Book Review The Principles of Human Physiology . By Ernest Henry Starling, M.D. (London), F.R.C.P., F. R. S., Jodrell Professor of Physiology in University College, London. Octavo, 1423 pages, with 564 illustrations, some in color. Philadelphia and New York: Lea and Febiger. 1912
Boston Medical and Surgical Journal
motor ataxia was substantiated by showing definitely that the percentage of locomotor ataxia in those who had syphilis was far greater than the percentage in other disease. If Dr. Spiller's statements are to be accepted, he should show that a large percentage of patients suffering from amyotrophic lateral sclerosis are the subjects of syphilis. I can recall perfectly well three cases treated for some years for amyotrophic lateral sclerosis in all of whom a history of syphilis was obtained. Dr.
... was obtained. Dr. E. E. Southardt, Boston: I am inclined to think that one should not assert lues on the basis of leukocytosis. It is well known that anterior poliomyelitis shows lymphocytosis in a particular characteristic way. Tuberculosis of the meninges shows it. I have seen cases of pneumococcal meningitis which showed monoculear infiltration. We might wake up some day suddenly to find that many things called syphilitic are not syphilitic. Dr. Israel Strauss, New York: I think that what Dr. Southard has said is true. We find leukocytic infiltration in tuberculosis and in other conditions of the nervous system. It is the method by which the nervous system reacts to infectious states in the acute or subacute types. In the chronic states we do not know of anything in the present state of our knowledge which gives us the lymphocytic infiltration which syphilis does. Dr. Joseph Collins, New York: I venture to suggest that this paper that Dr. Spiller has presented is an extremely important one and will mark a very distinctive period in our interpretation of spinal cord disease. There can be no doubt that what Dr. Southard has said is true, but it does not invalidate the importance of Dr. Spiller's claim and contention, it will permit us now to make investigation of our cases clinically, to demonstrate a syphilitic disorder. For instance, we will not be justified in allowing any case of asymotrophic lateral sclerosis to go through our hands without repeated investigations as to whether or not the syphilitic poison exists in the system, and it seems to me that that is the great application to our problem of the contribution that Dr. Spiller has made. Dr. Spiller, in closing: Of course I do not expect to have my views accepted in large part. It would not have been worth while to present the paper if I had expected that. I emphasize that I did not say that every case of amyotrophic lateral sclerosis or chronic bulbar palsy is syphilitic. I wished only to call attention to the possibility of syphilis occurring in a number of such cases and feel that I am justified in reporting a study.