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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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Fig. 261.—Cerebral_ syphilis (arterial type) with softening. Aphasia, hemiplegia,advancing dementia. (Lafora.) To return to the syphilitic etiology of paresis. It is practicallyconceded no syphilis, no paresis. One is not speaking now of thosefew individuals who, either because of the presence of brain tumor,or the existence of arteriosclerosis, or of other cerebral disorder, showa close clinical resemblance to paresis. Finally the findings by Moore and Noguchi of Treponema paUidumin twelve of seventy paretic brains serve to render more certain therelationship of the organism to the disease. But syphilis does not by any means necessarily lead to paresis, for- 534 SYPHILIS OF THE NERVOUS SYSTEM tunately. The most recent studies of Mettler show that about 2 percent, of those infected by syphiHs develop paresis. A considerablylarger percentage develop cerebrospinal syphilis—how large, can onlybe surmised.
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Fig. 262.—Treponema pallidum in the brain of a paretic. (Moore.) The question then arises, How is it that in certain cases a disorderarises, usually more than five, more frequently about ten years afterinfection which, while closely resembling many forms of cerebralsyphilis, yet differs from it in certain very noteworthy particulars,and what underlies these differences? In other words, Why para-or metasyphilis ? PARESIS 535 Naturally there are those who say there is no difference, eitheranatomically, biologically, or therapeutically. They are in the mi-nority with certain well-developed arguments, some of which are asyet unanswerable. The present-day attitude is to maintain a dis-tinction between the strictly cerebral syphilitic disorders and generalparesis, chiefly because the histological pathology is unique, thebiological tests are difterent, and the results of therapy diverse.

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