An introduction to pathology and morbid anatomy / by T. Henry Green ; revised and enlarged by H. Montague Murray.

Green, T. Henry (Thomas Henry), 1841-1923

Date:: 1900

Credit: An introduction to pathology and morbid anatomy / by T. Henry Green ; revised and enlarged by H. Montague Murray. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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$inidal tracts; because in some cases the degeneration has been found to extend only as high as the medulla, in others to the ])ons or crus; while in others, again, the internal capsule and the cortex have been affected. Bii/lxir jxim/i/xi.i is the same disease as progressive muscular atropliy, and is due to a degeneration affecting the motor nuclei of the medulla, particularly a group of cells known as the glosso-labio-laryngeal Jiucleus. It often forms the final stage of ])rogressive muscular atrophy. PRIMARY PROGRESSIVE MYOPATHIES. The aetiology of this group of muscular atrophies is still ob.scure. Heredity plays a prominent part, especially through the maternal side. No definite pathological lesion of the central nervous system has been obsej'ved, and the disease is said to be a primai-y atroph)' of the muscle fibres. Pseiido-hypei-trophic paralyxii {ji. 140), and Verb's juvenile paralysis, are the best known tyj)es. GENERAL PARALYSIS OF THE INSANE. .Stiology.—General j)aralysis has increased ra))idly of late years, and is probably one effect of syphilisalion and civilisation. It is a disease of large cities and towns, so is syphilis ; men are affected much more often than Avomen. The disease has been ascribed to alcohol, but in countries where intemperance is rife yet syphilis absent, general paralysis is unknown, e.g., rural districts of Ireland and Sweden. The writer has found a history of syphilis and signs of S3'j)hilis much more frequently in general paralysis than in other classes of mental disease. Kraft Ebing has shown that eight general paralytics, who exhibited no external signs of syphilis, jiossessed an immunity to the disease, for they could not be inoculated with the syphilitic virus. One of the strongest arguments in favour of the view that syphilis is the factor of all others which causes general paralysis is the existence of a juvenile j'onn, occurring in the subjects of congenital syphilis, twenty-five typical cases of which have come under the writer's notice. Other factors, such as worry, anxiety, mental strain and over- work, sexual excesses, alcoholism, blows on the head, sunstroke, and continual mental excitement, act as predisposing or exciting causes. Heredity plays a less important part in this disease than in other forms of insanity. The aetiologj^ of general paralj'sis and tabes is very similar. Age and Sex.—It affects especially men in the prime of life, in the thirties—the average age of death is -1-0. It is rare after 50; it$