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Nervous and mental diseases . Fig. 327.—Epileptic idiocy. Fig. 328 —Imbecile, with extreme dolichocepbaly.(Length-breadth index, 51.). Fig. 329.—Hemiplegic idiocy.(Blainville ears.) Fig. 330.—Microcephalic imbecile. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-327epileptic-idiocy-fig-328-imbecile-with-extreme-dolichocepbalylength-breadth-index-51-fig-329hemiplegic-idiocyblainville-ears-fig-330microcephalic-imbecile-image342847800.htmlRM2AWP1T8–Nervous and mental diseases . Fig. 327.—Epileptic idiocy. Fig. 328 —Imbecile, with extreme dolichocepbaly.(Length-breadth index, 51.). Fig. 329.—Hemiplegic idiocy.(Blainville ears.) Fig. 330.—Microcephalic imbecile.
Nervous and mental diseases . Fig. 175.—A mixed case Bhowiug facio-scapulohumeral involvement, peroneal wast-ing, and the foot deformity of Friedreichsdisease. There were fibrillary twitchings andthe reaction of degeneration in the leg muscles. 410 DISEASES OF THE CORD PROPER. the lower border of the pectoralis, and the lower part of the deltoids.The serratus magnus, erector spinse, and humeral muscles commonlysuffer early. The myopathic facies is not well marked, but can bedetected in late cases. The forearms, hands, and feet are commonlyspared until the last. The enlarged muscles finally shr Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-175a-mixed-case-bhowiug-facio-scapulohumeral-involvement-peroneal-wast-ing-and-the-foot-deformity-of-friedreichsdisease-there-were-fibrillary-twitchings-andthe-reaction-of-degeneration-in-the-leg-muscles-410-diseases-of-the-cord-proper-the-lower-border-of-the-pectoralis-and-the-lower-part-of-the-deltoidsthe-serratus-magnus-erector-spinse-and-humeral-muscles-commonlysuffer-early-the-myopathic-facies-is-not-well-marked-but-can-bedetected-in-late-cases-the-forearms-hands-and-feet-are-commonlyspared-until-the-last-the-enlarged-muscles-finally-shr-image342913626.htmlRM2AWW1R6–Nervous and mental diseases . Fig. 175.—A mixed case Bhowiug facio-scapulohumeral involvement, peroneal wast-ing, and the foot deformity of Friedreichsdisease. There were fibrillary twitchings andthe reaction of degeneration in the leg muscles. 410 DISEASES OF THE CORD PROPER. the lower border of the pectoralis, and the lower part of the deltoids.The serratus magnus, erector spinse, and humeral muscles commonlysuffer early. The myopathic facies is not well marked, but can bedetected in late cases. The forearms, hands, and feet are commonlyspared until the last. The enlarged muscles finally shr
Nervous and mental diseases . warm water, with which it is also well to wetthe skin, is applied over the sternum, where the absence of muscles andof much sensitiveness obviates disturbing features. The small or activeelectrode, fitted with an interrupter and well moistened, is then placedover the nerve or muscles to be examined, and the current allowed topass (that isN made) or is interrupted (that is, broken) as required. 42 NERVOUS AND MENTAL DISEASES. This interference, for the sake of brevity, is called the make and breakof the constant current. In Health.—The nerve-trunk—as, for instance, Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-warm-water-with-which-it-is-also-well-to-wetthe-skin-is-applied-over-the-sternum-where-the-absence-of-muscles-andof-much-sensitiveness-obviates-disturbing-features-the-small-or-activeelectrode-fitted-with-an-interrupter-and-well-moistened-is-then-placedover-the-nerve-or-muscles-to-be-examined-and-the-current-allowed-topass-that-isn-made-or-is-interrupted-that-is-broken-as-required-42-nervous-and-mental-diseases-this-interference-for-the-sake-of-brevity-is-called-the-make-and-breakof-the-constant-current-in-healththe-nerve-trunkas-for-instance-image343003954.htmlRM2AX1516–Nervous and mental diseases . warm water, with which it is also well to wetthe skin, is applied over the sternum, where the absence of muscles andof much sensitiveness obviates disturbing features. The small or activeelectrode, fitted with an interrupter and well moistened, is then placedover the nerve or muscles to be examined, and the current allowed topass (that isN made) or is interrupted (that is, broken) as required. 42 NERVOUS AND MENTAL DISEASES. This interference, for the sake of brevity, is called the make and breakof the constant current. In Health.—The nerve-trunk—as, for instance,
Nervous and mental diseases . diagnosis can rarely presentdifficulty if the disease has attained any consider-able degree of development. Myxedema shows no osseous deformities, and the thickening of the soft parts is waxy andboggy. Pulmonary ostco-arthropathy presents joint-changes and a chronicpulmonary process. The clubbed enlargement of the fingers is largelyconfined to the terminal phalanges, over which the hypertrophic nailshang like parrot-beaks. In hyperostosis cranii the hands, feet, andmandible are not affected. Pagets disease, or osteitis deformans, spares theface, but affects the sk Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-diagnosis-can-rarely-presentdifficulty-if-the-disease-has-attained-any-consider-able-degree-of-development-myxedema-shows-no-osseous-deformities-and-the-thickening-of-the-soft-parts-is-waxy-andboggy-pulmonary-ostco-arthropathy-presents-joint-changes-and-a-chronicpulmonary-process-the-clubbed-enlargement-of-the-fingers-is-largelyconfined-to-the-terminal-phalanges-over-which-the-hypertrophic-nailshang-like-parrot-beaks-in-hyperostosis-cranii-the-hands-feet-andmandible-are-not-affected-pagets-disease-or-osteitis-deformans-spares-theface-but-affects-the-sk-image342896153.htmlRM2AWT7F5–Nervous and mental diseases . diagnosis can rarely presentdifficulty if the disease has attained any consider-able degree of development. Myxedema shows no osseous deformities, and the thickening of the soft parts is waxy andboggy. Pulmonary ostco-arthropathy presents joint-changes and a chronicpulmonary process. The clubbed enlargement of the fingers is largelyconfined to the terminal phalanges, over which the hypertrophic nailshang like parrot-beaks. In hyperostosis cranii the hands, feet, andmandible are not affected. Pagets disease, or osteitis deformans, spares theface, but affects the sk
Nervous and mental diseases . Fig. 42.—Two early cases of facial hemiatrophy. and less markedly the muscles, which may escape entirely. The oppositeside of the face may finally become involved, though this is rare. The dis-ease develops usually before adult life, but mayappearat any age. Itproduces a most notable difference of appearance on the two sides. Theatrophic half lacks the proportions of the sound side in every particular.The condition is usually most marked in the lower portionof the face.gradually lessening upward sothatthe brow may show almost no discrep-ancy on the two sides. The Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-42two-early-cases-of-facial-hemiatrophy-and-less-markedly-the-muscles-which-may-escape-entirely-the-oppositeside-of-the-face-may-finally-become-involved-though-this-is-rare-the-dis-ease-develops-usually-before-adult-life-but-mayappearat-any-age-itproduces-a-most-notable-difference-of-appearance-on-the-two-sides-theatrophic-half-lacks-the-proportions-of-the-sound-side-in-every-particularthe-condition-is-usually-most-marked-in-the-lower-portionof-the-facegradually-lessening-upward-sothatthe-brow-may-show-almost-no-discrep-ancy-on-the-two-sides-the-image342986764.htmlRM2AX0B38–Nervous and mental diseases . Fig. 42.—Two early cases of facial hemiatrophy. and less markedly the muscles, which may escape entirely. The oppositeside of the face may finally become involved, though this is rare. The dis-ease develops usually before adult life, but mayappearat any age. Itproduces a most notable difference of appearance on the two sides. Theatrophic half lacks the proportions of the sound side in every particular.The condition is usually most marked in the lower portionof the face.gradually lessening upward sothatthe brow may show almost no discrep-ancy on the two sides. The
Nervous and mental diseases . Fig. 316 —Extreme hydrocephalic idiocy, with diplegia. IDIOCY. 869. Fig. 317.—Cretin aged thirteen years standing beside normal brother aged four years (showing dwarf-ing of growth). Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-316-extreme-hydrocephalic-idiocy-with-diplegia-idiocy-869-fig-317cretin-aged-thirteen-years-standing-beside-normal-brother-aged-four-years-showing-dwarf-ing-of-growth-image342850922.htmlRM2AWP5RP–Nervous and mental diseases . Fig. 316 —Extreme hydrocephalic idiocy, with diplegia. IDIOCY. 869. Fig. 317.—Cretin aged thirteen years standing beside normal brother aged four years (showing dwarf-ing of growth).
Nervous and mental diseases . st ina narrow but widening strip up the dorsum of the forearm, and over theouter aspect of the arm as high as the insertion of the deltoid. Thesebranches, however, are seldom involved in a musculospiral palsy. Thisnerve is injured in a variety of ways, and is especially involved in systemicstates, such as lead poisoning. In these latter conditions it is interestingto note that the supinator longus, which is an active flexor of the elbow,does not participate. From its exposed position in the axilla, crutchpressure and dislocation of the humerus frequently affect it Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-st-ina-narrow-but-widening-strip-up-the-dorsum-of-the-forearm-and-over-theouter-aspect-of-the-arm-as-high-as-the-insertion-of-the-deltoid-thesebranches-however-are-seldom-involved-in-a-musculospiral-palsy-thisnerve-is-injured-in-a-variety-of-ways-and-is-especially-involved-in-systemicstates-such-as-lead-poisoning-in-these-latter-conditions-it-is-interestingto-note-that-the-supinator-longus-which-is-an-active-flexor-of-the-elbowdoes-not-participate-from-its-exposed-position-in-the-axilla-crutchpressure-and-dislocation-of-the-humerus-frequently-affect-it-image342957999.htmlRM2AWY2BY–Nervous and mental diseases . st ina narrow but widening strip up the dorsum of the forearm, and over theouter aspect of the arm as high as the insertion of the deltoid. Thesebranches, however, are seldom involved in a musculospiral palsy. Thisnerve is injured in a variety of ways, and is especially involved in systemicstates, such as lead poisoning. In these latter conditions it is interestingto note that the supinator longus, which is an active flexor of the elbow,does not participate. From its exposed position in the axilla, crutchpressure and dislocation of the humerus frequently affect it
Nervous and mental diseases . It may be limitedto thoracic or abdominal hands. It maybe unilateral or symmetrical. In figure147 it is of unusual outline, but will benoticed to roughly conform to some spinalsegments. In some eases areas at firstdiscrete have been observed to coalesceinto anatomical cord-territories. The analgesia may be partial or com-plete, and usually conforms in outline tothe thermo-anesthetic area or may be moreextensive. It embraces all the tissues, so that felons, caries of bone, and disintegrating joints may be painlessand insensitive. As a general rule, tactile sensibil Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-it-may-be-limitedto-thoracic-or-abdominal-hands-it-maybe-unilateral-or-symmetrical-in-figure147-it-is-of-unusual-outline-but-will-benoticed-to-roughly-conform-to-some-spinalsegments-in-some-eases-areas-at-firstdiscrete-have-been-observed-to-coalesceinto-anatomical-cord-territories-the-analgesia-may-be-partial-or-com-plete-and-usually-conforms-in-outline-tothe-thermo-anesthetic-area-or-may-be-moreextensive-it-embraces-all-the-tissues-so-that-felons-caries-of-bone-and-disintegrating-joints-may-be-painlessand-insensitive-as-a-general-rule-tactile-sensibil-image342925456.htmlRM2AWWGWM–Nervous and mental diseases . It may be limitedto thoracic or abdominal hands. It maybe unilateral or symmetrical. In figure147 it is of unusual outline, but will benoticed to roughly conform to some spinalsegments. In some eases areas at firstdiscrete have been observed to coalesceinto anatomical cord-territories. The analgesia may be partial or com-plete, and usually conforms in outline tothe thermo-anesthetic area or may be moreextensive. It embraces all the tissues, so that felons, caries of bone, and disintegrating joints may be painlessand insensitive. As a general rule, tactile sensibil
Nervous and mental diseases . re primary, theneuroglia and cellular structures being secondarilyinvolved in degenerative changes. Fatty changes inthe muscles are encountered in very old cases, andsometimes a peripheral nerve degeneration of aslight degree. Schiefferdecker and Schultze2 find the muscle fibers,fibrillar and nerve spindles diseased, but no change in the nerves.Catola3 has described changes in the muscles indicating a toxic chronicnodular myositis, and occasionally patients do complain of tender mus-cular thickenings. C. D. Camp4 calls prominent attention to the para-thyroids and Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-re-primary-theneuroglia-and-cellular-structures-being-secondarilyinvolved-in-degenerative-changes-fatty-changes-inthe-muscles-are-encountered-in-very-old-cases-andsometimes-a-peripheral-nerve-degeneration-of-aslight-degree-schiefferdecker-and-schultze2-find-the-muscle-fibersfibrillar-and-nerve-spindles-diseased-but-no-change-in-the-nervescatola3-has-described-changes-in-the-muscles-indicating-a-toxic-chronicnodular-myositis-and-occasionally-patients-do-complain-of-tender-mus-cular-thickenings-c-d-camp4-calls-prominent-attention-to-the-para-thyroids-and-image342880812.htmlRM2AWRFY8–Nervous and mental diseases . re primary, theneuroglia and cellular structures being secondarilyinvolved in degenerative changes. Fatty changes inthe muscles are encountered in very old cases, andsometimes a peripheral nerve degeneration of aslight degree. Schiefferdecker and Schultze2 find the muscle fibers,fibrillar and nerve spindles diseased, but no change in the nerves.Catola3 has described changes in the muscles indicating a toxic chronicnodular myositis, and occasionally patients do complain of tender mus-cular thickenings. C. D. Camp4 calls prominent attention to the para-thyroids and
Nervous and mental diseases . contact of clothing. Involvement of the vasomotor andtrophic functions of the nerve in se-vere and protracted eases renders thelimb livid in color, cold to the touch,with a temperature reduced severaldegrees. The perspiration is usuallyreduced, but may be increased, and the dermal structures frequently suffer, as in neuritis elsewhere. Scaliness,herpetiform eruptions, erythema, and acne sometimes appear, and perfo-rating ulcer has been encountered. The muscles waste and show thereaction of degeneration to electricity. The wasting is most noticeablein the leg and b Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-contact-of-clothing-involvement-of-the-vasomotor-andtrophic-functions-of-the-nerve-in-se-vere-and-protracted-eases-renders-thelimb-livid-in-color-cold-to-the-touchwith-a-temperature-reduced-severaldegrees-the-perspiration-is-usuallyreduced-but-may-be-increased-and-the-dermal-structures-frequently-suffer-as-in-neuritis-elsewhere-scalinessherpetiform-eruptions-erythema-and-acne-sometimes-appear-and-perfo-rating-ulcer-has-been-encountered-the-muscles-waste-and-show-thereaction-of-degeneration-to-electricity-the-wasting-is-most-noticeablein-the-leg-and-b-image342951075.htmlRM2AWXNGK–Nervous and mental diseases . contact of clothing. Involvement of the vasomotor andtrophic functions of the nerve in se-vere and protracted eases renders thelimb livid in color, cold to the touch,with a temperature reduced severaldegrees. The perspiration is usuallyreduced, but may be increased, and the dermal structures frequently suffer, as in neuritis elsewhere. Scaliness,herpetiform eruptions, erythema, and acne sometimes appear, and perfo-rating ulcer has been encountered. The muscles waste and show thereaction of degeneration to electricity. The wasting is most noticeablein the leg and b
Nervous and mental diseases . Fig. 214.—1 and 2, Hand in acromegalia; 3, foot in acromegalia. Speech is frequently thickened from the clumsiness and voluminoussize of the tongue, and the voice is ordinarily very deep, strong, andrough, owing to the enlargement of the larynx, which to palpation mayappear of increased dimensions and unusual prominence. The organs of special sense may all be affected. Smell, taste, or hearingmay be reduced or abolished, but this is uncommon. Vision, however,is usually more or less affected eventually. This may arise from opticneuritis or from atrophy, and in eith Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-2141-and-2-hand-in-acromegalia-3-foot-in-acromegalia-speech-is-frequently-thickened-from-the-clumsiness-and-voluminoussize-of-the-tongue-and-the-voice-is-ordinarily-very-deep-strong-andrough-owing-to-the-enlargement-of-the-larynx-which-to-palpation-mayappear-of-increased-dimensions-and-unusual-prominence-the-organs-of-special-sense-may-all-be-affected-smell-taste-or-hearingmay-be-reduced-or-abolished-but-this-is-uncommon-vision-howeveris-usually-more-or-less-affected-eventually-this-may-arise-from-opticneuritis-or-from-atrophy-and-in-eith-image342896467.htmlRM2AWT7XB–Nervous and mental diseases . Fig. 214.—1 and 2, Hand in acromegalia; 3, foot in acromegalia. Speech is frequently thickened from the clumsiness and voluminoussize of the tongue, and the voice is ordinarily very deep, strong, andrough, owing to the enlargement of the larynx, which to palpation mayappear of increased dimensions and unusual prominence. The organs of special sense may all be affected. Smell, taste, or hearingmay be reduced or abolished, but this is uncommon. Vision, however,is usually more or less affected eventually. This may arise from opticneuritis or from atrophy, and in eith
Nervous and mental diseases . ipheralfilament divided, degeneration follows below the lesion, in both the nerveand muscle, with loss of voluntary control. The reactions of such anerve and muscle to electricity are modified in a highly characteristic 46 NERVOUS AND MENTAL DISEASES. manner. They present the reaction of degeneration (R. D.), the presenceof which is an indubitable sign of structural change. At the end ofabout a week, during which there has been a gradual decrease of electricexcitability in the muscle and nerve to both faradic and galvanic shocks,four differences become manifest: F Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ipheralfilament-divided-degeneration-follows-below-the-lesion-in-both-the-nerveand-muscle-with-loss-of-voluntary-control-the-reactions-of-such-anerve-and-muscle-to-electricity-are-modified-in-a-highly-characteristic-46-nervous-and-mental-diseases-manner-they-present-the-reaction-of-degeneration-r-d-the-presenceof-which-is-an-indubitable-sign-of-structural-change-at-the-end-ofabout-a-week-during-which-there-has-been-a-gradual-decrease-of-electricexcitability-in-the-muscle-and-nerve-to-both-faradic-and-galvanic-shocksfour-differences-become-manifest-f-image343001363.htmlRM2AX11MK–Nervous and mental diseases . ipheralfilament divided, degeneration follows below the lesion, in both the nerveand muscle, with loss of voluntary control. The reactions of such anerve and muscle to electricity are modified in a highly characteristic 46 NERVOUS AND MENTAL DISEASES. manner. They present the reaction of degeneration (R. D.), the presenceof which is an indubitable sign of structural change. At the end ofabout a week, during which there has been a gradual decrease of electricexcitability in the muscle and nerve to both faradic and galvanic shocks,four differences become manifest: F
Nervous and mental diseases . Fig. 249.—Hysterical bilateral concentric contraction of visual fields (Tourette).. Fig. 250.—Concentric retraction of visual fields for colors usually found in hysteria. Red field inclosedthus: + + + ; white field, ; blue field, ; green field, - 1 1- (Souques). Accommodative errors in hysteria are sometimes encountered, by whichnear vision, particularly, is rendered faulty. To the same source havebeen attributed the monocular diplopia, polyopia, macropsia, and micropsiathat are occasionally met. In this condition, with the opposite eye cov-ered, the patient fixe Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-249hysterical-bilateral-concentric-contraction-of-visual-fields-tourette-fig-250concentric-retraction-of-visual-fields-for-colors-usually-found-in-hysteria-red-field-inclosedthus-white-field-blue-field-green-field-1-1-souques-accommodative-errors-in-hysteria-are-sometimes-encountered-by-whichnear-vision-particularly-is-rendered-faulty-to-the-same-source-havebeen-attributed-the-monocular-diplopia-polyopia-macropsia-and-micropsiathat-are-occasionally-met-in-this-condition-with-the-opposite-eye-cov-ered-the-patient-fixe-image342871949.htmlRM2AWR4JN–Nervous and mental diseases . Fig. 249.—Hysterical bilateral concentric contraction of visual fields (Tourette).. Fig. 250.—Concentric retraction of visual fields for colors usually found in hysteria. Red field inclosedthus: + + + ; white field, ; blue field, ; green field, - 1 1- (Souques). Accommodative errors in hysteria are sometimes encountered, by whichnear vision, particularly, is rendered faulty. To the same source havebeen attributed the monocular diplopia, polyopia, macropsia, and micropsiathat are occasionally met. In this condition, with the opposite eye cov-ered, the patient fixe
Nervous and mental diseases . act but 7 mm. Facial Asymmetry.—Inequality of the two sides of the face—when congenital and not due to some such disease as hemiatrophy—isto be looked upon as a stigma of degeneration. In the same categorymay be grouped various irregularities, and such conditions as excessiveprognathism or retrognathism. Great prominence or unequal promi- GENERAL ETIOLOGY OF INSANITY. 711 nence of the malar bones is to be observed, and also asymmetry of theorbits (Fig. 280). Deformities of the Palate.—In connection with the soft palate,bifurcation of the uvula may be mentioned. As Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-act-but-7-mm-facial-asymmetryinequality-of-the-two-sides-of-the-facewhen-congenital-and-not-due-to-some-such-disease-as-hemiatrophyisto-be-looked-upon-as-a-stigma-of-degeneration-in-the-same-categorymay-be-grouped-various-irregularities-and-such-conditions-as-excessiveprognathism-or-retrognathism-great-prominence-or-unequal-promi-general-etiology-of-insanity-711-nence-of-the-malar-bones-is-to-be-observed-and-also-asymmetry-of-theorbits-fig-280-deformities-of-the-palatein-connection-with-the-soft-palatebifurcation-of-the-uvula-may-be-mentioned-as-image342861720.htmlRM2AWPKHC–Nervous and mental diseases . act but 7 mm. Facial Asymmetry.—Inequality of the two sides of the face—when congenital and not due to some such disease as hemiatrophy—isto be looked upon as a stigma of degeneration. In the same categorymay be grouped various irregularities, and such conditions as excessiveprognathism or retrognathism. Great prominence or unequal promi- GENERAL ETIOLOGY OF INSANITY. 711 nence of the malar bones is to be observed, and also asymmetry of theorbits (Fig. 280). Deformities of the Palate.—In connection with the soft palate,bifurcation of the uvula may be mentioned. As
Nervous and mental diseases . ed improvement in the spasmodic affection.The tendency to recurrence and to extension has already been noted. Itis rare for a patient, even after years of rest, to be able to return towriting occupations without a reappearance of the neurosis. Treatment.—Recognizing the fatigue element in the production ofwriters cramp, rest becomes the principal note of treatment. Allphysical failings and conditions which tend to make fatigue of readyappearance must be scrupulously sought and carefully managed. Abso- NEURASTHENIA. 567 lute cessation of writing is of the first imp Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ed-improvement-in-the-spasmodic-affectionthe-tendency-to-recurrence-and-to-extension-has-already-been-noted-itis-rare-for-a-patient-even-after-years-of-rest-to-be-able-to-return-towriting-occupations-without-a-reappearance-of-the-neurosis-treatmentrecognizing-the-fatigue-element-in-the-production-ofwriters-cramp-rest-becomes-the-principal-note-of-treatment-allphysical-failings-and-conditions-which-tend-to-make-fatigue-of-readyappearance-must-be-scrupulously-sought-and-carefully-managed-abso-neurasthenia-567-lute-cessation-of-writing-is-of-the-first-imp-image342874036.htmlRM2AWR798–Nervous and mental diseases . ed improvement in the spasmodic affection.The tendency to recurrence and to extension has already been noted. Itis rare for a patient, even after years of rest, to be able to return towriting occupations without a reappearance of the neurosis. Treatment.—Recognizing the fatigue element in the production ofwriters cramp, rest becomes the principal note of treatment. Allphysical failings and conditions which tend to make fatigue of readyappearance must be scrupulously sought and carefully managed. Abso- NEURASTHENIA. 567 lute cessation of writing is of the first imp
Nervous and mental diseases . I At-. Fig. 137.—Diagram of arterialmechanism producing infantile par-alysis (Williamson). Fig. 138.—Section of spinal cord in a case ofacute anterior poliomyelitis of the adult, a,a, Dilatedvessels surrounded by round cells (Williamson). that field supplied by the arteries which enter the cord along the anteriorroots, or both. Rarely it extends backward in the middle arterial fieldand invades the neck of the posterior horn, and usually it embraces theadjoining white matter of the cord to a varying extent. It is evidentthat the lesion is not strictly systematized, Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-i-at-fig-137diagram-of-arterialmechanism-producing-infantile-par-alysis-williamson-fig-138section-of-spinal-cord-in-a-case-ofacute-anterior-poliomyelitis-of-the-adult-aa-dilatedvessels-surrounded-by-round-cells-williamson-that-field-supplied-by-the-arteries-which-enter-the-cord-along-the-anteriorroots-or-both-rarely-it-extends-backward-in-the-middle-arterial-fieldand-invades-the-neck-of-the-posterior-horn-and-usually-it-embraces-theadjoining-white-matter-of-the-cord-to-a-varying-extent-it-is-evidentthat-the-lesion-is-not-strictly-systematized-image342930630.htmlRM2AWWREE–Nervous and mental diseases . I At-. Fig. 137.—Diagram of arterialmechanism producing infantile par-alysis (Williamson). Fig. 138.—Section of spinal cord in a case ofacute anterior poliomyelitis of the adult, a,a, Dilatedvessels surrounded by round cells (Williamson). that field supplied by the arteries which enter the cord along the anteriorroots, or both. Rarely it extends backward in the middle arterial fieldand invades the neck of the posterior horn, and usually it embraces theadjoining white matter of the cord to a varying extent. It is evidentthat the lesion is not strictly systematized,
Nervous and mental diseases . blood-current of this duralchannel. Here the circulatory conditions are rendered still moreunfavorable by hydrostatic pressure, by the presence of trabecular in thesinuses which impede the flow of blood, and by venous retardationduring inspiration. The cerebellar veins empty mainly into the lateralsinuses. Into the dural sinuses also empty many veins from the faceand scalp. The facial vein communicates with the cavernous sinusthrough the ophthalmic vein. The veins of the nasal vault open intothe anterior extremity of the superior longitudinal sinus. Numerousveins Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-blood-current-of-this-duralchannel-here-the-circulatory-conditions-are-rendered-still-moreunfavorable-by-hydrostatic-pressure-by-the-presence-of-trabecular-in-thesinuses-which-impede-the-flow-of-blood-and-by-venous-retardationduring-inspiration-the-cerebellar-veins-empty-mainly-into-the-lateralsinuses-into-the-dural-sinuses-also-empty-many-veins-from-the-faceand-scalp-the-facial-vein-communicates-with-the-cavernous-sinusthrough-the-ophthalmic-vein-the-veins-of-the-nasal-vault-open-intothe-anterior-extremity-of-the-superior-longitudinal-sinus-numerousveins-image342967438.htmlRM2AWYED2–Nervous and mental diseases . blood-current of this duralchannel. Here the circulatory conditions are rendered still moreunfavorable by hydrostatic pressure, by the presence of trabecular in thesinuses which impede the flow of blood, and by venous retardationduring inspiration. The cerebellar veins empty mainly into the lateralsinuses. Into the dural sinuses also empty many veins from the faceand scalp. The facial vein communicates with the cavernous sinusthrough the ophthalmic vein. The veins of the nasal vault open intothe anterior extremity of the superior longitudinal sinus. Numerousveins
Nervous and mental diseases . n in thehead. The body and limbs sutler in their nu-trition and are unequal to the task of holdingup the head and trunk. In some cases sjntsii-citjj develops in the limbs, especially in thelower ones, and some paralytic loss of power isfrequently noted. Vomiting is frequent andmay be provoked by movements or much *> lpo.—chronic hydro- ?i j-i. eepualus in a child of four handling. years. Circumference of head, If not rapidly fatal by exhaustion, convul-sion, coma, or syncope, the disease may come to a standstill or proceed with such slowness that the child is e Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-n-in-thehead-the-body-and-limbs-sutler-in-their-nu-trition-and-are-unequal-to-the-task-of-holdingup-the-head-and-trunk-in-some-cases-sjntsii-citjj-develops-in-the-limbs-especially-in-thelower-ones-and-some-paralytic-loss-of-power-isfrequently-noted-vomiting-is-frequent-andmay-be-provoked-by-movements-or-much-gt-lpochronic-hydro-i-j-i-eepualus-in-a-child-of-four-handling-years-circumference-of-head-if-not-rapidly-fatal-by-exhaustion-convul-sion-coma-or-syncope-the-disease-may-come-to-a-standstill-or-proceed-with-such-slowness-that-the-child-is-e-image342960975.htmlRM2AWY667–Nervous and mental diseases . n in thehead. The body and limbs sutler in their nu-trition and are unequal to the task of holdingup the head and trunk. In some cases sjntsii-citjj develops in the limbs, especially in thelower ones, and some paralytic loss of power isfrequently noted. Vomiting is frequent andmay be provoked by movements or much *> lpo.—chronic hydro- ?i j-i. eepualus in a child of four handling. years. Circumference of head, If not rapidly fatal by exhaustion, convul-sion, coma, or syncope, the disease may come to a standstill or proceed with such slowness that the child is e
Nervous and mental diseases . Fig. 181.—Section of cords in advanced tabes. 1, Dorsal region; 2, cervical region. Sclerosis shown by white region (Marie). present a marked difference between the anterior or motor members,which are ordinarily normal, and the posterior sensory roots, which areusually, if not invariably, greatly degenerated. Only when changeshave taken place in the anterior cornual cells do we find changes in theanterior roots, and then there is corresponding amvotrophy. This is27 418 DISEASES OF THE CORD PROPER. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-181section-of-cords-in-advanced-tabes-1-dorsal-region-2-cervical-region-sclerosis-shown-by-white-region-marie-present-a-marked-difference-between-the-anterior-or-motor-memberswhich-are-ordinarily-normal-and-the-posterior-sensory-roots-which-areusually-if-not-invariably-greatly-degenerated-only-when-changeshave-taken-place-in-the-anterior-cornual-cells-do-we-find-changes-in-theanterior-roots-and-then-there-is-corresponding-amvotrophy-this-is27-418-diseases-of-the-cord-proper-image342910548.htmlRM2AWTWW8–Nervous and mental diseases . Fig. 181.—Section of cords in advanced tabes. 1, Dorsal region; 2, cervical region. Sclerosis shown by white region (Marie). present a marked difference between the anterior or motor members,which are ordinarily normal, and the posterior sensory roots, which areusually, if not invariably, greatly degenerated. Only when changeshave taken place in the anterior cornual cells do we find changes in theanterior roots, and then there is corresponding amvotrophy. This is27 418 DISEASES OF THE CORD PROPER.
Nervous and mental diseases . Fig. 235.—Sitting attitude in paralysisagitans. Fig. 236.—Parkinsons disease : facies. creased fades. % tremble. Owing to the rigidity, this reaction-time is increased about forty per cent. Passive motion is sometimes impeded by the rigidity, but there is no hypertonus and the tendon reflexes are only slightly in- A foot-clonus is never encountered. There is a characteristic The nasolabial folds and lines of expression tend to disappear. The face becomes smooth. The brow may retain its cross-wrinkles through enforced V |^^ elevation requisite for forward vision, i Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-235sitting-attitude-in-paralysisagitans-fig-236parkinsons-disease-facies-creased-fades-tremble-owing-to-the-rigidity-this-reaction-time-is-increased-about-forty-per-cent-passive-motion-is-sometimes-impeded-by-the-rigidity-but-there-is-no-hypertonus-and-the-tendon-reflexes-are-only-slightly-in-a-foot-clonus-is-never-encountered-there-is-a-characteristic-the-nasolabial-folds-and-lines-of-expression-tend-to-disappear-the-face-becomes-smooth-the-brow-may-retain-its-cross-wrinkles-through-enforced-v-elevation-requisite-for-forward-vision-i-image342879715.htmlRM2AWREG3–Nervous and mental diseases . Fig. 235.—Sitting attitude in paralysisagitans. Fig. 236.—Parkinsons disease : facies. creased fades. % tremble. Owing to the rigidity, this reaction-time is increased about forty per cent. Passive motion is sometimes impeded by the rigidity, but there is no hypertonus and the tendon reflexes are only slightly in- A foot-clonus is never encountered. There is a characteristic The nasolabial folds and lines of expression tend to disappear. The face becomes smooth. The brow may retain its cross-wrinkles through enforced V |^^ elevation requisite for forward vision, i
Nervous and mental diseases . Fig. 246.—Facial tic. Fig. 247.—Mental torticollis. ments are abrupt and momentary, they may. in a part or the whole of theirdistribution in long-standing cases, present tonic features of greater or lessduration. In some instances the eyelids are so firmly closed that thepressure upon the eyeball is painful. Rigidity in the lips is complainedof at times as a feeling of stiffness, and the action of the zygomaticsand buccinator may keep the angle of the mouth persistently retractedand elevated. The neck may be rigidly held in a given position. Asomewhat similar spas Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-246facial-tic-fig-247mental-torticollis-ments-are-abrupt-and-momentary-they-may-in-a-part-or-the-whole-of-theirdistribution-in-long-standing-cases-present-tonic-features-of-greater-or-lessduration-in-some-instances-the-eyelids-are-so-firmly-closed-that-thepressure-upon-the-eyeball-is-painful-rigidity-in-the-lips-is-complainedof-at-times-as-a-feeling-of-stiffness-and-the-action-of-the-zygomaticsand-buccinator-may-keep-the-angle-of-the-mouth-persistently-retractedand-elevated-the-neck-may-be-rigidly-held-in-a-given-position-asomewhat-similar-spas-image342872912.htmlRM2AWR5W4–Nervous and mental diseases . Fig. 246.—Facial tic. Fig. 247.—Mental torticollis. ments are abrupt and momentary, they may. in a part or the whole of theirdistribution in long-standing cases, present tonic features of greater or lessduration. In some instances the eyelids are so firmly closed that thepressure upon the eyeball is painful. Rigidity in the lips is complainedof at times as a feeling of stiffness, and the action of the zygomaticsand buccinator may keep the angle of the mouth persistently retractedand elevated. The neck may be rigidly held in a given position. Asomewhat similar spas
Nervous and mental diseases . acranial inflammation. The idea thatit is due to intracranial pressure or pressure within the optic-nerve sheathin all cases has been abandoned. In toxic cases it may represent the localaction of the poison. Deutschmann 1 insists that it is due to pathogenicorganisms which enter from without. The question is not settled. Atrophy of the optic nerve may (1) follow papillitis and reti-nitis or choroiditis; (2) it may result from injury or inflammationto the nerve-trunk; (3) it may be associated with sclerotic disease inthe brain and spinal cord ; (4) it may be due to Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-acranial-inflammation-the-idea-thatit-is-due-to-intracranial-pressure-or-pressure-within-the-optic-nerve-sheathin-all-cases-has-been-abandoned-in-toxic-cases-it-may-represent-the-localaction-of-the-poison-deutschmann-1-insists-that-it-is-due-to-pathogenicorganisms-which-enter-from-without-the-question-is-not-settled-atrophy-of-the-optic-nerve-may-1-follow-papillitis-and-reti-nitis-or-choroiditis-2-it-may-result-from-injury-or-inflammationto-the-nerve-trunk-3-it-may-be-associated-with-sclerotic-disease-inthe-brain-and-spinal-cord-4-it-may-be-due-to-image342990598.htmlRM2AX0G06–Nervous and mental diseases . acranial inflammation. The idea thatit is due to intracranial pressure or pressure within the optic-nerve sheathin all cases has been abandoned. In toxic cases it may represent the localaction of the poison. Deutschmann 1 insists that it is due to pathogenicorganisms which enter from without. The question is not settled. Atrophy of the optic nerve may (1) follow papillitis and reti-nitis or choroiditis; (2) it may result from injury or inflammationto the nerve-trunk; (3) it may be associated with sclerotic disease inthe brain and spinal cord ; (4) it may be due to
Nervous and mental diseases . d 0> sJ-1 32 =< a. ?S2 23g ss a u II «* 5 og en o c <U a -3 <e H co co s o i s s n s ° !U««i ?3 3§3 • o si £2<2 = s oSo c C 3 £ £ is * = * 2-2-£a |S5 * JJ * x rt • o 2 ° 55 S H OGO -2 346. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-d-0gt-sj-1-32-=lt-a-s2-23g-ss-a-u-ii-5-og-en-o-c-ltu-a-3-lte-h-co-co-s-o-i-s-s-n-s-!ui-3-33-o-si-2lt2-=-s-oso-c-c-3-is-=-2-2-a-s5-jj-x-rt-o-2-55-s-h-ogo-2-346-image342938689.htmlRM2AWX5P9–Nervous and mental diseases . d 0> sJ-1 32 =< a. ?S2 23g ss a u II «* 5 og en o c <U a -3 <e H co co s o i s s n s ° !U««i ?3 3§3 • o si £2<2 = s oSo c C 3 £ £ is * = * 2-2-£a |S5 * JJ * x rt • o 2 ° 55 S H OGO -2 346.
Nervous and mental diseases . Fig. 256.—Phase of resolution (Richer). HYSTERIA. 599 ing and sonorous borborygrni are frequently produced. All the clonicmovements are independent and illogical. This phase may last severalminutes and gradually subside, the patient falling into a phase of resolu-. Fig. 257.—Phase of resolution, retaining partial contractures (Richer). Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-256phase-of-resolution-richer-hysteria-599-ing-and-sonorous-borborygrni-are-frequently-produced-all-the-clonicmovements-are-independent-and-illogical-this-phase-may-last-severalminutes-and-gradually-subside-the-patient-falling-into-a-phase-of-resolu-fig-257phase-of-resolution-retaining-partial-contractures-richer-image342866458.htmlRM2AWPWJJ–Nervous and mental diseases . Fig. 256.—Phase of resolution (Richer). HYSTERIA. 599 ing and sonorous borborygrni are frequently produced. All the clonicmovements are independent and illogical. This phase may last severalminutes and gradually subside, the patient falling into a phase of resolu-. Fig. 257.—Phase of resolution, retaining partial contractures (Richer).
Nervous and mental diseases . heavy welt of fibro-elastic increase around the heel and along the outer border of the foot. The thorax usually presents an anteroposterior curvature in the cer-vicodorsal region, which may be compensated by lumbar lordosis andattended by scoliotic twists. The clavicles are almost invariably increasedin thickness and sometimes in length, and the sternum may also share inthe hypertrophy. The ribs and cartilages are often enlarged. Thesebony changes give the chest an unusual breadth and anteroposteriordepth. The respiration is ordinarily abdominal in character, and Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-heavy-welt-of-fibro-elastic-increase-around-the-heel-and-along-the-outer-border-of-the-foot-the-thorax-usually-presents-an-anteroposterior-curvature-in-the-cer-vicodorsal-region-which-may-be-compensated-by-lumbar-lordosis-andattended-by-scoliotic-twists-the-clavicles-are-almost-invariably-increasedin-thickness-and-sometimes-in-length-and-the-sternum-may-also-share-inthe-hypertrophy-the-ribs-and-cartilages-are-often-enlarged-thesebony-changes-give-the-chest-an-unusual-breadth-and-anteroposteriordepth-the-respiration-is-ordinarily-abdominal-in-character-and-image342896717.htmlRM2AWT879–Nervous and mental diseases . heavy welt of fibro-elastic increase around the heel and along the outer border of the foot. The thorax usually presents an anteroposterior curvature in the cer-vicodorsal region, which may be compensated by lumbar lordosis andattended by scoliotic twists. The clavicles are almost invariably increasedin thickness and sometimes in length, and the sternum may also share inthe hypertrophy. The ribs and cartilages are often enlarged. Thesebony changes give the chest an unusual breadth and anteroposteriordepth. The respiration is ordinarily abdominal in character, and
Nervous and mental diseases . Figs. 1G8, 109, and 170.—Method of rising from the ground in cases of myopathy.. Figs. 171, 172. and 173.—Method of rising from the ground in myopath placed on the back, the patient may have great difficulty in rising at all.His usual plan is to turn over on his face, then huddle himself together,and get upon his knees. The usually weakened psoas, vastus, and 408 DISEASES OF THE CORD PROPER. gluteal muscles are now inadequate to the effort of lifting him. He,therefore, advances the body into the all fours position, and, carryingthe weight of the head and shoulders Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-figs-1g8-109-and-170method-of-rising-from-the-ground-in-cases-of-myopathy-figs-171-172-and-173method-of-rising-from-the-ground-in-myopath-placed-on-the-back-the-patient-may-have-great-difficulty-in-rising-at-allhis-usual-plan-is-to-turn-over-on-his-face-then-huddle-himself-togetherand-get-upon-his-knees-the-usually-weakened-psoas-vastus-and-408-diseases-of-the-cord-proper-gluteal-muscles-are-now-inadequate-to-the-effort-of-lifting-him-hetherefore-advances-the-body-into-the-all-fours-position-and-carryingthe-weight-of-the-head-and-shoulders-image342916183.htmlRM2AWW52F–Nervous and mental diseases . Figs. 1G8, 109, and 170.—Method of rising from the ground in cases of myopathy.. Figs. 171, 172. and 173.—Method of rising from the ground in myopath placed on the back, the patient may have great difficulty in rising at all.His usual plan is to turn over on his face, then huddle himself together,and get upon his knees. The usually weakened psoas, vastus, and 408 DISEASES OF THE CORD PROPER. gluteal muscles are now inadequate to the effort of lifting him. He,therefore, advances the body into the all fours position, and, carryingthe weight of the head and shoulders
Nervous and mental diseases . Fig. 298.—No crus superius;no anthelix; small fossa con-chse ; few details of ear.. Fig. 299. —No lobule; nofossa conchse; shallow fossascaphoidea; fusion of helix,anthelix, and antitragus ; a typeof Stahl ear, No. 3. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-298no-crus-superiusno-anthelix-small-fossa-con-chse-few-details-of-ear-fig-299-no-lobule-nofossa-conchse-shallow-fossascaphoidea-fusion-of-helixanthelix-and-antitragus-a-typeof-stahl-ear-no-3-image342855536.htmlRM2AWPBMG–Nervous and mental diseases . Fig. 298.—No crus superius;no anthelix; small fossa con-chse ; few details of ear.. Fig. 299. —No lobule; nofossa conchse; shallow fossascaphoidea; fusion of helix,anthelix, and antitragus ; a typeof Stahl ear, No. 3.
Nervous and mental diseases . Fig. 189.—Abnormal abduction of thighs, the split position, due to hypotonus in tabes.. Fig. 190.—Abnormal flexibility of spine and hips in tabes due to hypotonus. DISEASES OF THE WHITE MATTER OF THE CORD. 429 Disturbance of the Visual Apparatus.—Both the external andinternal portions of the ocular mechanism are frequently impaired intabes. Ptosis and squints, usually unilateral, sometimes bilateral, are of com-mon occurrence in the preataxic as well as in the later stages of loco-motor ataxia. They may be and often are temporary and fleeting, almostmomentary, but Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-189abnormal-abduction-of-thighs-the-split-position-due-to-hypotonus-in-tabes-fig-190abnormal-flexibility-of-spine-and-hips-in-tabes-due-to-hypotonus-diseases-of-the-white-matter-of-the-cord-429-disturbance-of-the-visual-apparatusboth-the-external-andinternal-portions-of-the-ocular-mechanism-are-frequently-impaired-intabes-ptosis-and-squints-usually-unilateral-sometimes-bilateral-are-of-com-mon-occurrence-in-the-preataxic-as-well-as-in-the-later-stages-of-loco-motor-ataxia-they-may-be-and-often-are-temporary-and-fleeting-almostmomentary-but-image342904996.htmlRM2AWTJR0–Nervous and mental diseases . Fig. 189.—Abnormal abduction of thighs, the split position, due to hypotonus in tabes.. Fig. 190.—Abnormal flexibility of spine and hips in tabes due to hypotonus. DISEASES OF THE WHITE MATTER OF THE CORD. 429 Disturbance of the Visual Apparatus.—Both the external andinternal portions of the ocular mechanism are frequently impaired intabes. Ptosis and squints, usually unilateral, sometimes bilateral, are of com-mon occurrence in the preataxic as well as in the later stages of loco-motor ataxia. They may be and often are temporary and fleeting, almostmomentary, but
Nervous and mental diseases . ule.Each ear is represented on both sides of the brain, but also principallyupon the opposite side. The auditory center for speech, however, in right-handed individuals is practically confined to the left temporal lobe, thedestruction of which produces word-deafness, or a loss of spoken-wordmemories. At its peripheral termination the auditory nerve enters thecribriform opening in the internal meatus. The auditory portion is dis-tributed to the cochlea and the organ of Corti. The labyrinthian portionis distributed to the vestibule and ampullae of the semicircular c Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-uleeach-ear-is-represented-on-both-sides-of-the-brain-but-also-principallyupon-the-opposite-side-the-auditory-center-for-speech-however-in-right-handed-individuals-is-practically-confined-to-the-left-temporal-lobe-thedestruction-of-which-produces-word-deafness-or-a-loss-of-spoken-wordmemories-at-its-peripheral-termination-the-auditory-nerve-enters-thecribriform-opening-in-the-internal-meatus-the-auditory-portion-is-dis-tributed-to-the-cochlea-and-the-organ-of-corti-the-labyrinthian-portionis-distributed-to-the-vestibule-and-ampullae-of-the-semicircular-c-image342984358.htmlRM2AX081A–Nervous and mental diseases . ule.Each ear is represented on both sides of the brain, but also principallyupon the opposite side. The auditory center for speech, however, in right-handed individuals is practically confined to the left temporal lobe, thedestruction of which produces word-deafness, or a loss of spoken-wordmemories. At its peripheral termination the auditory nerve enters thecribriform opening in the internal meatus. The auditory portion is dis-tributed to the cochlea and the organ of Corti. The labyrinthian portionis distributed to the vestibule and ampullae of the semicircular c
Nervous and mental diseases . v-« Diagram showing Eelations and Distribute Plate 1.. Cervical and Brachial Nerves (Flower). LESIONS OF SPECIAL SPINAL NERVES. 291 that the condition has arisen from a simple pressure neuritis. In casesnot open to nerve suture Tubby x has suggested and successfully prac-tised the ingenious operation of substituting a portion of the pectoralismajor muscle, which is dissected from its humeral implantation, splitup, and inserted into the digitation of the serratus. The suprascapular nerve arises from the fifth and sixth cervi-cal nerves. It may suffer alone in shoul Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-v-diagram-showing-eelations-and-distribute-plate-1-cervical-and-brachial-nerves-flower-lesions-of-special-spinal-nerves-291-that-the-condition-has-arisen-from-a-simple-pressure-neuritis-in-casesnot-open-to-nerve-suture-tubby-x-has-suggested-and-successfully-prac-tised-the-ingenious-operation-of-substituting-a-portion-of-the-pectoralismajor-muscle-which-is-dissected-from-its-humeral-implantation-splitup-and-inserted-into-the-digitation-of-the-serratus-the-suprascapular-nerve-arises-from-the-fifth-and-sixth-cervi-cal-nerves-it-may-suffer-alone-in-shoul-image342959112.htmlRM2AWY3RM–Nervous and mental diseases . v-« Diagram showing Eelations and Distribute Plate 1.. Cervical and Brachial Nerves (Flower). LESIONS OF SPECIAL SPINAL NERVES. 291 that the condition has arisen from a simple pressure neuritis. In casesnot open to nerve suture Tubby x has suggested and successfully prac-tised the ingenious operation of substituting a portion of the pectoralismajor muscle, which is dissected from its humeral implantation, splitup, and inserted into the digitation of the serratus. The suprascapular nerve arises from the fifth and sixth cervi-cal nerves. It may suffer alone in shoul
Nervous and mental diseases . Fig. 281.—Palate with Gothic arch.. Fig. 282.—ralate with horseshoe arch. classed among the well-marked stigmata of degeneration. I havefound but two or three cleft-palates among the 450 idiots and imbecileson Randalls Island, while a number of cases of this kind with which I 714 MENTAL DISEASES. have come in contact in my professional life were very far from degen-erates. However, it would seem that there is great need of a faithfulstudy of a large number of cases of cleft-palate in relation to the ques- Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-281palate-with-gothic-arch-fig-282ralate-with-horseshoe-arch-classed-among-the-well-marked-stigmata-of-degeneration-i-havefound-but-two-or-three-cleft-palates-among-the-450-idiots-and-imbecileson-randalls-island-while-a-number-of-cases-of-this-kind-with-which-i-714-mental-diseases-have-come-in-contact-in-my-professional-life-were-very-far-from-degen-erates-however-it-would-seem-that-there-is-great-need-of-a-faithfulstudy-of-a-large-number-of-cases-of-cleft-palate-in-relation-to-the-ques-image342860769.htmlRM2AWPJBD–Nervous and mental diseases . Fig. 281.—Palate with Gothic arch.. Fig. 282.—ralate with horseshoe arch. classed among the well-marked stigmata of degeneration. I havefound but two or three cleft-palates among the 450 idiots and imbecileson Randalls Island, while a number of cases of this kind with which I 714 MENTAL DISEASES. have come in contact in my professional life were very far from degen-erates. However, it would seem that there is great need of a faithfulstudy of a large number of cases of cleft-palate in relation to the ques-
Nervous and mental diseases . ession of teratological defect in themotor and trophic portions of the central apparatus, and constitutes aprimordial shortcoming by which these parts reach an early death. Morbid Anatomy.—The lesions of progressive spinal muscularatrophy embrace in rare cases the entire motor field of the nervousapparatus from cerebral cortex to muscular nerve-endings, and includethe muscles themselves. Both upper and lower motor neurons in theirentirety are destroyed by a degenerative process. Following the patholog-ical rule that a neuron degenerating from toxic cause or involu Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ession-of-teratological-defect-in-themotor-and-trophic-portions-of-the-central-apparatus-and-constitutes-aprimordial-shortcoming-by-which-these-parts-reach-an-early-death-morbid-anatomythe-lesions-of-progressive-spinal-muscularatrophy-embrace-in-rare-cases-the-entire-motor-field-of-the-nervousapparatus-from-cerebral-cortex-to-muscular-nerve-endings-and-includethe-muscles-themselves-both-upper-and-lower-motor-neurons-in-theirentirety-are-destroyed-by-a-degenerative-process-following-the-patholog-ical-rule-that-a-neuron-degenerating-from-toxic-cause-or-involu-image342923154.htmlRM2AWWDYE–Nervous and mental diseases . ession of teratological defect in themotor and trophic portions of the central apparatus, and constitutes aprimordial shortcoming by which these parts reach an early death. Morbid Anatomy.—The lesions of progressive spinal muscularatrophy embrace in rare cases the entire motor field of the nervousapparatus from cerebral cortex to muscular nerve-endings, and includethe muscles themselves. Both upper and lower motor neurons in theirentirety are destroyed by a degenerative process. Following the patholog-ical rule that a neuron degenerating from toxic cause or involu
Nervous and mental diseases . Fig. 228.— Symmetrical adenolipornatosis (Launois and Bensailde). axillae and groins; or on the extremities, as in the case reported byMathieu, one pair over the trochanters, one pair on the inner side ofthe knees. The adiposis dolorosa of Dercum, the cases of Petersonand Loveland, and the adenolipornatosis of Launois and Bensaudex1 Nouv. Icon, de la Salpet,, 1900. 522 NEUROSES. (Fig. 228) appear to belong to the same group. Peterson, Collins, andothers look upon the condition as due to a rudimentary polyneuritis,and the idea is supported by the common history of Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-228-symmetrical-adenolipornatosis-launois-and-bensailde-axillae-and-groins-or-on-the-extremities-as-in-the-case-reported-bymathieu-one-pair-over-the-trochanters-one-pair-on-the-inner-side-ofthe-knees-the-adiposis-dolorosa-of-dercum-the-cases-of-petersonand-loveland-and-the-adenolipornatosis-of-launois-and-bensaudex1-nouv-icon-de-la-salpet-1900-522-neuroses-fig-228-appear-to-belong-to-the-same-group-peterson-collins-andothers-look-upon-the-condition-as-due-to-a-rudimentary-polyneuritisand-the-idea-is-supported-by-the-common-history-of-image342883053.htmlRM2AWRJR9–Nervous and mental diseases . Fig. 228.— Symmetrical adenolipornatosis (Launois and Bensailde). axillae and groins; or on the extremities, as in the case reported byMathieu, one pair over the trochanters, one pair on the inner side ofthe knees. The adiposis dolorosa of Dercum, the cases of Petersonand Loveland, and the adenolipornatosis of Launois and Bensaudex1 Nouv. Icon, de la Salpet,, 1900. 522 NEUROSES. (Fig. 228) appear to belong to the same group. Peterson, Collins, andothers look upon the condition as due to a rudimentary polyneuritis,and the idea is supported by the common history of
Nervous and mental diseases . Fig. 249.—Hysterical bilateral concentric contraction of visual fields (Tourette). Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-249hysterical-bilateral-concentric-contraction-of-visual-fields-tourette-image342872398.htmlRM2AWR56P–Nervous and mental diseases . Fig. 249.—Hysterical bilateral concentric contraction of visual fields (Tourette).
Nervous and mental diseases . Fig. 31S.—Hydrocephalic imbecile. Fig. 319.—Idiot with multiple sclerosis. 870 3IENTAL DISEASES.. Fig. 320.—Microcephalic idiocy—wildrelsorne, perverted. quar- Fig. 321.—Hydrocephalic feeble-mindedness. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-31shydrocephalic-imbecile-fig-319idiot-with-multiple-sclerosis-870-3iental-diseases-fig-320microcephalic-idiocywildrelsorne-perverted-quar-fig-321hydrocephalic-feeble-mindedness-image342849583.htmlRM2AWP43Y–Nervous and mental diseases . Fig. 31S.—Hydrocephalic imbecile. Fig. 319.—Idiot with multiple sclerosis. 870 3IENTAL DISEASES.. Fig. 320.—Microcephalic idiocy—wildrelsorne, perverted. quar- Fig. 321.—Hydrocephalic feeble-mindedness.
Nervous and mental diseases . Fig. 124.—Divisions of the cross-section of the cord hased on Flecbsigs study of their development.A, Direct pyramidal tract; B, fundamental fasciculus of the anterior column ; C, rest of lateral column.I), direct cerebellar tract; E, crossed pyramidal tract; F, lateral limiting zone; G, anterior root zone;H, middle root zone; /, median zone; J, column of Goll; K, postero-internal root zone; L, postero-external root zone or zone of Lissauer (Marie).. Fig. 125.—Scheme showing secondary degenerations. Ascending degenerations: 1, Fioers of theascending sulcomarginal Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-124divisions-of-the-cross-section-of-the-cord-hased-on-flecbsigs-study-of-their-developmenta-direct-pyramidal-tract-b-fundamental-fasciculus-of-the-anterior-column-c-rest-of-lateral-columni-direct-cerebellar-tract-e-crossed-pyramidal-tract-f-lateral-limiting-zone-g-anterior-root-zoneh-middle-root-zone-median-zone-j-column-of-goll-k-postero-internal-root-zone-l-postero-external-root-zone-or-zone-of-lissauer-marie-fig-125scheme-showing-secondary-degenerations-ascending-degenerations-1-fioers-of-theascending-sulcomarginal-image342942858.htmlRM2AWXB36–Nervous and mental diseases . Fig. 124.—Divisions of the cross-section of the cord hased on Flecbsigs study of their development.A, Direct pyramidal tract; B, fundamental fasciculus of the anterior column ; C, rest of lateral column.I), direct cerebellar tract; E, crossed pyramidal tract; F, lateral limiting zone; G, anterior root zone;H, middle root zone; /, median zone; J, column of Goll; K, postero-internal root zone; L, postero-external root zone or zone of Lissauer (Marie).. Fig. 125.—Scheme showing secondary degenerations. Ascending degenerations: 1, Fioers of theascending sulcomarginal
Nervous and mental diseases . Fig. 38. Fig. 39. Fig. 38. Convergent squint. The ray of light, a c, falls to the right of the sensitive spot, m, ofthe inturned left eye, L. Such stimulus has always been recognized by the mind as emanating fromobjects to the left, and not realizing the disordered position of the ocular globe a false image, e, is pro-jected an additional distance to the left, measuring from c as the operating sensitive spot, in theline d e. Fig. 39.—Divergent squint. The ray of light, a c, falls to the left of the macula, m, of the outwardlyturned left eye, L. Such stimulus has a Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-38-fig-39-fig-38-convergent-squint-the-ray-of-light-a-c-falls-to-the-right-of-the-sensitive-spot-m-ofthe-inturned-left-eye-l-such-stimulus-has-always-been-recognized-by-the-mind-as-emanating-fromobjects-to-the-left-and-not-realizing-the-disordered-position-of-the-ocular-globe-a-false-image-e-is-pro-jected-an-additional-distance-to-the-left-measuring-from-c-as-the-operating-sensitive-spot-in-theline-d-e-fig-39divergent-squint-the-ray-of-light-a-c-falls-to-the-left-of-the-macula-m-of-the-outwardlyturned-left-eye-l-such-stimulus-has-a-image342989008.htmlRM2AX0DYC–Nervous and mental diseases . Fig. 38. Fig. 39. Fig. 38. Convergent squint. The ray of light, a c, falls to the right of the sensitive spot, m, ofthe inturned left eye, L. Such stimulus has always been recognized by the mind as emanating fromobjects to the left, and not realizing the disordered position of the ocular globe a false image, e, is pro-jected an additional distance to the left, measuring from c as the operating sensitive spot, in theline d e. Fig. 39.—Divergent squint. The ray of light, a c, falls to the left of the macula, m, of the outwardlyturned left eye, L. Such stimulus has a
Nervous and mental diseases . Figs. 165, 166, and 167.—Waddling gait in a case of pseudohypen paralysi The gait is broad-based and waddling (Figs. 165, 166, and 167). Thefoot to be advanced is clumsily put forward, the pelvis tilting sharplydownward on that side, the body being inclined over the supportingfoot as a counterpoise to the swinging limb. This is repeated in theopposite sense at the next step, and the patient advances in a swaying,waddling, awkward fashion, stumbling over the least obstacle, and falling LESIONS AND DISEASES OF SPINAL GRAY. 407 heavily if the very unstable equilibriu Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-figs-165-166-and-167waddling-gait-in-a-case-of-pseudohypen-paralysi-the-gait-is-broad-based-and-waddling-figs-165-166-and-167-thefoot-to-be-advanced-is-clumsily-put-forward-the-pelvis-tilting-sharplydownward-on-that-side-the-body-being-inclined-over-the-supportingfoot-as-a-counterpoise-to-the-swinging-limb-this-is-repeated-in-theopposite-sense-at-the-next-step-and-the-patient-advances-in-a-swayingwaddling-awkward-fashion-stumbling-over-the-least-obstacle-and-falling-lesions-and-diseases-of-spinal-gray-407-heavily-if-the-very-unstable-equilibriu-image342917365.htmlRM2AWW6GN–Nervous and mental diseases . Figs. 165, 166, and 167.—Waddling gait in a case of pseudohypen paralysi The gait is broad-based and waddling (Figs. 165, 166, and 167). Thefoot to be advanced is clumsily put forward, the pelvis tilting sharplydownward on that side, the body being inclined over the supportingfoot as a counterpoise to the swinging limb. This is repeated in theopposite sense at the next step, and the patient advances in a swaying,waddling, awkward fashion, stumbling over the least obstacle, and falling LESIONS AND DISEASES OF SPINAL GRAY. 407 heavily if the very unstable equilibriu
Nervous and mental diseases . n and written. The firsttwo are afferent qualities of perception. The second two are efferentqualities of expression. We, therefore, have four groups of word mem-ories : (1) Those of sound, or auditory word memories ; (2) those of sight,or visual word memories; (3) those of the motions necessary to expresswords in speech, vocal motor word memories, and (4) probably those ofthe motions required to express them by written symbols, graphic motorword memories. For these four memory groups we have four corticalmemory depots, as indicated in Fig. 71. These memory word-c Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-n-and-written-the-firsttwo-are-afferent-qualities-of-perception-the-second-two-are-efferentqualities-of-expression-we-therefore-have-four-groups-of-word-mem-ories-1-those-of-sound-or-auditory-word-memories-2-those-of-sightor-visual-word-memories-3-those-of-the-motions-necessary-to-expresswords-in-speech-vocal-motor-word-memories-and-4-probably-those-ofthe-motions-required-to-express-them-by-written-symbols-graphic-motorword-memories-for-these-four-memory-groups-we-have-four-corticalmemory-depots-as-indicated-in-fig-71-these-memory-word-c-image342978489.htmlRM2AX00FN–Nervous and mental diseases . n and written. The firsttwo are afferent qualities of perception. The second two are efferentqualities of expression. We, therefore, have four groups of word mem-ories : (1) Those of sound, or auditory word memories ; (2) those of sight,or visual word memories; (3) those of the motions necessary to expresswords in speech, vocal motor word memories, and (4) probably those ofthe motions required to express them by written symbols, graphic motorword memories. For these four memory groups we have four corticalmemory depots, as indicated in Fig. 71. These memory word-c
Nervous and mental diseases . ascular color and asoft consistency quite like that of the brain-substance. Glioma is emi-nently an infiltrating and a destructive growth. Its outlines are difficultto determine. Owing to its strangulating effect, the center of a glioma isfrequently filled with softened detritus and fatty-degeneration products,which may become fluid and the growth thereby cystic. Many allegedlocal brain-hypertrophies have been gliomatous infiltration in fact,and the microscopic examination of cyst-walls has alone discoveredthe true nature of the lesion in other instances. The favo Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ascular-color-and-asoft-consistency-quite-like-that-of-the-brain-substance-glioma-is-emi-nently-an-infiltrating-and-a-destructive-growth-its-outlines-are-difficultto-determine-owing-to-its-strangulating-effect-the-center-of-a-glioma-isfrequently-filled-with-softened-detritus-and-fatty-degeneration-productswhich-may-become-fluid-and-the-growth-thereby-cystic-many-allegedlocal-brain-hypertrophies-have-been-gliomatous-infiltration-in-factand-the-microscopic-examination-of-cyst-walls-has-alone-discoveredthe-true-nature-of-the-lesion-in-other-instances-the-favo-image342962398.htmlRM2AWY812–Nervous and mental diseases . ascular color and asoft consistency quite like that of the brain-substance. Glioma is emi-nently an infiltrating and a destructive growth. Its outlines are difficultto determine. Owing to its strangulating effect, the center of a glioma isfrequently filled with softened detritus and fatty-degeneration products,which may become fluid and the growth thereby cystic. Many allegedlocal brain-hypertrophies have been gliomatous infiltration in fact,and the microscopic examination of cyst-walls has alone discoveredthe true nature of the lesion in other instances. The favo
Nervous and mental diseases . ra-orbital nerveeither at the point where itemerges or somewhat higherup in its field, and consists ofa fibrillary twitching of theFig. 4.-Method of eliciting the jaw-jerk. orbicularis palpebrarum. It should not be confounded withthe palpebral reflex. It is absent in severe injury or disease of thefacial and of the fifth cranial nerves.1 The pupillary reflex is manifest under several conditions : (1) Ifthe eyes have been closed for a few moments and then suddenly openedin a strong light, or if in a dark room a beam of light is thrown uponthem, the dilated pupils q Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ra-orbital-nerveeither-at-the-point-where-itemerges-or-somewhat-higherup-in-its-field-and-consists-ofa-fibrillary-twitching-of-thefig-4-method-of-eliciting-the-jaw-jerk-orbicularis-palpebrarum-it-should-not-be-confounded-withthe-palpebral-reflex-it-is-absent-in-severe-injury-or-disease-of-thefacial-and-of-the-fifth-cranial-nerves1-the-pupillary-reflex-is-manifest-under-several-conditions-1-ifthe-eyes-have-been-closed-for-a-few-moments-and-then-suddenly-openedin-a-strong-light-or-if-in-a-dark-room-a-beam-of-light-is-thrown-uponthem-the-dilated-pupils-q-image343007759.htmlRM2AX19W3–Nervous and mental diseases . ra-orbital nerveeither at the point where itemerges or somewhat higherup in its field, and consists ofa fibrillary twitching of theFig. 4.-Method of eliciting the jaw-jerk. orbicularis palpebrarum. It should not be confounded withthe palpebral reflex. It is absent in severe injury or disease of thefacial and of the fifth cranial nerves.1 The pupillary reflex is manifest under several conditions : (1) Ifthe eyes have been closed for a few moments and then suddenly openedin a strong light, or if in a dark room a beam of light is thrown uponthem, the dilated pupils q
Nervous and mental diseases . Fig. 90.—Attitude and deformityin cerebral right hemiplegia in a boyof seven. Fig. 91.—Right hemiplegia datingfrom birth, with overaction in right sideof face and athetosis of right hand. motility the muscles, from constant though involuntary use, are fre-quently firm and well nourished. They may even be overdeveloped.Clark 1 has proven hypertrophy in such cases and actual enlargementof bones has been shown by the X-ray. On the other hand, well-marked atrophy may be encountered. The joints frequently present amarked increase in their range of motion so that the di Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-90attitude-and-deformityin-cerebral-right-hemiplegia-in-a-boyof-seven-fig-91right-hemiplegia-datingfrom-birth-with-overaction-in-right-sideof-face-and-athetosis-of-right-hand-motility-the-muscles-from-constant-though-involuntary-use-are-fre-quently-firm-and-well-nourished-they-may-even-be-overdevelopedclark-1-has-proven-hypertrophy-in-such-cases-and-actual-enlargementof-bones-has-been-shown-by-the-x-ray-on-the-other-hand-well-marked-atrophy-may-be-encountered-the-joints-frequently-present-amarked-increase-in-their-range-of-motion-so-that-the-di-image342966638.htmlRM2AWYDCE–Nervous and mental diseases . Fig. 90.—Attitude and deformityin cerebral right hemiplegia in a boyof seven. Fig. 91.—Right hemiplegia datingfrom birth, with overaction in right sideof face and athetosis of right hand. motility the muscles, from constant though involuntary use, are fre-quently firm and well nourished. They may even be overdeveloped.Clark 1 has proven hypertrophy in such cases and actual enlargementof bones has been shown by the X-ray. On the other hand, well-marked atrophy may be encountered. The joints frequently present amarked increase in their range of motion so that the di
Nervous and mental diseases . Fig. 137.—Diagram of arterialmechanism producing infantile par-alysis (Williamson). Fig. 138.—Section of spinal cord in a case ofacute anterior poliomyelitis of the adult, a,a, Dilatedvessels surrounded by round cells (Williamson). that field supplied by the arteries which enter the cord along the anteriorroots, or both. Rarely it extends backward in the middle arterial fieldand invades the neck of the posterior horn, and usually it embraces theadjoining white matter of the cord to a varying extent. It is evidentthat the lesion is not strictly systematized, and it Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-137diagram-of-arterialmechanism-producing-infantile-par-alysis-williamson-fig-138section-of-spinal-cord-in-a-case-ofacute-anterior-poliomyelitis-of-the-adult-aa-dilatedvessels-surrounded-by-round-cells-williamson-that-field-supplied-by-the-arteries-which-enter-the-cord-along-the-anteriorroots-or-both-rarely-it-extends-backward-in-the-middle-arterial-fieldand-invades-the-neck-of-the-posterior-horn-and-usually-it-embraces-theadjoining-white-matter-of-the-cord-to-a-varying-extent-it-is-evidentthat-the-lesion-is-not-strictly-systematized-and-it-image342930237.htmlRM2AWWR0D–Nervous and mental diseases . Fig. 137.—Diagram of arterialmechanism producing infantile par-alysis (Williamson). Fig. 138.—Section of spinal cord in a case ofacute anterior poliomyelitis of the adult, a,a, Dilatedvessels surrounded by round cells (Williamson). that field supplied by the arteries which enter the cord along the anteriorroots, or both. Rarely it extends backward in the middle arterial fieldand invades the neck of the posterior horn, and usually it embraces theadjoining white matter of the cord to a varying extent. It is evidentthat the lesion is not strictly systematized, and it
Nervous and mental diseases . p. 562. MULTIPLE CEREBROSPINAL SCLEROSIS. 467 instances such an apoplectiform attack is the initial manifestation of thedisease.1 Sometimes both limbs and the face on the same side areinvolved; sometimes we have a crossed paralysis; sometimes the faceescapes, and sometimes the palsy is paraplegic in distribution. The upper limbs present not only the spastic weakness alreadynoted in the lower extremities, but here is developed to its highest de-gree the so-called intention tremor, which is characteristic of the dis-ease. While at rest the hands, trunk, and head are Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-p-562-multiple-cerebrospinal-sclerosis-467-instances-such-an-apoplectiform-attack-is-the-initial-manifestation-of-thedisease1-sometimes-both-limbs-and-the-face-on-the-same-side-areinvolved-sometimes-we-have-a-crossed-paralysis-sometimes-the-faceescapes-and-sometimes-the-palsy-is-paraplegic-in-distribution-the-upper-limbs-present-not-only-the-spastic-weakness-alreadynoted-in-the-lower-extremities-but-here-is-developed-to-its-highest-de-gree-the-so-called-intention-tremor-which-is-characteristic-of-the-dis-ease-while-at-rest-the-hands-trunk-and-head-are-image342900631.htmlRM2AWTD73–Nervous and mental diseases . p. 562. MULTIPLE CEREBROSPINAL SCLEROSIS. 467 instances such an apoplectiform attack is the initial manifestation of thedisease.1 Sometimes both limbs and the face on the same side areinvolved; sometimes we have a crossed paralysis; sometimes the faceescapes, and sometimes the palsy is paraplegic in distribution. The upper limbs present not only the spastic weakness alreadynoted in the lower extremities, but here is developed to its highest de-gree the so-called intention tremor, which is characteristic of the dis-ease. While at rest the hands, trunk, and head are
Nervous and mental diseases . en generally found in other cases.6 In someinstances there is a tendency to improve and to relapse, as in the caseof Collins, in which case the special senses of sight and hearing also showedrapid exhaustion. E. F. Buzzard,7 in a study of five cases, noted decidedsensory disturbances of a tabetic distribution in one, and fleeting areas ofparesthesia and analgesia in others. Localized atrophies are also pos- 1 Presse med.. April 14. 1897. 2 Neurol. Centralbl., Feb. 1. 1902. 3 Berlin, klin. Wochens., 1899. 4 Deut. Zeit. f. Xervenheilk.. Nov , 1906. Bd. 31. 5 Oppenhe Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-en-generally-found-in-other-cases6-in-someinstances-there-is-a-tendency-to-improve-and-to-relapse-as-in-the-caseof-collins-in-which-case-the-special-senses-of-sight-and-hearing-also-showedrapid-exhaustion-e-f-buzzard7-in-a-study-of-five-cases-noted-decidedsensory-disturbances-of-a-tabetic-distribution-in-one-and-fleeting-areas-ofparesthesia-and-analgesia-in-others-localized-atrophies-are-also-pos-1-presse-med-april-14-1897-2-neurol-centralbl-feb-1-1902-3-berlin-klin-wochens-1899-4-deut-zeit-f-xervenheilk-nov-1906-bd-31-5-oppenhe-image342981406.htmlRM2AX047X–Nervous and mental diseases . en generally found in other cases.6 In someinstances there is a tendency to improve and to relapse, as in the caseof Collins, in which case the special senses of sight and hearing also showedrapid exhaustion. E. F. Buzzard,7 in a study of five cases, noted decidedsensory disturbances of a tabetic distribution in one, and fleeting areas ofparesthesia and analgesia in others. Localized atrophies are also pos- 1 Presse med.. April 14. 1897. 2 Neurol. Centralbl., Feb. 1. 1902. 3 Berlin, klin. Wochens., 1899. 4 Deut. Zeit. f. Xervenheilk.. Nov , 1906. Bd. 31. 5 Oppenhe
Nervous and mental diseases . Fig. 289.—Blainville ear; also excessive lengthof ears. Fig. 290.—Morel ears. X. The Stahl ear, No. I.1 A series of anomalies of the helix.The helix is broad, like a band, and coalesces with the cartilages See Zeitschrift fur Psych., vol. xvi. GENERAL ETIOLOGY OF INSANITY. 719 of the crura furcata. The fossa ovalis and fossa scaphoidea arescarcely to be seen. The lower half of the helix is obliterated. Thereare occasionally slight variations from this type. XI. The Darwin ear; helix interrupted where its transverseportion passes into the descending, and at this po Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-289blainville-ear-also-excessive-lengthof-ears-fig-290morel-ears-x-the-stahl-ear-no-i1-a-series-of-anomalies-of-the-helixthe-helix-is-broad-like-a-band-and-coalesces-with-the-cartilages-see-zeitschrift-fur-psych-vol-xvi-general-etiology-of-insanity-719-of-the-crura-furcata-the-fossa-ovalis-and-fossa-scaphoidea-arescarcely-to-be-seen-the-lower-half-of-the-helix-is-obliterated-thereare-occasionally-slight-variations-from-this-type-xi-the-darwin-ear-helix-interrupted-where-its-transverseportion-passes-into-the-descending-and-at-this-po-image342857318.htmlRM2AWPE06–Nervous and mental diseases . Fig. 289.—Blainville ear; also excessive lengthof ears. Fig. 290.—Morel ears. X. The Stahl ear, No. I.1 A series of anomalies of the helix.The helix is broad, like a band, and coalesces with the cartilages See Zeitschrift fur Psych., vol. xvi. GENERAL ETIOLOGY OF INSANITY. 719 of the crura furcata. The fossa ovalis and fossa scaphoidea arescarcely to be seen. The lower half of the helix is obliterated. Thereare occasionally slight variations from this type. XI. The Darwin ear; helix interrupted where its transverseportion passes into the descending, and at this po
Nervous and mental diseases . Fig. 324.—Microcephalic imbecile—good-naturedand a fair worker. Fig. 325.—Good-natured imbecile—fairworker.. Fig. 326.—Two epileptic idiots 872 MENTAL DISEASES. extent of our latest knowledge. Almost any of the types of thedivisions here made use of may be congenital or acquired. The termidiocy itself is generic, including as it does all degrees of mentalimpairment in early life. But the variations in degree or intensity ofthe mental weakness are indicated by the expressions : idiocy, for thelowest degree of mental disability ; imbecility, for a higher degree, and Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-324microcephalic-imbecilegood-naturedand-a-fair-worker-fig-325good-natured-imbecilefairworker-fig-326two-epileptic-idiots-872-mental-diseases-extent-of-our-latest-knowledge-almost-any-of-the-types-of-thedivisions-here-made-use-of-may-be-congenital-or-acquired-the-termidiocy-itself-is-generic-including-as-it-does-all-degrees-of-mentalimpairment-in-early-life-but-the-variations-in-degree-or-intensity-ofthe-mental-weakness-are-indicated-by-the-expressions-idiocy-for-thelowest-degree-of-mental-disability-imbecility-for-a-higher-degree-and-image342848669.htmlRM2AWP2Y9–Nervous and mental diseases . Fig. 324.—Microcephalic imbecile—good-naturedand a fair worker. Fig. 325.—Good-natured imbecile—fairworker.. Fig. 326.—Two epileptic idiots 872 MENTAL DISEASES. extent of our latest knowledge. Almost any of the types of thedivisions here made use of may be congenital or acquired. The termidiocy itself is generic, including as it does all degrees of mentalimpairment in early life. But the variations in degree or intensity ofthe mental weakness are indicated by the expressions : idiocy, for thelowest degree of mental disability ; imbecility, for a higher degree, and
Nervous and mental diseases . nd some such ocular experience. Its temporary character is the bestevidence of its tabetic, we may even say of its syphilitic, nature. Anyof the extrinsic muscles of the eye may be selected by the disease, butthose under the control of the third cranial nerve show more than theirdue proportion of paralytic disturbances. They may be gradually in-vaded, and a progressive external ophthalmoplegia results with perma-nent disability. Lacrimation, exophthalmos, enophthalmos, nystagmus,and reduced ocular tension on one or both sides has been noticed in rareinstances. The Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-nd-some-such-ocular-experience-its-temporary-character-is-the-bestevidence-of-its-tabetic-we-may-even-say-of-its-syphilitic-nature-anyof-the-extrinsic-muscles-of-the-eye-may-be-selected-by-the-disease-butthose-under-the-control-of-the-third-cranial-nerve-show-more-than-theirdue-proportion-of-paralytic-disturbances-they-may-be-gradually-in-vaded-and-a-progressive-external-ophthalmoplegia-results-with-perma-nent-disability-lacrimation-exophthalmos-enophthalmos-nystagmusand-reduced-ocular-tension-on-one-or-both-sides-has-been-noticed-in-rareinstances-the-image342904692.htmlRM2AWTJC4–Nervous and mental diseases . nd some such ocular experience. Its temporary character is the bestevidence of its tabetic, we may even say of its syphilitic, nature. Anyof the extrinsic muscles of the eye may be selected by the disease, butthose under the control of the third cranial nerve show more than theirdue proportion of paralytic disturbances. They may be gradually in-vaded, and a progressive external ophthalmoplegia results with perma-nent disability. Lacrimation, exophthalmos, enophthalmos, nystagmus,and reduced ocular tension on one or both sides has been noticed in rareinstances. The
Nervous and mental diseases . Fig. 68.—Functional areas of tine mesial surface of the left hemisphere (after Campbell). At the branching of the fissure of Sylvius motions of the tongue andplatysma are found, and immediately above them the muscles of the face,first the lower, then the upper face parts. Next in order we encounter. Fig. 69.—Relations of body to cortical areas. finger, wrist, elbow and shoulder movements; then those of the trunk, andhighest of all those of the lower extremity, which lap over the mesial marginof the hemisphere. 166 DISEASES OF THE BRAIN PKOPER. In front of the cent Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-68functional-areas-of-tine-mesial-surface-of-the-left-hemisphere-after-campbell-at-the-branching-of-the-fissure-of-sylvius-motions-of-the-tongue-andplatysma-are-found-and-immediately-above-them-the-muscles-of-the-facefirst-the-lower-then-the-upper-face-parts-next-in-order-we-encounter-fig-69relations-of-body-to-cortical-areas-finger-wrist-elbow-and-shoulder-movements-then-those-of-the-trunk-andhighest-of-all-those-of-the-lower-extremity-which-lap-over-the-mesial-marginof-the-hemisphere-166-diseases-of-the-brain-pkoper-in-front-of-the-cent-image342979426.htmlRM2AX01N6–Nervous and mental diseases . Fig. 68.—Functional areas of tine mesial surface of the left hemisphere (after Campbell). At the branching of the fissure of Sylvius motions of the tongue andplatysma are found, and immediately above them the muscles of the face,first the lower, then the upper face parts. Next in order we encounter. Fig. 69.—Relations of body to cortical areas. finger, wrist, elbow and shoulder movements; then those of the trunk, andhighest of all those of the lower extremity, which lap over the mesial marginof the hemisphere. 166 DISEASES OF THE BRAIN PKOPER. In front of the cent
Nervous and mental diseases . junctiva, lids, and a cir-cular area about the eye are usually anesthetic. In hysterical deafnessthe auditory canal and concha are frequently insensitive. In hystericalaphonia the larynx may be anesthetic. Islets of anesthesia of peculiar and paradoxical outline are sometimesencountered. These may be many or few, and it often requires minuteand painstaking search to find them. 1 Phila. Med. Jour.. May 17. 1902. 592 NEUEOSES. Peculiarities of Hysterical Anesthesia.—1. In the first place,the outlines of limited hysterical anesthesias, excepting hemianesthesia,do not Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-junctiva-lids-and-a-cir-cular-area-about-the-eye-are-usually-anesthetic-in-hysterical-deafnessthe-auditory-canal-and-concha-are-frequently-insensitive-in-hystericalaphonia-the-larynx-may-be-anesthetic-islets-of-anesthesia-of-peculiar-and-paradoxical-outline-are-sometimesencountered-these-may-be-many-or-few-and-it-often-requires-minuteand-painstaking-search-to-find-them-1-phila-med-jour-may-17-1902-592-neueoses-peculiarities-of-hysterical-anesthesia1-in-the-first-placethe-outlines-of-limited-hysterical-anesthesias-excepting-hemianesthesiado-not-image342871313.htmlRM2AWR3T1–Nervous and mental diseases . junctiva, lids, and a cir-cular area about the eye are usually anesthetic. In hysterical deafnessthe auditory canal and concha are frequently insensitive. In hystericalaphonia the larynx may be anesthetic. Islets of anesthesia of peculiar and paradoxical outline are sometimesencountered. These may be many or few, and it often requires minuteand painstaking search to find them. 1 Phila. Med. Jour.. May 17. 1902. 592 NEUEOSES. Peculiarities of Hysterical Anesthesia.—1. In the first place,the outlines of limited hysterical anesthesias, excepting hemianesthesia,do not
Nervous and mental diseases . ary excretion. There is (1) a notablediminution in the fixed residue; (2) the urea is reduced about one-third ; (3) the phosphates are decreased about one-half of the normaloutput for twenty-four hours. Upon examination they found (4) thatthe normal proportion of the alkaline to the earthy phosphates wasaltered. Ordinarily, it is in the ratio of alkaline 3 to earthy 1, butimmediately after or during such attacks they become about equal. Itis necessary to secure a twenty-four-hour collection on which to basesuch estimates, and it should embrace the period of the hy Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ary-excretion-there-is-1-a-notablediminution-in-the-fixed-residue-2-the-urea-is-reduced-about-one-third-3-the-phosphates-are-decreased-about-one-half-of-the-normaloutput-for-twenty-four-hours-upon-examination-they-found-4-thatthe-normal-proportion-of-the-alkaline-to-the-earthy-phosphates-wasaltered-ordinarily-it-is-in-the-ratio-of-alkaline-3-to-earthy-1-butimmediately-after-or-during-such-attacks-they-become-about-equal-itis-necessary-to-secure-a-twenty-four-hour-collection-on-which-to-basesuch-estimates-and-it-should-embrace-the-period-of-the-hy-image342863522.htmlRM2AWPNWP–Nervous and mental diseases . ary excretion. There is (1) a notablediminution in the fixed residue; (2) the urea is reduced about one-third ; (3) the phosphates are decreased about one-half of the normaloutput for twenty-four hours. Upon examination they found (4) thatthe normal proportion of the alkaline to the earthy phosphates wasaltered. Ordinarily, it is in the ratio of alkaline 3 to earthy 1, butimmediately after or during such attacks they become about equal. Itis necessary to secure a twenty-four-hour collection on which to basesuch estimates, and it should embrace the period of the hy
Nervous and mental diseases . 0tC J)- « a * c ® .2fl « £ § -S « § 5 Sew ii£ .— 3 to ^?3 m c3 2 »- •-? ?. „ 5 e ja 3 £ «5 — 4) 2§ EnOf^ * J- M CD W o o c boO 0 o « cS .2 o> &»to .a££ — oh2.£ S« © O O ou-Si •-£ K> .0 * * S C..O-- «u- <KH ccMi 2 .°- S? 5 £. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-0tc-j-a-c-2fl-s-5-sew-ii-3-to-3-m-c3-2-5-e-ja-3-5-4-2-enof-j-m-cd-w-o-o-c-boo-0-o-cs-2-ogt-to-a-oh2-s-o-o-ou-si-kgt-0-s-co-u-ltkh-ccmi-2-s-5-image342936849.htmlRM2AWX3CH–Nervous and mental diseases . 0tC J)- « a * c ® .2fl « £ § -S « § 5 Sew ii£ .— 3 to ^?3 m c3 2 »- •-? ?. „ 5 e ja 3 £ «5 — 4) 2§ EnOf^ * J- M CD W o o c boO 0 o « cS .2 o> &»to .a££ — oh2.£ S« © O O ou-Si •-£ K> .0 * * S C..O-- «u- <KH ccMi 2 .°- S? 5 £.
Nervous and mental diseases . Fig. 253.—Schematic representation of the wide tonic movements (Richer).. Fig. 254.—Tonic phase, circumduction movements of upper members (Richer). Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-253schematic-representation-of-the-wide-tonic-movements-richer-fig-254tonic-phase-circumduction-movements-of-upper-members-richer-image342868531.htmlRM2AWR08K–Nervous and mental diseases . Fig. 253.—Schematic representation of the wide tonic movements (Richer).. Fig. 254.—Tonic phase, circumduction movements of upper members (Richer).
Nervous and mental diseases . , we have still furtherdivision of the tracts. These are shown in LOCALIZATION. 333 figure 125 for the ascending degenerations which follow complete divi-sion of the cord, and for the descending degenerations after similar lesions. The H-shaped cross-section of the gray matter shows numerous cell-bodies. Of these the anterior cornual groups are the best understoodand contain the cell-bodies of the lower motor neuron through whichmotor, trophic, and vasomotor influences are exercised over the muscles,bones, and skin. The central canal is situated in the gray commis Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-we-have-still-furtherdivision-of-the-tracts-these-are-shown-in-localization-333-figure-125-for-the-ascending-degenerations-which-follow-complete-divi-sion-of-the-cord-and-for-the-descending-degenerations-after-similar-lesions-the-h-shaped-cross-section-of-the-gray-matter-shows-numerous-cell-bodies-of-these-the-anterior-cornual-groups-are-the-best-understoodand-contain-the-cell-bodies-of-the-lower-motor-neuron-through-whichmotor-trophic-and-vasomotor-influences-are-exercised-over-the-musclesbones-and-skin-the-central-canal-is-situated-in-the-gray-commis-image342948256.htmlRM2AWXJ00–Nervous and mental diseases . , we have still furtherdivision of the tracts. These are shown in LOCALIZATION. 333 figure 125 for the ascending degenerations which follow complete divi-sion of the cord, and for the descending degenerations after similar lesions. The H-shaped cross-section of the gray matter shows numerous cell-bodies. Of these the anterior cornual groups are the best understoodand contain the cell-bodies of the lower motor neuron through whichmotor, trophic, and vasomotor influences are exercised over the muscles,bones, and skin. The central canal is situated in the gray commis
Nervous and mental diseases . monary osteo-arthropathy. The disease runs a protracted course, but may come to a standstill,or it may recede slightly if the thoracic condition is greatly improved.Desmons and Beraud 4 report some improvement following subcutaneousinjections of extracts made from sheeps lungs. 1 Phila, Med. Jour., Nov. 5, 1898. 3 Medicine, Jan., 1898. 2E. F. Buzzard, Br. Med. Jour., June 1, 1902. 4 Archives gen.de Med., 1894. TROPHONEUROSES. 493 HYPEROSTOSIS CRANIL Virchow used the term leontiasis ossea, Starr, megalocephalie, andPutnam, hyperostosis eranii to designate certain r Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-monary-osteo-arthropathy-the-disease-runs-a-protracted-course-but-may-come-to-a-standstillor-it-may-recede-slightly-if-the-thoracic-condition-is-greatly-improveddesmons-and-beraud-4-report-some-improvement-following-subcutaneousinjections-of-extracts-made-from-sheeps-lungs-1-phila-med-jour-nov-5-1898-3-medicine-jan-1898-2e-f-buzzard-br-med-jour-june-1-1902-4-archives-gende-med-1894-trophoneuroses-493-hyperostosis-cranil-virchow-used-the-term-leontiasis-ossea-starr-megalocephalie-andputnam-hyperostosis-eranii-to-designate-certain-r-image342895724.htmlRM2AWT6YT–Nervous and mental diseases . monary osteo-arthropathy. The disease runs a protracted course, but may come to a standstill,or it may recede slightly if the thoracic condition is greatly improved.Desmons and Beraud 4 report some improvement following subcutaneousinjections of extracts made from sheeps lungs. 1 Phila, Med. Jour., Nov. 5, 1898. 3 Medicine, Jan., 1898. 2E. F. Buzzard, Br. Med. Jour., June 1, 1902. 4 Archives gen.de Med., 1894. TROPHONEUROSES. 493 HYPEROSTOSIS CRANIL Virchow used the term leontiasis ossea, Starr, megalocephalie, andPutnam, hyperostosis eranii to designate certain r
Nervous and mental diseases . penetrating blood-vessel. They comport themselves as do brain-tumors generally, and give rise to similarlocalizing signs and symptoms. Sclerous or fibrous degeneration marksthe later stages of all these specific neoplastic lesions, and gives rise towhat is sometimes called sclerous syphilitic meningitis. Syphilitic cerebritis may exist as a direct extension from a specificmeningitis or gumma, or may occur more or less independently. It maypresent itself as a diffuse, gummatous encephalitis, or as localized en-cephalic gummata which tend to easeate, or it may appea Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-penetrating-blood-vessel-they-comport-themselves-as-do-brain-tumors-generally-and-give-rise-to-similarlocalizing-signs-and-symptoms-sclerous-or-fibrous-degeneration-marksthe-later-stages-of-all-these-specific-neoplastic-lesions-and-gives-rise-towhat-is-sometimes-called-sclerous-syphilitic-meningitis-syphilitic-cerebritis-may-exist-as-a-direct-extension-from-a-specificmeningitis-or-gumma-or-may-occur-more-or-less-independently-it-maypresent-itself-as-a-diffuse-gummatous-encephalitis-or-as-localized-en-cephalic-gummata-which-tend-to-easeate-or-it-may-appea-image342899708.htmlRM2AWTC24–Nervous and mental diseases . penetrating blood-vessel. They comport themselves as do brain-tumors generally, and give rise to similarlocalizing signs and symptoms. Sclerous or fibrous degeneration marksthe later stages of all these specific neoplastic lesions, and gives rise towhat is sometimes called sclerous syphilitic meningitis. Syphilitic cerebritis may exist as a direct extension from a specificmeningitis or gumma, or may occur more or less independently. It maypresent itself as a diffuse, gummatous encephalitis, or as localized en-cephalic gummata which tend to easeate, or it may appea
Nervous and mental diseases . uted to contract more orless vigorously in proportion to the intensity of the current employed.It is to be particularly noted that upon allowing the current to passthe response is instantaneous, and that the muscular contraction atonce reaches its maximum and maintains it until the current is modi- ELECTRICAL CONDITIONS. 43 fied. This phenomenon attends stimulation by either the positive ornegative faradic pole or electrode, but the negative causes a slightlystronger effect. If, now, the constant current be substituted, we notice, first of all, thatmild currents a Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-uted-to-contract-more-orless-vigorously-in-proportion-to-the-intensity-of-the-current-employedit-is-to-be-particularly-noted-that-upon-allowing-the-current-to-passthe-response-is-instantaneous-and-that-the-muscular-contraction-atonce-reaches-its-maximum-and-maintains-it-until-the-current-is-modi-electrical-conditions-43-fied-this-phenomenon-attends-stimulation-by-either-the-positive-ornegative-faradic-pole-or-electrode-but-the-negative-causes-a-slightlystronger-effect-if-now-the-constant-current-be-substituted-we-notice-first-of-all-thatmild-currents-a-image343003240.htmlRM2AX143M–Nervous and mental diseases . uted to contract more orless vigorously in proportion to the intensity of the current employed.It is to be particularly noted that upon allowing the current to passthe response is instantaneous, and that the muscular contraction atonce reaches its maximum and maintains it until the current is modi- ELECTRICAL CONDITIONS. 43 fied. This phenomenon attends stimulation by either the positive ornegative faradic pole or electrode, but the negative causes a slightlystronger effect. If, now, the constant current be substituted, we notice, first of all, thatmild currents a
Nervous and mental diseases . C- i Fig. 271.—Leptocephalus. top of the head. The condition is also called platicephalus (Fig.270). Leptocephalus.—Early synostosis of the frontal and sphenoid pro-duces leptocephalus, or narrow-headedness (Fig. 271). Macrocephalus is a large head, usually due to hydrocephalus. Microcephalus is a small head, due either to aplasia of the brain orpremature synostosis of the sutures (rarely the latter). Oxycephalus, or steeple-shaped skull, is due to synostosis of theparietal with the occipital and temporal bones, with compensatory de-velopment in the region of the Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-c-i-fig-271leptocephalus-top-of-the-head-the-condition-is-also-called-platicephalus-fig270-leptocephalusearly-synostosis-of-the-frontal-and-sphenoid-pro-duces-leptocephalus-or-narrow-headedness-fig-271-macrocephalus-is-a-large-head-usually-due-to-hydrocephalus-microcephalus-is-a-small-head-due-either-to-aplasia-of-the-brain-orpremature-synostosis-of-the-sutures-rarely-the-latter-oxycephalus-or-steeple-shaped-skull-is-due-to-synostosis-of-theparietal-with-the-occipital-and-temporal-bones-with-compensatory-de-velopment-in-the-region-of-the-image342863208.htmlRM2AWPNEG–Nervous and mental diseases . C- i Fig. 271.—Leptocephalus. top of the head. The condition is also called platicephalus (Fig.270). Leptocephalus.—Early synostosis of the frontal and sphenoid pro-duces leptocephalus, or narrow-headedness (Fig. 271). Macrocephalus is a large head, usually due to hydrocephalus. Microcephalus is a small head, due either to aplasia of the brain orpremature synostosis of the sutures (rarely the latter). Oxycephalus, or steeple-shaped skull, is due to synostosis of theparietal with the occipital and temporal bones, with compensatory de-velopment in the region of the
Nervous and mental diseases . Diagram showing Kelations and Distribu Plate II. .. ? Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-diagram-showing-kelations-and-distribu-plate-ii-image342952605.htmlRM2AWXRF9–Nervous and mental diseases . Diagram showing Kelations and Distribu Plate II. .. ?
Nervous and mental diseases . es and of the contractures that some-times appear in them. It, therefore, varies withthe location of the disease. Owing to the shorten-ing of the calf muscles, little difficulty is found inmaintaining the ankle-joint at a proper angle unlessan equine position of the foot has developed, caus-ing the patients to stand upon their toes. Stand-ing then becomes extremely difficult. The positionat the knee and hip is often entirely dependentupon the ligamentous support of these joints.This allows the pelvis to tip forward upon thehead of the femurs and necessitates a str Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-es-and-of-the-contractures-that-some-times-appear-in-them-it-therefore-varies-withthe-location-of-the-disease-owing-to-the-shorten-ing-of-the-calf-muscles-little-difficulty-is-found-inmaintaining-the-ankle-joint-at-a-proper-angle-unlessan-equine-position-of-the-foot-has-developed-caus-ing-the-patients-to-stand-upon-their-toes-stand-ing-then-becomes-extremely-difficult-the-positionat-the-knee-and-hip-is-often-entirely-dependentupon-the-ligamentous-support-of-these-jointsthis-allows-the-pelvis-to-tip-forward-upon-thehead-of-the-femurs-and-necessitates-a-str-image342918109.htmlRM2AWW7F9–Nervous and mental diseases . es and of the contractures that some-times appear in them. It, therefore, varies withthe location of the disease. Owing to the shorten-ing of the calf muscles, little difficulty is found inmaintaining the ankle-joint at a proper angle unlessan equine position of the foot has developed, caus-ing the patients to stand upon their toes. Stand-ing then becomes extremely difficult. The positionat the knee and hip is often entirely dependentupon the ligamentous support of these joints.This allows the pelvis to tip forward upon thehead of the femurs and necessitates a str
Nervous and mental diseases . Fig. 252.—Tonic phase, the tongue rolling from one angle of the mouth to the other (Eicher). m. Fig. 253.—Schematic representation of the wide tonic movements (Richer). Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-252tonic-phase-the-tongue-rolling-from-one-angle-of-the-mouth-to-the-other-eicher-m-fig-253schematic-representation-of-the-wide-tonic-movements-richer-image342868840.htmlRM2AWR0KM–Nervous and mental diseases . Fig. 252.—Tonic phase, the tongue rolling from one angle of the mouth to the other (Eicher). m. Fig. 253.—Schematic representation of the wide tonic movements (Richer).
Nervous and mental diseases . Fig. 152.—A case of syringomyelia with inof face and tongue—syringobulbia volvement Fig. 153.—Syringomyelia with much atrophyand spinal deviation. Diagnosis.—The diagnosis depends upon the insidious develop-ment of the disease and upon the combination of sensory, trophic, andmotor disorders. The dissociation of touch and pain is well-nigh dis-tinctive, but is occasionally found in tabes, neuritis, and hysteria. Us-ually it will be necessary to exclude progressive muscular atrophy,amyotrophic lateral sclerosis, pachymeningitis hypertrophica cervicalis,locomotor at Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-152a-case-of-syringomyelia-with-inof-face-and-tonguesyringobulbia-volvement-fig-153syringomyelia-with-much-atrophyand-spinal-deviation-diagnosisthe-diagnosis-depends-upon-the-insidious-develop-ment-of-the-disease-and-upon-the-combination-of-sensory-trophic-andmotor-disorders-the-dissociation-of-touch-and-pain-is-well-nigh-dis-tinctive-but-is-occasionally-found-in-tabes-neuritis-and-hysteria-us-ually-it-will-be-necessary-to-exclude-progressive-muscular-atrophyamyotrophic-lateral-sclerosis-pachymeningitis-hypertrophica-cervicalislocomotor-at-image342923548.htmlRM2AWWEDG–Nervous and mental diseases . Fig. 152.—A case of syringomyelia with inof face and tongue—syringobulbia volvement Fig. 153.—Syringomyelia with much atrophyand spinal deviation. Diagnosis.—The diagnosis depends upon the insidious develop-ment of the disease and upon the combination of sensory, trophic, andmotor disorders. The dissociation of touch and pain is well-nigh dis-tinctive, but is occasionally found in tabes, neuritis, and hysteria. Us-ually it will be necessary to exclude progressive muscular atrophy,amyotrophic lateral sclerosis, pachymeningitis hypertrophica cervicalis,locomotor at
Nervous and mental diseases . heilk., Dec, 1903. 3 Riv. di pathologia nerv. e ment., 1906. i Jour. A. M. A., April 13,190 552 NEUBOSES. forward, the neck extended and rigid, the elbows flexed and slightlyabducted, bringing the hands, with their trembling fingers, to the levelof the groins. The face is mask-like, the eyes bright and unwinking.The patient turns bodily, deliberately, and rigidly. He sits down slowly,with precaution, on the edge of the chair, always leaning forward, hisshaking hands on his knees in constant motion. Every change of posi-tion is studied and reluctant. We may take up Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-heilk-dec-1903-3-riv-di-pathologia-nerv-e-ment-1906-i-jour-a-m-a-april-13190-552-neuboses-forward-the-neck-extended-and-rigid-the-elbows-flexed-and-slightlyabducted-bringing-the-hands-with-their-trembling-fingers-to-the-levelof-the-groins-the-face-is-mask-like-the-eyes-bright-and-unwinkingthe-patient-turns-bodily-deliberately-and-rigidly-he-sits-down-slowlywith-precaution-on-the-edge-of-the-chair-always-leaning-forward-hisshaking-hands-on-his-knees-in-constant-motion-every-change-of-posi-tion-is-studied-and-reluctant-we-may-take-up-image342879790.htmlRM2AWREJP–Nervous and mental diseases . heilk., Dec, 1903. 3 Riv. di pathologia nerv. e ment., 1906. i Jour. A. M. A., April 13,190 552 NEUBOSES. forward, the neck extended and rigid, the elbows flexed and slightlyabducted, bringing the hands, with their trembling fingers, to the levelof the groins. The face is mask-like, the eyes bright and unwinking.The patient turns bodily, deliberately, and rigidly. He sits down slowly,with precaution, on the edge of the chair, always leaning forward, hisshaking hands on his knees in constant motion. Every change of posi-tion is studied and reluctant. We may take up
Nervous and mental diseases . Fig. 231.—Microdactyly: localized hypertrophy ol a single finger (Ridlon). edema in instances marked by diffuse lipomatosis, but the hands, feet,and face are spared. It is of interest to remember that in five casesa diseased condition of the thyroid has been found post mortem.1. Fig. 232.—Chronic hereditary troplio-edenia iu sisters at seventeen and twenty-one years of age (Meige). The ill-defined fatty masses are commonly spread out at their borders1 Dercum and McCarthy, Amer. Jour. Med. Sciences, Dec, 1902. 524 NEUBOSES. into the surrounding tissue. They may, ho Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-231microdactyly-localized-hypertrophy-ol-a-single-finger-ridlon-edema-in-instances-marked-by-diffuse-lipomatosis-but-the-hands-feetand-face-are-spared-it-is-of-interest-to-remember-that-in-five-casesa-diseased-condition-of-the-thyroid-has-been-found-post-mortem1-fig-232chronic-hereditary-troplio-edenia-iu-sisters-at-seventeen-and-twenty-one-years-of-age-meige-the-ill-defined-fatty-masses-are-commonly-spread-out-at-their-borders1-dercum-and-mccarthy-amer-jour-med-sciences-dec-1902-524-neuboses-into-the-surrounding-tissue-they-may-ho-image342882355.htmlRM2AWRHXB–Nervous and mental diseases . Fig. 231.—Microdactyly: localized hypertrophy ol a single finger (Ridlon). edema in instances marked by diffuse lipomatosis, but the hands, feet,and face are spared. It is of interest to remember that in five casesa diseased condition of the thyroid has been found post mortem.1. Fig. 232.—Chronic hereditary troplio-edenia iu sisters at seventeen and twenty-one years of age (Meige). The ill-defined fatty masses are commonly spread out at their borders1 Dercum and McCarthy, Amer. Jour. Med. Sciences, Dec, 1902. 524 NEUBOSES. into the surrounding tissue. They may, ho
Nervous and mental diseases . later periodthan in boys, and then runs aslower course. When commenc-ing in childhood, sometimes anage of forty years may be reached,but death usually occurs betweentwenty and thirty. Not, as arule, fatal in itself, except bypneumogastric accidents, death or-dinarily occurs from intercurrentdisease. Varieties.—A number of clin-ical varieties have been described and are worthy of some attention, but it should be borne in mind thatthey are not distinct morbid conditions. The earliest recognized form is the one called pseudohypertrophicparalysis. It usually appears i Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-later-periodthan-in-boys-and-then-runs-aslower-course-when-commenc-ing-in-childhood-sometimes-anage-of-forty-years-may-be-reachedbut-death-usually-occurs-betweentwenty-and-thirty-not-as-arule-fatal-in-itself-except-bypneumogastric-accidents-death-or-dinarily-occurs-from-intercurrentdisease-varietiesa-number-of-clin-ical-varieties-have-been-described-and-are-worthy-of-some-attention-but-it-should-be-borne-in-mind-thatthey-are-not-distinct-morbid-conditions-the-earliest-recognized-form-is-the-one-called-pseudohypertrophicparalysis-it-usually-appears-i-image342913980.htmlRM2AWW27T–Nervous and mental diseases . later periodthan in boys, and then runs aslower course. When commenc-ing in childhood, sometimes anage of forty years may be reached,but death usually occurs betweentwenty and thirty. Not, as arule, fatal in itself, except bypneumogastric accidents, death or-dinarily occurs from intercurrentdisease. Varieties.—A number of clin-ical varieties have been described and are worthy of some attention, but it should be borne in mind thatthey are not distinct morbid conditions. The earliest recognized form is the one called pseudohypertrophicparalysis. It usually appears i
Nervous and mental diseases . Fig. 148.—Various distributions of thermo-anesthesia and analgesia (Brissaud). recognizing contact, and may receive burns in this way without expe-riencing any pain. The thermo-anesthesia may be complete or partial, andis then relative to the part examined and somewhat to the patients in-telligence (see Part I). Sometimes heat is felt as pain, or hot as cold. The distribution of the thermo-anesthesia is also significant.Rarely it may be hemiplegic ; it is seldom general. Ordinarily, it in-volves the limbs, or portions of them, suchas would be covered by a glove or Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-148various-distributions-of-thermo-anesthesia-and-analgesia-brissaud-recognizing-contact-and-may-receive-burns-in-this-way-without-expe-riencing-any-pain-the-thermo-anesthesia-may-be-complete-or-partial-andis-then-relative-to-the-part-examined-and-somewhat-to-the-patients-in-telligence-see-part-i-sometimes-heat-is-felt-as-pain-or-hot-as-cold-the-distribution-of-the-thermo-anesthesia-is-also-significantrarely-it-may-be-hemiplegic-it-is-seldom-general-ordinarily-it-in-volves-the-limbs-or-portions-of-them-suchas-would-be-covered-by-a-glove-or-image342925938.htmlRM2AWWHEX–Nervous and mental diseases . Fig. 148.—Various distributions of thermo-anesthesia and analgesia (Brissaud). recognizing contact, and may receive burns in this way without expe-riencing any pain. The thermo-anesthesia may be complete or partial, andis then relative to the part examined and somewhat to the patients in-telligence (see Part I). Sometimes heat is felt as pain, or hot as cold. The distribution of the thermo-anesthesia is also significant.Rarely it may be hemiplegic ; it is seldom general. Ordinarily, it in-volves the limbs, or portions of them, suchas would be covered by a glove or
Nervous and mental diseases . rmations of the ear—those that may beregarded as belonging to the stigmata of degeneration, and those, too,which are striking and plain to the eye—are to be summarized asfollows : The deep position of the eras anterius. Marked prominence of the anthelix. Excessive broadening of the ear. Stunted development of or absence of the helix. Trifurcation of the anthelix. Widening of the fossa scaphoidea. Absence of the eras superius. Complete absence of lobule. Asymmetry of the two ears. Excessive enlargement or diminution of the concha. Excessive conchoidal structure of Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-rmations-of-the-earthose-that-may-beregarded-as-belonging-to-the-stigmata-of-degeneration-and-those-toowhich-are-striking-and-plain-to-the-eyeare-to-be-summarized-asfollows-the-deep-position-of-the-eras-anterius-marked-prominence-of-the-anthelix-excessive-broadening-of-the-ear-stunted-development-of-or-absence-of-the-helix-trifurcation-of-the-anthelix-widening-of-the-fossa-scaphoidea-absence-of-the-eras-superius-complete-absence-of-lobule-asymmetry-of-the-two-ears-excessive-enlargement-or-diminution-of-the-concha-excessive-conchoidal-structure-of-image342856844.htmlRM2AWPDB8–Nervous and mental diseases . rmations of the ear—those that may beregarded as belonging to the stigmata of degeneration, and those, too,which are striking and plain to the eye—are to be summarized asfollows : The deep position of the eras anterius. Marked prominence of the anthelix. Excessive broadening of the ear. Stunted development of or absence of the helix. Trifurcation of the anthelix. Widening of the fossa scaphoidea. Absence of the eras superius. Complete absence of lobule. Asymmetry of the two ears. Excessive enlargement or diminution of the concha. Excessive conchoidal structure of
Nervous and mental diseases . Fig. 204.—Lesions of insular sclerosis in thebrain (Charcot). Fig. 205.—Lesions of the insular sclerosisin the pons and medulla (Charcot). toms of multiple sclerosis within a few weeks or months.2 Oppen-heim 3 found that in eleven out of twenty-eight cases treated by himthe patients had long been exposed to the influence of lead, copper,zinc, etc., and emphasizes the significance of occupations attended bysuch intoxications. Charcot, in one of his later lectures, reported acase consecutive to cerebral rheumatism. Infection may explain someof the family groups of m Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-204lesions-of-insular-sclerosis-in-thebrain-charcot-fig-205lesions-of-the-insular-sclerosisin-the-pons-and-medulla-charcot-toms-of-multiple-sclerosis-within-a-few-weeks-or-months2-oppen-heim-3-found-that-in-eleven-out-of-twenty-eight-cases-treated-by-himthe-patients-had-long-been-exposed-to-the-influence-of-lead-copperzinc-etc-and-emphasizes-the-significance-of-occupations-attended-bysuch-intoxications-charcot-in-one-of-his-later-lectures-reported-acase-consecutive-to-cerebral-rheumatism-infection-may-explain-someof-the-family-groups-of-m-image342900972.htmlRM2AWTDK8–Nervous and mental diseases . Fig. 204.—Lesions of insular sclerosis in thebrain (Charcot). Fig. 205.—Lesions of the insular sclerosisin the pons and medulla (Charcot). toms of multiple sclerosis within a few weeks or months.2 Oppen-heim 3 found that in eleven out of twenty-eight cases treated by himthe patients had long been exposed to the influence of lead, copper,zinc, etc., and emphasizes the significance of occupations attended bysuch intoxications. Charcot, in one of his later lectures, reported acase consecutive to cerebral rheumatism. Infection may explain someof the family groups of m
Nervous and mental diseases . uctor andopponens and can not be adducted. The fingers lose all lateral motion. 296 DISEASES OF SPINAL MENINGES AND SPINAL NERVES. The distortion and deformity that result are pronounced and charac-teristic. There is overextension at the metacarpophalangeal joints,which makes the head of the metacarpal bones prominent in the hollowedpalm. The unopposed flexors claw the second and third joints, andwith the strongly-acting common extensor increase the deformity. Thisis least marked in the index and middle fingers, which do not lose theirlumbrical muscles. All the in Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-uctor-andopponens-and-can-not-be-adducted-the-fingers-lose-all-lateral-motion-296-diseases-of-spinal-meninges-and-spinal-nerves-the-distortion-and-deformity-that-result-are-pronounced-and-charac-teristic-there-is-overextension-at-the-metacarpophalangeal-jointswhich-makes-the-head-of-the-metacarpal-bones-prominent-in-the-hollowedpalm-the-unopposed-flexors-claw-the-second-and-third-joints-andwith-the-strongly-acting-common-extensor-increase-the-deformity-thisis-least-marked-in-the-index-and-middle-fingers-which-do-not-lose-theirlumbrical-muscles-all-the-in-image342956086.htmlRM2AWXYYJ–Nervous and mental diseases . uctor andopponens and can not be adducted. The fingers lose all lateral motion. 296 DISEASES OF SPINAL MENINGES AND SPINAL NERVES. The distortion and deformity that result are pronounced and charac-teristic. There is overextension at the metacarpophalangeal joints,which makes the head of the metacarpal bones prominent in the hollowedpalm. The unopposed flexors claw the second and third joints, andwith the strongly-acting common extensor increase the deformity. Thisis least marked in the index and middle fingers, which do not lose theirlumbrical muscles. All the in
Nervous and mental diseases . Fig. L9&. Fig. 199. Figs. 197, 198, and 199.—Sections from three spinal cords showing degenerations due to pernicious anemia (Hillings). the fourth decade of life. In addition to the features of the anemiasand cachexias and the conditions arising from these states, there is oftena decided mental irritability. Atrophy of the optic nerve has been ob-served in some instances. Epileptiform attacks have occurred. The symptoms referable to the spinal cord are those of ataxia, spas- 454 DISEASES OF THE CORD PROPER. ticity, and weakness, variously combined, giving rise, a Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-l9-fig-199-figs-197-198-and-199sections-from-three-spinal-cords-showing-degenerations-due-to-pernicious-anemia-hillings-the-fourth-decade-of-life-in-addition-to-the-features-of-the-anemiasand-cachexias-and-the-conditions-arising-from-these-states-there-is-oftena-decided-mental-irritability-atrophy-of-the-optic-nerve-has-been-ob-served-in-some-instances-epileptiform-attacks-have-occurred-the-symptoms-referable-to-the-spinal-cord-are-those-of-ataxia-spas-454-diseases-of-the-cord-proper-ticity-and-weakness-variously-combined-giving-rise-a-image342902536.htmlRM2AWTFK4–Nervous and mental diseases . Fig. L9&. Fig. 199. Figs. 197, 198, and 199.—Sections from three spinal cords showing degenerations due to pernicious anemia (Hillings). the fourth decade of life. In addition to the features of the anemiasand cachexias and the conditions arising from these states, there is oftena decided mental irritability. Atrophy of the optic nerve has been ob-served in some instances. Epileptiform attacks have occurred. The symptoms referable to the spinal cord are those of ataxia, spas- 454 DISEASES OF THE CORD PROPER. ticity, and weakness, variously combined, giving rise, a
Nervous and mental diseases . %. DISEASES OF THE FACIAL NERVE. 125 management. The early loss of faradic stimulability of the musclesgradually passes away, but voluntary motion returns before the faradiccurrent regains its control. Very frequently the paralyzed muscles willtwitch or even act in vigorous spasm as regeneration in the nerve re-stores its irritability. Those cases which last a month or two, or more,usually leave traces for the rest of life. They may be so slight as torequire careful scrutiny, or marked weakness may persist. Very excep-tionally the palsy is permanent. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-diseases-of-the-facial-nerve-125-management-the-early-loss-of-faradic-stimulability-of-the-musclesgradually-passes-away-but-voluntary-motion-returns-before-the-faradiccurrent-regains-its-control-very-frequently-the-paralyzed-muscles-willtwitch-or-even-act-in-vigorous-spasm-as-regeneration-in-the-nerve-re-stores-its-irritability-those-cases-which-last-a-month-or-two-or-moreusually-leave-traces-for-the-rest-of-life-they-may-be-so-slight-as-torequire-careful-scrutiny-or-marked-weakness-may-persist-very-excep-tionally-the-palsy-is-permanent-image342984585.htmlRM2AX089D–Nervous and mental diseases . %. DISEASES OF THE FACIAL NERVE. 125 management. The early loss of faradic stimulability of the musclesgradually passes away, but voluntary motion returns before the faradiccurrent regains its control. Very frequently the paralyzed muscles willtwitch or even act in vigorous spasm as regeneration in the nerve re-stores its irritability. Those cases which last a month or two, or more,usually leave traces for the rest of life. They may be so slight as torequire careful scrutiny, or marked weakness may persist. Very excep-tionally the palsy is permanent.
Nervous and mental diseases . e-fited by a tenotomy. Muscle cutting should always be preceded byexercise of the muscles with prisms, which sometimes is helpful, and bygeneral treatment. Nystagmus, excepting in the unusual cases where itis due to meningeal and sinus diseases, or other curable lesion, is prac-tically unyielding to all measures. Miners nystagrhus usually ceaseswhen the occupation is changed. DISEASES OF THE TRIFACIAL NERVE. 113 CHAPTER VI. DISEASES OF THE TRIFACIAL NERVE* Anatomical Considerations.—The fifth nerves represent the sen-sory portions of all the motor cranial nerves. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-e-fited-by-a-tenotomy-muscle-cutting-should-always-be-preceded-byexercise-of-the-muscles-with-prisms-which-sometimes-is-helpful-and-bygeneral-treatment-nystagmus-excepting-in-the-unusual-cases-where-itis-due-to-meningeal-and-sinus-diseases-or-other-curable-lesion-is-prac-tically-unyielding-to-all-measures-miners-nystagrhus-usually-ceaseswhen-the-occupation-is-changed-diseases-of-the-trifacial-nerve-113-chapter-vi-diseases-of-the-trifacial-nerve-anatomical-considerationsthe-fifth-nerves-represent-the-sen-sory-portions-of-all-the-motor-cranial-nerves-image342988563.htmlRM2AX0DBF–Nervous and mental diseases . e-fited by a tenotomy. Muscle cutting should always be preceded byexercise of the muscles with prisms, which sometimes is helpful, and bygeneral treatment. Nystagmus, excepting in the unusual cases where itis due to meningeal and sinus diseases, or other curable lesion, is prac-tically unyielding to all measures. Miners nystagrhus usually ceaseswhen the occupation is changed. DISEASES OF THE TRIFACIAL NERVE. 113 CHAPTER VI. DISEASES OF THE TRIFACIAL NERVE* Anatomical Considerations.—The fifth nerves represent the sen-sory portions of all the motor cranial nerves.
Nervous and mental diseases . exed or ex-tended at the wrist, but the fingers are always held more or less inflexion. A position similar to that of holding a pen is common, or thehand may be partially closed. The digits frequently deviate to theulnar side of the hand, as in rheumatoid conditions, and these may alsobe present. In the lower extremity the stiffness is less marked, but inadvanced cases causes a knee-sprung attitude and gait. The gait of Parkinsonians is strikingly peculiar. When the patientrises from the chair, he hesitates a moment as if to take aim, and startsahead in a direct l Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-exed-or-ex-tended-at-the-wrist-but-the-fingers-are-always-held-more-or-less-inflexion-a-position-similar-to-that-of-holding-a-pen-is-common-or-thehand-may-be-partially-closed-the-digits-frequently-deviate-to-theulnar-side-of-the-hand-as-in-rheumatoid-conditions-and-these-may-alsobe-present-in-the-lower-extremity-the-stiffness-is-less-marked-but-inadvanced-cases-causes-a-knee-sprung-attitude-and-gait-the-gait-of-parkinsonians-is-strikingly-peculiar-when-the-patientrises-from-the-chair-he-hesitates-a-moment-as-if-to-take-aim-and-startsahead-in-a-direct-l-image342879273.htmlRM2AWRE09–Nervous and mental diseases . exed or ex-tended at the wrist, but the fingers are always held more or less inflexion. A position similar to that of holding a pen is common, or thehand may be partially closed. The digits frequently deviate to theulnar side of the hand, as in rheumatoid conditions, and these may alsobe present. In the lower extremity the stiffness is less marked, but inadvanced cases causes a knee-sprung attitude and gait. The gait of Parkinsonians is strikingly peculiar. When the patientrises from the chair, he hesitates a moment as if to take aim, and startsahead in a direct l
Nervous and mental diseases . C 5 D 5 Sac 2. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-c-5-d-5-sac-2-image342944156.htmlRM2AWXCNG–Nervous and mental diseases . C 5 D 5 Sac 2.
Nervous and mental diseases . Fig. 299. —No lobule; nofossa conchse; shallow fossascaphoidea; fusion of helix,anthelix, and antitragus ; a typeof Stahl ear, No. 3.. Fig. 300.—Prominent anthe-lix ; maldeveloped helix; ab-sence of lobule; diminution ofthe concha; Wildermuth ear,No. 1. were apparently normal persons. As regards heredity, it is very com-mon for children to inherit ears with the identical characteristics ofthose of one or the other parent, but, on the other hand, it is not uncom-mon for the ears of the children to be quite different. 46 722 MENTAL DISEASES. Anomalies of the Limbs.— Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-299-no-lobule-nofossa-conchse-shallow-fossascaphoidea-fusion-of-helixanthelix-and-antitragus-a-typeof-stahl-ear-no-3-fig-300prominent-anthe-lix-maldeveloped-helix-ab-sence-of-lobule-diminution-ofthe-concha-wildermuth-earno-1-were-apparently-normal-persons-as-regards-heredity-it-is-very-com-mon-for-children-to-inherit-ears-with-the-identical-characteristics-ofthose-of-one-or-the-other-parent-but-on-the-other-hand-it-is-not-uncom-mon-for-the-ears-of-the-children-to-be-quite-different-46-722-mental-diseases-anomalies-of-the-limbs-image342855151.htmlRM2AWPB6R–Nervous and mental diseases . Fig. 299. —No lobule; nofossa conchse; shallow fossascaphoidea; fusion of helix,anthelix, and antitragus ; a typeof Stahl ear, No. 3.. Fig. 300.—Prominent anthe-lix ; maldeveloped helix; ab-sence of lobule; diminution ofthe concha; Wildermuth ear,No. 1. were apparently normal persons. As regards heredity, it is very com-mon for children to inherit ears with the identical characteristics ofthose of one or the other parent, but, on the other hand, it is not uncom-mon for the ears of the children to be quite different. 46 722 MENTAL DISEASES. Anomalies of the Limbs.—
Nervous and mental diseases . Fig. 139.—1, Section of cervical cord in an old case of infantile paralysis. The right half is shrunkenin all its extent (Charcot). 2, Lumbar section in a case of infantile palsy: a, Focus of old inflamma-tion ; left half of cord shrunken. it is vascular. A contention has arisen as to whether the lesion is firstparenchymatous, as Charcot claimed, or is first interstitial, as insistedupon by Goldscheider, Redlich, and others. The present weight ofauthority points to invasion by the blood-vessels, interstitial dissemina-tion, and cellular destruction as the natural Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-1391-section-of-cervical-cord-in-an-old-case-of-infantile-paralysis-the-right-half-is-shrunkenin-all-its-extent-charcot-2-lumbar-section-in-a-case-of-infantile-palsy-a-focus-of-old-inflamma-tion-left-half-of-cord-shrunken-it-is-vascular-a-contention-has-arisen-as-to-whether-the-lesion-is-firstparenchymatous-as-charcot-claimed-or-is-first-interstitial-as-insistedupon-by-goldscheider-redlich-and-others-the-present-weight-ofauthority-points-to-invasion-by-the-blood-vessels-interstitial-dissemina-tion-and-cellular-destruction-as-the-natural-image342929814.htmlRM2AWWPDA–Nervous and mental diseases . Fig. 139.—1, Section of cervical cord in an old case of infantile paralysis. The right half is shrunkenin all its extent (Charcot). 2, Lumbar section in a case of infantile palsy: a, Focus of old inflamma-tion ; left half of cord shrunken. it is vascular. A contention has arisen as to whether the lesion is firstparenchymatous, as Charcot claimed, or is first interstitial, as insistedupon by Goldscheider, Redlich, and others. The present weight ofauthority points to invasion by the blood-vessels, interstitial dissemina-tion, and cellular destruction as the natural
Nervous and mental diseases . Fig. 245.—1, Splint to immobilize hand and wrist in the treatment of writers cramp; 2, splint ia use. machine can often be substituted for the pen. The use of spinalsedatives to control the cramp and permit a continuance of writing ispernicious, and rarely gives even temporary help. When writing isresumed, the free-hand method from the shoulder must be employed, andthe splint (Fig. 245) affords a help by immobilizing the wrist andfingers during writing exercises. OTHER OCCUPATION NEUROSES. The general considerations pertaining t writers cramp are equallyapplicable Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-2451-splint-to-immobilize-hand-and-wrist-in-the-treatment-of-writers-cramp-2-splint-ia-use-machine-can-often-be-substituted-for-the-pen-the-use-of-spinalsedatives-to-control-the-cramp-and-permit-a-continuance-of-writing-ispernicious-and-rarely-gives-even-temporary-help-when-writing-isresumed-the-free-hand-method-from-the-shoulder-must-be-employed-andthe-splint-fig-245-affords-a-help-by-immobilizing-the-wrist-andfingers-during-writing-exercises-other-occupation-neuroses-the-general-considerations-pertaining-t-writers-cramp-are-equallyapplicable-image342873740.htmlRM2AWR6XM–Nervous and mental diseases . Fig. 245.—1, Splint to immobilize hand and wrist in the treatment of writers cramp; 2, splint ia use. machine can often be substituted for the pen. The use of spinalsedatives to control the cramp and permit a continuance of writing ispernicious, and rarely gives even temporary help. When writing isresumed, the free-hand method from the shoulder must be employed, andthe splint (Fig. 245) affords a help by immobilizing the wrist andfingers during writing exercises. OTHER OCCUPATION NEUROSES. The general considerations pertaining t writers cramp are equallyapplicable
Nervous and mental diseases . Fie:. 296.—Triplication of crura furcata; mal-formed helix and antitragus ; absent lobule.. authelix; slight Darwinight antitragus. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fie-296triplication-of-crura-furcata-mal-formed-helix-and-antitragus-absent-lobule-authelix-slight-darwinight-antitragus-image342856011.htmlRM2AWPC9F–Nervous and mental diseases . Fie:. 296.—Triplication of crura furcata; mal-formed helix and antitragus ; absent lobule.. authelix; slight Darwinight antitragus.
Nervous and mental diseases . Fig. 187. —Tabetic cuirass of blunted tactile sensation. head. It has a tendency to symmetry, affecting both upper extremities,both lower extremities, or the trunk bilaterally. On the head, however,there is a tendency to a unilateral distribution of the analgesia. On thetrunk the most common location for the analgesia is over both pectoralregions, about the umbilicus, in eaeh inguinal region, and over theshoulders. Frequently these analgesic plaques are marked by a hyper- 426 DISEASES OF THE COED PEOPEB. esthetic border. On the upper extremities the analgesia most Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-187-tabetic-cuirass-of-blunted-tactile-sensation-head-it-has-a-tendency-to-symmetry-affecting-both-upper-extremitiesboth-lower-extremities-or-the-trunk-bilaterally-on-the-head-howeverthere-is-a-tendency-to-a-unilateral-distribution-of-the-analgesia-on-thetrunk-the-most-common-location-for-the-analgesia-is-over-both-pectoralregions-about-the-umbilicus-in-eaeh-inguinal-region-and-over-theshoulders-frequently-these-analgesic-plaques-are-marked-by-a-hyper-426-diseases-of-the-coed-peopeb-esthetic-border-on-the-upper-extremities-the-analgesia-most-image342907440.htmlRM2AWTNX8–Nervous and mental diseases . Fig. 187. —Tabetic cuirass of blunted tactile sensation. head. It has a tendency to symmetry, affecting both upper extremities,both lower extremities, or the trunk bilaterally. On the head, however,there is a tendency to a unilateral distribution of the analgesia. On thetrunk the most common location for the analgesia is over both pectoralregions, about the umbilicus, in eaeh inguinal region, and over theshoulders. Frequently these analgesic plaques are marked by a hyper- 426 DISEASES OF THE COED PEOPEB. esthetic border. On the upper extremities the analgesia most
Nervous and mental diseases . the optic radiationsstreaming from the basal ganglia to the occipital cortex, hemianopsia is 176 DISEASES OF THE BRAIN PROPER. added. A lesion in the optic radiation within the white matter of theoccipital lobe may involve the connecting tracts between the half-visioncenters in the apex and the higher visual centers in the angular gyre,producing both hemianopsia and word-blindness. It thus appears thatword-blindness is due to disturbance of the angular gyre alone, and thatassociated hemianopsia is present only when the lesion implicates theoptic radiation (see Fig Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-the-optic-radiationsstreaming-from-the-basal-ganglia-to-the-occipital-cortex-hemianopsia-is-176-diseases-of-the-brain-proper-added-a-lesion-in-the-optic-radiation-within-the-white-matter-of-theoccipital-lobe-may-involve-the-connecting-tracts-between-the-half-visioncenters-in-the-apex-and-the-higher-visual-centers-in-the-angular-gyreproducing-both-hemianopsia-and-word-blindness-it-thus-appears-thatword-blindness-is-due-to-disturbance-of-the-angular-gyre-alone-and-thatassociated-hemianopsia-is-present-only-when-the-lesion-implicates-theoptic-radiation-see-fig-image342976633.htmlRM2AWYX5D–Nervous and mental diseases . the optic radiationsstreaming from the basal ganglia to the occipital cortex, hemianopsia is 176 DISEASES OF THE BRAIN PROPER. added. A lesion in the optic radiation within the white matter of theoccipital lobe may involve the connecting tracts between the half-visioncenters in the apex and the higher visual centers in the angular gyre,producing both hemianopsia and word-blindness. It thus appears thatword-blindness is due to disturbance of the angular gyre alone, and thatassociated hemianopsia is present only when the lesion implicates theoptic radiation (see Fig
Nervous and mental diseases . the paretic dement, but usuallythe mind becomes completely vacu-ous ; the patient speechless, filthyin his habits, bedridden, and morehelpless than an infant. He lies inbed, either motionless or restlesslymoving his limbs and grinding histeeth. He can scarcely swallow his food, and often requires to be fedto prevent strangling. He wets and soils himself, and bed-sores andcontractures develop. Finally, death by inhalation-pneumonia, septi-cemia (from the bed-sores), cystitis, marasmus, intestinal catarrh, or ex-haustion steps in to draw the curtain on the distressi Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-the-paretic-dement-but-usuallythe-mind-becomes-completely-vacu-ous-the-patient-speechless-filthyin-his-habits-bedridden-and-morehelpless-than-an-infant-he-lies-inbed-either-motionless-or-restlesslymoving-his-limbs-and-grinding-histeeth-he-can-scarcely-swallow-his-food-and-often-requires-to-be-fedto-prevent-strangling-he-wets-and-soils-himself-and-bed-sores-andcontractures-develop-finally-death-by-inhalation-pneumonia-septi-cemia-from-the-bed-sores-cystitis-marasmus-intestinal-catarrh-or-ex-haustion-steps-in-to-draw-the-curtain-on-the-distressi-image342852307.htmlRM2AWP7H7–Nervous and mental diseases . the paretic dement, but usuallythe mind becomes completely vacu-ous ; the patient speechless, filthyin his habits, bedridden, and morehelpless than an infant. He lies inbed, either motionless or restlesslymoving his limbs and grinding histeeth. He can scarcely swallow his food, and often requires to be fedto prevent strangling. He wets and soils himself, and bed-sores andcontractures develop. Finally, death by inhalation-pneumonia, septi-cemia (from the bed-sores), cystitis, marasmus, intestinal catarrh, or ex-haustion steps in to draw the curtain on the distressi
Nervous and mental diseases . t or tencentimeters or more in a vertical direction, but usually are one to twocentimeters in longitudinal extent. Sometimes single, more frequentlythere are several foci either on the same or on opposite sides of the cordand at various levels. They may even invade the medulla, and thebrain is similarly involved in the cases that perish within the first fewweeks. In cases of many years standing the cord is seen to be shrunken onone side at the level of the lesion and the cross-section is lacking insymmetry. The acute inflammatory condition has long disappeared and Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-t-or-tencentimeters-or-more-in-a-vertical-direction-but-usually-are-one-to-twocentimeters-in-longitudinal-extent-sometimes-single-more-frequentlythere-are-several-foci-either-on-the-same-or-on-opposite-sides-of-the-cordand-at-various-levels-they-may-even-invade-the-medulla-and-thebrain-is-similarly-involved-in-the-cases-that-perish-within-the-first-fewweeks-in-cases-of-many-years-standing-the-cord-is-seen-to-be-shrunken-onone-side-at-the-level-of-the-lesion-and-the-cross-section-is-lacking-insymmetry-the-acute-inflammatory-condition-has-long-disappeared-and-image342929181.htmlRM2AWWNJN–Nervous and mental diseases . t or tencentimeters or more in a vertical direction, but usually are one to twocentimeters in longitudinal extent. Sometimes single, more frequentlythere are several foci either on the same or on opposite sides of the cordand at various levels. They may even invade the medulla, and thebrain is similarly involved in the cases that perish within the first fewweeks. In cases of many years standing the cord is seen to be shrunken onone side at the level of the lesion and the cross-section is lacking insymmetry. The acute inflammatory condition has long disappeared and
Nervous and mental diseases . Fig. 333.—Paraplegic idiocy. Fig. 334.—Idiocy after acute insanity of childhood.Peculiar tic of fingers.. Fig. 335.—Two imbeciles, one epileptic aud one of unknown origin (both homosexual perverts). 876 MENTAL DISEASES. Degenerative / Hereditary transformation of nervous and mental diseases. Pathological heredity in the form of vitiating diseases or habits (tu-/ berculosis, rheumatism, gout, herpetism, syphilis, alcoholism, etc.).) Sociological factors (extreme youth of parents, extreme age of( parents, disproportionate age of parents, consanguinity). Adventitiou Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-333paraplegic-idiocy-fig-334idiocy-after-acute-insanity-of-childhoodpeculiar-tic-of-fingers-fig-335two-imbeciles-one-epileptic-aud-one-of-unknown-origin-both-homosexual-perverts-876-mental-diseases-degenerative-hereditary-transformation-of-nervous-and-mental-diseases-pathological-heredity-in-the-form-of-vitiating-diseases-or-habits-tu-berculosis-rheumatism-gout-herpetism-syphilis-alcoholism-etc-sociological-factors-extreme-youth-of-parents-extreme-age-of-parents-disproportionate-age-of-parents-consanguinity-adventitiou-image342846846.htmlRM2AWP0J6–Nervous and mental diseases . Fig. 333.—Paraplegic idiocy. Fig. 334.—Idiocy after acute insanity of childhood.Peculiar tic of fingers.. Fig. 335.—Two imbeciles, one epileptic aud one of unknown origin (both homosexual perverts). 876 MENTAL DISEASES. Degenerative / Hereditary transformation of nervous and mental diseases. Pathological heredity in the form of vitiating diseases or habits (tu-/ berculosis, rheumatism, gout, herpetism, syphilis, alcoholism, etc.).) Sociological factors (extreme youth of parents, extreme age of( parents, disproportionate age of parents, consanguinity). Adventitiou
Nervous and mental diseases . ses in children. In the hemiplegic cases the arm usually recovers less than the legor face and the athetoid condition is commonly confined to it. Con-tractures predominate in the foot and leg, producing an equinovarus,rarely a valgus, deformity, which is also favored by the shortness of thelimb, and there is some tendency to contractured flexion at the knee andhip. The toes are frequently cramped and distorted by the contract-ures and hammer-toe is a usual deformity, but when athetosis is present1 Jour. Nerv. and Ment. Dis., Nov., 1902. THE CEREBRAL PALSIES OF CHI Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ses-in-children-in-the-hemiplegic-cases-the-arm-usually-recovers-less-than-the-legor-face-and-the-athetoid-condition-is-commonly-confined-to-it-con-tractures-predominate-in-the-foot-and-leg-producing-an-equinovarusrarely-a-valgus-deformity-which-is-also-favored-by-the-shortness-of-thelimb-and-there-is-some-tendency-to-contractured-flexion-at-the-knee-andhip-the-toes-are-frequently-cramped-and-distorted-by-the-contract-ures-and-hammer-toe-is-a-usual-deformity-but-when-athetosis-is-present1-jour-nerv-and-ment-dis-nov-1902-the-cerebral-palsies-of-chi-image342965531.htmlRM2AWYC0Y–Nervous and mental diseases . ses in children. In the hemiplegic cases the arm usually recovers less than the legor face and the athetoid condition is commonly confined to it. Con-tractures predominate in the foot and leg, producing an equinovarus,rarely a valgus, deformity, which is also favored by the shortness of thelimb, and there is some tendency to contractured flexion at the knee andhip. The toes are frequently cramped and distorted by the contract-ures and hammer-toe is a usual deformity, but when athetosis is present1 Jour. Nerv. and Ment. Dis., Nov., 1902. THE CEREBRAL PALSIES OF CHI
Nervous and mental diseases . ECIAL SPINAL NERVES. 295 unusually extensive distribution of the ulnar and radial nerves. It ismost pronounced on the volar surface of the index, but may extend overthe area shown in figure 107. The ulnar nerve originates from the lowest cervical and the firstdorsal nerves, and supplies in the forearm the ulnar flexor of the wrist,the two inner divisions of the deep flexor of the fingers, and all the smallmuscles of the hand except those innervated by the median—namely,the dorsal and palmar interossei, the muscles of the hypothenar eminence,and the third and fourt Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-ecial-spinal-nerves-295-unusually-extensive-distribution-of-the-ulnar-and-radial-nerves-it-ismost-pronounced-on-the-volar-surface-of-the-index-but-may-extend-overthe-area-shown-in-figure-107-the-ulnar-nerve-originates-from-the-lowest-cervical-and-the-firstdorsal-nerves-and-supplies-in-the-forearm-the-ulnar-flexor-of-the-wristthe-two-inner-divisions-of-the-deep-flexor-of-the-fingers-and-all-the-smallmuscles-of-the-hand-except-those-innervated-by-the-mediannamelythe-dorsal-and-palmar-interossei-the-muscles-of-the-hypothenar-eminenceand-the-third-and-fourt-image342956578.htmlRM2AWY0H6–Nervous and mental diseases . ECIAL SPINAL NERVES. 295 unusually extensive distribution of the ulnar and radial nerves. It ismost pronounced on the volar surface of the index, but may extend overthe area shown in figure 107. The ulnar nerve originates from the lowest cervical and the firstdorsal nerves, and supplies in the forearm the ulnar flexor of the wrist,the two inner divisions of the deep flexor of the fingers, and all the smallmuscles of the hand except those innervated by the median—namely,the dorsal and palmar interossei, the muscles of the hypothenar eminence,and the third and fourt
Nervous and mental diseases . to place it in theall-fours position, making the coccygeal end of the vertebral column theposterior or last segment. The diagrams of Starr (Fig. 17) clearly showthis, and the difference between the spinal-segment area and the nerve-trunk representation of sensation is apparent. It at once becomes plain, SENSOEY CONDITIONS. 55 when we find an anesthetic area corresponding to a spinal-segment levelthat the lesion is in the cord and at a particular part of the cord ; more-over, that its upper level corresponds to the upper level of the anestheticzone. Just above this Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-to-place-it-in-theall-fours-position-making-the-coccygeal-end-of-the-vertebral-column-theposterior-or-last-segment-the-diagrams-of-starr-fig-17-clearly-showthis-and-the-difference-between-the-spinal-segment-area-and-the-nerve-trunk-representation-of-sensation-is-apparent-it-at-once-becomes-plain-sensoey-conditions-55-when-we-find-an-anesthetic-area-corresponding-to-a-spinal-segment-levelthat-the-lesion-is-in-the-cord-and-at-a-particular-part-of-the-cord-more-over-that-its-upper-level-corresponds-to-the-upper-level-of-the-anestheticzone-just-above-this-image342996573.htmlRM2AX0RHH–Nervous and mental diseases . to place it in theall-fours position, making the coccygeal end of the vertebral column theposterior or last segment. The diagrams of Starr (Fig. 17) clearly showthis, and the difference between the spinal-segment area and the nerve-trunk representation of sensation is apparent. It at once becomes plain, SENSOEY CONDITIONS. 55 when we find an anesthetic area corresponding to a spinal-segment levelthat the lesion is in the cord and at a particular part of the cord ; more-over, that its upper level corresponds to the upper level of the anestheticzone. Just above this
Nervous and mental diseases . defect. Death takes place in but five percent of cases. The cause of deathis sometimes exhaustion, as in acutedelirium ; more often an intercurrentaffection, such as pneumonia, neph-ritis, and the like. Heart diseaseand alcoholism add greatly to thedanger of lethal termination. Dementia is the result of thedisorder in about one-tenth of thecases. The degree of dementiavaries from a slight diminution in some of the higher qualities andpowers of the mind to pronounced mental enfeeblement with vestigesof the antecedent mania and complete confusion and incoherence. Th Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-defect-death-takes-place-in-but-five-percent-of-cases-the-cause-of-deathis-sometimes-exhaustion-as-in-acutedelirium-more-often-an-intercurrentaffection-such-as-pneumonia-neph-ritis-and-the-like-heart-diseaseand-alcoholism-add-greatly-to-thedanger-of-lethal-termination-dementia-is-the-result-of-thedisorder-in-about-one-tenth-of-thecases-the-degree-of-dementiavaries-from-a-slight-diminution-in-some-of-the-higher-qualities-andpowers-of-the-mind-to-pronounced-mental-enfeeblement-with-vestigesof-the-antecedent-mania-and-complete-confusion-and-incoherence-th-image342854250.htmlRM2AWPA2J–Nervous and mental diseases . defect. Death takes place in but five percent of cases. The cause of deathis sometimes exhaustion, as in acutedelirium ; more often an intercurrentaffection, such as pneumonia, neph-ritis, and the like. Heart diseaseand alcoholism add greatly to thedanger of lethal termination. Dementia is the result of thedisorder in about one-tenth of thecases. The degree of dementiavaries from a slight diminution in some of the higher qualities andpowers of the mind to pronounced mental enfeeblement with vestigesof the antecedent mania and complete confusion and incoherence. Th
Nervous and mental diseases . of theseventh, and are eventually distributed to the orbicular muscle of themouth, correlating the labial and lingual movements necessary inphonation, mastication, and other buccal processes. The decussation of the seventh explains the phenomena of crossed oralternate paralysis of the face and limbs. A lesion in the pons abovethe decussation involves at once the seventh nerve and the pyramidaltract for the opposite side of the body, but below the facial crossing andabove the pyramidal decussation a lesion involves the face on the sameside and the limbs on the oppo Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-of-theseventh-and-are-eventually-distributed-to-the-orbicular-muscle-of-themouth-correlating-the-labial-and-lingual-movements-necessary-inphonation-mastication-and-other-buccal-processes-the-decussation-of-the-seventh-explains-the-phenomena-of-crossed-oralternate-paralysis-of-the-face-and-limbs-a-lesion-in-the-pons-abovethe-decussation-involves-at-once-the-seventh-nerve-and-the-pyramidaltract-for-the-opposite-side-of-the-body-but-below-the-facial-crossing-andabove-the-pyramidal-decussation-a-lesion-involves-the-face-on-the-sameside-and-the-limbs-on-the-oppo-image342986133.htmlRM2AX0A8N–Nervous and mental diseases . of theseventh, and are eventually distributed to the orbicular muscle of themouth, correlating the labial and lingual movements necessary inphonation, mastication, and other buccal processes. The decussation of the seventh explains the phenomena of crossed oralternate paralysis of the face and limbs. A lesion in the pons abovethe decussation involves at once the seventh nerve and the pyramidaltract for the opposite side of the body, but below the facial crossing andabove the pyramidal decussation a lesion involves the face on the sameside and the limbs on the oppo
Nervous and mental diseases . nary scale,—namely, circum-duction of the upper limb and the opposition of the thumb to the LESIONS AND DISEASES OF SPINAL GEA Y. 397 fingers. If the morbid process be one of involution, we might naturallyexpect such a program. It results in flattening the palm, and thethumb falls back into the same plane with the other digits, producingthe uape hand (Fig. 156). The interossei and lumbricales are alsoaffected, and again most on the radial side of the hand. Furrowsbetween the metacarpals mark the loss of the small muscles, and theintegument hangs loose and redundan Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-nary-scalenamely-circum-duction-of-the-upper-limb-and-the-opposition-of-the-thumb-to-the-lesions-and-diseases-of-spinal-gea-y-397-fingers-if-the-morbid-process-be-one-of-involution-we-might-naturallyexpect-such-a-program-it-results-in-flattening-the-palm-and-thethumb-falls-back-into-the-same-plane-with-the-other-digits-producingthe-uape-hand-fig-156-the-interossei-and-lumbricales-are-alsoaffected-and-again-most-on-the-radial-side-of-the-hand-furrowsbetween-the-metacarpals-mark-the-loss-of-the-small-muscles-and-theintegument-hangs-loose-and-redundan-image342921016.htmlRM2AWWB74–Nervous and mental diseases . nary scale,—namely, circum-duction of the upper limb and the opposition of the thumb to the LESIONS AND DISEASES OF SPINAL GEA Y. 397 fingers. If the morbid process be one of involution, we might naturallyexpect such a program. It results in flattening the palm, and thethumb falls back into the same plane with the other digits, producingthe uape hand (Fig. 156). The interossei and lumbricales are alsoaffected, and again most on the radial side of the hand. Furrowsbetween the metacarpals mark the loss of the small muscles, and theintegument hangs loose and redundan
Nervous and mental diseases . s usual plan is to turn over on his face, then huddle himself together,and get upon his knees. The usually weakened psoas, vastus, and 408 DISEASES OF THE CORD PROPER. gluteal muscles are now inadequate to the effort of lifting him. He,therefore, advances the body into the all fours position, and, carryingthe weight of the head and shoulders on the arms, pushes up the lowerend of the trunk with his legs as a cow gets up by the hindquarters.The hands are now brought toward the feet, one is placed above theknee on the same side, then the other at a higher point on t Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-s-usual-plan-is-to-turn-over-on-his-face-then-huddle-himself-togetherand-get-upon-his-knees-the-usually-weakened-psoas-vastus-and-408-diseases-of-the-cord-proper-gluteal-muscles-are-now-inadequate-to-the-effort-of-lifting-him-hetherefore-advances-the-body-into-the-all-fours-position-and-carryingthe-weight-of-the-head-and-shoulders-on-the-arms-pushes-up-the-lowerend-of-the-trunk-with-his-legs-as-a-cow-gets-up-by-the-hindquartersthe-hands-are-now-brought-toward-the-feet-one-is-placed-above-theknee-on-the-same-side-then-the-other-at-a-higher-point-on-t-image342914613.htmlRM2AWW32D–Nervous and mental diseases . s usual plan is to turn over on his face, then huddle himself together,and get upon his knees. The usually weakened psoas, vastus, and 408 DISEASES OF THE CORD PROPER. gluteal muscles are now inadequate to the effort of lifting him. He,therefore, advances the body into the all fours position, and, carryingthe weight of the head and shoulders on the arms, pushes up the lowerend of the trunk with his legs as a cow gets up by the hindquarters.The hands are now brought toward the feet, one is placed above theknee on the same side, then the other at a higher point on t
Nervous and mental diseases . Fig. 257.—Phase of resolution, retaining partial contractures (Richer).. Fig. 258.—Posterior arc de cercle (Richer). Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-257phase-of-resolution-retaining-partial-contractures-richer-fig-258posterior-arc-de-cercle-richer-image342866114.htmlRM2AWPW6A–Nervous and mental diseases . Fig. 257.—Phase of resolution, retaining partial contractures (Richer).. Fig. 258.—Posterior arc de cercle (Richer).
Nervous and mental diseases . key to diagnosis. Disease of the cervical vertebrae, as Potts disease ; of the meninges, as cervical pachymen-ingitis ; or diseaseof the cord, assyringomyelia, mayinvolve the brachialnerves in varyinggroups. Neuritis of thebrachial plexus isa rather commoncondition that isusually mistaken fora neuralgia, anginapectoris, or a rheu-matic trouble inthe shoulder andarm. According toGowers, who firstcarefully described it, brachial plexus neuritis is analogous to sciaticneuritis in the lower extremity. Causes.—This disease of the brachial plexus is encountered mainlyaf Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-key-to-diagnosis-disease-of-the-cervical-vertebrae-as-potts-disease-of-the-meninges-as-cervical-pachymen-ingitis-or-diseaseof-the-cord-assyringomyelia-mayinvolve-the-brachialnerves-in-varyinggroups-neuritis-of-thebrachial-plexus-isa-rather-commoncondition-that-isusually-mistaken-fora-neuralgia-anginapectoris-or-a-rheu-matic-trouble-inthe-shoulder-andarm-according-togowers-who-firstcarefully-described-it-brachial-plexus-neuritis-is-analogous-to-sciaticneuritis-in-the-lower-extremity-causesthis-disease-of-the-brachial-plexus-is-encountered-mainlyaf-image342954680.htmlRM2AWXX5C–Nervous and mental diseases . key to diagnosis. Disease of the cervical vertebrae, as Potts disease ; of the meninges, as cervical pachymen-ingitis ; or diseaseof the cord, assyringomyelia, mayinvolve the brachialnerves in varyinggroups. Neuritis of thebrachial plexus isa rather commoncondition that isusually mistaken fora neuralgia, anginapectoris, or a rheu-matic trouble inthe shoulder andarm. According toGowers, who firstcarefully described it, brachial plexus neuritis is analogous to sciaticneuritis in the lower extremity. Causes.—This disease of the brachial plexus is encountered mainlyaf
Nervous and mental diseases . Fig. 107.—Showing area- of sensory loss in injuries of the median nerve (Bowlby). its exposed position behind the inner condyle and its superficial coursethrough the forearm and at the wrist lay it liable to pressure neuritisand injury from wounds of all sorts. Even long-continued extremeflexion of the elbow-joint, as in sleep, in one predisposed, may suffice toinduce a neuritis at this point. Occupations which necessitate continu-ous leaning on the elbow are also said to be active causes, but are cer-tainly infrequent in this country. (3) Cuts at the wrist with v Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-107showing-area-of-sensory-loss-in-injuries-of-the-median-nerve-bowlby-its-exposed-position-behind-the-inner-condyle-and-its-superficial-coursethrough-the-forearm-and-at-the-wrist-lay-it-liable-to-pressure-neuritisand-injury-from-wounds-of-all-sorts-even-long-continued-extremeflexion-of-the-elbow-joint-as-in-sleep-in-one-predisposed-may-suffice-toinduce-a-neuritis-at-this-point-occupations-which-necessitate-continu-ous-leaning-on-the-elbow-are-also-said-to-be-active-causes-but-are-cer-tainly-infrequent-in-this-country-3-cuts-at-the-wrist-with-v-image342956328.htmlRM2AWY088–Nervous and mental diseases . Fig. 107.—Showing area- of sensory loss in injuries of the median nerve (Bowlby). its exposed position behind the inner condyle and its superficial coursethrough the forearm and at the wrist lay it liable to pressure neuritisand injury from wounds of all sorts. Even long-continued extremeflexion of the elbow-joint, as in sleep, in one predisposed, may suffice toinduce a neuritis at this point. Occupations which necessitate continu-ous leaning on the elbow are also said to be active causes, but are cer-tainly infrequent in this country. (3) Cuts at the wrist with v
Nervous and mental diseases . DISEASES OF THE FACIAL NERVE. 125 management. The early loss of faradic stimulability of the musclesgradually passes away, but voluntary motion returns before the faradiccurrent regains its control. Very frequently the paralyzed muscles willtwitch or even act in vigorous spasm as regeneration in the nerve re-stores its irritability. Those cases which last a month or two, or more,usually leave traces for the rest of life. They may be so slight as torequire careful scrutiny, or marked weakness may persist. Very excep-tionally the palsy is permanent.. Fig. 49.—Same c Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-diseases-of-the-facial-nerve-125-management-the-early-loss-of-faradic-stimulability-of-the-musclesgradually-passes-away-but-voluntary-motion-returns-before-the-faradiccurrent-regains-its-control-very-frequently-the-paralyzed-muscles-willtwitch-or-even-act-in-vigorous-spasm-as-regeneration-in-the-nerve-re-stores-its-irritability-those-cases-which-last-a-month-or-two-or-moreusually-leave-traces-for-the-rest-of-life-they-may-be-so-slight-as-torequire-careful-scrutiny-or-marked-weakness-may-persist-very-excep-tionally-the-palsy-is-permanent-fig-49same-c-image342984487.htmlRM2AX085Y–Nervous and mental diseases . DISEASES OF THE FACIAL NERVE. 125 management. The early loss of faradic stimulability of the musclesgradually passes away, but voluntary motion returns before the faradiccurrent regains its control. Very frequently the paralyzed muscles willtwitch or even act in vigorous spasm as regeneration in the nerve re-stores its irritability. Those cases which last a month or two, or more,usually leave traces for the rest of life. They may be so slight as torequire careful scrutiny, or marked weakness may persist. Very excep-tionally the palsy is permanent.. Fig. 49.—Same c
Nervous and mental diseases . Fig. 81.—Distribution of the middle cerebral artery (Duret). The main cerebral arteries coursing up over the hemispheres in thearachnopia have each a definite cortical territory, and these only slightlyoverlap. They give off two sets of branches,—namely, delicate arteri-oles, nourishing the cortex, which they enter at right angles, and largerstraight, long branches, which pierce the cortex and supply the whitematter of the cerebrum (see Fig. 66, p. 163). These pass inward and. Fig. 82.—Showing the distribution of the anterior, middle, and posterior cerebral arteri Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-81distribution-of-the-middle-cerebral-artery-duret-the-main-cerebral-arteries-coursing-up-over-the-hemispheres-in-thearachnopia-have-each-a-definite-cortical-territory-and-these-only-slightlyoverlap-they-give-off-two-sets-of-branchesnamely-delicate-arteri-oles-nourishing-the-cortex-which-they-enter-at-right-angles-and-largerstraight-long-branches-which-pierce-the-cortex-and-supply-the-whitematter-of-the-cerebrum-see-fig-66-p-163-these-pass-inward-and-fig-82showing-the-distribution-of-the-anterior-middle-and-posterior-cerebral-arteri-image342972197.htmlRM2AWYMF1–Nervous and mental diseases . Fig. 81.—Distribution of the middle cerebral artery (Duret). The main cerebral arteries coursing up over the hemispheres in thearachnopia have each a definite cortical territory, and these only slightlyoverlap. They give off two sets of branches,—namely, delicate arteri-oles, nourishing the cortex, which they enter at right angles, and largerstraight, long branches, which pierce the cortex and supply the whitematter of the cerebrum (see Fig. 66, p. 163). These pass inward and. Fig. 82.—Showing the distribution of the anterior, middle, and posterior cerebral arteri
Nervous and mental diseases . Fig. 164.—Showing thedeltoid in advanced myo-pathy.. Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-164showing-thedeltoid-in-advanced-myo-pathy-image342917714.htmlRM2AWW716–Nervous and mental diseases . Fig. 164.—Showing thedeltoid in advanced myo-pathy..
Nervous and mental diseases . Co Fig. 123.—Transverse sections of the cord at various levels, to show the relative variations in gray and white matter.. Fig. 124.—Divisions of the cross-section of the cord hased on Flecbsigs study of their development.A, Direct pyramidal tract; B, fundamental fasciculus of the anterior column ; C, rest of lateral column.I), direct cerebellar tract; E, crossed pyramidal tract; F, lateral limiting zone; G, anterior root zone;H, middle root zone; /, median zone; J, column of Goll; K, postero-internal root zone; L, postero-external root zone or zone of Lissauer (M Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-co-fig-123transverse-sections-of-the-cord-at-various-levels-to-show-the-relative-variations-in-gray-and-white-matter-fig-124divisions-of-the-cross-section-of-the-cord-hased-on-flecbsigs-study-of-their-developmenta-direct-pyramidal-tract-b-fundamental-fasciculus-of-the-anterior-column-c-rest-of-lateral-columni-direct-cerebellar-tract-e-crossed-pyramidal-tract-f-lateral-limiting-zone-g-anterior-root-zoneh-middle-root-zone-median-zone-j-column-of-goll-k-postero-internal-root-zone-l-postero-external-root-zone-or-zone-of-lissauer-m-image342943094.htmlRM2AWXBBJ–Nervous and mental diseases . Co Fig. 123.—Transverse sections of the cord at various levels, to show the relative variations in gray and white matter.. Fig. 124.—Divisions of the cross-section of the cord hased on Flecbsigs study of their development.A, Direct pyramidal tract; B, fundamental fasciculus of the anterior column ; C, rest of lateral column.I), direct cerebellar tract; E, crossed pyramidal tract; F, lateral limiting zone; G, anterior root zone;H, middle root zone; /, median zone; J, column of Goll; K, postero-internal root zone; L, postero-external root zone or zone of Lissauer (M
Nervous and mental diseases . right angle. The toes remain in a flexed, bunchedposition, and can not be extended or separated. Efforts against resist-ance at once disclose the weakness of these muscles. A peculiar andcharacteristic gait is developed. In order to clear the ground the patientis compelled to raise the foot by flexing the thigh. The leg is thenthrown forward like a flail ; the toe is pendent; the outer border of thefoot is depressed and brought to the ground toe first, or in a flat-footedmanner, or the outer border of the foot strikes the floor first. Theother foot is then advance Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-right-angle-the-toes-remain-in-a-flexed-bunchedposition-and-can-not-be-extended-or-separated-efforts-against-resist-ance-at-once-disclose-the-weakness-of-these-muscles-a-peculiar-andcharacteristic-gait-is-developed-in-order-to-clear-the-ground-the-patientis-compelled-to-raise-the-foot-by-flexing-the-thigh-the-leg-is-thenthrown-forward-like-a-flail-the-toe-is-pendent-the-outer-border-of-thefoot-is-depressed-and-brought-to-the-ground-toe-first-or-in-a-flat-footedmanner-or-the-outer-border-of-the-foot-strikes-the-floor-first-theother-foot-is-then-advance-image342950643.htmlRM2AWXN17–Nervous and mental diseases . right angle. The toes remain in a flexed, bunchedposition, and can not be extended or separated. Efforts against resist-ance at once disclose the weakness of these muscles. A peculiar andcharacteristic gait is developed. In order to clear the ground the patientis compelled to raise the foot by flexing the thigh. The leg is thenthrown forward like a flail ; the toe is pendent; the outer border of thefoot is depressed and brought to the ground toe first, or in a flat-footedmanner, or the outer border of the foot strikes the floor first. Theother foot is then advance
Nervous and mental diseases . Fig. 254.—Tonic phase, circumduction movements of upper members (Richer).. Fig. 255.—Clonic phase, schematic representation of clonic movements (Richer). Stock Photohttps://www.alamy.com/image-license-details/?v=1https://www.alamy.com/nervous-and-mental-diseases-fig-254tonic-phase-circumduction-movements-of-upper-members-richer-fig-255clonic-phase-schematic-representation-of-clonic-movements-richer-image342868089.htmlRM2AWPYMW–Nervous and mental diseases . Fig. 254.—Tonic phase, circumduction movements of upper members (Richer).. Fig. 255.—Clonic phase, schematic representation of clonic movements (Richer).
