Syphilis of the brain and spinal cord, showing the part which this agent plays in the production of paralysis, epilepsy, insanity, headache, neuralgia, hysteria, hypochondriasis, and nervous derangements / by Thomas Stretch Dowse.

  • Dowse, Thomas Stretch.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Syphilis of the brain and spinal cord, showing the part which this agent plays in the production of paralysis, epilepsy, insanity, headache, neuralgia, hysteria, hypochondriasis, and nervous derangements / by Thomas Stretch Dowse. Source: Wellcome Collection.

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    lay considerable stress upon this point, we must take care and not be led astray by the existence of one factor alone, let it be ever so weighty in itself. For my own part, I know of no cerebral growth that produces the peculiar pain, which is so exceptionally diagnostic of a syphilitic gummata, and it is in all probability because these are found at the cortex, and in connection with the brain membranes. I have never seen, and I am inclined to doubt the existence of, an isolated gummatous tumour in the central substance of the hemispheres, or motor ganglia, in the same way that we often find glioma, sarcoma, and tubercular growths. I have shelled out sarcomatous tumours from a man's brain, aged twenty-nine, who never suffered from any cerebral symptoms, pain, or otherwise, until a fortnight before his death ; in reference to tubercle, we have age and location to guide us. Gumma of the cerebellum is rare. The cerebellum is the most frequent seat of tubercle. I showed at the Pathological Society (see 'Path. Trans.,' vol. xxvii.) an enormous glioma in a man's brain, who had rarely suffered from pain. I do not wish here to draw out a differential diagnosis between cerebral growths, but the importance of headache in making a differential diagnosis of the seat of the syphilitic lesion will be readily seen and acknowledged. There is no description of headache, and one might say no kind of pain, which equals in intensity that which results from a localised syphilitic hyperplasia of the dura mater. It is of a different character altogether from that which will be shown in Case 33; and it is important to remember that it matters not whether the neoplasm be situated at the base, and involving the tract of some important nerve, or whether it be over the surface of the hemispheres and in contiguity with any special sensorial or motor functional area. Why the dura mater under these circumstances should be so sensitive, it is not easy to explain. Yet we know by experiment that this membrane is very sensitive to the electric current, and that the most violent and general muscular movement results from its action. Again, the nature of the texture invaded by the growth has to be taken into considera-