{"title":"THE NEUROTIC CONSTITUTION: A Statistical Study of Two Thousand Neurotic Soldiers.","authors":"E Slater","doi":"10.1136/jnnp.6.1-2.1","DOIUrl":"https://doi.org/10.1136/jnnp.6.1-2.1","url":null,"abstract":"","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.1-2.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109741","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":"SUGGESTIBILITY AND HYSTERIA.","authors":"H J Eysenck","doi":"10.1136/jnnp.6.1-2.22","DOIUrl":"https://doi.org/10.1136/jnnp.6.1-2.22","url":null,"abstract":"","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.1-2.22","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109743","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 ALTHOUGH the majority of patients who sustain a closed head injury appear to make a complete and satisfactory recovery, some are left with residual disabilities, which interfere with their well-being and their adjustment to society. It is known that in such cases permanent structural changes often occur in the brain, but clinically it is difficult to ascertain their severity and extent. There is no single method of investigation which affords this information. Such methods as neurological examination, radiological investigation of the skull, psychological tests, and electro-encephalography, each contribute something to the analysis, but each has its limitations. The following study was undertaken in order to evaluate air encephalography, not so much as a method of demonstrating the presence of posttraumatic space-occupying lesions, but of assessing the degree ofdamage which has occurred in the brain. That changes in the outline of the ventricles often follow closed head injury was clearly established in papers from Foerster's clinic at Breslau by Schwab (1926a and b) and by Bielschowsky (1928). Both authors employed encephalography with air introduced by the lumbar route and both described three groups of cases with abnormal encephalographic findings, viz. (a) cases in which the ventricles did not fill; (b) cases with enlargement and deformity of the ventricles; and (c) cases with abnormalities of distribution of the sub-arachnoid air over the cerebral convexities. In addition both studied the circulation of the cerebro-spinal fluid after head injury by injecting sodium iodide solution into the ventricles or lumbar theca, and subsequently ascertaining the time of its appearance in other parts of the cerebro-spinal fluid system or in the urine. On comparing their findings with standards obtained from control cases, both of them concluded that in the majority of cases with abnormal encephalograms there were disturbances of the cerebro-spinal fluid circulation, either in the form of obstruction to the cerebro-spinal fluid pathways or of delayed absorption of the fluid into the bood stream. Bielschowsky, whose paper was based on 106 cases of head injury, of both closed and open types, went further than Schwab and tried to correlate the clinical features of his cases with the encephalographic appearances. He showed that, while in many cases there was an obvious relationship between the two, in other cases this relationship was not apparent; and indeed the same encephalographic appearances as were seen in some cases with persistent symptoms and signs would also be seen in others without persistent symptoms or with only a history of post-traumatic epilepsy. Since then several other authors have confirmed that encephalographic changes often follow head injury, but without exception they have based their findings on smaller groups of cases and have not extended the scope of Bielschowsky's observations. Fischer (1927), after investigating a se
{"title":"VENTRICULAR CHANGES AFTER CLOSED HEAD INJURY.","authors":"H Davies, M A Falconer","doi":"10.1136/jnnp.6.1-2.52","DOIUrl":"https://doi.org/10.1136/jnnp.6.1-2.52","url":null,"abstract":"Introduction ALTHOUGH the majority of patients who sustain a closed head injury appear to make a complete and satisfactory recovery, some are left with residual disabilities, which interfere with their well-being and their adjustment to society. It is known that in such cases permanent structural changes often occur in the brain, but clinically it is difficult to ascertain their severity and extent. There is no single method of investigation which affords this information. Such methods as neurological examination, radiological investigation of the skull, psychological tests, and electro-encephalography, each contribute something to the analysis, but each has its limitations. The following study was undertaken in order to evaluate air encephalography, not so much as a method of demonstrating the presence of posttraumatic space-occupying lesions, but of assessing the degree ofdamage which has occurred in the brain. That changes in the outline of the ventricles often follow closed head injury was clearly established in papers from Foerster's clinic at Breslau by Schwab (1926a and b) and by Bielschowsky (1928). Both authors employed encephalography with air introduced by the lumbar route and both described three groups of cases with abnormal encephalographic findings, viz. (a) cases in which the ventricles did not fill; (b) cases with enlargement and deformity of the ventricles; and (c) cases with abnormalities of distribution of the sub-arachnoid air over the cerebral convexities. In addition both studied the circulation of the cerebro-spinal fluid after head injury by injecting sodium iodide solution into the ventricles or lumbar theca, and subsequently ascertaining the time of its appearance in other parts of the cerebro-spinal fluid system or in the urine. On comparing their findings with standards obtained from control cases, both of them concluded that in the majority of cases with abnormal encephalograms there were disturbances of the cerebro-spinal fluid circulation, either in the form of obstruction to the cerebro-spinal fluid pathways or of delayed absorption of the fluid into the bood stream. Bielschowsky, whose paper was based on 106 cases of head injury, of both closed and open types, went further than Schwab and tried to correlate the clinical features of his cases with the encephalographic appearances. He showed that, while in many cases there was an obvious relationship between the two, in other cases this relationship was not apparent; and indeed the same encephalographic appearances as were seen in some cases with persistent symptoms and signs would also be seen in others without persistent symptoms or with only a history of post-traumatic epilepsy. Since then several other authors have confirmed that encephalographic changes often follow head injury, but without exception they have based their findings on smaller groups of cases and have not extended the scope of Bielschowsky's observations. Fischer (1927), after investigating a se","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.1-2.52","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109747","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}
The anatomical features of hydrocephalus are fairly well known, and a growing knowledge of the pathology suggests that in most if not all cases the ventricular dilatation can be explained by obstruction to the circulation of the cerebro-spinal fluid. It is not always easy to identify the site or cause of the obstruction, but a common place is in the narrows of the midbrain where the aqueduct may be compressed by a benign proliferation of the subependymal glia or by a tumour of the brain stem, pineal gland or vermis cerebelli. As the prognosis and treatment differ considerably in these various conditions, we commonly look to ventriculography for help in diagnosis. For various reasons, the interpretation of air shadows in this region is not always easy, or indeed possible, and we feel that any additional information about the pathological possibilities should be of importance. This report deals chiefly with two cases of hydrocephalus in which the dilatation of the lateral ventricles was accompanied by rupture of the wall of the ventricle in the region of the vestibule, and the formation of a cyst-like space under the tentorium communicating with the lateral ventricle. The site of the rupture was identical in the two cases, and the ventriculographic appearances were similar. In both cases the hydrocephalus resulted from aqueduct obstruction, in one by proliferation of the subependymal glia and in the other by a fibrillary astrocytoma of the brain stem. We have also included the pathological report of a case of hydi ccephalus due to adhesive arachnoiditis in which an early stage in the development of this process was seen. Our interest in this abnormality began with an earlier case of stenosis of the aqueduct which had produced great dilatation of the third ventricle. The distended suprapineal recess protruded as a cyst-like swelling beneath the splenium, insinuating itself between the lower surfaces of the occipital lobes, and the upper surface of the cerebellum. Since then we have seen such dilatations in ventriculograms on a number of occasions and had come to regard the presence of a large suprapineal recess as evidence for an intrinsic lesion of the brain stem (benign stricture or tumour) as opposed to an extrinsic lesion such as a tumour of the superior vermis or of the pineal gland. The recess may be dilated in cases of obstruction in the distal part of the fourth ventricle too, but in these cases the aqueduct and fourth ventricle are generally dilated and it is fairly easy to demonstrate them in ventriculograms. In our first case, a large air-shadow beneath the tentorium was thought to be such a dilated suprapineal recess until it was shown at necropsy to be in communication with the lateral and not with the third ventricle.
{"title":"SPONTANEOUS VENTRICULAR RUPTURE IN HYDROCEPHALUS, WITH SUBTENTORIAL CYST FORMATION.","authors":"J Pennybacker, D S Russell","doi":"10.1136/jnnp.6.1-2.38","DOIUrl":"https://doi.org/10.1136/jnnp.6.1-2.38","url":null,"abstract":"The anatomical features of hydrocephalus are fairly well known, and a growing knowledge of the pathology suggests that in most if not all cases the ventricular dilatation can be explained by obstruction to the circulation of the cerebro-spinal fluid. It is not always easy to identify the site or cause of the obstruction, but a common place is in the narrows of the midbrain where the aqueduct may be compressed by a benign proliferation of the subependymal glia or by a tumour of the brain stem, pineal gland or vermis cerebelli. As the prognosis and treatment differ considerably in these various conditions, we commonly look to ventriculography for help in diagnosis. For various reasons, the interpretation of air shadows in this region is not always easy, or indeed possible, and we feel that any additional information about the pathological possibilities should be of importance. This report deals chiefly with two cases of hydrocephalus in which the dilatation of the lateral ventricles was accompanied by rupture of the wall of the ventricle in the region of the vestibule, and the formation of a cyst-like space under the tentorium communicating with the lateral ventricle. The site of the rupture was identical in the two cases, and the ventriculographic appearances were similar. In both cases the hydrocephalus resulted from aqueduct obstruction, in one by proliferation of the subependymal glia and in the other by a fibrillary astrocytoma of the brain stem. We have also included the pathological report of a case of hydi ccephalus due to adhesive arachnoiditis in which an early stage in the development of this process was seen. Our interest in this abnormality began with an earlier case of stenosis of the aqueduct which had produced great dilatation of the third ventricle. The distended suprapineal recess protruded as a cyst-like swelling beneath the splenium, insinuating itself between the lower surfaces of the occipital lobes, and the upper surface of the cerebellum. Since then we have seen such dilatations in ventriculograms on a number of occasions and had come to regard the presence of a large suprapineal recess as evidence for an intrinsic lesion of the brain stem (benign stricture or tumour) as opposed to an extrinsic lesion such as a tumour of the superior vermis or of the pineal gland. The recess may be dilated in cases of obstruction in the distal part of the fourth ventricle too, but in these cases the aqueduct and fourth ventricle are generally dilated and it is fairly easy to demonstrate them in ventriculograms. In our first case, a large air-shadow beneath the tentorium was thought to be such a dilated suprapineal recess until it was shown at necropsy to be in communication with the lateral and not with the third ventricle.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.1-2.38","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109745","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 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 B Medawar","doi":"10.1136/jnnp.5.3-4.130","DOIUrl":"https://doi.org/10.1136/jnnp.5.3-4.130","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":"1942-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.5.3-4.130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109738","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}
THE clinical features of an extradural hTmatoma due to rupture of the middle meningeal artery are well known; the " classical" picture may, however, be frequently absent or overshadowed by the signs produced by single or multiple cerebral lesions by a second extradural or a subdural haematoma. Besides the meningeal arteries the great venous sinuses can produce intracranial heemorrhages. If a tear involves such a sinus and gives rise to an extradural hematoma overlying one of the more or less " silent" cortical areas, early diagnosis may be very difficult. To this latter group belongs the extradural haematoma of the posterior fossa; probably the rarest form of traumatic intracranial bleeding. The present paper contains a description of such a case, which was under the writer's care in spring, 1938. A girl, aged 24, was thrown off her bicycle by a blow from an opening door of a stationary car, which she was about to pass. She struck the back of her head heavily, fell, and lost consciousness for a few minutes. Later she vomited, but on admission to hospital shortly after the accident she only complained of severe headache. There were no external injuries and no neurological abnormality was detected. X-ray pictures showed a slight separation of the left half of the lambdoid suture. About 30 hours later an experienced ward-sister observed the patient in a series of typical " cerebellar fits." In these her head was well retracted and her extremities rigidly extended; she was cyanosed, her breathing was irregular and she rapidly became unconscious. The first attack lasted about 2 minutes, a second one occurring a few hours later, and a third prolonged and severe attack was observed on the morning of the third day. After the first attack the patient's condition, which had been satisfactory until then, changed for the worse. She became increasingly restless and finally comatose. A lumbar puncture was performed, but only a few drops of clear cerebro-spinal fluid were obtained, the flow then ceased abruptly. A second puncture, performed 2 hours later, yielded the same result. There was no nystagmus and the tendon reflexes were equal on both sides. The history of trauma, the separation of the left half of the lambdoid suture, the cerebellar fits, the cerebro-spinal fluid block, and the increasing coma all pointed to a htmorrhage in the posterior fossa, probably extradural. Owing to the patient's deterioration operation could no longer be delayed.
{"title":"CEREBELLAR EXTRADURAL HÆMATOMA.","authors":"F K Kessel","doi":"10.1136/jnnp.5.3-4.96","DOIUrl":"https://doi.org/10.1136/jnnp.5.3-4.96","url":null,"abstract":"THE clinical features of an extradural hTmatoma due to rupture of the middle meningeal artery are well known; the \" classical\" picture may, however, be frequently absent or overshadowed by the signs produced by single or multiple cerebral lesions by a second extradural or a subdural haematoma. Besides the meningeal arteries the great venous sinuses can produce intracranial heemorrhages. If a tear involves such a sinus and gives rise to an extradural hematoma overlying one of the more or less \" silent\" cortical areas, early diagnosis may be very difficult. To this latter group belongs the extradural haematoma of the posterior fossa; probably the rarest form of traumatic intracranial bleeding. The present paper contains a description of such a case, which was under the writer's care in spring, 1938. A girl, aged 24, was thrown off her bicycle by a blow from an opening door of a stationary car, which she was about to pass. She struck the back of her head heavily, fell, and lost consciousness for a few minutes. Later she vomited, but on admission to hospital shortly after the accident she only complained of severe headache. There were no external injuries and no neurological abnormality was detected. X-ray pictures showed a slight separation of the left half of the lambdoid suture. About 30 hours later an experienced ward-sister observed the patient in a series of typical \" cerebellar fits.\" In these her head was well retracted and her extremities rigidly extended; she was cyanosed, her breathing was irregular and she rapidly became unconscious. The first attack lasted about 2 minutes, a second one occurring a few hours later, and a third prolonged and severe attack was observed on the morning of the third day. After the first attack the patient's condition, which had been satisfactory until then, changed for the worse. She became increasingly restless and finally comatose. A lumbar puncture was performed, but only a few drops of clear cerebro-spinal fluid were obtained, the flow then ceased abruptly. A second puncture, performed 2 hours later, yielded the same result. There was no nystagmus and the tendon reflexes were equal on both sides. The history of trauma, the separation of the left half of the lambdoid suture, the cerebellar fits, the cerebro-spinal fluid block, and the increasing coma all pointed to a htmorrhage in the posterior fossa, probably extradural. Owing to the patient's deterioration operation could no longer be delayed.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1942-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.5.3-4.96","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109735","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}
MOST of our knowledge of the processes of sensory recovery after nerve lesions is derived from human cases. Indeed, in some ways man is most suitable for such work, because he can give verbal information about the quality of sensation which is felt. But there are many problems which can only be solved by the comparison of recovery under conditions which differ in respect of one variable only, say level of lesion. Human cases are rarely sufficiently comparable to allow this to be done. Complications are introduced by such factors as varying length of nerve that has been crushed, the time between injury and operation, skill of the surgeon, and so on. It is somewhat surprising, therefore, that there has been remarkably little detailed study of sensory recovery in animals. Vanlair (1882 and 1887) studied recovery of sensation on the sole of dogs after various operative procedures, and several workers have used sensory recovery among other signs for testing the suitability of surgical procedures (Takimoto 1917, Huber 1919, Gosset and Bertrand 1938, 'Tangari 1940, Muesch and Roessel 1941). Most of the observations on recovery of sensation following the interruption of a nerve in animals are restricted to a brief statement that recovery of sensation had taken place after a certain time. Such statements are both insufficient and unsatisfactory. It will be seen later that recovery of sensation in a denervated -area is a complex process and only a part of it is due to regeneration of the interrupted nerve. An exact description of the denervated area in which recovery is observed is thus necessary before any conclusions may be drawn. Therefore a clear knowledge of the sensory distribution of various nerves is an essential preliminary to the study of recovery of sensation in animals. In rabbits there is no satisfactory account of the areas innervated by the various peripheral nerves. No doubt the reason for this lack of investigation has been the fear that reflex responses of the animal would not be sufficiently consistent to enable accurate mapping of the sensory state of the skin. However, if properly handled, rabbits may serve as satisfactory " observers." The responses which may be most conveniently used in the rabbit are withdrawal reactions to pin prick stimuli. The work reported here may be said to have three objects: first, to delimit the maximal and autonomous areas of the skin served by various nerves of the lower extremities of the rabbit; secondly, to show the manner in which shrinkage of the insensitive area left after denervation takes place, and the parts played in this shrinkage by (a) recovery in the zone of overlap between the interrupted nerve and the neighbouring nerves; (b) recovery in the autonomous zone of the interrupted nerve; and thirdly, to show how recovery is affected by such factors as the nature of the lesion, its distance from the skin, age of the animal, and infection.
{"title":"FACTORS AFFECTING RECOVERY OF SENSORY FUNCTION AFTER NERVE LESIONS.","authors":"E Gutmann, L Guttmann","doi":"10.1136/jnnp.5.3-4.117","DOIUrl":"https://doi.org/10.1136/jnnp.5.3-4.117","url":null,"abstract":"MOST of our knowledge of the processes of sensory recovery after nerve lesions is derived from human cases. Indeed, in some ways man is most suitable for such work, because he can give verbal information about the quality of sensation which is felt. But there are many problems which can only be solved by the comparison of recovery under conditions which differ in respect of one variable only, say level of lesion. Human cases are rarely sufficiently comparable to allow this to be done. Complications are introduced by such factors as varying length of nerve that has been crushed, the time between injury and operation, skill of the surgeon, and so on. It is somewhat surprising, therefore, that there has been remarkably little detailed study of sensory recovery in animals. Vanlair (1882 and 1887) studied recovery of sensation on the sole of dogs after various operative procedures, and several workers have used sensory recovery among other signs for testing the suitability of surgical procedures (Takimoto 1917, Huber 1919, Gosset and Bertrand 1938, 'Tangari 1940, Muesch and Roessel 1941). Most of the observations on recovery of sensation following the interruption of a nerve in animals are restricted to a brief statement that recovery of sensation had taken place after a certain time. Such statements are both insufficient and unsatisfactory. It will be seen later that recovery of sensation in a denervated -area is a complex process and only a part of it is due to regeneration of the interrupted nerve. An exact description of the denervated area in which recovery is observed is thus necessary before any conclusions may be drawn. Therefore a clear knowledge of the sensory distribution of various nerves is an essential preliminary to the study of recovery of sensation in animals. In rabbits there is no satisfactory account of the areas innervated by the various peripheral nerves. No doubt the reason for this lack of investigation has been the fear that reflex responses of the animal would not be sufficiently consistent to enable accurate mapping of the sensory state of the skin. However, if properly handled, rabbits may serve as satisfactory \" observers.\" The responses which may be most conveniently used in the rabbit are withdrawal reactions to pin prick stimuli. The work reported here may be said to have three objects: first, to delimit the maximal and autonomous areas of the skin served by various nerves of the lower extremities of the rabbit; secondly, to show the manner in which shrinkage of the insensitive area left after denervation takes place, and the parts played in this shrinkage by (a) recovery in the zone of overlap between the interrupted nerve and the neighbouring nerves; (b) recovery in the autonomous zone of the interrupted nerve; and thirdly, to show how recovery is affected by such factors as the nature of the lesion, its distance from the skin, age of the animal, and infection.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1942-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.5.3-4.117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109737","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}
IN this paper we are concerned, not with the simple tumours-fibroma, lipoma, lymphangioma, lymphosarcoma, round-cell sarcoma-which occasionally (though rarely) arise in the thymus, as in other parts of the body, but with those which arise from the essential epithelioid cells of the thymic medulla associated in greater or lesser proportion with lymphocyte-like cells (probably really lymphocytes), such as constitute the normal thymic cortex. These primary thymic tumours-true " thymomata "may be termed " lympho-epitheliomata " (Grandhomme, 1900; Schmincke, 1921; Regaud, 1921), and are much less often malignant than are the primary lympho-epitheliomata of the tonsils, pharynx, and naso-pharynx (Cappell, 1934; Harvey, Dawson and Innes, 1937). For recent histological accounts of thymic lympho-epitheliomata, see Wu (1935) and Obiditsch (1937). The thymic lympho-epitheliomata seem in some cases to exert an endocrine effect, and are specially related to myasthenia gravis. Most important and interesting was the original observation by Weigert (1901) of a thymus tumour in a case of myasthenia gravis in which he wrongly interpreted the " lymphorrhages " in the muscles as tumourmetastases. To these questions we will return in the discussion further on, but for a summary of the literature of the subject we must refer to the recent papers by Gold (1935), Meister (1936), Norris (1936), Miller (1940), Blalock et al. (1941), and Poer (1942).
{"title":"LYMPHO-EPITHELIOMA OF THE THYMUS: NERVOUS AND OTHER CLINICAL SYMPTOMS IN THE ADULT.","authors":"F P Weber, K Blum","doi":"10.1136/jnnp.5.3-4.148","DOIUrl":"https://doi.org/10.1136/jnnp.5.3-4.148","url":null,"abstract":"IN this paper we are concerned, not with the simple tumours-fibroma, lipoma, lymphangioma, lymphosarcoma, round-cell sarcoma-which occasionally (though rarely) arise in the thymus, as in other parts of the body, but with those which arise from the essential epithelioid cells of the thymic medulla associated in greater or lesser proportion with lymphocyte-like cells (probably really lymphocytes), such as constitute the normal thymic cortex. These primary thymic tumours-true \" thymomata \"may be termed \" lympho-epitheliomata \" (Grandhomme, 1900; Schmincke, 1921; Regaud, 1921), and are much less often malignant than are the primary lympho-epitheliomata of the tonsils, pharynx, and naso-pharynx (Cappell, 1934; Harvey, Dawson and Innes, 1937). For recent histological accounts of thymic lympho-epitheliomata, see Wu (1935) and Obiditsch (1937). The thymic lympho-epitheliomata seem in some cases to exert an endocrine effect, and are specially related to myasthenia gravis. Most important and interesting was the original observation by Weigert (1901) of a thymus tumour in a case of myasthenia gravis in which he wrongly interpreted the \" lymphorrhages \" in the muscles as tumourmetastases. To these questions we will return in the discussion further on, but for a summary of the literature of the subject we must refer to the recent papers by Gold (1935), Meister (1936), Norris (1936), Miller (1940), Blalock et al. (1941), and Poer (1942).","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1942-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.5.3-4.148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109740","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":"FACTORS AFFECTING RECOVERY OF MOTOR FUNCTION AFTER NERVE LESIONS.","authors":"E Gutmann","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1942-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1089897/pdf/jnpsychiatry00005-0001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109734","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}
DURING the past two years at the Oxford Peripheral Nerve Injury Centre I have found that a great deal of information may be gained by the simple procedure of anxsthetizing peripheral nerves with procaine. The procedure is not original-it has been employed by J. C. White in the investigation of peripheral vascular disorders, and by Woollard in the investigation of sensory dissociation. I have employed nerve blocks in over fifty cases and have succeeded in establishing a satisfactory technique. In no case has there been evidence that the procedure is harmful. Nerve block has been used in the following investigations: 1. Anomalous innervation of muscles. 2. " Supplementary" and Trick movements. 3. Sensory and sudomotor distribution of peripheral nerves, in relation to the differentiation of complete and incomplete or recovering lesions. 4. The vasomotor distribution of peripheral nerves.
{"title":"PROCAINE NERVE BLOCK IN THE INVESTIGATION OF PERIPHERAL NERVE INJURIES.","authors":"W B Highet","doi":"10.1136/jnnp.5.3-4.101","DOIUrl":"https://doi.org/10.1136/jnnp.5.3-4.101","url":null,"abstract":"DURING the past two years at the Oxford Peripheral Nerve Injury Centre I have found that a great deal of information may be gained by the simple procedure of anxsthetizing peripheral nerves with procaine. The procedure is not original-it has been employed by J. C. White in the investigation of peripheral vascular disorders, and by Woollard in the investigation of sensory dissociation. I have employed nerve blocks in over fifty cases and have succeeded in establishing a satisfactory technique. In no case has there been evidence that the procedure is harmful. Nerve block has been used in the following investigations: 1. Anomalous innervation of muscles. 2. \" Supplementary\" and Trick movements. 3. Sensory and sudomotor distribution of peripheral nerves, in relation to the differentiation of complete and incomplete or recovering lesions. 4. The vasomotor distribution of peripheral nerves.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1942-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.5.3-4.101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109736","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}
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