The clinical aspects of 'juvenile general paralysis' : with an account of a case treated with '606,' and observations on prophylaxis / by J. Johnston Abraham.

  • James Johnston Abraham
Date:
[1911]
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Credit: The clinical aspects of 'juvenile general paralysis' : with an account of a case treated with '606,' and observations on prophylaxis / by J. Johnston Abraham. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    demonstration that “no syphilis means no general paralysis.” The only other view with any pretence to scientific support as to etiology is that of Ford-Robertson (18), who maintains that the organism isolated by himself and MacRae from the cerebro- spinal fluid of general paralytics, and named by them the “ bacillus paralyticans,” is the causal factor of the disease. O’Brien (19) has published a paper in support of the view, but other competent investigators, Marie (20), Chandler (21), Thomson (22), and Williamson (23), have either not been able to find the organism, or have found it as often in controls as in general paralytics, or have found that it exists as a common organism in the throat and skin in normal individuals, and cannot be considered the causal factor of the disease, or more than a secondary infection in general paralytics. Most alienists have therefore come to the conclusion that syphilis is a neces- sary precursor of the disease. [Anyone interested will find the views for and against syphilis discussed at length in Nonne.^] That syphilis is not the exciting cause seems, however, evident, since only from 3 to 5 per cent, of syphilitics develop tabes or general paralysis (Mott). In adults it- is generally stated that alcoholic and sexual excess is responsible for tipping the scale, but in children excess “ in baccho et venere ” can generally be excluded, and so the stress of puberty is usually considered the exciting cause, the ordinary age of onset being from 13 to 15 years, though cases as early as 8 years of age, and as late as 23 years are recorded. The fact, however, that as a rule the reproductive organs are of the infantile type seems to weaken the assumption. One of McDowall’s cases - was, notwith- standing, sexually well developed. Mott (24) mentions one case where a fall from a van seems to have been the exciting cause, and Collin (25) one of a boy who developed symptoms after an injured finger had been removed. As to sex, in contradistinction to the adult type where 80 per cent, of the cases are male, in the juvenile type the sexes are almost equally divided, with perhaps a slight preponderance amongst females. Syphilis imd Nervensystem. Berlin ; S. Krager, 1909. Journal of Mental Science, January, 1908, p. 112.