Clinical Psychiatry

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1902 edition. Excerpt: ...irregular in outline, especially about the base; the nucleus loses its rotundity, is triangular or oblong, and the membrane folds upon itself, producing sharply stained bands. The chromatic and achromatic portions of the cell lose their characteristic structure and stain profusely. The nucleus appears at the periphery of the cell. In the darkly stained portions one often sees fine, clearly stained bands. The chronic change is represented in Figure 5. The smaller pyramidal cells in their shrinkage take on a star-like formation. It often happens that cells with this chronic change give evidence of a superimposed acute process, as seen in Figure 6. The difference in the intensity of the process in the different areas is probably due to difference in the power of resist-ance of the neurones. As yet no relationship has been established between the clinical symptoms and the pathological changes in the different areas, except where there are speech disturbances, word deafness and convulsions, in which cases there is uniformly found involvement of the temporal, parietal, and central convolutions. The nerve fibres of the cortex and the corona radialis present anatomical changes which bear a definite relationship to the extent of the process in the nerve cells. Where the clinical course has been prolonged and the neurones are much degenerated there remain but a very few normal fibres. Similar destruction of the nerve fibres may be found in senile dementia and epileptic insanity, but it is not as far advanced as in dementia paralytica. As the result of the degeneration of the nerve cells and then-processes, there is an atrophy of the cortex, which in extreme cases may shrink to one-half its normal width. This degeneration may be more marked about...