File:Diseases of the nervous system - a text-book of neurology and psychiatry (1915) (14782535942).jpg

Identifier: diseasesofnervo00jell (find matches)
Title: Diseases of the nervous system : a text-book of neurology and psychiatry
Year: 1915 (1910s)
Authors: Jelliffe, Smith Ely, 1866-1945 White, William A. (William Alanson), 1870-1937
Subjects: Mental Disorders Nervous System Diseases
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ricview, that whereas, the two disorders are undoubtedly fundamentallysyphilitic, yet they are two different kinds of processes, and that whenthe symptoms of tabes are added to paresis the changes in the cord arenot exactly similar to those found in tabes limited to the cord. Thedifferent findings in the cerebrospinal fluid in the two disorders wouldpoint to some sort of a difference as well. JUVENILE PARESIS 549 The matter still rests in the lap of the gods. Clinically, taboparesis shows in a combination of the symptomsobserved in the two. forms. Raymond and Nageotte would have itthat every paretic would show tabetic signs if he lived long enough.In those patients with pronounced tabetic onset one finds the frequentpupillary anomalies, the diminution or loss of the patellar reflexes,Romberg sign, ataxia of lower or upper extremities, or both, hypo-tonia, lancinating pains, crises, and arthropathies. These are foundin the more definite tabopareses closely associated with the psychical
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Fig. 272.—Juvenile paresis in the emaciated stage. disturbances already outlined. In the more classical tabetic patientsthe mental disturbances, to which Cassirer and 0. Meyer have devotedtheir attention, are very distinct from those of paresis. 6. Juvenile Paresis.—This form is quite distinct. It was apparentlyfirst recognized as late as 1877 by Clouston. It appears at the presenttime not infrequently, since the Wassermann-Plaut findings offer suchcertain criteria for its determination. Such tests seem necessary,since the clinical picture may be so extremely variable—hence it wasoverlooked—many patients dying diagnosed as imbeciles. 550 SYPHILIS OF THE NERVOUS SYSTEM Here the patient may make a comparatively normal developmentto five or ten years of age—certain non-developmental forms probablybelong here, but are now disregarded. Then the childs mentalityseems to drop. In older children, ten to sixteen, this drop is moreapparent. Poor memory, bad motor adaptation and gradua

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