Bilde eincs Hirn-
tumora mit Ausgang in Heilung aufgetretenen Krankheitszustand. BerL klin.
Wchnschr., 1913, 1., Juli 28, S. 1400.
SACHS, B., and BERG, A. A. Operative Heilung einer Getchwultt det Ganglion
GatterL BerL klin . Wchnschr., 1913, L, Juli 28, S. 1395.
TERRIEN, F. La state papillaire dant let tumeurs cdrdbrales. Prog. Med., 1913,
xliv., Juillet 12, p. 369.
Pituitary Tain tart, Ac.—RUPP. Der intrakranielle Weg zur Exstirpation von
Hypophysengeschwiilsten. (4 Abbild.) Deut. Med. Wchnschr., 1913, xxxix.,
Juli 17, S. 1406.
WASSING, HANS. Zur Frage der 41 Ausfiihrwege der Hypophyse.” Wien,
klin. Wchnschr., 1913, xxvi., Juli 31, S. 1270.
HILL, EMORY. Hypophysit disease (from the ophthalmological standpoint).
Arch, of Ophthalmol., 1913, xlii., July, p. 352.
BAUER, TH. Zur Frage der Adipoaitas hypophysarea. (Basophiles Adenom der
Hypophyse.) Wien. klin. Wchnschr., 1913, xxvi., Juli 24, S. 1236.
Acromegaly.—MARK, L. P. Acromegaly, a personal experience. Baillicr&,
Tindall & Cox, London, 1912. Pr. 7s. 6d. net.
HBINICKE. Zur Kasuiatik der Akromegalie. Archiv f. Psychiat. u. Ntrvenkr.,
1913, li., S. 688.
GRINKER, J. Tumor of the hypophysis in a case of acromegaly. Joum. Arner .
Med. Assoc., 1913, lxi., July 26, p. 235.
JADIOKE. Uber innarsekretorische Stoffwechselstorungen bei Atbyreosis,
mongoloider Idiotie und Akromegalie. (6 Textfig.) Ztschr. des Jugcndl.
Schwachsinus, 1913, vi., S. 286.
Imfknlllltm.—SOUQUES and CHAUYET. Infantilisme hypophysaire. Nouv .
Icon. d. 1. Salpit., 1913, xxvi., Mart-Avril, p. 69.
Ackendroplaala.—BERTOLOTTI. Contribution i l’ltude de l’achondroplasie.
Interpretation des varilt^s morphologiques bas4e sur l’ontogen&se. Presse
Mid., 1913, Juin 28, p. 525.
Apfeatla, Ac.—MACKENZIE, HECTOR. Functional aphasia. Proc. Boy. Soc.
Med., 1913, vi, June (Clin. Sect.), p. 220.
ftypfellls.—KAPLAN, D. M. The quantitative animo (NH a ) nitrogen content of
syphilitio and nonsyphilitic serums. N. Y. Med. Joum., 1913, xcviii., July 26,
p. 157.
KAUSKI, D. J. The luetin skin reaction in syphilis. N. Y. Med. Joum., 1913,
xoviii, July 5, p.,24.
SAUVAGE and GERY. Un oat de gommes syphilitiques volumineuses chez un
nouveau-nA Repartition des tr6ponemes. Annales de VInstitut Pasteur, 1913,
xxvii, Juin 25, p. 489.
SCHERESCHEWSKY, J. Vereinfachung des Yerfahrens zur Reinztichtung der
Syphilisspirochaten. Deut. Med. Wchnschr., 1913, xxxix., Juli 17, S. 1408.
BAUMER, E. Erfahrungen mit Jodottarin bei der Behandlung der Syphilis.
Deut. Med. Wchnschr., 1913, xxxix., Juli 10, S. 1361.
SCHERESCHEWSKY, J. Syphilispropbylaxe mit der Chininsalbe. Deut.
Med. Wchnschr., 1913, xxxix., Juli 3, S. 1310.
BAERMANN and HEINE MANN. Die intrakutanreaktion bei Syphilis und
Frambosie. Munch. Med. Wchnschr., 1913, lx., Juli 15, S. 1537.
TH1BIERGE. G. La valeur en mldecine legale des m^thodes r^oentes de
diagnostic de la syphilis. Annal. d Hygiene Publ. et de Mid. Lig., 1913, xx.,
Juillet, p. 5.
telrarta*.—CAESAR, V. Sieben Falle von cerebralen Erkrankungen nach
Salvarsanbehandlung. Dermatol. Ztschr ., 1913, xx., Juli, S. 569.
ULLMANN, KARL. Zur Salvarsanintoxikation. Wien, klin. Wchnschr., 1913,
lxiii., Juli 12 and 19, S. 1784 and 1858.
BIBLIOGRAPHY
(hi*
COT’RMONT ft.ml DrRAND. Action des lavements de ataman surcerUinei
formes de tuberculose. Lyon Med., 1913, Ann. xIy., T. cxxi, Juillet 30,
p. 97.
BK< >rg, L. Commpnt peut-on et doit on ft Theum actuelleemployerleSaluima.
Prrsse Aftd., 1913, No. 61, Juillet 26, p. 616.
LOEWY, A., and WECHSELMANN. Kxperimentelle Untersuchungen uber
die Wirkung intravenoser Salvarsaninjektionen anf die Funktion der Mere,
inshenoiidcre bei bestehender (^uecksilberintoxikation. BerL kltn . FckwcAr.,
1913, 1., Juli 21, S. 1342.
Sr HOLTZ and RIEBES. Ueber die Heilung der 8yphilis durch die kombmitfti
Salvar*an - (Juecksilberbehandiung. Dcut. Mid . Wchnsckr ., 1913, mix ,
Juli 24, 8. 1441.
STERN, CARL. Konzentrierte intravenoee Salvarsaainjektionen. Dermoid,
h'ehnschr., 1913, xzvu., S. 792.
KAVOGLI, A. Salvaraan versus Profeta*e law. Joum. Amir. Med . Assoc.,
1913, lxi., July 12, p. 95.
ZCMBTSOH, LEO V. Erfolgloee Anwendung ron Salvaraan bei Ljm. Wien,
kim. Wchnschr ., 1913, xxvi., Juli 17, 8. 1209.
tfeosalvaraan.— ORMSBY, R. Neosalvarsan; intramuscular or infciYenotu!
N. Y. Med. Journ ., 1913, xcviii., July 12, p. 83.
NIXON, J. A. The intravenous administration of neosalvanan in syphilis
Mai. Press, 1913, July 16, p. 66.
PERRIER. Un cas de mort aprds une seule injection de neo-alvarsau. Joan
des Prat ., 1913, xxvii., Juillet 19, p. 466.
ALEXANDRESCU-DERSCA. Uber ein neuea Verfahren der intrwnoseo
Noosalvarsaninjektion. Munch . Med. Wchnsckr ., 1913, lx., Juli22, S. 1601.
Waiienesna Reaction.—KOLMER, J. A., and CA88KLMAN, A J. Concern¬
ing the Wassermann reaction with normal rabbit eerum. Joum. Med Board,
1913, xxviii., July, p. 369.
WALKER, I. C., and 8WIFT, HOMER F. A study of the addition of
cholesterin to the alcoholio extracts of tissues used for antigens in the
Waasermann reaction. Joum. Exp. Med. % 1913, xviii, July, p, 78!
LUCAS, W. P. The Wassermann reaction in its application to medicine.
Boston Med . and Burg. Journ. % 1913, clxix., July 24, p. 116.
STINER, OTTO. Ueber die Modifikationen der Wassennannsehen Betktion
nach Mintz und Rossi. Ztschr. /. Immunitdts/orsch. u. exp. Therap. (Orig.)i
1913, xviii., H. 4, S. 378.
MULZER. Zur Technik der Blutentnahme flir die Wassermannwhe Rcaktkm
Munch. Med. Wchnschr 1913, lx., Juli 1, 8. 1429.
WIDAL. Salvaraan et Wassermann. Joum. da Prof., 1913, xxvii, Juillet35,
p. 472.
SEIFFERT, G., and RASP, C. Reaktionsumschlage bei wiederholter Wsaer
mannacher Reaktion. Arehiv. f. Hygiene , 1913, lxxix., S. 269.
BUNDSCHUH, R. Beitrag zur diagnostisohen Anwendung der Wsiwr*
mannschen Reaktion in der Psychiatric. AUg. Ztschr. /. PsychiaL, 1913, bo.,
S. 365.
KOLMER, J. A., WILLIAMS, W. W„ and LANBAUGH, E. R A study of
complement fixation in syphilis with treponema antigens. Joum. Mei
Research , 1913, xxviii, July, p. 346.
KOLMER, JOHN A. Concerning agglutinins for Treponema pallidum. Joan.
Exp. Med., 1913, xviii., July, p. 187
Cere bro-8 plnal Fluid.—KARP AS, M. J. Clinical of the cerebro¬
spinal fluid in nervous and mental diseases. Joum. Amer, Med. Assoc., 1913,
lxi., July 26, p. 262.
GRULEE, C. G., and MOODY, A. M. Lange’s colloidal gold chlorid test on tie
cerebro-spinal fluid in congenital syphilis. Joum. Amer. Med. Assoc., 1913,
lxi, July 5, p. 13.
BIBLIOGRAPHY
91*
MARUYAMA, H. Vorlfcufige Mitteilung fiber eine diagnoetisch verwertbare
Reaktion in der Spinalfltissigkeit von Par&lytikern. Wien. klin. Wchnsehr
1913, xxvi., Juli 24, S. 1233.
r
SZABO, J. Uber Fermentwlrkungen des Liquor cerebrospinalis bei verschiedenen
geisteskrankheiten. Ztschr. f. d. gee. Neurol. u. Psychiat. (Orig.), 1913, xvii.,
S. 145.
FEILING, A. The blood and the cerebro-spinal fluid in mumps. Lancet , 1913,
July 12, p. 71.
STANFORD, R, V. Vergleichende Studien liber Cerebrospinalfliissigkeit bei
Geisteakrankheiten. I. Dichte. Hoppe-Seyler^9 Ztschr 1913, lxxxvi., H. 1,
S. 43.
Pellagra.—BOX, C. R. Fatal pellagra in two English boys. Brit. Med. Journ.,
1913, July 5, p. 2.
MOTT, F. W. The histological changes in the nervous system in Dr Box’s
second case compared with the changes in an Egyptian case. Brit. Med.
Journ., 1913, July 5, p. 4.
SAMBON, L. W. The natural history of pellagra, with an account of two new
cases in England. Brit. Med. Journ., 1913, July 5, p. 5.
HAMMOND, J. A. B. A case of pellagra in England (probably contracted in
Scotland). Brit. Med. Journ., 1913, July 5, p. 12.
SAMBON, L. W. Pellagra in Great Britain; three new indigenous cases. Brit .
Med. Journ., 1913, July 19, p. 119.
HARRIS, WM. H. The experimental production of pellagra in the monkey by
a Berkefeld filtrate derived from human lesions. Journ. Amer. Med. Assoc.,
1913, lx., June 21, p. 1948.
SILER, J. F., and GARRISON, P. E. An intensive study of the epidemiology of
pellagra. Report of Progress. Amer. Journ. Med. Set., 1913, cxlvi., July,
p. 42.
ALESSANDRINI and SCALA. Nieuwe bijdrage tot het onstaan en hot wezen
der pellagra. Nederlandsch Tijdschr. v. Gcncesk., 1913, Juli 26, p. 229.
UBNEEAL AND FUNCTIONAL DISEASES—
Epilepsy.—RODIET, A. De l'influence des emotions danB la genese de l’attaque
d’4pilepsie. Prog. Med., 1913, xliv., Juillet 5 , p. 354 .
TOULOUSE and MARCHAND. Influence de la menstruation sur l’epilepsie.
Rev. de Psychiat., 1913, xvii., Mai, S. 177.
LLOYD, J. H. Epilepsy in childhood. Archives of Ped., 1913, xxx., p. 432.
BOSS. Epilepsie und Sedobrol. AUg. Ztschr. f. Psychiat., 1913, lxx., S. 568 .
KUKULA, D. Clinical lecture on the surgical treatment of epilepsy. Med.
Press, 1913, July 9, p. 30.
RODIET, A. De la meilleure dietetique dans le cas d’epilepaie dite “ essentielle.”
Gaz. des H6p., 1913, lxxxvi., Juillet 1, p. 1206.
PIERRET, A. Pathologic de Fepilepsie. Rev. de Med., 1913, xxxiii., Juillet,
p. 521.
Hysteria.—CHARON and COURBON. Seiv hysterique et suggestion. Nouv,
Icon. d. 1. Saltpit., 1913, xxvi., Mars-Avril, p. 118.
Chorea.—KALKHOF, J.. and RANKE, O. Eineneue Chorea Huntington-Familie.
(lOTextfig. &nd6Taf.). Ztschr. f. d ges. Neurol, u. Psychiat. (Orig.), 1913,
xvii., 8. 256.
GOLDSTEIN. Ein Kasuistischer Beitrag zur Chorea Chronica heieditaria.
MUnch. Med. Wchnschr., 1913, lx., Juli 29, S. 1659.
HORSTMANN. Zur forensen Bedentung der chorea. AUg. Ztschr. f. Psychiat.
1913, lxx., S. 540.
WEISENBURG, T. H. The choreas of childhood. Archives of Ped., 1913, xxx.,
p. 424.
BIBLIOGRAPHY
*
NEWLIN, A. Diai>enaary treatment of chorea. Arcku*i of Pei., 1913, xxx.,
p. 441.
DKLEARDK and VALKTTE. Contribution i I’etude de la theorie orgaaique de
la choree de Sydenham. Arckiv de Med. dts Enf, 1913, xrt, Juillet, p. 48L
Kfaraitkeelft -A8H, EDWIN L. Combined psycho-electrical treatment of
neurasthenia, Ac. Practitioner, 1913, xci., July, p. 123.
HARTENBERG. Comment traiter un neuraathenique? Joun. dcMd.dc
Parts , 1913, xxxiii, Juillet, p. 579.
KREBS. W. Syphilia and Neurasthenic. Deut. Med* Wchnsckr., 1913, xxxix.,
Juli 10, S. 1358.
Nearaaea.—LEVINSTEIN, O. Zur Pathologic and Therapie ram Tubutmlum
•epti auHgchonder naaaler Refiexneuroaen. Ztsehr. f, Laryngol, Rkinol. u. i.
Grtnzgcb ., 1913, vi., Juni, S. 251.
BURR, C. W. The neuroeea of childhood. Archives of Ped. 9 1913, xxx., p. 416.
GOTTHEIL, W. S. Neuroeea of the akin. Tkerap . Gaz. t 1913, xxxnl, July,
p. 460.
Kevalfffla*—BABINSKI. Traitement de la nevralgie facial*. Joum. da Prat,
1913, xxviL, Juillet 19, p. 456.
LAPINSKY, M. Zur Frage der idiopathiachen Neuralgien dee harten Gsumeni
(Neuralgia n. palatini) und dee Mechanitmue der Auastrmhhmg der Schmenen
im Gehiet dee Trigeminus. Ztsehr . /. d . get . Neurol, u. Psyckiat. (Orig.), 1913,
XTii., S. 402.
LAPIN SKY, M. Die kliniaohen und diagnoetiachen Beeonderhdten der idio-
patiachen und aympatiachen Geeiohteneuralgie. Arckiv f. Psychiat. &
Ntrvtnkr., 1913, li., S. 477.
Nearltta.—TALMEY, MAX. Bilateral optic peeudoneoritii and unilateral
medullated nerve fibre* in cranial injury by blunt foroe. Med. Record 1913,
July 5, p. 13.
GUNZBURG, I. Die phyaiologiaohe Behandlung der Jachiaa. Itsekr. f.
physxkal . u. dial. TKerap. 9 1913, xviL, Juli, S. 398.
Megrt*.—MARGULIE9, A. Uber migraine otique. Proper Med. Wchnsckr.'
1913, xxxviii., Juli 3, S. 381.
Alcafcalism, Ac.—SCHRODER, P. Vertuche mit cbroniacher Alkoholiatoxilcation
bei Kaninchen. Monatssch. f. Psychiat. u. Neurol., 1913, xxxir., H. 1,8.1.
NICLOUX, M. L'aloool et raloooliame an point de me biochimique. Prtm
Mid., 1913, No. 59, Juillet 19, p. 593.
Tetaaas. — ASHH U RST, A. P. C., and JOHN, R. L The rational treatment of
tetanua, with a report of twenty-three oaaea from the Episcopal Hoapttal,
Philadelphia. Amer. Joum. Med . Sei. t 1913, cxlvi, July, p. 77.
WORRALL, RALPH. Puerperal tetanua. Austral Med. Gas., 1913, um»
May 17. p. 464.
Tetany.—HOLTERDORF, A. Tetania bei Perforationaperitoaitis. Dent. Med.
Wchnsckr 1913, xxxix., Juli 31, S. 1499.
AdAlson’s Disease. —LONGHTJRST, B. W. A oaae of Addiaon’s disease. Joum
Boy. Army Med. Corps, 1913, xxL, July, p. 81.
PIERSOL, G. M. Addison's disease: clinical and pathological ohaemtwoa
Boston Med. and Surg. Joum., 1913, dxix., July 17, p. 76.
paralysis Agf tans.—HA&KOYEC, L., and BASTA, J. Contribution i l'dtode do
■ystfeme nerveux dans la paralyaie agitente. (22 fig.) Nouv . Icon. d. I Salph,
1913, xxvi. Mara-Avril, p. 127.
Exaphtlialmlc Goitre, Cretinism, Ac.—MARIMON, JUAN. Theoretisoha sad
experimenteller Beitrag zu einer neuen Theorie der Baaedowscbeu Krenkbeit
Bert. klin. Wchnsckr., 1913, L, Juli 14, S. 1296.
COLLA, ERNST. Zur Frage der Baaedowpeyohoeen. AUg. Ztschr. f. Psychiat,
1913, lxx., S. 525.
ALQU1ER, L. Trent* caa de Baaedowiame fraate ou ndvroae vaso-motnoe. iter.
NeuroL , 1913, xxi., Juin 30, p. 795.
BIBLIOGRAPHY
93*
KINGSBURY, W. M. Cases of exophthalmic goitre treated by X-rays. Proe.
Boy. Soc. Med., 1913, vi., June (Eleotro-therap. Scot.), p. 158.
BRUCE, W. L Treatment of exophthalmic goitre by X-rays. Proe. Boy. Soc.
Med., 1913, vi , Jane (Electro-therap. Sect.), p. 159.
KSSENSON, S. J. Exophthalmic goitre. N.Y. Med.'Joum., 1913, xcviii.,
July 12, p. 80.
ROUSSY, G., and CLUNET, J. Lesions du oorps thyroids dans la maladie de
Basedow. (3 fig.) Rev. Neural ., 1913, xxL, Juillet 15, p. 1.
PEARSON, WM. Pole ligation for hyperthyroidism. Dublin Joum. Med. Sci.,
1913, Series III., No. 499, July, p. 19.
PORTER, M. F. Injection of boiling water in the treatment of hyperthyroidism.
Journ. Amer. Med. Assoc ., 1913, lxi, July 12, p. 88.
gAlI, G&jA. Strumitis posttyphosa apoetematosa tarda und sekundare
Basedowsche Krankheit. Deut. Med. Wcknschr., 1913, xxxix., Juli 3, S. 1302.
RECKZEH, P. ExperimenteUe und klinisohe Untersuchungen liber das Verhalten
des Blutes nach totaler und partieller Entfernung der Schilddriise. Deut . Med.
Wchnschr., 1913, xxxix., Juli 17, S. 1396.
DALCHE, P. Myxoed&me de la menopause et pseudo-myxoedfeme. Joum. des
Prof., 1913, xxvii, Juin 28, p. 401.
SYMMERS and WALLACE. Observations on the pathological changes hi the
thyroid gland in a cretinistic variety of ohondroaystrophia foetalis. Archiv
Ini. Med., 1913, xii, July, p. 37.
POLLAG. Uber die Tuberculose der Schilddriise. Beitrage t. klinik d.
Tuberkul ., 1913, xxvii., H. 2, S. 159.
SHEPHERD, F. J. A note on cancer of thyroid and its extension to the lungs
by means of the blood vessels. Annals of Surgery, 1913, lviii., July, p. 109.
MARKOE, J. W., and WING, L. W. The thyroid in pregnancy. Bull, of the
Lying-in Hosp. of City of New York, 1913, ix., p. 96.
MAYO, C. H. Surgery of the thyroid. Observations on five thousand opera¬
tions. Journ. Amer. Med. Assoc., 1913, lxi, July 5, p. 10.
SPECIAL SENSES AND CEANIAL NESTED—
CLARKE, E. An unusual arrangement of opaque nerve-fibres. Proe. Boy. Soc.
Med., 1913, vi, June (Ophthalmol. Sect.), p. 102.
FRY. F. R. The rebounding pupil. Joum. Nerv. and Merit. Dis., 1913, xL,
July, p. 437.
WALKER, C. B. Some new perimetry instruments. Joum. Amer. Med.
Assoc., 1913, lxi., July 26, p. 277.
HIRD, R. BEATSON. A hand perimeter. Birmingham Med. Beview, 1913,
July, p. 23.
HERBERT, H. Oculomotor paralysis with rhythmic spasm. Proe. Boy. Soc.
Med., 1913, vi, June (Ophthalmol. Sect.), p. 96.
SINGER, KURT. Zur klinik der Augenmuskellahmungen, besonders der
L&hmungen arteriosklerotischen Ursprungs. Monatssch f. Psychiat. u. Neurol.,
1913, xxxiv., Juli, S. 60.
SHUTER, R. E. The influenoe of the vestibular nerve upon involuntary eye
movements and orientation or spaoe perception. Austral. Med. Joum., 1913,
ii, June 14, p. 1077.
BOUCHAND. Othdmatome et 4panohement s^reux du pavilion de l’oreille.
Rev. Neurol., 1913, xxi., Juin 15, p. 737.
DONELAN, JAMES. Persistent paroxysmal couph apparently due to irritation
of ohorda tympani nerve by a spicule of steel which penetrated the tympanum.
Proe. Boy. Soc. Med., 1913, vi, June (OtoL Sect.), p. 92.
ru #
BIBLIOGRAPHY
nim elunmiji sYvmmi ix» met-
CARLSON, A. J., and WOELFEL, A. The solubility of lead lilts in human
gastric juice and its bearing on the hygiene of the lead industries. Jovrn.
A mer. Med. Assoc.. 1913, lxi., July 19, p. 181.
DKRCUM. Die nervnien Symptoms fur Krkrankuog der Proststs und ihn
Rv/iehung zur Behandlung. Med. Blatter , 1913, mt, Juni 7, 8 12L
DEC ROLY. Questionnaire pour l'examen dee enfants irregulien. Jotmu
AVuroL, 191 J, xviii., Juin 5, p. 2Ul.
DECKOLY and HKNROTIN. Un oae d’insuffieaaoe motrioe. Joum. deYeurd.,
1913, xviii., Mai 20, p. 181.
RUMKK, O. Kin ohjektivea Zeichen der nervosen Erechopfung. MonaUrk /■
Psychiat. v. Neurol. t 1913, xxxiv., Juli, 8. 92.
LAIGNKL-LAVASTINE and MERSEY. L’amour de la mort che* les Hal*
bourg. (4 pi). Now. Icon. d. 1. Saltpet 1913, xxvL, Mart-Avril, p. 146.
F AZZI, MUZIO. Vecchie e nuove vedute ealla struttura del cerrello umamonott
che sulla interpretazione dei fenomeni mentalt in rapporto con l^cdirino
rnoderno della acienza pensde. (Note crit.) Rassegna di Studi Paickial, 1913,
iii.. p 2<X).
SAINTON, P , and ROL, L- Contribution k retude dee syndromes polyglando*
laires. Diabete juvenile. Tumeur de Thypophyseetinfantiliime. fov.Ncurci f
1913 xxi., Juin 3<_L p. 783,
FENDE, N. and GAGLIARDO, P. Sulle sindromi pluriglandolari. A proposito
di un nuovu caso se<juito da autopeia. Air. crit. di. Clin. Med., 1913* at.,
p. 417.
KNOX, HOWARD A. Psyohogenetic disorders; casts seen in detained
immigrants. Med. Record f, 1913, July 12, p. 58.
STRUMSKY, MAX. Creating false motor paths. N.Y. Med. /wm,, 1913,
xcviii., July 19, p. 125.
LINDSAY, J. Vasomotor phenomena as a premonitory symptom in rheumatoid
arthritis. Clin. Journ ., 1913, xliL, July 30, p. 268.
DBGENKOLB, K. Die Raumanachauung und das BaumumgangifeldL (Schlw)
Neurol. Ccntralbl ., 1913, xxxii., Juli 1, S. 820.
MAGNUS, R. Gutachten liber einen Fall von Morphinvergiftung. Viertd-
jahrssch . /. gtr. Mcd. % 1913, xlvl, Juli, 8* 1.
SEELERT, HANS. Ein Fall chronischer Manganvergiftung. MonaUsch. /.
Psychiat. u. Neurol 1913, xxxiv., Juli, S. 82.
STERLING, W. Ubor die akuten paralytischen Syndrome nach Wotochutcmp-
fungen. Ztschr. f. d. get. Neurol, u. Psychiat . (Orig.), 1913, xvil, 8 160.
LOMKR, GEORG. Ueber einige Beziehungec zwiechen Gehirn, Keimdriiaen und
Gesamtorganismus. Archivf. Psychiat , u. Nervcnkr. t 1913, li., 8 578.
HEGAR, A. Der Taubstumme als Zeuge vor dem Strafriehter. Ally. ZUchr. f.
Psychiat. , 1913, L\x., S. 554.
PSYCHIATRY.
gbhebai pmifwi-
REZZA. A., and VEDRANI, A. Reperti istologiei in un caso di Paraliai general*
giovanile. Riv. ital di Neuropatol ., Psichiat. cd EUttrotcr., 1913, ri, p. 35i
ALLERS, R. Untersuchungen iiber den Stoffwechsel bei der progression
Paralyse. I. Ztschr. j. d. get. Neurol . u. Psychiat. (Orig.), 1913, xvii., S. 223.
DAHM, I. Untersuchungen iiber den Stoffwechsel bei der progression Paralj**
II (1 Textfig.) ZUchr. f. d , get. Neurol, u. Psychiat. (Orig.), 1913, nii.,
S. 228.
JUNIUS, P., and ARNDT, M. Uber die Deszenderz der Paralytiker. ZUchr. /.
d. get. Neurol, u. Psychiat. (Orig.), 1913, xvii., 8. 303.
RAECKE. Zur Salvareanbebandlung der progression Paralyse. Deut. Med .
Wchnschr ., 1913, xxxix., Juli 10, S. 1349.
BIBLIOGRAPHY
95*
HOCHE, A. Ueber die Tragweite der Spirochatenbefunde bei progressiver
Paralyse. Med. Klinik, 1913, ix., Juli 6, S. 1065.
BRASSERT, H. Selbstversttlmmelung bei Paralyse. Allg. Ztschr. /. Psychiat
1913, lxx. | S. 564.
NOGUCHI, HIDEYO. The transmission of treponema pallidum from the brains
of paretics to the rabbit. Joum. Amer. Med. Assoc., 1913 f lxi., Juli 12, p. 85.
NICHOLS, H. J., and HOUGH, W. H. Positive results following the inoculation
of the rabbit with paretio brain substance. A preliminary note. Joum. Amer.
Med. Assoc., 1913, lxi., July 12, p. 120.
STRANSKY, E. Bemerkung zu der Arbeit “ Unterschiede zwischen dem
Blutserum von Paralytikern und Prsecoxen in Bezug auf die Auslosung von
Immunhamolysinen von L. Benedek und St. D&k," in Bd. 51, Heft i dieses
Archives. Archiv f. Psychiat. u. Nervenkr., 1913, li., S. 703.
DEMENTIA PEAIOX-
ZIYERI, A. Su di on oaso di demenza presbiofrenica. Riv. di Patol. ncrv. e
ment. t 1913, xviii., Luglio, p. 300.
BURR, C. W. A case of dementia prsecox with autopsy. N.Y. Med. Joum.,
1913, xcviii., July 19, p. 109.
GENERAL—
LTVJ5T, MOREL and PUILLET. Du signe de l’avant-bras (signe de L^ri) dans
les maladies men tales. (2 fig.) Rev. Neurol., 1913, xxi., Juin 30, p. 791.
BENON, R., and DENES, P. Manie chronique. (1 pi.). Nouv. Icon. d. 1. Salpet.,
1913, xxvi., Mari-Avril, p. 122.
ZIVERI, ALBERTO. Nuovo contribute per la “malattia di Alzheimer/'
Rassegna di Studi Psichiat., 1913, iii., p. 187.
THOMA, E. Zur patholog. Histologie der Korsakoffschen Psychose. Allg.
Ztschr. f. Psychiat., 1913, lxx., H. 3 und 4, S. 331.
SCHULTES. Uber Zwillingspsychosen. Allg. Ztschr. f. Psychiat., 1913, lxx.,
S. 348.
KELLOGG, T. H. Mental morbidities of the oonjugal state. Med. Record
1913, July 19, p. 104.
BALLET, G., and MALLET, R. Hallucinations et dissociation de la personnalite.
UEnctpholc, 1913, viii., Juillet, p. 1.
DOWN, R. LANGDON. The Mental Deficiency Bill. Eugenics Rev., 1913. v.,
July, p. 166.
DARWIN, MAJOR L. The cost of degeneracy. Eugenics Rev., 1913, v., July,
p. 93.
SHANAHAN, W. T. Custodial power over inmates of state institutions for defec¬
tives. j Med. Record, 1913, July 5, p. 9.
PICQUE, L., and GEORGHIN, E. Ectopie r^nale et troubles mentaux.
JJEnctphale, 1913, viii., Juillet, p. 33.
HASS MANN, W. Bin Beitrag zur Psvchopathologie des Familienmords durch
Geisteskranke. Allg. Ztschr. /. Psychiat., 1913, lxx., S. 410.
ZIEMKE, ERNST. Zur Entstehung sexueller Perversitaten und ihrer Beur-
teilung vor Gericht. Archiv f. Psychiat. u. Nervenkr., 1913, li., S. 420.
ROEMER, HANS. Zur Kenntnis des psychisch abnormen Landstreichertums.
Allg. Ztschr. f. Psychiat., 1913, lxx., S. 384.
STEMMER, W. Zur Geschichte des Waisen-, Toll- und Krankenhauses, sowie
Zucbt und Arbeitshauses in Pforzheim. Allg. Ztschr. f. Psychiat., 1913, lxx.,
S. 432.
FISCHER, MAX. Die Entwicklung des Bauwesens der Irrenaustalten. Allg.
Ztschr. f. Psychiat., 1913, lxx., S. 480,
SMART, I. T. The physician and the defective child. Archills of Ped., 1913,
xxx., p. 456.
MACALISTER, A. Mental influences in the treatment of children. Archives
of Ped., 1913, xxx.. p„ 462.
96*
BIBLIOGRAPHY
SUBOTIC. W. M. Irrengeeetze in Serbian. AUg. ZUckr. /. Ptyckiai., 1913,
lxx., 8. 549.
MULLER, E. Die Regenten dee Jnliech-Claudiechen Kaieerhaueee in hie*
torieeher genealogiscber and peychiatriechcr Beleuehtnng. AUg. ZUckr . /.
Ptychiat ., 1913, lxx., 8. 675.
HIRT, H. Die Aufnehmen der Heil*und Pflegeanetallen eowie der peychia-
trUchen Kiiniken dee Groeehenogt ume Baden ran 1826*1919. AUg. ZUckr . f.
P$ychiai. t 1913, lxx., 8. 698.
BUMKE, O. Gynfckologie und Psychiatric. Med. Zlinik, 1913, ix., Juli 27
S. 1194.
SCHULTZ, J. H. Haematologisohe Unterenehnngemethoden im Dienste der
Psychiatric. Deut. Med. WcKneckr ., 1913, xxxix., Jnli 17, 8. 1399.
WBBRR, L. W. Zur Aetiologie der ekuten Peyehooen. Deut. Med. Wekn$ckr. 9
1913, xxxix., Juli 10, 8. 1346.
BALLET. Le projet de rerieion de In lot de 1838 eur lee alilnle. Rev. de
Ptychiat ., 1913, xriL, Mai, p. 186.
SOUTHARD, E. E. Contributione from the peyehopethie hospital, Boston,
Massachusetts: Introductory note. Boeton Med . and Surg. Joum. 9 1913,
olxix., July 24, p. 109.
PLASELLER, FR. Die in den Jehron 1888 bis 1904 (bxw. 1911) in der Landes
Heil* und Pflegeanstalt flir Geisteskranke in Hell in Tirol Veretorbenen und
deren Todesursachen. Archiv /. Ptychiai. u . Nervenbr ., 1913, li., 8. 387.
TREATMENT.*
FORSYTH, DAVID. On Peycho-enalytia. Brit. Med. Journ., 1913, July 6, p. 13.
KNAUER, ALWYN, end MALONEY, WM. A preliminary note on the psTchic notion
of meecalin, with epeciel reference to the mechaniem of ritual hallucinations
Joum. Nerv. and Ment. Dit. 9 1913, xl., July, p. 426.
• A number of refereooee to papers oo Treatment are inoloded in the BSbUocmnhy under
Individual diseases.
Bibliography
ANATOMY.
RANSON, S. W. The course within the spinal cord of the non-medullated fibres of
the dorsal roots; a study of Lissauer’s tract in the cat. Joum. Comp. Neurol.,
1913, xxiii., Aug., p. 259.
BATTEN, F. E., and HOLMES, GORDON. The endogenous fibres of the human
spinal cord (from the examination of acute poliomyelitis). Brain , 1913, xxxv.,
p. 259.
HELDT, T. J. Mollgaard’s reticulum. Joum. Comp. Neurol. , 1913, xxiii., Aug., p. 315.
KING, HELEN D. The effects of formaldehyde on the brain of the albino rat. Joum.
Comp. Neurol ., 1913, xxiii., Aug., p. 283.
D’HOLLANDER, F. Quelques mots sur le septum lucidum. Joum. de Neurol. , 1913,
xviii., Juin 20, p. 224.
PHYSIOLOGY.
LESCHKE, ERICH. Ueber den Einfluis der Zwischenhirns auf die Warmeregulation.
Ztschr. f. Exp. Path. u. Therapie , 1913, xiv., S. 167.
BIKELES, G., and ZBYZEWSKI, L. Uber die Wirksamkeit von Strychninapplika-
tion an der Hirnrinde bei Anwendung von Schlafmitteln respektive bei Kokain-
applikation. Centralbl. f. Physiol ., 1913, xxvii., S. 433.
NAGEOTTE. Note sur la croissance des appareils de Schwann & l’extr^mit^ proximale
du bout p^riph4rique des nerfs sectionnes, lorsque la regeneration a ete rendue
impossible. Compt. Rend, de la Soc. de Biol ., 1913, lxxv., Aout 1, p. 186.
LODHOLZ, EDWARD. Uber die Gultigkeit des “ Alles- oder Nichtsgesetzes ” fur die
markhaltige Nervenfaser. Ztschr. f. allg. Physiol ., 1913, xv., S. 269.
WEILL, J. Action sur le nerf moteur et le muscle de quelques poisons consid^rth
comme curarmnts. Joum. de Physiol, et de Path, gen., 1913, xv., p. 789.
EDINGER, FRITZ. Die Leistungen des Zentralnervensystems beim Frosch dargestellt
mit Rticksicht auf die Lebensweise des Tieres. (Sammelref.) Ztschr. f. allg.
Physiol ., 1913, xv. (Ref.), S. 15.
YESZI, JULIUS. Untersuchungen fiber die rhythinisch-intermittierenden Enkladungen
des StrychninrUckenmarks. Ztschr. f. allg. Physiol 1913, xv., S. 245.
LODHOLZ, EDWARD. Das Dekrement der Erregungswelle im eratickenden Nerven.
Ztschr. f. allg. Physiol., 1913, xv., S. 297.
STtfBBL, HANS. Morphologische Verknderungen des gereizten Nerven. II. Mitteilung.
PflUger's Arehtv., 1913, cliii., S. 111.
DRESSLER, ALOIS. Uber das Yerhalten der Lichtempfindlichkeit und der Pupillar
reaktion bei Dunkelaufenthall von Pferden und Hunden. Pjtugers Archiv., 1913,
cliii., S. 137.
PARKER, G. H., and STABLER, E. M. On certain distinctions between taste and
smell. Amer . Joum. Physiol., 1913, xxxii., p. 230.
ROAF, H. E. The influence of muscular rigidity on the oxygen intake of decerebrate
oats. Quart. Joum. Exp. Physiol., 1913, vi., p. 393.
LEVENE, P. A. On the cerebrosides of the brain tissue (II ). Joum. Biol. Chem
1913, xv., Aug., p. 359.
P
97 *
BIBLIOGRAPHY
OS*
TOC i A MI, K. Ein Beitrag zur Lehr© vom Stoffwechsel bei Psychosen. I. Mittheilung :
Stirmnung und Magenverdauung. Ztschr . /. Exp. Path. u. Thcrap., 1913, ii?., S. 71
LAHV, J. M. Lea conditions psycho-physiologiquea de l'aptitude au travail dactylo¬
graphy ue. Journ. de Physiol, et de Path . yen., 1913, xv., p. 826.
BRUCE, A. NINIAN. Vaso dilator axon-reflexes. Quart. Journ. Exp. Physiol 1913,
vi., p. 339.
HESS, L., and BERM ANN, E. v. Ueber Gefaasreflexe. Wien. Hin. Wchnschr., 1913,
xxvi., Aug. 7, S. 1297.
LEBON and AUBOURO. Contractions reflexes du gros intestin et rdflexotherapie.
Pres ir A fed., 1913, No. 69, Aout 23, p. 693.
KAPPIS, MAX. Bcitrage zur Fr&ge der Sensibilitat der Bauch ho hie. Mitteil. a. d.
Urcnzyti*. d. Med. u. i*hir. % 1913, xxvi., S. 493.
SCHLIMPERT, H. Experimentelle Untersuchungen zur Physiologic der Hypophyae.
Monatsschr. f. Uehurtsh. u. Uymik, 1913, xxxviii., Juli, 8. 8.
LEWIS, D. D., and MILLER, J. L. The relation of the hypophysis to growth and the
effect of feeding anterior and posterior lobe. Archives int. Med., 1913, xii, Aug.,
p. 137.
ASCOLI, G., and LEONANI, T. LTiypophyse est-aile un organe indispensable k la
vie? Archil' ital. de Biol., 1913, lix., p. 235.
MUSSKR, J. H. The effects of continuous administration of extract of the pituitary
gland. Amer. Journ. Med. »SVi., 1913, cxlvi., August, p. 208.
HAMMOND, JOHN. The effect of pituitary extract on the secretion of milk. Quart.
Journ. Exp. Physiol. , 1913, vi., p. 311.
MATTIROLO, G., and GAMNA, C. Recherches physio-pathologiquss but les voies
sympathiques oculo-popillaires et action de l'adr^naline sur Poeil. Archiv ital. de
Biol., 1913, lix., p. 193.
SEIDELL, A. Colorimetric determination of epinephrine in desiocated suprarenal
glands. Journ. Biol. Chem ., 1913, xv., Aug., p. 197.
POPIELSKI, L. Adrenalin und Komprimierung der Nebenniere. Zentralbl. f. Physiol.,
1913, xxvii., S. 479.
KLEINER, I. 8., and MELTZER, 8. J. The relation of the rate of absorption of
adrenalin to its glycosuric and diuretic effects. Journ. Exp . Med., 1913, xviii.,
August, p. 190.
MULON. Disparition dea enclaves de cholest^rine de la surr^nale au cours de la
tetanisation faradiqus ou stryebnique. Compt . Rend, de la Soc. de Biol., 1913,
lxxv., Aout, p. 189.
FUCHS, D., and ROTH, N. Untersuchungen iiber die Wirkung des Adrenalins auf
den Respirationsstoffwechsel. (II. Mittheilung.) Ztschr. f. Exp. Path. u. Ther. %
1913, xiv., 8. 64.
PSYCHOLOGY.
RIGNANO, EUGENIO. Was it das Rasonnement? Archiv /. d. get. Psychol 1913,
xxviii., S. 277.
PFGRDTEN, OTTO VON DER. Beschreibende und erkl&rende Psychologia. Archir
f. d. yes. Psychol ., 1913, xxviii., S. 302.
RITTERHAUS, E. Zur Frage der Komplexforschung. Archiv f. d. get. Psychol..
1913, xxviii., S. 324.
HA SHE ROOT, W. GcsichtH|>unkte zu einer experimentellen Analyse geometria-
choj.tischer Tauschungen. (10 figs, in Text.) Archiv /. d. get. Psychol., 1913, xxviii.,
8. 330.
HARTENBERG, P. Zwangsvorgange und Wille. Ztschr. f. Pst/chotherap. u. med.
Psychol ., 1913, v., 8. 129.
ELLIS, HAVELOCK. Sexo-asthetische Inversion. Ztschr. f. Psychothcran. u. med.
Psychol. , 1913, v., 8. 134.
BIBLIOGRAPHY
99*
MARCINOWSKI, I. Glossen zur Psychoanalyse. Ztschr. /. Psychothtrap. u.
P$ychol. % 1913, v., S. 162.
MAJOR, 6. Das Wesen der Debilit&t im Gegensatz zur moralischen Verderbtheit.
Ztschr./. Psychotherap. u. mod. Psychol ., 1913, v., S. 185.
STERNBERG, W. Zur Physiologic der Geftihle. Zentralbl. f. Physiol ., 1913, xxvii.,
S. 429.
BUNNEMANN, G. Ueber psychogene Schmerzen. Monatssch. f. Psychiat. u.
Neurol ., 1913, xxxiv., Aug., S. 142.
HILL, O. B. The psychology of the anus. Indian Med. Qaz.> 1913, xlviii., Aug.,
p. 301.
WEBER, L. W. “ Gedankentibertragung ” und Suggestion. Ztschr. /. Medizinal-
beamte , 1913, xxvi., Juli 20, S. 525.
VOELKEL, E. Untersuchungen tiber die Rechtshandigkeit beim Sangling. (2 textfig.)
Ztschr. f. Ktnderheilk. (Orig.), 1913, viiL, Juli, S. 351.
PATHOLOGY.
ORR, ROWS, and STEPHENSON. The spread of infection by the ascending lymph
stream of nerves from peripheral inflammatory foci to the central nervous system.
Review of Neurol, and Psychiat. , 1913, xi., p. 349; Joum. Mcnt. Sci. 9 1913, lix.,
p. 411.
MARINESCO, G. Bur la structure colloidale des cellules nerveuses et sea variations
k l^tat normal et pathologique. Joum. dc Neurol. , 1913, xviii., Juillet 5 and 20,
pp. 241 and 261.
MATTIOLI, L. Su l'origine delle “Plasmazellen” e la loro presenza nel sangue
circolante. Riv. di Patol. nerv. e ment. 9 1913, xviii., p. 345.
BUSCAINO, V. M. Sulla genesi e sul signiflcato delle cellule ameboidi. Riv. di Patol.
nerv. e ment. 9 1913, xviii., p. 360.
RIGOTTI, L. Indagini sulle alterazioni del reticolo endocellulare degli elementi
nervosi nell* ipertermia sperimentale. Riv. di Patol. nerv . e ment. 9 1913, xviii.,
p. 388.
HESSE, R. Bin Fall von seltener Schrotschussverletzung. Beitrag zur Kenntnis des
Faserverlaufes im Tractus opticus. Klin . MonatsU. f. Augenheilk. 9 1913, li.,
Juli, S. 29.
ROSA, G. dk. Le forme pih frequenti di pazzia fra gli emigranti. Annali di Nevrol .,
1913, xxxi., p. 32.
TAKASB[IMA, S. Fiinf Falle von Hydrophthalmus congenitus unter besonderer
Beriicksichtigung des pathologisch-anatomischen Befundes. Klin. Monatsbl. f.
Augenheilk.y 1913, li., Juli, S. 48.
OTT, AUGUSTO. Cousiderazioni sulla flsiopatologia della contrattura. Riv. di Patol.
nerv. ement. 9 1913, xviii., Agosto, p. 429.
OTT, AUGUSTO. A proposito della flsiopathologia della contrattura. Riv. di Patol.
nerv. e menl. 9 1913, xviii., Agosto, p. 4o4.
BUSCAINO, Y. M. Sui rapporti funzionali tra i centri corticali ed i sottocorticali
tonici dell’ uomo in oondizioni normali e patologiche (contrattura). Riv. di Paid,
nerv. e ment. 9 1913, xviii., Agosto, p. 441.
RBZZA, A. Alterazioni delle cellule gangliari del bulbo in un caso di demenza precoce
con morte improvvisa. Riv. di Paid. nerv. e ment. t 1913, xviii., Agosto, p. 426.
ROSSKNECHT, E. Haufung dysontogenetischer Bildungen im Zentralnervensystem.
(Diplomyelie und Cholesteatom mit Ubergang in Karzinom). Frankfurter Ztschr.
f. Path. 9 1913, xiii., S. 300.
BONSMANN, M. R. Uber nachtragliche Uberhautung von Myelomeningozelen.
Virchow's Archiv., 1913, ccxiii., S. 131.
ASCHNER, B. Ueber den Einfluss der Innervation auf das Tumorwachstum. Ztschr.
f. Krebsfor8chung 9 1913, xiii., S. 336.
100
BIBLIOGRAPHY
CREUTZFELDT, GERHARD, and KOCH. Uber Veranderungen in der Hypophysis
cerebri bei Diphtheric. Virchow* Archiv. y 1913, ccxiii, S. 133.
GLYNN, E., and HEWETSON, J. T. Adrenal hypernephroma in an adult female
associated with male secondary sex characters. Journ. Path. and Bad ., 1913,
xviii., July, p. 81.
ANITSCHKOW, N. Zur Frago der Veranderungen dee Myokards bei Adronalinver
giftung. Virchow'* Archiv ., 1913, ccxiii., 8. 157.
HELLY. Zur Pathologic der Nebenniere. Munch. Med . WchntcKr. % 1913, lx.,
Aug. 19, S. 1811.
CLINICAL NEUROLOGY.
•BUBAL—
KAPLAN, D. M. The importance of serological analyses in neurology. N. Y.
Med . Journ 1913, xcviii., Aug. 16, p. 308.
BARANY, R. Die klinischo Eutwicklung meines Symptomenkomplexea.
Wien . Med . Wchnschr ., 1913, lxiii., Aug. 23, S. 2156.
DELHEKM, L. La contraction galvano-tonique dans la reaction de degene-
resence avee hypoexitabilite galvanique. Gaz. de*. H6p. y 1913, lxxxvi., Aout
5, p. 1417.
BEEVES—
DELBET. Fracture dc l’humerus, paralysis radiale. Journ. de* Prat. y 1913,
xxvii., Aout 2, p. 487.
FRIEDLANDER. Sockranklicit und Vagotonic. Munch. Med . Wchn*chr. y 1913,
lx., Aug. 19, S. 1S30.
MlfttLEft—
ROSE, F. L’atropbie musculaire particlle dans let myopathies. iSew. Med. y
1913, xxxiii., Aout 29, p. 397.
HOOVER, C. F. The functions of the diaphragm and their diagnostic signifi¬
cance. Archives Int. Mcd. y 1913, xii., August, p. 214.
ft PINAL COBB—
General.—HERN AM AN-JOHNSON, F. The treatment of chronio progressive
diseases of the spinal cord by X-rays. With an acoount of two cases. Brit.
Med. Journ. , 1913, Aug. 9, p. 299.
BABINSKI. Hemisection de la mocllo. Journ. dc* Pral. % 1913, xxvii., Aout 9,
p. 501.
Fracture, Dislocation, Ac.—BENTALL, W. C. Spontaneous reduction of a
dislocation of the cervical vertebne. Brit. Med. Journ. , 1913, July 12, p. 69.
FLATAU, E., and FRENKEL, BU. Uber das Zittern beider Hknde mit dcren
Abduktion, nebst eincr einseitigen sj>astischen Skoliose. Neurol. Ccntralbl
1913, xxxii., Aug. 1, S. 950.
BITTNER, F. Die Behandlung der Skoliose unter besonderer Beriicksichtigung
des neuen Verfahrena nach Abbott Prog. Med. Wchn*chr. 9 1913, xxxviiL,
Aug. 21, 8. 471.
Tabes Dorsalis.— FRKNKKL-HEIDEN. Die Behandlung schwerster Formen von
Ataxic bci Tabes. Bcrl. klin. Wchnschr 1913, 1., Aug. 4, S. 1429.
CROCQ. Tabes-Wassermann n^gatif tant dans le sang que dans le liquide
cephalo-rachidien. Journ. dc Neurol. , 1913, xviii., Juin 20, p. 221.
CROCQ. Tabes ancien sans incoordination— Wassermann n^gatif dans le sang,
positif dans le liquide cephalo-rachidicn. Journ. dc Neurol. , 1913, XTiii.,
Juin 20, p. 223.
MINOR, J. C. So-called latent syphilitics, or paretics and tabetics. N. Y. Med.
Journ. 9 1913, xcviii., Aug. 16, p. 327.
Paraplegia.—MARFAN, A. B. Paraplegic spasmodique herbdo-syphilitique chez
les grands enfants. Archives dc Med. des Enf. y 1913, xvi., Aout, p. 561.
BIBLIOGRAPHY
101*
Myelitis.—SOUQUES, A., and BARBE, A. Amyotrophic AranDuchenne con¬
secutive k one m4ningo-my41ite diffuse. Rev. Neurol ., 1913, xxi., Juillet 30, p.
57.
Spondylitis.—KIENAST, V.. and FRANKFURTER. OTTO. Ein Fall Ton
Spondylitis cervicalis, durch Sonnenbestrahlung geheilt. Wien. Med. Wchnsehr.,
1913, lxiii. Aug. 9, S. 2036.
BRAIN—
General. —0ASCELLA, P. Paralisi ocrebrale dell’ infanzia. Movimenti atetoidei,
ooreiformi ed associati disturbi sentimentali. Annali di NetrcL, 1913, xxxL,
p. 1.
ROBINSON, G. W. Over-response to affective stimuli from stationary cortical
lesions. Joum. Amer. Med. Assoc., 1913, lxi., Aug. 16, p. 452.
SUDHOFF, W. Die Lehre von den Hirnventrikeln in textlicher und graphischer
Tradition des Altertums und Mittelalters. Archiv f. Geschichte d. Med., 1913,
vii., Aug., S. 149.
Blssemlnated Sclerosis.—METTLER, L. H. Symptomatology of multiple
sclerosis. Joum. Amer. Med. Assoc., 1913, lxi., Aug. 16, p. 474.
Poliomyelitis Anterior Acsts.—SCHIPPERS, J. C., and LANGE, C. db. Uber
eine Epidemic der Heime-Medinschen Krankheit in den Niederlanden w Ah rend
dee Jahres, 1912. (3 textfig.) Ztschr. f. Kinderheilk. (Orig.), 1913, viiL, Juli,
S. 359.
SAWYER, W. A., and HERMS, W. B. Attempts to transmit poliomyelitis by
means of the stable-fly (SUrmozys calcitrans). Joum. Amer. Med. Assoc.,
1913, lxi., Aug. 16, p. 461.
LEVADITI. Virus de la poliomy&ite et culture des oellules in vitro. Compt.
Rend, de la Soc. de Biol., 1913, lxxv., Aout, p. 202.
Landry's Paralysis.—PFEIFFER, J. A. F. A case of Landry’s paralysis with
especial reference to the anatomical changes. Brain, 1913, xxxv., p. 293.
MACNAMARA, E. D. Syphilitic infection followed by Landry’s syndrome and
later by tabes dorsalis. Lancet, 1913, Aug. 9, p. 385.
Meningitis.—RIVIERE and DUMAS. M6ningites k param&iingocoques (etude
clinique et bacteriologique). (Rev. gen.) Qaz. des H6p ., 1913, Ann. lxxxvi.,
Aotit 9, p. 1439.
ORTICONI and BOUCLIER. Une 4pidomie de mlningite cc r ebr o-spinal e k la
Flfeche, en 1912. Annal. d'Hyg. Pub., 1913, xx., Aout, S. 167.
Encephalitis.— KCELICHEN and SKODOWSKI. Bnc^phalite k Evolution
subaigue chez un gar^on de 9 ans. Rev. Neurol., 1913, xxi., Aofit 15, p. 152.
Meningocele.—KONDRING, H. Basale sphenoorbitale Meningocele. Monatsschr.
f. Gcburtsh. u. Gyn., 1913, xxxviii., Aug., S. 170.
Spina Blflda.—BIBERCEIL, E. Die klinische Bedoutung der Spina bifida
ooculta. Bcrl. Klin. Wchnsehr., 1913, L, Aug. 18, S. 1481.
Anearlsm.—REINHARDT, AD. Ueber Hirnarterienaneurysmen und ihre
Folgen. Mitteil. a. d. Qrcnzgel. d. Med. u. Chir., 1913, xxvi., S. 432.
Masmorrhage.—HART, C. Uber nourotische H&morrhagie. Frankfurter Ztschr.
f. Path., 1913, xiii., S. 242.
Aphasia, Ac. —CHAPMAN, W. L., MORRIS, H. A., and SIMRELL, G. W.
Surgical aphasia. N. Y. Med. Joum., 1913, xcviii., Aug. 2, p. 222.
Facial Paralysis.—MOSKOVITZ, I. Uber genese und Therapie der rheumatischen
Fazialislahmung. We in. Med. Wchnsehr., 1913, lxiii., Aug. 16, S. 2102.
Nenroma.—FREUND, P. Ein ganglioneurom des rechten Halssympathikus.
Frankfurter Ztschr. f. Path., 1913, xiii., S. 266.
HEIDINGSFELD, M. L. Neuroma cutis (dolorosum). Joum. Amer. Med .
Assoc., 1913, lxi., Aug. 9, p. 405.
Microcephaly.—HARBITZ, F. Ein Fall von Mikrokephalie. (4 Abbild. im Text.)
Frankfurter Ztschr . /. Path., 1913, xiii., S. 210.
102*
BIBLIOGRAPHY
iieieephaly —BROUWER, B. Over Anencephalie. (Met twee platen.) Neder-
landtck Tijdtchr. voor GeneesL, 1913, Aug. 16, p. 467.
Acrasnegaly*—BARTLETT, F, K. A case of aeromeply and polyglandular
syndrome, with special referenoe to the pineal gland. Archive* InL Med
1913, xii.. August, p. 201.
LANGE, O. Zur Kasuistik der Erkrankungen der Hypophysis und deren
Umgebung, aowie zur Kenntnis der binasalen Hemianopsia. Klin, Monatsbl
f. AugenheUk ., 1913, li., Juli, S. 16.
Mafcetes lailpMsi. — GUNTHER, HANS. Anhidrosis und Diabetes insipidus.
ZUchr. /. Klin. Med. t 1913, lxxviii, S. 53.
BENARIO.—Zur Pathologie und Therapie des Diabetes insipidua Miineh.
Med. Wchntchr., 1913, lx., Aug. 12, S. 1768.
AefcMAropIasla.—ZUCCARI, G. Su di un oaso di peioosi maniaco-depressive in
aoondroplasioo. Riv. ital. di Neuropalol. Psichiat. ed EUttroier ., 1913. vi..
Luglio, p. 289.
Bypfellls.—ZYLBERLAST, Mm. N. Contribution k l’4tude de la syphilis dphalo-
rachidienne. (2 fig.) Rev. Neurol ., 1913, xxi., Juillet 30, p. 63.
BUETTNER, W. Akti vit&teveranderungen und entsprechende Avid itatesoh wan -
kungen des luetischen Virus gegeniiber antisyphilitiachen Mitteln. R ten. klin.
Wchntchr ., 1913, xxvi., Aug. 21, S. 1353.
HAERLE, T. Uber die Bedeutung akut-entzundlicher Prozetse in den Organen
bei kongenitaler Syphilis. Jahrb. /. Ktndcrhcilk ., 1913, lxxviii., 8. 125.
HUZAR, W. Ueber akute luetische Polyarthritis im Spatstadium der Syphilis.
Wien. klin. Wchntchr., 1913, xxvi., Aug. 14, S. 1333.
BURNIER, R. La culture du spirochete pile et la cuti*reaction dans la syphilis.
Presse Med., 1913, No. 69, Aout 23, p. 694.
GUTMANN, C. Ueber intravenose Injektionen mit Toxynon, einem neuen
Quecksilberpraparat, bei Syphilitischen und Niohtsyphilitischen. Berl. kJm.
Wchntchr., 1913,1., Aug. 25, S. 1561.
GRUNBERG. Beitrag zur Behandlung der Lues mittelst Aurum Kalium
Cyanatum. Munch. Med. Wchtitchr., 1913, lx., Aug. 5, S. 1711.
BERING, FR. Ueber die Fortschritte in der Behandlung der Syphilis. Berl.
Klin. Wchntchr., 1913, 1., Aug. 25, S. 1553.
TRINCHESE, J. Die Eigenhemmung der Sera, ein Symptom der Lues. Deut.
Med. Wchntchr. , 1913, xxxix., Aug. 21, S. 1636.
SCHMITTER, F. The Luetin Test. Joum. Cut. Dit,, 1913, xxxi., Aug.,
p. 549.
RICHTER, ED. Zur Kontraluesinbehandlung. Dermatol. Wchntchr. , 1913,
lvii., Juli 26, S. 883.
Aal versa n.—HITROWO, A. Uber die Jarisch-Herxhdmersche Reaktion der
Gummata auf die Salvarsanbehandlung. Zttchr. f. Chemotherapic , 1913, ii.
(Orig.), S. 50.
LINSER. Zur Technik Konzentrierter, intravenoser Salvarsaninjektionen.
Dermatol. Wchntchr. , 1913, lvii., Aug. 2, S. 916.
ZIEGEL, H. F. L. Results of salvarsan therapy in malignant syphilis prseeox,
syphilide of the palms and gumma of the tongue. Joum. Out. Dit. 9 1913,
xxxi., Aug., p. 555.
GENNERICH. Ueber Salvarsanstorungen. Berl. klin. Wchntchr. , 1913, 1.
Aug. 25, S. 1576.
KROL. Ein merkwiirdiger Todesfall nach Salvarsan. Miineh. Med. Wchntchr .,
1913, lx., Aug. 5, S. 1712.
SCHLASBERG, H. I. Salvarsanets inverkan pi njurama vid intravenose in*
jektioner. Nord. Med. Arkiv. % 1912, xlv. (lure. Med.), pp. 1*39.
WAD HAMS, 8. H. Three oases of amebio dysentery treated with salvarsan.
Joum. Amer. Med. Astoc. 9 1913, lxi., Aug. 9, p. 385.
BIBLIOGRAPHY
103*
VALENTINS, J. A. Salvarsan on tea estates. Indian Med. Gas., 1913, xlvilL,
Aug., p. 299.
Neosalvarsaw.—RIEMPST, T. S. van. Personal experienoes with neosalvarsan.
Med. Record , 1913, lxxxiv., Aug. 9, p. 246.
ZUMBUSCH, L. R. v. Zur intravenosen Applikation von Neosalvarsan mittels
Spritze. Wien. klin. Wchnschr ., 1913, xxvi., Aug. 7, S. 1305.
GRUNBERG, J. Reflexionen tiber Neosalvarsan. Petersburger Med. Ztschr .,
1913, xxxviii., Aug., S. 176.
Wassermann Reaction.—WESENER. Zweijahrige Erfahrungen mit der Wasser-
mannschen Reaktion. Munch. Med. Wehmchr., 1913, lx., Aug. 19, S. 1816.
BITTER. Ein brauohb&rer, leiebt zu besehaffender Organextrakt zur Anstellung
der Wassermannsehen Reaktion. Milnch. Med. Wchnschr ., 1913, lx., Aug. 19,
S. 1819.
BRAUTIGAM, FR. Die Hermann-Perutz’sohe Reaktion im Vergleioh zur
Wassermann’sohen Reaktion. Berl. Klin. Wchnschr ., 1913,1., Aug. 18, S. 1525.
KOTZEWALOFF, 8. Zur Frage der Titration des Komplements bei der Wasser-
mannschen Reaktion. Centralbl. f. Bakt., Ac., 1 Abt. (Orig.), 1913, Ixx., S. 98.
NEUE, H., and VORKASTNER, W. Diagnostisobe Vorteile und Ersohwerungen
duroh die WassermannBehe Reaktion. MonaUschr . /. Psychiat. u. Neurol.,
1913, xxxiv., Aug., S. 117.
Cerebro-gplnal Fluid.—SCHALLER, W. F. A report on the analysis of the
cerebrospinal fluid, with clinical notes in 109 cases of disease of the nervous
system, not including the acute meningeal affections. Joum . Nerv. and Ment.
Die., 1913, xL, Aug., p. 489.
ELLIS, A. W. 1C., and SWIFT, H. F. The oerebro-spinal fluid in syphilis.
Joum. Exp. Med., 1913, xviii., Aug., p. 162.
Pellagra.—SAMBON, L. W. Pellagra in Great Britain. Brit. Med. Joum.,
Aug. 9, p. 297.
NICHOLLS, LUCIUS. The pathological changes in pellagra and the production
of the disease in lower animals. (2 Plates.) Joum. Hygiene , 1913, xiii., July,
p. 149.
NILES, G. M. The rdle of hydrotherapy in the treatment of pellagra. Amer.
Joum. Med. Sci., 1913, clxvi., Aug., p. 230.
ROBERTS, S. R. The analogies of pellagra and the mosquito. Amer. Joum.
Med. Sci., 1913, cxlvi., Aug., p. 233.
SILER, J. F., and GARRISON, P. E. An intensive study of the epidemiology
of |MAlAgra. Report of progress. Amer. Joum. Med. Sci., 1913, cxlvi., Aug.,
FINATO, L., and NOVELLS, F. Ricerche sulla ipersensibiliU dei pellagrosi.
Pathologic a, 1913, v., Aguosto 15, p. 492.
TIZZONI, G., and ANGELIS, G. DE. Uber den Entwickelungszyklus des plco-
morphen Streptobacillus der Pellagra. Centralbl. f. Bakt., Ac., 1 Abt. (Orig.),
1913, lxx., S. 24.
LISI, L. de. Isolisine e potere antitriptioo del siero di sangue dei pellagrosi.
Riv. di Patol. nerv. e ment., 1913, xviii., Agosto, p. 409.
SHOEMAKER, H. Pellagra, surgery, the colloids, and strong drugs; also
introducing a possible new etiological factor. N. Y. Med. Joum., 1913, xoviii.,
Aug. 2, p. 214.
OBNERAL AND FUNCTIONAL DISEASES—
Epilepsy.—STERLING, W. Uber die paralytische Aura der geniunen Epilepeie
und uber die auflosende Wirkung des Krampfanfalles auf die paralytisonen
Erocheinungen. Neurol. Centralbl., 1913, xxxii., Juli 16, S. 887.
NOLAN, J. N. G. The recognition and treatment of true idiopathic epilepsy
in children. Dublin Joum. Med. Sci., 1913, No. 500, Aug., p. 92.
D^J^RINE. L’lpilepsie jacksonienne. Prog. Mid., 1913, xliv., Aoflt 9, p. 420.
LONG LANDRY and QUERCY. Un cas d^pilepsie partielle continue. (5 fig.)
Rev. Neurol., 1913, xxi., Aoflt 15, p. 145.
1U4*
BIBLIOGRAPHY
KANNGIESSER, F. War Napoleon EpUepttker? Prog. Med. Wehnsehr ..
1913, xxxviii., Aug. 7, S. 451.
POWERS, HALE. The rile of gastric and intestinal stasis in some oases of
epilepsy. Boston Med . and Surg. Joum., 1913, dxix., Aug. 7, p. 189.
CLARK, L. PIERCE. Newer aspects of the treatment of epilepsy. Med.
Record, 1913, lxxxiv., Aug. 2 V p. 185.
HEBOLD, OTTO. AbkUhlung im Wasser als anslosende Ursaohe der Epileptic
und iiber den Ein flues der Erstickung in gleioher Beriehnng. Epilepsia, 1913,
iv., p. 239.
DONATH, J. Die Entstehung der salxloeen Dikt in der Behandlung der
Epilepsie. Epilepsia , 1913, iv., p. 282.
ORZECHOWSKI, K., and MEISELS, E. Untersuehungen iiber das Verhalten
den Vegetativen Nervensy stems in der Epilepsie (Fortsetzung und Schluss).
Epilepsia , 1913, iv., p. 293.
SPANGLER, R. H. The erotalin treatment of epilepsy. Epilepsia, 1913. iv.,
p. 3U7.
ANDREWS, B. J. The palsies in epilepsy. Epilepsia, 1913, iv., p. 31S.
FLEMING, R. A. Three cases of “fits.” Clin . Joum. , 1913, xlii., Aug. 13,
p. 300.
■ysterla.—MYERSON, A. Hysteria with fever and ankle clonus; a case report.
Boston Med . and Surg . Joum., 1913, clxix., Aug. 7, p. 194.
WILLIAMS, TOM A. Recent work upon hysteria. Med. Press , 1913, Aug. 20,
p. 199.
YIX. Die Breuer-Freud’sche Betrachtungsweise der Hysteric und anderer
neurotische Symptome. Fortsehr . d. Med., 1913, xxxL, Juli 17. S. 785.
BRILL, A. A. Piblokto or hysteria among Peary’s Eskimos. Joum. Nerv. and
Ment. bis., 1913, xl., Aug., p. 514.
Chore*.— PFEIFFER, J. A. F. A contribution to the pathology of chronic pro¬
gressive chorea. Brain , 1913, xxxv., p. 276.
Mctrilfli.—TUCKER, B. R, Trigeminal Dural Neuralgia. Joum. Nerv. and
Ment. Dis., 1913, xl., Aug., p. 521.
SCHURIG. Zur Behandlung der Ischias. Miinch. Med. Wehnsehr., 1913. lx.,
Aug. 19, S. 1830.
Xevrfltl*.—BAXTER, J. M. Double optic neuritis associated with mastoiditis.
Australian Med . Journ., 1913, ii., July 5, p. 1112.
Menroses.—JUQUELIER and VINCHON. Lc vol dans les n^vroees. Journ. de
Mid . de Paris, 1913, xxxiii., Aout 16, p. 651.
■aynamd’s Disease.—BOSANYI, A. Die Raynandsche Krankheit als ein
Symptom der hereditkren Syphilis. Jahrb. f. Kinderheilk ., 1913, lxxviii.,
S. 177.
Addison’s Disease.—VOGT. Morbus Addisonii and Schwangerschaft. Miinch.
Med. Wehnsehr ., 1913, lx., Aug. 19, S. 1821.
Exophthalmic Colt re, Cretinism, *e.—WALTER, F. K. Was lehrt uns die
Wirkung der normalen und pathologisch veranderten Schilddrtise auf das
Nervcnsystem fiir die anderer innersskretorischer Driisen ? Monatsschr . /.
Psychiat . u. Neurol., 1913, xxxiv., Aug., S. 171.
LAMPE, A. ED. Basedowsche Krankheit und Genitale. Monatsschr . /. Oeburtsh .
u. Oynak., 1913, xxxviiL, Juli, S. 45.
HALSTED, WM. S. (1) The excision of both lobes of the thyroid gland for the
cure of Graves’s disease ; (2) the preliminary ligation of the thyroid arteries
and of the inferior in preference to the superior artery. Annals of Surgery,
1913, lviii,, Aug., p. 178.
JONES, A. P., and TATUM, A. L. On the demonstration of variations in the
thyroid colloid in conditions of hyper- and hypothyroidism. Archives Int.
Med., 1913, xii., Aug., p. 225.
THEISEN, C. F. Acute thyroiditis as a complication of acute tonsillitis.
Albany Med. Annals , 1913. xxxiv., Aug., p. 465,
BIBLIOGRAPHY
105*
EDMUNDS, W. Further observations on the thyroid gland. (IX.) Joum. Path,
and Bad., 1913, xviii., July, p. 53.
ftriCUl 8BM8E8 AM* CKAMUL NERVEft—
SCHLOFFER. H. Zur operativen Behandlung der Lehstorungen beim Turin-
■chfcdel. Klin. Monatsbl. f. AngenkeUk ., 1913, li., Juli, S. L
SOMOGYI, R. Das vagotonische Pupillenphgnomon. Wien. Jdin. Wchn$chr.,
1913, xxvi, Aug. 14, S. 1331.
MAAS, OTTO. Zur Bewertung der reflektorischen Pupillenstarre. Neurol.
Centralbl., 1913, xxxii., Aug., S. 958.
CLAUDE, H. Ophtalmologie totale ehez un saturnin. Joum. des Prat.,
1913, xxvii., Aofit 9, p. 481.
CAPPELLI, J., and TORRIGIANI, C. A. Sovra alcuni cam di lesione dell*
acuttioo • del faciale nella aifilide (oont.). Riv. crit. di Clin. Med., 1913,
xiv., Agoato 16, p. 513.
FRAZIER, CHARLES H. Intracranial division of the auditory nerve for
persistent tinnitus. Joum. Amer. Med. Assoc., 1913, lxi M Aug. 2, p. 397.
SACK, N. Ein Fall von Atrophie des Gehororgana durch Missbildung dea
Schadels und Facialiaatrophie kompliziert. (2 Fig.) Monatuch. /. OhrenheilL
«. Laryngo-Rhinol., 1913, xlvii., S. 908.
NI8CEUANEOU8 SYMPTOMS AND CASES—
DUHOT, E Syndrome dmi-bulbaire: h4mianeath4aie alterne avec dissociation
thermo-analgesique, triade oculo-papillaire sympathique unilat4rale, hemiplegic
palato-pharyng4e. L Encephale, 1913, viii., Aout, p. 132.
RIGGS. C. B. Some nervous symptoms of pernicious anemia. Joum. Amer.
Med. Assoc., 1913, lxL, Aug. 16, p. 481.
DECROLT and HENROTIN. Un oaa d’insuffisanoe motrioe (suite). Joum.
de Neurol., 1913, xviii., Aofit 5, p. 281.
JUNGMANN and MEYER. Experimented Untersuehungen iiber die Abh&ngig-
keit der Nierenfunktion vom Nervensystem. Archiv. /. Exp. Path. u.
Pkarmakd ., 1913, lxxiii., S. 49.
JUNGMANN. Die Abh&ngigkeit der Nierenfunktion vom Nervensystem.
Milnch. Med. Wchnschr. , 1918, lx., Aug. 12, S. 1760.
ROUBINOVITCH, J., and BOREL. P. Un oas d'uranisme: Enlevement de
mineur par un inverti. L'Enciphale , 1913, viii., Ao&t, p. 117.
WKSTPHAL, KARL, and KATSCH, G. Das neurotisohe. Ulcus duodenL
MitteU. a. d. Grenzgcb. d. Med . u. Chir., 1913, xxvi., S. 391.
AUERBACH. Einiges neurologisch Bemerkenswerte aus Amerika. Fortschr.
d. Med., 1913, xxa, Juli 17, S. 790.
HIRSCHFELD, M., and BURCHARD, E. Ein Fall von Transvestitismus bei
musikalischem Genie. Neurol. Centralbl., 1913, xxxii., Aug. 1, S. 946.
OLIVER, Sir THOMAS. The preventive and curative treatment of industrial
lead poisoning. Lancet, 1913, clxxxv., Aug. 23, p. 527.
CLAUDE, H., and GOUGEROT, H. L’insuffisanoe pluriglandulaire totale
tardive et lea syndromes pluriglandulaires. L'Enctphalc, 1913, viiL, Ao&t,
p. 97.
CSEPAI. Beitrage zur Diagnostik und Pathologie dee polyglandulkren Systems.
Deut. Archiv. f. Klin. Med., 1913, cxi., S. 271.
MURRAY, GEORGE R. Some aspects of internal secretiona in disease. Brit.
Med. Joum., 1913, July 26, p. 163; Lancet , 1913, July 26, p. 199.
SOUTHARD, E. E. Psychopathology and neuropathology: the psyohopathic
hospital as research and teaching oentor. Boston Med. and Surg. Joum., 1913,
elxfx., July 31, p. 151.
SADGER. Ueber den Wert der Autobiographien sexuell Perverser. Fortschr .
d. Med., 1913, xxxi., S. 772.
BIERMANN. "Uber Myokymie.” Neurol. Centralbl., 1913, xxxiL, Juli 16,
S. 882.
DEXLER, H. Uber das Vorkommen der Idiotie bei Tieren (Bemerkungen zur
Systematik der tierischen Nervenkrankheiten). Neurol. Centralbl., 1913, xxxiL
Juli 16, S. 894.
Inti*
BIBLIOGRAPHY
PSYCHIATRY.
GB.HIAL rAlALIMH-
LESAGE am! COLLIN. Paralyse general® on meningo-myelite syphilitique
die/, uit enfant precocc. Journ. de Ahd. de Parti, 1913, xxxi., Aout 2, p. 620.
FIT/M AUKICE KELLY, M. SalvarBan in General Paralysis of the Insane and
Tains. Journ. Mcnt. Set., 1913, lix., July, p. 498.
ECONOMO, c. Vber einige neuere Gesichtspimkte rur Pathogenese, Diagnoitik
und Therapic der progressive!* Paralyse. Wien. Med . IFcAnscAr., 1913, Ixiii.,
Aug. P», S. 2093.
NOGUCHI, H. Additional studies on the presence of Spirockata pdlida in
General Paralysis and Tabes Dorsalis. Journ . CuL Du. } 1913, xxxi., Aug.,
p. 543.
LKVADITL C , MARIE, A., and BANKOWSKI, J. Le trdponeme dan* le
cervrau ilea paralytiques gendraux. Annalcs de VInslUui PatUur, 1913.
xxvii., p. 577.
MAKINKSCO and MINKA. Relation entre les “Treponema pallida** et le*
lesions dc la paralysie generals. Cornpt. Rend. dc la Soc. de BwL , 1913, lu?.,
Aout, p. 231.
DKMESTIA PIAi’OX-
ROSS, E. L. The source of urinary indoLacetic acid in two dementis prscox
(jatients. Archives Ini. Med., 1913, xii., Aug., p. 231.
Cii;\fc«AL—
MARTINI, G. Contribute alio studio della psioosi maniaoo-depressira. &r.
ital. di A'curupnt. P&chiat. ed ElcUrotcr ., 1913, vi., Luglio, p. 297.
STEEN, K. H. Moral insanity. Journ. Mcnt. Sci., 1913, lix., July, p. 478.
BRIDGMAN, OLGA. Mental deficiency and delinquency. Journ. Amer. Med.
Assoc., 1913, lxi., Aug. 16, p. 47L
CORNELL, W. B. The mental symptoms of renal insufficiency. N.Y\ Mei
Journ ., 1913, xcviii., Aug. 2, p. 220.
PEACH ELL, G. E. The influence of physical illness on the mental lists in
insanity. Journ . Afcnt. Sci., 1913, lix., July, p. 492.
DOUGLAS, A. R. Some suggestions respecting the care of the feeble-minded
under the Mental Deficiency Bill, 1913. Journ. Mcnt. Sci , 1913, lix., July,
p. 487.
IIOCHWART, L. V. FRANKL. The relations of internal secretion to mental
conditions. Amcr . Journ. Med. Sci., 1913, cxlvi., Aug., p. 186.
ARNAUD, F. L. L’anarchie psychiatrique. L'Encephalc, 1913, viit, Aout,
p. 106.
NEUE, H. Ueber die Anwendung des Abderhaldenachen Dialyrierverfahrens in
der Psychiatric. Monatsschr. f. Psychiat. t*. NcuroL , 191$, xxxi*., Aug M S.
95.
URSTEIN, M. Die Bedeutung des Abderhaldenschen Dialywerverfshrens fur
die Psychiatric und das korrelative Verhaltnis der Geachlecbtsdriisen in anderea
Organon mit inneren Sekretion. Wien. klin. Wchmchr 1913, xxvi, Aug. 14,
S. 1325.
EAST, W. N. On attempted suicide, with an analysis of 1000 ooosecutire cases.
Journ . Mcnt. Sci., 1913, lix., July, p. 428.
TREATMENT.*
WOLF, K. Zirbeldriiscnextrakt in der geburtshilfiiohen Landpraxis. Deut. Med.
Wchnschr., 1913, xxxix., Aug. 7, S. 1567.
TOPP. Ovo-Lezithin Billon bei Nerven- und Geisteskranken. fbrtschr. d. M«d. t
xxxi., S. 768.
• A number of references to papers on Treatment are Included in the Bibliography under
indiriduat diseases
Bibliography
ANATOMY.
HBUSEft, CHESTER H. Tht development of the cerebral ventricles in the pig.
Amer. Joum. Anat., 1913, xv M Sept., p. 215.
MONTI, RINA. Sur les relations mutuelles entre les elements dans le systems ncrveux
des insectes. Archives d’Anat „ Microsc ., 1913, xv., p. 349.
B<EKE, J. Neue Beobachtuneen Uber das Infundibularorgan im Gehirn des Amphioxus
und das homologe Organ des Craniotengehirnes. Anat. Anzeig., 1913, xliv., Sept.
11, S. 460-477.
PSYCHOLOGY.
AALL, ANATHON. Ein neuea Gedachtnisgesetz ? Ztschr. /. Psychol., 1913, lxvi., S. 1.
KOHLER, WOLFGANG. Uber unbemerkte Empfindungen und UrteilstAuschungen,
Ztschr. f. Psychol., 1913, lxvi., S. 51.
BAADE, WALTER. Uber die Kegistrierung von Selbstbeobachtungen durch Diktier
phonographen. Zischr. f. Psychol ., 1913, lxvi., S. 81.
FIRTH, R. H. A study in oomparative psychology. Joum. Ron. Army Med. Corps ,
1913, xxi., Sept., p. 292.
SOLLIER, P. Les ^tats de regression de la personnalite. Joum, de Neurol., 1913,
xviii., Aout 20, p. 301.
MOTT, F. W. I. Nature and nurture in mental development. II. The potentiality
of the ohild. Science Progress, 1913, No. 30, Oct., p. 291.
M‘CREADY, E. B. Feeble-mindednesH and school children. Med . Record, 1913,
lxxxiv., Aug. 23. p. 329.
KNOX, HOWARD A. Two new tests for the detection of defectives (6 illustr.). N. Y.
Med. Joum., 1913, xcviii., Sept. 13, p. 522.
BRANDEIS, JULIAN W. Dream interpretation. Med. Record, 1913, lxxxiv., Aug.
16, p. 291.
PHYSIOLOGY.
HRRWERDEN, M. A. van. Ueber die chemische Zusamxnensetzung der Nissl'schen
Korner der Ganglienzellen. Perl. klin. Wchnschr., 1913,1., Sept. 22, S. 1820.
FRISS, HENRY O. An investigation of nerve regeneration. Quart. Joum. Exp.
Physiol., 1913, vii., p. 31.
PIKE, F. H. Studies in the physiology of the oentral nervous system. III. The
general condition of the spinal vaso-motor paths in spinal shock. Quart. Joum.
Exp. Physiol., 1913, viL, p. 1.
ADUCCO, V. Sur la fonction vaso-motrice de la moelle cpiniere. Arch, it at. de Biol.,
1913, lix., Sept., p. 412.
r
U»7*
108*
BIBLIOGRAPHY
tilULARDUCCT, K. Le altera/ioni della eceiUbiliU elettrica nerveo muscoUre nelle
lcsinni penferiche del nervo omologo. Hi t\ Spec. di Frentat.. 1913, xxxix., pp.
4*3-511.
GOl'liKT. Lea functions de la glande pineale. Press? Med., 1913, No, 77, Sept $•,
p. 709.
POL1MANTI, O. Contributions a la physiologic du systeme nerveux central et tin
inouvement ties jK>iHsons. Arch. ital. de Biol., 1913, lix., Sept,, p. 383.
KOCH, \V„ anti KOCH, M. L. Contributions to the chemical differentiation of the
central nervous system. III. The chemical differentiation of the brain of the
albino rat during growth. Journ. Biol. Chcm. 9 1913, xv., Sept., p. 423,
HNATKK, J. Sur un cas d'omoplates aileea physiologiquea (1 pL). Nouv . Icon . ii
Salj*t. % 1913, xxvi., p. 223.
SAMOJLOFF, A. Die Anderung der Starke des Demarlcationsstromes des Froacbhen-
van trike Is dutch Vagusreizung, Zentralbl. f. Physiol., 1913, xxvii,, S. 575.
ASHER, LEON, anti PEARCE, R. O. Nachweis der sekretorischen Inaerotion der
Niere. ZcnirallL /. Physiol 1913, xxvii., S. 584.
TRINCI, G. Le systeme chromaffin cardiaco cervical chez les Sauriens. Arch, itai d<
Biol 1913, lix., Sept., p. 431.
HOSKINS, R. G. f and MTEEK, CLAYTON. I* the preasor effect of pituitrindue to
adrenal stimulation? Avier. Journ. Phytiol 1913, xxxii., p, 241.
BERITOFF, J. S. Zur Kenntnis der Erregungsrhythmik des Nerven* und Mustel-
systems. Ztschr. f. Biol 1913, lxii., S. 125.
li‘LRAN, F. C. Ul>er den Kohlehydratumsatz des isolierten Herzens tbyrW' und
parathyreopriver Kaninohen. Zenlrabl. /. Physiol ., 1913, xxvii,, p. 582.
SAINTON, PAUL. Le diabcte hypophysaire. Gaz . des H6p., 1913, Ixxxvi., Sept, 2,
p. 1553.
KONKLE, W. B. Medicine's need of a cerebellum. Med. Record , 1913, lxxxix..
Sept. 13, p. 478.
PATHOLOGY.
ALZHEIMER, ALOIS. The present status of our knowledge of the pathological
histology of the oortex in the psychoses. Amer. Journ . Insanity , 1913, lxx.,
July, p. 175.
KREIBICH, 0. Farbung der markloeen Nenren. Prager Med. Wchnsckr ., 1913,
xxxviii., Sept. 18, S. 629.
VALLE, G. LA. Ricerohe spenmentali sulla permeability meninges. Arch, internal,
de Pharmacodyn ., 1913, xxiii., p. 113.
HERXHEIMER, GOTTHOLD. Uber Tumoren des Nebennierenmarkea, iasbesondew
das Neuroblastoma sympathicum. Beitrdge z. path. Amt. u. z. ally. Path., 1913,
lvii., S. 112.
OORRIERI, ARTURO. Contributo all' anatomia pstologics di alcune ghiandole a
gecrezione interna in alcune forme di malattia manta le. Riv. Sper. di Freniat>>
1913, xxxix., pp. 203-349.
NEUBER, ERNST. Uber Geschwiilste der Carotisdriise. Archiv. f. Idin. Chit., 1913,
cii., S. 289.
CONSOLI, G. Osservazioni istologiche su midolli di can i sottoposti a rachistoTzmir
zazione. Arch, internal , de Pharmacodyn , 1913, xxiii., p. 17.
BIBLIOGRAPHY
109*
CLINICAL NEUROLOGY.
GENERAL—
ZAHORSKY, JOHN. Recent progress in the diseases of the nervous system
in children. Pediatrics , 1913, xxv., Sept., p. 571.
SWIFT, WALTER B. Reflex Frequency and its Clinical Value. Joum. New.
and Mcnt. Dis., 1913, xl., Sept., p. 585.
MYERSON, A. Note on Contralateral Oppenheim and Gordon Reflexes, with
observations in Two Cases. Joum. New. and Mcnt. DU., 1913, xl.. Sept.,
p. 574.
MYERSON. A. Note on adductor response to homolateral and contralateral
stimulation. Boston Med. and Surf/. Joum., 1913, clxix., Sept. 11, p. 380.
TROMNER, E. Ueber Sehnen* und Muskelreflexe und die Merkmale ihrer
Schwachung und Stiegerung. Bert, ktin . Wchnschr., 1913, 1., Sept. 15,
S. 1712.
NERVES—
STOFFEL, A. Die moderne Chirurgie der peripheren Nerven. Med. Klinik.,
1913, ix., Aug. 31, S. 1401.
RAMADIER, J., and VTGNES, H. Nerf larynge superieur (Rev. gen.). Gaz.
dcs H6p., 1913, lxxxvi*, Sept. 27, p. 1711.
NOICA and ZAHARESCU. Paralysie puerperal© du nerf sdatique poplite
extern© du c6t^ gauche (1 fig.). Nouv. Icon. d. L Salpet., 1913, xxvi. p. 230.
MUSCLES—
CLUZET and NOVE-JOSSERAND. Paralysie isol^e du long extenseur propre
du pouce (1 pi.). Nouv. Icon. d. 1. Salpit ., 1913, xxvi., p. 234.
ft PINAL CORD—
Central. —SEWELL, S. V. Some clinical phenomena of the transverse lesions of
the spinal cord. Australian Med . Joum., 1913, ii. 9 Aug. 23, p. 1178.
PRICE, GEORGE E. Spinal gliosis occurring in thiee members of the same
family, suggesting a familial type. Auur. Joum. Med. Sci. , 1913, oxlvi.,
Sept., p. 386.
WIRSCHUBSKI, A. Ein Fall von familiarer spastischer Spinalparalyse. Neurol.
Centralbl ., 1913, xxxii., Aug. 16, S. 1025.
LORENZ, ADOLF. Zur alten und modernen Behandlung der spastischen
Paralysen. Wien. Med. Wchnschr ., 1913, lxiii., S. 2497 und 2607.
Fracture, Dislocation, Ac. —ELSBERG, CHARLES A. Some surgical features
of injuries of the spine, with special reference to spinal fracture. Annals of
Surgery , 1913, lviii., Sept., p. 296.
SMITH, J. 8. KELLETT. The Necessity for Selection and for Skilled Super¬
vision in the Treatment of Spinal Deformities by Exercise. Brit. Med. Joum.,
1913, Sept. 27, p. 806.
CALOT. Therapeutique moderne de la scoliose. Comment traiter ses diverses
formes. Journ. dcs. Prat., 1913, xxvii., Aout 23 et 30, pp. 629 et 546.
VULPIUS, O. Erfahrungen und Erwagungen liber die neue Verbandbehandlung
dcr Skoliose nach Abbott. Bert, klin. Wchnschr., 1913,1., Sept. 22, S. 1745.
BOLZANI, G. A proposito di un caso di morbo di Pott. Riv. ttal. di Neuro -
patol., Psichiat. ed Elcttroter., 1913, vi., Agosto., p. 345.
CLAUDE, H. Mai de Pott k evolution rapide avec reflexes cutanes dc defonse.
Joum. dcs Prat., 1913, xxvii., Sept. 13, p. 577.
110 *
MM.KXJIIAPHY
On Ini Ilb.-SKYMOIH, N. G. Seven owes of cervical rib, oue liinutas
aneurysm. Amer. Journ. Med. Set., 11113, cxlvi., Sept, p. 396.
WATERHOUSE, RUPERT. A cate of oervkal rib. Bristol Mei.-Chir, Jonrn.,
1913, mi., Sept., p. 232.
Tabes dorsalis. — MANHELMER. GOMMES. Troubles de 1 ecriteur per artbro-
pathie de lepaule cbez un tabetique (2 fig.). Nouv. Icon. d. I Salptt, 1918,
xxvi., p. 242.
LUBBERS, H. A. Ucber Lahmung ilea motorischen Trigetnintn bei Tabes
dorsalis. Berl. klin. Wchnschr., 1913,1.. Sept. 1, S, 1656.
STERNBERG, WM. Neue Gesichtepunkte fttr die Atiologie und Thmpie des
Erbrechens in dor Graviditat. bei Tabes und in der Seekrankheit. Jretor./.
VenianungsKrankheiten, 1913, xix., S. 447.
MALONEY, W. J. M. A. Blindness and Tabes-an Introduction to s Ne*
Method of Curing Ataxia. Journ Ncrv . and Mcnt. DU 1913, xL Sept.,
p. 553.
FORTKSCUE BRICKDALE, J. M. Three oases of ataxia. BrM Mei Ckir.
Journ. % 1913, xxxi., Sept, p. 235.
Poliomyelitis Anterior Acnfa.—FLEXNKR, SIMON, and NOGUCHI, HIDKYO
Kultivierung des Mikroorganismus der Poliomyelitis epidemics, Bert tin
Wchnsehr ., 1913, 1., Sept. 15, S. 1693.
BRUNO. Kin Beitrag xur Aetiologie der spinalen Kinderlahmung. Munch.
Med. Wchnschr 1913, lx., Sept. 9., S, 1995.
ROSENAU, M. J. The mode of transniiasion of poliomyelitis. Boston Med. o*i
Surg. Joum., 1913, clxix., Sept, 4, p, 337.
LEOPOLD, S. The polyneuritic form of aoute poliomyelitis: a eUnioel ltd
pathologic study. Amcr . Joum. Med. Sci ., 1913, exlvi, Sept, p. 406.
BANKART, A. S. BLUNDELL. The Treatment of Aoute Poliomyeiitia (In¬
fantile Paralyaia). Brit. Med. Joum. f 1913, Sept 27, p. 809.
KLING, C., and LEVADITI, C. Etudes snr la poliomyelite aigtrt epidwuiqw-
Antut/es dc Vlnstit. Pasteur, 1913, xxvii., p, 718,
FRASER, FRANCIS R. A study of the oerebrospinal fluid in acutepohooyelitii.
Journ. Exp. Med., 1913, xviii., 8ept, p. 242.
OPENSHAM', T. H. Discussion on the Choice of Methods in Reeling with
Paralytic Deformities in Children. Brit. Med. Joum. , 1913,8ept 27, p. 796.
Prledreleb’s AtaxU. —ALZONA, FED. Le alterarioni del midollo ipinale in dw
oasi di 44 Morbo di Friedreich.” Annali di Neurol.., 1913, xxxi., p 113.
DOBROCHOTOM r . Ein Fall von hereditarer Familienerkrankung vom Ubtf-
gangstypus zwiseben spastischer Spinalparalyse und Friedreiohscfaer Krsakhsit
Dcut. Ztsckr . /. Ntrvtnheilk. , 1913, xlix., S. 1.
Paraplegia.— BABINSKI. Paraplegie 4 type de syndrome de Brown-Ssqwi
d’origine up^cifique. Joum. da Prat., 1913, xxvii., Aodt 23, p. 536.
BABINSKI. Parapldgie hysterique. Joum . da Prat., 1913, xxrii, Sept 6,
p. 566.
▼en See kit agba a sea’s Sisease.—GATT1, LODOVICO. Uber psychiscbe Stor
ungen im Verlaufe der Reoklinghausen’schen Krankheit Ku tines, gastrifokes,
und peyohischea Symptomenbild. Neurol. Centrulbl., 1913, xxxiL, Aug. 1A
S. 1027.
Tamo vs—POT EL and VEAIXDRAU. La ohirurgie des tnmeura du rachis et de
la moelle. (8uite et fin.) Her. de Chir., 1913, xxxiiu, 8ept, p. 477.
BIBLIOGRAPHY
111*
BftAM—
Cieafnil. —SUTHERLAND, G. A., and PATERSON, HUGH. On a type of
cerebral mal-development (forebrain aplasia). Quart . Journ. Med., 1913, viL,
Oct., p. 61.
CATOLA, G. Lacuna di disintegrazioue cerebrale. Riv. crit. di Clin. Med .,
1913, xiv., pp. 545 et 561.
BICHATON and GUILLEMIN. Du drainage spontane dans lea suppurations
craniennea d’origine otique. Rev. Htbd . de Laryngol ., dCOtoL et de Rhinol.,
1913, xxxiv., Sept. 20, p. 345.
Skill Injury, Ac.—BURNHAM, A. C. Prognosis and treatment of compound
fracture of the base of the skull. Boston Med. and Surg. Journ., 1913, olxix.,
Aug. 21, p. 270.
31 ‘GAVIN, L. A case of head injury. Clin . Journ., 1913, xlii., Sept. 3, p.
344.
WALZEL, P. R. v. Ueber zwei erfolgreiche Projektilentfernungen aus der
Gegend des Ganglion Gasseri. Wien, klin . Wchnschr., 1913. xxvi., Sept. 25.
S. 1567.
Amrslreptile Lateral aelerosl*.—WENDEROWIC, E., and NIKITIN, M. Ueber
die Verbreitung der Faserdegenerationen bei amyotrophischer Lateralsklerose
mit besonderer Beriicksichtigung der Veranderungen im Grosshim. Archiv. f.
Psychiat., 1913, lii., S. 300.
Encephalitis*—LUCAS, W. P., and SOUTHARD, E. H. Contributions to the
neurology of the child. III. Further observations upon nervous and mental
sequelje of encephalitis in children. Boston Med. and Surg. Journ., 1913,
clxix., Sept. 4, p. 341.
Meningitis.— OGAN, M. L. Cerebrospinal meningitis, its occurrence in New
York city during half a century : references to some recent literature. AT. Y.
Med. Journ., 1913, xcviii., Sept. 13, p. 624.
WEISSENBACH, R.-J. Leu mtmingites ©berthiennes et les manifestations
meningees de la fievre typhoide, Gaz. dcs H6p., 1913, lxxxvi., Sept. 13, p.
163L
WOODRUFF, I. O. Studies of the chest in tuberculous meningitis. Archives
of Ped.y 1913, xxx., Sept., p. 659.
BKRGMARK, G. Contribution k Pctude Tune substance tuberculineuse specifique
dans le liquid© c^phalo-rachidien en cas dc meningite tuberculeuse. Upsala
Lakartfbr. Forkandl ., 1913, Sept., p. 377.
RKISCHIG, LEOPOLD. Ein Fall von Meningitis puruleuta aseptics nach einem
intranasalem Eingriff. Ztschr. /. Ohrcnhcdk. u. f. d. Krankh. d. Luftwegc ,
1913, lxix., S. 78.
ZANGE, JOHANNES. Uber einen Fall von geheilter rhinogener Meningitis
nebst Bemerkungen iiber den diagnoetischen und prognostischen Weit der
Lumbalpunktion. Archiv. /. Ohrcnheilk., 1913, xcii., S. 132.
FRUHWALD, Y. Der Bacillus fusiformis als Errcger von Meningitis und Him-
abscess nach Fremdkorperverletzung des Pharynx. Monatssch. f. Ohrcnheilk.
u. Laryngo*Rhinol., 1913, xlvii., S. 1021.
HEIMAN, HENRY, and FELDSTEIN, SAMUEL. R&um4 of the recent litera¬
ture on meningitis (not including meningococcus meningitis). Amer. Journ.
Dis . Child., 1913, vi., p. 199.
■ytfrocepfealu*.—CIUFFINI, P. R4acutisation de Thydrocephalie interne con-
genital© avec syrup tomes bulbaires. Nouv. Icon. d. 1. SalpR., 1913, xxvi., p. 209.
HAYNES, I. S. Cisterna-sinus drainage for hydrocephalus. Archives of Ptd.,
1913, xxx., Sept., p. 670.
112*
BIBLIOGRAPHY
Abscess.—RENTON, HAROLD F. An unusual case of cerebral abscess. Lanrrt .
1913, cUxiv,, Sept. 27, p. 929.
MURPHY, JOHN, and LEWERS, ALEX. A case of otogenic cerebral abscess.
Auslraluin Med . Journ., 1913, ii., Aug. 23, p. 1177.
KEMPF, FR. Ueber den traumatise hen Gehirnabscess, seine Complication durch
Kxtraduralabsccss und eine Mcthode des plastischen Verschlusses operat.
Schadeldefecte. Arehiv. f. klin. CAtr., 1913, cii.. S. 139.
Tferam basis.—GOLDSTEIN, KURT, and BAUMM, HANS. Klinische und ana to
mische Beitragc zur Lehre von der Vcrstopfung der Arteria oerebelli post. inf.
Arehiv. /. Pspehiat., 1913, lii., S. 335.
Emballsm. —KOKBL, H. Retrograde Embolie in die Arteria fossae Sylvii, ausge-
bend von einem Thrombus der Aorta descendens, nach einer Stichverletzung der
letztercn. I Vicn. klin . Wehnsvhr. ., 1913, xxvi., Sept. 25, S. 1504.
Aaearlsw.—JAGIK, N. v., and REIBMAYR, HANS. Zur Kasuistik intra-
kranieller Aueurysmen. Wien. Med. Wchnschr., 1913, lxiii., S. 2503.
JAKSCH, R. v. Klinische Beitrage zur Kenntnis der Geliirnaneurysmen jugend*
licher Individuen. Prager Med. Wchnschr 1913, xxxviii., Aug. 28, S. 483.
Hfvmsrrbagr.—CIARLA, E. Emorragia nel girosopramarginalee nelgiroangolare
di sinistra. Htv. di Patul. mrr. c meat., 1913, xviii., Sett. G, p. 473.
FORSHEIM. Kin Beitrag zuin Stadium der spontanen Suharachnoidealblutung.
Prut. Xtsehr. /. Nt rrenhnlk., 1913, xlix., S. 123.
■rmlplegla.—SAGRINI, E. A. Su d’un caso di emiplegia ed emianestesia con
atrofia muscolare. Jiiv, ital . di Ncuroptitol., Pspchiat. ed Elettroter ., 1913, vL,
Agosto, p. 337.
MONIER-VINARD, R. Les anesthetics dans Themiplegie cerebrals. Rev.
Neurol. , 1913, xxi., Aout 30, p. 209.
Tamovrs.— STRANSKY, E., and DIMITZ, L. Zur Kenntnis der Thalamus-
tumoren. Wien, Mid. Wchnschr ., 1913, lxiii., S. 2570.
BERGMARK, G. Fall af tumor cerebri. Bidrag till dc cerebrals forlamuingaruas
symtomatologi. Upsala Ld kart for. Forhandl 1913, Sept., p. 339.
MILIAN, G., and SCHULMANN. ER. Tumour cerebello-pontine. Metastase
sous-rolandique. L'Enc*phale, 1913, viii., Sept. 10, p. 193.
PATON, LESLIE. Indications for oi>eration on cerebral tumour from the point
of view of the ophthalmic surgeon. Lancet , 1913, clxxxv., Sept. 27, p. 928.
BALLANCE, C. A. Remarks on the treatment of brain tumour (Illustr.).
Lancet, 1913, clxxxv., Sept. 13, p. 792.
RAIMISTE, J. M., and NEIDING, M. Les modifications dans la moelle epiniere
au court des tumours siegeant dans la fosse postcrieurc du crane. (3 Fig.)
Nouv. Icon. d. 1. Satpft, 1913, xxvi., p. 245.
Acromegaly.—SOHLESINGER, HERMANN. Fruhakromegalie von dauernd
stationarem charaktcr. Ein nicht bcschriebencr Krankhcitstypus. JFirm.
Med. Wchusehr ., 1913, lxiii., S. 25&>.
BARTLETT, Frank K. A case of acromegaly with polyglandular syndrome.
Trans. Chicago Path. .So<\, 1913, ix., July, p. 50.
Dyspltultarlsm. —REUBEN, MARK S. Dyspituitarism. Avier. Journ. Dis.
Child., 1913, vi., Sept., p. 145.
LUGER, ALFRED. Some features of Roeutgenographic changes in pituitary
diseases. Journ. Amcr. Med. Assoc 1913, lxi., Sept. 6, p. 752.
GUTHRIE, LEONARD. Did Napoleon Bonaparte suffer from Hypopituitarism
(Dystrophia Adiposo-Genitalis) at the close of liis life? Lancet , clxxxv., Sept.
13, p. 823.
BIBLIOGRAPHY
113*
Orebellaai.—KORBSCH, R. Bin Fall von Kleinhirnhypoplasie. Monatsschr. f.
Psychiat. u. Neurol ., 1913, xxxiv., Sept,, p. 207.
GOLDSTEIN, KURT. Uber Storungen der Schwerempfindung bei gleichseitiger
Kleinhirnaffektion. Neurol. Centralbl ., 1913, xxxii., Sept. 1, S. 1082.
Progressive Lenticular Degeneration.— HENRICI, A. T. Degeneration of the
nncleus lentiformis, associated with cirrhosis of the liver. Lancet , 1913, dxxxv.,
Sept., 13, p. 797.
DAV1DENKOF, SERGE. Sur un syndrome peu connu. La rigidity paralyaante
de l\$tat de veille. Contribution k l’etude du “syndrome lcnticulairc.”
VEnctphale, 1913, viii., Sept. 10, p. 200.
Aphasia, Ac.—PELLACANI, G. Glioma prefrontale sinistro con afasia. Riv.
di. Patol. nerx\ e ment ., 1913, xviii., p. 512.
KEHRER, F.A. Beitrage zur Aphasielehre mit besonderer Beriicksichtigung der
amnestischen Aphasie. Archirf. Psychiat ., 1913, lii., S. 103.
PICK, A. Uber den Nachweis latenter aphasischer Erscheinungen lurch
Ermiidung nnd die Moglichkeit seiner diagnostischen Verwertung. Prayer
Med. Wchnschr ., 1913, xxxviii., Sept. 18, S. 531.
Aehondroplasla.—RAVENNA, F. Achondroplasie et chondrohypoplasie. Con¬
tribution clinique. (3 PI.) Nouv. Icon . d. 1. Salptt ., 1913, xxvi., p. 157.
PACHON, C., and SCHUNDA, ATH. Nouvelle contribution k l’dtude de
l’achondroplasie. (0 PI.) Nouv. Icon. d. 1. Salpet. t 1913, xxvi., p. 185.
BAUMEL, J., and MARGARET, J. A propos d’un cas d’achondroplasie.
L’achondroplasie nhxmd-elle k une insuffisance hypophysaire partielle? Nouv.
Icon d. I . SalpH. f 1913, xxvi., p. 202.
Pellagra.—BLANDY, GURTH S. A contribution to the study of pellagra in
England. Lancet , 1913, clxxxv., Sept. 6, p. 713.
COLE, J. W. E. Notes of a case of pellagra. Lancet , 1913, clxxxv.. Sept. 6,
p. 717.
REID, ROBERT, and CALWELL, WM. Notes of a supposed case of pellagra.
British Med . Joum., 1913, Sept. 27, p. 784.
BARDIN. JAMES, C. Further observations on the blood in pellagra. Amer.
Journ. Insanity , 1913, lxx., July, p. 155.
JENNINGS, A. H., and KING, W. V. An intensive study of insects as a
possible etiologic factor in pellagra. Amer. Joum. Med. Sci. t 1913, cxlvi.,
Sept., p. 411.
Lead Poisoning.—KENNEY, J. S. Lead poisoning in New York city : a study of
twenty-five cases with special reference to industrial hygiene from the dis¬
pensary standpoint. Med. Record , 1913, lxxxiv., Sept. 6, p. 415.
ERLENMEYER, ERNST. Der mechanismus der chronischen Bleivergiftung
nach experimentellen Studien. Ztschr. f. exp. Path. u. Therap ., 1913, xiv.,
S. 310.
Syphilis.—COLLINS, JOSEPH, Syphilis and the nervous system. Joum. Nerv.
and Ment. Dis ., 1913, lxi., Sept. 13, p. 860.
MTNTOSH, JAMES, and F1LDES, PAUL. The Pathology of the Condition
known as Parasyphilis. Lancet , 1913, clxxxv., Sept. 27, p. 921.
SWIFT, HOMER F., and ELLIS, ARTHUR, W. M. The treatment of syphilitic
affections of the central nervous system, with especial reference to the use of
intraspinous injections. Archives Int. Med., 1913, xii., Sept., p. 331.
SWIFT and ELLIS. Die kombinierte Lokal- und Allgemeinbehandlung der
Syphilis des Zentralnervcnsystems. Munch. Med. Wchnschr., 1913, lx., Sept.
9, S. 1977 und 2054.
114*
BIBLIOGRAPHY
JAKOB and WKYGANDT. Mi t toil tinge n Uber expert men telle Syphilis det
Nervensystem*. Munch. Med . IPeAnseAr, 1913, lx.. Sept 16, S. 2637.
STRIKE H. O. Moderne Syphilisforschung und Neuropathologie. Mlt beeonderer
Benicksichtigung der pathologischen Histologic dec Zentralnervensystems
syphilitischer Kaninchen. Arcfiir f. Psychiat ., 1913, liL, S. 1.
ARZT, L., and KERL. W. Rxperimentelle Kanincheosynhilia. Bin Beitrag zur
Generalisation des Virus. Wien. kiin. Wchnsehr., 1913, xxvi., Sept 2T», S.
1550.
BUSCHKE, A. Ueber die Beziehunf der experimentell erxengten Hertyphilis
tur mensch lichen Lues. Drut. Med. Wchnsehr., 1913, xxxix., Sept 11, S. 3,1783.
GORDON, J. LK8LIR. The incidence of inherited syphilis in congenital
mental deficiency. Lancet , 1913, clxxxv., Sept 20, p. 861.
SCHERESCHEWSKY, J. Syphilisimmunitfctsversuche mit ipirocha ten rein
kulturen. Deut. Med. Wchnsehr. 9 1913, xxxix., Aug. 28, S. 1676.
FRO H WALD. Beitrag zur Abortivbehandlung der Syphilis. Wieru kiin.
Wchnsehr ., 1913, xxvi., Sept 25, S. 1555.
FISCHL, FRITZ. Ueber die Widerstandsfrhigkeit lokaler Spiroehfctenherde
gegenliber kombiniertor Luesbehandlung. Wien. kiin. Wchnsehr ., 1913, 1,
Sept. 11, S. 1466.
ZURN. Beitrag zur Abortivbehandlung der Lues. Berl. kiin. Wchnsehr 1913,
1., Sept 1, S. 1654.
HAZEN, H. H. The leucocytes in syphilis. Joum. Cut. Dis., 1913, xxxi..
Sept., p. 618.
LECONTE, P. Le diagnostic de la syphilis par la meiostagmine-r^action. Arc A.
intemat. de Pharmacodyn ., 1913, xxiii., p. 69.
KALLOS, J. Ueber die Hennan-Perutzsche Syphilisrcaktion. Dent. Med.
Wchnsehr ., 1913, xxxix., Sept. 25, S. 1885.
BROWN, ALAN. The Leutin reaction in infancy. Amer. Joum. Dis. Child.,
1913, vi., p. 171.
NOGUCHI, HIDEYO. La luetine-r&ction. (Cuti*reaction de la syphilis.)
Presse med ., 1913, No. 76, Sept 17, p. 757.
Mt)LLLRR, R., and STEIN, R. O. Kutireaktion bei Lues. Wien. Med .
Wchnsehr ., 1913, Ixiii., S. 2419 und 2614.
FAGIUOLI, A., and FISICHELLA, V. Ueber die Cutanreaktion von Noguchi
bei Syphilis. Bed. kiin. Wchnsehr ., 1913, L. Sept 22, S. 1811.
GUTMANN, C. Ueber intravenose Injsktionen mit Toxynon, einem neuen
Queeksilberpraparat, bei Syphilitischen und Nichtsyphilitiaohen. BerL kiin.
Wchnsehr 1913,1. Sept. 1, S. 1615.
ALMKOIST, J. Uber quecksilbernukleinsaures Natrium bei sekundarer Syphilis.
Dermatol. Wchnsehr ., 1913, xxxix., Sept 27, S. 1147.
FRENCH, H. C. Syphilis : its dangers to the community, and the question of
State control. Lancet , 1913, clxxxv., Sept. 27, p. 914.
Balvarsan.—RAVAUT, P. R&idives et reinfections apr&s traitement de la
syphilis recente par le salvarsan. Presse med., 1913, No. 75, Sept. 13, p. 749.
BALLENGER, E. G., and ELDER, O. F. An easy method of administering
salvarsan and neosalvarsan intravenously. Med. Record , 1913, lxxxiv., Sept
20, p. 527.
STEVENS, J. H. A new salvarsan needle. Med . Record, 1913, lxxxiv..
Sept. 6, p. 435.
SCHKRSCHMIDT, A. Eine Vereinfachung der intravenosen Salvarsaninjelrtion.
Archiv./. Schitfs- u. Tropen-Hygiene, 1913, xvii., S. 565.
BIBLIOGRAPHY
115*
HOLT, L. E., and BROWN, ALAN. Results with salvarsan in hereditary
syphilis. Aimer. Journ. Dis. Child. , 1913, vi., p. 174.
STRATHY, GEO. S., and CAMPBELL, GEO. A. Results of treatment with
salvarsan in late congenital syphilis. Amer. Journ. Dis. Child., 1913, vi.,
p. 187.
MUCHA, V., and KETRON, L. W. Uber Organ ve hinder ungen bei mit
Salvarsan behandelten Tieren. Wien. Med. Wchnsckr., 1913, lxiii., S. 2379.
Seosalvarsan.—SCHREIBER. Kurze Bemerkungen Uber Salvarsan- reap.
Neosalvarsaninjektionen. Munch. Med. Wchnschr., 1913, lx., Sept. 9, S. 1993.
OULMANN, L., and WOLLHEIM, J. L. The administration of salvarsan and
neosalvarsan by enteroclysis. Report of thirty-seven injections. Journ.
Amer. Med. Assoc., 1913, lxi., Sept. 13, p. 867.
CORLETT, W. T. Two and one-half years’ experience with salvarsan and
neosalvarsan. Journ. Amer. Med. Assoc. , 1913, lxi., Sept. 20, p. 961.
WHITEHOUSE, H. H., and CLARK, A. S. Salvarsan and neosalvarsan in
syphilis: a comparative study. Journ. Cut. Dis., 1913, xxxi., Sept., p. 633.
KING-SMITH, D. The experience of the medical profession of Toronto in the
treatment of syphilis with salvarsan. Journ. Cut. Die., 1913, xxxi., Sept.,
p. 639.
SCHLESINGER. Unsere Resultate mit Neosalvarsan bei luetischen Affektionen
der oberen Luftwege. Ztschr. f. Laryngol., Rhinol. u. i. Orenzgeb., 1913, vi.,
S. 375.
Wassermami Reaction —GREEN, A. RUSSELL. The Wassermann Reaction.
Birmingham Med. Review , 1913, lxxiv., Sept., p. 105.
KAPSENBERG, G. Twee mededeeiingen betreffende de techniok der reactie
van Wassermann. Nederlandsch Tijdsch. voor Gcneesk., 1913, Sept. 27,
p. 1007.
VARNEY, H. R., and BAESLACK, F. W. A comparative study of antigens for
the Wassermann reaction. Journ. Amer. Med. Assoc., 1913, lxi., Sept. 6,
p. 754.
BLACKFAN, K. D., NICHOLSON, S. T., and WHITE, T. W. A study of
Wassermann reaction in one hundred infants. Amer. Journ. Dis. Child.
1913, vi., p. 162.
HOLT, L. E. The Wassermann reaction in hereditary syphilis, in congenital
deformities, and in various other conditions in infancy. Amer. Journ. Dis.
Child., 1913, vi., p. 166.
RAAB. Zur Teohnik der Blutentnahme fur die Wassermannsohe Reektion.
Munch. Med. Wchnschr., 1913, lx., Sept. 2, S. 1941.
SCHLOSSBERGER, H. Beitrage zur Serodiagnose der Syphilis mittels der
Wassermannsohen Reaktion. Ztschr. f. Immunitatsforschung (Orig.), 1913,
xix., S. 116.
NEWLIN, A. Positive Wassermann reaction in apparently non-syphilitic cases.
Med. Record , 1913, lxxxiv., Aug. 16, p. 295.
FOX, F. J. The Wassermann reaction in canoer. Med. Record, 1913, lxxxiv.,
Aug. 16, p. 283.
ZSCHUCKE, HANS. Ueber den Ausfall der Muller-Brendel’schen Modifika-
tion der Wassermann’schen Reaktion bei Malaria. Bcrl. klin. Wchnschr.,
1913,1., Sept. 15, S. 1716.
Cerebro-ftpflnal Fluid.-ENGMAN, M. F., BUHMAN, R., GORHAM, F. D., and
DAVIS, R. H. A study of the spinal fluid in one hundred cases of syphilis,
iuoluding investigations for arsenic after intravenous administration or neo¬
salvarsan. Journ. Amer. Med. Assoc., 1913, lxi., Sept. 6, p. 735.
116*
BIBLIOGRAPHY
BRKM, W V. The intensive treatment of syphilitic nervous affections controlled
by examinations of the cerebrospinal fluid. A preliminary report. Journ.
Amer. Veil. Assoc., 11113, lxi., Sept. 6, p. 742.
THARPTS and BARRE. La composition phyaico-chinique du liquide cephalo-
rachidicn des epileptiques. Rev. Neurol., 1013, xxi., Sept. 15 f p. 248.
v. DLNGERN and HALPERN. Ueber Kompiementbindungsraaktion mit Liquor
cercbrospinalis bei Karzinoin. Munch. Med. Wchnschr. % 1913, lx., Sept. 2,
S. 1923.
RAVEN. Weitere Beitragc zur Kenntnis de* Kompressionssyndroms im Liquor
cerebroapinalis. Dent. Ztschr. / Ncrvenhedk., 1913, xlix., S. 36.
CAMPER. K. t and SKUTEZKY, K. Liquorstudien bei Syphilis. Wien. Med .
Wchnschr. % 1913, lxhi., S. 2409 uiul 2621.
KAFKA, V. Neues aus dem Gebiete dor diagnostiachen Untersuchung des Blutes
und der ZerebroBpinalflusMgkeit bei Erkrankungen des Zentralnervenayatema.
Deut. Med. Wchnschr., 1913, xxxix., Sept. 25, S. 1874.
KAPLAN, D. M. The importance of serological analyses in neurology (con¬
cluded). N. Y. Med. Journ., 1913, xcviii , Aug. 23, p. 366.
FALSER, A. Patliologinch-aerologirfcho Befunde bei Geisteskranken auf Grund
d< r Abderlmldetischen Ant-chauungen und Methodik. AUg. Ztschrf. Psyrhtat.,
1913, lxx., S. 719.
MAYER. D ic Bedentung der Abderhaldenschen Serodiagnostik fur die Psy¬
chiatric. Munch. Med. Wchnschr 1913, lx.. Sept. 16, S. 204 4.
liKNEKU A1VD FUNCTIONAL OlftEAfiEH—
Epilepsy. —HECHT, D’ORSAY. The inheritance of epilepsy. Med . Record,
1913, lxxxiv., Aug. 23, p. 323.
CAMP, CARL D. Epilepsy and paresis in railway engineers and fireman.
Journ. Amer. Med. Assoc., 1913, lxi., Aug. 30, p. 665.
PRICE, GEORGE E. Pnychic Epilepsy occurring without other Epileptic
Phenomena. Journ. Ncrv. and Meat. Dis. % 1913, xl., Sept., p. 680.
MUNZKR, A. Bettachtungcn uber die psychischen Anomalien der Epileptiker.
Btrl. kiit i. JFc^rwchr., 1913, 1., Sept. 22, S. 1766 und 1808.
BIKELES, G., and ZBYSZEWSKI, L. Unterauchungen an der Grosahirnrinde
betreffend beaonders daa Erzeugen von Rindenepilei>«ie : (o) unter Einfluaa von
Schlafmitteln, (6) nach Verabreichung grosaerer Bromgaben. [Vorlaufige
Mitteilung.] Neurol. Cent rat bl. , 1913, wxii., Sept. 1, S. 1081.
GIACOMO PIGHINI. Ricerche aulla patologia della epileaaia. Riv. Sper. di
Freniat ., 1913, xxxix., pp. 378-467.
• RODIET, A. Contribution k l’etude du traitement de lepilepsie par les ferments
lactiquea. IJEactphalc, 1913, viii., Sept. 10, p. 209.
MAIER, G. Klarson bei genuiner Epilepsie. Deut. Med. Wchnschr. , 1913,
xxxix., Aug. 28, S. 1677.
SUSSMANN, M. Elaraon bei Epilepsie. Deut. Med. Wchnschr. , 1913, xxxix.
Sept. 25, S. 1886.
BERG. Nekrophilie oder Leichenschandung im epileptiBchen Dammerxustand.
Ztschr. /. MedizinalbcamtCj 1913, xxvi., S. 681.
BENON and LEGAL. Etude cliuique de la demonce epileptique. Rev. de Med. %
1913, xxxiii., Sept., p. 673.
STERLING, \Y. Contribution k l'etude du bispaame facial et de l'h^mispaame
facial alterne combine k lepilepsie arterio-sclerotique et a un syndrome
meaenc^plialique pseudo-parkinsonicn. Rev. Neurol 1913, xxi., Sept. 15,
p. 211.
BIBLIOGRAPHY
117*
GILROY, JAMES. Three oases of infantile convulsions. Lancet , 1913, clxxxv..
Sept. 20, p. 865.
Hysteria.—STEYERTHAL, A. Der Hysteriebegriff. Fortsch. d. Med., 1913,
xxxi., S. 981.
Neuralgia*—KAUFMANN. Un cas de tic douloureux de la face traite par
Falcoolisation du ganglion de Gather. Gueriaon depuis cinq mois. Rev. Htbd.
de Laryngol ., d'Otol. et de Rhinol. , 1913, xxxiv., Sept. 20, p. 337.
MANN, LUDWIG. Die elektrische Behandlung der Neuralgien. Ztschr. /.
Physikal . u. Diat. Therap., 1913, xvii., S. 513.
ZUELZER, G. Die Feststellung der Neuralgie in ihrer klinischen Bedeutung ;
die Spinalgie. Berl. klin. Wchnschr 1913, 1., Sept. 1, S. 1657.
TOBBEN. Die Beeinflussung der Neuralgie des Plexus brachialis durch Kuhlen-
kampfsche Anasthesio. Munch. Med. Wchnschr ., 1913, xxxix., Aug. 26, S. 1883.
Xeurltis.—LONG, E., and ROCH, M. Ndvrites tronculaires multiples et graves,
des membres sup^rieurs, cons^cutives k un refroidissement prolong^. Rev. Med.
de la Suisse Rom., 1913, xxxiii., Aout, p. 596.
OLIVERO, C. Achilia gastrica e polinevrite. Riv. crit. di Clin. Med., 1913,
xiv., p. 536.
RAIM1STE, J. M. Sciatique spinale. Rev. Neurol ., 1913, xxi., Sept. 15, p. 253.
HORNE, J. FLETCHER. Remedies for sciatica in the middle ages. Therap.
Gaz. s 1913, xxxvii., Sept. 15, p. 622.
Xenrasthenla.—LECLERCQ, A. La neurasthenic de la cinquantaine. Journ.
des Prat., 1913, xxvii., Aotit 30, p. 551.
MOORE, ROSS. Preneurasthenic and preinsane conditions. Journ. Amer.
Med. Assoc., 1913, Ixi., Aug. 30, p. 643.
LEGUEU. Lesions de l’ur&tre posUrieur dans la neurasthenic urinaire (faux
urinaires). Journ. des Prat., 1913, xxvii., Sept. 20, p. 593.
Xeuroscs.—WIMMER. Uber Rezidive von traumatischer Neurose. Deut. Ztschr.
f. Nervtnheilk ., 1913, xlix., S. 133.
BENON, R. Le8 n^vroses traumatiques (Rev. g£n.). Gaz. des H6p., 1913,
lxxxvi., pp. 1535 et 1591.
Exophthalmic Goitre, Cretinism, Ac.—BECKER, W. H. Zur internen Beband-
lung der Basedowschen Krankbeit. Deut. Med. Wchnschr., 1913, xxxix.,
Sept. 11, S. 1785.
WILSON, L. B. Notes on the pathology of simple and exophthalmic goitre.
Med. Record, 1913, lxxxiv., Aug. 30, p. 373.
BLACKFORD, J. M., and SANFORD, A. H. Results of intravenous injections
of extracts of goitre on blood pressure in the dog. Med. Record, 1913, lxxxiv.,
Aug. 30, p. 378.
JAUREGG, W. v. Ueber chirurgische Behandlung des Hypothyreoidismus.
Wien. klin. Wchnschr., 1913, xxvi., Sept. 25. S. 1532.
TURNER, DAWSON. Radium rays in the treatment of hypersecretion of the
thyroid gland. Lancet , 1913, clxxxv., Sept. 27, p. 924.
AUBERTIN, CH., and PASCANO, A. Lesions thyroidiennesdansle rhumatisme
chronique. Presse mH., 1913, No. 79, Sept. 27, p. 785.
GOLDSTEIN. Zwei Geschwister mit Myxidiotic und vorhandener, sicher nicht
grob veranderter, Schilddriise. Deut. Ztschr. f. Nervenheilk., 1913, xlix.,
S. 103.
EHLERS, H. W. E. Uber ein Teratoma embryonalo der Schilddrusengegend.
Beitrage. z. path. Anat. u. z. allg. Path., 1913, lvii., S. 46.
JACOBJSUS. Metastasierendes Schilddriiscnadenom unter dem Bilde eiuer
Wirbelgeschwulst mit Kompressionsmyelitis nebst einer Method© zu Probe-
exzisionen von Knochenmerk aus tiediegenden Knochen. Deut. Ztschr. /.
Nervenheilk ., 1913, xlix., S. 74.
BIBLIOGRAPHY
US'
PARHON, MATKE5CO. And TrrA. Nouvellee recherche* surlaglande thrrd?
chez les aliens#. Rev. gen.) L Enr'y-haU, 1013, riii., Sept. 10, p. 235.
P«ral;«U Agltana.— OACTHIEK, JKAN. Nature et causes de h panl/a*
a^iunte. J<>urn. da I* rat.. 1913, xxvii., Sept 20, p. 5oS.
CA< VfAPCOTL O. R. M«*rbodeI Parkinson in un antico Basedowiano.
<i\ Sr* -roL, 1913. xxxi., p. M.
TelMM.-MVLINTOClC (\ T.. and HCTCHIXGS, W. H. The treatment of
tetanus. Journ. In/c r tious //rt % 11*13, xiii., Sept., p. 34*9.
NATONKK, D. 1 K*t mcht tr.iumutiMdic'lYtanus. GntraW.j, 0 >. Y.1F
u. 1'hir., 1913, xvii., S. 1‘.**.
WOLFF, t«KoK<r. Fin giheiltcr Fall von Tetanus neonatorum. D'tf.M'P
h'rfinjrrJir., 1013, xxxix., Sept. 11, S. 17*9,
aPM lU St:\*i:s AND 4 K4M4L NE»4I>
DIMMER, F. Zur Piufung der Funktion dea Sebnervenapparats bei dkbrer
Trwbung der brochenden Mcdien. MV/*. M<d. Wckn^hr., 1013, lxni.,
RADoS, A. Hht die kavt*rn«»ae Sehnerveiu’Dtartung. Khn. Mount#. /«
A 1913, li., Sept., S. 3,Y>.
riliUDFF, W. Leber einen Fall von periodischen und k on tio uier lie ten
Schwaiikungtn im Durcliincsstr der Pupille bei angehorener oder wemg^w
ft ub/otig erworbener linksatitigcr Vlkulomotorinsiaiimung bei einem neua-
jabrigen s<m«t gcsuudeu Madchen. Kim. Monattbl. f. Au<ja>ha!k., ivUli,
Sept., S. 34 4.
ONODI, LAD. rber die rhinogenen und otogenen Lasioncn deg Okulomotorim,
Trochlearis, Trigeminus und Abducens. Ztsckr. f. Okrenhedk. u. f. d. Kranik
d. Lit ft k? fit* 1013, lxix., Aug., S. 1.
A CK. REACH. Zur Pathogenese der postdiphtherischen AkkoracMUtionsUhrcung
L>f\its Zts^hr. /. Xernnheiik., 1013, xlix., S. 04.
POLLOCK, W. B. INGLIS. Minora nystagmus: the stage prior to nystagmus
trUityow Altd. Jou m., 1013, lx.\x., Sept., p. 178.
SHUM WAY, E. A. Traumatic bilateral external rectus paralysis, with transient
paresis of the left facial nerve. Med. Record, 1913, ixxxiv., Aug. 23, p. 340.
CAPPKLLI, J., and TORRIGIANI, C. A. Sovra alcuni casi di lesione dell'
accustico e del faciale nella sifilide. Riv. ent, di Clin, Med., 1913, xiv., pp
M3 and 529.
UIM ELLASEOl * SlltPTOMS AND iASEH-
RUMPEL. Lber das Wesen und die Bedeutung der Leberver&nderungen und
der Piginentierungen bei den damit verbundenen Fallen von Pgeudosklerow,
zucleich ein Beitrag zur Lehre von der Pseudosklerose (Westphal-Strumpellk
Dint. Ztfirhr. /. Nervtnhcilk ,, 1013, xlix., S. 54.
JENTSCH, ERNST. Die Degenerationszeichen bei Unfallnervenkricken
JVniroL Cmtra/bl ., 1913, xxxii., Sept. 16, S. 1138,
BENEDEK, LADISLAUS. Das Vorkommen des Babinski’schen Phanorcewbei
“ organoiderEklampsie. Kntrol. Ccntralbl 1913, xxxii., Sept 1, S. 1087.
GATTI, L. 11 comportamento dei muscoli ad azione uni-© bilaterale del facciale
nellc lesioni di origine centrale. Annals di. Ncrrol., 1913, xxxi.,p. 102.
RHKSE. Zur Frag© der Rhinitis sicca postoperativa und deren Verhutung,
gleichzeitig ein Beitrag zur Frage der Verhutung rhinogener posioperativer
Hirukomplikationen. ZUchr . /. OkrcnheUk . u. f, d. Kronkh. d. Luftur? t
1913, lxix., S. 82.
HOFFMANN. Seekrankheit und Hypnoee. Munch. Med . Wchnschr 1913, lx.,
Sept. 16, S. 2054.
EISLBR and LENK. Radiologisch© Studien hber Beziehungen Nerren*
systems zur motorischen Funktion dee Magens. MtincK. Med. Wdnschr.,
1913, lx., Sept. 16, S. 2048.
CURSCHMANN, H. Zur Psvchotherapie fuuktioneller Magenstorungen.
Therap. MonaUhefte , 1913, xxvii., Sept., 8. 633.
BIBLIOGRAPHY
119*
CARSTENS. J. H. Nervous conditions and their relations to pelvic diseases.
New York Med. Journ., 1913, xcviii., Aug. 30, p. 407.
PSYCHIATRY.
UEXBKAl PARALYSIS—
WILE, UDO J. The demonstration of the gpirochaeta pallida in the brain
substance of living paretics. (Forster and Tomaaczewski.) Joum. Amer. Med.
Assoc. , 1913, lxi., Sept. 13, p. 866.
GEBER, HANS, BENEDEK, LAD, and TAT.A.R, K. Vorkommen von Spiroch&ten
bei Dementia paralytica progressiva. Wien. klin. Wchnschr 1913, 1., Sept.
11, S. 1491.
VIDONI, GIUSEPPE. A proposito dell* aortite nei paralitici generali. Riv.
Sper. di Freniat., 1913, xxxix., pp. 474-482.
HAMMOND, FRED S. Statistical studies in syphilis with the Wassermann
reaction, with remarks on general paralysis. Amer. Journ. Insanity, 1913,
lxx., July, p. 107.
JAUREGG, W. v. Uber Bebandlung der progressiven Paralyse mit Staphy-
lokkenvakzine. Wien. Med. Wchnschr. , 1913, lxiii., S. 2556.
BENEDEK. Uber Hautreaktion mit Noguchis Luetin bei Paralytikern. Munch.
Med. Wchnschr., 1913, lx., Sept. 16, S. 2033.
BERGER. Ueber den Nachweis der Spirochaten des Paralytikergehirns im
Tierexperiment. Munch. Med. Wchnschr. , 1913, lx., Sept. 2, S. 1921.
SCHOENHALS. Serologische Beitrage zur Lues-Paralyse-Frage. Monatssch. f.
Psychiat. u. Neurol ., 1913, xxxiv., S. 230.
SCHULTZ, J. H. Zur Statistik der somatischen, besonders serologischen
Symptome der progressiven Paralyse. Neurol. Centralbl ., 1913, xxxii., Aug.
16, S. 1010.
OEMEXTIA PHECOX-
CAZZAMALLI, FERDINANDO. Contributo alio studio della “dementia
praecox.” Riv. Spcr. di Freniat., 1913, xxxix., pp. 350*377.
MODENA, GUSTAVO. La sindrome demenra precooe in rapporto alia evoluzione
della personality psichica. Riv. Sj^er. di Freniat 1913, xxxix., pp. 468-473.
TREIBER. Heilversuche mit Tuberkulininjektionen bei Dementia praecox.
Allg. Ztschr. f. Psychiat., 1913, lxx., S. 734.
MARSHALL, R. M. On the differential diagnosis of manic-depressive insanity
and dementia priecox. Glasgow Med. Journ. , 1913, lxxx., Sept., p. 185.
LAGRIFFE, LUCIEN. Les troubles du mouvement dans la ddmence prdcoce.
Rev. Neurol., 1913, xxi., Aout. 30, p. 200.
MORETTI, ANTONIO. Sul valor© terapeutico del nucleinato di aodio nella
paralisi e nella demenza precoce. Rassegna di Studi Psichiat ., 1913, iii., p. 269.
LAGRIFFE, LUCIEN. Recherches de physiologie pathologique sur les troubles
du mouvement dans la d^mence precoce. Rev. de Psychiat ., 1913, xvii., Aodt.,
p. 309.
GENERAL—
NICOLSON, DAVID. An address on mind and motive : some notes on criminal
lunacy. Lancet , 1913, clxxxv., Sept. 13, p. 787 ; Brit. Med. Journ., 1913,
Sept. 13, p. 641.
BERGER, H. Klinische Beitrage zur Paranoiafrage. Monatssch. /. Psychiat. u.
Neurol., 1913, xxxiv., Sept., S. 181.
ZIVERI, A. Contributo clinico per alcune psicosi paranoidi secondo gli ultimi
concetti di kraepelin. Rev. di Patol. nerv. e ment ., 1913, xviii., p. 494.
JOLLY, PH. Die Hereditat der Psychogen. Archiv. f. Psychiat., 1913, lii.,
8. 377.
BUCKLEY, A. C. Functional Psychoses of the Senile Period. Pennsylvania
Med. Journ., 1913, Feb.
120 *
BIBLIOGRAPHY
PASSOW, C. A. Zur KaiuiHik der Psychoeen wahrend der Schwangtnchifi
Brrl. klin. Wcknerhr., HU3, 1., Sept. 1, S. 160*2.
BOWERS, PAUL E. Prison psychosis a pseudonym. Amer. Journ. Iwntt.
1913, lxx., July, p. 161.
TOULOUSE and PUILLKT. GuerUon rapide de psychoses aiguessousI'iniiattW
d injection* sous-cutanees doxygune. Rev . de PiwAiaL, 1913, xvii, kail
p. 3.31.
PF()R RINGER, OTTO. Affekt*t«>rungen bei Psychopathen. Med. Klml 19ft
ix , Aug. 31, S. 1485.
DUBOIS, P. Le rdle de IV mot ion dans la genfese des psychopathies. Rev. wi
de hi Suits* Rom ., 1913, xxxiii., Audi, p. 577.
J ACKSON. J. ALLEN. Report of an imbecile with paresis. N. Y. Med. /««..
1913, cxviii., Aug. 30, p. 419.
PAUSER. Die Serologie in der Psychiatric. Munch . Med . ITcAnielr., 19ft
lx.. Sept. 9, S. 1984.
BORNSTEIN, Ueber den Stoffwechsel der Geieteskranken. Munch. MM
Wchnsekr ., 1913, lx.. Sept. 9, 8. 1994.
DAMAYE, H. La tberapeutique dec maladies men tales. Prog. Med L, 1911
xliv., Sept. 6, p. 463.
SALMON, T. W. Immigration and the prevention of insanity. JM
aruf Surg Journ ., 1913, clxix., Aug. 28, p. 297.
SOUTHARD. E. E. Second note on the geographical distribution of mental
disease in Massachusetts, 1901 *1910: the insanity rates of the smaller cities
Boston Med. and Surg. Journ., 1913, clxix, Aug. 28, p. 302.
ROSANOFF, A. J. Dissimilar heredity in mental disease. Amer.
Insanity , 1913, lxx., July, p. 1.
8WIFT, H. M. Insanity and race. Amer . Journ, Insanity, 1913, lxx., p. 141
BUSS EL, COLIN K. Insanity and its relation to the Stats. Canadian AM.
Assoc . Journ., 1913, iii., Sept., p. 771.
NEFF, MARY L. The minimizing of insanity. Journ. Amer. Med L Anne.,
1913, Lxi., Aug. 23, p. 559.
NACKE, P. Die Psychiatrie als Hilfswissonsohaft, auch der Historik. (Die
Pathographien : inshesondere die von Jesus Christos.) Neurol, CentriM.,
1918, xxxii., Sept. 1, 8. 1074.
P1CQU E, LUCIEN. Des indications opdratoires chex les alipeds au point de voe
therapeutique et mddiso-ldgal. Rev. Neurol 1913, xxi., Aodt 30, p. 2*21.
MONKEMOLLER. Psychiatrie and Fiirsorgeertiehung. AUg. Itsckr. /
Psych iat., 1913, lxx., S. 743.
ROESEN, L. Die Entwicklung der Familienpflege an der Brandenburgiscben
Landesirrenanstalt Landsberg a. W. and ihr weiterer Ausbau. AUg. Ztxhr.j.
Psychiat., 1913, lxx., S. 761.
TREATMENT.*
POPE, C. Hydrotherapy in nervous fatigue. Journ. Amer. Med. Attoc,, 1913, lxi*
Sept. 13, p. 851.
LAQUEUR, A., aud LAQUEUR, W. Zur Behandlung mit Hochfrequenatromen
Berl. klin. Wchnechr., 1913, L, Sept. 1, 8. 1602.
HABERMANN, J. V. The Psychoanalytic delusion. A criticism and review. MM
Record , 1913, lxxxiv., Sept. 6, p. 421.
WALLIN, J. E. W. The functions of the psychological clinic. Med. Record, 1913,
lxxxiv., Sept. 20, p. 521.
BLEULER, E. Kritik der Freurlsohen Theorien. AUg. ZUckr. /. Ptyehiah, 1913, lxx,
S. 665.
* A number of references to papers on Treatment are tnoMed in the Bibllofnphy ufa
individual dittoes*.
36fbUograpb\>
ANATOMY.
HUBER. G. C., and GUILD, S. R. Observations on the histogenesis of protoplasmic
processes, and of collaterals terminating in end bulbs, of the neurones of peripheral
sensory ganglia. Anat. Record, 1913, vii., Oct., p. 331.
BLACK, D. DAVIDSON. The study of an atypical cerebral cortex. Journ. Comp.
Neurol., 1913, xxiii., Oct., p. 351.
JOHNSTON, J. B. The morphology of the septum, hippocampus, and pallial com¬
missures in reptiles and mammals. Journ. Comp. Neurol ., 1913, xxiii., Oct.,p. 371.
GREENMAN, M. J. Studies on the regenerate of the peroneal nerve of the albino
rat: number and sectional area of fibres : area relation of axis to sheath. Journ.
Comp . Neurol., 1913, xxiii., Oct., p. 479.
RIQUIER, CARLO. Sulla fine struttura del ganglio otico. Riv. di Paid, nerv . e
merit., 1913, xviiL, Ott., p. 609.
TRETJAKOFF, D. Die zentralen Sinnesorgane bei Petromyzon. Archiv. /. Mikr.
Anat., 1913, Ixxxiii., S. 68.
FISHER, A. G. T. A case of oomplete absenoe of both internal carotid arteries, with
a preliminary note on the developmental history of the stapedial artery. Journ.
Anat. and Physiol., 1913, xlviii., Oct., p. 87.
MEIKLEJOHN, JEAN. On the innervation of the nodal tissue of the mammalian
heart. Journ. Anat. and Physiol., 1913, xlviii., Oct., p. 1.
BARIL, G. Etude anatomique snr l'innervation et l’anesthesie regionale du sinus
maxillaire. Archives de Med. et Pharm. Nav., 1913, c., Sept., p. 161.
PHYSIOLOGY.
INGEBRIGTSEN, RAGNVALD. Regeneration of axis cylinders in vitro. Journ.
Exp. Med., 1913, xviii., Oct., p. 412; Munch. Med. Wchnsckr., 1913, lx., Okt 14,
8. 2265.
GUTTICH, A. Beit rag zur Physiologie des Vestibularapparates. Beitriigc z. Anat.,
Physiol. Path. u. Therap. des Ohres, dr., 1913, vii., S. 1.
NEMINSKI, W. W. Einige elektrische Erscheinungen im Zentralnervensystem bei
Rana temporaria. A re Air. /. Anat. u. Physiol., 1913 (PhysioL Abtig.), H. iii.
u. iv., S. 321.
MARTIN, E. G., and GRUBER, C. M. On the influence of muscular exercise on the
activity of bulbar centres. Amer. Journ. Physiol., 1913, xxxiL, 315.
BROWN, T. GRAHAM. On postural and non-postural activities of the mid-brain.
Proc. Roy. Soc Series B., 1913, lxxxvii., Oct 16, p. 145.
BROWN, T. GRAHAM. On the question of fractional activity (“all or none”
phenomenon) in mammalian reflex phenomena. Proc. Roy. Soc., Series B, 1913,
lxxxvii., Oct 16, p. 132.
PARNAS, J. Uber die gesattigte Fettsfcure des Kephalins. Biochem. Ztschr., 1913 f
hi., S. 17.
GILDEMEISTER. Ueber die phyeikaluch ehemuehen und physiologiachen
im menschlichen Korper, auf denen der psychogalvanische Keflex beruht.
Med. Wehnschr., 1913, lx., Okt 28, S. 2389.
TEZNER, R. Anteilnahme des sympathischen Nervensystems an der Erkrankungen des
Singlings (II. Mitteil). Monatssch. f. Kindtrheilk. (Orig ), 1913, xii., S. 399.
$
lil*
122*
BIBLIOGRAPHY
LEGENDRE, R. Action de quelques ohlorures car las callnles nerveuses das ganglions
■pinsux isol4s de 1'organisms. Compt. Bend. d. 1. Soe. de BioL , 1918, lu? M Oct
34, p. 246.
CAMUS, JEAN, and PORAK, RENE. Ablation rapids at destruction lanta des capsules
surrtnalas. Compt. Bend. d. I. Soe. de Biol. f 1913, Ixxv., Oct 34, p. 362.
MU LON and PORAK. Structure ds surr^nales acoassoiras an 4 tat de suppUanoe
fonctionnelle. Compt. Bend . d. 1. Soe. cfe Biol., 1913, lxxv., Oct 24, p. 253.
VOEGTLIN, CARL, and TOWLES, CAROLINE. Tha treatment of experimental
Beri beri with extracts of spinal oord. Joum. Pharmacol, and Kxper. Thermo,
1913, v., Sept, p. 67.
GOLLA. F. L., and STAIRS, W. L. Tha reversible action of adraaalina and s etae
kindred drugs on the bronohlobes. Journ. Pharmacol, and Kxper. Therap ., 1913,
v., Sept, p. 87.
PSYCHOLOGY.
MYERS, CHARLES 8. Are tha Intensity Differences of Sensation Quantitative ?
I. Brit. Joum. Psychol ., 1913, vi, Oct, p. 137.
HICKS, G. DAWES. Are the Intensity Differences of Sensation Quantitative? EL
Brit. Joum. Psychol ., 1913, vi, Oct, p. 156.
WATT, HENRY J. Are the Intensity Differences of Sensation Quantitative? HI.
Brit. Joum. Psychol ., 1913, vi, Oct, p. 175.
BROWN, WILLIAM. Are the Intensity Differences of Sensation Quantitative? IV.
Brit. Journ. Psychol ., 1913, vi, Oct, p. 184.
VALENTINE, C. W. The Aesthetic Appreciation of Musical Intervals among School
Children and Adults. Brit. Joum. Psychol 1913, vi, Oot, p. 190.
THOMSON, GODFREY H. Note on the Probable Error of Urban’s Formula for the
Method of Just Psroeptible Differences. Brit. Joum. Psychol ., 1913, vi, Oct,
p. 217.
BROWN, WILLIAM. The Effects of Observational Errors and other Factors upon
Correlation Coefficients in Psychology. Brit. Joum. Psychol., 1913, vi, Oct,
p. 223.
WATT, HENRY J. The Main Principles of Sensory Integration. Brit. Joum. Psychol. 9
1913, vi., Oct, p. 239.
KAFKA, O. Uber grundlagen und Ziele einer wissenschaftlichen Tierpeyohologie.
Archiv. f. d. gee. Psychol ., 1913, xxix., S. 1.
STORZINGER, O. Die Grilnde des Gef&llens und Missfallens am poetisehen Bftde.
Archiv. f. d. ges. Psychol ., 1913, xxix., S. 16.
PETTOW, R. Zur Psychologic der Transvestie. II. Zugleich ein Beitrag sur Reform
des g 51, St G. B. Archiv. f. d. ges. Psychol 1913, xxix., S. 92.
KOHNSTAMM, O. Zwecktfctigkeit und Ausdruokstatigkeit. Archie. /. d. ges.
Psychol ., 1913, xxix., S. 111.
KEMP, WM. Methodise be« und Experimentelles sur Lehre von der Tonversohmeliung.
Archiv. f. d. ges. Psychol ., 1913, xxix., S. 139.
WAIBLINGBR, E. Zur peychologischen Begriindung der Harmonielehre. Archie. /.
d. ges. Psychol 1913, xxix., S. 258.
ELLIS, HAVELOCK. The relation of erotic dreams to vesical dreams. Joum.
Abnorm. Psychol ., 1913, viii., Aug.-Sept, p. 137.
PUTNAM, JAMES J. Presidential address before the American Psychopathologioal
Association. Joum. Abnorm. Psychol 1913, viii, Aug.-Sept, p. 168.
EMERSON, L. E. A psychoanalytic study of a severe oaee of phobia (concluded).
Joum. Abnorm. Psychol ., 1913, viii, Aug.-Sept, p. 180.
WELLS, F. L. On formulation in psychoanalysis. Joum. Abnorm. Psychol., 1913*
viii, Oct-Nov., p. 217.
PRINCE, MORTON. The psychopathology of a case of phobia. Joum. Abnorm.
Psychol., 1918, viii, Oot-Nov., p. 228.
BIBLIOGRAPHY
123*
BURROW, TRIGANT. The psychological analysis of so-called neurasthenic and
7 allied states. Joum. Abnorm. Psychol , 1913, viii., Oct.-Nov., p. 243.
SOUTHARD, £. £., and TEPPER, A. S. The possible correlation between delusions
and cortex lesions in general paralysis. Joum. Abnorm. Ptyckcl 1913, viii.,
’'f'’ Oct.'Nov., p. 259.
4 PATHOLOGY.
:< ANITSCHKOW, N. Zur Kenntnis der roalignen Neuroblastome des N. sympathicus.
r' ; Virchow's Archiv ., 1913, ccxiv., S. 137.
GUIDI, FERRUCCIO. Sulla struttura della guaina mielinica e sul suo comportamento
& nolle regenerazione secondarie, con un nuovo metodo d’indagine. Riv. di Paid,
nerv. e ment., 1913, xviii., Ott., p. 628.
PANDOLFI, G. La nevroglia nelle intossicarioni. Annali di Neurol,, 1913, xxxi.,
p. 161.
DUSTIN, A. P. Regeneration normale et pathologique du systems nerveux. Joum
di Neurol ., xvii., 1913, Sept. 5, p. 321.
^ LAVE RAN, A., and FRANCHINI, G. Infezione aperimentale del topo bianco ooll
herpetomonas ctenocephali. Palhologica, 1913, Oct., p. 605.
> RACHMANOW, A. Kin Fall von Encepbalocele occipitalis. (Hirnbruch ohne
Cystenbildung.) Frankfurter Ztschr . /. Path 1913, xiiL, S. 402.
> ROSSI, O. Contributo alia conoscenza dei nuclei meso- e romboencefalici. Riv. di
Patol. nerv . e ment ., 1913, xviii., Ott., p. 637.
<* BIONDI, GIOSUE. Sul significato dei corpuscoli fucsinoftli dolle cellule nervose e
nevrqghche. Riv. ital. di Neuropatol. , Psichiat. ed Elettroter ., 1913, vi., p. 394.
HADWEN, SEYMOUR. On “tick paralysis” in sheep and man following bites of
Ikrmacentor venustus . Parasitology , 1913, vi., Oct., p. 283.
HADWEN, SEYMOUR, and NUTTALL, GEORGE. Experimental 44 tick paralysis ”
in the dog. Parasitology , 1913, vi. f Oct., p. 298.
8 IM8, H. A. A method of preparing nerve tissues for microphotography. Med.
Record , 1913, Ixxiv., Oct. 11, p. 665.
CLINICAL NEUROLOGY.
OiVUUlr-
PAWLOW, I. An address on the investigation of the higher nervous functions.
Brit. Med. Joum., 1913, Oct. 18, p. 973.
HOWLAND, G. W. A new and rational method for the study of the functional
diseases of the nervous system. Canadian Med. Assoc. Joum., 1913, iii.,
Oct, p. 835.
LOKWY, ERWIN. Die Chirurgie des Centralnervensystems. (Sammelreferat.)
Btrl. Jtlin. Wehnschr ., 1913, L., Okt. 27, S. 1996.
BABINSKJ. Localisation organique d'apr&s let reflexes. Joum. des Prof.,
1913, xxvii., Oct. 4, p. 630.
BABINSKJ. Association organique. Joum. des Prat., 1913, xxvii., Oct. 18,
p. 662.
wnra—
PURJE8Z , BELA. Gleichzeitiges Vorkommen von Stenoae des linken venosen
Ostiums und Lahmung des linkseitigen Nervus recurrent. Wien. klin.
Wehnschr., 1913, xxvi., Okt. 23, S. 1662.
mm coin-
fieaersl. —LORENZ, ADOLF. Zur alten und modemen Behandlung der spat-
tiohen Paraiysen. Wien. Med. Wehnschr 1913, lxiii., Okt. 4, S. 2670.
FOERSTER, O. Zur Kenntnis der spinalen Segmen tin nervation der Ifuskeln.
Neurol. Centralbl J913, xxxii., Okt. 1, S. 1202.
124*
BIBLIOGRAPHY
WOERKOM. A propos dec mouvement* de retrait des membr m inferieurs et du
rotiexe de Babiniki. Re r. A enrol., 1913, xxi., Oct. 15, p. 407.
PASTING, C. Le sign© de Babinski et lea reflexes d’automatiame medullaire.
Rev. Neurol ., 1913, xxi., Oct. 15, p. 403.
MARIK, PIERRE, and FOIX, CH. Reflexes d’automatisme medullaire et
reflexes dits “de defense’ 1 : le phenomene des raocourcisseurs. Srrn. Mai..
1913, xxxiii., Oot. 22, p. 506.
DELBET. Reflexes dans lea sections m&lullaires. Joum. de» Prat., 1913,
xxvii., Oct, 11, p. 648.
BABINSKI. Lesion medullaire determiner et localise© d’apres l'etat des reflexes.
Joum. des Prat., 1913, xxvii., Oct. 11, p. 646.
KRAFT, H. Die Entwicklung des Drehreflexes am Neugeborenen. Ztsch r. f.
Oeburtshul/e, 1913, Ixxiv., S. 201.
PETERSEN, O. H. Zur Frage der sogenannten Pleuiareflexe. Mittcil. a. d
(Irenztjch. d. Med. u. Ckir., 1913, xxvi., S. 834.
STIEFLER, GEORG. Isolierter Dorsalklonus der grossen Zehe. NevnU.
Central hi ., 1913, xxxii., Okt., S. 1297.
KIXTNER. Uber die RUckbildung peripherer, traumatischer Lahmungen.
Neurol. Centralhl., 1913, xxxii., Okt. 1, S. 1229.
SODERBERGH. Uber den proximalen Typus der braohiocruralen Monoplegie.
llcui. Ztsrhr. f. Nervcnheilk., 1913, xlix., S. 253.
AGUGLIA, EUGENIO. Affezione del oono midollare in seguito a rachisto
vainizzazione. Riv. ital. di Neuropatol., Psichiai . ed Elcttroter ., 1913, vi. t
p. 389.
Cervical Bib.—TELFORD, E. D. Two cases of cervical ribs with vascular
symptoms. Lancet , 1913, clxxxv., Oct. 18, p. 1116.
MORLEY, JOHN. Brachial pressure neuritis due to a normal first thoracic
rib: its diagnosis and treatment by excision of rib. Clin. Joum., 1913, xiii ,
Oct. 22, p. 461.
Hplna Bifida.—BROCA, AUGUSTE. “Spina bifida” latent avec tumeur.
Pressc Mid., 1913, lxxxvii., Oct. 25, p. 865.
Tabes Borsalls*—COLLINS, JOSEPH. The modern treatment of tabes. Med.
Record, 1913, lxxxiv., Oct. 11, p. 645.
DELBET. Arthrites dites tabetiques. Joum. des Prat., 1913, xxviL, Oct. 4,
p. 629.
CLAUDE, HENRI. Tabes et troubles psychiques. Joum. des Prat., 1913,
xxvii., Oct. 18, p. 657.
ALEMAN, OSCAR. Kasuistischer Beitrag zur Foe rater’schen operation bei
gastrischen Krisen. Nord. Med. Arkiv., 1913, xlvt (Kirurgi), pp. 1-12.
Poliomyelitis Anterior Acata.—FLBXNER, S., and NOGUCHI, H. Experi¬
ments on the cultivation of the micro-organism causing epidemic poliomyelitis.
Joum. Exp. Med., 1913, xviii., Oct., p. 461.
PARSON8, LEONARD. Acute epidemic poliomyelitis. Public Health, 1913,
xxviL, Oct., p. 3.
LAPAGE, C. PAGET. Epidemic poliomyelitis. Med. Chron., 1913, lviii.,
Oct., p. 12.
BATTEN, F. E. Polio-encephalitis and polio-myelitis. Med. Press, 1913, cxlvii.,
Oct. 22, p. 445.
HUTINEL, V. The occurrence of meningeal reactions in the course of polio¬
myelitis. Med . Press, 1913, cxlvii., Oct. 1, p. 364.
Brewa-Seqaard Hymptem-Cemplex.—DELBET. Syndrome de Brown-Sequard
par compression de la moelle par une balle de revolver. Joum. des Prat.,
1913, xxvii., Oct. 18, p. 662.
Paraplegia.—HICHENS, P. S. Congenital spastic paraplegia, with oongenital
optic atrophy. Proc. Roy. Soe. Med., 1913, vi., July (Sect. Dis. of Child.)
p. 196.
BIBLIOGRAPHY
125*
Tmwwi.—OPPENHEIM, EL, and BORCHARDT, M Beitrag zur ehirurgischen
Therapiedos “intramedulliren Rfickenmarkstumors.” MiUcU. a. d. Grcnzgeb.
d. Med. u. Ckir., 1913, xxvi., S. 811.
EISELSBERG, F. v. 9 and RANZI, E. Ueber die chirnrgiache Behandlung der
Him- und Riickenmarkatumoren. Archiv.f. klin. Chir., 1913, eii., S. 309.
Syringomyelia. —REICH, JOSEPH. Bin Beitrag zur Lehre von der Syringo-
bulbie. Neurol. Centralbl., 1913, xxxii., Okt. 1, 8. 1254.
BERNSTEIN, E. P., and HORWITT, S. Syringomyelia, with pathological
findings. Med. Record , 1913, lxxxiv., Oct. 18, p. 698.
Myelitis. —BARTH, HENRI. Un oaa de mydite ascendante aigue au oours d’une
syphilis seoondaire, recherche* bacteriologiqnes et anatomiques (2 fig.). Rev .
Neurol. , 1913, xxi., Oct. 15, p. 393.
LEWY, F. H. Die pathologisohe Stellung der sogenannten kombinierten
System-erkrankungen (funikmare Myelitis). Neurol. Centralbl ., 1913, xxxii.,
Okt. 1, S. 1232.
Spinal Abscess. —YOUNG. JAMES K. Spinal abscesses. Boston Med. and Surg.
•/bum., 1913, elxix., Sept. 25, p. 457.
Spcndylltis. —CRESPIN, J. Spondyloses et spondylites. Prase Med., 1913,
lxxxviiL, Oct. 29, p. 877.
Myasthenia. —KUH, SYDNEY, and BRANDS, MORRIS. A contribution to the
pathology of myasthenia gravis. Journ. Nerv. and Ment. Dis., 1913, xl., Oct.,
p. 617.
General.— RHEIN, JOHN H. W. Cerebral palsies without demonstrable ana to-
mioal findings. Journ. Nerv. and Ment. Dis., 1913, xl., Oct., p. 639.
KRASNOGORSKI, N. Uber die Grundmechanismen der Arbeit der Grosshirn-
rinde bei Kindern. Jahrbuch. f. Kindtrheilk ., 1913, Ixxviii., S. 373.
ZEMANN. Beitrag zur Kenntnis der endokraniellen Komplikationen nach
chronischer Nebenhohlenoiterung. Ztschr. /. Laryngol., Rhinol . u. i.
Grcnzgeb, 1913, vi., S. 545.
OSEKI, S. Beitrag zur Heterotopie der grauen Substanz im Gehirn. Monatssch.
f. Psychiat. u. Neurol 1913, xxxiv., Okt., S. 332.
ftknll Injury, die.— BERARD, LEON. The treatment of fractures of the skull
by lumbar puncture and early trephining. Med. Press , 1913, cxlviL, Oct. 15,
p. 416.
LOP, M. Deux observations de chirurgie cranienne d’urgence. Gaz. des Hop .,
1913, lxxxvi., Oct. 2, p. 1743.
Mssemtnated Sclerosis. —EICHHORST, H. Multiple Sklerose und spasti^che
Spinalparalyse. Med. Klinik ., 1913, ix. y Okt. 5, S. 1617.
DONELAN, JAMES. Double paralysis of the superior laryngeal nerves in a
man, aged 25, in the course of disseminated sclerosis from lead poisoning.
Proc. Roy. Soc. Med,, 1913, vi, July (Laryngol. Sect.), p. 180.
BULLOCK, W. E. The experimental transmission of disseminated sclerosis to
rabbits. (Illust.) Lancet, 1913, Oct. 25, p. 1185.
Progressive Muscular Atrophy. —BRAUNWARTH. Ein Fall von Dystrophia
musculorum progressiva. Tod durch Zwerchfellkhmung. Ztschr. f. klin.
Med., 1913, lxxxviii., S. 361.
NeuroMa.—PATERSON, PETER. A neuroma-myoma of the mesentery. La met,
1913, dxxxv., Oet. 4, p. 997.
■eniugltls. —HUTINEL. La m^ningite cer4brospinale et son traitement* Jou rn.
da Prat., 1913, xxvii., Oct. 25, p. 690.
GUNN, WM. A. Notes on the serum treatment of oerebro-spinal meningitis.
Glasgow Med. Journ., 1913, lxxx., Oct., p. 254.
PRZEDBORSKI, J. Ueber einen interessanten Fall von Ascaridiasis und
Meningitis tuberculosa und fiber Wirkung des Oleum chenopodii auf Ascariden.
BerLklin. Wchnschr., 1913, 1., Okt. 27, S. 1987.
126 *
BIBLIOGRAPHY
MEONI, L. Una specials forma di meningite haiilare oon esito di guarigione.
Riv. erit. di Clin. Med., 1913, xiv., Ott. 25, p. 373.
ROSS, ATHOLE, and MOORE, A. B. A case of i&flnenad meningitis. (Olnstr.)
Brit . Med. Journ .. 1913, Oct. 25, p. 1056.
PLATE. Uber einen Fall von Meningitis saturnism. Munch. Med. Wcknsckr .,
1913. lx., Okt. 21, S. 2343.
Abscess.—EMERSON, F. P. Temperosphenoidal abscess with meningeal
symptoms. Drainage through the cisterna magna; mastoid operation; re¬
covery. Journ. Artur. Med. Assoc., 1913. lxi, Sept. 27, p. 1209.
BABINSKI. Suppuration intracranienns, trepanation, gudrison. Journ . dee
Prat., 1913, xxvii., Sept. 27, p. 616.
■wmerrbage.— EUZ1ERE and BONNET. L'h4morragie m4ning4e chex la
parturieiite. G'az. dee H6p., 1913, lxxxvi., Oct. 14, p, 1821.
SCHUSTER. Ueber traumatische Spitapoplexie. Munch. Med. Wchnsehr.,
1913, lx., Okt. 28, S. 2404.
Memflptogla.—MACKINNON, MURDOCH. Hemiplegia following syphilis, with
special reference to a case of double hemiplegia and pseodo-bulbar paralysis.
Lancet , 1913, olxixv., Oct. 4, p. 989.
MACKINNON, MURDOCH. Hemiplegia following syphilis. Lancet , 1913,
clxxxv., Oct. 18, p. 1119.
Lead Poisoning—MELLON. R, R. The relation of fatigue to paralysis localisa¬
tion in plumbism. Archives Ini. Med., 1913, xii., p. 399.
Tnmemrs.— BYCHOW8KI. Zur klinik dcr oberflachlich gelegenen Oehirntu-
moren und das Verhalten des Babinakischen Zehenphanomens bei kortikalen
Hemiplegien. Deut. Ztschr. f. Nervcnheilk, 1913, xlix., 8. 227.
DEROITTE, VICTOR. Diagnostic prtaoce et localisation des tumeurs du
cerve&u. Journ. de Neurol ., 1913, xvii., Oct. 6, p. 361.
BABITZKI, PAUL. Zur Chirurgie der Gehirngeschwiilste Bin Fall von
Jacksonschcr Epilepsie bei auboorticaler Lage des Tumors im Gebiet der rechten
Centralwindungen. Kntfernung der Geschwulst. Genesung. Arehiv. f. klin.
Chir ., 1913, cii., S. 627.
LARUELLE, LEON. Diagnostic et localisation pr&ooes dee tumeurs de la
fosse cerebrale posterieure. Journ. de Neurol., 1913, xvii.. Sept. 20, p. 34L
MEYER. Cystischer Hirntuinor unter dem Bilde des Hydrooephalus internus.
Monatssch. /. Psychiat. u. Neurol., 1913, xxxiv., Okt., S. 370.
niultary Tumours, 4U.— CATARINICH, J. A case of pituitary tumour.
Australian Med. Journ., 1913, ii., Sept. 20, p. 1220.
HOFFMANN, RUDOLF. Ueber die pernasale Eroffnung der Sella turcica.
Ztschr . f. Ohrenheilk n. /. d. Krankh. d. Luftwege , 1913, Leix., S. 11L
POTTS, JOHN B. Some comparative measurements of the skull and stlla
turcica, with report of eight cases. Journ. Artur. Med. Assoc., 1913, lxi.,
Sept. 27, p. 1188.
Acromegaly.—TRAQUA1R, H. M. Contribution to the stndy of bitemporal
hemiopia. Ed in. Med. Journ., 1913, xi., Sept., p. 197.
Mabetes Insipidus — SOCIN, CH. Ueber diabetes insipidus. Ztschr. f. klin.
Med., 1913, lxxviii., S. 294.
Apbasla, Ac.—CLAUDE, HENRI, and LOYBZ, Mllb. M. Etude anatomkjue
d’un cas d’apraxie avee hemiplegic droite et clcit^ verbals. L'Enctphale ; 1913,
viii., Oct., p. 289.
rellagim.—JOHNSTONE, EMMA M. A note on a case of pellagra. Lancet,
1913, clxxxv., Oct. 18, p. 1114.
MACDONALD, J. B. Notes on pellagra in Massachusetts. With report of
two cases in Danvers State Hospital. Boston Med. and 9urg. Journ., 1913,
elxix., Oct, 16, p. 567.
VOLP1NO, G., and BORDONI, E. F. E possibile nn immuniuaiione attiva dci
pellagrosi. Patholoyica , 1913, v., Oct., p. 602.
BIBLIOGRAPHY
127*
VALTORTA. Intossicazione pellagrosa ed ipersensibilitfc egli estratti aoquosi
di mais sano. II Manicomio, 1913, xxviii., p. 43.
8ypfcftlls.—DERCUM, F. X. The olinioal forms presented by nervous syphilis.
N. Y. Med. Joum., 1913, xeviii., Oct. 18, p. 745.
EDDY, N. B. A case of brain syphilis. Joum. Amer. Med. Assoc., 1913, lxi,
Oct. 4, p. 1296.
CARLE. Quatri&me et derni&re note sur rherddo-syphilis, ses lois, et leur inter¬
pretation. Annates de Dermatol . et de Syphil ., 1913, iv., 8. 451.
FURTH, J. Zur Behandlung der Syphilis mit Kontraluesin. (Richter.)
Dermatol . Wchnschr ., 1913, idiiL, Okt., 8. 1251.
GRAYE8. Uber das klinisohe Erkennen von sogenannten 1a ten ten Syphilitikem.
Deut. Ztsehr. f. Nervenkeilk ., 1913, xlix., 8. 194.
MULLER, ERICH. Zor Therapie and Klinik der Lues oongenita. Therap.
Monatsch ., 1913, xxvii., Okt., 8. 706.
GRERORY, MENAS S., and KARP AS, MORRIS J. Syphilitic bone disease of
the skull. Joum. Nerv. and Ment. Die ., 1913, xl., Oct., p. 651.
HAZEN, H. H. The leucooytes in Syphilis (concluded). Joum. Cut. Di*.,
1913, xxxL, Oct., p. 739.
NOGUCHI, H. Etat actual de la culture du treponfeme p&le. Preset Mid.,
1913, lxxxL, Oct. 4, p. 801.
NOGUCHI, H. Die Zlichtung der Spiroehceta pallida. Wien. Med. Wchnschr.,
1913, lxiii., Okt. 4, S. 2664.
ftal varsam. —WOLBARST, ABR. L. A report of seven cases of syphilis apparently
cured with one injeotion of salvarsan. N.Y. Med. Joum., 1913, xeviii.,
Oct. 18, p. 747.
DREYFUS. Die Injektion konzen trier ter Altsalvarsan-losungen mit der Spritze.
Munch. Med. Wchnschr., 1913, lx., Okt. 21, 8. 2333.
FUCHS. Ueberleitungsstdrung im Verlauf der Salvarsan-beliandlung bei einem
Patienten mit spfcter Sekundarlues. Munch. Med. Wchnschr., 1913, lx.,
Okt. 21, S. 2339.
GENNERICH. Weitere Beitrage zur Reinfectio syphilitica naoh Salvarsan uud
zur Biologie der humanen Syphilis. Munch, med. Wchnschr., 1913, lx.,
Okt. 28, S. 2391.
BERGER. Waitere statue he und klinische Beobaohtungen in der Salvaman-
therapie der Syphilis. Miinch. Med. Wchnschr., 1913, lx., Okt. 28, S. 2394.
SAALFELD. Zur Teohnik der intravenosen S&lvarsaninjektion. Miinch. Med.
Wchnschr., 1913, lx., Okt. 21, S. 2338.
GIBBARD, T. W., and HARRISON, L. W. The treatment of syphilis with
salvarsan. Brit. Joum. Dermatol., 1913, xxv., Oct., p. 318.
MUCHA, V., and KETRON, L. W. Uber Oig&nveriinderuiigen bei mit Sal¬
varsan behandelten Tieren. Wien. Med. Wchnschr., 1913, lxiii., Okt. 25,
8. 2844.
BOGGS, THOMAS R. Salvarsan in pernicious anaemia. Bull. Johns Hopkins
Hosp., 1913, xxiv., Oct., p. 322.
JRAN8ELME, YERNES, BERTRAND, and BLOCH. Des localisations de
rarsenic dans les visc&resaprta injections de “606." Preset Mid., 1913,
lxxxvi., Oct. 22, p. 857.
Neasalvarsnn.— ELLIS, A. W. M., and SWIFT, HOMER F. The effect of
intraspinous injections of salvarsan and neosalvarsan in monkeys. Joum. Exp.
Med., 1913, mii., Oct., p. 428.
SWIFT, HOMER F., and ELLIS, A. W. M. A study of the spirooh»ticidal
action of the serum of patients treated with salvarsan. Joum. Exp. Med.,
1913, xviii., Oot., p. 435.
KATZ. Ueber intravenose Injektionen von konzentriertem Neosalvarsan.
Miinch. Med. Wchnschr., 1913, lx., Okt. 21, S. 2337.
MILLER, D. T. Intravenous injection of salvarsan and neosalvarsan. N. Y.
Med. Joum., 1913, xeviii., Oot. 11, p. 713.
BIBLIOGRAPHY
rj.s
a
ASt'OLI, ALBERT. Salvarmn- und NeoealvereantherapK in Iulieu. Rdr
f. CheiHviktr., 1913 (Toil: Raf.), n., 8. $49.
HAGKRTY, M. E. A neonlfinui fatality. /oura. itur. Ifd. .4«oc„ 1511
lxi , Oct. 4, p. 1J94.
RAVAUT, PAUL. La suppression du W»le nodf de leau (Wtwerfehler <i«i
auteurs allemands) par 1 emploi de solutions conoentrees de neoolnnu.
Prtsse M*d., 11*13, LxxxviL, Oct. 2a, p. 867.
^ttifteraisBa Head-IVEY, R. R. The Wassermann reaction tbt
negro inrane of Alabama. Med. Record, 1913, lxxxir., Oct 18, p. 712.
SIGNORELLI, B. Veber den Einfluss der Phenols auf die Waswmnnichtt
Svpbili* reaktion. Zteekr. f. ImmunilaUforsch.^ 1913 |Teil L: Orig.), xii-,S.
1W.
WKsENER, F. I’bcr die Iledeutung der Wassermannschen Reaktion bei der
\ erwenthmg von Ammen. Mvnatssch. /, Kinderkexlk. tOrig.), 1913, i&,
S. 44r».
LANDAU, W. Untersuchungen iiber eine Reaktion luetiacher Seramiteiwn
Jodoi Re&gens. ir<Vn. kitn* IVchnsckr., 1913, xxvi., Okt. 16, S. 1702.
€>re**ro-HplaaI Flatsl.- FERRIER, Sir DAVID. The eerebro-spinal fluid is
health and dieease. Lancet, 1913, clxxxv., Oct 18, p. 1107.
DKKRIKN, KUZIKRE, ROGER. Les dissociations albumino-cytoJopqne* du
Inpude ccphalo rachidien. L Enctphale, 1913, viii., Oct, p. 308,
MKRTKNS. Klinische und aerologische Untersuchungen iiber diediagaoatische
Kedeutung der Weil-K&fkaechcn Harooly sin reaktion im Liquor oewbiwpuata
L>exd. Ztschr./. Utrvenheilk., 1913, xlix., 8. 169.
fcESEEAL AHH FINtTIOlAl MIKiiBt*
Epilepsy. -CLARK, L. PIERCE, and SHARP, EDWARD A. Tht r6k which
heredity plays in inducing epilepsy in children suffering from infantile csrdnl
palay. Joum Nerv. and AferU. Dis. t 1913, xL, Oct., p. 633.
MANGKLSDORF, G. Ueber die mtindlicbe Anwendung von Brom-pwpws^
insbesondere in der Epilepsie, Ztschr. f. Jupendl. Schwachsinns, 1913, viL,
S, 117.
JODICKE, P. Ueber die atiologischen VerhSltnisse. Lebensdaoer, allgennaw
Sterblichkeit, Todesuraachen und Sektionabefunde bei Epileptikfrn. Rt&t.
f, Juijcnd. Schxcacksinn*, 1913, vii., 8. 193.
BI NSW ANGER. Die Abderhaldenache Seroreaktion bei Epileptfkern. Mink
Med. Wcktitch 1913, lx., Okt. 21, S. 2321.
Hysteria.— NICCOLAI, N. A proposito di un caao di sorditi rerhaleistcricsp^
di origine pitiatica. Rir. crit. di Clin. Med., 1913, xiv., Ott 4, p. 628
BIANCHINI. Una teoria biologica deU’isterismo. H Manicmia , 1913, unit
p. 83.
C1TELLI. Un nuovo metodo mol to effioaoe per guarire l’afonio isterica /hr.
itn/. di Nturopatoi., Psichiat . ed EUttrotcr., 1913, vi., p, 386,
BIANCHINI, LEVI. Psiooanalisi ed isterismo. II ManicovUs, 1913, xiriiL,
p. 49.
Cfcarea.—COLLIN, ANDRE. Le traitement de la ehorde. Jou m. de MU to
Paris, 1913, xxxiii., Oct 18, p. 815.
MESLAY, R. A propos d’un cas de chorde de Sydenham. Joum. de$
• 1913, xxrii., Sept. 27, p. 609.
DICK and ROTHSTEIN. A streptooooeus producing symptoms of chorea is *
dog. Joum. Amer. Med. Assoc., 1913* lxi., Oct 11, p. 1376.
Wemralgla.—SLUDER, GREENFIELD. Etiology, diagnosis, prognosis, and treat¬
ment of sphenopalatine ganglion neuralgia. Joum. Amer ; Med, Asm, 1913,
lxi., Sept. 27, p. 1201.
BIBLIOGRAPHY
129*
DALZIEL, T. K. Neuralgia of the twelfth dorsal nerve simulating visceral
lesions. Brit. Med. Journ 1913, Oct. 25, p. 1087.
SEROG, MAX. Ueber Pseudoneuralgien. Med. Klinik., 1913, ix., Okt. 26,
S. 1751.
neuritis. —RUTTIN, ERICH. Beitrag zur Frage der Polyneuritis cerebralis.
Wien. Med. Wchnschr ., 1913, Ixiii., Okt. 4. S. 2676.
REINHARDT, AD. Phlebektasien und Varizen des Nervus ischiadicus.
Frankfurter Ztschr. f. Path., 1913, xiii., S. 353.
HNAtEK, JOHANN. Lchias kyphotica. Deut. Med. Wchnschr. , 1913, xxxix.,
Okt. 9, S. 1989.
Neurasthenia* —THOMSON, H. CAMPBELL. Traumatic neurasthenia. Journ.
Ment. Sci.y 1913, lix., Oct., p. 582.
Neuroses*— HOVELACQUE, A., and VIRENQUE, M. Les apon^vroses inter-
pt^rygouliennes. Pres sc Med., 1913, lxxxii., Oct. 8, p. 817.
MARCUSE. Die phyaikaliache Therapie bei Herzneurosen und Herzkrank-
heiten insbesondere in den schlesischen Badeorten. Med. Blatter , 1913,
xxxv., Sept. 20, S. 206.
Exophthalmic Goitre, Cretinism, dc.—WATSON, L. F. Exophthalmic goitre
cured by ligating one superior thyroid artery. Med. Record , 1913, lxxxiv..
Sept. 27, p. 563.
HIRSCH. R. Thymin und seine Wirkung in der Behandlung des Morbus
Bascdowii und Thvmin als Schlafmittel. Dcut. Med. Wchnschr. 9 1913, xxxix.,
Okt. 30, S. 2141. "
KRAUS, F. Pathologie der Schilddriise, der Beischilddriise, des Hirnanhangs
und deren Wechselwirkung. Dent. Med. Wchnschr., 1913, xxxix., Okt. 2
und 9, S. 1921 und 1972.
ZUCKERMANN, HANS. Ubor einen Hypophysenbefund bei Schilddriisen-
aplasie. Frankfurter Ztschr. f. Path., 1913, xiv., S. 143.
ZUCKERMANN, HANS. Uber Schilddriisenaplasie. Frankfurter Ztschr. f.
Path., 1913, xiv., S. 126.
PERRERO, E., and FENOGLIETTO, E. Sopra un caso di polinevrite gravidica
unita a morbo di Flaiani-Basedow. Riv. de Patol. nerv. e ment., 1913, xviii.,
Ott., p. 649.
STRAUSS, H. Uber neurogene und thyreogene Galaktosurie, Neurol.
Centralbl., 1913, xxxii., Okt., S. 1281.
Tetanus. —LOEWE, S. Kurze Bemerkungen iiber die Adsorption von Tetanus-
toxin, anschliesaend an die Arbeit von E. Wolff: “Ueber das Verhalten der
Leukocyten in toxin- und toxin antitoxinbaltigen Losungen.” Ztschr. /.
Immunitatsforsch., 1913 (Teil I.: Orig.), xix., S. 362.
WEBER. Ueber den Wert dor Serumtherapie bei Tetanus. Munch. Med.
Wchnschr ., 1913, lx., Oct. 7, S. 2232.
SPECIAL SENSES AND CBAN1AL NERVES—
WORTON, A. S. Hereditary optic neuritis: eleven cases in three generations.
(Illust.) Lancet , 1913, clxxxv., Oct. 18, p. 1112.
PHILLIPS, S. L. Unilateral amblyopia and diplopia following suppressio
mensium. Med. Record, 1913, lxxxiv., Sept. 27, p. 573.
CASSIRER, R. Ein Fall von progressiver Linsenkernerkrankung. Neurol.
Centralbl., 1913, xxxii., Okt., S. 1284.
WALKER, CLIFFORD B. Topical diagnostic value of the bemiopic pupillary
reaction and the Wilbrand heinianopic prism phenomenon. Journ. Amer .
Med. Assoc., 1913, lxi., Sept. 27, p. 1152.
DOWNEY, J. W. Report of a case of monocular paralysis of the aooommodation
due to lues. Journ. Amer. Med. Assoc., 1913, lxi., Sept. 27, p. 1043.
130 *
BIBLIOGRAPHY
FREUND, C. S. Zur Klinik uod Anatomic der vertikalen Blicklfchmungen.
Neurol. CentralM 1913, xxxiL, Okt. 1, 8. 1315.
KAI8KH. Uber einen Fall von Acceasoriuslahmung duroh eine eigenartige
Stichverletzung. Drut. Ztschr. f. Nertrnheilk 1913, xlix., 8. 244.
INOALS, E. F. Diagnosia and treatment of paralysis of the rooal cord*.
Journ. Amer. Med. Assoc., 1913, Ixi., Sept. 27, p. 1221.
NIM:EiUXK4t« SYNrreNS aub casks—
OFFICER, D. M‘M. Three interesting brain cases. Australian Med. Journ.,
1913, U., Sept. 27, p. 1227.
HIKTZ and BEAUFUME. Un cas de telephonophobie. Oaz. da H6p., 1913,
lxxxvi., Oct. 28, p. 1933.
GRAVES, W. P. Relationship between gynecologioal and neurological diseases.
Boston Med. and Burg. Journ., 1913, clxix., Oct. 16, p. 557.
HARRIS, M. L. Nerve blocking as a substitute for (general anesthesia in
surgical operations. Journ. Amcr. Med. Assoc., 1913, lxi., Sept. 27, p. 1040.
CARMICHAEL, NORMAN 8. Elephantiasis Neuromatosa. Edin. Mtd.
Journ., 1913, xi., Nov., p. 421.
OKLLHOKN, ERNST, and LKWIN, HANS. Verknderungen des Blutdruckes
bei p*ychi*clieu Vorgangen an gesunden und kranken Menschen. Archtv /.
Aunt. v. Physiol., 1913 (Physiol. Abtlg.), H. iii. u. iv. t 8. 225.
HEWLETT, A. W. A case of strychnine poisoning. Amer. Journ. Med. S^i..
1913, cxlvi., Oct., p. 536.
GRECO, DEL. II largo giro di applicazioni della Psicologia morbosa ed il vario
giudizio degli nomini colti. 11 Manicmnio, 1913, xxviii., p. 21.
KOBYLINSKY, MOISSEY. Delle psicoei nel deoorso del tifo. Riv. di Patol.
nerv. e went., 1913, xviii., Ott., p. 633.
CHARON, RENE, and COURBON. PAUL. Anormalitl psychiqne et responsi¬
bility relative. LKncephale, 1913, viii., Oct., p. 315.
SIMONELLI, G1XO. A proi>osito della determinazione dell* indioe antitriptico
del siero di sangue. Riv. di Patol. nerv. e ment., 1913, xviii., Ott., p. 659.
LEVA. Ueher einige korperliche Begleiterscheinungen psychischer Vorgange,
mit besonderer Bei uckbichtigung des psychogalvauiscben Refiexphanomens.
Munch. Med. Wchnschr., 1913, lx., Okt. 28, 8. 2386.
MANN, LUDWIG. Ueber traumatisebe Entstehung spasmophiler Zustfcnde.
Neurol. CentralU., 1913, xxxii,, Okt. 1, S. 1242.
KLOSE. ERICH. Zur Kenntnis der Oateopsathyroaia idiopathica. Monatssch. f.
Kirulerheilk. (Orig.), 1913, xii., S. 347.
BUNN EM ANN. Ueber die Erklarbarkeit suggest! ver Erse hein ungen. Monatssch.
f. Psychiat. u. Neurol ., 1913, xxxiv., Okt., 8 . 349,
KUTZINSKI, A. Ueber das Fremdheitsgefiihl. Monatssch. /. Psychiat. u.
Neurol ., 1913, xxxiv., Okt., 8 . 301.
DOBLIN, A., and FLEISCHMANN, P. Ueber die nervose Regnlierung der
Korpertemperatur insbesondere iiber die Rolle der Nebenniere. Ztschr. f. Klin.
Med., 1913, lxxviii., S. 275.
SALLE, V., and APOLANT, E. Zur Frage des Adrenalingehalts der Neben-
nieren bei Thorium X-Intoxication. Ztschr. f. Klin. Med., 1913, lxxviii.,
8. 255.
HOKE, ED. Bradykardie, Hvpotonie, niedere Korpertemperatur, sigenartige
Muskelschwfcche, Neigung zu Ohnmachten (Funktionelle Nebennieren-
insuffizienz ?). Wien. klin. Wchnschr ., 1913, xxxi„ Okt. 2, 8. 1625.
BERNARD, LEON. Relations entre les syndromes surrlnaux et les troubles
des fonctious surr^nales. Presse Med., 1913, lxxxi., Oct. 4, p. 807.
BIBLIOGRAPHY
131 *
PSYCHIATRY.
fiRCEKil PABiLTftlS-
NOGUCHI, H. Par&lysie generate et syphilis. Prtsse Med., 1913, lxxxi.,
Oct. 4, p. 805.
NOGUCHI, H. Dementia paralytica und Syphilis. Berl. klin. Wchnsehr.,
1913, L., Okt. 13, S. 1884.
GEBBR, HANS, and BENEDEK, LAD. Vorkommen Ton lebeuden Spirodhaten
bei Paralysis progressiva. Wien, klin . Wchmchr ., 1913, xxvi., Okt. 2, S. 1624.
KUPPEL, M., and WEIL, M. La rlaotion d’activation da venin de cobra; sa
frequence au cours des maladies mentales; sa valeur pronostique chcz les
paralytiques g^n^raax and lee dements prAoooes. Sem. Mid., 1913, xxxiii.,
Oct. 8, p. 481.
BARNES, F. M. General paralysis in the negro. N.Y. Med. Joum., 1913,
xoriii., Oct. 18, p. 767.
BALL, CHARLES R. The nature, diagnosis, prognosis, and treatment of
general paresis. Joum. Amer. Med . Assoc., 1915, lid., Oct. 4, p. 1281.
WHITE, E. BARTON. The bacteriological examination of the urine in some
cases of general paralysis. Joum. Ment. Sci ., 1913, lix., Oct., p. 596.
DEMENTIA PEJECOX—
PINI. Ricerche sul potere osaidativo nei Dementi preooci. II Manicomio , 1913,
xxriii., p. 1.
GENERAL—
CHAMBERS, JAMES. The Prevention of the Insanities. (Presidential Address,
Med.-Psychol. Assoc.) Joum. Mental Sci., 1913, lix., Oct., p. 549.
BBNON, R. De la dAmence traumatique. Annates dCHygiine Publique, 1913,
xx., Oct., p. 307.
LAIGNEL-LAVASTINE. Les d&nences dts syphilitiques. Joum. de Mid. de
Paris, 1913, xxxiii., Oct. 25, p. 835.
FRASER, KATE, and WATSON, H. FERGUSON. The r61e of syphilis in
mental deficiency and epilepsy; a review of 206 oases. Joum. Mental Sci.,
1913, lix., Oct., p. 640.
SOUTHARD, E. E. Medical contributions to the State Board of Insanity of
Massachusetts: Introductory note. Boston Med. and Surg. Joum., 1913,
clxix., Oct. 9, p. 537.
SCHNITZER, HUBERT. Psychiatric und Fttrsorgeerziehung. Ztschr. f.
Jugendl. Schwachsinns, 1913, vii., S. 74.
GLUECK, B. The mentally defective immigrant. N.Y. Med. Joum., 1913,
xcviii, Oct. 18, p. 760.
BUNDSCHUH, R., and ROEMER, H. Ueber das Abderhaldensche Dialysierver-
fahren in der PsychiAtrie. Deut. Med. Wchnsehr., 1913, xxxix., Okt. 16,
S. 2029.
POD ALL, H. C. Prophylaxis of insanity. N.Y. Med. Joum., 1913, xcviii.,
Sept. 27, p. 620.
GETTINGS, H. S. Dysentery, past and present. Joum. Ment. Sci., 1913, lix.,
Oct, p. 605.
REID, D. M‘KINLEY. On the baoteriology of asylum dysentery in England.
Joum. Ment. Sci., 1913, lix., Oct., p. 621.
SMITH, W. MAULE. Size of hospitals for the insane and feeble-minded.
Boston Med. and Surg. Joum., 1913, olxix., Sept. 25, p. 459.
132*
BIBLIOGRAPHY
TREATMENT.*
WALLACE, C. M., and CHILD, F. S. Extract of the pituitary body of the ox in the
treatment of rheumatic arthritis. A preliminary report. Med. Record , 1913,
ixxxiv., Oct. 4 t p. 608.
ENGELEN. Beitrag zur Freudschen Psychoanalyse. Deut. Med. Wchntchr ., 1913,
xxxix., Okt. 16, 8. 2048.
* A number of references to papers on Treatment are included in the Bibliography under
individual diseases.
Bibliography
ANATOMY.
STOCKARD, CHARLES R. An experimental study of the position of the optic anlage
in Amblystoma punotatum, with a discussion of certain eye defects. A met. Journ.
Anat., 1918, xv., Nov., p. 253.
DANDY, W. E. The nerve supply to the pituitary body. Amer. Journ. Anat ., 1913,
xv., Nov. p. 333.
HUBER, G. C., and GUILD, D. R. Observations on the peripheral distribution of the
nervus terminalis in Mammalia. Anat. Record , 1918, vii,, Aug., p. 258.
JOHNSON, A. E. The principles underlying the distribution of the nerves to the
limbs. Archives of Middlesex ffosp., 1913, xxix., p. 28.
PHYSIOLOGY.
MEYER, M. Klinischer Beitr&g zur Kenntnis der Funktionen des Zwischenhirns.
(Enoephalitis corporum mamimllarium). Ztschr. f. d . ges. Neurol . ti, Psychiat.
(Orig.), 1918, xx., S. 327.
ROTHMANN, MAX. Die Funktion des Mittellappens dee Kleinhirns. Monattic hr. f.
Psychiat. u . Neurol ., 1913, xxxiv., Nov., S. 389.
ROSSI, G. Sui rapporti funzionali del cervelletto con la zona motrice della corteccia
cerebrale. Archivio di Fisiol ., 1913, xi., p. 258.
DOLLEY, D. H. The morphology of functional depression in nerve cells and its
significance for the normal and abnormal physiology of the cell. Journ. Med.
Research , 1913, xxix., Oct., p. 66.
D'ABUNDO, G. Sulla probabile funzione del nucleo lenticolare. Riv. ital. di
Neurop. t Psichiat. ed Elettroter ., 1913, vi., Ott., p. 433.
PAGANO, G. Observations sur quelques cbiens sans cerveau. Arch. ital. di Biol.,
1913, lx., Oct., p. 71.
DIXON. W. E.. and HALLIBURTON, W. D. The cercbro-spinal fluid. I. Secretion
of the fluid. Journ. Physiol ., 1913, xlvii., p. 216.
DEL PRIORE, N. L aotion du lujuide c^phalo-rachidien, du sue des plexus ohoroides
et de quelques organes, et de diverts substances sur le coeur isole ae lapiu. Arch,
ital. di Biol., 1913, lx., Oct., p. 1.
SOROKINA-AGAFONOWA. Sur lea modifications du systfeme periph^rique nerveux
chez les iusectes durant 1a metamorphose- Cotnpt. Rend. d. 1. Soc. de Biol., 1913,
lxxv., Nov. 14, p. 369.
SHERRINGTON, C. S. Further observations on the production of reflex stepping by
combination of reflex excitation with reflex inhibition. Journ. Physiol 1913,
xlvii., p. 196.
VERWORN, MAX. Die allgemein-physiologischen Grundlagen der reriproken
Innervation. Ztschr. /. allg. Physiol ., 1913, xv., S. 413.
CANNON, W. B., and BURKET, I. R. The endurance of anemia by nerve cells in the
myenteric plexus. Amer. Journ. Physiol ., 1913, xxxii., p. 347.
CARLSON, A. J. The inhibitory reflexes from the gastric mucosa. Amer. Journ.
Physiol ., 1913, xxxii., Nuv,, p. 389.
KATSCH, G. Der mcnscbliche Darin bei phannakologischer Beeinflu*sung seiner
Innervation. Fortsckr. a . d. Gcb. d. Rontgcnstrahlcn , 1913, xxi., S. 159.
KLEE, PH. Der Einfluss der Splancbnicusreizung auf den Ablaut der Verdauungs-
bewegungen. Rontgenversuche au der Katzo. Pfliiger's Archiv ., 1913, cliv.,
8. 552.
H
1 «*
134*
BIBLIOGRAPHY
SCAFFIDI, V. Sulla fun riant dei musooli immobilixxati mediants il taglio dei nerri
inotori. Ztschr. f. ally. Physiol., 1913, xv., 8. 329.
SCHWARTZ, ALFRED. Uber das galvanische Verhalten der konstant durchstromten
Froschant bei Reizung ibrer Nerven. Anderung der Polarisation durch die Erregung.
Zcntralb. /. Physiol., 1913, xxvii., p. 734.
MACNAUGHTON, MARJORY. The action of protoveratrine and aoonitine on the
neuro muscular apparatus of the frog. Quart. Joum. Exp. Physiol., 1918, Tii.,
p. 129.
SICCARDI, P. D., and LOREDAN, L. Sur la contraction dee fibres lieeee dee
vaisseaux, specialement par rapport k Faction dee extraits d'organee. Arch. ital. dr
Biol., 1913, lx., Oct., p. 19.
FROLICH and PICK. Zur Kenntnie der Wirkungen der HTpophysenpr*parate. I.
Wirkung auf Lunge und Atmung. II. Wirkung auf die Blutgefieee dee Froeches
III. Kesinflussung der Ergo toxin wirkung durch Hypophysin. Arch. f. exp. Path.
u. Pharmnkol ., 1913, xxiv., S. 92.
HECHT, A. F., and NADEL, V. Experimentelle Unterenohungen Uber die Wirkung
von Hypophysenextrakten mit Hilfe der Elektrokardiographie. Wien. klin.
Wchnschr 1913, xxvi., Nov. 20, S. 1927.
KING, C. E., and STOLAND, O. O. The effect of pituitary extract upon renal
activity. Amcr. Joum. Physiol ., 1913, xxxii., Nov., p. 405.
VELDEN, R. v. d. Die Nierenwirkung von Hypophysenextrakten beim Menechen.
Berl. klin. Wchnschr ., 1913, 1., Nov. 17. 8. 2083.
FARRANT, R. Hyperthyroidism : its experimental production in animals, (lllust.)
Brit. Med. Joum., 1913, Nov. 22, p. 1303.
I SCO VE SCO, H. Action physiologique, en particulier sur la croiuance d un lipoide
(11 Ba) extrait de la thyroids. Compt. Rend. d. 1. Soc. dc Biol., 1913, lxxv.,
Nov. 14, p. 361.
CARLSON, A. J. The tonus and hunger contractions of the empty stomach during
parathyroid tetany. Amcr. Joum. Physiol ., 1913, xxxii., p. 398.
VIGNES, H. Influence de la masse hibernale sur diverses intoxications (adrenaline—
chloroformo—toxine tetanique). Compt. Rend. d. 1. Soc. dc Biol., 1913, lxxv.,
Nov. 21, p. 397.
GOOD ALL, J. 8., and EARLE, H. G. The physiology of the posterior roots in the
light of recent surgical procedures. Archives of Middlesex Hosp ., 1913, xxix., p. 7.
PSYCHOLOGY.
BALLARD, P. B. Oblivitcenoe and remiuiscenoe. Brit. Joum. Psychol., Monograph
Supplements, Vol. I., 1913.
ABBOTT, E. STANLEY. Psychology and the medical schools. Amcr. Joum.
Insanity, 1913, lxx., Oct., p. 447.
LAHY, J. M. Une calculatrice-prodige (7 fig.). Arch . de Psychol., 1913, xiii., Sept.,
p. 209.
CLAPAREDE, ED. Encore les chevaux d’Elberfeld. Arch, dc Psychol., 1913, xiii.,
Sept., p. 244.
URBAN, F. N. Der Eintluss der Ubung bei Gewichtsversuchen. Archiv. /. d. gcs.
Psychol ., 1913, xxxix., 8. 271.
SCHLESINGER, A. Der Begriff des Ideals. III. Empirisch—peyehologieche
Untersuchung des Idealerlebnisses. Archiv. /. d. gcs. Psychol., 1913, xxix., S. 312.
BENUSS1, V. Kinematohaptische Erscheinungen. (Vorlaufige Mitteilung fiber
Scheinbewegungsauffassung auf Grund haptischer Eindrucke). Archiv. f. d. gts.
Psychol., 1913, xxix., S. 385.
WITTMANN, JOH. Uber die russenden Flammen und ihre Verwendung xu Vokal*
und Sprachmelodie-Untersuchungen. Archiv. /. d. gcs. Psychol., 1913, xxix.,
S. 399.
HENNIG, R. Zur Theorie der “ fausse reconnaissance.” Ztschr. f. Psychothcrapie u
mcd. Psychol., 1913, v., S. 257.
BIBLIOGRAPHY
135 *
FLATAU, G. Zur Psychologic des Schaingeflihls. Ztzchr. j. Pst/ckotkcrapic u. med.
Psychol., 1913, v., S. 269.
STERNBERG, W. Die Psychologic des Genusses. Ztschr. f. Psychotherapic u. med.
Psychol ., 1913, v., S. 293.
HILLEBRAND, FRANZ. Die Aussperrung der Psychologen. Ztschr. f. Psychol .,
Abt. I., 1913, lxviL, S. 1.
RANSCHBURG, PAUL. Uber die Wechselwirkungen gleichzeitiger Reize im Nerven-
system und in der Seele. Ztschr. /. Psychol ., Abt. I., 1913, lxvii., S. 22.
GERTZ, HANS. Uber die kompensatorische Gegenwendung der Augen bei spontan
bewegtem Kopfe (Schluss). Ztschr. f. Sinnesphysiol ., Abt. II., 1913, xlviii., S. 1.
FROHLICH, F. W. Beitr&ge allgemeinen Physiologic der Sinnesorgane. Ztschr. f.
Sinnesphysiol ., Abt. II., 1913, xlviii., S. 28.
PATHOLOGY.
SOUTHARD, E. E., and CANAVAN, M. M. Bacterial invasion of blood and cerebro¬
spinal fluid by way of lymph-nodea. Findings in lymph-nodes draining the pelvis.
Joum. Amer. Med. Assoc., 1913, lxi., Oct. 25, p. 1526.
MARGULIS, M. S. Pathologische Anatoinie und Pathogenese der Ependymitis
granulans. Archiv. f. Psychiat., 1913, lii,, S. 780.
FONTANA K SANGIORGI. Treponema nel cervello. Pathologica, 1913, exxi., Nov.,
p*677.
STEINHARDT, EDNA. A preliminary note on Spirochccta pallida and living tissue-
cells in vitro. Joum. Amer. Med. Assoc., 1913, lxi., Nov. 15, p. 1810.
SERONO, C., and PALOZZI, A. Sur les lipoides contenus dans la substance nerveuse.
Arch. ital. di Biol., 1913, lx., Oct., p. 136.
MAIR, W. On the lipoids of ancient Egyptian brains. Joum. Path, and Bad., 1913,
xviii., Oct., p. 179.
LISI, L. dk, and SIMONELU, G. Sulla determinazione del potere antitriptico del
siero di sangue. Bcr. di Patol. nerv. e merit., 1913, xviii., Nov., p. 727.
BUSCAINO, V. M. Grassi, sterine e lipoidi nel aistema nervoso centrale in condizioni,
normali, sperimentali e patologiche. Riv. di Patol. nerr. e mint., 1913, xviii.,
Nov., p. 673.
FERELMANN. Proccde rapide pour la coloration combine des fibres k myeline et des
cellules nerveuses. Rev. Neurol., 1913, xxi., Nov. 15, p. 523.
MOLNAR, B. Klinisch diagnostizierter Fall von primarem Nebenuierenmelanom.
Ztschr. f. klin. Med., 1913, lxxviii., S. 454.
CLINICAL NEUROLOGY.
GENERAL—
FLEXNER, SIMON. The local specific therapy of infections. II. Treatment of
certain infections. Joum. Amer. Med. Assoc., 1913, lxi., Nov. 22, p. 1872.
PULLEY, W. J. The reflex or protective phenomena of angina pectoris. N. Y
Med. Joum., 1913, xcviii., Nov. 8, p. 918.
NERVES—
TUBBY, A. H. Some additional experiences of nerve surgery (Illustr.). Lancet ,
1913, clxxxv., Nov. 8, p. 1312.
MARTEL, M. T. DK. La technique operatoire en chirurgie nerveuse. Gaz . des
H6p., 1913, lxxxvi., Nov. 13, p. 2045.
GOULD, Sir A. P. Posterior spinal neurectomy for the relief of pain in certain
cases of incurable cancer. Archives of Middlesex Hosp., 1913, xxix., p. 1.
CADWALADER, W. B., and SWEET, J. E. Experiments of intradural anas¬
tomosis of nerves for tho cure of paralysis. Med. Record , 1913, Ixxxiv., Nov. 1,
p. 800 .
136 *
BIBLIOGRAPHY
mrftCLEfr—
CAMP, CAKL D. A contribution to the study of hereditary degeneration (peeudo-
hypertrophic mutoultf dystrophy in combination with degeneration in the
central nervous system). Amer. Joum. Med. Sci., 1913, cxlvL, Nov. f p. 716.
spinal ceip-
Generml.— ROTHMANN, MAX. Zur Frage der kombinierten Strangerkranknngen
des Rucken marks. Neurol. Centralbl., 1913, xxxii, Nor. 1, S. 1363.
LUSSANA, F. Modification! delle funrioni riflesse spinali in presents di sostanxe
diverse aventi rapporto col rioambio materiale dell* organ tun o. Arcktvio d\
Pistol. y 1913, xi., p. 269.
MING AZZINI, G. Sur quelquea “ petite signes * des paresies organiquee (3 figs.).
Rev . Neurol., 1913, xxi., Oct. 30, p. 469.
HASEBROCK, K. Zur phylogenetisohen aufifassung der spastischen Kontrak-
turen. Berl. klin. Wchnschr., 1913, 1., Nor. 3, S. 2046.
PA8TINE, C. Sur le reflexe controlat^ral des orteils. VEneephale, 1913, viii,,
Nov., p. 417.
MALONEY, J. M. A. Fear and ataxia. Joum . Nerv. and Meni. Dis., 1913,
xl., Nov., p. 681.
Fraclnre, Dislocation, *c*—JANSEN, MURK. Die physiologisehe Skolioee und
ihre Ursachs. Ztschr. f. Ortkopad. Chir., 1913, xxxiii., 8. 1.
MAYET and DELAPCHIER. Skoliose und Appendicitis chronica. Ztschr. f.
Or(hop<>d. Chxr., 1913, xxxiii., S. 260.
RiEDEKEK, C. Quclqucs mots sur la m^thode d'Abbott dans le traitement dee
scolioses graves. Joum. de Mid . de Parity 1913, xxxiii., Nov. 15, p. 895.
Hpiu •illda.—FROELICH. Is it necessary to operate in spina bifida? Med.
Press , 1913, cxlvii., Nov. 5, p. 496.
DUNCKER, F. Der Klauenhohlfuss und verwandte progressive Deformitaten
als Folgeerscbeinungcn von spina bifida occulta. Ztschr. /. Ortkopad . Chir.,
1913, xxxiii., S. 131.
BIBKRGEIL, E. Die Beziebungen der Spina bifida occulta sum Klauenhohlfuss.
Ztschr. /. Ortkopad. Chir., 1913, xxxiii., 8. 225.
Tabes Dorsalis.— DREY and MALESINE. Le tabes amyotrophique. Loon
Med., 1913, exxi., Nov. 9, p. 749.
TAYLOR, U. L. Charcot joints as an initial or early symptom in tabes dorsalis.
Joum. Ai/icr. Med. Assoc., 1913, lxi., Nov. 15, p. 1784.
RIGGS, C. K. Report of a case of juvenile tabes. Joum. Ncn\ and Ment.
Dis., 1913, xl., Nov., p. 711.
BAEYER. Mechanischc Behandlung der tabischen At&xie. Munch. Med.
Wchnschr., 1913, lx., Nov. 25, 8. 2621.
Poliomyelitis Anterior Acuta*—MAGRUDER, E. P. Infantile paralysis.
(10 Illust.) N. Y. Med. Joum., 1913, xcviii., Nov. 8, p. 908.
KLING, C., and LKVAD1TI, C. Etudes sur la poliomy61ite aigue epidemique
(Deuxieme partic). Annales de Unstttut Pasteur , 191o, xxvii., p. 839.
BATTEN, F. E. The use of celluloid splints in the treatment of acute cases of
poliomyelitis and other nervous diseases. Clin. Joum., 1913, xlii., Nov. 26,
p. 529.
MAGRUDER, E. P. Infantile paralysis affecting the lower extremities; its
suigical treatment and possibilities of cure. Journ. Amer. Med. Assoc., 1913,
lxi., Nov. 8, p. 1705.
RYERSON, E. \V. The surgery of infantile paralysis. Joum. Amer. Med .
Assoc., 1913, lxi., Nov. 1, p. 1614.
HAUSHALTER and JACQUOT. Mcuingite subaigue a bacilles de Pfeiffer a
la suite d’une paralysis spinale infantile. Arch, de Med. des Enf., 1913, xvi.,
Nov., p. 845.
KOFMANN, 8. Muskelverlagcrung als Methods der Beseitigung der paraly-
tischen Deformitat. Ztschr. f. Orthupdd. Chir., 1913, xxxiii., 8. 107.
BIBLIOGRAPHY
137 *
Meningitis. —SUDHONARAIN. Epidemic cerebro-apinal meningitis. Indian
Med. Gaz., 1913, xlviii., Nov., p. 431.
ONG, H. A. Serum treatment of epidemic cerebro-spinal meningitis. Archives
of Ped., 1913, xxx., Oct., p. 781.
SCHWARTZ, T. Beitrag rar Dystrophia adiposo-genitalis (Typ. Frohlich)
verursacht durch Meningitis serosa. St Petersburger Med. Ztschr ., 1913,
xxxviii., S. 310.
PICK. A. Geheilte tuberkulose Meningitis; zugleich ein Beitrag zur aphasie
der Polyglotten. Prager Med. Wchnschr ., 1913, xxxviii., Nov. 13, S. 635.
ALLAN, GEO. A. Tuberculous meningitis (bovine infection) in an infant aged
12 weeks. Lancet, 1913, elxxxv., Nov. 29, p. 1535.
SPAT, WM. Der Zellbefund bei Meningitis. Prager Med. Wchnschr., 1913,
xxxviii., Nov. 20, S. 650.
CIARLA, E. Beitrag zura pathologisoh-anatomischen und klinischen Studium
der Pachymeningitis cerebralis hemorrhagica. Arehiv. f. Psychiat., 1913,
lii., S. 439.
HADA, BENZO. Uber die Gehirnkomplikationen des Keuchhustens mit
besonderer BerUcksichtigung der “Pachymeningitis productiva interna.”
Virchow's Arehiv , 1913, ccxiv., S. 206.
PASTEUR, W. Fatal meningitis ooourring fifteen years after a bullet wound
of the brain. Archives of Middlesex Hosp., 1913, xxix., p. 14.
GOLDBERG, J., and OCZESALSKI, K. Ein Fall von Lyssa mit msningi-
tischen Symptomen. Wien, klin. Wchnschr ., 1913, xxvL, Nov. 27, S. 1981.
Syringomyelia.—KLOTZ, OSKAR. Syringomyelia: with autopsy findings in
two oases. Amer. Joum. Med. Sex., 1913, cxlvi., Nov., p. 681.
CRAIG, C. B. Mild manifestations of syringomyelia, with report of three cases.
Med. Record, 1913, lxxxiv., Oct. 25, p. 747.
DEJERINE. Lea types principaux de la syringomy&ie. Joum. des Prat.,
1913, xxvii., Nov. 15, p. 742.
JAKSCH, R. v. Uber einen Fall von Syringomyelie mit symptomen der
Verknocherung oder Verkalkung der Skelettmuskulatur, Prager Med.
Wchnschr., 1913, xxxviii., Nov. 20, S. 647.
Paraplegia.— LITTLE, E. M. Remarks on the treatment of spastic paraplegia.
(Little's disease). Brit. Med. Joum., 1913, Nov. 1, p. 1132.
Von Recklinghausen's Disease.— BERTEIN, M. P. Contribution h l'etude des
formes frustes de la maladie de Recklinghausen. Gaz. des H&p., 1913, lxxxvi.,
Nov. 20, p. 2093.
MURAKAMI, S. Zur pathologischen Anatomic und Pathogenese des Buph-
t halm us bei Neurofibromatosis. Klin. Monatsbl. f. Augenheilk ., 1913, li.,
S. 514.
Psendo-Bnlbar Paralysis.— OETTINGER, B. A case of pseudo-bulbar paralysis,
f presenting facial spastic movements simulating laughter. Med. Record , 1913,
xxxiv., Oct. 25, p. 737.
ZAPPERT, J. Uber einen epileptiformen pseudobulbaren Symptomenkomplex
mit gunstigem Verlauf. Ztschr. f. Kinderheilk., 1913, ix., S. 111.
BRAIM—
General.—KOSTER, H. Uber kranielle GerSusche. Zentralbl. f. innere Med.,
1913, xxxiv., S. 1145.
STIEDA, A. Beitrage zur Gehirnchirurgie, Arehiv. f klin. Chir., 1913, cii.,
S. 873.
Abscess.— MURPHY, JOHN. Brain abscess of aural origin. Joum. Laryngof.,
Rhinol. and Otol. , 1913, xxviii., Nov., p. 587.
Hfenarrhage. — WEINLANDER, G. E. Apoplexie mit letalem Ausgang nach
Lumbalpunktion bei Uramie. Wien. klin. Wchnschr., 1913, xxvi., Nov. 27,
S. 1984.
WHI.IOCIIAPHY
. 4 nfurl<tm SILVAN, C. .Supra una aingolare forma di anomalia dvH’artetii
vertebiale con succo*siva expansion* aneurisrnatica, comprimente il raiiUllo
cervical* t* il bulbo rachideo. Lo N/x rimcntaU, 1913, lxvii., p. 614.
t'rrfbfllon —SALVETTI, 0. Contributo alio studio dinico delle sindromi
cerebellari. Ilir. cnt. di Cim. Med., 1913, xiv., Nov, 1, p. 692.
CASTEX. Un nouveau rortexe chez un ku jet presentaut un syndrome c^nbelleuv.
Her. Neurol 1913. \xi., Nov. 1'), p. 517.
TiM«vr«—MOORHEAD, T. G. Remarks on the localisation of intracranial
tumour*. Med. Press, 1913, cxlvii., Nov. 12, p. 525.
ROPER, E. Nach Palliativtrepanation regresaiv gewordener basaler Hirntumor.
Monatssch. f. Psuchmt. u. Neurol., 1913, xxxiv., Nor., p. 470.
(’11’FFINL I\ Osservazioni cliniche ed anatomo patologiche sopra i tum^ri
della pia cerebrale. Jiiv. di I'atol. nerv. e merit., 1013, xviii., Nov., p. 7U9.
JDMKNTIE, J. A propoa d’une autopsie de tumeurde 1‘angle ponto-cercbelleux,
pratiques trois ans apres une operation decompressive. (3 figs.) Rc*\ Sturdy
1013, xxi., Oct. p. 47-4.
KRATSK, FEDOR. Vngewohnliche Kleinhirngeschwulst, durch operation
gcheilt. Jirrl. k/tn. Wchnschr. f 1013, 1., Nov. 24. S. 2160.
OPPENHKIN, H., and BORCHARDT, M. Erfahrungen bei Operationen von
Kleinhirngeschwulsten. Berl. klin. HV/ui.Wir., 1013, 1., Nov. 3, S. 2025.
rilallary Tonosm, Ac.—TAYLOR, A. S. A case of tumour of the pituitary
hotly. (Must.) Ijuncet, 1913, clxxxv., Nov. 22, p. 14t>4.
HARRIS, WILFRED, and GRAHAM. CECIL. A case of pituitary tumour and
sellar decompression. (lllust.) Lancet, 1913, clxxxv., Nov. 1, p. 1251.
FRAZIER, C. H. A case of tumour of the hypophysis partially removed by tbe
transfrontal method of approach. Journ. Amer. Med. Assoc., 1913, lii.,
Nov. 1, p. 102b.
THOMSON, H. C., and LANG, WM. On failure of vision and its treatment in
pituitary disease. Archives of Middlesex Hasp 1913, xxix., p. 17.
BOER, W. Hypophysiserkrankungen und Augensymptome mit Bericht iber
drei beobachtete Falle. Klin. Monatsbl . /. Augcnheilk ., 1913, li., S. 553.
InfhmtllUm.—ZUNDEL, C. E. Infantilism. Practitioner, 1913, xci. f Nov.
p. 681 .
STETTEN, PR WITT, and ROSENBLOOM, JACOB. Clinical and metabolic
atudie* of a case of hypopituitarism due to cyst of the hypophysis with
infantilism of the Lorain type (so-called typhus Frcehlich or adiposo genittl
dystrophy of Bartels). Amer. Journ. Med. Sri. , 1913, cxlvi,, Nov., p. 731.
Aphasia, Ac.-— FROSCHEL8, E. Uber die Behandlung der Aphasien. Mfd.
Blatter, 1913, xxxv., Nov. 15, S. 253.
Ayplallfla.—HENDERSON, D. K. Cerebral syphilis. A clinical analyst of
twenty-six cases—seven with autopsy. Amer. Journ, Insanity, 1913, lix.,
Oct., p. 281.
VERSE. Ueber das Vorkommen’ der'Spirochaete pallida bei friih- und spat-
syphilitischen Erkrankungen des Zentralnerven-systems. Miinch. 3/ft/.
Wchnschr., 1913, lx., Nov. 4, S. 2446.
FOSTER, GEORGE B. The Noguchi luetin reaction in syphilis. Amr.
Journ. Med. Set., 1913, cxlvi., Nov., p. 645.
ZIGLER. M. A plea for more intensive mercurial medication in syphilis. N. Y.
Med. Journ., 1913, xcviii., Oct. 25, p. 819.
NEWHAM, H. B. Cases of syphilitic pyrexia. Journ. London School Trop.
Med., 1913, ii., Nov., p. 199.
GIBBARD and HARRISON. The treatment of syphilis in its earlier stage*.
Brit. Med. Journ., 1913, Nov. 22, p. 1341.
UHLENHUTH, P., and MULZER, P. Weitere Mitteilungen fiber Ergebaisw
der experimentellen Syphiliaforschung. Berl. klin. Wchnschr. ,1913, l, Nov. 3,
S. 2031.
BIBLIOGRAPHY
139 *
LIER, W. Ueber Abortivbehandlung der Syphilis. Deut. Med., Wehnschr
1913. xxxix., Nov. 13, S. 2247.
KERL, W. Zur Abortivbehandlung der Syphilis. Wien. Win. Wehnschr., 1913.
xxvi., Nov. 13, S. 1893.
SACHS, O. Zur Friihbehandlung der Syphilis. Wien. Win. Wehnschr ., 1913,
xxvi., Nov. 13, S. 1896.
SPITZER, L. Zur Kasuistik der Syphilis. Wien. Win. Wehnschr., 1913, xxvi.,
Nov. 13, S. 1896.
fcalvarsan.—DUGUID, J. H., and GRAHAM, W. T. Death from syphilis
ooeurring nine days after injeetion of salvartan. Joum . Roy. Army Med.
Corps, 1913, xxL, Nov., p. 582.
KLOTZ, HERMANN G. A plea for oily injections of salvarsan. N. Y. Med .
Joum., 1913, xcviiL, Nov. 1, p. 865.
MORRIS, Sir MALCOLM. Two years' experience with salvarsan. Lancet,
1913, dxxxv., Nov. 1, p. 1243.
LAB AND, L. Die Ohrstorungen bei Salvarsan. (Sammelreferat.) Internal.
Zentralbl.f. Ohrenheilk , <fcc., 1913, xi., S. 459.
MULLERN- ASPEGREN, V. Beitrag zur Abortivbehandlung der Syphilis mittels
Salvarsan. Derm. Ztschr ., 1913, xx., S. 992.
GENNERICH. Weitere Beitrage zur Reinfectio syphilitica nach Salvarsan und
zur Biologie der humanen Syphilis (Schluss). Miinch. Med. Wehnschr ., 1913,
lx., Nov. 4, S. 2460.
BOAS. Zwei F&lle von Reinfektion bei Salvarsan-Quecksilberhandelten Patienten
nebet einer Zusammenstellung unserer Resultate mit der kombinierten Beband-
lung. Miinch. Med. Wehnschr ., 1913, lx., Nov. 25, S. 2620.
OBERMILLER. Arsen und Salvarsanwirkung, ein Nachtrag zu meinen Arbeiten
Uber die Nebenwirkungen des Salvarsan. Berl. Klin. Wchnsch „ 1913, 1.,
Nov. 3, S. 2045.
MUCHA, V., and KETRON, L. W. Uber Organveriinderungen bei mit Salvarsan
behandelten Tieren. Wein. Med. Wehnschr ., 1913, lxiii., Nov. 1, S. 2909.
SCOTT, G. B. The treatment of syphilis at the Royal Naval Hospital, Chatham.
Brit. Med. Joum., 1913, Nov. 22, p. 1344.
Neaealvarsam.—ROBERTSON, H. E. Studies of the neoroeis following injections
of salvarsan and neosalvarsan. Joum. Amcr. Med. Assoc., 1913, lxi., Nov. 8,
p. 1698.
SHAW, T. B. Salvarsan and neosalvarsan in the treatment of syphilis. Joum.
State Med., 1913, xxL, p. 661.
FRUHWALD. Ueber konzentrierte intravenose Neosalvarsaninjektionen.
Miinch. Med. Wehnschr ., 1913, lx., Nov. 11, S. 2512.
CUTTER, J. ASHBURTON. Neosalvarsan and malaria: a personal experience.
N.Y. Med . Joum., 1913, xcviii., Nov. 1, p. 864.
Wassemau Meactloii.—MACCORMAC, HENRY. Syphilitic disease of the
brain and oord: its treatment by salvarsan, and the diagnostic value of
the Wassermann Reaction. Archives of Middlesex Hasp., 1913, xxix., Oct.,
p. 38.
HEIDINGSFELD, M. L. Clinical and laboratory salvarsan relapses and their
remedy. A serologic study of six hundred and fifty-one cases, oovering nine
hundred and fifty-two intravenous administrations and three thousand three
hundred and four Wassermann examinations. Joum. Amcr. Med. Assoc., 1913,
lxi., Nov. 1, p. 1598.
LUCAS, W. P. Note on the importance of the Wassermann reaction from a
prognostic as well as a diagnostic standpoint. Archives of Ped., 1913, xxx.,
Oct., p. 747.
STENDER, OTTO. Zur Klinischen Bedeutung der Wassermannschen Reaktion.
St Petersburger Med. Ztschr., 1913, xxxviii, S. 304.
ELIA8BERG, J. Die Herz- und Gefbsserkrankungen im Lichte der Waaser
mann’sohen Reaktion. St Petersburger Med. Ztschr., 1918, xxxviii,, S. 283.
140 *
BIBLIOGRAPHY
GULADSK, J. Die Wassermannsche Reaktion in der pathologisohen Anatomic.
Ccntralbl. /. Bakter ., Ac. (Orig.), 1913, lxxi., 8. 329.
NAKANO, H. Untersuchung liber das Wesen der Wassermannschen Reaktion.
Ztschr.f. Hygiene , Ac., 1913, lxxvi., 8. 39.
KAPLAN, D. M. y and M'CLBLLAND, J. £. A quantitative chemical reaction
for the control of positive Wassermann reactions. N. Y. Med. Joum., 1913,
xcviii., Nov. 22, p. 1012.
GROSZ, 8., and VOLK, R. Syphilistherapie und Wastermannsche Reaktion.
Wien . klin. Wchnschr 1913, xxvi., Nov. 13, S. 1890.
REZZA, A. Effetto della somminiatrazione di alcool sulla reaxione di Wasser-
mann. Riv. ital. di Neuropat ., Psichiat. ed Elettrotcr., 1913, vi., Ott., p. 464.
DESMOULIERE, A. L'antigbne dans la reaction de Wassermann. Prene mid.,
1913, Nov. 9, p. 898.
LEREDDE and RUBINSTEIN. Reaction de fixation du complement et pouvoir
himolytique des serums humains. Procedi de Wassermann et procide de
Hecht-Weinberg. Ztschr . /. Immunitdtsforschung , 1913, xix., 8. 499.
Mt)LLER, R., and STEIN, R. O. Bemerkungen zur Cutireaktion bei Lues
und ihre Beziehungen zur Wassermann’schen Reaktion, BerL Jdin.
Wchnschr ., 1913, 1., Nov. 24, 8. 2184.
EPSTEIN, ALOIS. Uber die Bedeutung der Wassermann’schen Reaktion in
der Sanglingsfursorge. Prager Med. Wchnschr ., 1913, xxxviii., Nov. 6, 8. 621.
HA AN, J. DE. Uber das Vorkommen der Wassermann'schen Reaktion bei
akuten Malariakrankheiten in den Tropen. Archiv. f. Schifft - u. Tropen-
Hygiene , 1913, xvii., 8. 693.
Cerebra-Bpftaal Flnld.—PRATORIUS, P. Milzbranddiagnose durch Unter¬
suchung der Liquor zerebrospinalis. St. Petersburger Med . Ztschr., 1913,
xxxviii., S. 290.
DEBRE, ROBERT, and PARAF, JEAN. Coagulation massive dn liauide
oiphalo-r&chidien ditermini par une miningite bacillaire. Preset mid., 1913,
Nov. 22, p. 952.
GENERAL AND FUNCTIONAL DIfi EASES—
Epilepsy.—BABINSKI. Epilepsie hystirique. Journ. des Prat., 1913, xxvii.,
Nov, 1, p. 712.
WALSHE. 8. J. A. H. Case with comments. Effect on the mental state of
minor and major attacks in epileptic insanity. Practitioner , 1913, xci., Nov.,
p. 715.
EHRHARDT, A. Ein statistischer Beitrag zur Entstehung der Epilepsie, AUg.
Ztschr.f. Psychiat., 1913, lxx., 8. 937.
CLARK, L. PIERCE. A clinical contribution to the irregular and nnusual
forms of status epilepticus. Amer. Joum. Insanity , 1913, lxx., Oot., p. 335,
RODIET, A. La cure de disintoxication et les injections salies dans le traitment
de Tepilepsie. Journ. de Mid . de Paris, 1913, xxxiii., Nov. 29, p. 936.
ALLERS, R., and SACRISTAN, J. M. Vier Stoffwechselversuche bei Epilepti-
kern. Ztschr. f. d. ges . Neurol, u. Psychiat. (Orig.), 1913, xx., 8. 305.
CORSY. Myoclonie epileptique. Bull, de VAcad.de Med., 1913, lxx., Oct. 28,
p. 293.
GRAETZ, MARTIN. Bpasmophilie und Epilepsie. Neurol. Ccntralbl ., 1913,
xxxii., Nov. 1, 8. 1306.
Hysteria.—GLYNN, T. R. Hysteria in some of its prospects. (Bradshaw
lecture.) Lancet , 1913, clxxxv., Nov. 8, p. 1303; Brit. Med . Journ., 1913,
Nov. 8, p. 1193.
KREUSER, FRITZ. Zur Differentialdiagnose swischen Hebephrenic und
Hysterie. AUg. Ztschr. f. Psychiat ., 1913, lxx., 8. 873.
Cfeorea*—BOYD, WM. A. Hereditary chorea, with report of a case. Boston Med.
and Surg. Journ., 1913, olxix., Nov. 6, p. 680.
BIBLIOGRAPHY
141 *
SHANNON, GEO. A. Note* on Huntington's Chorea. Canadian Med. Assoc.
Joum., 1913, iii., Nov., p. 962.
v. NIESSL-MAYENDORF. Uber die Uraaohe der choreatiachen Zuokung
(Sohluas). Fortsehr. d. Med., 1913, xxxiv., S. 1216.
CLAUDE, HENRI. Choree persistants et tica. Joum. dtt Prat., 1913, xxvii.,
Nov. 8, p. 721.
Mcaralgla. —SHIELDS, N. T. The etiology of trifaoial neuralgia or tic douloureux
and clinical treatment. Joum. Amer. Med. Assoc., 1913., lxi., Nov. 22, p.
1892.
RAMOND, F., and DURAND, J. Lea n^vralgiea du plexua brachial. Prog.
Mid., 1913, xli., Nov. 27, p. 614.
LAPINSKY, M. Die latente Form der Neuralgic dea N. oruralia und ihre
diagnoatiaohe Bedeutung bei den Erkrankungen der Organe dea kleinen Bee kens.
Ztschr. f. d. ges. Neurol, u. Psychiat. (Orig.), 1913, xx., S. 386.
Wewitla.— JULLIEN. Sur quelques polyndvrites et quelquea ced&mes observes
chez lee tirailleura noire en aervice au Maroo. Presse mtd., 1913, Nov. 1, p. 888.
Wemrasthemta. —PERSHING, H. T. Neurasthenia an increased auaoeptibility to
emotion. Joum. Amer. Med. Assoc., 1913, lxL, Nov. 8, p. 1675.
RUSSELL, J. S. RISIEN. The treatment of neurasthenia. Lancet , 1913,
clxxxv., Nov, 22, p. 1453.
Kemroses. —RAFF. Blutdruokmeaaungen bei Alkoholikeru und funktionellen
Neuroaen unter Ausschluas von Kreielaufstorungen. Deut. Archiv. f. Klin .
Med., 1913, cxi., S. 209.
SAVAGE, Sib GEORGE H. Clinical lecture on post-influenzal neuroses and
psychoses. Med. Press, 1913* oxlvii., Nov. 26, p. 578.
FRINK, H. W. The sexual theories formed in early childhood, and their rile in
the psychoneuroses, N.Y. Med. Joum., 1913, xoviiL, Nov. 15, p. 949.
ROSENBLUTH, B. The neuroses and psyohoneuroses of children: their mode
of development and treatment. Med. Record , 1913, lxxxiv., Nov. 8, p. 834.
HELLER, TH. Uber affektiv bedingte Psyohoneurosen dee Kindesalters.
Ztschr. f. Kinderheilk., 1913, ix., S. 104.
VINGHON, JEAN. L’emploi de la muaique dana le traitement dea psychoses.
Rev. de Psychiat., 1913, xviL, Sept., p. 360.
JOLLY, PH. Die HerediUt der Paychoaen (Schluaa). Archiv. f. Psychiat.,
1913, lii., S. 492.
Alcoholism, Ac. —CROTHERS, T. D. Premonitory auras in inebriety. Med.
Record , 1913, lxxxiv., Nov. 15, p. 885.
CLOUSTON, Sir THOMAS. Some of the psychological and clinical aspects of
aloohol. Med. Press, 1913, cxlvii, Nov. 5, p. 501.
Exophthalmic Goitre, Cretinism, Ac*— ASHBY, HUGH T. A case of sub*
aoute exophthalmic goitre in a child. Med. Chron., 1913, lviiL, Nov., p. 113.
OCHSNER, A. J. Diseases of the thyroid gland viewed from the standpoint of
the aurgeon. Canadian Med. Assoc . Joum., 1913, iii., Nov., p. 965.
PYCHLAU. Ein erfolgreich mit. Milch einer thyreodektomierten Frau behandelter
Fall von Morbus Baaedowii. Deut. Med. Wehnschr., 1913, xxxix., Nov. 20,
S. 2299.
Tetamas.— BERGER, H.—Daa Magnesiumsulfat in der Therapie dea Tetanus.
Berl. Min . Wehnschr., 1913, L, Nov. 3, S. 2047.
RUFFER, MARC-ARMAND and CRENDIROPOULO. M. Sur la gudrieon du
tdtanos experimental ohez les oobayes. Presse mid., 1913, Nov. 8, p. 905.
MILLIONI, L. Conaiderazioni e note aulla terapia del tetano (Continue). Riv.
erit. di Clin. Med., 1913, xiv., Nov. 22, p. 742.
LESIEUR, CH., and MILHAUD, M. A propos d’un cas de tltanoe aubaigu
terming par gueriaon chez un dpileptique. Lyon Mid., 1913, oxxi., Nov. 23,
p. 866.
142 *
BIBLIOGRAPHY
BERGE, A., and PERNET, P. Urlmie k forma tltanique. Prog. Mid., 1913,
xli., Not. 22, p. 599.
Tetany.—IRWIN, W. K. Gastric tetany in the adult. Brit. Med. Journ 1913,
Not. 8, p. 1200.
SPECIAL SENSES AND CRANIAL NED YEA—
BECK and MOHR. Uber die Httufigkeit und diagnostische Bedeutung der
Papillitis nerri optici dei der S&ugllngssysphilis. Derm. Wchntchr., 1913,
lvii., S. 1363.
LEVINSOHN, G. Der optische Blinselreflex. Ztschr. f. d. get. Neurol, u.
Ptychiat. (Orig.), 1913, xx., 8. 377.
WOLFF, R Die areflexie der Komea bei organisohen Nerrenkrankheiten.
Archiv f. Ptychiat., 1913, lii., S. 716.
WILSON, J. A. Nystagmus: a reriew of one hundred oases, chiefly ordinary
or non-miner's nystagmus. Brit . Med. Journ., 1913, Not. 1, p. 1150.
STEINDORFF, K. Ueber einen Fall von isolierten Lfchmung dee M. obliquus
inf. Klin. Monattbl. f. Augenkeilk., 1913, li., 8. 567.
DUTOIT, A. Drei Falle mit verzogerter und voriibergehender L&hmung des
abduzens nach Schadelbasisfraktur. Klin. Monattbl. f. Augenheilk., 1913, li..
8. 672.
MYERSON, A., and EVERSOLE, G. E. Notes on sunlight and flashlight
reactions and on consensual amyosis to blue light. Journ. New. and Merit.
Dit ., 1913, xl., Nov., p. 705.
HEINE. Ueber die Hohe des Hirndruckes bei einigen Augenkrankheiten.
Milnch. Med. Wchntchr., 1913., lx., Nov. 4, 8. 2441.
COHN, A. E., and FRASER, F. R. Paroscysmal tachyoardia and the effect o
stimulation of the vagus nerves by pressure. Heart, 1913, v., p. 93.
MISCELLANEOUS SYMPTOMS AND CASES—
LANGELAAN. Sur un cas d’hlmiatrophie faciale avec signe d'Argyll Robertson
contralateral. Rev. Neurol., 1913, xxi., Nov. 15, p. 520.
TAYLOR, A. 8., and CASAMAJOR, L. Traumatic Erb’s paralysis in the adult.
Annalt of Surgery, 1913, lviii., Nov., p. 577.
BERIEL, L., and DURAND, P. Sur les paralysies respiratoires (suite). Lyon
Mid., 1913, cxxi., Nov. 16 and 23, pp. 786 and 846.
PATTERSON, J. F. The cerebral form of pernicious malaria. Journ. Atner.
Med. Attoc., 1913, lxi., Nov. 15, p. 1807.
SODERBERGH, G. Uber Ostitis deformans ochronotiea. [Yorlkuflge Mitter-
lung.] Neurol. Centralbl., 1913, xxxii., Nov. 1, S. 1362.
DAVIDENKOF, SERGE. En quoi consistent rlellement les phdnom&nes de la
cdcite psychique? VEnciphale, 1913, viii., p. 425.
CHRISTINGER, M. Die Krankheit der Geschwister Weilemann. Monaittchr.
f. Ptychiat. u. Neurol., 1913, xxxiv., Nov., p. 456.
v. BERGMANN. Ueber Beziehungen des Nervensystems zur motorischen
Funktion des Magens. Munch. Med. Wchntchr., 1913, lx., Nov. 4, S. 2459.
MASSINI. Radiologische Studien Uber Beziehungen des Nervensystems zur
motorischen Funktion des Magens. Milnch. Med. Wchntchr., 1913, lx., Nov.
4, 8. 2460.
BECHTEREW, W. v. Ueber die Entwicklung der psychischenTatigkeit. Deut.
mid. Wchntchr., 1913, xxxix., Nov. 20 und 27, 8. 2284 und 2332.
ISSAILOVITCH-DUSCIAN. Les rlflexee conditionnels ou associatifs. Prette
med., 1913, Nov. 8, p. 907.
MAGNUS and DE KLEIJN. Ein weiterer Fall von tonischen “ Halsrefiexen”
beim Menschen. Milnch. Med. Wchntchr., 1913, lx., Nov. 18, S. 2566.
INGELRANS, M. L. Les idles actuelles sur la nature des rlflexe* cutands de
defense. Oaz. des Hfrp., 1913, lxxxvi., Nov. 29, p. 2157.
BIBLIOGRAPHY
143 *
FINSTERER, H. Pleurogenic reflexes in the limbs. Med. Press, 1913, cxlvii.,
Oct. 29, p. 472.
BLOOMFIELD, M. D. Neurovascular gangrene. Med . Record , 1913, lxxxiv.,
Nov. 8, p. 829.
BAUDOUIN, M. Un nouveau craniopage vivant: Emi-Lisa Stoll. Sem. Mid.>
1913, xxxiii., Nov. 19, p. 553.
PSYCHIATRY.
fillllll PARALYSIS—
B^RIEL, L., and DURAND, P. Demonstration sur le vivant de la presence du
tr^pon&me dans le cerveau des paralytiques generaux. Lyon M6d. 9 1913, exxi.,
Nov. 23, p. 802.
GRAVES, WM, W. Can rabbits be infected with syphilis directly from the
blood of paretics? Observations on the recognition of the virus in the later
periods of the disease. Journ. Amer. Med. Assoc. , 1913, lxi., Oct. 25, p. 1504.
DEMENTIA PKACOI-
HALBERSTADT. La d4mence pr4coce k evolution circulaire. Rev. de Psychiat .,
1913, xvii., Sept., p. *353.
MIGNOT, ROGER, and PETIT, GEORGES. Corps etrangers du rectum chez
un dement precoce. Occlusion complete et perforation secondaire du colon
ilio-pelvien. VEncepkale, 1913, viii., p. 436.
DEGENKOLB, K. Ueber schizophrene Symptome, Muskelerregbarkeit und
Schleimhautrcflexe in einem Falle von Blitzneurose und iiber die Kapitalab-
findung solcher Falle. Monatsschr. f. Psychiat. u. Neurol. t 1913, xxxiv.,
Nov., p. 428.
GENERAL—
KIRBY, G. H. The catatonic syndrome and its relation to manic-depressive
insanity. Journ. Nerv. and Ment. Dis. 9 1913, xl., Nov., p. 694.
JACKSON, J. ALLEN. Laboratory studies of the manic-depressive group.
N. Y. Med. Journ. , 1913, xcviii., Nov. 15, p. 962.
HAWLEY, M. C. Studies of blood-pressure in states of excitement and
depression. Arch. Int. Med., 1913, xii., Nov., p. 526.
MANDRILA, K. Wechselbeziehung zwischen Prostata und Hypophyse.
I. Melancholic infolge der Prostatitis. Wien. Med. Wchnschr ., 1913, lxiii.,
Nov. 1, S. 2915.
DUHEM, P. La fonction peristaltique de l’intestin dans les maladies nerveuscs
4 forme depressive. Journ. de Mid. de Paris , 1913, xxxiii., Nov. 29, p. 936.
KAHANE, H. Ueber psychische Depressionen. Wien. klin. Wchnschr. , 1913,
xxvi., Nov. 13, S. 1881.
HOLLINGWORTH, L. S. The frequency of amentia as related to sex. Med.
Record , 1913, lxxxiv., Oct. 25, p. 753.
THEOBALD, MAX. Zur Abderhalden’schen Serodiagnostik in der Psychiatrie.
Berl. klin. Wchnschr ., 1913, 1., Nov. 24, S. 2180.
BEYER. Ueber die Bedeutung des Abderhalden’schen Dialysierverfahrens fiir
die psychiatrische Diagnostik. Munch. Med. Wchnschr ., 1913, lx., Nov. 4, S.
2450.
KAFKA, Y. Weitere Untersuchungen mit dem Abderhalden'schen Dialj’sierver-
fahren au Geisteskrankon. Deut. Med. Wchnschr. , 1913, xxxix., Nov. 27, S.
2353.
MARCUSE, H. Ueber die Bedeutung der Psychologic Jodi’s fiir die Psychiatrie.
Berl. klin. Wchnschr. , 1913, 1., Nov. 17, S. 2143.
RUSSELL, WM. L. The widening field of practical psychiatry. Amer. Journ.
Insanity , 1913, lxx., Oct., p. 459.
BRIGGS, L. VERNON. Problems with the insane. Amer. Journ. Insanity ,
1913, lxx., Oot., p. 467.
GOSS, ARTHUR V. Occupation as a remedial agent in the treatment of
mental diseases. Amer. Journ. Insanity , 1913, lxx., Oct., p. 477.
144 *
BIBLIOGRAPHY
HARRINGTON, ARTHUR H. The congregate dining-room and its manage -
inent. Amcr. Joum . Insanity, 1913, lxx., Oct., p. 487.
RYON, W. C. Some suggestions regarding the improvement of the medical
service and the ears and treatment of the insane. Amir. Joum. Insanity,
1913, lxx., Oct., p. 497.
WHITE. WM. A. The genetic concept in psychiatry. Amir. Joum. Insanity ,
1913, lxx., Oct., p. 441.
MAY, JAMES Y. Statistical studies of the insane. Amir. Joum . Insanity ,
1913, lxx., Oct., p. 427.
SELDEN, C. S. Conditions in South China in relation to insanity. Amer.
Joum. Insanity , 1913, lxx., Oct., p. 411.
LOU BAT and OR ASSET. Une oontro verse sur lee demi-fous. Rev. dc
Psyckiat., 1913, xvii., Sept., p. 373.
PFISTER, O. Zur personiichen Verteidigung gegen Herrn Prof. Dr A. Hoche.
Archiv. f. Psyckiat ., 1913, lii., S. 845.
HOCH, A. Kurze Erwidening auf Vorstehendee. Archiv . /. Psyckiat ., 1913,
lii., S. 846.
PONITZ. K. Beitrag zur Kenntnis der Frilhkatatonie. Ztschr. /. ges. Neurol.
u. Psyckiat . (Orig.), 1913, xx., S. 343.
HYSLOP, THEO B. Presidential address on clinical psychiatry. Med . Press.,
1913, cxlvii., Nov. 26, p. 585.
CHANNING, W. The better training of nurses in insane hospitals. Boston
Med. and Burg. Joum., 1913, clxix., Nov. 13, p. 719.
KNOX, HOWARD A. A test for adult imbeciles and six-year-old normals (with
2 illustr). N. Y. Med. Joum ., 1913, xcviii., Nov. 22, p. 1017.
M*VICAR, C. S. Some psychiatric problems from the general practitioner's
standpoint. Canadian. Med. Assoc . Joum., 1913, iii., Nov., p. 957.
MAGNAN, M. Inversion sexuelle et pathologic mentale. Bull, de VAcad. de
Med., 1913, lxx., Oct. 21, p. 226.
Rt)LF, J. Die familiitre Rindenkrampf. Archiv. J. Psyckiat ., 1913, lii., S. 748.
WICKEL, CARL. Fortscbritte im Bau und in der Einrichtung der Anstalten
fur psyohisch Kranke. Ally. Ztschr. f. Psyckiat ., 1913, lxx., S. 957.
ROESEN. Kasuistischer Beitrag zur Frags der forensisch-psyohiatrischen
Beurteilung der Heimweh-Verbreckerinnen. AUg. Ztschr. f. Psyckiat., 1913,
lxx., S. 975.
SIMONIN, J. L’expertise psychiatrique dans 1'armde. Lee originee et lee dis¬
positions de sa reglementation officielle. Annales d'Hygiene Publique, 1913,
xx., p. 443.
STIER, E. Psychiatrie und FUrsorgeerziehung mit besonderer Beriioksichtigung
der Frage der psyohopathischen Kinder. Monatssch. /. Psyckiat. u. Neurol.,
1913, xxxiv., Nov., p. 415.
SMITH, H. OSWALD. Research work in insanity and the study of curative
treatment of the insane. Lancet, 1913, clxxxv., Nov. 8, p. 1340.
WILLIAMS, E. H. Liquor legislation and insanity. Med. Record, 1913, lxxxiv.,
Nov. 1, p. 791.
TREATMENT.*
GOLDSCHEIDER, A. Die Erkrankungen des Nervensvstems und ihre Bexiehungen
zur Balneotherapie. Ztschr. f. Physikal. u. Diat. Tnerap., 1913, xvi, S. 641.
GORN, W. Uber therapeutische Yersuche mit kolloidalem PaUadiumhydroxydul
(“ Leptynol”) bei verschiedenen Psychosen. Ztschr. f. d. ges Neurol, u. Psyckiat.
(Orig.), 1913, xx., S. 358.
SOLOMON, MEYER. If certain conclusions of the Freudian sohool were true. N. Y.
Med. Joum., 1913, xcviii., Nov. 8, p. 913.
* A number of references to papers on T rea t ment are ineluded in the Bibliography under
Individual diseases.
Jnbices*
SUBJECT INDEX.
Page References to Original Articles are indicated by Heavy Type Figures .
Abderhalden’s Dialysis Method :
Demonstration of Defence-Ferments
in Blood Serum of Insane by, 608
Abducens : vide Nerves, Cranial
Abortion : Polyneuritic Psychosis after
Induced, 114
Abscess: Extirpation of Vestibule of
Labyrinth with Cerebellar, New Re¬
flex Phenomenon, 399; “Idiopathic”
Cerebral, 496; Otogenic Cerebral,
540; Unusual Case of Cerebral, 540;
Extra-Dural, in Toxic Exhaustive
Insanity with Chronic Suppurative
Otitis Media and Labyrinthitis, 566
Accommodation: Case of Monocular
Paralysis of, due to Lues, 603 ; Patho¬
geny of Post-Diphtheritic Paralysis of,
623
Achilles Jerk : in Sciatica from Disease
of Nerve Root and of Nerve Trunk,
43; Absence of Knee and, without
other Signs of Disease, 208
Achondroplasia : 92 ; Manic-Depressive
Psychosis in, 557
Acrocephaly, 92
Acromegaly: a Personal Experience
(Review), 457; Case with Mental
Symptoms, 46 ; Tuberculous Leprosv,
Giantism, and, 169; Giantism with¬
out Enlargement of Sella Turcica,
Sexual Inversion and “Mental
Feminism,” 222; Diabetes, Pituitary
Tumour, 402; with Diabetes ana
Hypophysis Tumour, with Discussion
of Hypophysis Tumours found so
far, 401 ; with Localised Muscular
Atrophy, 441 ; Tumour of Hypophysis
in Case of, 441 ; Case with Autopsy,
545
Addison’s Disease ; Case of, treated with
Tuberculin, 112; Nervous and Mental
Symptoms in Case of, 112; Case of,
in Boy aged 10 j^ears, 637
Adiposis Dolorosa : Striking Benefit from
Fresh Thyroid Gland, 173 ; in Sciatica,
a Variety Localised in the Affected
Lower Limb, 287
Adiposo-Genitalis : Did Napoleon suffer
from, at Close of his Life ? 546
Adrenal: vide Suprarenal
Adrenalin : Action on Pulmonary Vessels
and Vasomotors of Lung, 28; Effect
on Pulmonary Circulation, 28 ; Hypo¬
physial Glycosuria and, Glycosuria,
29 ; Action on Kidney, 96
Agglutinins: for Treponema pallidum ,
447 ; of Typhoid Bacillus by the Cere-
bro-Spinal Fluid of Typhoid Patient,
632
Agitans, Paralysis: vide Paralysis, Agi-
tans
Ague: Brass Founder’s, Occupational
Brass Poisoning, 498
Alcohol: Injection of, into Gasserian
Ganglion for Trigeminal Neuralgia,
343, 553
Alcoholism: Absence of Abdominal
Reflex in Chronic, 498
Alzheimer’s Disease, 405; with Unusual
Neurological Disturbances, 457
Alzheimers Method : Differentiation of
Cells in Cerebro-Spinai Fluid by, 196
Amyloid Degeneration: of Brain in
General Paralysis, 96
Amyotonia Congenita : Case of, 391
Amyotrophy: Case of Combined De¬
generation of Spinal Cord with, T6
Anencephaly : Suprarenal Glands in, 34
Angiospasm: Motor and Speech Paralysis
due to Cerebral, 105
Ankle Clonus : without Gross Disease of
the Central Nervous System, 483;
Hysteria with Fever and, 604
Antigens, 448; tide Wassermann Re¬
action
Anuria: perhaps Hysteric, 286
Aorta : Innervation of, 322
Aphasia : Cortical Localisation of (Re¬
view), 230 ; Motor and Speech Para¬
lysis duo to Cerebral, 105; Chroma-
toptic Word Deafness, 109; in Typhoid
Fever of Children, 439; Functional,
498; Very Successful New Method of
Curing Hysterical, 633
148 *
140*
INDICES
Appendicitis : in Private and Public
Hospitals for the Insane, .‘>2
Appendix Vcriniformis : Case simulating
Meningitis in which Symptoms were
caused by Escape of Thread-Worms
into Peritoneal Cavity through a
perforated, 539
Apraxia: Dementia Pnvcox in Relation
to, f>2 ; Bilateral Motor, with Autopsy,
1011; Present Knowledge of State of,
338
Aran-Puchenne: Type of Progressive
Muscular Atrophy of Neuritic Nature ;
Second Case with Autopsy, 213
Argyll Robertson Pupil : in non*
Syphilitic Affections, 42 ; Unilateral,
due to Orbital Trauma, 217
Aiseno-Benzol : rid* Salvarsan
Arterio-Sclerotic Brain Disorder: Karly
Symptoms of, 4it"); Case of Precocious,
602
Artery: Lesion in “ Cervical” Rib, 02 ;
Thrombosis of Vertebral and Posterior
and Inferior Cerebellar, 281 ; Occlusion
of the Posterior Inferior Cerebellar,
441 ; Indications of Nerve Lesion in
Certain Pathological Conditions of,
431, 483 ; Some Anatomical Considera¬
tions of Disposition of Sciatic Nerve
and Femoral, 331 ; Complete Absence
of Both Internal Carotid, and Note on
Developmental History of Stapedial,
590; ridt Pulmonary, &c
Arthropathy : Etiology of, in Tabes, 99:
Tabetic, Pharyngeal Ciises, 212
Asthma: Bronchial, with Intermittent
Exophthalmic Coitre in Tabes Dorsalis,
35
Ataxia : Acute, with Rapid Recovery,
484 ; Blindness and Tabes, New' Method
of Curing, 622
Ataxy : Marie's, 344
Athetosis : of Left Hand w ith Tremor of
Right Hand, 333
Axis-Cylinders : Degeneration and Re¬
generation of, in vitro, 164, 391
Auditory Centre : Case with Bearing on
Localisation of, 342
Auditory Nerve: ride Nerves, Cranial
Autonomic System : Histology of the
Cranial Autonomic Oangliaot the Sheep,
24 ; Control of Pituitary (Hand by, 274
Axon-Reflex : Vaso dilator, 532
Bajjjnski : “Second Sign”—Combined
M ovenicut of Trunk and Pelv is—]nesei i t
in Case of Organic Hemiplegia follow¬
ing Typhoid, 330.
Basedow’s Disease : ridt Exophthalmic
(ioitre
Bcsta's Method : for the Myelin Sheath
in Secondary Degenerations, 534
Biocytoneurology : by Aid of Ultra¬
microscope, 206
Bladder: Innervation of, Anatomical and
Experimental Studies, 271
Blood: Cytological and Chemical Re¬
searches on, in Scorbutic Mental Cases,
227; in Pellagra, 445; in Mumps,
430, 626
Blood-Pressure : Action of Intravenous
Injection of Saline Extract of Choroid
Plexuses on, 93 ; in the Insane, 344 ;
Effects of Adrenal Massage on, 326
Brain : ride Cerebellum, Tumour, &e.
Brass Poisoning : Occupational, Brass
Founder's Ague, 498
Broncho-Dilator Nerves, 26
Brow n-Stquard : Syndrome w ith Dis¬
sociation of Sensory Loss of Syringo¬
myelic Type, 328
Bulbar Paralysis: in Typhoid, 493;
Pseudo-, 550; Post-Diphtheritic, 594
Bullet Wound : of Spinal Cord between
First and Secondary Vertebra :
Laminectomy: Recovery after Removal
of Bullet, 4*1 ; Fatal, Fifteen Years
after, of Brain, 596
Carbohydrate : Role of Hypophysis in
Metabolism of, 274
Carbon Dioxide: Production from Nerve
Fibres w hen Resting and W'hen Stimu¬
lated ; Contribution to Chemical Basis
of Irritability, 325
Carbon Monoxide: Poisoning, Psychosis
follow ing, with Complete Recovery, 501
Carcinoma : Metastases in Cerebellum,
220
Caries, Vertebral : ride Pott s Disease
Carotid Artery: Complete Absence of
Both Internal, 5!MJ
Castration ; Effect of,on Weight, Rabbit's
Pituitary, 164
Catatonia : Histology of Central Nervous
System in Case of. Dementia Priecox,
327 ; Study of Brain in Case of, 389
Cerebellum : Carcinoma Metastases in,
220; Intermittent Claudication, 281 ;
Tumour of, 283, 400 ; Acute Cerebro-
Spinal Meningitis with, Syndrome,
491 ; Transitory, Spastic Syndrome in
Convalescence from Typhoid, 493
Ccrebro Cerebellar: Tracts, 478; Diplegia
of Flaccid Atonic-Astasia Type, 630
Cerebro-Spinal Fluid : Differentiation of
Cells in, by Alzheimer's Method, 195 ;
Normal ami Pathological, Clinical
Value of Chemical Examination (Re¬
view), 406 : Secretion of, 591 ; Action
INDICES
147*
of Intravenous Injection of Saline
Extract of Choroid Plexus on Blood
Pressure and Formation of, 95 ; Action
of, Choroid Plexuses and some Organs
and Substances on Isolated Heart of
Rabbit, 531; in Mumps, 450, 626;
in acute Poliomyelitis, 627 ; Report of,
Analysis of, 551; Absence of Cellular
Reaction in, in Purulent Pneumococcus
Meningitis, 212; Case of Pneumo¬
coccus Meningitis with normal, 331,
395; Typhoid Infection of, 165; Ag¬
glutination of Typhoid Bacillus by,
of Typhoid Patients, 632; Frequency
of Wassermann Reaction in, in General
Paralysis, 500; General Paralysis with¬
out Reaction of, 501
“ Cervical” Rib: Arterial Lesion in
Cases of, 92; Discussion on, 486;
Technique of Excision of, 621
Child-Bearing; Forms of Mental Dis¬
order in Connection with, 229
Children: Text-book of Nervous Dis¬
eases in (Review), 231; Precocious
Development in Boy aged 6, 49 ; Fresh
Case oi Typhoid Spine in, 36; Corneal
Sensibility and Corneal Nerve Ter¬
minations in Newly Born, 276. Vide
Tuberculous Meningitis, Ac.
Chloretone Poisoning: Tetanus. Re¬
covery, followed by Polyneuritis, 341
Cholesteatoma: Epidermoid, of Brain,
208 ; of Brain, 337
Cholesterin: Addition of, to Alcoholic
Extracts of Tissues used for Antigens
in Wassermann Reaction, 448
Chorea: Avenues of Rheumatic Infection,
based on 75 Cases of Sydenham’s, 112;
Pathology of Chronic Progressive,
389
Choroid Plexus: Action of Intravenous
Injections of Saline Extract of, on
Blood Pressure and Formation of
Cerebro-Spinal Fluid, 95; Action of,
on Isolated Heart of Rabbit, 531
Chromaffin : Elements in Cardio-Cervical
Region of Certain Lizards. 91 ; Cardio-
Cervical Chromaffin System in Rep¬
tiles, 618
Circulation: Action of Trostatic Extracts
on Cerebral and Renal, 273
Claudication, intermittent: Cerebellar,
281 ; Unilateral, of Lumbar Region,
282
Cleido-Cranial Dysostosis, 222
Codein : Use of, in Mental Therapeutics,
in Particular in Melancholic States, 345
Combined Degeneration of Spinal Cord :
Case of, with Amyotrophy, 76; Sub-
Acute, 36; Combined Lesions of Pos¬
terior and Lateral Columns, 165
Concussion: Experimental Investiga¬
tions on Influence on Circulation in
Brain, 220; Experimental Investiga¬
tions of, of Spinal Cord and Allied
Conditions, 433
Congenital: Deficiency of Cranial Vault,
399; Multiple Osteoohondromata, with
Degeneration of Cranial Nerves, 497;
Macroglossia, Neurofibromatosa, 538;
Mental Deficiency, Incidence of In¬
herited Syphilis in, 557
Continuity: in Vertebrate Nervous Sys¬
tem and Mutual and Intimate Con¬
nections between Neuroglia and Nerve
Cells and Fibres, 25
Contracture: Considerations on Patho¬
logical Physiology of, 431; Volkmann’s
Ischaemic, of Hand, 434
Conus Medullaris: Affection of, follow¬
ing Rachstovainisation, 624
Co-ordination : Nervous Mechanisms
which regulate, of Locomotor Move¬
ments in Diplopoda, 323
Cord, Spinal: ride Spinal Cord
Cornea : Sensibility and Nerve Termina¬
tions in Newly Born, 276
Corpus Callosum ; Bilateral Haemorrhagic
Softening of Radiations of, 440 ;
Absence of, in Human Brain, 481
Cortex : Motor, in Raccoon, 429; Func¬
tions of Cerebral, 272
Cranial Nerves : ride Nerves, Cranial
Craniectomy: Decompression, 45
Cretin : Symmetrical Hypertrophy of
Salivary Glands in, 46
Criminal Lunacy : Address on Mind and
Motive, 555
Criminals : Psychology of Juvenile, 207
Crotalin : Treatment of Epilepsy, 450;
Cutaneous Reaction for Syphilis : ride
Luetin Reaction
Cyst: of Pituitary Fossa, Operation by
Nasal Route, 33/
Cysticercus : Cerebral and General
Paralysis, 226 ; On Histopathology of,
in Brain, 226
Deafness: Chromatoptic Word, 109
Decompression: Craniectomy, 45
Defectives : Significance of Habit Move¬
ments in Mental, 228
Defence-Ferments: in Blood Serum of
Insane, 608
Degeneration : Wallerian, Nature of, 94;
of Nerve Fibres, 93 ; of Axis Cylinders
in vitro , 164 ; Besta’s Method for
Myelin Sheath in Secondary, 534
Delirium Tremens: and Cranial Trauma¬
tism, 404 ; due to Stramonium Poison¬
ing, 636
148*
INDICES
Dementia Paralytica : ritlr General
Paralysis
Dementia Priecox Fruste with Dys-
praxia, 51 ; in Relation to Apraxia,
52; Pluriglandular Endocrinic Syn¬
drome and, 225; Ductless Glands in,
289 : Histological Research oil Central
Nervous System in Case of Catatonic,
327 ; Source of Urinary Indol-Acetic
Acid in Two Patients, 501 ; Sodium
Nucleinate in, 555
Dentine : Nerve Supply of, 530
Diabetes Insipidus : Eunuchoidism in,
285
Diabetes Niellitis : Action of Large Doses
of Sod. Bicarb, in, 53; Malum Perforans
in, 171 ; Wassennann Reaction in,
with Special Reference to its Relation
to Acidosis, 286; Acromegaly, Pituitary
Tumour, 4; Acromegaly with, and
Hypophysis Tumour, 401 ; Paralysis of
External Rectus, 602; ride Glycosuria
Digestive Tube : Innervation of, 386
Diplegia : Infantile Cerebro Cerebellar,
of Flaccid Atonie-Astasic Type, 630
Diphtheria : Hemiplegia, 280, 436; Par¬
alysis, 398 ; Remarkable Case of, Par¬
alysis, 216 ; Paralysis and Hemiplegia,
101 ; Paralysis and Hereditary De¬
generation, 490; Pathogeny and Clini¬
cal Aspects of, Cerebral Palsies, 593 ;
On Toxic Neuritis of Eighth Nerve and
Changes in Corresponding Ganglia in,
275 ; Herpes Facialis in, 593; Post-
Bulbar Paralysis, 594 : Pathogeny of.
Paralysis of Accommodation, 623 ;
Changes in Hypophysis in, 594 ; Epi¬
demic Cerebro-Spinal Meningitis cured
by Antitoxin, 277 ; Dissemination of,
in Heart Blood and Organs, 397
Dislocation : Spontaneous Reduction of,
of Cervical V ertebne, 434
Disseminated Sclerosis: Heminpiu Cen¬
tral Scotoma in, and Retrobulbar
Neuritis, 279; Acute Ataxia with
Rapid Recovery, 484
Dog : General Paralysis in, 33 : Effects
of Labyrinthectomy in, 30; Method
of Operation for Destruction of Semi¬
circular Canals of, 30 ; Glycosuria con¬
secutive to Destruction of Semicircular
Canals of, 32 ; Removal of Hypophysis
in, 273, 533; Origin of Phrenic Nerve
in, 324; Paralysis in a, simulating
Poliomyelitis, 439; Cerebral Symptoms
in, associated with Lymphocytic Infil¬
tration of Vessels and Membrane of
Brain and Spinal Cord, 536
Dopter’a Serum : Cachectic Form of Para¬
meningococcus Meningitis cured by,
214
Dreams : and Myths. A Study in Race
Psychology (Review), 291
Ductless Glands : Internal Secretion and
(Review), 176; in Dementia Praecox,
289
Dysentery ; Past and Present, 639;
Bacteriology of Asylum, in England,
639
Dyspituitarism : Case of, 48 ; ride Acro¬
megaly, Hypophy so-Genital Syndrome,
Ac.
Dyspraxia: Dementia Pr*eox Fmste
with, 61
Dystonia Musculorum Deformans (Oppcn-
heim), 276
Dwarfism : Mitral, 441
Eccentric Movements : in Treatment
of Paresis, 115
Electricity: High Frequency, in Tri¬
geminal Neuralgia, 115
Embolism : Cerebral, Experimental In¬
vestigations on Influence on Circulation
in Brain, 220
Encephalitis: Acute Syphilitic Meningo-,
in Tabes, 99 ; Localised, with Epilepsia
Con tinua, 285
Eneephalo-Meningitis ; due to Pfeiffer's
Coccohacillus, 332
Enccphalo - Myelitis : after Smallpox,
with Remarks on Diseases of Glands
of Internal Secretion, 491
Endothelioma: Meningeal Fibro-, 283;
Case of Large, of Frontal Region,
401
Epidemiology: of Pellagra, 342, 554,
601
Epilepsy; Recent Studies on Patho¬
genesis of, 223 ; Experimental Investi¬
gations on Influence of Epileptic
Attacks on Circulation in Brain, 220 ;
Localised Encephalitis with, 285;
Crotalin Treatment of, 450 ; Note on
Remission in Case of, 551 ; Preven¬
tion of, 634 ; Psychic, without other
Phenomena, 634; Role of Syphilis in
Mental Deficiency and, Review of 205
Cases, 638
Epiphysis: ride Pineal
Ergogram : of Labryinthectomised Frog,
29
Esthesionieter : a New, 276
Etiology : of Tabetic Arthropathy, 99 ;
of Bitemporal Hemiopia in Hypophysis
Disease, 283 ; of Unilateral Paralysis
of Recurrent Laryngeal Nerve, 488 ; of
Scarlet Fever in Nervous Diseases, 537;
of Pernicious Anemia, 599
Eunuchoidism: in Diabetes Insipidus,
285
INDICES
149*
Exophthalmic Goitre: Myasthenia
Gravis with, 475 ; with Generalised
Pigmentation, 46; Intermittent (in
Tabes Dorsalis with Bronchial Asthma),
35 ; and Marie’s Ataxy, Friedreich’s
Disease, and Manic-Depressive Psy¬
chosis, 344 ; Cured by X-Ray, 403;
with Sclerodermia and Positive Wasser-
mann Reaction treated with Salvarsan,
446; treated by X-Rays, 504; Post-Ty¬
phoid Thyroiditis ana Secondary, 552
Exophthalmos : and Oxycephaly, 217 ;
Diagnostic Value of Unilateral, in
Brain Tumour, 219
Eye Muscles : Development of Prootic
Head Somites and, in Chdydra serpen¬
tina, 90; Nerves in Necturus, 385
Eye Lesion : following Two Intravenous
Injections of Salvarsan, but relieved by
its Further Use, 339
Eye-Strain : in Everyday Practice, 233
Facial Paralysis : Pathology of Tem¬
porary, in Fracture of Petrous Portion
of Temporal Bone, 44; Importance of
General Nutritional Disturbances in
Determination of, 104 ; Tabes and,
538 ; Cervical Zoster and, 120
Familial Diseases ; Irregular and Un¬
usual Types of Familial Periodic Para¬
lysis, 459 ; Molluscum Fibrosum, 42;
Progressive Lenticular Degeneration,
167 ; Four Cases of Multiple Neuro-
myxofibrosarcomatosis, 279 ; Spinal
Gliosis occurring in Three Members of
Same Family, 629
Fever: in late Stage of Syphilis, 43 :
Nystagmus in, 221 ; Hysteria with, and
Ankle-Clonus, 604
Fillet : Atrophy of, in Friedreich's
Disease, 35
Fissure: Central, of Cerebrum, 317
Fits : Three Cases of, 635
Fracture : Delayed Temporary Paralysis
of the Sixth Cranial Nerve in, of
Skull, 44 ; Pathology of Temporary
Facial Paralysis in, of Petrous Portion
of Temporal Bone, 44; of Base, Purulent
Meningitis, Recovery with Hexame-
thylene-tetramine, 539
Franke’s Operation : in Tabetic Gastric
Crises and in Post-Herpetic Neuralgia,
35
Frequency: Reflex, and its Clinical Value,
620
Friedreich’s Disease: Atrophy of Medulla,
Fillet and Superior Cerebellar Peduncle
in, 35 ; Another Case of, with Autopsy,
210 : Manic-Depressive Psychosis,
Graves’ Disease and Marie’s Ataxy, 344
Frontal Lobe : Sarcoma of, 108; Case of
Large Endothelioma of, 401
Ganulia : Histology of Cranial Auto¬
nomic, of Sheep, 24; Histology of
Sensory, of Birds, 88; Changes in, of
Eighth Nerve in Diphtheria, 275;
Development of Cranial Sympathetic,
in Pig, 270 ; in Human Temporal Bone
not hitherto described, 321 ; Injection
of Alcohol into Gasserian, for Trige¬
minal Neuralgia, 343; Presence of
Negri’s Bodies in Nerve Ganglia of
Salivary Glands of Rabid Animals,
618
Ganglionitis : Acute Posterior, Simulat¬
ing Surgi cal Condi tions in Abdomen, 331
Ganser s Syndrome : and Simulation of
Insanity, 114
Gasserian Ganglion : Herpes Zoster
Frontalis with Bacterial Findings in,
210; vide. Neuralgia, Trigeminal
Gastric Crises : -vide Tabes
General Paralysis: with Amyloid De¬
generation of Brain, 96; Demonstration
of Trejtonema pallidum in Brain in, 174,
404, 535; Occurrence of Syphilitic
Organism in Brain of,343; Transmission
of Treponema pallidum from Brains
of, to Rabbits, 456; Treatment of,
175 ; Patho-Physiological Interpreta¬
tion of Attacks and Deliria in, 225 ;
Conviction and Imprisonment of, 225 ;
Urethritis in, with Hexamethylene-
Tetramine, 225 ; Cerebral Cysticercosis
and, 226 ; Two New Cases of Suppura¬
tive Parotitis in, 289 ; Morrison
Lectures, 1913, 454 ; Histological
Findings in Case of Juvenile, 481 ; On
Frequency of Wassermann Reaction
in Cerebrospinal Fluid in, 500; with¬
out Reaction of Cerebro-spinal Fluid,
501; Sodium Nucleinate in, 556;
in Negro, 607; Salvarsan in, 607;
Bacteriological Examination of Urine
in Some Cases of, 637; in Dogs, 33 ;
Post-traumatic Syndrome resembling,
caused by Acute Meningitis of Slow
Evolution, 40
Genesis: of Peripheral Nerve, 285; in
Tumour Formation, 866
Geniculate Body: Localised Atrophy in
Lateral, causing Quadrantic Hemian¬
opsia of Both the Right Lower Fields
of Vision, 546
Giantism: with Tuberculous Leprosy and
Acromegaly, 169; without Enlarge¬
ment of Sella Turcica, Sexual Inversion,
and “ Mental Feminism,” 222
Glands : xndt Suprarenal, Ac,
x
i:.u*
INDICES
Glaucoma : Sclero-Corneal Trephining in
Operative Treatment of (Review), 346
Glioma: Diffuse of Pia Mater, 401;
Ependymal Gliomatosis of Brain
Ventricles, 480
Glioneuroma: Ganglionic, of Optic Nerve,
107
Gliosis : Spinal, and Syringomyelia ;
(ilia Tuft on Floor of Fourth Ventricle,
400 ; Spinal, occurring in Three
Meml>erH of the same Family suggest¬
ing a Familial Type, 6*20
Glycosuria : Mechanism of Pituitary,
40 ; Hypophysial, and Adrenalin, 20 ;
Consecutive to Destruction of the
Semicircular Canals in the Dog, 32;
in Tuberculous Meningitis, 101 ; in
Mental Disorders, 220; Pituitary, in
Human and Animal Tuberculosis, 222;
vxdt Diabetes
(Oaves’ Disease : vide Exophthalmic
Goitre
Gumma Cerebri : Results of Treatment ;
Some Histological Features, 549
Gynecological Disease: in the Insane,
and its Relationship to the Various
Forms of Psychosis, 51 ; Pelvic Dis¬
orders in Relation to Neurasthenia,
554
Haiut-Movemknts : Significance of, in
Mental Defectives, 228
H.'ematoma: Spontaneous, in a Tabetic
Woman, 331
H.emophilic Organisms: Meningitis due
to, so-called Influenzal Meningitis, 39
Hiemorrlmge: Diagnosis of Cerebral, bv
M cans of Lumbar Puncture, 440;
Bilateral, Softening of Radiations of
Corpus Callosum, 440 ; Cerebral,
Experimental Investigations on Influ¬
ence on Circulation in Brain, 220;
Consecutive Displacement of Cerebral
Hemisphere on Localisation and Re¬
moval of (Apoplectic, and Clots), 543
Hallucinations: Psychic Action of Mes-
calin, with Special Reference to
Mechanism of Visual, 503
Hands: Preferential Use of Right and
Left Hands by Monkeys, 322
Hanging: Ideal Lesion produced by
Judicial, 97
Headache: in Acute Infectious Diseases
cured by Lumbar Puncture, 165
Heart: Action of Vagus on Human, 95;
Distribution of Nerves in, 272; Cardiac
Plexus and Innervation of Aorta,322;
Actionof Cerebro-Spinal Fluid, Choroid
Plexus on Isolated, of Rabbit, 531;
Strychnine in, Failure, 559
Hemianesthesia: and Hemiplegia with
Muscular Atrophy, 629
Hemiopia: Etiology of Bitemporal, with
Particular Reference to Hypophysis
Disease, 283 : Central Scotoma in dis¬
seminated Sclerosis with Retrobulbar
Neuritis, 279; Contribution to Study
of Bitemporal, 545; Localised Atrophy
in Lateral Geniculate Body causing
Quadrantic, of Both of Right Lower
Fields of Vision, 546
Hemiplegia: in the Early Stage of
Syphilis, 43; in Typhoid Fever, 102;
following Scarlet Fever in Puerperium,
102; Post-Diphtheritic, 101, 280, 436;
Recent Syphilitic, considerably im¬
proved by Salvarsan, 172; Cerebral,
with Atrophy, Flaccidity, and Loss of
Reflexes, 280; Organic following
Typhoid, with Flexor Plantar Response
and Babinski’s “Second Sign,” 330;
in Scarlet Fever, 436; following
Syphilis, with Special Reference to
Case of Double, and Pseudo-Bulbar
Paralysis, 550; and Hemianesthesia
with Muscular Atrophy, 629
Hereditary: Degeneration and Poet-
Diphtheritic Paralysis, 490 ; Congeni¬
tal Wry neck, 605; Optic Neuritis, 606
Herpes: Facialis in Diphtheria, 594:
vide Zoster, Herpes
Hexamethylcne-Tetramine: in Urethritis
in General Paralysis, ‘225; Case of
Purulent Meningitis after Fracture of
Base treated with. Recovery, 539
High Frequency Currents : in Trigeminal
Neuralgia, 115
Hirsh’s Method, 337 ; ride Pituitary
Hydrocephalus : Osteitis Deformans of
Cranium simulating, 103; On the
Pathology and Pathogenesis of Primary
Chronic, 103; Diagnosis of Tumours
of Fourth Ventricle and of Idiopathic,
with Note on Brain Puncture, 169 ;
Congenital Internal, its Treatment by
Drainage of the Cistorna Magna into
the Cranial Sinuses, 541 ; Case of
Chronic Internal, 628
Hydrotherapy : in Pellagra, 600
Hypernephroma: Case of Reckling¬
hausen’s Disease wdth, 278
Hyperplasia : Experimental Studies on
Nervous Mechanism in Production of,
387
Hypophysin : Action on Kidney, 96
Hypophysis : ride Pituitary Body
Hypophyso-Oenital Syndrome: due to
Syphilis, 48, 113
Hypopituitarism : Did Napoleon suffer
from, at close of his Life, 546; idde
Dyspituitarism, Pituitary, Ac,
INDICES
151*
Hysteria, 605; Multiple Personality.
Report of Case, 224 ; Anuria, 286 ;
Contributions to the Clinical Study of,
Situation-Ps 3 r cho 8 es, 502 ; or Piblokto
among Peary's Eskimos, 552; with
Fever and Ankle-Clonus, 604 ; Very
Successful New Method of curing,
Aphasia, 633
Ichthyosis : with Mental Deficiency,
638
Indol-Acetic Acid : Source of Urinary,
in Two Dementia Pra*oox Patients,
501
Inebriety : tide Alcoholism
Infantile Paralysis : vi<h Poliomyelitis
Infantilism, 284
Inferior Maxillary Nerve: Zoster of,
485
Inheritance, Neuropathic, 343
Insular Sclerosis : vide Disseminated
Sclerosis
Intermittent Claudication : rule Claudi¬
cation
Internal Secretion : and Ductless (Hands
(Review), 176 ; Encephalo - Myelitis
after Smallpox, with Remarks on
Diseases of Glands of, 491 ; Rela¬
tion of, to Mental Conditions, 608 ;
tide Glands
Ionic Medication : (Review), 505; in
Herpes Zoster, 620
Ischaemic Contracture : Volk man n’s, of
Hand, 434
Keknio’s Sion : Mechanism of, 98 !
Kidney: Action of Adrenalin, Para-
ganglin, and Hypophysin on, 96;
Action of Prostatic Extracts on Renal
Circulation, 273 ; Effect of Intravenous |
Injection of Salvarsan upon, 447
Knee : Flexion of, an Organic Sign, 432
Knee Jerk : Absence of, without Other
Sign of Disease of Nervous System,
208
Korsakoff s Disease: Pathological Ana¬
tomy of, 114; The Pathological ,
Changes in the Brain in, 227
Labyrinth : Diseases of, caused by
Suppurative Middle Ear Inflamma¬
tion, 402; Extirpation of Vestibule
of, with Cerebellar Abscess. New
Reflex Phenomenon, 399
Labyrinthectomy: Ergogram of Frog,
29; Effects of, in Dog, 30 ; Myosis
and Paradoxical Mydriasis in, in
Cat, 31 ; Clinical and Pathological-
Anatomical Studies on Question of,
Suppuration, 287
Labyrinthitis: with Chronic Suppura¬
tive Otitis Media and Extra-Dural
Abscess in Toxic Exhaustive Insanity,
665
Laminectomy : Recovery after, for Bui-
bet Wound of Spinal Cord, 41 ; in
Compression Paraplegia, 329
Landry’s Paralysis : Case of, with
especial Reference to Anatomical
Changes, 394; Syphilitic Infection
followed by, and later by Tabes
Dorsalis, 489
Lead : Solubility of Lead Salts in Human
Gastric Juice, and its Bearing on
Hygiene of Lead Industry, 453
Leprosy : Tuberculous, Giantism, and
Acromegaly, 169
Leucocytes : Resistance of, in Mental
Disease, 610: ride Blood.
Lithiasis : Reflex Zoster in, 211
Liver : Cirrhosis of, in Progressive Lenti¬
cular Degeneration, 167
Locomotor Ataxia : vide Tabes
Luetin Reaction, 403, 550
Lumbar Puncture : Headache in Acute
Infectious Diseases Treated and Cured
by, 165; in Meningeal State in Typhoid
Fever, 165; Suppuration in Needle
Tract after, 282 ; Diagnosis of Cerebral
Hemorrhage by Means of, 440
Lymphocytic Infiltration : Cerebral
Symptoms in a Bull dog associated
with, of Vessels and Membrane of
Brain and Spinal Cord, 536
Lvmph Stream : Spread of Infection by
Ascending, of Nerves from Peripheral
Inflammatory Foci to the Central
Nervous System, 349
M Af ro< iLossi a Co\ <; kn ita l N kv uo-
FIRROMATOSA, 538
Magnesium Sulphate: Intraspinal Injec¬
tion of, for Tetanus, 451
Malum Perforans : in Diabetes Mellitus,
171
Manic-Depressive Psychosis : in Twins,
176; with Graves' Disease, Marie’s
Ataxy and Friedreich’s Disease, 344 ;
Contribution to Study of, 556; in
Achond roplasi a, 557
Massage : Effects of Adrenal, on Blood-
Pressure, 326
Mastoid Disease : Analysis of 123 Con¬
secutive Cases of, with Operations, 40
Medulla Oblongata: Atrophy of, in
Friedreich’s Disease, 35; Bulbo-Pontine
and Peduncular Syndromes in Typhoid,
102
152*
INDICES
Melancholia : Use of C<*lein in, 341
Meningitis : Ctn.hro-Spinal: Acute, with
Cerebellar Syndrome, 491 ; Fulminat¬
ing, due to undetermined Coccolxacillus,
214; Kpidemie, Cured by Diphtheria
Antitoxin, 277; Cachectic Form of Para¬
meningococcus, Treated and Cured by
Dopter’s Serum, 214 ; Two Fatal Cases
of Non-Meningococcal, Caused by a 1
Polymorphous Coccus, 37 ; in an Infant |
of five months ; Purpura, Septicaemia, I
Serotherapy: Recovery, 37 : Para- '
meningoc<K cus, 213, ami Pseudomenin- ,
go< (K/cus, 100 ; Parameningococcus,
M eningoeoceic and Pararneningoeoecie
Serotherapy ; Death, 213, 277 ; Para-
meningococcie, Treated and Cured by
Anti-Parameningocoe< ie Serum, 213 ;
Meningococcal Septicaemia, 37 ; Fresh
Case of Parameningocoecus Septieivniia
with Recurring Meningeal Attacks, 39.1 »
/ ttfhtfinal , 396 ; On Meningitis due to
Hiemophilic Organisms, 39
Pnenmocorra/: Case of, 39.1; Recovery
from, .138 ; with Normal Cerebro¬
spinal Fluid, 331, 39.1 ; Purulent,
Absence of Cellular Reaction in, 212; I
Cerebral Complications in Pneumonia, 1
49.1 j
Serout: Papilhedema, and Multiple j
Polyneuritis of Cranial Nerves in
Young Alcoholic Smoker, 166; Otitic,
with Septic Thrombosis of Left Lateral
Sinus and Internal Jugular Vein,
Successfully Treated by Operation, 333
St/phi/ itir: Very Early Acute, 38 ; Acute
and Subacute Secondary, 39; Acute,
107 ; Acute, in Tabes, 99 ; Subacute
Meningeal Syndrome of Syphilitic
Origin, 438
Typhoid , 492; Purulent, Onset with
Acute Otitis, 101; Purulent, in Typhoid
State, with Intestinal Lesions, 160 ;
Meningeal State in Typhoid, 10.1;
Meningeal Reactions in, 191; in Infant,
191; Meningeal State at Onset of Severe
and Prolonged Paratyphoid, B. Fever,
278
Tnherculon*: Recovery from, 38; Ab¬
normal Forms in Adult, 160; in Adults,
438 ; Haemorrhagic, in Baby, 390 ;
Recovery from, with Report of Cases,
492 ; Two Cases of Recovery from,
539; In infant aged 12 Weeks (Bovine
Injection), 025 ; Glycosuria in, 101
Meningeal State in Poliomyelitis in
Child, 278 ; Meningism, a Review,
437 ; in Scarlet Fever, 437 ; in Infec¬
tious Diseases, 621 ; Case due to Serum,
332 ; Possible Source of Danger in Use
of Antimeningitis Serum, 332; Acci¬
dents following Subdural Injection of
Anti-Meningitis Serum, 396; Ence-
phalo-meningitiB due to Pfeiffer's
Coecobacillus, 332; On Acute Mild,
396 ; Fatal, 15 Years after a Bullet
Wound of Brain, 596 ; Purulent, after
Fracture of Base of Skull Treated with
Hexamethylene-tetramine, Recovery.
139 ; Post-Traumatic Syndrome re¬
sembling General Paralysis Caused by
Acute, of Slow Evolution, 40: Case
simulating, in which the Symptoms were
Caused by Escape of Thread Worms
into Peritoneal Cavity through Per¬
forated Apj)endix Vermiformis, 139 ;
Fusiform Bacilli in various Pathological
Processes, 020
Mental Deficiency Bill: Suggestions for
Case of Feeble-Minded under the, 610
Mental Disorders: Address on, 50
Mesealin : Psychic Action of, with Special
Reference to Mechanism of Visual
Hallucinations, 103
Metabolism : of Carbohydrates, Role of
Hypophysis in, 274 ; in Pellagra, 441
Meynert’s Bundle, I. A. K., 266
Microgyria: Partial Symmetrical, of
Cerebral Hemispheres and its Probable
Compensatory Effects, 218
Mirror Writing: and other Associated
Movements occurring without Palsy, 393
Mitral Dwarfism, 441
Mollgaard's Reticulum, 478
| Mongolism, 500, 100
; Moral Insanity, 610
Mosquito : and Pellagra, 601
Multiple Personality: Hysteria and.
Report of Case, 224
Multifile Sclerosis: ride Disseminated
Sclerosis
Mumps: Blood and Cerebro-Spinal Fluid
in, 410, 626
Muscular Atrophy: Isolated and Station¬
ary, of Small Muscles of Hand, Anterior
Tephromalacia, 216; Distal, in all
Four Extremities? Cause, 330; Acro¬
megaly with Localised, 441 ; Case of
Hemiplegia and Hemiana^sthesia w ith,
629
Muscular Rigidity : on Oxygen Intake of
Decerebrate Cals, 533
Myasthenia, 171 ; Gravis with Exoph¬
thalmic Goitre, 475
Myatonia Congenita, 277
Mydriasis: Paradoxical, and Myosis in
Labyrinthectomised Cat, 31
Myelin Sheath : Bcsta’s Method for, in
Secondary Degeneration, 634
Myelitis : Various Clinical Evolutions
of Toxi-Infections, 484; following
Typhoid Fever in a Child, 493
INDICES
153*
Myoma : Neuroma-, of Mesentery, 541
Myosis : and Paradoxical Mydriasis in
Labyrinthectomised Cat, 31
Myxaxlema: Microscopical Investiga¬
tion of Nervous System in Three
Cases of Spontaneous, 482
Nasopharynx : Physiopathological Re¬
lations between Hypophysis System
and Various Chronic Diseases of, and
Sphenoidal Sinus, 338
Negro: Paralysis Agitans in, 111 ;
Wassermann Reaction among Insane
of Alabama, 638
Neo-Salvarsan : Case of Seventh and
Eighth Nerve Paralysis after Injec¬
tion of, 339 ; Sub-Arachnoid Injec¬
tions of, 548 ; Fatality, 604 ; Death
after Single Injection of, 604 ; Intra-
spinous Injections of, in Monkeys, 603
Neri’s Sign : Mechanism of, 98
Nerve : Innervation of Bladder, 271 ;
of Digestive Tube, .*186 ; of Tensor
Veli Palatini and Tensor Tympani,
•271 ; of Aorta, 322; Distribution, in
Heart, 272 ; Supply of, to Pituitary
Body, 617 ; Origin of Phrenic, in
Rabbit, Cat, and Dog, 324 ; Direct
and Crossed Respiration upon Stimu¬
lation of Phrenic, Sciatic, and Brachial,
325 ; Carbon Dioxide Production from,
when Resting and when Stimulated,
325 ; Experiments on Intradural Anas¬
tomosis of, for Cure of Paralysis, 631
Nerve Cells : Continuity in Vertebrate
Nervous System and Mutual and
Intimate Connections between Neur- j
oglia and Nerve Cells and Fibres, 25 ;
Three Distinct Types of, in Nucleus
of Vagus, which innervate the Three .
Different Types of Muscle, 589 !
Nerves, Cranial : Cephalic Nerves, A
Suggestion, 588 ; Degeneration of, in
Multiple Congenital Osteochondro-
niata, 497 ; Multiple Polyneuritis of,
166
Optic : Ganglionic Glioneuroma of, 107 ;
Case of Evulsion of, 452; Solitary
Tubercle of, Head, 453
Oculomotor: Direct Trochlear and Crossed
Oculomotor Fibres, 507 ; Relapsing,
Paralysis in Uricamiic Subjects, 171 ;
Paresis of, with Abnormal Cyclic In¬
nervation of Inner Branches, 452;
Eye Muscle Nerves in Neeturus, 385
Trigeminal : Segmental Distribution of
Spinal Root Nucleus of, Nerve, 269 ;
Afferent Ganglionated Nerve Fibres >
of Muscles Innervated by, 271 ; ride 1
Neuralgia
Abducent: Diabetic Paralysis of Exter¬
nal Rectus, 602; Delayed Temporary
Paralysis of, in Fractures of Skull, 44
Facial : Case of, and Eighth Nerve Par¬
alysis after Neo-Salvarsan Injection,
339 ; Facio-Hypoglossal Anastomoses,
441
Auditory : Sal varsan on, 172; Intra¬
cranial Division of, for Persistent
Tinnitus, 497; Toxic Neuritis of,
and Changes in Corresponding Gang¬
lion in Diphtheria, 275
Vagus : Action on Human Heart, 95 ;
Nucleus Vagi and Three Distinct
Types of Nerve Cells which innervate
the Three Different Types of Muscle,
589
Hyoglossal : Case of, Nuclei Paralysis,
339
Nerve Fibres : Genesis of Peripheral, 235
Histogenesis of, in Regeneration, 293 ;
Genesis of, in Tumour Formation, 366;
Wallerian Degeneration of, 94 ; De¬
generation and Regeneration of, 93 ;
Degeneration and Regeneration of
Axis Cylinders in nVro, 164
Nerve Root: Achilles .Jerk and Reflex
of Tensor Fascia* Femoris in Sciatica
from Disease of, and of Nerve Trunk,
43
Nerve Tracts : On Direct Ventro-Lateral
Pyramidal Tract, 615; Pyramidal Tract
ot Canadian Porcupine, 429; Motor
Cortex and Pyramidal Tract in Rac¬
coon, 429 : On Cerebro - Cerebellar
Tract, 478; Posterior Longitudinal
Bundle, 318, 430; Meynert's Bundle,
I.A.K., 266: Endogenous Fibres of
Human Spinal Cord (from Examination
of Acute Poliomyelitis), 388
Neuralgia : High Frequency Currents in
Trigeminal, 115; New Method of
Treating Trigeminal, by Injection of
Alcohol into Gasserian Ganglion, 343 ;
Trigeminal Dural, 553; Hyoscine-
Morphia Amesthesia for Alcohol In¬
jection in, 553 ; Franke’s Operation in
Post-Herpetic, 35
Neurasthenia : Pelvic Disorders in Rela¬
tion to, 554: Traumatic, 635
Neurofibrils: in Pellagra according to
Urechia, 32
Neurofibromatosis: Optic Neuritis in,
623 ; Case of Multiple, of Skin, 623;
Macroglosia Congenita Neurofibro-
matosa, 538 ; Four Familial Cases of
M ultiplc Neuromyxofibrosarcomatosis,
279: Molluscum Fibrosuin, Case of,
with Dehnite Family History, 42 ;
Case of von Recklinghausen’s Disease,
42 ; Case of, with Hypernephroma,
154*
INDICES
278 ; and Suprarenale, 497 ; Psychical
Disturbances in Course of, Cutaneous
Gastric and Psychical Complex, 623;
Ganglionic Glio Neuroma of Optic
Nerve, 107
Neuroglia: Continuity in the Vertebrate
Nervous System and the Mutual and |
Intimate Connections lietween, and
Nerve Cells and Fibres, 25
Neuroma: Multiple, of Central Nervous
System: Structure and Histogenesis,
117; Cutis (Dolorosum), 494; Myoma
of Mesentery, 541
Neuroses: Progress in Treatment of, 53;
On Respiratory, 110; Precipitating ;
Causes of Certain, 224 I
Nomenclature : of Sympathetic and I
Related Symptoms of Nerves, 388
Nucleinate, Sodium : Therapeutic Value
of, in General Paralysis and Dementia
Pr.ecox, 556
Nystagmus : in Fevers, 221, 221 ; !
Miner's, 398; Should a Man with
Miner’s, Work? 554
Napoleon: Did, Sutler from Hypopitui- |
tarisin (Dystrophia Adiposo-genitalis)
at Close of his Life? 546
Negri’s Bodies: Presence of, in Nerve i
Ganglia of Salivary (Rands of Rabid
Animals, 618
Negro : General Paralysis in, 007 ; I
Wassormann Reaction among Insane
of Alabama, 638
Neuritis: Rheumatic, 107; Toxic, of
Eighth Nerve and Changes in Corre¬
sponding Ganglia in Diphtheria, 275 ;
Tuberculous, 342
Neuritis, Optic: with Serous Menin¬
gitis and Multiple Polyneuritis, 100; ,
Diagnostic Value of Unilateral, in
Brain Tumour, 219; Retrobulbar, (of
Cbiasma and Tract) in Disseminated |
Sclerosis, 279; Hereditary, 600; in
Neurofibromatosis, 623 ,
OnmiALMnrLKuiA : Bilateral, in Ty¬
phoid, 103
Opsonic Index : of Blood Serum and
Resistance of Leucocytes in Mental
Disease, 010 I
Optic Atrophy: Form of Field of Vision j
in Tabetic, 435 |
Optic Neuritis : ride Neuritis, Optic I
Osteoohondromatft : Multiple Congenital, j
with Degeneration of Cranial Nerves, 1
497
Otitis Media: Suppurative, Analysis of
123 Consecutive Cases with Operation,
40; Purulent Typhoid Meningitis.
Onset with Symptoms of Acute, 101 ;
Paths of Encephalic Infection in, 106 ;
Serous, Meningitis, with Septic Throm¬
bosis of Left Lateral Sinus and Internal
Jugular Vein, Successfully Treated by
Operation, 333 ; Diseases of Labyrinth
Caused by Suppurative, 402; Chronic
Suppurative, Labyrinthitis, and Extra-
Dural Abscess in Toxic Exhaustive
Insanity, 565
Ovary : Functional Association of
Thyroid and, 341
Oxycephaly : and Exophthalmos, 217
Patill<ki>kma : ride Neuritis, Optic
Paraganglin : Action on Kidney, 96
Paraldehyde ; Intravenous, in Tetanus,
030
Paralysis Agitans : Myotonic Defects in,
110; in Negroes, 111 ; on the Psycho¬
pathology of, 111
Paralysis, Facial: r hh Facial Paralysis
Paralysis, General: rich General Paralysis
Parameningococcus, 100; Cerebro-Spinal
Meningitis, 213 ; Meningoeoccic and
Parameningococcic Serotherapy, Death,
213, 277 ; Meningitis Treated and
Cured by Anti Parameningococcus
Scrum, 213 ; Cachectic Form of. Menin¬
gitis Treated and Cured by Dopter’s
Serum, 214 ; Fresh Case of Septicaemia,
with Recurring Meningeal Attacks, 395;
rith Meningitis
Paraplegia: Spastic, with Dorsal Root
Section for Pain and Spasticity, 282 ;
Laminectomy in Compression, 329 ;
Response of Lower Limbs to External
Stimuli in Normal Individuals, and in
Patients Suffering from Spastic, Normal
Movements of Defence and Pathological
Movements of Defence, 328
Parasyphilis: Some Rarer Manifestations
of, of Nervous System, 105; Patho¬
logical Anatomy of Peripheral Nerves
in, 172 ; Passing of, 403 ; Pathology of
Condition known as, 536
Parathyroid : Age as Factor in Effects
whicli Follow Thyroidectomy and Para¬
thyroidectomy in Sheep, 431
Paratyphoid B. : Meningeal State at
Onset of Severe and Prolonged Fever,
278
Parkinson’s Disease ; vide Paralysis
Agitans
Parotitis: Two New Cases of Suppurative,
in General Paralysis, 289
Pasteur, Louis : Study of Flaccid Spinal
Paralysis which attacked, in Early
Maturity, and its similarity to Attack
of Acute Epidemic Poliomyelitis ;
Together with a Study of Silkworm as
INDICES
155*
a possible Mediary Host of the same
Disease, 393
Pathological Anatomy: of Korsakoff’s
Disease, 114; of Peripheral Nerves in
Metasyphilitic Disorders, 172
Pellagra : Fatal, in Two English Boys,
442; Natural History of, with Account
of two New Cases in England, 443 ; in
Great Britain, Three New Indigenous
Cases, 443 ; some Further Cases, 444 ;
Case in England, probably Contracted
in Scotland, 444 ; Further Cases, 499;
a Case of, 499 ; Histological Changes
in Nervous System, 442 ; Neurofibrils
in, according to Urechia, 32; Intestinal
Bacteria in, 499; Metabolism in, 445 ;
Some Hsematological Findings in, 288,
445; Some Facts in its Epidemiology,
342 ; Experimental Production of, in
Monkey of a Berkefeld Filtrate from
Human Lesions—Preliminary Note,
390; Epidemiology of, 554, 601 ; Sup¬
posed Case of, 600; Case of, 600;
Role of Hydrotherapy in, 600; and
Mosquito, 601 ; Intensive Study of In¬
sects as Possible EtiologicFactor in, 636
Periarthritis: Chronic Rheumatic, follow¬
ing Zoster, and restricted to Area of
Eruption, 621
Periodic Paralysis: Remarks upon Ir¬
regular and Unusual Types of Familial,
and Conditions simulating the same,
with a Preliminary Report upon a New
Sub-Type of this Palsy, 459; Case of,
334
Periodicity : in the Male, 288
Pernicious Anaemia: Degenerations of
Spinal Cord in, 489; Etiology of, 599
Personality : Guide to Descriptive Study
of, with Special Reference to Taking
of Anamneses of Cases of Psychoses, 577
Pharyngeal Crises: in Talies, 212
Phrenic Nerve : Origin in Rabbit, Cat,
and Dog, 324; Direct and Crossed
Respiration on Stimulation of, 325
Pia M ater: Punctiform Hcemorrhagio
Pigmentation of Cerebral, 327; Diffuse
Glioma of, 401
Piblokto: or Hysteria among Peary’s
Eskimos, 552
Pigmentation: Generalised with Exoph¬
thalmic Goitre, 46; Punctiform Haemor¬
rhagic, of Cerebral Pia Mater, 327
Pineal Gland: a Review, 1; Anatomy
of, in Man, 206; Medication and
Functions, 274
Pituitary: Anatomy : Nerve Supply of,
617
Physiology : Mechanism of, Glycosuria,
29, 49; Glycosuria in Human and
Animal Tuberculosis, 222; Metabolism
of Carbohydrates, Autonomic Control
of, 274 ; Cardio-Vascular Action of
Posterior Lobe Extract in Acute
Adrenal Insufficiency, 326; Effect of
Thyroidectomy and Castration on
Weight of Rabbit’s, 164; Effect of
Thyroidectomy on, of Rabbit, 430;
Removal of, in Dog, 273,533; Relation
to Growth and Effect of Feeding An¬
terior and Posterior Lobe, 480
Pathology : Changes in, in Diphtheria,
594 ; Classification of Tumours of, 482
Clinical : and its Disorders (Review),
612. Case of Tumour of, 598 ; Tumour
of, in Case of Acromegaly, 441; Tumour
of, Diabetes and Acromegaly, 402;
with Discussion on Tumours found so
far, 401; Tumour of, Operated on by
Hirsch’s Method, 337 ; Symptoms of,
and Uncinate Lesions, 283; Approach
to, through Anterior Cranial Fossa,
220; Hypophyso-Genital Syndrome,
48, 113; Precocious Development in
Boy, aged 9, 49 ; Bitemporal Hemiopia,
283; Failure of Vision and its Treat¬
ment in Diseases of, 599; Case of
Hyperactivity of Anterior Lobe
combined with Deficient Posterior
Lobe, 599; On Physio - Pathological
Relations between, and Various
Chronic Diseases of Nasopharynx and
Sphenoidal Sinus, 338 ; Cyst of,
operated on by Nasal Route, 337;
Continuous Administration of Extract
of, 612. Vide Hypopituitarism, &c.
Plaques : Investigations on Senile, 207
Pluriglandular : Endocrinic Syndrome
and Dementia Pra*cox, 226
Pneumococcus : Purulent, Meningitis.
Absence of Cellular Reaction in Cere-
bro-Spinal Fluid, 212 ; Case of, Menin-
gi tis wi th Normal Cerebro-Spinal Fluid,
331, 395 ; Case of, Meningitis, 395 ;
Cerebral Complications in Pneumonia,
495
Poliomyelitis Anterior Acuta : Treatment
of (Review), 562; Two Simultaneous
Cases of Acute, in Two Children of
Same Family—Typical Paralysis in
One, Simple Meningeal State in Other,
278; Aborted Forms in Pre-Paralytic
Stage of, in Buffalo Epidemic, 394; Poly-
neuritic Form of, Clinical and Patho¬
logical Study, 597, 628; Epidemic,
Passive Human Carriage of Virus of,
627 ; Experiments on Cultivation of
Micro - Organism causing Epidemic,
596; Transmission to Monkeys of
Virus Obtained from English Cases of,
537 ; Transmission of, by Stable Fly,
104 ; Similarity to Spinal Flaccid Par-
loti*
INDICES
alysis which Attacked Louis Pasteur,
and Possibility of Silkworm as Mediary
Host, 393; Study of Cerebro-Spinal
Fluid in, 627 ; Endogenous Fibres of
Human Spinal Cord (Case of), 388 ;
Paralysis in I>og Simulating, 439
Polyneuritis : Psychosis after Induced
Abortion, 114; Multiple, of Cranial
Nerves with Papilhedema and Serous
Meningitis in Young Alcoholic Smoker,
166 ; Tetanus ; Chloretone Poisoning ;
Recovery followed by, 341 ; following
a Phlegmon of Right Index, 451 ; Form
of Poliomyelitis—Clinical and Patho¬
logical Study, 597, 628
Posterior Longitudinal Bundle : An
Anatomical Study, 318; Physiological
Analysis of, 430
Posterior Roots: Physiology of, in
Light of Recent Surgical Procedures,
590; Neurectomy of, for Relief of
Pain in Incurable Cancer, 600
Pott’s Disease: Without Curvature in
the Senilium, 109 ; Case of, 624
Preoocious : Development in Boy aged 6,
49; Cerebral Syphilis, 286
Progressive Lenticular Degeneration : a
Familial Nervous Disease associated
with Cirrhosis of the Liver, 167
Progressive Muscular Atrophy : Aran-
Duchenne Type of—Second Case with
Autopsy, 215 ; Unilateral, Facio-
Soapulo • Humeral Type, 215; and
Acromegaly, 441 ; Relation of Syphilis
to, 446
Prostate : Action of Extracts of, on Cere¬
bral and Renal Circulation, 273
Pruritus : in Tabes and Arseno-Benzol,
277
Pseudomeningococcus Infections, 100;
ride Meningitis
Psycho-Analysis (Review), 506
Psychology: of Juvenile Criminals, 207 ;
Dreams and Myths: a Study in Race
(Review), 291
Psychopathology: of Paralysis Agitans,
111 ; of Emotional Psychosis during
War, 345 ; Series of Normal-Looking
Brains in Psychopathic Subjects, 405 ;
International Treatise of (Review), 559
Psychoses : Syphilitic, 52 ; Gynecological
Disease in Insane and its Relationship
to, 51 ; Polyneuritic, after Induced
Abortion, 114; Manic-Depressive, in
Twins, 176 ; Precipitating Causes of
Certain, 224; Psycho-Pathology of
Emotional, during War, 345 ; Pre-
Sen ile, 456; following Carbon Mon¬
oxide Poisoning with Complete Re¬
covery, 501 ; Contributions to Clinical
Study of Hysterical Situation-, 502;
Functional, of Senile Period, 557;
Guide to Descriptive Study of Person¬
ality — with Special Reference to
Taking of Anamneses of Cases with,
577 ; rid* Manic-Depressive
Puorperium : Hemiplegia following
Scarlet Fever in, 102; Herpes Zoster
in, 211 ; Tetanus, 340
Pulmonary Vessels : Action of Adrenalin
on, ana on Vasomotors of Lung, 28,
28
Puncture : of Brain in Tumour of Fourth
Ventricle and Idiopathic Hydro¬
cephalus, 169 ; ride Lumbar Puncture
Pupil: Rebounding, 484
Purpura : Meningococcal Septicaemia,
Serotherapy. Recovery, in Infant of
Five Months, 37; Symmetrical, of
Left Arm and Zoster of Right Arm, 98
Pyramidal Tract, Direct Ventro-Lateral,
610; in Canadian Porcunine, 429; in
Raccoon, 429 ; Cerebral Paralysis with
Intact, 170
Raynaud's Disease, 341
Recurrent Laryngeal Nerve: ^Etiology
of Unilateral Paralysis of, 488
Keflex : Achilles Jerk and, of Tensor
Fascia? Femoris in Sciatica from
Diseases of Nerve Root and of Nerve
Trunk, 43; A Reflex Phenomenon in
Upper Limb—the “Forearm Sign,”
432 ; Absence of Abdominal, in Chronic
Alcoholism, 498; Note on Contra¬
lateral Oppenheira and Gordon, with
Observations in Two Cases, 619;
Frequency and its Clinical Value, 620 ;
Response of Lower Limbs to External
Stimuli in Normal Individuals and in
Patients suffering from Spastic Para¬
plegia—Movements of Defence, 328;
Plantar, Flexor in Organic Hemiplegia
following Typhoid, with Babinski’s
“Second Sign ” present, 330 ; New, in
Extirpation of Vestibule of Labyrinth
with Cerebellar Abscess, 399; Vaso¬
dilator Axon-, 532
Regeneration: Histogenesis of Nerve
Fibres in, 293 ; Investigation of Nerve,
531
Respiration : Graphic Records of, Par¬
alysis, 433; Neuroses, 110.
Retina : Tuberculous Changes in, 452
Reviews: (Sw r ale Vincent) Internal Secre¬
tion and the Ductless Glands, 176;
(Niessl v. Mayendorf) Aphasia and its
Cortical Localisation, 230 ; (Bruns and
Ziehen) Text-book of Nervous Diseases
in Children, 231 ; (Stephenson) Eye-
Strain in Everyday Practiee, 233;
INDICES
1*7*
(Sermyn) The Study of Some Little
Appreciated Cerebral Faculties, 290;
(Abraham) Dreams and Myths: a
Study of Race Psychology, 291 ;
(Elliot) Sclero-Corneal Trephining in
the Operative Treatment of Glaucoma,
346; (Mestrezat) The Cerebro-Spinal
Fluid, Normal and Pathological, Clini¬
cal Value of Chemical Examination,
406; (White) Outlines of Psychiatry,
407; (Mark) Acromegaly, a Personal
Experience, 457 ; (Lewis Jones) Ionic
Medication, 505; (Ernest Jones) Papers
on Psycho-Analysis, 506; (A. Marie)
International Treatise on Psychologi¬
cal Pathology, 559; (Villiger) Brain
and Spinal Cord [translated bv Piersol],
562; (Vulpius) Treatment of Infantile
Paralysis [translated by Todd], 563 ;
(Cushing) Pituitary Body and its Dis¬
orders, 612 ; (Dejerine and Gauckler)
Psychoneuroses and their Treatment
by Psychotherapy [translated by Smith
Ely Jelliffe], 613; (Hug-Hellmuth)
The Mental Life of the Child, 640;
Internationale Zeitschrift fur Arztliche
Psychoanalyse, 613; (Cole) Mental
Diseases, 641
Rheumatism: Neuritis, 107; Avenues
of Infection based on 75 Cases of
Sydenham’s Chorea, 112; Chronic,
Periarthritis following Zoster and re¬
stricted to Area of Eruption, 621
Rib : vide Cervical Rib
Richelieu’s, Cardinal, Disease, 500
Salivary Glands : Symmetrical Hyper¬
trophy of, in a Cretin, 46 ; Reactions
of Salivary Centres, 532; Presence of
Negri’s Bodies in Nerve Ganglia of, of
Rabid Animals, 618
Salvarsan: Effect on Auditory Nerve,
172; Recent Syphilitic Hemiplegia
considerably improved by, 172 ; Pruri¬
tus in Tabes and, 277; and Tal>es,
392; An Eye Lesion following Two
Intravenous Injections of, but Relieved
by its Further Use, 339; Treatment
of Syphilis with, 340; Oily Injections
of, a Warning, 340; Dangers and
Complications of, 447 ; Graves’ Dis¬
ease with Sclerodermia and Positive
Wassermann Reaction treated with,
446 ; Effect of Intravenous Injection
of, on Kidneys, 447 ; Death from, 547 ;
Intraspinous Injections of, 548 ; Intra-
spinous Injections of, in Monkeys, 603 ;
in General Paralysis and Tabes, 607 ;
Spirochaeticidal Action of Serum of
Patients treated with, 603 ; Death
from Syphilis occurring Nine Days
after Injection of, 635; Seven Cases
of Syphilis apparently Cured with One
Injection of, 633
Sarcoma: of Left Frontal Lobe, 108 ;
Positive Wassermann’s Reaction in,
169
Scarlet Fever: Hemiplegia following, in
Puerperium, 102 ; Hemiplegia in, 436 ;
Meningism in, 437; Role of, in Etiology
of Nervous Diseases, 537
Schopenhauer : Importance of, for Psy¬
chiatry, 227
Sciatica : Achilles Jerk and Reflex of
Tensor Fascia* Femoris in, from Disease
of Nerve Root and of Nerve Trunk,
43 ; Adiposis Dolorosa in, a Variety
Localised in the Affected Lower Limb,
287
Sciatic Nerve: Some Anatomical Con¬
siderations of Disposition of, and
Femoral Artery, 551
Sclerodermia: with Graves’ Disease and
Positive Wassermann Reaction Treated
with Salvarsan, 446
Sclerosis, Disseminated: Disseminated
Sclerosis
Scoliosis : Spinal Tumour with, Opera¬
tion, 392
Scotoma: Hemiopic Central, in Dissemin¬
ated Sclerosis and Retrobulbar Neuritis,
279
Scurvy : Cytological and Chemical Re¬
searches on Blood in, Mental Cases,
227
Sella Turcica : ride Acromegaly
Semicircular Canals : Operation for
Destruction of, in Dog, 30; Glycosuria
following Destruction of, in Dog, 32
Septiciemia: Meningococcal, 37 ; Menin¬
gococcal, Purpura, in Infant of Five
Months ; Serotherapy ; Recovery, 37
Serratus Magnus : Paralysis of, 488
Sheep : Histology of the Cranial Auto¬
nomic Ganglia of the, 24
Simulation: of Insanity and Ganser’s
Syndrome, 114
Skull : Delayed Temporary Paralysis of
Sixth Cranial Nerve in Fractures of 44,
Sleeping Sickness : Contribution to Psy¬
chiatry and Neurology of, 173
Smallpox ; Encephalo - Myelitis after,
with Remarks on Diseases of Glands
of Internal Secretion, 491 ; Diseases
of Spinal Cord in, 592
Spasticity: Dorsal Root Section for
Pain and, 282
Sphenoidal Sinus: Physio-Pathological
Relations between Hypophysis System
and various Chronic Diseases of Naso¬
pharynx and, 338
1.38*
INDICES
•Spinal Corel: Anatomy: Endogenous |
Fibres of Human, from Examination I
of Case of Acute Poliomyelitis, 388 j
PhytirjJo'iy: Functional Autonomy of i
Experiments on Avian Lumbar Cord,
828; On Sensory Conduction of Human,
Paths of Sensory Conduction
in. Brown • Serjuard Syndrome with
Dissociation of Sensory Loss of Syrin¬
gomyelic Typ*, 828: Experimental
Investigation of Concussion of, and
Allied Conditions, 488
Patholo<jy: Degeneration of, in Pernici¬
ous Amernia, 4s9 ; Striped Muscle
Fibres in, in Syringomyelia, 97
Clinical: Combined Degeneration of, 86,
76, 165; Bullet Wound of, 41 ; Diseases |
c>f, in Smallpox, 5i*2; Some Clinical
Phenomena of Transverse Lesions of,
587; Spinal Tumour witli Scoliosis,
Operation, 31*2 ; Differential Diagnosis
of Intra- and Extra * Medullary Dis¬
orders of, 210
Spirochit'ifi ptiUida. in (General Paralysis
and Tabes Dorsalis, 585
Splanchnic Nerves: Control of Supra¬
renal Glands by, 479
Stable Fly : Transmission of Polio
myelitis by, 104
Status Epilepticus : r id*. Epilepsy
Stramonium : Delirium Tremens? due
to, Poisoning, 686
Strychnine: in Heart Failure, 559
Sub-Acute Combined Degeneration ; of
Spinal Cord, 86 ; 165 ; 76
Suicide, 114 ; on attempted, with
Analysis of 1000 Consecutive Cases, 6J1
Suprarenals : in Aneneephaly, 84 ; Con¬
trol by Splanchnic Nerves, 479 ; Part
played in Normal Vascular Reactions
of Body, 27 ; Muscular Syndromes,
178 ; Effects of Massage of, on Blood
Pressure, 826 ; Cardio-Vascular Action
of Pituitary Posterior Lobe Extract in
Acute, Insufficiency, 826 ; and Reck¬
linghausen’s Disease, 497 ; Weight of,
in Insane, 619 ; Slowly Developing,
Insufficiency of Cerebral Form follow'-
ing Typhoid Fever, 682; ride Adrenalin
Sympathetic : Development of Cranial,
Ganglia in Pig, 270 ; Nomenclature of,
and of related Systems of Nerves, 888 ;
ride Autonomic
Synapse: The Interneuronic Synapse in
Disease, 488
Syndrome : Hypophy so-Genital, due to
Syphilis, 49, 113; Pexluncular and
Bulbo-Pontine, in Typhoid, 102 ;
Thyro-Testiculo-Hypophyseal, 113 ;
Simulation of Insanity and Gangers,
114 ; Suprarenal Muscular, 173 ; Pluri- |
glandular Endocrinie, and Dementia
rrwcox, 226; Brown-Sequard, with
Dissociation of Sensory Loss of Syringo¬
myelic Type, 328; Subacute Meningeal,
of Syphilitic Origin, 438
Syphilis : Case of Cerebral, occurring Six
Months after the Initial Lesion, 367 ;
Clinico - Pathological Findings in, of
Central Nervous System, 411 ; Psy¬
choses, 52 ; Fever in Late Stage of, 43 ;
Hemiplegia in Early Stage of, 43 ; Case
of Hypophvso-Genital Syndrome due
to, 48,113; Acute, Meningo-Encephali¬
tis in Tabes, 99; Recent, Hemiplegic
considerably improved by Salvarsan,
172; Acute Meningitis, 167 ; On Recur¬
rence of Nervous Symptoms of, Origin,
223 ; On Precocious Cerebral, 286;
with concealed Primary Lesion, 285;
Cutaneous Reaction in, 403, 550; and
Progressive Muscular Atrophy, 446;
Subacute Meningeal Syndrome of.
Origin, 438 ; foliow'ed W Landry’s
Syndrome and later by Tabes Dorsalis,
489 ; Intra-Spinous Injections in Treat¬
ment of, 548, 603; Subarachnoid Injec¬
tion of Neosalvarsan in, 548; Double
Hemiplegia and Pseudo-Bulbar Par¬
alysis following, 550; Incidence of
Inherited, in Congenital Mental Defici¬
ency, 557 ; Monocular Paralysis of
Aceommediation due to, 603; Death
from, occurring Nine Days after
Injection of Salvarsan, 633; Seven
Cases of, apparently Cured with One
Injection of Salvarsan, 633; Role of,
in Mental Deficiency and Epilepsy;
Review of 205 Coses, 638; Gumma
Cerebri, Histological Features, 549;
ride Salvarsan, Neo-Salvarsan, Ac.
Syringomyelia: with Hyperplasia of
Connective Tissue and with Striped
Muscle Fibres in Cord, 97; Brown-
Sccjuard Syndrome with Dissociation
of Sensory Loss of Type of, 328 ; Spinal
Gliosis and, Involvement of Cervical
Cord, Glia Tuft on Floor of Fourth
Ventricle, 490; with Pathological
Findings, 629; Mild Manifestations
of, 630 ; vide Gliosis
Tabes Dorsalis ; Intermittent Exoph¬
thalmic Goitre in, with Bronchial
Asthma, 35; Franke’s Operation for
Gastric Crises in, 35; Intercostal Zoster
in, 98 ; Etiology of Arthropathies, 99 ;
Acute Syphilitic Meningo-Encephalitis
in, 99; Case of Juvenile, 211 ; Central
Convolutions in, 212; Arthropathy,
Pharyngeal Crises, 212; Pruritus in,
INDICES
159*
and Arseno-Benzol, 277; Spontaneous
Haematomata in, Woman, 331 ; and
Salvarsan, 392, 607; Form of Field of
Vision in Optic Atrophy, 435 ; Gastric
Crises in Ulcerative Cancer of Lesser
Curvature, 436; Syphilitic Infection
followed by Landry’s Syndrome and
later by, 489; and Facial Paralysis,
538 ; Presence of Spirochirta pallida
in, 535 ; Blindness and, Introduction
to New Method of Curing Ataxia, 622
Temporal Bone: Ganglion in Human,
not hitherto Described, 321
Tephromalacia: Anterior, Isolated and
Stationary Atrophy of Small Muscles
of Head, 216
Tetanus: Case treated with Massive
Doses of Antitetanic Serum, 111;
Cure of, by In tra-Spinal Serotherapy,
223; Case of Puerperal, 340; Chlore-
tone Poisoning ; Recovery ; followed
by Polyneuritis, 341 ; Intraspinai In¬
jections of Magnesium Sulphate in,
451 ; Case of, Treated bv Intravenous
Injections of Paraldehyde and Copious
Injections of Normal Saline resulting
in Cure, 636
Tetany: following Extirpation of the
Thyroid, 46
Thread-Worms : Case of Meningitis in
which the Symptoms were Caused by
Escape of, into Peritoneal Cavity
through Perforated Appendix Vermi-
formis, 539
Thrombosis : of Vertebral and Posterior
and Inferior Cerebellar Arteries, 281
Thyroid : Tetany following Extirpation
of, 46; Effect of Th} r roidectomy and
Castration on Weight of Rabbit’s
Pituitary, 164; Effect of Extirpation
of, on Hypophysis Cerebri in Rabbit,
430; Age as a Factor in Effects
which follow Thyroidectomy and Para¬
thyroidectomy in Sheep, 431 ; Func¬
tional Association of, and Ovary, 341 ;
Adiposis Dolorosa—Striking Benefit
from Fresh, 173
Thyroiditis: Late Suppurative Post-
Typhoid, and Secondary Graves* Dis¬
ease, 552; Acute, as Complication of
Acute Tonsillitis, 606
Thyro-Testiculo-Hypophyseal Syndrome,
113
Tinnitus : Intracranial Division of Audi¬
tory Nerve for Persistent, 497
Torticollis: Mental, 104
Touch : Accuracy of Localisation of,
Stimuli on Different Bodily Segments,
390
Transient Attacks of Paralysis : Autopsy,
419
Trauma: Post-Traumatic Syndrome Re¬
sembling General Paralysis Caused by
an Acute Meningitis of Slow Evolu¬
tion, 40; Unilateral Argyll Robertson
Pupil due to Orbital, 217 ; Delirium
Tremens and Cranial, 404; Neuras¬
thenia, 635
Treatment: vide Psychoanalysis, Sal¬
varsan, kc.
Treponema pallidum : Demonstration of,
in Brain in General Paralysis, 174,
343, 404 ; Transmission of, from Brains
of Paretics to the Rabbit, 456 ; Con¬
cerning Agglutinins for, 447 ; Study of
Complement Fixation in Syphilis with,
Antigens, 448
Trigeminal Nerve : tnde Nerves, Cranial
Trigeminal Neuralgia : vide Neuralgia
Trochlear Nerve : vide Nerves, Cranial
Tuberculin: in Case of Addison’s Disease,
112
Tuberculosis: Association of, with Dis¬
orders of the Nervous System, 98;
Leprosy, Giantism and Acromegaly,
169; Pituitary Glycosuria in Human
and Animal, 222 ; Neuritis, 342; in
Retina, 452; Solitary, of Optic Nerve
Head, 453; Subcortical Cerebral
Tumour, Operation, Recovery, 544;
vide Meningitis
Tumour: Spinal , with Scoliosis, Opera¬
tion, 392
Cerebral , Sarcoma of Left Frontal
Lobe without Definite Symptoms until
shortly before Death, 108 ; Two Cases
of Colloid Tumour of Third Ventricle
causing Death, 108; Diagnosis of
Tumours of Fourth Ventricle and of
Idiopathic Hydrocephalus, with Note
on Brain Puncture, 169; Epidermoid
Cholesteatoma of Brain, 208 ; Diag¬
nostic Value of Unilateral Choked
Disc and Unilateral Exophthalmus in
Brain, 219; Cerebellar and Vestibular
Symptoms caused by Cerebral, Acting
from a Distance, 218 ; Cerebellar, 283,
400; Meningeal Fibro-Endothelio-
rnata, 283; Case of Brain, 336; of
Cerebello - Pontine Angle, 45, 336;
Cholesteatoma of Brain, 337; End
Results in 63 Cases of Operation for,
400; Report of Case of I^arge Endo¬
thelioma of Frontal Region, 401;
Diffuse Glioma of Pia Mater, 401 ;
Remarks on Treatment of, 543; Sub¬
cortical, Tuberculous, Removed by
Operation; Recovery, 544; Conse¬
cutive Displacement of Cerebral
Hemispheres, or Removal of, and
i Haemorrhage, 543; Decompression
♦ Craniectomy, 45 ; vide Pituitary
ICO*
INDICES
Twins : Manic-Depressive Psychosis in,
176; Insanity in, 345
Typhoid : Purulent, Meningitis ; Onset
with Acute Otitis, 101 ; Hemiplegia in,
10*2 ; Peduncular and Bulbo Pontine |
Syndromes in, 10*2 ; Bilateral Ophthal¬
moplegia in, 103 : Meningeal State in, j
105; Purulent, Meningitis in Typhoid i
State without Intestinal Lesions, 166 ; .
('use of Organic Hemiplegia following, !
with Flexor Plantar Reflex, and 1
Bahinski's “Second Sign”—Combined \
Movement of Trunk and Pelvis, 330 ; i
Two Unusual Cases of, 430; Aphasia j
in, of Children, 430; Myelitis following, 1
in a Child, 403 ; Bulbar Paralysis in, j
403 ; Meningitis, 49*2 ; Transitory !
Cere hello-Spastic Syndrome in Con¬
valescence from, 403 ; Suppurative
Post-Thyroiditis and Secondary < J raves’
Disease, 55*2 ; Influence of, on Existing
Mental Conditions, (>07 ; Disease of *
Ulnar Nerve after, 031 ; Agglutination |
of, Bacillus by Cerebro-Spinal Fluid of, j
Patient, 032 ; Slowly developing |
Suprarenal Insuflicieney of Cerebral ;
Form following, 03*2
Typhoid Spine : A Fresh Case of, in the
Child, 30; Two Cases of. Observed in j
Paris, 30, ‘281 ; Case of, 397 I
UenakNkkvk: Disease of, after Typhoid |
Fever, 031 I
Uncinate; and Pituitary Symptoms and |
Lesions, *283 j
Unemia : Pathogeny of, Paralysis, *216 j
Urethritis : in General Paralysis, with
Remarks on Exhibition of Hexamcthy-
lene-Tetramine, *2*25
Urie.emia : Relapsing Oculomotor Par¬
alysis in, 171
on Brain Puncture, 169; Spinal Gliosis
and Syringomyelia. G lia Tuft on Floor
of Fourth Ventricle, 490
Fifth, 397
Ventricle (Heart): Action of Certain
Drugs on Isolated Strips of, *275
Vertebra: Spontaneous Reduction of
Dislocation of Cervical, 434
Vertigo: Aural (non-suppurative), a
Clinical and Therapeutic Study, 106
Vestibular Apparatus : and Central
Nervous System; Cerebellar and Vesti¬
bular Symptoms caused by Cerebral
Tumours acting from a Distance, 218
Volkmann : Isememie Contracture of
Hand, 434
von Recklinghausen’s Disease : iHde
Neurofibromatosis
Wallkkian Degeneration : Nature of,
94
War : Psycho-Pathology of Emotional
Psychosis during, 345
Wossermann’s Reaction ; Positive in
Sarcoma, 169 ; in Diabetes Mellitus,
with Special Reference to its Relation
to Acidosis, ‘286 ; Graves’ Disease with
Kcleroderntia and Positive, treated
with Salvarsan, 446 ; with Normal
Rabbit’s Serum, 449; Study of the
Addition of Cholesterin to the Alcoholic
Extracts of Tissues used for Antigens
in, 448 ; A Study of Complement Fixa¬
tion in Syphilis with Treponema
Antigens, 448; On Frequency of, in
Cerebro-Spinal Fluid in General Par¬
alysis, 500; among Negro Insane of
Alai Mima, 638
Wry neck : Hereditary Congenital, (305
X-Ray : Exophthalmic Goitre Cured by,
403 ; Treated by, 504
Vaso-Dilator ; Axon Reflexes, 532
Vagus : vide Nerves, Cranial
Vasomotor ; Part Played by Suprarenal
in Normal, Reactions of Body, 27;
Further Observations on, Phenomena,
*27 ; of Lung, and Action of Adrenalin,
28 ; Effect of Lubyrinthectomy in Dog,
especially on, Innervation, 30
Ventricle : Third , Two Cases of Colloid
Tumour of, causing Death, 108 ; Epen¬
dymal Gliomatosis of Brain Ventricles,
48°
Fourth j Diagnosis of Tumours of, and of
Idiopathic Hydrocephalus, with Note
Zoster: Intercostal, in Tabes, 98; of
Right Arm, with Symmetrical Purpura
of Left Arm, 98; Herpes, in Puer-
perium, 211 ; Reflex, in Lithiasis, 211 ;
Herpes Frontalis with Bacterial Find¬
ings in Gasserian Ganglion, 210 ; Case
of Cervical, 434 ; of Inferior Maxillary
Nerve, 485; Cervical, and Paralysis,
6*20 ; Ionic Medication in Herpes,
620: Chronic Rheumatic Periarthritis
following, and Restricted to Area of
Eruption, 621; Franke’s Operation in
Post Herpetic Neuralgia, 35
INDICES
161*
INDEX OF AUTHORS.
Page r ffe.rznc.es to Original Articles are indicated by heavy type figures.
Abercrombie, R. The Treatment of
Muscular Paresis by Means of Eccentric
Movements, 115
Abraham, Karl. Dreams and Myths; a
Study in Race Psychology. (Review),
291
Abrahamson, I. A Case of Dystonia
Musculorum Deformans (Oppenheim),
276
Abundo, G. d*. Partial Symmetrical >
Microgyria of the Cerebral Hemis¬
pheres and its Probable Compensatory
Effects, 218
Achard, C., and Desbouis, G. Very
Early Acute Syphilitic Meningitis, 88
Aguglia, E. Affection of Conus Medul-
laris following Rachistovainisation,
624
Allan, Geo. A. Tuberculous Meningitis
(Bovine Infection) in an Infant aged
12 Weeks, 625
Allen, A. R., and Sweet, J. E. The
Effect of the Removal of the Hypo¬
physis in the Dog, 273, 533
Almkvist, J. Syphilis with Concealed
Primary Lesion, 285.
Amsden, George S., and Hoch, August. |
A Guide to the Descriptive Study of !
the Personality. With Special Refer- '
ence to the Taking of Anamneses of i
Cases with Psychoses, 577
Anderson, J. F., and Frost, W. H.
Transmission of Poliomyelitis by i
Means of the Stable Fly, 104
Angelo, P. Manic-Depressive Psychosis.
Graves* Disease and Marie’s Ataxy:
Friedreich’s Disease, 344
Angus, H. B., and Hall, George. Case
of Sul>cortical Cerebral Tumour, Tuber¬
culous in Nature, Removed by Opera¬
tion ; Recovery, 544.
Anrep, G. von. The Part Played by the
Suprarenals in the Normal Vascular
Reactions of the Body, 27.
Ardin-Deltheil, Raynaud, M., and
Coudray, M. A Fresh Case of Typhoid
Spine in the Child, 36
Atkey, Oliver. A Case of Tetanus
treated by Intravenous Injections of
Paraldehyde and Copious Injections of
Normal Saline resulting in Cure. 636
Atwood, C. E., and Clark, L. Pierce.
A Study of the Significance of the
Habit-Movements in Mental Dejec-
tives, 228
Auclair, J., and Weissenbach, R. J.
Two Cases of Typhoid Spine observed
in Paris, 36
Auerbach, S. A New Esthesiometer,
276; On the Pathogeny of Post-
Diphtheritic Paralysis of Accommoda¬
tion, 623
Baird, Harvey. Urethritis in General
Paralysis with Remarks on the Ex¬
hibition of Hexaraethylene-Tetramine,
225
Ballance, C. A. Remarks on the Treat¬
ment of Brain Tumour, 543
Bankart, A. S. Blundell. The Technique
of Excision of Cervical Ribs, 621
Bankart, A. S. Blundell, and Harris, W.
A Case of Spinal Tumour with
Scoliosis; Operation, 392
Barany, R. Observations concerning the
Relations existing between the Vesti¬
bular Apparatus and the Central
Nervous System—Cerebellar and Vest i -
bular Symptoms caused by Cerebral
Tumours acting from a Distance, 218
Bardes, A. The Effect of Salvarsan
upon the Auditory Nerve, 172
Bari£, E., and Colombe, J. Transitory
Cerebello-Spastic Syndrome in Con¬
valescence from Typhoid Fever, 493
Barkowski, J., Marie, A., and Levaditi,
C. Presence of the Treponema jtal/i-
Jnm in the Brains of Three General
Paralytics, 404
Barnes, F. M. The Syphilitic Psychoses,
52; General Paralysis in the Negro,
607
Baron, Oettinger, and Marie, P. L. A
Fresh Case of Parameningococcus
Septicemia with recurring Meningeal
Attacks, 395
Barr, C. H., and Crow, C. B. Mirror
Writing and other Associated Move¬
ments occurring without Palsy, 393
Barrett, A. M. Diffuse Glioma of the
Pia Mater, 401 ; A Case of Alzheimer’s
101'*
INDICES
Disease with Unusual Neurological j
Disturbances, 4,57 I
Batten, F. E. Atrophy of Distal Muscles I
in all Four Extremities. ’Cause, 330 ;
Cerebral Symptoms in a Bulldog asso¬
ciated with Lymphocytic Infiltration
of the Vessels and Membrane of the
Brain and Spinal Cord, ,530 ]
Batten, F. E., and Holmes, Cordon.
The Endogenous Fibres of the Human
Spinal Cord (from the Examination of
Acute Poliomyelitis), 388
Battez, C. On the Functional Associa¬
tion of the Thyroid and Ovary, 341 !
Baudouin, A., and Claude, H. Hypo¬
physial Glycosuria and Adrenalin ,
Glycosuria, 29; The Mechanism of j
Pituitary Clycosuria, 49
Baudouin, A., Vorak, K., and Claude, H. \
Pituitary Clycosuria in Human and j
Animal rulsTculosis, 222
Baumel, J., and Roger, H. Headache
in Acute Infectious Diseases treated
and cured by Lumbar Puncture, 16,5 ^
Bayly, H. W. The Dangers and Com¬
plications of Salvarsan Treatment,
447
Bean, It. B. The Cephalic Nerves:
Suggestions, 588
Beck, ()., and Biach, P. Nystagmus in
Fever, 221
Becker, W. H. The Influence of
Typhoid Fever on Existing Mental
Disease, 697
Bee us, O. Keflex Zoster in Lithiasis,
211
Benedict, H. Hereditary Degeneration
and Post-Diphtheritic Paralysis, 4!MI
Bentall, W. C. Spontaneous K(h1uc-
tion of a Dislocation! of the Cervical |
Vertebra*, 434 |
Berger, H. On Experimental Investiga- i
tions on the Influence of Cerebral
Hiemorrhage, Cerebral Embolism, Epi¬
leptic Attacks and Concussion on the
Circulation in the Brain, 220
Berkeley, W. N., and Dana, C. L. Pineal
Medication and Functions, 274
Bernheim. On the Various Clinical
Evolutions of Toxi-Infective Myelitis,
484
Bernstein, E. P., and Harwitt, S. Syring- j
omvelia; with Pathological Findings,
629
Bertschinger, H. On the Precipitat- !
ing Causes of Certain Neuroses and
Psychoses, 224
Besta, C. On the Cerebro-Cerebellar
Tracts, 478
Be vers, E. C. A Case of Facio Hypo¬
glossal Anastomosis, 441
Biach, P., and Beck, O. Nystagmus in
Fever, 221
Bigelow, 0. P. The Diagnosis of Cerebral
Haemorrhage by Means of Lumbar
Puncture, 440
Bjalokur. Fever in the Later Stages of
Syphilis, 43
Blandy, Gurth S. A Contribution to the
Study of Pellagra in England, 499
Blaye, R. le, Delage, and Morichau-
Beauchant. Fulminating Cerebro-
Spinal Meningitis due to an Undeter¬
mined Cocco-Bacillus, 214
Bogatseh. Contribution to the /Etiology
of Bitemporal Hemiopia with Particular
Reference to Hypophysis Disease, 283.
Boggs, T. R. Multiple Congenital
Osteochondromata, with Degeneration
of Cranial Nerves, 497
Boghassian. Delirium Tremens? due to
Stramonium Poisoning, 636
Boidin, L. Meningeal State at the Onset
of Severe and Prolonged Paratyphoid
B. Fever, 278
B< >lzani, G. On a Case of Pott’s Disease, 624
Bon hoe tier, K. On the Diagnosis of
Tumours of the Fourth Ventricle and
of Idiopathic Hydrocephalus, with a
Note on Brain Puncture, 169
Bonhoure, J. Typhoid Spine, 281
Bonin, Gerhardt v. A Case of Dyspitui-
tarisin, 48 ; Classification of THimoura
of the Pituitary Body, 482
Bonola. The Achilles Jerk and Reflex
of the Tensor Fascia; Femoris in
Sciatica from Disease of the Nerve
Root, and from Disease of the Nerve
Trunk, 43
Bosquet, I. Recklinghausen’s Disease
and the Suprarenals, 497
Bout* he, E. Decompression Craniec¬
tomy, 45 ; Tabes and Salvarsan, 392
Boulet, L., and Dubois, C. The Action
of Prostatic Extracts on the Cerebral
and Renal Circulation, 273
Bourdiniere, J., and Chevrel, F. Two
Fatal Cases of Non-Meningococcal
Cerebro-Spinal Meningitis caused by
a Polymorphous Coccus, 37
Bourdiniere, J., and Follet, A. Para¬
meningococcus Cerebro-Spinal Menin¬
gitis, Meningococcicand Parameningo-
coccic Serotherapy; Death, 213; Para¬
meningococcus Cerebro-Spinal Menin¬
gitis, Meningococcal and Parameningo-
coecal Serotherapy : Death, 277
Bovier and Favre. A case of Typhoid
Spondylitis, 397.
Boyd, Wm., and Hop wood, J. 8. A
Case having a Bearing on the Localisa¬
tion of the Auditory Centre, 642
INDICES
1G3*
Box, Charles, R. Fatal Pellagra in Two
English Boys, 442
Brady, J. M. Report of a Case of Pneu¬
mococcus Meningitis with Normal
Cerebro-Spinal Fluid, 331, 395
Brandeis, R., and Mongour, C. Ag¬
glutination of the Typhoid Bacillus by
the Cerebro - Spinal Fluid of the
Typhoid Patient, 632
Branson, W. P. S. The Avenues of
Rheumatic Infection; Based upon
Examination of Seventy-five Cases of
Sydenham’s Chorea, 112
Brelet, M. Aphasia in the Typhoid
Fever of Children, 439
Breton, P. le, and Kauffmann, Lesse.
A Case of Spastic Paraplegia, with
Dorsal Root Section for Pain and
Spasticity, 282
Brigham, F. G., Fitz, R., and Minot, J.
J. Bulbar Paralysis in Typhoid Fever,
493
Brill, A. A. Piblokto or Hysteria
among Peary’s Eskimos, 552
Briseve, J. F. Appendicitis in Private
and Public Hospitals for the Insane,
52
Broca, A., and Desplas, B. Delayed
Temporary Paralysis of the Sixth
Cranial Nerve in Fractures of the
Skull, 44
Bronstein, B. Acute Syphilitic Menin¬
gitis, 167
Brown, T. Graham, and Sherrington, C.
S. Note on the Functions of the
Cortex Cerebri, 272
Bruce, the late Alexander, and Dawson,
James W. Multiple Neuromata of
the Central Nervous System: Their
Structure and Histogenesis, 117, &c.
Bruce, A. Ninian. V 7 aso-dilator Axon- |
Reflexes, 532 1
Bruce, Lewis C. The Records of Four j
Unusual Recoveries in Cases of Mental *
Disease, 558 1
Bruce, W. Ironside. Treatment of
Exophthalmic Goitre by X-Rays, 504
Brun, R., and Mott, F. W. Micro¬
scopical Investigation of the Nervous
System in Three Cases of Spontaneous
Myxcedema, 482
Burns, L., Cramer, A., and Ziehen, Th.
Text-book of Nervous Diseases in
Childhood (Review), 231
Buckley, A. C. Functional Psychoses
of the Senile Period, 557
Burk, W. Clinical and Pathological-
Anatomical Studies on the Question
of Labyrinth Suppuration, 287
Burr, C. W. Paralysis Agitans in
Negroes, 111
Buscanio, M. Considerations on the
Pathological Physiology of Contrac¬
ture, 431
Cadwalader, W. B., and Corson-
White, E. P. The Relation of
Syphilis to Progressive Muscular Dys¬
trophy, 446
Cadwalader, W. B., and Mills, C. K.
Pituitary and Uncinate Symptoms and
Lesions, 283
Cadwalader, W. B., and Sweet, J. E.
Experiments on Intradural Anasto¬
mosis of Nerves for the Cure of
Paralysis, 631
Calwell, Wm, f and Reid, R. Notes of
a Supposed Case of Pellagra, 600
Camis, M. Further Observations on
Vasomotor Phenomena, 27 ; The Ergo-
gram of the Labyrinthectomised Frog,
29; A Method of Operation for
Destruction of the Semicircular Canals
of the Dog, 30; Effects of Labyrin-
thectomy in the Dog, especially on
the Vasomotor Innervation, 30 ; On the
Myosis and the Paradoxical Mydriasis
in the Labyrinthectomised Cat, 31 ;
The Glycosuria Consecutive to Destruc¬
tion of the Semicircular Canals in the
Dog, 32
Cantley, Edmund. Case of Mongolian
Idiocy, 500
Carles, J., and DorA Osteitis De¬
formans of the Cranium simulating
Hydrocephalus, 103
Carlson, A. J., and Woelfel, A. The
Solubility of Lead Salts in Human
Gastric Juice and its Bearing on the
Hygiene of the Lead Industry, 453
Carnot, P., and Dumont, J. A Case of
Hypophyso-Genital Syndrome due to
Syphilis, 48, 113
Carnot, Rathery, and Dumont, J.
Acromegaly ; Diabetes ; Pituitary
Tumour, 402
Carpenter, F. W. The Histology of the
Cranial Autonomic Ganglia of the
Sheep, 25
Casselman, A. J., and Kolmer, J. A.
Concerning the Wassermann Reaction
with Normal Rabbit Serum, 449
Castro, De. Thyro-Testiculo-Hypophy-
seal Syndrome, 113
Catarinich, J. A Case of Pituitary
Tumour, 598
Chataignon, J. On Acute, Mild, Epi¬
demic Meningitis, 396
Chevrel, F., and Bourdini&re, J. Two
Fatal Cases of non-Meningococcal
Cerebro-Spinal Meningitis caused by a
Polymorphous Coccus, 37
1G4*
INDICES
Chievitz. A Case of Purulent Meningitis
after Fracture of the Base treated with
Hcxamcthylenetetramine. Recovery,
539
Citelli. A very Successful New' Method
of curing Hysterical Aphasia, <133
Citelli, Prof., and Verel, R. On the
Physioputholngical Relations between
the Hypophysis System and Various
Chronic Diseases of the Nasopharynx
and Sphenoidal Sinus, 338
Clarke, < i. The Forms of Mental Disorder
Occurring in Connection with Child-
Bearing, 229
Chirk, L. Pierce. Remarks u|>on the
Irregular and Unusual Types of
Familial Periodic Paralysis and Condi¬
tions simulating the Same, with a
Preliminary Rej>ort upon a New’ Sub-
Type of this Palsy, 459 ; Infantile
Cerebro-Cerebellar Diplegia of Flaccid
Atonic-Astasie Type, 030; Remarks
upon some Recent Studies in the
Pathogenesis of Epilepsy, 225; The
Prevention of Epilepsy, 034
Clark, L. Pierce, and Atwood, C. E.
A Study of the Significance of the
Habit Movements in Mental Defec¬
tives, *228
Clark, Paul F., and Fiexner, Simon.
Paralysis in a Dog simulating Polio¬
myelitis, 439
Clark, Paul F., Fiexner, Simon, and
Fraser, Francis R. Epidemic Polio¬
myelitis : Fourteenth Note: Passive
Human Carriage of the Virus of
Poliomyelitis, 027
Claude. Acute Syphilitic Meningo-
Eneephalitis in Tabes, 9b
Claude, H., and Baudouin, A. Hypo¬
physial Glycosuria and Adrenalin
Glycosuria, 29; The Mechanism of
Pituitary Glycosuria, 49
Claude, H., Baudouin, A., and Porak, R.
Pituitary Glycosuria in Human and
Animal Tulwreulosis, 222
Claud, H., and Porak, R. The Cardio¬
vascular Action of Pituitary Posterior
Lobe Extract in Acute Adrenal In¬
sufficiency, 326
Claude, H., and Sezary, A. Adiposis
Dolorosa : Striking Benefit from Fresh
Thyroid Gland, 173
Clementi, A. The Nervous Mechanisms
which regulate Co-ordination of Loco¬
motor Movements in Diplopoda, 323 ;
The Functional Anatomy of the Spinal
Cord; Experiments on the Avian
Lumbar Cord, 323
Cleu, H. Cardinal Richelieu’s Disease,
500
Cole, J. W. E. Notes of a Case of
Pellagra, 499
Cole, R. H. Mental Diseases (Review), 641
Coley, William B. Bullet Wound of the
Spinal Cord between the First and
Second Dorsal Vertebra: Laminec¬
tomy : Removal of the Bullet:
Complete Recovery, 41
Collet, M. Peduncular and Bulbo
Pontine Syndromes in Typhoid Fever,
102
Collet, M., Lemierre, A., and Collet, M.
Bilateral Ophthalmoplegia in Tvphoid
Fever, 103
Colombo, J., and Barit*, E. TransiUny
Ore hello Spastic Syndrome in Con¬
valescence from Typhoid Fever, 493
Corbin, Morichau-Beauchant, R., and
Guyonnet, R. Two Simultaneous
Cases of Acute Poliomyelitis in Two
Children of the Same Family : Typical
Paralysis in One, Simple Meningeal
State in the Other, 278
Corson-White, E. P., and Cadwalader,
W. B. The Relation of Syphilis to
Progressive Muscular Dvstrophy, 446
Cot ten 11, D. Note on a Case of Amyo¬
tonia Congenita, 391
Cot tin. Mile. E. Recovery from Tuber¬
culous Meningitis, 38
Coudrav, M., Ardin-Deltheil and
Raynaud, M. A Fresh Case of Typhoid
Spine in the Child, 36
Covon and Joltrain. Acute Cerebro¬
spinal Meningitis with Cerebellar
Syndrome, 491
Cra< e-Calvert, G. A. Tuberculous
Meningitis in Adults, 438
Craig, C. Bums. Mild Manifestations
of Syringomyelia. With Report of
Three Cases, 630
Cramer, A., Bruns, L., and Ziehen, Tli.
Textbook of Nervous Diseases in Child¬
hood (Review'), 231
Cramer, W., and Feiss, Henry 0. Con¬
tributions to the Histo-Chemistry of
Nerve : on the Nature of Wallerian
Degeneration, 94
Creutzfeldt, H. G., and Koch, R.
Changes in the Hypophysis in Diph¬
theria, 694
Crookshank, F. G. Case of Mongolism,
500
Crow, C. B., and Barr, C. H. Mirror
Writing and Other Associated Move¬
ments occurring without Palsy, 393
Crvmble, P. T., and Symington, J. The
Central Fissure of the Cerebrum,
317
Cubells, A. A Remarkable Case of Diph¬
theritic Paralysis, 216
INDICES
165*
Cullis, Winifred and Tribe, Enid M. Dis- |
tribution of Nerves in the Heart, 272
Curshmann, H. On Intermittent Exoph¬
thalmic Goitres (in Tabes Dorsalis with
Bronchial Asthma), 35
Cushing, Harvey. The Pituitary Body
and its Disorders (Review), 612 ; |
Meningeal Fibro-Endotheliomata, 283 l
Cushing, H., Jacobson, C., and Weed,
L. H. Further Studies on the Role of
the Hypophysis in the Metabolism of
Carbohydrates. The Autonomic Con¬
trol of the Pituitary Gland, 274
Czyhlarz, E. v. Nystagmus in Febrile
Diseases, 221 j
Dan, C., and Parhon, C. Ichthyosis
with Mental Deficiency, 638
Dana, C. L., and Berkeley, W. N.
Pineal Medication and Functions, 274
Dandy, Walter E. The Nerve Supply
to the Pituitary Body, 617
Daneo, L. The Psycho-Pathology of
Emotional Psychosis during the War,
345
Daneo, Luigi, and Ferrari, Manlio.
Cytological and Chemical Researches
on the Blood in Scorbutic Mental
Cases, 227
Darier, J., and Flandin, C. A Case of
Tetanus treated by Massive Doses
of Antitetanic Serum, 111
Davidenkof. Chromatoptic Word Deaf¬
ness, 109
Dawson, James W., and Bruce, the
late Alexander. Multiple Neuro¬
mata of the Central Nervous System :
Their Structure and Histogenesis, 117,
&c.
Debaisieux, G. The Innervation of the
Bladder : Anatomical and Experi¬
mental Studies, 271
Degener, Lyda May. The Effect of
Thyroid Extirpation on the Hypo¬
physis Cerebri in the Rabbit, 430
Degener, Lyda May, and Livingston,
A. E. The Effect of Thyroidectomy
and Castration, respectively, on the
Weight of the Rabbit’s Pituitary, 164
D6j6rine, J., and Gauckler, E. The
Psychoneuroses and their Treatment
by Psychotherapy ; translated by
S. E. Jellifle (Review), 613
Delage, Morichau-Beauchant, and Blaye,
R. Le. Fulminating Cerebro-Spinal
Meningitis due to an Undetermined
Cooco-Bacillus, 214
Demole, V. General Paralysis without
Reaction of the Cerebro-Spinal Fluid,
501
Dercum, F. X. Cerebral Hemiplegia
with Atrophy, Flaccidity, and Ix>ss of
Reflexes, 280
Dercum, F. X., and Ellis, A. G. The
Ductless Glands in Dementia Praecox,
289
Desbouis, G., and Achard, C. Very
Early Acute Syphilitic Meningitis,
38
Desplas, B., and Broca, A. Delayed Tem¬
porary Paralysis of the Sixth Cranial
Nerve in Fractures of the Skull,
44
Desqueroux. Intercostal Zoster in Tabes,
98
Dick, G. F. Fusiform Bacilli associated
with Various Pathological Processes,
626
Dickie, J. K. Milne, and Fraser, G. S.
An Analysis of 123 Consecutive Cases
in which Operations were Performed
for the Relief of the Mastoid, Labyrin¬
thine and Intracranial Complications
of Suppurative Otitis Media, 40
Dixon, W. E., and Halliburton, W. D.
The Cerebro-Spinal Fluid.—I. Secre¬
tion of the Fluid, 591
Dixon, W. E., and Ransom, F. Broncho-
Dilator, Nerves, 26
Dolgopol, B. M. Disease of the Ulnar
Nerve after Typhoid Fever, 631
Donnis, R. Slowly Developing Supra¬
renal Insufficiency of Cerebral Form
following Typhoid Fever, 632
DonS, and Carles, J. Osteitis Deformans
of the Cranium simulating Hydro¬
cephalus, 103
Douglas, A. R. Some Suggestions re¬
specting the Care of the Feeble-
Minded under the Mental Deficiency
Bill, 610
Douzelot and Monier-Vinard. Purulent-
Pneumococcal Meningitis. Absence
of Cellular Reaction in Cerebro-Spinal
Fluid, 212
Dowes, S. L. The Problem of the Alien
Insane, 456
Downey, J. W. Report of a Case of
Monocular Paralysis of the Accomoda¬
tion due to Lues, 603
Dubois, C., and Boulet, L. The Action
of Prostatic Extracts on the Cerebral
and Renal Circulation, 273
Duguid, J. H., and Graham, W. T.
Death from Syphilis occurring Nine
Days after Injection of Salvarsan,
633
Duhot and Leroy. Tabetiform Gastric
Crises in Ulcerative Cancer of the
Lesser Curvature, 436
Duhot and Pierret. Tabetic Arthro-
y
166*
INDICES
pathy. Pharyngeal Crises, 212 ; Sub- j
acute Meningeal Syndrome of Syphilitic
Origin, 438 |
Dufour, H. Pathogeny of Uraemic Par- 1
alysiH, 216 j
Dumont, J., and Carnot, P. A Case of j
Hvpnphyso-Genital Syndrome due to
Syphilis, 48, 113 |
Dumont, J., Carnot, and Rath cry. Acro¬
megaly ; Diabetes ; Pituitary Tumour,
402
Dupuy. Absence of the Knee and
Achilles Jerks without Other Sign of
Disease of the Nervous System, 208 j
Durupt and Thomas. Atrophy of the ;
Medulla, Fillet, and Superior Cere- j
be liar Peduncle in Friedreich’s Disease, j
35 !
Dvnkin, A. L. The Pathogeny and
Clinical Aspects of Post-Diphtheritic ,
Cerebral Palsies, 593
Earle, H. 0., and Goodall, J. S. The
Physiology of the Posterior Roots in
the Light of Recent Surgical Pro¬
cedures, 51)0
East, E. R. A Case of Acromegaly with
Mental Symptoms, 4G
East, W. N. On attempted Suicide, with
an Analysis of 1,000 Consecutive Cases,
611
Ebstein, E. Eunuchoidism in Diabetes
Insipidus, 285
Edgeworth, F. H. The Afferent Gan-
glionated Nerve Fibres of the Muscles j
Innervated by the Fifth Cranial Nerve ;
and the Innervation of the Tensor Veli
Palatini and the Tensor Tympani, 271
Eiehhorst, H. On Diseases of the Spinal
Cord in Smallpox, 502
Elliot, K. H. Sclero-Corneal Trephin¬
ing in the Operative Treatment of
Glaucoma (Review), 346
Elliot, T. R. The Control of the Supra¬
renal Glands by the Splanchnic Nerves,
470
Ellis, A. G., and Dercuni, F. X. The
Ductless Glands in Dementia Priecox,
2S0
Ellis, A. W. M., and Swift, Homer F.
The Treatment of Syphilitic Affections
of the Central Nervous System with
Especial Reference to the Use of
In traspi nous Injections, 548 ; The
Effect of In Iras pi noil s Injections of
Salvarsail .and Neosalvarsan in Mon¬
keys, 003 ; A Study of the Spirochoeti-
ciclal Action of the Serum of Patients
treated with Salvarsan, 003
Esposel, F. Tuberculous Neuritis, 342
Fabritics, H. On Sensory Conduction
in the Human Spinal Cord, 209; On
the Differential Diagnosis of Intra- and
Extra-Medullary Spinal Disorders,
210
Fairise, C., and Remy, A. Hemorrhagic
Tuberculous Meningitis in a Baby,
396
Favre and Bovier. A Case of Typhoid
Spondylitis, 397
Favre, M., and Savy, P. Hemiplegia in
Scarlet Fever, 436
Favre, M., and Toumade, A. Adiposis
Dolorosa in Sciatica: A Variety
Localised in the Affected Lower Limb,
287
Fcarnsides, E. G. Athetosis of Left
Hand with Tremor of Right Hand,
333 ; Tetanus ; Chloretone Poisoning ;
Recovery ; Followed b} f Polyneuritis,
341
Felling, A. The Blood and the Cerebro¬
spinal Fluid in Mumps, 626
Feiss, Henry 0. An Investigation of
Nerve Regeneration, 531
Reiss, Henry 0., and Cramer, W. Con¬
tributions to the Histo-Chemistry of
Nerves: on the Nature of W&Uerian
Degeneration, 94
Fernos, F. R. G. On a Case of Pneumo¬
coccal Meningitis, 395
Ferrari, Manlio, and Daneo, Luigi.
Cytological and Chemical Researches
on the Blood in Scorbutic Mental
Cases, 227
Ferrier, Sir David. Discussion on the
/Etiology of Unilateral Paralysis of
the Recurrent Laryngeal Nerve. 488
Ficling, Anthony. The Blood and the
Cerebro-Spinal Fluid in Mumps, 450
Fildes, Paul, and M 4 In tosh, James. The
Pathology of the Condition known as
Parasyphilis, 536
Fischel, J. Spontaneous Haematomata
in a Tabetic Woman, 331
Fisher, A. G. T. A Case of Complete
Absence of Both Internal Carotid
Arteries, with a Preliminary Note on
the Developmental History of the
Stapedial Artery, 590
Fitz, R., Brigham, F. G., and Minot,
J. J. Bulbar Paralysis in Typhoid
Fever, 493
Fitzmaurice - Kelly, M. Salvarsan in
General Paralysis of the Insane and
Tubes, 607
Flandin, C., and Darier, J. A Case of
Tetanus treated by Massive Doses of
An tile tan ic Serum, 111
Fleming, Robert A. Three Cases of
“ Fits,” 635
INDICES
167*
Flexner, Simon. Accidents following
the Subdural Injection of the Anti-
meningitis Serum, 396
Flexner, Simon, and Clark, Paul F.
Paralysis in a Dog simulating Polio¬
myelitis, 439
Flexner, Simon, Clark, Paul F., and
Fraser, Francis R. Epidemic Polio¬
myelitis. Fourteenth Note: Passive
Human Carriage of the Virus of Polio¬
myelitis, 627
Flexner, Simon, and Noguchi, Hideyo.
Experiments on the Cultivation of
the Micro-organism causing Epidemic
Poliomyelitis, 596
Foix and Marie, P. Isolated and Station¬
ary Atrophy of the Small Muscles of
the Hana: Anterior Tephromalacia,
216
Follet, A., and Bourdiniire, J. Para¬
meningococcus Cerebro-Spinal Menin¬
gitis. Meningococcic and Paramenin-
f ococcic Serotherapy. Death, 213.
Parameningococcus Cerebro - Spinal
Meningitis. Meningococcal and Para-
meningococcal Serotherapy. Death,
277
Forster, Laura. Meynert’s Bundle—
I.A.K., 266
Frans, S. Ivory. The Accuracy of
Localisation of Touch Stimuli on
different Bodily Segments, 390. Obser¬
vations on the Preferential Use of the
Right and Left Hands by Monkeys,
322
Fraser, FrancisR. A Study of the Cerebro-
Spinal Fluid in Acute Poliomyelitis,
627
Fraser, Francis R., Flexner, Simon, and
Clark, Paul F. Epidemic Polio¬
myelitis. Fourteenth Note: Passive
Human Carriage of the Virus of
Poliomyelitis, 627
Fraser, J. S., and Dickie, J. K. Milne.
An Analysis of 123 Consecutive Cases
in which Operations were Performed
for the Relief of the Mastoid, Laby¬
rinthine and Intra cranial Complica¬
tions of Suppurative Otitis Media, 40
Fraser, J. S., Henderson, D. K., and
Muirhead, Winifred. A Case of Toxic
Exhaustive Insanity, associated with
Chronic Suppurative Otitis Media,
Labyrinthitis, and Extra- Dural Abscess,
566
Fraser, Kate, and Watson, H. F. The
Role of Syphilis in Mental Deficiency
and Epilepsy : a Review of 205 Cases,
638
Frazier, Charles H. An Approach to
the Hypophysis through the Anterior
Cranial Fossa, 220. Intracranial Divi¬
sion of the Auditory Nerve for Persistent
Tinnitus, 497
Frew, R. S., and Garrod, A. E.
Glycosuria in Tuberculous Meningitis,
Frost, W. H., and Anderson, J. F.
Transmission of Poliomyelitis by Means
of the Stable Fly, 104
Fry, Frank R. The Rebounding Pupil,
4K4
Gaetani, L. de. Chromaffin Elements
in the Cardio-Cervical Region of Certain
Lizards, 91
Gali, G. Late Suppurative Post-Typhoid
Thyroiditis ana Secondary Graves’
Disease, 552
Galippe, J. A Case of Cervical Zoster,
434
Gallain. Acromegalic Gigantism without
Enlargement of the Sella Turcica:
Sexual Inversion and “ Mental
Feminism,” 222
Gardner, H. Willoughby. A Case of
Periodic Paralysis, 334
Garrison, P. E., and Siler, J. F. The
Epidemiology of Pellagra, 554 ; 601
Garrod, A. E., and Frew, K. S. Glycosuria
in Tuberculous Meningitis, 101
Gat£, J., and Savy, P. Recovery from
Pneumococcal Meningitis, 538
Gatti, L. Psychical Disturbances in the
Course of von Recklinghausen’s Disease.
A Cutaneous Gastric and Psychical
Complex, 623
Gatti, S. Oxycephaly and Exophthalmos,
217
Gauckler, E., and D6j6rine, J. The
Psychoneurosea and their Treatment
by Psychotherapy. Translated by
S. E. Jelliffe (Review), 613
Geerts. Tumour of the Cerebello-Pontine
Angle, 45
Gehuchten, A. van, and Lambotte, A.
Laminectomy in Compression Para¬
plegia, 329
Gettings, H. S. Dysentery, Past and
Present, 639
Ginestous, E. Diabetic Paralysis of the
External Rectus, 602
Girardi, P. On Carcinoma Metastases
in the Cerebellum, 220
Glascock, A. The Present Knowledge
of the Status of Apraxia, 338
Goodall, J. 8., and Earle, H. G. The
Physiology of the Posterior Roots in
the Light of Recent Surgical Pro¬
cedures, 590
Gordinier, H. C., and Kirk, Wm. A.
ltiS*
INDICES
(')w- ul Acronug.ilia with Autopsy, »
.>45
Gordon, A. Myatonia Congenita, 277
Gordon, J. Iveslio. The Incidence of
Inherited SyphilisinCongenitAl Mental
Deticiencv, 557
Gorham, \V. L., and Sample, .T. T.
Malum Perforans in Dial>etes Mo 11 it us,
171
Gona, C. Mental Torticollis, 104
Gougemt, H., and Thibant. Symmetrical
Purpura of Ixdt Arm and Zoster of
Right- Arm, 98
Gould, Sir A. P. Posterior Spinal
Neurectomy for the Relief of Pain in
Certain Cases of Incurable Cancer, WH)
Graham, C. I. Case of Cyst of the
Pituitary Fossa: operation by the
Nanai Route, 537
Graham, W. T., and Duguid, J. H. 1
Death from Syphilis occurring Nine j
Days after Injection of Salvarsan, 633 !
Gray, A. A. A Ganglion in the Human j
Temporal Bone not hitherto described, I
321
Gray, A. M H. Case of Seventh and
Eighth Nerve Paralysis after Neo-
Sal varsan Injection, 339
Gregory, M. S., and Karpas, M. J. A
Case of Cerobral Syphilis occurring
Six Months after the Initial Lesion, 235
Greig, D. M. Hereditary Congenital
Wry-Neck, 605
Grimm, R. M. Pellagra: Some Facts in
its Epidemiology, 342
Grinker, Julius. Tumour of the Hypo-
ph ysis in a Case of Acromegaly, 441 ;
A New Method of Treating Neuralgia
of the Trigeminus by the Injection of
Alcohol into the Gasserian Ganglion,
343
Guillain, G., and Routier, D, Chronic
Rheumatic Periarthritis following
Zoster, and restricted to the Area of
the Eruption, 621
Guthrie, Leonard. Did Napoleon Bona¬
parte suffer from Hypopituitarism
(Dystrophia Adiposo-Genitalis) at the
Close of his Life? 546
Guyonnet, R., Corbin, and Moriohau-
Beauchant, R. Two Simultaneous
Cases of Acute Poliomyelitis in Two
Children of the Same Family : Typical
Paralysis in One, Simple Meningeal
State in the Other, 278
Hagbkty, M. E. A Neosal varsan
Fatality, 604
Hahn, R. Polyneuritic Psychosis after
Induced Abortion, 114
Hall, Arthur, J. Two Cases of CoN
Tumour of the Third Ventricle, etusiig
Death, 108
Hall, F. de Havilland. Discussion «
the ACtiology of Unilateral Paralyse
of the Recurrent Laryngeal Sene,
488
Hall, George, and Angus, H. B. Case oi
Subcortical Cerebral Tumour, Tuber
culous in Nature, Removed by Open
tion ; Recovery, 544
Halliburton, VV. D., and Dixon. IV R
The Cerebro-Spinal Fluid—I. Secretion
of the Fluid, 591
Hamnies, E. M., and Riggs, C. Eugene-.
Two Cases of Circulatory Disturbance
of the Brain, 495
Hammond, J. A. B. A Case of Pellagra
in England, Probably contracted in
Scotland, 444
Hannedouche and Pierret. Recent
Syph i li tic Hemiplegia considerably
improved by Salvarsan, 172
Hanssen, Olav. The Action of Urge
Doses of Sodium Bicarbonate in Dw'
betas Mcllitis, 53
Harris, Wilfred. Hyoscine-M»rphb
Anaesthesia for Alcohol Injection in
Neuralgia, 553
Harris, W., and Bankart, A. S. Blundell
A Case of Spinal Tumour with Scoliosi*;
Operation, 392
Harris, W. H. The Experimental Pro¬
duction of Pellagra in the Monkey
of a Berkefeld Filtrate from Human
Lesions—A Preliminary Note, 390
Harwitt, S., and Bernstein, E. P-
Syringomyelia: with Pathological
Findings, 6*29
Hayashi, A. Macroglossia congenita
neurofibroraatosa, 538
Hayhurst, Emery R. Occupational Br^'
Poisoning : Brass Founder’s Ague, 4“
Haynes, Irvine S. Congenital Interna.
Hydrocephalus: its Treatment b)
Drainage of the Cisterna Magna into
the Cranial Sinuses, 541
Hazen, H. H. Oily Injections ot
Salvarsan : A Warning, 340
Heidingsfeld, M. L Neuroma Cuti*
(Dolorosum), 494
Heldt, Thomas J. Mollgaards Reti¬
culum, 478 ‘ .
Henderson, D. K., and Muirhead,
fred. The Differentiation of Cells in
the Cerebro-Spinal Fluid by Alxheuners
Method, 195 ,
Henderson, D. R, Muirhead, Wwfred.
and Fraser, J. S. A Case of Tone
E xha ustive Insanity, associated wu
Chronio Suppurative Otitis Media*
%
. N-
hri>
I t
H.] n
b
v
INDICES
169*
Labyrinthitis and Extradural Abscess,
660
Henderson, John. A Case of “Idio¬
pathic ” Cerebral Abscess, 496
Henry, Herbert. On Meningitis due to
Hemophilic Organisms: So-called
Influenzal Meningitis, 39
Heriason-Laparu and Vigouroux, A.
Cerebral Cysticerosis and General
Paralysis, 226
Hertz, A. F. Case of Organic Hemi¬
plegia following Typhoid Fever, in
which the Plantar Reflex is Flexor,
but Babinski’s “Second Sign”—Com¬
bined Movement of the Trunk and
Pelvis—is Present, 330
Hillman, 0. 8. Some Hjematological
Findings in Pellagra, 445
Hoch, August, and Amsden, George, S.
A Guide to the Descriptive Study of
the Personality. With Special Refer¬
ence to the Taking of Anamneses of
Cases with Psychoses, 677
Hochwart, L. V. Frankl. The Relations
of Internal Secretions to Mental Con¬
ditions, 608
Hoestermann, E. Cerebral Paralysis
with Intact Pyramidal Tract, 170
Hollander, F. d\ Bilateral Motor
Apraxia with Autopsy, 109; Infantil¬
ism, 284
Holmes, Gordon. A Case of Combined
Degeneration of the Spinal Cord with
Amyotrophy, 76
Holmes, Gordon, and Batten, F. E. The
Endogenous Fibres of the Human
Spinal Cord (from the Examination of
Acute Poliomyelitis), 388
Holmgren, G. A Case of Hypophysis
Tumour Operated on by Hirsch’s
Method, 337
Hopwood, J. S., and Boyd, Wm.
A Case having a Bearing on the
Localisation of the Auditory Centre,
542
Hurand, R., Puillet, P., and Morel, L.
Two New Cases of Suppurative Paro¬
titis in General Paralysis, 2$9
Hoskins, R. G., and M‘Peek, C. The
Effects of Adrenal Massage on Blood
Pressure, 326 •
Hough, William H. Clinico-pathological
Findings in Syphilis of the Central
Nervous System, 411
Howell, C. M. Hinds. The Results of
Operative Treatment of Cervical Ribs,
486
Hudson, Wm. H. Consecutive Dis¬
placement of the Cerebral Hemisphere
on the Localisation and Removal of
Intra-Cerebral Tumours and Haemor¬
rhages (Apoplectic Hemorrhages and
Clots), 543
Hug-Hellmuth, H. von. The Mental
Life of the Child (Review), 640
Hughes, E. C. Paralysis of the Serratus
Magnus, 488
Humphry, L. Case of Post-Diphtheritic
Paralysis and Hemiplegia, 101
Hunt, J. Ramsay. Unilateral Inter¬
mittent Claudication of the Lumbar
Region, 282
Hunter, Walter K., and Robertson, M.
E. A Case with Transient Attacks
of Paralysis : Autopsy, 419
In^ebrigtsen, Ragnvald. Studies of
the Degeneration and Regeneration of
Axis Cylinders in Vitro, 164, 591
Issaibovitch-Duscian. Hemiplegia fol¬
lowing Scarlet Fever in the Puer-
peri um, 102
Ivy, R. R. The Wassermann Reaction
among the Negro Insane of Alabama,
638
Jacobson, C., Weed, L. H., and Cush¬
ing, H. Further Studies on the Role
of the Hypophysis in the Metabolism
of Carbohydrates. The Autonomic
Control of the Pituitary Gland, 274
Jacques, L. A. M. Tabes and Facial
Paralysis, 538
Jakob, A., and Tromner, E. Post-Diph¬
theritic Bulbar Paralysis, 594
Jakobs. Clinical and Microscopical Con¬
tribution to Solitary Tubercle of the
Optic Nerve-Head, 453
Jeanselme, L. Acute and Subacute
Secondary Syphilitic Meningitis, 39
Jelliffe, Smith Ely. The Psychoneuroses
and their Treatment by Psychotherapy
by J. Dejerine and E* Gaucklen
Translation (Review), 613
Jennings, A. H., and King, W. V. An
Intensive Study of Insect* as a Possible
Etiologic Factor in Pellagra, 636
Job, E., and Levy, L. A Case of
Meningitis due to Serum, 332
Johnson, C E. The Development of the
Prootic Head Somites and Eye Muscles
in Uitlydra serpentina, 90
Johnstone, Emma M. A Note on a Case
of Pellagra, 600
Jol train and Coy on. Acute Cerebro¬
spinal Meningitis with Cerebellar Svn
drome, 491 J
Joltrain, E., and Lemierre, H. Puru
lent Typhoid Meningitis. Onset with
Symptoms of Acute Otitis, 101
170*
INDICES
Jones, D. \V. Carmalt. A Note on i Kolmer, J. A., and O&aselm&n, A. J.
Remission in a Case of Epilepsy, 551 Concerning the Wassermann Reaction
Jones, Ernest. Papers on Psycho- with Normal Rabbit Serum, 449 l
Analysis (Review), 506 | Kolmer, J. A., Williams, W. W., and
Jones, H. f^wis. Ionic Medication j Laubaugh, K. E. A Study of Oom-
(Review), 5 h 5 i element Fixation in Syphilis with
Jones, Robert. Dementia Pr«cor in Trt]>ontma antigens, 448
relation to Apraxia. 52; A Difficult : Konig, H. On the Psychopathology of
Diagnosis in an Insane Person, 640 Paralysis Agitans, 111
Jong, Milo, do, and Sired ay, A. Exoph- Kraepefin, E. On Hysteria, 605
thalmio Goitre with Generalised Pig- Kramer, S. P. A Possible 8ource of
mentation, 46 Danger in the Use of Anti-Meningitis
Juliusburger, O. The Importance of Serum, 332
Schopenhauer for Psychiatry, 227 Krause, K. On the Histopathology of
Cysticercus in the Brain, 226
Krumholz, S. Localised Encephalitis
Kafka, V. On the Demonstration of with Epilepsia Continua, 285
Defence Ferments in the Blood Serum ( Kuntz, A. The Development of the
of the Insane by AUlerhalden’s Dialysis Cranial Sympathetic Ganglia in the
Method, OHS Pig, 270; The Innervation of the
Karpas, M. J., and Gregory, M. S. A Digestive Tube, 386
Case of Cerebral Syphilis occurring Six Kunz, H. Herpes Zoster in the Puer-
Months after the initial Lesion, 235 perium, 211
Kautl'mann, Lesser, and Breton, P. le.
A Case of Spastic Paraplegia, with ;
Dorsal Root Section for Pain and i Lacroix. Cervical Zoster and Paralysis,
Spasticity, 282 620
Kayser, C. Meningism. A Review, 437 , Lakes, R. Aural Vertigo (non-suppura-
Keith, Arthur. Abnormal Crania— | tive): A Clinical and Therapeutical
Achondroplastic and Acroccphalic, 02 i Study, 106
Kidd, Leonard J. The Pineal Body : \ Lambotte, A., and Gehuchten, A. van.
a Review, 1 and 55 ; Direct Trochlear I Laminectomy in Compression Para-
and Crossed Oculomotor Fibres, 507 I plegia, 329
Kilroy, L. Tlie Treatment of Syphilis j Lambrior, A. A. Another Case of
with Salvarsan : First Thousand Cases I Friedreich’s Disease, with Autopsy,
treated at the Royal Naval Hospital i 210
at Plymouth, 310 * ' Lang, Wm., and Thomson, H. Campbell.
King, \V. V., and Jennings, A. H. An I On Failure of Vision and its Treat
Intensive Study of Insects as a Possible i ment in Pituitary Disease, 599
Etiologic Factor in Pellagra, 636 | Langcnbeck, K. The Form of the Field
Kingsbury, W. M. Cases of Exoph- i of Vision in Tabetic Optic Atrophy, 435
thalmio Goitre treated by X-Rays, 504 i Langley, J. V. The Nomenclature of
Kirchberg, P. On the Frequency of the I the Sympathetic and of the Related J
Wassermann Reaction in the Cerebro- | Symptoms of Nerves, 388
Spinal Fluid in General Paralysis, 500 | Langmead, F. Congenital Deficiency in
Kirehheim and Schroder. On Meningism , the Cranial Vault, 399 ; on a Case of
in Infectious Diseases, 025 i Addison’s Disease in a Boy aged 10
Kirk, Wm., and Gordinier, H. C. A Case years, 637
of Acromegalia with Autopsy, 545 | Larroque, and Raymond, L. Tuberculous
Klicneberger, O. Encephalo-myelitis , Leprosy, Giantism, and Acromegaly,
after Smallpox, with Remarks on 169
Diseases of Glands of Internal Secretion, Lassen, 0. A Case of Positive Wasser-
491 mann’s Reaction in Sarcoma, 169
Knauer, A., and Maloney, W. J. The Laubaugh, E. E., Kolmer, J. A., and
Psychic Action of Mescalin, with Williams, W. W. A Study of Comple-
Special Reference to the Mechanism of j ment Fixation in Syphilis with Tre-
Visual Hallucinations, 503 j poncma antigens , 448
Koch, R., and Creutzfeldt, H. G. Changes I Leblanc and Sicard. Anatomical and
in the Hypophysis in Diphtheria, 594 I Clinical Remarks on Franke’s Opera -
Kolmer, J. A. Concerning Agglutinins j tion in Tabetic Gastric Crises and in
for Trejpontma -pallidum , 447 i Post-Herpetic Neuralgia, 35
INDICES
171*
Leede, W. H. Diphtheritic Hemiplegia,
436
Leetham, Constance. Action of Certain
Drugs on Isolated Strips of Ventricle,
275
Legrain and Menctrier, P. Pararaenin- s
ococcu8 Cerebro-Spinal Meningitis, (
13 j
Lemierre, H., and Joltrain, E. Purulent j
Typhoid Meningitis. Onset with •
Symptoms of Acute Otitis, 101 |
Leraierre, A., May, E., and Collet, M. J
Bilateral Ophthalmoplegia in Typhoid
Fever, 103 l
Lenel, R. O. On Degenerations of the i
Spinal Cord in Pernicious Ameinia, 489
Leopold, S. The Polyneuritic Form of
Poliomyelitis: a Clinical and Pat ho- t
logical Study, 597, 628
L4ri, Andr£. A Reflex Phenomenon in :
the Upper Limb—the ‘ 4 Forearm Sign,”
432
Leroy, A. The Use of Codein in Mental i
Therapeutics, in Particular in Melan¬
cholic States, 345
Leroy and l)uhut. Tabctiform Gastric
Crises in Ulcerative Cancer of the
Lesser Curvature, 436
Leroy, H., and Pierret. A Case of
Puerperal Tetanus, 344)
Lesieur, C., and Marchand, J. Menin¬
geal States in Typhoid Fever. Hyper¬
tension and Typhoid Infection of
Cerebro-Spinal Fluid without Leuco¬
cytic Reaction. Mild Course after
Lumbar Punctures, 105; Purulent
Typhoid Meningitis in a Typhoid State
without Intestinal Lesions, 106
Levaditi, C., Barkowski, J., and Marie,
A. Presence of the Treponema pal
lidum in the Brains of Three General
Paralytics, 404
Levis, H. J. An Eye Lesion following
Two Intravenous Injections of Salvar-
san, but Relieved by it* Further Use,
339
Levy, L., and Job, E. A Case of
Meningitis due to Serum, 332
L£vy, P. P., and Renault, J. Myelitis
following Typhoid Fever in a Child,
493
Lowers, Alex., and Murphy, John. A
Case of Otogenic Cerebral Abscess, 540
Lewin, Leo. On Toxic Neuritis (Neuro¬
lysis) of the Eighth Nerve and on the
Changes in the Corresponding Ganglia
in Diphtheria, 275
Lewis, Dean I). The Relation of the
Hypophysis to Growth, and the Effects
of Feeding Anterior and Posterior Lobe,
480
Ley. The Fifth Cerebral Ventricle, 397 ;
Delirium Tremens and Cranial Trau¬
matism, 404
Lier, E. B. H. van. Suppuration in the
Needle Track after Lumbar Puncture,
282
Litchfield, L. Acute Posterior Ganglion¬
itis, simulating Surgical Conditions in
the Abdomen, 331
Livingston, A. E., and Degener, L. M.
The Effect of Thyroidectomy and
Castration, respectively, on the
Weight of the Rabbit's Pituitary,
164
Llewellyn, T. L. A Lecture on Miner's
Nystagmus, 398
Long. Sub-Acute Combined Degenera¬
tion of the Spinal Cord, 36; Aran-
Duchenne Type of Progressive Mus¬
cular Atrophy of Neuritic Nature:
Second Case with Autopsy, 215
Louth>n, Julian. Acromegaly with Local¬
ised Muscular Atrophy, 441
Luoke, A. W. Tumours of the Cerebello-
pontine Angle, 336
Lugiuto, L. Besta’s Method for the
Myelin Sheath in Secondary Degenera¬
tions, 534
Lutel, S. Abnormal Forms of Tuber¬
culous Meningitis in the Adult, 166
Lyall, H. W. Meningitis in an Infant
caused by the Typhoid Bacillus, 595
Mathlle. Dementia Praeeox Fruste wdth
Dyspraxia, 51
MTntosh, James, and Fildes, Paul. The
Pathology of the Condition known as
Parasyphilis, 536
MTntosh, James, and Turnbull, H.
Transmission to Monkeys of Virus
obtained from English Cases of Polio
myelitis, 537
Mackenzie, Hector. Functional Aphasia,
41K
M‘Kibben, P. S. The Eye-Muscle Nerves
in Necturus, 385
Mackinnon, Murdoch. Hemiplegia fol¬
lowing Syphilis, with Special Reference
to a Case of Double Hemiplegia and
Pseudo-Bulbar Paralysis, 550
Manual), Angus. Ionic Medication in
Herpes Zoster, 624)
Maonamain, E. 1). Syphilitic Infection
followed by Landry's Syndrome, and
later by Tabes Dorsalis, 489
Macneal, W. J. Observations on the
Intestinal Bacteria in Pellagra, 499
M'Pcek, C., and Hoskins, R. G. The
El feet s of Adrenal Massage on Blood
Pressure, 326
172*
INDICES
Madhouse, M., and Verdi, W. F.
Cerebellar Tumour, 283, 400
Maillard, G. Myntonic Defects in Par¬
alysis Agituns, 110
Major, G. On the Psychology of Juvenile
Criminals, 207
Mai dares* o and Parhon. Cleido-Cranial
Dysostosis, 222
Malone, E. F. The Nucleus Cardioous
Nervi V r agi and the Three Distinct
Types of Nerve Cells which innervate
the Three Different Types of Muscle,
r>K9
Maloney, W. J., M.A. Blindness and
Tabes : an Introduction to a New
Method of Curing Ataxia, 022
Maloney, \V. J., and Knauer, A. The
Psychic Action of Mesealin, with
Special Reference to the Mechanism
ot Visual Hallucinations, 503
Manning, J. Van Vliet. A Study of
the Flaccid Spinal Paralysis which
attacked Louis Pasteur in Early
Maturity, and its Similarity to an
Attack of Acute Epidemic Polio¬
myelitis. Together with a Study of
the Silkworm as a possible Mediary
Host of the same Disease, 393
Manouelian, Y. The Curdiac Plexus
and Innervation of the Aorta, 322 ;
The Presence of Negri's Bodies in the
Nerve Ganglia of the Salivary Glands
of Rabid Animals, bl8
M&rchund, J., and Lesieur, C. Menin¬
geal State in Typhoid Fever; Hyper¬
tension and Typhoid Infection of
Cerebro Spinal Fluid without Leuco¬
cytic Reaction: Mild Course after
Lumbar Puncture, 165 ; Purulent
Typhoid Meningitis in a Typhoid State
without Intestinal Lesions, 166
Marchand and Mignot. General Paralysis
with Amyloid Degeneration of the
Brain, 9b
Marchand, L., and Petit, G. General
Paralysis in Dogs, 33
Marchand and Rayneau. Post-Traumatic
Syndrome Resem blingGeneral Paralysis
caused by an Acute Meningitis of Slow
Evolution, 40
Margulis, M. S. On the Pathology and
Pathogenesis of Primary Chronic
Hydrocephalus, 103; On Ependymal
Gliomatosis of the Brain Ventricles,
480
Marie, A. International Treatise of
Psychological Pathology (Review), 559
Marie, A., Levaditi, C., and Barkowski,
J, Presence of the Treponema
pallidum in the Brains of Three General
Paralytica, 404
j Marie, P., and Foix. Isolated and
Stationary Atrophy of the Small
Muscles of the Hand: Anterior Tephro-
I malaeia, 216
I Marie, 1\ L., Baron, and Oettinger. A
I Fresh Case of Parameningococcus
Septicemia with recurring Meningeal
Attacks, 395
Marinesco, G. Biocytoneurology by the
Aid of the Ultramicroscope, 206 ; The
Treatment of Syphilitic Diseases of the
Nervous System by Sub-Arachnoid
Injections of Neosalvarsan, 548
Marinesco, G., and Minea, J. Investiga¬
tions on Senile Plagues, 207
Marinesco and Noica. The Response of
the Lower Limbs to External Stimuli
in Normal Individuals and in Patients
suffering from Spastic Paraplegia—
Normal Movements of Defence and
Pathological Movements of Defence,
328
Mark, Leonard Portal. Acromegaly
(Review), 457
Markelofl, G. J. Myasthenia, 171
Martini, G. Contribution to the Study
of the Manic-Depressive Psychosis,
556
Mathies, A. Four Familial Cases of
Multiple Neuromyxofibrosaroomatoeis,
279
May, E., Lemierre, A., and Collet, M.
Bilateral Ophthalmoplegia in Typhoid
Fever, 103
Mayendorf, E. Niessl von. The Aphasic
Syndrome and its Cortical Localisation
(Review), 230
Mazel and Savoy. Polyneuritis following
a Phlegmon of the Right Index, 451
Menetrier, P., and Legrain. Paramenin¬
gococcus Cerebro-Spinal Meningitis,
213
Merle, E. Cure of Tetanus by Intra-
Spinal Serotherapy, 223
M6ry, H., Salin, H., and Wilborts, A.
Parameningococcus Meningitis Treated
and Cured by Anti-Parameningoooccus
Serum, 213
Mestrezat, W. The Cerebro-Spinal Fluid,
normal and pathological, Clinical Sig¬
nificance of the Chemical Examination
(Review), 406 ,
Meyer, A. New Formation of Nerve
Cells in an Isolated Part of Nervous
Portion of the Hypophysis-Tumour in
a Case of Acromegaly with Diabetes,
with Discussion of the Hypophyais-
Tumours found so far, 401
Meyer, E. On the Pathological Ana¬
tomy of Korsakoffs Disease, 114; The
Treatment of General Paralysis, 175
INDICES
173*
Meyer, Robert. The Suprarenal Glands
in Anencephaly, 34
Meyer, W. R. Epidermoid Cholestea-
- toma of the Brain, 208
Mignot and Marchand. General Para¬
lysis with Amyloid Degeneration of
the Brain, 96
Mignot, R., and Souques, A. Brown-
S^quard Syndrome with Dissociation of
Sensory Loss of the
Type —Paths of Sensory
the Spinal Cord, 328
Milhit, J. Typhoid Meningitis, 492 I
Millant. The Neurofibrils in Pellagra, j
according to Urechia, 32
Miller, F. K. On the Reactions of the
Salivary Centres, 532
Miller, Joseph L. The Relation of the
Hypophysis to Growth, and the Effect
of Feeding Anterior and Posterior j
Lobe, 480
Mills, C. K. f and Cadwalader, W. B. I
Pituitary and Uncinate Symptoms and
Lesions, 283 I
Mills, H. P. Pellagra, 288
Minea, J., and Marinesco, G. Investi¬
gations on Senile Plagues, 207
Mingazzini, G. Unilateral Progressive
Muscular Dystrophy : Facio-scapulo¬
humeral Type, 215 ; Bilateral Haemor¬
rhagic Softening of the Radiations of
the Corpus Callosum, 440
Minot, J. J., Fitz, R., and Brigham, F.
G. Bulbar Paralysis in Typhoid Fever,
493
Miskdjian, H. Death from “606,” 547
Mita, S. On Glycosuria in Mental
Disorders, 229
Mitchell, J. W. A Study in Hysteria
and Multiple Personality, with Report
of a Case, 224
Mohr. The Diagnostic Valueof Unilateral
Choked Disc and Unilateral Exophthal-
mus in Brain Tumour, 219
Moll, A. M. A Case of Hypoglossal
Nuclei Paralysis, 339
Mondio, G. Combined Lesions of the
Posterior and Lateral Columns, 165
Mongour, C., and Brandeis, R. Agglu¬
tination of the Typhoid Bacillus by
the Cerebro-Spinal Fluid of the
Typhoid Patient, 632
Monier-Vinard and Douzelot. Purulent
Pneumococcal Meningitis. Absence of
Cellular Reaction in Cerebro-Spinal
Fluid, 212 •
Moore, A. Eisdell, and Ross, Athole.
A Case of Influenzal Meningitis, 596
Moore, Sir John. Two Unusual Cases
of Enteric Fever, 439
Moore, J. H. The Occurrence of the
Syringomyelic
Conduction in
Syphilitic Organism in the Brain in
Paresis, 343
Moore, J. W., and Noguchi, Hideyo.
A Demonstration of Treponema pal -
lidum in the Brain in Cases of General
Paralysis, 174
Moorhead, T. Gillman. A Case of
Juvenile Tabes, 211
Moraes, F. V. de, and Pernambuco, P.
Pluriglandular Endocrinic Syndrome
and Dementia Prjeoox, 226
Morel, L., Horand, R., and Piullet, P.
Two New Cases of Suppurative Paro¬
titis in General Paralysis, 289
Moretti, A. The Therapeutic Value of
Sodium Nucleinate in General Paralysis
and Dementia Pnecox, 556
Morichau-Beauchant, Blaye, R. le, and
Delage. Fulminating Cerebro-Spinal
Meningitis due to an Undetermined
Cocco-Baeillus, 214
Morichau-Beauchant, R., Guyonnet, R.,
and Corbin. Two Simultaneous Oases
of Acute Poliomyelitis in Two Children
of the Same Family : Typical Paralysis
in One, Simple Meningeal State in the
Other, 278
Morrison, E. E. Report of a Case of
Brain Tumour, 336
Mott, F. W. The Neuropathic Inherit¬
ance, 343 ; The Histological Changes in
the Nervous System oi Dr Box’s Case
of Pellagra, compared with Changes
found in a Case of Pellagra dying in
the Abassieh Asylum, Cairo, 442
Mott, F. W., and Brun, R. Micro¬
scopical Investigation of the Nervous
System in Three Cases of Spontaneous
Myxcedema, 482
Muirhead, Winifred, and Henderson,
D. K. The Differentiation of Cells in
the Cerebro-Spinal Fluid by Alzheimer’s
Method, 195
Muirhead, Winifred, Henderson, D. K.,
and Fraser, J. S. A Case of Toxic
Exhaustive Insanity, associated with
Chronic Suppurative Otitis Media,
Labyrinthitis, and Extra-DuralAbscess,
565
Mummery, J. Howard. The Nerve Supply
of the Dentine, 530
Munro, J. M. H. A Cose of Addison’s
Disease Treated with Tuberculin, 112
Murphy,John, and Lewers, Alex. A Case
of Otogenic Cerebral Abscess, 540
Muskens, L. J. J. The Physiological
Analysis of the Posterior Longitudinal
Fascicle, 430
Musser, John H. Effects of Continuous
Administration of Extract of the
Pituitary Gland, 612
INDICES
174*
Myrrson, A. Hysteria with Fever and
Ankle (-limns, Bi>4 ; Note on Contra-
lateral Opjxiihoim and Gordon Re-
flexes, with Ohser vat ions in Two Cases,
til if
Natan son, A. A Case of Kvulsion of
the <)|»tu Nerve, 4*»2
Newruth, R. The Rule of Scarlet Fever
in the .Etiology of Nervous Diseases,
Ml
Newton, Alan. A Preliminary Note upon
an Experimental Investigation of Con¬
cussion of the Spinal Cord and Allicnl
Conditions, 4.1.1
Nd olson, David. An Address on Mind
and Motive: some Notes on Criminal
Lunaey, ;Vm
Niles, George M. Tin* R*'de of Hydro¬
therapy in Pellagra. CM \
Ximier, 11., and Nimier, A. Observations
on the Pathology of Temporary Faeial
Paralysis, Secondary to Fractures of the
Petrous Portion of the Temporal Hone,
44
Noguchi, Hidi yo. The Transmission of
Infionnmi fmll\<hnn from the Brains of
Paretics to the Rahhit, 4.*>t>; Additional
Studies on the Presenee of Spirorhirta
jKdlitf.n in General Paralysis and Tabes
Dorsalis, 535
Noguchi. Huleyo, and Flexner, Simon.
Experiments on the (Cultivation of the
Micrn-organisincausing Epidemic Polio¬
myelitis, 5(M>
Noguchi, Huleyo, and Moore, J. \V. A
Demonstration of Tr*'}tounn*t palfidum
in the Brain in Cases of General
Paralysis, 174 ;
Noica and Marinosoo. The Response of 1
the I^ower Lind) to External Stimuli in 1
Normal Individuals and in Patients
Sutiering from Spastic Paraplegia— ,
Normal Movements of Defence and !
Pathological Movcmentsof Defence,328
Noica and Paulian. An Organic Sign— |
“the Flexion of the Knee/’ 432
Noica, Paulian, and Sulica. The Meehan- j
ism of Kernig's Sign, and of Neri’s i
Sign, 98 " |
0 hern dork, C. P. Periodicity in the 1
Male, 288
Oct linger, Marie P. L., and Baron. A
Fresh Case of Parameningococcus j
Septicaemia with recurring Meningeal I
Attacks, 39.5 j
Oldfield, Carlton. Some Pelvic Disorders I
in Relation to Neurasthenia, 354 *
Officer, I). M‘M. Three Interesting
Brain Cases, 538
O'Malley, Mary. A Psychosis following
Car k>n-Monoxide Poisoning, with Coo
pie to Recovery, 501
Orr, Rows, and Stephenson. The Spresad
of Infection hv the Ascending Lyn.ph
Stream of Nerves from Peripheral Id-
tlaminatory Foci to the Central Nervous
System, 349
Orton, S. T. A Study of the Brain in a
Case of Catatonic Hirntod, 389
Paladino, G. Continuity in the Verte¬
brate Nervous System, and the Mutual
and Intimate Connections between
Neuroglia and Nerve Cells and fibres,
Parat, Trihoulet, and Debiv. Cerehro-
Spiml Meningitis in an Infant of five
Months. Purpura, Meningococcal
Septicemia, Serotherapy. HecWery,
P.iVhon, C. The Importance of Genenl
Nutritional Disturbances in tbelMer
mi nation of Facial Paralysis, 104
Par lion C., and Dan, C. Ichthyosis with
Mental Deficiency, 638 • ,
Parlum and Maldatvsco. Cleido-Craniii
Dysostosis, 222 Q
Parhon, C, and Ureclua C. ^
metrical Hypertrophy of the ban J
Glands in a Cretin, 46 ,
Parhon, C., and Zugravu,U. The W eig
of the Adrenals in the Insane, ok
Paris, A. The Conviction and wjpnw*
rnent of General Paralytics, to
Parkinson, John, and Rowlands,
Strychnine in Heart Failure,
Pasteur, VY. Fatal Meningitis FUW>
Years after a Bullet Wound of tie
Brain, 5% . f _
Paterson, Peter. A Neuroma-M)
the Mesentery, 541 .
Paulian and Noica. An Organic ^
“The Flexion of the Knee,
Paulian, Noica, and Sulica. The ^ ^
f Tv a’* SilTT! and 01 ^
SllG. E. The Influence of Physical
Illness on the Mental State in Insanity,
arson, J. M. Hemiplegia in Typhoid
Fever, 102 u , .
llacani, G. On u Precocious Cerebral
Syphilis, 286 , v T ..
ntimalli, P., and Quercia, M
Action of Adrenalin, Paraganglia,
Hypophyain on the Kidney, 96
rmewan. W. Discussion on the & 1
INDICES
175*
logy of Unilateral Paralysis of the <
Recurrent Laryngeal Nerve, 488 |
Pernambuco, P., and Moraes, F. V. de. j
Pluriglandular Endocrinic Syndrome j
and Dementia Praecox, 226 !
Perrier. Death after a Simple Injection j
of Neosalvarsan, 604 |
Petit, G., and Marchand, L. General
Paralysis in Dogs, 33 I
Pfeiffer, J. A. F. The Pathology of j
Chronic Progressive Chorea, 389 ; A
Case of Landry's Paralysis, with
especial reference to the Anatomical
Changes, 394
Phillips, J. G. Porter. Nervous and
Mental Symptoms in a Case of
Addison’s Disease, 112
Pianetta, C. Manic-depressive Psychosis
in Twins, 176
Pierret, R. Rheumatic Neuritis, 107
Pierret and Duhot. Tabetic Arthropathy:
Pharyngeal Crises, 212; Subacute
Meningeal Syndrome of Syphilitic*
Origin, 438
Pierret and Hannedouche. Recent
Syphilitic Hemiplegia considerably
improved by Salvarsan, 172
Pierret and Leroy, II. A Case of Puer¬
peral Tetanus, 340
Pier so l, George A. Translation of
Villiger’s “Brain and Spinal Cord”
(Review). 562
Pilcher, J. T. The .Etiology of Pernicious
Anaemia, 599
Pincus, I 1 . Neuritis in Neurofibroma¬
tosis, 623
Pitfield, R. L. Recovery from Tubercular
Meningitis, with Report of Cases, 492
Plumier-Clennont, L. The Action of
Adrenalin on the Pulmonary Vessels,
and the Va so motors of the Lung, 28
Pollitzer, S. The Passing of Para-
syphilis, 403
^lX an b Anatomical Study of the
Pineal Gland in Man, 206
Porak, R., and Claud, H. The Cardio¬
vascular Action of Pituitary Posterior
Lobe Extract in Acute Adrenal In¬
sufficiency, 326
1 orak, R., Claude, H., and Raudouin,
A. Pituitary Glycosuria in Human
and Animal tuberculosis, 222
*°Tter, W. T., and Turner, A. H.
Direct and Crossed Respiration upou
Stimulation of the Phrenic, the
Sciatic, and the Brachial Nerves, 325
Portret, S. Meningococcal Septicemia,
87
Price, George E. Spinal Gliosis occur¬
ring in Th ree Members of the Same
Family, suggesting a Familial Type,
«29; Psychic Epilepsy without other
Phenomena, 634
Priore, N. del. On the Action of Intra¬
venous Injections of Saline Extract of
Choroid Plexuses on the Blood Pressure
and Formation of Cerebro-Spinal
Fluid, 95 ; The Action of the Cerebro-
Spinal Fluid, the Choroid Plexuses,
and some Organs and Substances on
the Isolated Heart of the Rabbit,
531
Puillet, P. ,* Horand, R., and Morel, L,
Two New Cases of Suppurative Paro¬
titis in General Paralysis, 289
Pujol, M. Pruritus in Tabes and Arseno-
Benzol, 277
Pujol and Rispal. Acute Ataxia with
Rapid Recovery, 484
Quercia, N., and Pentiinalli, P. The
Action of Adrenalin, Paraganglin, and
Hypophysin on the Kidney, 9b
Quercy and Thomas, Andre. Syringo¬
myelia with Hyperplasia of the Con¬
nective Tissue and with Striped Muscle
I ibres in the Cord, 97
Rados. Contribution to our Knowledge
of Tuberculous Changes in the Retina
452 ’
Rae, Janies, Note on a Case of Chronic
Internal Hydrocephalus, 628
Raeeke. The Early Symptoms of Arterio¬
sclerotic Brain Disorder, 495
Rajenoff, Prof. Insanity in Twins, 345
Ramella, Nino,and Zuccari.O. Researches
on the Opsonic Index of the Blood
Serum, and on the Resistance of the
Leucocytes in Mental Disease, 610
Ramond, L., and Larrocpie. Tuberculous
Leprosy, Giantism, and Acromegaly
Randolph, B. M. Sarcoma of Left Frontal
Lolie of Brain without Definite Symp
toms until shortly before Death, 108
Ransom. F., and Dixon, \V. E. Broncho-
Dilator Nerves, 20
Ran son, S. Walter. Degeneration and
Regeneration of Nerve Fibres. 93
Rathery, Dumont, J., and ’ Carnot
Acromegaly ; Diabetes ; Pituitary
Tumour. 402 J
Rauch, F. t and Reichmann, v. Two
Cases of Recovery from Tuberculous
Meningitis, 539
Rawitscli, N. A. Epidemic Cerebro-
Spinal Meningitis Cured by Diphtheria
Antitoxin, 277
Raynaud, M., Ardiu-Deltlieil, and
IN PICES
170 *
( out 1 1 .IV. M. A Fivsh ( ;pe of Typhoid
Spun* m t lit* ( In 111. 30
KagM-au and Mart-hand. P«M Traumatic
Syndrome U«M-mblmg General Para*
1\caused hy an A<ute Meningitis of
Slow Involution, 4u
Regi*. The Simulation of Infinity and
(larwrV S\ndi«*me, 114
Ken he. K. Hm-pes l'at iali"?n 1 hphtheiia,
f*93
Hen hinann, v., and Rauch, F. Two Cases
of Recovery fiorn Tul*rcuh>us Menin¬
gitis.
Reid. D. M’Kinley. On the Bacteriology
of A^vlum I )vs»*ntery m England, 639
Reid, R., and ( alwi 11, Win. Notes of a
Suppos'd ( t>f lVllagi.i,
Keilly.tl., and >nlm, H. I aeiieetie form
<»t Parameningococcus (Vrehro-Spinal
Meningitis Treated and (*ured hy
I >< tpterT Serum, *_? 14
Kemy, A., and F anise. (\ Ha in<»rrhapc
f i uU-n iiltuis Meningitis in a Baby, IV .Hi
Ken.iult. •!., and Levy. P. P. Myelitis
following Tvplioid Fever in a Child,
4*. * ; i
Kennie. George K. Myasthenia Gravis
with Kvophthalniie Goitre. 475
Kenton. H. S. An I niisual Case of
Cerebral Abscess, 54 ( I
Re/za, A., and Vedrani, A. Histological
Findings in a Case of Juvenile General
Paralysis, 4S1
Richards, J. H. The Wassennann
Kea tion in I halites Mcllitus, with
Special Reference to its Relation to
Acidosis, 2*6
Riggs, C. Eugene, and Hamnies, E. M.
Two Cases of Circulatory Disturliance
of the Brain, 495
Kiselev. S. Should a Man with Miners
Nystagmus Work ? 554
Rispal and Pujol. Acute Ataxia with
Rapid Recovery, 4*4
Ritehcr. Extirpation of the Vestibule
of the Labyrinth wit li Cerebellar
Abscess Operation; Further a New
Reflex Phenomenon, 399
Ritchie, W. T. The Action of the Vagus
on the Human Heart, 95
Riviere, A. R. 1). de la. Pseudomeningo-
coccus and Parameningococcus Menin¬
gitis, 100
Roaf, H. E. The Influence of Muscular
Rigidity on the Oxygen Intake of
Decerebrate Cats, 533
Roberts, S. R. The Analysis of Pellagra
and the Mosquito, 601
Robertson, George M. The Morrison
Lectures, 1913. General Paralysis of
the Insane, 454
Rolertson, M, E., and Hunter, M alter
K. A Case with Transient Attacks of
Paralysis: Autopsy, 419
Robinson, G. W. Occlusion of
Posterior Inferior Cerebellar Artery,
441
Roger H., and KuunnT J. Headache in
Acute Infectious Diseases Treated aw
Cured by Lumbar Puncture. Hb
Rnlleston, J. 1). 1 diphtheritic Henn-
plegia, ‘.NO; Diphtheritic Paralysis
.398
RoinagnaAbmoia, A. On the Recur-
mice of Nervous Symptoms of Luetic
Origin, 223
R«>nne. On the Occurrence of a Hemian-
n|»ie Central Scotoma in I )isseniinated
Sclerosis and RetrohuUvir Neunti v
(Neuritis of the Chiasma and Opnc
'Tract), ‘279
Rose, Felix. The Argyll Robert**
Pupil in Non Syphilitic Affections L
Rosenthal,(». EiU'cplialO'nieninguisdw
to Pfeitier’s Coocohn illus, XXI
Rosenthal, M. S. A Case of Von Reck¬
linghausen's Disease. 42
Ro^r At hole, and Moore. A. EwleU-
A Case of Influenzal Meningitis
Ross, E. L. The Source of Innary
lndol-Acetic Acid in Two Dementia
Pneeox Patients, 301
Rotstadt. Vertebral Caries: PotO
Disease without Curvature in the
Senilium, 109
Rentier, IX, and Giullian, G. Cluonu
Rheumatic Periarthritis following
Zoster, and restricted to the Art* 0
the Eruption, 621
Rowlands, R. A., and Parkinson John.
Strychnine in Heart Pailure, out
Rows, Orr, and Stephenson. The>p
of Infection bv the Ascending Lyinp
Stream of Nerves from Peripheral! : •
flam matory Foci to the Central Neno
System. 349 . p -;i
Roy, J. N. Serous Meningitis, lap*
lo-dema, and Multiple Polvneun i*
the Cranial Nerves in a ^ oung -
holic Smoker, 166
Ruhland, G. C. Ganglionic Ghoneurom
of the Optic Nerve, 107 ,
Russell, William. Motor and bpwen
Paralysis due to Cerebral Angiospasm
talmas. On a Caw of Ruckling-
hausen's Disease with Hypernephroma.
it .iriem in Scarlet Fe'er,
437
INDICES
177*
Sagrini, E. A. The Blood-Pressure in
the Insane, 344; A Case of Hemi¬
plegia and Hemianesthesia with Mus¬
cular Atrophy, 629
Salin, H., ana Reilly, J. Cachectic Form
of Parameningococcus Cerebro-Spinal
Meningitis Treated and Cured by
Dopter’s Serum, 214 |
»Salin, H., Wilborts, A., and M£ry, H. j
Parameningococcus Meningitis Treated |
and Cured by Anti-Parameningococcus
Serum, 213
Salmon, A. A Case of Thrombosis of
the Vertebral and Posterior and In¬
ferior Cerebellar Arteries, 281
Salus. Paresis of the Oculomotor Nerve i
with Abnormal Cyclic Innervation of |
the Inner Branches, 452 i
Sambon, L. W. The Natural History |
of Pellagra. With an Account of Two !
New Cases in England, 443 ; Pellagra 1
in Great Britain : Three New* Indigen¬
ous Cases, 443; Pellagra in Great
Britain : Notes on Some Further Cases.
444
Sample, J. T., and Gorham, W. L.
Malum Perforans in Diabetes Mellitus.
171
Sargent, P. Some Points in the Surgery
ot Cervical Ribs, 486
Sauer, H. Absence of the Abdominal
Reflex in Chronic Alcoholism, 498
Savage, Sir E. H. An Address on Mental
Disorders, 50
Savy, P., and Favre, M. Hemiplegia in i
Scarlet Fever, 436
Savy, P., and Gat6, J. Recovery from
Pneumococcal Meningitis, 538.
Savy and Mazel. Polyneuritis following
a Phlegmon of the Right Index, 451
Scalinci, N. Relapsing Oculo- Motor
Paralysis in Uriccemic Subjects, 171
Scarpini, V. Histological Research on '
the Central Nervous System in a Case
of Catatonic Dementia Prsecox, 327 ;
A Case of Precocious Arterio-Sclerosis,
602
Schaller, W. F. A Report on the
Analysis of the Cerebro Spinal Fluid,
551
Schlasberg, H. I. The Effect of Intra- i
venous Injection of Salvarsan upon the
Kidneys, 447
Schluchterer, B. Hemiplegia in the
Early Stages of Syphilis, 43 i
Schmitter, F. The Luetin Test, 550
Schoonheid, P. H. A Case of Multiple
Neurofibromatosis of the Skin, 623
Schroder and Kirchheim. On Meningism
in Infectious Diseases, 625
Schrottenbach, H. On the Patho- '
Physiological Interpretation of the
Attacks and Deliria in General
Paralysis, 225
Schueren, A. van der. The Posterior
Longitudinal Bundle : An Anatomical
Study, 318
Selling, L. The Central Convolutions
in Tabes Dorsalis, 212
Semon, H. C. Case of Raynaud’s
Disease, 341
Sermaksechian, H. K. Zoster of the
Inferior Maxillary Nerve, 485
Sermyn, W. C. de. Contribution to the
Study of Certain Cerebral Faculties
(Review), 290
Sewell, S. V. Some Clinical Phenomena
of the Transverse Lesions of the Spinal
Cord, 537
Sezary, A. Suprarenal Muscular Syn¬
dromes, 173
Sezary, A., and Claude, H. Adiposis
Dolorosa : Striking Benefit from Fresh
Thyroid Gland, 173
Sharp, E. H. The Aborted Forms and
Pre-Paralytic Stage of Acute Polio¬
myelitis in the Buffalo Epidemic, 394
Shaw, B. Henry. The Interneuronic
Synapse in Disease, 433
Sheahan, F. J. Anuria — Perhaps
Hysteric, 286
Shepherd, Francis J. Tetany following
Extirpation of the Thyroid, 46
Sherrington, C. S., and Brown, T.
Graham. Note on the Functions of
the Cortex Cerebri, 272
Sicard and Leblanc. Anatomical and
Clinical Remarks on Franke’s Opera¬
tion in Tabetic Gastric Crises and in
Post-Herpetic Neuralgia, 35
Siemerling, E. Spinal Gliosis and
Syringomyelia. Marked Involvement
of the Cervical Cord with Destruction
of the Posterior Roots, but preserved
Pupillary Reaction. Glia Tuft on the
Floor of the Fourth Ventricle, 49(3
Siler, J. F., and Garrison, P. E. The
Epidemiology of Pellagra, 554, 601
Simpson, S. The Pyramidal Tract in the
Canadian Porcupine, 429; The Motor
Cortex and Pyramidal Tract in the
Raccoon, 429 ; Age as a Factor in the
Effects which follow Thyroidectomy
and Ihyro-parathyroidectoniv in the
Sheep, 431
Siredey, A., and Jong, Mile, de. Ex¬
ophthalmic Goitre with Generalised
Pigmentation, 46
Smith E Bellingham. Some Cases of
Mental Deficiency, 456
Smith, E. Victor. Histology of the
Sensory Ganglia of Birds, Hb
178*
INDICES
Somerville, W. F. High Frequency
Currents in Trigeminal Neuralgia, 115
Sommcrfelri, P. The Dissemination of
Diphtheria in the Heart Blood and
Organs, 397
Souques, A., and Mignot, R. Brown-
S^quard Syndrome with Dissociation
of Sensory Loss of the Syringomyelic
Tyjw— Paths of Sensory Conduction in
the Spinal Cord, 32S
Southard, K. K. A Series of Normal-
Looking Brains in Psychopathic
Subjects, 405
Spangler, Ralph H. The Crotalin Treat¬
ment of Epilepsy, 45<J
Spielmeyer, VV. On the Treatment of
Genera! Paralysis, 175
Spiller, William G. The Direct Ventro-
lateral Pyramidal Tract, 615
Stargardt, K. On the Etiology of 1
Tabetic Arthropathies.
Steen, H. B. Case of Molluscum
Eihrosum with Definite Family History,
4*2
Steen, R. H. Moral Insanity. 010 j
Stephenson, Orr, and Rows. The Spread
of Infection hv the Ascending Lymph j
Stream of Nerves from Peripheral
Inflammatory Foci to the Central j
Nervous System, 349
Stephenson, Sidney. Eye-strain in Every- j
day Practice (Review), 233 }
Stern, F. Contributions to the Clinical
Study of Hysterical Situation■ Psy- *
choses, 502
Stockdale, E. M. Serous Otitic Menin¬
gitis, with Septic Thrombosis of the
Left Lateral Sinus and Internal Jugnlar
Vein, Successfully Treated by Opera¬
tion, 333
Stoecker, W. On the Absence of the I
Corpus Callosum in the Human Brain,
481
Strauss, J. A Case of Cholesteatoma of
the Brain, 337
Sulica, Non a, and Paulian. The Mechan¬
ism of Kcrnig’s Sign and of N^ri’s
Sign, OS
Sunde, A. Herpes Zoster Frontalis with
Bacterial Findings in the Gasserian (
Ganglion, 210 1
Sutherland, G. A. Graphic Records of
Respiratory Paralysis, 453
Sweet, J. E., and Allen, A. R. The
Effect of the Removal of the Hypo¬
physis in the Dog, 273, 533
Sweet, J. E., and Cadwalader, W. B.
Experiments on Intradural Anasto¬
mosis of Nerves for the Cure of
Paralysis, 031
Swietochowski, G. de. A Case of Volk-
man ; e Ischaemic Contracture of the
Hand, 434
Swift, Walter B. Reflex Frequency and
its Clinical Value, 620
Swift, Homer F., and Ellis, A. W. M.
The Treatment of Syphilitic Affections
of the Central Nervous System, with
Especial Reference to the Use of Intra-
spinous Injections, 548 ; the Effect of
Intraspinous Injections of S&lv&rsan
and Neosalvarsan in Monkeys, 603;
A Study of the Spiroch«'eticidal Action
of the Serum of Patients treated with
Salvarsan, 603
Swift, Homer F., and Walker, I. C. A
Study of the Addition of Cholesterin
to the Alcoholic Extracts of Tissues
used for Antigens in the Wasserraann
Reaction. 448
Symington, J., and Crynible, P. T, The
Central Fissure of the Cerebrum, 317
Tawhiro, Shiro. Carbon Dioxide Pro¬
duction from Nerve Fibres when
Resting and when Stimulated, a Con¬
tribution to the Chemical Basis of
Irritability, 325
Taussig, F. J. Gynecologic Diseases in
the Insane, and its Relationship to the
Various forms of Psychosis, 51
Taylor, E. W. Progress in the Treat¬
ment of the Neuroses, 53
Taylor, W. J. The End Results in
Sixty-Three Cases of Operation for
Brain Tumour, 400
Theisen, C. F. Acute Thyroiditis as a
Complication of Acute Tonsillitis, 606
Thibaut and Gougerot, H. Symmetrical
Purpura of Left Arm and Zoster of
Right Arm, 98
Thomas and Durupt. Atrophy of the
Medulla, Fillet, and Superior Cere¬
bellar Peduncle in Friedreich’s Disease,
35
Thomas, Andr6, and Quercy. Syringo¬
myelia with Hyperplasia of the Con¬
nective Tissues, and with Striped
Muscle Fibres in the Cord, 97
Thomas, J. J. Retardation and Consti¬
tutional Inferiority, 289
Thomson, H. Campbell, Traumatic
Neurasthenia, 635
Thomson, H. Campbell, and Lang,
William. On Failure of Vision and
its Treatment in Pituitary Disease, 599
Thorburn, W. Surgical Treatment of
Cervical Ribs, 486
Tidy, H. Letheby. A Case of Tetanus
Treated with Intraspinal Injections of
Magnesium Sulphate, 451
Tileston, W. The Occurrence of Ankle-
INDICES
179*
Clonue without Gross Diseases of the
Central Nervous System, 483
Timme, W. Experimental Studies on
the Nervous Mechanism in the Pro¬
duction of Hyperplasia, 387
Todd, Alan H. Translation of “The
Treatment of Infantile Paralysis ” by
Oskar Vulpius (Review), 563
Todd, T. Wingate. The Arterial Lesion
in Cases of 14 Cervical ” Rib, 92; j
Indications of Nerve Lesions in Cer-
tain Pathological Conditions of Blood j
Vessels, 431 ; Blood-Vessel Changes j
consequent on Nervous Lesions, 485 j
Tooth, Howard II. Gumma Cerebri: ,
Results of Treatment: Some Histo¬
logical Features, 549 !
Tournade, A., and Faure, M. Adiposis
Dolorosa in Sciatica: A Variety ,
Localised in the Affected Lower
Limb, 287 j
Tousey, S. Case of Exophthalmic Goitre j
cured by X-Ray, 403
Traquair, H. M. Contribution to the
Study of Bitemporal Hemiopia, 545 1
Treadway, W. L. The Pre-senile Psy- !
ohnRpfl 458
Tribe, Enid M. The Effect of Adre- I
nalin on the Pulmonary Circulation, J
28 j
Tribe, Enid M., and Cullis, Winifred, j
Distribution of Nerves in the Heart, j
272 j
Triboulet, Debi6, and Paraf. Cerebro-
Spinal Meningitis in an Infant of
Five Months. Purpura, Meningo¬
coccal, Septicaemia, Serotherapy. Re¬
covery, 37
Trinci, G. The Cardio-Cervical Chro-
maffine System in Reptiles, 618
Trbmner, E., and Jakob, A. Post-Diph¬
theritic Bulbar Paralysis, 594
Tucker, B. R. Trigeminal Dural Neur¬
algia, 553
Turnbull, H., and MTntosh, James.
Transmission to Monkeys of Virus
obtained from English Cases of Polio¬
myelitis, 537
Turner, A. H. Remarks on the Origin
of the Phrenic Nerve in the Rabbit,
Cat, and Dog, 324
Turner, A. H., and Porter, W. T.
Direct and Crossed Respiration upon
Stimulation of the Phrenic, the Sciatic,
and the Brachial Nerves, 325
Tylor, Christopher. The Paths of Ence¬
phalic Infection in Otitis, 106
Uch firmann, V. Diseases of the Laby¬
rinth caused by Middle Ear Inflamma¬
tion (Complications, Diagnosis, Treat¬
ment), 402
Urechia, C., and Parhon, C. Sym¬
metrical Hypertrophy of the Salivary
Glands in a Cretin, 46
V edrani, A., and Rezza, A. Histological
Findings in a Case of Juvenile General
Paralysis, 481
Velter, E. Unilateral Argyll Robertson
Pupil due to Orbital Trauma, 217
Verderame. Corneal Sensibility and
Corneal Nerve-Terminations in Newly-
Born Children, 276
Verdi, W. F., and Madhouse, M. Cere¬
bellar Tumour, 283, 400
Verel, R., and Citelli, Prof. On the
Physiopathological Relations between
the Hypophysis System and Various
Chronic Diseases of the Nasopharynx
and Sphenoidal Sinus, 338
Vigouroux, A., and Herisaon-Laparu.
Cerebral Cysticerosis and General
Paralysis, 226
Villiger, Emil. Brain and Spinal Cord.
Translated by G. A. Piersol (Review),
562
Vincent, Swale. Internal Secretion and
the Ductless Glands (Review), 176
Vix, W. A Contribution to the Psychi¬
atry and Neurology of Sleeping Sick¬
ness, based on Observations in the
Sleeping Sickness Camps, Kigarama
and Usumbura, 173
Vollrath, U. The Pathological Changes
of the Brain in Korsakoff’s Psychosis,
227
Vulpius, Oskar. The Treatment of
Infantile Paralysis, translated by Alan
H. Todd (Review), 563
Walker, I. C., and Swift, H. F. A
Study of the Addition of Cholesterin to
the Alcoholic Extracts of Tissues used
for Antigens in the Wassermann Re¬
action, 448
Wassermeyer. On Suicide, 114
Watson, 11. F., and Fraser, Kate. The
Role of Syphilis in Mental Deficiency
and Epilepsy ; a Review of 205 Cases,
638
Weber, F. Parkes. Mitral Dwarfism, 441
Weed, L. H., Cushing, H., and Jacobson,
C. Further Studies on the Role of the
Hypophysis in the Metabolism of
Carbohydrates. The Autonomic Con¬
trol of the Pituitary Gland, 274
Weisenburg, T. H. Cerebellar Inter¬
mittent Claudication, 281
180*
INDICES
Weissenbach. R. J. Typhoid Meningitis
and the Meningeal Manifestations of
Typhoid Fever, 595
WeiswenUich, K. J.. and Auclair, J.
Two ( ases of Typhoid Spine observed
in Paris, 36
West, Samuel. On the Respiratory
Neuroses, 110
White, K. Barton. The Bacteriological
Examination of the Urine in Some
Cases of Ot neral Paralysis, 637
White, Win. A. Outlines of Psychiatry
I Review), 407
Whitelocke, K. N. H. A. A Case
simulating Meningitis in which the
Symptoms were caused by the Kscaj)e ,
of 'Hiread-Worms into the Peritoneal
Cavity through a Perforated Appendix
Vermiform is, 539
Whiting, A. J. The Associations of
Tubeieulo.sis with Disorders of the
Nervous System, 98
Whitney, R. L. Report of a Case of
a large Endothelioma of the Frontal j
Region of the Brain, 401
Wilbur ts, A., Mery, H., and Sal in, H.
Parameningococcus Meningitis Treated
and Cured by Anti-Parameningococcus
Serum, 213
Williams, E. C. Notes on a Case of
Precocious Development in a Boy aged
6 years, 40; Case of Hyperactivity of
Anterior Lobe,combined with Deficient
Action of Posterior Lobe, 500
Williams, E. M. Punctiform Haemor¬
rhagic Pigmentation of the Cerebral
Pia Mater, 327
Williams, W. W., Kolmer, J. A., and
Laubaugh, E. E. A Study of Com pie-
, ment Fixation in Syphilis with Tre¬
ponema antitjmAy 44S
Wilson, A. Read. Some Rarer Mani¬
festations of Parasyphilis of the
Nervous System, 105
Wilson, S. A. Kinnier. Progressive
Lenticular Degeneration ; a Familial
Nervous Disease associated with Cir¬
rhosis of the Liver, 107 ; Some Points
in the Symptomatology of Cervical
Ribs, with Especial Reference to
Muscular Wasting. 486
Winkler, C. On Localised Atrophy in
the Lateral Geniculate Body causing
Quad ran tic Hemianopsia of both the
Right Lower Fields of Vision, 546
Wi thing ton, C. F. Cerebral Complica¬
tions in Pneumonia, 495
Woclfel, A., and Carlson, A. J. The
Solubility of Lead Salts in Human
Gastric Juice, and its Bearing on the
. Hy g iene of the Lead Industry, 453
Woibarst, A. L. A Report of Seven
Cases of Syphilis apparently Cured with
One Injection of Kalvarsan, 633
Wolfsohn, J. M. The Cutaneous Re¬
action in Syphilis (Second Report),
403
W ’ood-Jones, F. The Ideal Lesion Pro¬
duced by Judicial Hanging, 97 ; The
Anatomy of Cervical Ribs, 486 ; Some
Anatomical Considerations of the
Disposition of the Sc iatic Nerve and
FY moral Artery, 551
W oods, A. H. Segmental Distribution
of Spinal Root Nucleus of the Tri¬
geminal Nerve, 269
Worton, A. S. Hereditary Optic Neur¬
itis, G06
Zieoel, H. F. L. A Case of Graves’
Disease with Sclerodermia and a Posi¬
tive Wassermann Reaction, treated
with Salvarsan, 446
Ziehen, Th., Bruns, L., and Cramer, A.
Text-book of Nervous Diseases in Child¬
hood (Review), 231
Ziveri, A. Contribution to Alzheimer’s
Disease, 405
Zuccari, G. A Case of Manic-Depressive
Psychosis in an Achondroplasiac, 557
Zuccari, G., and Ramella, Ninon. Re¬
searches on the Opsonic Index of the
Blood Serum and on the Resistance of
the Leucocytes in Mental Disease, 610
Zugravu, G., and Parhon, C. The
Weight of the Adrenals in the Insane,
619
^ £ 1
Printed at The Darien Prk*s, Ldir.bur^h.
r
Live Music Archive
Librivox Free Audio
Metropolitan Museum
Cleveland Museum of Art
Internet Arcade
Console Living Room
Books to Borrow
Open Library
TV News
Understanding 9/11