THE material of this paper consists of 2,288 consecutive admissions to a military hospital for neurosis. Selection has taken place before arrival, because only those cases which are considered to have a good chance of rehabilitation are recommended. Age ranges between 18 and 49 with a maximum number at the age of 23. Length of service ranges between 6 weeks and 17 years, with a preponderance at 24 to 3 years. Only a few old soldiers with 10 or more years service appear in the series. The proportion of N.C.Os. to other ranks are: Sergeants, Corporals, Lance-Corporals, Privates, in the ratio of 2, 2, 1, 11.
{"title":"THE PHYSICAL EXAMINATION OF TWO THOUSAND CASES OF NEUROSIS.","authors":"H G McGregor","doi":"10.1136/jnnp.7.1-2.21","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.21","url":null,"abstract":"THE material of this paper consists of 2,288 consecutive admissions to a military hospital for neurosis. Selection has taken place before arrival, because only those cases which are considered to have a good chance of rehabilitation are recommended. Age ranges between 18 and 49 with a maximum number at the age of 23. Length of service ranges between 6 weeks and 17 years, with a preponderance at 24 to 3 years. Only a few old soldiers with 10 or more years service appear in the series. The proportion of N.C.Os. to other ranks are: Sergeants, Corporals, Lance-Corporals, Privates, in the ratio of 2, 2, 1, 11.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.21","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction IN a recent communication (Slater, 1943), based on a statistical survey of two thousand neurotic soldiers, a hypothesis was developed to the effect that there was a generalized predisposition towards neurosis, which was in large part responsible for the appearance of neurotic symptoms in the individual when placed under stress. Evidence was adduced that this constitutional tendency, though it might be affected by such environmental factors as early processes of conditioning, was, at least in part, dependent on hereditary factors. Evidence was also brought that it could usefully be considered in a quantitative manner, and that so considered the intensity of the constitutional predisposition varied inversely with the degree of stress under which the individual was placed before breakdown occurred, i.e. the greater the intensity of the constitutional predisposition, the less was the degree of stress required to produce breakdown, and vice versa. On this last point, strong confirmatory evidence has recently been supplied by Symonds (1943). He states " the incidence of neurosis in different tactical duties varies directly with the amount of hazard encountered, as measured by the casualty rates." He also provides a table correlating the degree of predisposition with the degree of stress in 2,200 neurotic casualties, which shows that the degree of flying stress falls steadily as predisposition increases. From his table a correlation coefficient between the two variables of -0-26±0-02 can be calculated. In the paper referred to no very detailed analysis of the nature of the neurotic predisposition was undertaken. Yet the frequency of various traits of personality was shown to vary significantly in the several diagnostic groups, and significant and fairly high correlations were found between personality traits and eventual symptomatology. There was, therefore, evidence of constitutional heterogeneity in the population investigated. On the other hand all the neurotic personality traits were noted as being at least sometimes present in all the diagnostic groups, and the same was true of all the classes of symptoms observed, with the exception of obsessional compulsive symptoms and psychotic and organic symptoms. This means in effect that the different neurotic groups fade off into one another clinically, and do not form qualitatively distinct groups. This observation is one with which every clinician is in practice familiar. This, then, is the starting point of the argument which is developed in the following pages. It is our purpose to reduce the hypothesis already propounded to precise terms which may be handled statistically, lind made the basis of predictions which can be checked by further observations. What is involved is, in fact, a general theory of the nature of the neurotic constitution.
{"title":"A HEURISTIC THEORY OF NEUROSIS.","authors":"E Slater, P Slater","doi":"10.1136/jnnp.7.1-2.49","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.49","url":null,"abstract":"Introduction IN a recent communication (Slater, 1943), based on a statistical survey of two thousand neurotic soldiers, a hypothesis was developed to the effect that there was a generalized predisposition towards neurosis, which was in large part responsible for the appearance of neurotic symptoms in the individual when placed under stress. Evidence was adduced that this constitutional tendency, though it might be affected by such environmental factors as early processes of conditioning, was, at least in part, dependent on hereditary factors. Evidence was also brought that it could usefully be considered in a quantitative manner, and that so considered the intensity of the constitutional predisposition varied inversely with the degree of stress under which the individual was placed before breakdown occurred, i.e. the greater the intensity of the constitutional predisposition, the less was the degree of stress required to produce breakdown, and vice versa. On this last point, strong confirmatory evidence has recently been supplied by Symonds (1943). He states \" the incidence of neurosis in different tactical duties varies directly with the amount of hazard encountered, as measured by the casualty rates.\" He also provides a table correlating the degree of predisposition with the degree of stress in 2,200 neurotic casualties, which shows that the degree of flying stress falls steadily as predisposition increases. From his table a correlation coefficient between the two variables of -0-26±0-02 can be calculated. In the paper referred to no very detailed analysis of the nature of the neurotic predisposition was undertaken. Yet the frequency of various traits of personality was shown to vary significantly in the several diagnostic groups, and significant and fairly high correlations were found between personality traits and eventual symptomatology. There was, therefore, evidence of constitutional heterogeneity in the population investigated. On the other hand all the neurotic personality traits were noted as being at least sometimes present in all the diagnostic groups, and the same was true of all the classes of symptoms observed, with the exception of obsessional compulsive symptoms and psychotic and organic symptoms. This means in effect that the different neurotic groups fade off into one another clinically, and do not form qualitatively distinct groups. This observation is one with which every clinician is in practice familiar. This, then, is the starting point of the argument which is developed in the following pages. It is our purpose to reduce the hypothesis already propounded to precise terms which may be handled statistically, lind made the basis of predictions which can be checked by further observations. What is involved is, in fact, a general theory of the nature of the neurotic constitution.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.49","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HEMI-HYPERTROPHY, or abnormal enlargement of one side of the body, is of interest because of its varied forms and its frequent association with other congenital abnormalities, including mental deficiency. Wagner reported a case in 1839, and in the ensuing century about a hundred cases of partial or complete hemi-hypertrophy have been recorded. A brief description of the following case of hemihypertrophy, associated with Von Recklinghausen's disease, will serve as a basis for discussion.
{"title":"A CASE OF PARTIAL CONGENITAL HEMI-HYPERTROPHY.","authors":"A Huse","doi":"10.1136/jnnp.7.1-2.30","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.30","url":null,"abstract":"HEMI-HYPERTROPHY, or abnormal enlargement of one side of the body, is of interest because of its varied forms and its frequent association with other congenital abnormalities, including mental deficiency. Wagner reported a case in 1839, and in the ensuing century about a hundred cases of partial or complete hemi-hypertrophy have been recorded. A brief description of the following case of hemihypertrophy, associated with Von Recklinghausen's disease, will serve as a basis for discussion.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.30","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MYELITIS as part of a post vaccinial encephalomyelitis is well known, and histological changes occurring in the spinal cord were fully described in the earlier case records (Turnbull and McIntosh, 1926). The purpose of the present paper is to draw attention to the fact that myelitis uncomplicated by encephalitis also occurs as a sequel to vaccination. The following case which I have recently had the opportunity of observing is typical of thl group.
{"title":"MYELITIS DUE TO VACCINATION.","authors":"G J Dixon","doi":"10.1136/jnnp.7.1-2.18","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.18","url":null,"abstract":"MYELITIS as part of a post vaccinial encephalomyelitis is well known, and histological changes occurring in the spinal cord were fully described in the earlier case records (Turnbull and McIntosh, 1926). The purpose of the present paper is to draw attention to the fact that myelitis uncomplicated by encephalitis also occurs as a sequel to vaccination. The following case which I have recently had the opportunity of observing is typical of thl group.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CAUSATION OF MONGOLISM.","authors":"M Engler","doi":"10.1136/jnnp.7.1-2.27","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.27","url":null,"abstract":"","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.27","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IT is not uncommon, especially in wartime, to be faced by patients complaining of persistant severe pain in the hand or foot following an injury to a limb, despite the absence of apparent cause. It is with such cases that the present paper is concerned. Excluded from consideration are cases in which post-traumatic pain arises from tender neuromata or obvious vascular abnormalities. Weir Mitchell (1872) dealing particularly with injuries involving nerves used the term causalgia for this condition, and though describing many examples that have become classical he did not rigidly define the term. Indeed Homans (1939) suggests that a considerable number of states have been at one time or another included under this term and such a view is supported by ideas developed elsewhere (Doupe and Cullen 1943). On the other hand, it would seem that cases of causalgia have been described under a variety of other names. This tendency to dispersion in the literature has been noted, both by Homans (1939) and de Takats (1943), and they have been tempted to counteract it by grouping many of these conditions together. In Table I it will be seen that there is a disparity in the conditions so grouped by these two authors and that the cause of this disparity appears to lie not only in the redundant terminology but in different conceptions of the genesis of the condition: Homans stressing the part played by reflex arterial spasm while de Takats is impressed by the element of vasodilatation.
{"title":"POST-TRAUMATIC PAIN AND THE CAUSALGIC SYNDROME.","authors":"J Doupe, C H Cullen, G Q Chance","doi":"10.1136/jnnp.7.1-2.33","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.33","url":null,"abstract":"IT is not uncommon, especially in wartime, to be faced by patients complaining of persistant severe pain in the hand or foot following an injury to a limb, despite the absence of apparent cause. It is with such cases that the present paper is concerned. Excluded from consideration are cases in which post-traumatic pain arises from tender neuromata or obvious vascular abnormalities. Weir Mitchell (1872) dealing particularly with injuries involving nerves used the term causalgia for this condition, and though describing many examples that have become classical he did not rigidly define the term. Indeed Homans (1939) suggests that a considerable number of states have been at one time or another included under this term and such a view is supported by ideas developed elsewhere (Doupe and Cullen 1943). On the other hand, it would seem that cases of causalgia have been described under a variety of other names. This tendency to dispersion in the literature has been noted, both by Homans (1939) and de Takats (1943), and they have been tempted to counteract it by grouping many of these conditions together. In Table I it will be seen that there is a disparity in the conditions so grouped by these two authors and that the cause of this disparity appears to lie not only in the redundant terminology but in different conceptions of the genesis of the condition: Homans stressing the part played by reflex arterial spasm while de Takats is impressed by the element of vasodilatation.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.33","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
or meningo-cerebral cicatrix which may result from focal contusion and laceration of the brain rest upon a firm foundation of fact, of unequivocal observation. 2. The enlargement involves the whole of one lateral ventricle; it may occur on that side of the head which received the blow, or on the opposite side. These cases may provide a link connecting the processes leading to local bulging, and those causing general symmetrical dilatation. It is tempting to assume that a large focal contusion can lead to cedema of the whole hemisphere. If this were proven, and if the cedema alone, as opposed to any vascular disturbances which cause cedema were sufficiently severe and enduring, then doubtless gliosis and atrophy would lead to ventricular enlargement. Although such an explanation is accepted by many, an cedema of this extent has not yet been satisfactorily proven. The occurrence of contralateral enlargement seems related to contrecoup effects, but the precise mechanism of dilatation is not thereby explained. Raised intracranial pressure by itself cannot be the cause, unless a softened state of one hemisphere allows its ventricle to dilate. 3. General symmetrical enlargement of the lateral ventricles; rarely the third and fourth ventricles are involved, although not to any considerable extent. Two questions immediately present themselves. What is an abnormally large ventricle, and what is the incidence of the condition? Davidoff and Dyke (1937) measure the distance between the outermost limits of the bodies at the lateral angles as seen in the antero-posterior projection and regard 3*5-4*5 cm. as normal. Robertson (1941) proposed
{"title":"TRAUMATIC DILATATION OF THE CEREBRAL VENTRICLES.","authors":"D W Northfield","doi":"10.1136/jnnp.7.1-2.1","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.1","url":null,"abstract":"or meningo-cerebral cicatrix which may result from focal contusion and laceration of the brain rest upon a firm foundation of fact, of unequivocal observation. 2. The enlargement involves the whole of one lateral ventricle; it may occur on that side of the head which received the blow, or on the opposite side. These cases may provide a link connecting the processes leading to local bulging, and those causing general symmetrical dilatation. It is tempting to assume that a large focal contusion can lead to cedema of the whole hemisphere. If this were proven, and if the cedema alone, as opposed to any vascular disturbances which cause cedema were sufficiently severe and enduring, then doubtless gliosis and atrophy would lead to ventricular enlargement. Although such an explanation is accepted by many, an cedema of this extent has not yet been satisfactorily proven. The occurrence of contralateral enlargement seems related to contrecoup effects, but the precise mechanism of dilatation is not thereby explained. Raised intracranial pressure by itself cannot be the cause, unless a softened state of one hemisphere allows its ventricle to dilate. 3. General symmetrical enlargement of the lateral ventricles; rarely the third and fourth ventricles are involved, although not to any considerable extent. Two questions immediately present themselves. What is an abnormally large ventricle, and what is the incidence of the condition? Davidoff and Dyke (1937) measure the distance between the outermost limits of the bodies at the lateral angles as seen in the antero-posterior projection and regard 3*5-4*5 cm. as normal. Robertson (1941) proposed","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"THE EFFECT OF GALVANIC EXERCISE ON DENERVATED AND RE-INNERVATED MUSCLES IN THE RABBIT.","authors":"E Gutmann, L Guttmann","doi":"10.1136/jnnp.7.1-2.7","DOIUrl":"https://doi.org/10.1136/jnnp.7.1-2.7","url":null,"abstract":"","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1944-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.7.1-2.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29899867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1943-09-01DOI: 10.1093/oxfordjournals.bmb.a070219
L. Guttmann, P. Medawar
Introduction THE problem of suppressing the regenerative growth of nerve fibres by chernical or other means owes its clinical interest to the need for preventing or stopping the acute pain that sometimes develops after injury to peripheral nerves. The conditions under which acute pain develops have not been closely defined. It cannot be definitely attributed to any one particular cause, and it is not invariably accompanied be neuroma formation. Reactions from islands of infection and foreign bodies in the nerve itself (Marinesco 1918, 1920), the involvement of escaping nerve fibres in scar tissue and muscle (discussed by Corner, 1918b), and pressure upon " young " unmyelinated fibres (Cone, 1918) may each play a part. Clinical evidence nevertheless shows that pain in some form, particularly in amputation stumps, is associated with neuroma formation and other consequences of unorganized regenerative growth. Pain of this sort is sometimes relieved by excising the neuroma, and is prevented from recurring, or from arising in the first instance, by taking certain preventative measures. These may be reviewed shortly under two headings:
{"title":"THE CHEMICAL INHIBITION OF FIBRE REGENERATION AND NEUROMA FORMATION IN PERIPHERAL NERVES.","authors":"L. Guttmann, P. Medawar","doi":"10.1093/oxfordjournals.bmb.a070219","DOIUrl":"https://doi.org/10.1093/oxfordjournals.bmb.a070219","url":null,"abstract":"Introduction THE problem of suppressing the regenerative growth of nerve fibres by chernical or other means owes its clinical interest to the need for preventing or stopping the acute pain that sometimes develops after injury to peripheral nerves. The conditions under which acute pain develops have not been closely defined. It cannot be definitely attributed to any one particular cause, and it is not invariably accompanied be neuroma formation. Reactions from islands of infection and foreign bodies in the nerve itself (Marinesco 1918, 1920), the involvement of escaping nerve fibres in scar tissue and muscle (discussed by Corner, 1918b), and pressure upon \" young \" unmyelinated fibres (Cone, 1918) may each play a part. Clinical evidence nevertheless shows that pain in some form, particularly in amputation stumps, is associated with neuroma formation and other consequences of unorganized regenerative growth. Pain of this sort is sometimes relieved by excising the neuroma, and is prevented from recurring, or from arising in the first instance, by taking certain preventative measures. These may be reviewed shortly under two headings:","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/oxfordjournals.bmb.a070219","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61381532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1943-09-01DOI: 10.1093/OXFORDJOURNALS.BMB.A070230
G. Weddell, L. Guttmann, E. Gutmann
Introduction THE existence of extensive overlap between the cutaneous nerve fibres derived from successive nerve roots was first demonstrated by Sherrington (1893) in a study of residual sensibility after section of one or more roots. Other methods, such as that involving local strychninization of the dorsal spinal roots employed by Dusser de Barenne (1910), have been found to give essentially similar results. The method of antidromic stimulation (originally used by Stricker (1876) and Bayliss (1901)) and the study of residual sensibility after the section of dorsal nerve roots were both employed by Foerster (1936) to determine the extent of each human dermatome, and again the correspondence between the results obtained by both methods was close. The amount of overlap which exists between the peripheral cutaneous nerves of the limbs has been determined by a number of methods, which include anatomical dissection, the successive anesthetization of nerves supplying contiguous areas of skin followed by sensory tests (Woollard et al., 1940), electrical stimulation methods through the intact skin (Thompson et al., 1934), and finally by the analysis of the sensory loss following peripheral nerve injuries in a large series of patients (Foerster, 1917, 1929). The correspondence between the stimulation and anwsthetization methods is reasonably close. On the other hand, the analysis of sensory loss and sweat secretion (Guttmann, 1940) following nerve injuries shows in many cases very large degrees of overlap which are not demonstrated by the other methods. This finding, taken in conjunction with the clinical observation by Pollock (1920) that the areas of sensory loss following nerve injuries shrink circumferentially before any regeneration can have taken place from the central stump, suggests either that the method of recording residual sensibility is not entirely accurate or that a proportion of overlapping nerve fibres do not transmit impulses giving rise to sensations for some time following a nerve lesion (Pollock, 1919). It is also possible that a new growth of fibres from surrounding normal nerves towards the area of sensory loss takes place (Schuh, 191 1, and Weddell and Glees, 1941). The method of staining nerve fibres throughout large whole preparations of skin by local injection of methylene blue (Weddell, 1941) has been applied 206
Sherrington(1893)在对一个或多个神经根切除后残余敏感性的研究中首次证实了来源于连续神经根的皮神经纤维之间存在广泛的重叠。其他方法，如Dusser de Barenne(1910)所采用的脊髓后根局部strychninization，也得到了基本相似的结果。Foerster(1936)采用反角刺激法(最初由Stricker(1876)和Bayliss(1901)使用)和背神经根切片后残余敏感性的研究来确定人体每个皮节的范围，两种方法得到的结果也非常吻合。肢体周围皮神经之间存在的重叠量已通过多种方法确定，包括解剖解剖，连续麻醉供应连续皮肤区域的神经，然后进行感觉测试(woolard等人，1940)，通过完整皮肤的电刺激方法(Thompson等人，1934)，最后通过对大量患者周围神经损伤后感觉丧失的分析(Foerster, 1917, 1929)。刺激和激励方法之间的对应关系相当密切。另一方面，对神经损伤后感觉丧失和汗液分泌的分析(Guttmann, 1940)显示，在许多情况下，其他方法没有显示出非常大程度的重叠。这一发现与Pollock(1920)的临床观察相结合，即神经损伤后的感觉丧失区域在中央残端再生之前会呈周向收缩，这表明要么记录残余敏感性的方法并不完全准确，要么部分重叠的神经纤维在神经损伤后的一段时间内不能传递产生感觉的冲动(Pollock, 1919)。也有可能是周围正常神经的纤维向感觉丧失区域生长(Schuh, 1991, and Weddell and Glees, 1941)。通过局部注射亚甲基蓝染色神经纤维的方法已经应用于整个皮肤的大制剂(Weddell, 1941)
{"title":"THE LOCAL EXTENSION OF NERVE FIBRES INTO DENERVATED AREAS OF SKIN.","authors":"G. Weddell, L. Guttmann, E. Gutmann","doi":"10.1093/OXFORDJOURNALS.BMB.A070230","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.BMB.A070230","url":null,"abstract":"Introduction THE existence of extensive overlap between the cutaneous nerve fibres derived from successive nerve roots was first demonstrated by Sherrington (1893) in a study of residual sensibility after section of one or more roots. Other methods, such as that involving local strychninization of the dorsal spinal roots employed by Dusser de Barenne (1910), have been found to give essentially similar results. The method of antidromic stimulation (originally used by Stricker (1876) and Bayliss (1901)) and the study of residual sensibility after the section of dorsal nerve roots were both employed by Foerster (1936) to determine the extent of each human dermatome, and again the correspondence between the results obtained by both methods was close. The amount of overlap which exists between the peripheral cutaneous nerves of the limbs has been determined by a number of methods, which include anatomical dissection, the successive anesthetization of nerves supplying contiguous areas of skin followed by sensory tests (Woollard et al., 1940), electrical stimulation methods through the intact skin (Thompson et al., 1934), and finally by the analysis of the sensory loss following peripheral nerve injuries in a large series of patients (Foerster, 1917, 1929). The correspondence between the stimulation and anwsthetization methods is reasonably close. On the other hand, the analysis of sensory loss and sweat secretion (Guttmann, 1940) following nerve injuries shows in many cases very large degrees of overlap which are not demonstrated by the other methods. This finding, taken in conjunction with the clinical observation by Pollock (1920) that the areas of sensory loss following nerve injuries shrink circumferentially before any regeneration can have taken place from the central stump, suggests either that the method of recording residual sensibility is not entirely accurate or that a proportion of overlapping nerve fibres do not transmit impulses giving rise to sensations for some time following a nerve lesion (Pollock, 1919). It is also possible that a new growth of fibres from surrounding normal nerves towards the area of sensory loss takes place (Schuh, 191 1, and Weddell and Glees, 1941). The method of staining nerve fibres throughout large whole preparations of skin by local injection of methylene blue (Weddell, 1941) has been applied 206","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.BMB.A070230","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61382061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：