An introduction to pathology and morbid anatomy / by T. Henry Green.

  • Green, T. Henry (Thomas Henry), 1841-1923.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: An introduction to pathology and morbid anatomy / by T. Henry Green. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    594/612 (page 566)
    General Paralysis of the Insane is considered by many authorities to be due to a primary nutritional change in the cells of the cortex cerebri. The a;tiological factors of the disease are hereditary defect, alcohol, syphilis, mental overwork, sexual excess, and anxiety. The pathological process in the brain bears a resemblance to the changes in the cord in tabes. There is chronic thickening and opacity of the membranes, peri-encephalitis, the vessels are often gorged with blood, and their walls thickened and in a state of chronic inflammation. The perivascular lymphatic sheaths are distended and filled with leucocytes. The ganglion cells of the cortex are degenerated, some are swollen up, others atrophied, and there is an overgrowth of connective-tissue and increase of the glia-cells. Generally, the frontal lobes of the brain suffer first: the symptoms are varied and depend in a great measure upon the portions of the cortex which are most affected. Secondary degenerations of the spinal cord frequently occur. In some cases general paralysis may be associated with ataxy. Insular Sclerosis. — Disseminated throughout the central nervous system in the grey and white matter, more often the latter, are varying sized islets of sclerosis, consisting of a feltwork of fine neuroglia fibrils (Figs. 222 and 223). This sclerosis, however, does not cause systemic Wallerian degeneration, because; although the myeUn sheath disappears, the axis cylinders persist in the sclerosed tissue. The characteristic rhythmical tremors in intentional movement, may be due to the absence of the myelin sheath, by which voluntary impulses are not insulated in their passage along the pyramidal tract. Syphilis may produce multiple disseminated patches of softening and sclerosis, but the axis cylinders are destroyed in the diseased foci, and, consequently, there is always secondary degeneration. Syringomyelia. This is a central gliosis of the spinal cord causing destruction of the grey matter and excavation. The usual seat is around the central eanal in the j^eii-epcndymal tissue, generally behind the canal, in the grey substance of the posterior commissure; thence it invades the Fig. 222.—Section of the Mid- dorsal Spinal Cord from a Case of Insular Sclerosis. An islet of sclerosis, stained deeply, occupying no defi- nite tract, is seen in the posterior column. (F. W. Mott.)