File:A. M. A. archives of neurology and psychiatry (1919) (14594085777).jpg

Identifier: amaarchivesofneu08ameruoft (find matches)
Title: A. M. A. archives of neurology & psychiatry
Year: 1919 (1910s)
Authors: American Medical Association
Subjects: Neurology Psychiatry
Publisher: (Chicago) American Medical Association
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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al syphilitic strainthat entered the body at the time of infection, but would be alteredbiologically—a special selection of those best fitted to survive; that is,a straight syphilitic strain, but modified by the conditions of growthwithin the host. Moreover, as the recidive strains progress, the placesin which the syphilitic organisms can be found grow fewer and fewer; DUN LAP—GENERAL PARALYSIS 601 the parasites seem to retire in the later stages oi syphihs to certaincircumscribed foci, the central nervous system l)eing possibly one ofthese foci. It is only in the secondary stages and early stages ofsyphilis that one finds a general spread of spirochetes and generalizedlesions. In the tertiary stages of syphilis the lesions are much fewerin number and more focal in position. Thus the recidive theory of Ehrlich accounts for an indefinite periodof time during which the spirochetes are supposedly undergoing biologicalterations, and are receding more and more from general distribution
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Fig. 12.—A similar swarmlike colon)- of spirochetes more highly magnified. to more circumscribed locations, as is the case in tertiary, or latesyphilis, and in general paralysis. This is hardly the place to discuss the many other views and theoriesdealing with the latent period of syphilis and the habitat of the organ-isms between the time of primary infection and the outbreak of thesymptoms of general paralysis. This subject has been dealt with hyJahnel in a later article. 5. Jahnel: Das Problem der progressiven Paralyse, Ztschr. f. d. ges.Neurol, u. Psvchiat. 76:166-182, 1922. 602 AKCIlllES OF XEVROLOCY AM) ISYCIIIArKV As long as sjjirochetes are in the general mesoblastic tissue, theyare usually regarded as relatively accessible to treatment. Those thatreach the parenchyma of the brain appear to be extraordinarily inac-cessible, as even the most diffusible drugs are reported scarcely to enterthe brain substance at all, and arsenic, so far as I know, has not beendemonstrated in th

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