Remarks on a case of syphilitic insanity / by J. Batty Tuke.

  • John Batty Tuke
Date:
[1874?]
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on a case of syphilitic insanity / by J. Batty Tuke. Source: Wellcome Collection.

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    ing such changes as must have materially interfered with the return to the system of the products of waste and superabun¬ dant nutritive plasm. As a consequence, we have softenings, diseased cells, various morbid deposits and apoplexies, the result of the presence of which is affections of the various functions of the encephalon and spinal cord, motor, trophesial, and psychical. It may be said that the insanity was merely an accident in the case, and that the convulsive and trophesial abnormalities were the most important. But insanity was the first symptom of nerve degeneration on which these ab¬ normalities supervened. There is under my care at present a case in which very similar psychical symptoms are present, following on the tertiary stage of syphilis, but in which there is no modification of motion or trophesis. Were this patient to die, and we were to find the same indications of syphilitic deposit on the vessels of the hemispherical ganglia and degeneration of their cells, would we not be entitled to desig¬ nate it one of Syphilitic Insanity ? There can be no objection to the periphrasis “ insanity dependent on syphilis,” in the same way as there could be none to u iritis dependent on syphilis,” 66 rheumatism dependent on gonorrhoea,” and scores of other diseases which are the results of special condi¬ tions of the system. The periphrasis implies, if it implies anything, that the insanity, iritis, or rheumatism would not have occurred if the patient had not contracted syphilis or gonorrhoea. But if to this assumption we can add the pathological fact that in a case of insanity dependent on syphilis a lesion of the vessels is present which has not been observed in any other etiological class of so called mental disease, we, I hold, have an absolute right to call the condi¬ tion “ Syphilitic Insanity.” It is, perhaps, the only form of insanity in which a special lesion has been demonstrateol, coinciding with those of other parts of the system under a similar condition. The descriptions and plates of (Edmansson and Friinkel indicate a similar condition of the vessels of the syphilitic placenta, and reference need only be made to the thickened and occluded arteries of many other organs of the body in tertiary syphilis. From a merely clinical point of view this case is strongly illustrative of the acute remark of Dr. Buzzard, that the complexity and diversity of nervous symptoms in one individual are strong presumptive evidences of a syphilitic causation. With all deference to such an eminent pathologist as Dr. Wilks, I cannot refrain from reiterating the opinion that the clinical history and post-