The pathology of syphilis of the nervous system in the light of modern research : Morison Lectures, 1909 / by F.W. Mott.

  • Mott, F. W. (Frederick Walker), 1853-1926
Date:
[1948?]
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Licence: In copyright

Credit: The pathology of syphilis of the nervous system in the light of modern research : Morison Lectures, 1909 / by F.W. Mott. Source: Wellcome Collection.

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    neurasthenia, will, in conjunction with the effect of the syphilitic poison on the lipoids, cause the nerve-cells to exercise an abnormal metabolic activity. Ehrlich points out that we cannot suppose that the cells of the body possess, yer se, an executive defensive capacity to neutralise the noxious effects of all forms of organisms, and his work on hsemolysins shows that the hsemolysin for the corpuscles of a particular animal only occurs after incorporation of the molecules of those corpuscles. But we may suppose that there is an inherent aptitude for the cells of the body of certain individuals to adapt themselves readily to defence against the action of the syphilitic virus in a race that has been widely syphilised for genera- tions; consequently, a larger number will have a mild form of the disease. Cases of tabes and general paralysis occasionally arise within three years of the primary sore; possibly this may be due to an inherent hypersensibility to react to the poison. Dr. Byrom Bramwell has recorded a remarkable case of tabes which came on ten months after infection; it would be interesting to investigate the family history and past personal history of these cases to ascertain whether or not it was a second infection. The nerve-cells are perpetual elements incapable of regeneration, highly differentiated, and complex in structure and function; their centre of nutrition is the nucleus, and when decay sets in, the regressive process attacks first the fine twigs and branches of the tree, the dendrites and dendrons, and the rootlets; in fact, the process is an inversion of its growth and development. But what should cause this premature decay and lack of durability, for the specific energy of the whole of the neurons in the healthy body is sufficient to last until the vital spark dies out? We know the more prolonged duration of infectivity of the syphilitic virus as compared with other contagious diseases, also that one attack of syphilis confers immunity during the rest of the individual’s life; moreover, the experiments of Krafft-Ebing are important to remember in this respect. The nerve-elements being perpetual and having acquired a habit of in- creased metabolic activity, will continue it during life, and will contri- bute to the excess of lipoids in the blood. When there is no longer meta- bolic equilibrium, and decay sets in, these lipoid complexes are thrown off in increasing numbers (vide p. 25); this seems probable from the fact that in general paralysis and tabes the quantities increase with the progress of the decay. The process of decay will manifest itself in the earliest stages by an increased irritability and functional activity of the nervous structures, often manifesting itself in a hyperoesthesia sexualis, emotional exaltation, and, not infrequently, in striking intel- lectual activity, followed in each case by exhaustion and loss of function. In my second lecture I referred to the fact that the lipoids may be the