Some Doubtful Cases of So-Called General Paralysis of the Insane

1914 ◽  
Vol 60 (249) ◽  
pp. 291-295
Author(s):  
W. Robinson

Cases of mental disease which give definite mental symptoms and physical signs of the condition recognised and at present called general paralysis of the insane, and which, moreover give a Wassermann reaction, seem to be invariably due to syphilis, and to contain in many cases spirochætes in the cerebral substance. Out of seven such cases of well-marked general paralysis, which on death were examined for spirochætes by Dr. McIntosh, six cases showed the presence of spirochætes. The seventh case was regarded as doubtful.

1897 ◽  
Vol 43 (180) ◽  
pp. 63-67
Author(s):  
P. W. Macdonald ◽  
A. Davidson

The object of this paper is not so much to relate anything that is new as to show that mental symptoms are not always easy of classification when associated with organic changes in nerve tracts outside the cerebral cavity.


1922 ◽  
Vol 68 (280) ◽  
pp. 54-66 ◽  
Author(s):  
P. W. Bedford

General paralysis is often very difficult to diagnose, and the responsibility of coming to a decision is not lessened by the fatal character of the disease. Amongst the protean manifestations of neuro-syphilis, the early and definite recognition of this, its most deadly and intractable form, offers a problem in nice discrimination—a problem which is in the present tense and imperative mood. According to Southard, of 119 cases diagnosed as general paralysis, post-mortem examination revealed a diagnostic error of 26 per cent. If anyone had been able to devise a less intricate test for syphilis, the Wassermann reaction would never have survived to the present day. It is one of the most complicated methods that have been applied to diagnosis in medicine. Any simple test, therefore, which promises increased precision in diagnosis, is worthy of that careful investigation which is the half-way house to knowledge.


1823 ◽  
Vol 9 (2) ◽  
pp. 365-379 ◽  
Author(s):  
H. Dewar

The communication received from Dr Dyce chiefly consists of a description of a singular affection of the nervous system, and mental powers, to which a girl of sixteen was subject immediately before puberty, and which disappeared when that state was fully established. It exemplifies the powerful influence of the state of the uterus on the mental faculties; but its chief value arises from some curious relations which it presents to the phenomena of mind, and which claim the attention of the practical metaphysician. The mental symptoms of this affection are among the number of those which are considered as uncommonly difficult of explanation. It is a case of mental disease, attended with some advantageous manifestations of the intellectual powers; and these manifestations disappearing in the same individual in the healthy state.


1886 ◽  
Vol 31 (136) ◽  
pp. 504-507
Author(s):  
Geo. H. Savage

In so-called nervous disorders it is common to find changes occur in other of the bodily systems than the nervous. The pathology of nervous disease should be looked upon as a general pathology, and it is certain that we cannot look to the one system alone for causes of all the nervous disorders without greatly misunderstanding the whole subject. The more exact we become in limiting the causes, the more liable are we to error. We are all prepared to consider general paralysis of the insane as essentially a disease of the nervous system, a disease in which nearly every part of the nervous system may suffer sooner or later. But beside the essentially nervous symptoms which occur in the disease, we are constantly struck by the regular series of nutritional changes which occur in general paralysis, and this is so much the case that we are quite prepared to recognise as general paralysis a disorder in which any mental symptoms have been present, but have after a brief period of acuteness been followed by a state of fatness and weak-mindedness which again has been followed by a period of wasting and further mental weakness. We have here nervous symptoms related very directly with nutritional changes.


1904 ◽  
Vol 50 (208) ◽  
pp. 13-31
Author(s):  
Nathan Raw

My object in reading this paper before this important Association of mental experts is twofold: first, to draw attention to the great frequency of mental symptoms developing in the course of an attack of bodily illness; and secondly, to the unsatisfactory condition of our system in this country in dealing with and treating persons suffering from temporary mental disease.


1880 ◽  
Vol 25 (112) ◽  
pp. 547-556

The last class includes the so-called “general paralysis without mental symptoms.”


BMJ ◽  
1909 ◽  
Vol 2 (2534) ◽  
pp. 198-201 ◽  
Author(s):  
J. H. Smith ◽  
J. P. Candler

1967 ◽  
Vol 113 (504) ◽  
pp. 1291-1295 ◽  
Author(s):  
Richard Hunter ◽  
Muriel Jones ◽  
T. G. Jones ◽  
D. M. Matthews

In a leading article on mental symptoms in vitamin B12deficiency (Lancet, 1965), it was pointed out that “though mental illness due to vitamin B12deficiency is uncommon, it is readily treated, and, as in general paralysis of the insane, its protean manifestations and uncertain physical signs call for an easily applied screening test comparable to the Wassermann reaction”. In the correspondence which followed it was suggested that in psychiatric practice today mental symptoms were likely to be found more frequently in association with vitamin B12deficiency than with a positive serological test for syphilis (owing in part to the increasing number of patients with deficiency syndromes following gastro-intestinal surgery); and that estimation of serum B12concentration should be performed much more readily without waiting for clear-cut haematological evidence or neurological complications of megaloblastic anaemia (Hunter and Matthews, 1965). This was emphasized by the evidence of Strachan and Henderson (1965) who described three patients with psychiatric syndromes attributed to vitamin B12deficiency in whom not only peripheral blood but also bone marrow was normal; and the report from a mental hospital in Norway by Edwin et al. (1965) that of 396 patients over the age of thirty years admitted over a twelve months period, 23 (5·8 per cent.) had serum B12concentrations below the critical level of 100 μμg. per ml. as estimated by Euglena gracilis assay. This finding was challenged by Herbert et al. (1965), who suggested that drugs of the phenothiazine group administered to the patients might have suppressed the growth of the organism, but this was disputed by Edwin et al. (1966).


1866 ◽  
Vol 12 (59) ◽  
pp. 348-367
Author(s):  
Franz Meschede ◽  
G. F. Blandford

The disorder commonly called “general paralysis of the insane” presents so many points of interest to the pathologist and the physician, that as a necessary consequence it forms the commonest topic among the writings of those who specially study insanity. But after so much observation and so many treatises, it is disheartening to find that even now scarcely more than one fact with regard to it is laid down as settled and established beyond the possibility of doubt. One there is, the saddest that can be. It is, that for this malady we hitherto have found no cure; that to diagnose it is to pronounce the sentence, not only of incurable insanity, but also of speedy death. The marvel of the whole is, that although death occurs in every case at no very distant period, though postmortem examinations of general paralytics are made by hundreds every year in this and other countries, yet even at this day no two observers are agreed as to the pathology and morbid anatomy, as to the part in which it has its origin, or which constitutes its peculiar and proper seat. No wonder that the whole of the morbid anatomy of insane brain is vague and ill-defined, when this, the specially fatal form of mental disease, still hides itself from usâ still wraps itself in the mystery which envelopes all that relates to mind. I make no apology for drawing the attention of the readers of this Journal to a paper on the subject, published in the October and November numbers of ‘ Virchow's Archives/ 1865, and for giving a short and necessarily imperfect summary of its contents, it being too long for reproduction. But as every outline must needs be unsatisfactory, I trust my readers will go themselves to the original. In default of opportunity of examining many brains of paralytic patients, I present as a contribution to the English treatises on the subject these observations of another.


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