File:A. M. A. archives of neurology and psychiatry (1919) (14757593026).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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ent 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 the parenchyma of the brain after treatment witharsenical compounds. It is recognized that histologic changes in the brain of patients withgeneral jiaralysis may be advanced, although clinical symptoms arerecent. Alzheimer, in patients who had previously had syphilis, not
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Fig. 13.—Enormous numbers of spirochetes in the blood vessel walls and inthe neighboring tissue. Figures 13 and 14 are photographic reproductions from Plate 7, Figures 1and 5, in the article by Dr. F. Sioli. infrequently found considerable collections of lymphocytes and plasmacells in the meninges, without evidence of cortical disease in the brain.It seems highly probable that the spirochetes reach the meninges early inthe infection in a large proportion of cases of syphilis, but in mostcases they do not get a foothold in the parenchyma. They have beenshown, with the microscope, by various authors to exist in the spinalfluid in patients with early syphilis—not in those with general paralysis. D UXLA P—GEXERA L PARALYSIS 603 Again in early syphilis, untreated, about 80 per cent, of the patients,according to Sioli, who bases his figures on an extensive material col-lected from the literature, have shown an abnormal state of the spinalfluid, either in the Wassermann reaction, cell

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