Recent Progress in Therapeutics

ROBERT AMORY
1878 Boston Medical and Surgical Journal  
proliferation of cells of the epithelial lining. Heubner has shown that this form of growth, causing constriction in the arteries at the base of the brain, is quite constant in cerebral syphilis, and considers it an open question whether the growth is due to syphilitic disease of the epithelial coat of the arteries, or to irritation from diseased blood. Treatment : Iodide of potash was given regularly from the date of the patient's admission to the asylum to within a few days of his death, but
more » ... ithout perceptible benefit. Bromide of potash and chloral had no effect in controlling the hallucinations. Morphia was not employed in treatment of the hallucinations, the demented condition of the patient and the absence of severe mental suffering counterindicating its use. It is to be regretted that so little is known regarding the early treatment of our patient. In a large proportion of cases where syphilis affects the brain the early symptoms of the disease have been slight, and the patient has not undergone á thorough course of mercurial treatment. in the Edinburgh University Gold Prize Thesis,1 presents the record of some experiments on animals which in a measure justify his belief that aconite paralyzes the excitability of the sensory nerve system in the following order : first, the peripheral filaments ; second, the trunks ; and, finally, the posterior (or sensory) nerve roots. Moreover, the motor tract undergoes a certain functional exaltation, or hyper-excitation, which either from fatigue or otherwise is replaced by a diminution of the motory function, and owing to the paralysis of the inhibitory or restraining nerve influence the muscular contractions are increased. Again, the pneumogastric filaments are at first paralyzed, and thus cause a diminution and subsequent abolition of the ordinary reflex response. Hence he summarizes its toxical action : (1.) The effect on the respiration is primary and due to the direct action of the drug on the sensory fibres of the vagus and the respiratory centre. (2.) It induces a series of symptoms closely resembling those developed after section of the vagus. (3.) It causes death partly by asphyxia and partly by a variety of collapse spoken of by Brown-Séquard as " characterized by a great diminution of breathing, produced by a peculiar influence on the central organs of respiration, the heart continuing to beat with more or less vigor." Dr. Fothergill's report to the British Medical Associationa on the 1
doi:10.1056/nejm187809190991203 fatcat:jtacnmqdljfnlmzlav6wvdrvrm