THE OLFACTORY-PAROTID REFLEX: STUDY OF ONE HUNDRED AND FIFTY PATIENTS WITH DISORDERS OF THE CENTRAL NERVOUS SYSTEM; A PRELIMINARY REPORTELSBERG, C. A.;SPOTNITZ, H.;STRONGIN, E. I.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050009001
Abstract In the course of our investigations on the sense of smell, the possibility of obtaining an objective method of measuring olfactory function was carefully considered. With that object in view, the effects of odorous substances on the secretory rate of the parotid glands were investigated, and the results obtained in normal subjects were described in a recently published paper.1 Furthermore, we made studies of the resting activity of the parotid glands and of the effects of an odorous substance, citral, on the volume of secretion of each gland in persons with disorders of the central nervous system. A preliminary report of these investigations is herewith given. The rate of secretion of the parotid glands in normal persons has been studied and described by Winsor,2 Strongin and Korchin. They showed that the rate of secretion is fairly regular and that the average resting rate in normal persons (uninfluenced by References 1. Elsberg, C. A.; Spotnitz, H., and Strongin, E. I.: The Effect of Stimulation by Odorous Substances upon the Amount of Secretion of the Parotid Glands , J. Exper. Psychol. 27:59, 1940.Crossref 2. Winsor, A. L.: Conditions Affecting Human Parotid Secretion , J. Exper. Psychol. 11:355, 1928.Crossref 3. Elsberg, C. A., and Brewer, E. D.: The Sense of Smell: X. A Detailed Description of the Technique of Two Olfactory Tests Used for the Localization of Supratentorial Tumors of the Brain , Bull. Neurol. Inst. New York 4:501, 1935. 4. The resting rate is the average volume of parotid secretion with the subject at rest and without stimulation of the nasal passages. 5. Snarski A. T.: Analiz normalnikh usloviy raboti slyunikh zhelyoz u sobaki [Analysis of the Normal Conditions for Salivary Activity in Dogs], Thesis, St. Petersburg, 1901. 6. Lashley, K. S.: Reflex Secretion of the Human Parotid Gland , J. Exper. Psychol. 1:461, 1916.Crossref 7. Babkin, B. P.: Die äussere Sekretion der Verdauungsdrüsen , in Gildemeister, M.; Goldschmidt, R.; Neuberg, C.; Parnas, J., and Ruhland, W.: Monographien aus der Gesamtgebiet der Physiologie der Pflanzen und der Tiere , Berlin, Julius Springer, 1928. 8. Müller, L. R.: Lebensnerven und Lebenstriebe , ed. 3, Berlin, Julius Springer, 1931. 9. Pavlov, I. P.: Lectures on Conditioned Reflexes , translated from the Russian by W. H. Gantt, New York, International Publishers Co., Inc., 1928. 10. von Bechterew, W.: Die Funktionen der Nerven Centra , Jena, Gustav Fischer, 1911, vol. 3. 11. Hare, K., and Geohegan, W. A.: The Influence of Frequency of Hypothalamic Stimulation upon the Response , Am. J. Physiol. 126:524, 1939. 12. Bronk, D. W.; Pitts, R. F., and Larabee, M.G.: Rôle of Hypothalamus in Cardiovascular Regulation , A. Research Nerv. & Ment. Dis., Proc. (1939) 20:323, 1940.
ELECTROENCEPHALOGRAPHIC STUDIES ON NEUROSYPHILISFINLEY, KNOX H.;ROSE, AUGUSTUS S.;SOLOMON, HARRY C.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050020002
Abstract Electroencephalographic study of the human brain has not yet advanced beyond the descriptive stage. Records are described as normal or abnormal depending on their occurrence in normal control subjects or in patients with known pathologic conditions of the central nervous system. The ultimate goal of investigators in this field is to correlate the electroencephalographic patterns with neurophysiologic processes. Progress will come largely through animal experimentation and careful study of the electroencephalographic patterns associated with disorders of the central nervous system in which the location and type of lesions are known. It was with this problem in mind that the present study on neurosyphilis was begun. Furthermore, it is of practical interest to determine whether the electroencephalogram can be of any aid in the diagnosis of neurosyphilis, in the determination of the type of involvement or in the prognosis before or during the course of therapy. MATERIAL This report is a References 1. Gibbs, F. A., and Gibbs, E. L.: Atlas on Electroencephalography , Cambridge, Mass., Lew A. Cummings Co., 1941. 2. Finley, K. H., and Campbell, C. M.: Electroencephalography in Schizophrenia , Am. J. Psychiat. 98:374-381, 1941. 3. Berger, H.: Ueber das Elektrenkephalogram des Menschen: III , Arch. f. Psychiat. 94:16-60, 1931Crossref 4. VI , Berger Arch. f. Psychiat. 99:555, 1933.Crossref 5. Adrian, E. D.; Bishop, G. H.; Davis, H.; Hoagland, H., and Jasper, H. H.: Excitation Phenomena, in Cold Spring Harbor Symposia on Quantitative Biology , Cold Spring Harbor, L. I., New York, The Biological Laboratory, 1936, vol. 4. 6. Dusser de Barenne, J. G., and McCulloch, W. S.: The Direct Functional Interrelation of Sensory Cortex and Optic Thalamus , J. Neurophysiol. 1:176, 1938. 7. Personal communication to the authors. 8. Lindsley, D. B., and Cutts, K. K.: Clinical and Electroencephalographic Changes in Child During Recovery from Encephalitis , Arch. Neurol. & Psychiat. 45:156-161 ( (Jan.) ) 1941. 9. Gibbs, F. A.: Cortical Frequency Spectra of Schizophrenic, Epileptic and Normal Individuals , Tr. Am. Neurol. A. 65:141, 1939. 10. Finley and Campbell.2 11. Davis, P. A.: The Electroencephalograms of Manic-Depressive Patients , Am. J. Psychiat. 98:430-433, 1941. 12. Finley and Campbell.2
MIXED TUMORS OF THE SPINAL CANALFRENCH, LYLE A.;PEYTON, WILLIAM T.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050039003
Abstract It is possible to differentiate mixed tumors from other lesions of the spinal canal by the typical clinical history and the characteristic roentgenologic evidence. It is by the early recognition and treatment of these tumors that good results by surgical removal are obtained. Mixed tumors of the spinal canal are uncommon. In 1883 Chiari1 reported the first case of an epidermoid tumor. In 1931 Hosoi2 collected 10 cases of teratoid tumors occurring since 1883. Gross in 19343 collected 19 cases of dermoid and epidermoid tumors from the literature, to which he added 1 case. In 1938 Bradford4 brought the literature up to date by collecting 9 cases of dermoid or epidermoid cysts of the spinal canal reported since 1934. Mixed tumors are now accepted as arising from embryonic rests.5 At the stage of embryonic development at which the neurectoderm is separated from the medullary plate, References 1. Chiari, H.: Centrales Cholesteatoma des Dorsalmarkes mit vollkommen entwickelter auf- und absteigender Degeneration , Prag. med. Wchnschr. 8:378, 1883. 2. Hosoi, K.: Intradural Teratoid Tumors of the Spinal Cord , Arch. Path. 11:875 ( (June) ) 1931. 3. Gross, S. W.: Concerning Intraspinal Dermoids and Epidermoids , J. Nerv. & Ment. Dis. 80:274, 1934. 4. Bradford, F. K.: Intramedullary Dermoid Cyst , Ann. Surg. 107:107, 1938. 5. Ewing, J.: Neoplastic Diseases , ed. 2, Philadelphia, W. B. Saunders Company, 1919, p. 931. 6. Bostroem, E.: Ueber die pialen Dermoid, Epidermoid und Lipom und duralen Dermoide , Centralbl. f. allg. Path. u. path. Anat. 8:1, 1897. 7. Torak, J., cited by Salotti, A.: Dermoide del midollo spinale , Arch. ital. di chir. 19:135, 1927. 8. Baker, A. B.: An Outline of Neuropathology , Minneapolis, University of Minnesota Press, 1940, p. 23. 9. Walker, A. A., and Moore, C. H.: Tumors of the Spinal Cord in Children , Am. J. Dis. Child. 57:900 ( (April) ) 1939. 10. Bellis, C. J.: An Improved Apparatus for Tidal Drainage of the Urinary Bladder and Empyema Cavities , Surgery 8:791, 1940. 11. Naffziger, H. C., and Jones, O. W., Jr.: Dermoid Tumors in Spinal Cord , Arch. Neurol. & Psychiat. 33:941 ( (May) ) 1935. 12. Masson, C. B.: Dermoid of the Spinal Cord , Arch. Neurol. & Psychiat. 40:554 ( (Sept.) ) 1938. 13. Walker and Moore.8 14. Stookey, B.: Intradural Spinal Lipomas , Arch. Neurol. & Psychiat. 18:16 ( (July) ) 1927. 15. Elsberg, C. D., and Dyke, G. G.: The Diagnosis and Localization of Tumors of the Spinal Cord by Means of Measurements Made on the X-Ray Films of the Vertebrae and the Correlation of Clinical and X-Ray Findings , Bull. Neurol. Inst. New York 3:359, 1933. 16. Footnote deleted by the authors. 17. Camp, J. D.: Roentgenologic Contributions to the Localization of Tumors Affecting the Spinal Cord , Wisconsin M. J. 36:621, 1937.
THE BRAIN IN SICKLE CELL ANEMIAWERTHAM, FREDERIC;MITCHELL, NATHAN;ANGRIST, ALFRED
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050054004
Abstract The central nervous system has not been examined with specific neuropathologic methods in any series of cases of sickle cell anemia. The present study is based on such a series of 5 unselected cases. Diagnostically questionable cases were ruled out. In all 5 cases lesions were present in the central nervous system. The neuropathologic changes showed a great similarity in all cases, indicating a characteristic neuropathologic picture of sickle cell anemia. REPORT OF CASES Case 1. —A Negress aged 28 had a history of migratory polyarthritis for five years. The patient was described as mentally peculiar, with a history of possible psychotic episodes and two suicidal attempts. She had once been to a medical clinic complaining of frequent "bleeding from below." Five days before admission an infection of the upper respiratory tract, with cough, chills and fever, developed. On the day of admission she was semistuporous and disoriented and complained References 1. Sherman, I. J.: The Sickling Phenomenon, with Special Reference to the Differentiation of Sickle Cell Anemia from the Sickle Cell Trait , Bull. Johns Hopkins Hosp. 67:309 ( (Nov.) ) 1940. 2. Wertham, Frederic, and Wertham, Florence: The Brain as an Organ , New York, The Macmillan Company, 1934, plate 77. 3. Wertham, F.: The Cerebral Lesions in Purulent Meningitis [fig. 12] , Arch. Neurol. & Psychiat. 26:549 ( (Sept.) ) 1931. 4. Wertham, F.: The Nonspecificity of the Histologic Lesions of Dementia Paralytica , Arch. Neurol. & Psychiat. 28:1117 ( (Nov.) ) 1932. 5. Wade, L. J., and Stevenson, L. B.: Necrosis of the Bone Marrow with Fat Embolism in Sickle Cell Anemia , Am. J. Path. 17:47 ( (Jan.) ) 1941. 6. Vance, cited by Wade and Stevenson.5 7. Wollstein, M., and Kreidel, K. V.: Sickle Cell Anemia , Am. J. Dis. Child. 36:998 ( (Nov.) ) 1928. 8. Brittingham, J. W., and Phinizy, T.: Hemorrhagic Encephalitis After Neoarsphenamine , J. A. M. A. 96:2021 ( (June 13) ) 1931. 9. Hughes, J. G.; Diggs, L. W., and Gillespie, C. E.: The Involvement of the Nervous System in Sickle Cell Anemia , J. Pediat. 17:166 ( (Aug.) ) 1940.
DIVERTICULA OF THE LATERAL VENTRICLES EXTENDING INTO THE CEREBELLAR FOSSACHILDE, A. E.;McNAUGHTON, F. L.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050070005
Abstract Migration of the lateral ventricles from their normal position is a common occurrence and may be extreme. An expanding lesion almost invariably displaces the ventricular system away from it, while in many cases an atrophic lesion draws the ventricular system toward it. When the ventricles are enormously dilated, as in internal hydrocephalus, the brain and adjacent portions of the lateral ventricles may migrate through a defect in the skull. Protrusions from the lateral ventricle into the cerebellar fossa through the incisura tentorii are undoubtedly of rare occurrence. We are therefore reporting in detail a case of this kind, with the clinical and postmortem observations. The probable manner of formation of these "protrusions" and their ventriculographic interpretation will also be discussed. REPORT OF A CASE S. G., a girl aged 7½ years, was admitted to the Montreal Neurological Institute on Oct. 24, 1939. There was a history of whooping cough at References 1. Childe, A. E., and Penfield, W.: Anatomic and Pneumographic Studies of the Temporal Horn , Arch. Neurol. & Psychiat. 37:1021-1034 ( (May) ) 1937. 2. Penfield, W. G.: Diencephalic Autonomic Epilepsy , Arch. Neurol. & Psychiat. 22:358-374 ( (Aug.) ) 1929. 3. Peterson, H. O.: Personal communication to the authors. 4. Sweet, W. H.: Spontaneous Cerebral Ventriculostium , Arch. Neurol. & Psychiat. 44:532-540 ( (Sept.) ) 1940. 5. Reid, W. L., and Cone, W. V.: Mechanism of Fixed Dilatation of Pupil Resulting from Ipsilateral Cerebral Compression , J. A. M. A. 112-2030-2034 ( (May 20) ) 1939. 6. Verga, A.: Su'l ventricolo della vôlta a tre pilastri , Gazz. med. ital. lomb. 2:225 and 364, 1851. 7. Dandy, W. E.: Congenital Cerebral Cysts of the Cavum Septi Pellucidi and Cavum Vergae: Diagnosis and Treatment , Arch. Neurol. & Psychiat. 25:44-66 ( (Jan.) ) 1931. 8. Pendergrass, E. P., and Hodes, P. J.: Dilatations of Cavum Septi Pellucidi and Cavum Vergae , Ann. Surg. 101: 269-295 ( (Jan.) ) 1935.
LEUKOCYTOSIS DURING VARIOUS EMOTIONAL STATESMILHORAT, A. T.;SMALL, S. M.;DIETHELM, O.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050081006
Abstract Leukocytosis has been noted frequently in patients with affective disorders when no infectious process or structural changes could be found to account for it. Although this phenomenon has been reported by numerous observers and various hypotheses, such as dehydration, foci of infection and acidosis, have been suggested as causes, no adequate studies of these factors have heretofore been carried out. An important question that has not been adequately stressed is whether the leukocytosis is related to a specific disease entity or whether the increase in white cells is secondary to the emotion exhibited by the patient regardless of the type of mental disease. If the latter is true, it is especially desirable to note any correlation between the level of the white blood cell count and the intensity of the emotional response. In a given situation, well adjusted persons frequently exhibit emotional states, such as anxiety and fear, which differ References 1. Bowman, K. M., and Raymond, A. F.: Physical Findings in Schizophrenia , Am. J. Psychiat. 8:901, 1929. 2. Fleming, G. W. T. H.: Some Aspects of Leucocytosis Associated with Mental Disorder , J. Ment. Sc. 78:129, 1932. 3. Kasanin, J.: Leucocytosis in Mental Disease , New England J. Med. 210: 641, 1934.Crossref 4. Wittkower, E.: Ueber affektive-somatische Veränderungen; die Affektleukocytose , Klin. Wchnschr. 8:1082, 1929.Crossref 5. Dobreff, M., and Tomoff, W.: Durch Angst hervorgerufene somatische Veränderungen , Ztschr. f. d. ges. exper. Med. 84:695, 1932.Crossref 6. Mora, J. M.; Amtman, L. E., and Hoffman, S. J.: Effects of Mental and Emotional States on the Leukocyte Count , J. A. M. A. 86:945 ( (March 27) ) 1926.Crossref 7. Bryan, W. R., and Garrey, W. E.: Mechanical Device that Produces Uniform Dispersion of Blood Cells in Diluting Pipet , J. A. M. A. 103:1059 ( (Oct. 6) ) 1934.Crossref 8. Ponder, E.; Saslow, G., and Schweizer, M.: On Variations in the White Cell Count of Man , Quart. J. Exper. Physiol. 21:21, 1932. 9. Sabin, F. R.; Cunningham, R. S.; Doan, C. A., and Kindwall, J. A.: The Normal Rhythm of the White Blood Cells , Bull. Johns Hopkins Hosp. 37:14, 1925. 10. Rourke, M. D., and Ernstene, A. C.: A Method for Correcting the Erythrocyte Sedimentation Rate for Variations in the Cell Volume Percentage of Blood , J. Clin. Investigation 8:545, 1930.Crossref 11. McLeod, J. P. U., and Highsmith, J. D.: Effect of Fear on Diagnosis , M. Rec. 153:9, 1941. 12. Searles, P. W.: Effect of Certain Anesthetics on Blood , J. A. M. A. 113: 906 ( (Sept. 2) ) 1939.Crossref 13. Ebert, R. V., and Stead, E. A., Jr.: Demonstration That in Normal Man No Reserves of Blood Are Mobilized by Exercise, Epinephrine, and Hemorrhage . Am. J. M. Sc. 201:655, 1941.Crossref
INTRACRANIAL BLOOD FLOW IN DEMENTIA PARALYTICA, CEREBRAL ATROPHY AND SCHIZOPHRENIAROSENBAUM, MILTON;ROSEMAN, EPHRAIM;ARING, CHARLES D.;FERRIS, EUGENE B.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050095007
Abstract Recently an objective method for measuring a function of total intracranial blood flow has been developed,1 which seems suitable for comparing the blood flow of groups of subjects. The following report is a comparative study of the total intracranial blood flow, as determined by this method, of patients suffering from dementia paralytica, from nonsyphilitic cortical atrophy and from schizophrenia. A group of 18 patients in the hospital who exhibited no clinical evidence of abnormal circulation in the brain or elsewhere served as controls. METHOD The method has been described in detail.1 The relative intracranial blood flow was estimated by measuring the rate of cerebrospinal fluid displacement through a large lumbar puncture needle during sudden temporary compression of the veins of the neck. The studies were carried out with the cerebrospinal fluid pressure adjusted to 200 mm. of fluid. The veins were compressed by inflation of a freely distensible References 1. Ferris, E. B., Jr.: Objective Measurement of Relative Intracranial Blood Flow in Man, with Observations Concerning the Hydrodynamics of the Craniovertebral System , Arch. Neurol. & Psychiat. 46:377 ( (Sept.) ) 1941. 2. The values for the intracranial blood flow as used throughout this paper represent the cerebrospinal fluid displacement rate, which is not the actual total intracranial blood flow, but only a reasonably constant function of it. 3. Merritt, H. H.; Putnam, T. J., and Campbell, A. C. P.: Pathogenesis of the Cortical Atrophy Observed in Dementia Paralytica , Arch. Neurol. & Psychiat. 37:75 ( (Jan.) ) 1937. 4. McFarland, R. A., and Goldstein, H.: Review of the Biochemistry of Dementia Praecox , Am. J. Psychiat. 95:509 ( (Nov.) ) 1938.
FACTOR OF HYPOXIA IN THE SHOCK THERAPIES OF SCHIZOPHRENIAHIMWICH, HAROLD E.;FAZEKAS, JOSEPH F.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050102008
Abstract Observations1 on the physiologic changes occurring during the insulin treatment of schizophrenia have disclosed a diminished cerebral metabolism. Less oxygen is removed from each hundred cubic centimeters of blood passing through the brain, and the blood flow is somewhat diminished.2 In other studies made on patients receiving the metrazol treatment decreased oxygen saturation of arterial hemoglobin during the treatment was noted.3 This procedure, therefore, also causes decreased brain metabolism due not to an absence of sugar but to the lack of oxygen necessary to combine with dextrose. As a result of these observations another method was devised which also decreases cerebral metabolism.4 The patients are subjected to short periods of nitrogen inhalation. Under these conditions, too, a fall in the saturation of arterial hemoglobin is observed.5 Since the aforementioned studies have been published, the severity of the metrazol convulsions has been ameliorated by the use References 1. Himwich, H. E.; Bowman, K. M.; Wortis, J., and Fazekas, J. F.: Biochemical Changes Occurring in the Cerebral Blood During the Insulin Treatment of Schizophrenia , J. Nerv. & Ment. Dis. 89:273-293, 1939. 2. Himwich, H. E.; Bowman, K. M.; Daly, C.; Fazekas, J. F.; Wortis, J., and Goldfarb, W.: Cerebral Blood Flow and Brain Metabolism During Insulin Hypoglycemia , Am. J. Physiol. 132:640-647, 1941. 3. Himwich, H. E.; Bowman, K. M.; Fazekas, J. F., and Orenstein, L. L.: Effect of Metrazol Convulsions on Brain Metabolism , Proc. Soc. Exper. Biol. & Med. 37:359-361, 1937. 4. Himwich, H. E.; Bowman, K. M.; Wortis, J., and Fazekas, J. F.: Metabolism of the Brain During Insulin and Metrazol Treatments of Schizophrenia , J. A. M. A. 112:1572-1573 ( (April 22) ) 1939. 5. Alexander, F. A. D., and Himwich, H. E.: Nitrogen Inhalation Therapy for Schizophrenia , Am. J. Psychiat. 96:643-655, 1939. 6. Himwich, H. E.; Alexander, F. A. D., and Lipetz, M.: Effect of Acute Anoxia by Breathing Nitrogen on the Course of Schizophrenia , Proc. Soc. Exper. Biol. & Med. 39:367-369, 1938. 7. Lipetz, B.: Preliminary Report on the Results of the Treatment of Schizophrenia by Nitrogen Inhalation , Psychiatric Quart. 14:496-503, 1940. 8. Rosen, S. R.; Cameron, D. E., and Ziegler, J. B.: The Prevention of Metrazol Fractures by Beta-Erythroidin Hydrochloride , Psychiatric Quart. 14: 477, 1940. 9. Bennett, A. E.: Preventing Traumatic Complications in Convulsive Shock Therapy by Curare , J. A. M. A. 114:322-324 ( (Jan. 27) ) 1940. 10. Cerletti, U., and Bini, L.: L'elettroshock , Arch. gen. di neurol., psichiat. e psicoanal. 19:266, 1938. 11. Van Slyke, D. D., and Neill, J. M.: The Determination of Gases in Blood and Other Solutions by Vacuum Extraction and Manometric Measurement: I. , J. Biol. Chem. 61:523-573, 1924. 12. Kalinowsky, L., and Horwitz, W. A.: The "Petit Mal" Response in Electrical Shock Therapy: Its Theoretical and Therapeutic Significance, read at the ninety-seventh annual meeting of the American Psychiatric Association, Richmond, Va., May 5-9, 1941. 13. Loevenhart, A. S.; Lorenz, W. F.; Martin, H. G., and Malone, J. Y.: Stimulation of the Respiration by Sodium Cyanide and Its Clinical Application , Arch. Int. Med. 21:109-129 ( (Jan.) ) 1918. 14. Loevenhart, A. S.; Lorenz, W. F., and Waters, R. M.: Cerebral Stimulation , J. A. M. A. 92:880-883 ( (March 16) ) 1929. 15. Fazekas, J. F.; Colyer, H., and Himwich, H. E.: Effect of Cyanide on Cerebral Metabolism , Proc. Soc. Exper. Biol. & Med. 42:496-498, 1939. 16. Fabing, H. D.: Induction of Metrazol Convulsions with the Patient Under Nitrous Oxide Anesthesia , Arch. Neurol. & Psychiat. 47:223-233 ( (Feb.) ) 1942. 17. Himwich, H. E.; Martin, S. J.; Alexander, F. A. D., and Fazekas, J. F.: Electrocardiographic Changes During Hypoglycemia and Anoxemia , Endocrinology 24:536-541, 1939. 18. Yaskin, H. E.: Prevention of Traumatic Complications in Convulsive Shock Therapy by Magnesium Sulfate , Arch. Neurol. & Psychiat. 46:81-85 ( (July) ) 1941. 19. Gerard, R. W.: Anoxia and Neural Metabolism , Arch. Neurol. & Psychiat. 40:985-996 ( (Nov.) ) 1938. 20. Himwich, H. E.; Hadidian, Z.; Fazekas, J. F., and Hoagland, H.: Cerebral Metabolism and Electrical Activity During Insulin Hypoglycemia in Man , Am. J. Physiol. 125:578-585, 1939. 21. Loman, J.: Sugar and Oxygen Metabolism of the Brain During and After Insulin Hypoglycemia , Arch. Neurol. & Psychiat. 45:282-288 ( (Feb.) ) 1941. 22. Wortis, J.; Bowman, K. M., and Goldfarb, W.: Human Brain Metabolism, Normal Values and Values in Certain Clinical States , Am. J. Psychiat. 97:552-565, 1940. 23. Hoskins, R. G., and Sleeper, F. H.: The Thyroid Factor in Dementia Praecox , Am. J. Psychiat. 10:411-432, 1930. 24. Tietz, E. B.: Personal communication to the authors. 25. Gildea, E. F.; Himwich, H. E.; Hubbard, O. E., and Fazekas, J. F.: A Comparative Study of Some of the Changes Produced by Various Types of Drugs in Schizophrenic Patients , Am. J. Psychiat. 91:1289-1309, 1935. 26. Hoskins, R. G., and Jellinek, E. M.: The Schizophrenic Personality with Special Regard to Psychologic and Organic Concomitants , A. Research Nerv. & Ment. Dis., Proc. 14:211-233, 1933. 27. Gellhorn, E.: Effects of Hypoglycemia and Anoxia on the Central Nervous System , Arch. Neurol. & Psychiat. 40:125-146 ( (July) ) 1938. 28. Dynes, J. B., and Tod, H.: The Emotional and Somatic Response of Schizophrenic Patients and Normal Controls to Adrenalin and Doryl , J. Neurol. & Psychiat. 3:1-8, 1940. 29. Myerson, A.: The Effects of the Sympatheticomimetic Drug Benzedrine on the Viscera and the Mood of Man , Psychol. Bull. 33:746, 1936. 30. Cameron, D. E.: Objective and Experimental Psychiatry , ed. 2, New York, The Macmillan Company, 1941, pp. 271-272. 31. Dynes and Tod.23 32. Cameron.24b 33. Myerson, A.: Human Autonomic Pharmacology: XII. Theories and Results of Autonomic Drug Administration , J. A. M. A. 110:101-103 ( (Jan. 8) ) 1938. 34. Jackson, J. H.: The Croonian Lectures on Evolution and Dissolution of the Nervous System , Brit. M. J. 1:591, 660 and 703, 1884. 35. Tannenberg, J.: Advantages and Danger of Combined Anoxic and Insulin Shock , Arch. Neurol. & Psychiat. 44:811-828 ( (Oct.) ) 1940.
PARAPYRAMIDAL FASCICULOTOMY IN THE BRAIN STEMSIRIS, JOSEPH H.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050110009
Abstract The surgical interruption of the parapyramidal pathways at the cervical level in cases of adventitious movement due to disease of the basal ganglia has not been uniformly successful, partly, it is thought, because the level of section has not been sufficiently high to interrupt the more cephalic neuromuscular innervations. To test this hypothesis it, was decided to make an effort to secure interruption of the parapyramidal complex at a point in the brain stem where it might be reasonably superficial. It was felt that section of the rubrospinal tract cephalad to the pyramidal decussation would offer less chance of coincident injury to the corticospinal pathway. The actual course of the various parapyramidal pathways in the human brain stem is as yet imperfectly understood. Opinion, however, tends to favor the reticular formation in the medulla as including the rubrospinal, tectospinal and vestibulospinal bundles. The first of these occupies a position between References 1. Sjöqvist, O.: The Conduction of Pain in the Fifth Nerve and Its Bearing on the Treatment of Trigeminal Neuralgia , Yale J. Biol. & Med. 2:593-600 ( (July) ) 1939. 2. Schwartz, H. G., and O'Leary, J. L.: Section of the Spinothalamic Tract in the Medulla with Observations on the Pathway for Pain , Surgery 9:183-193 ( (Feb.) ) 1941. 3. White, J. C.: Spinothalamic Tractotomy in the Medulla Oblongata: An Operation in the Relief of Intractable Neuralgias of the Occiput, Neck and Shoulder , Arch. Surg. 43:113-127 ( (July) ) 1941. 4. Putnam, T. J.: Results of Treatment of Athetosis by Section of the Extrapyramidal Tracts in the Spinal Cord , Arch. Neurol. & Psychiat. 39:258-275 ( (Feb.) ) 1938. 5. Walker, A. E.: The Spinothalamic Tract in Man , Arch. Neurol. & Psychiat. 43:284-298 ( (Feb.) ) 1940.
STUDIES OF THE SENSATION OF VIBRATION: II. VIBRATION SENSIBILITY IN THE FACE FOLLOWING RETROGASSERIAN NEURECTOMYBROWN, MEYER;YACORZYNSKI, G. K.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050115010
Abstract At present there are four different theories as to the mechanism by which vibratory stimuli are perceived. Early clinical studies made with the vibrating tuning fork as the source of stimulation convinced many investigators that vibration sensibility was nothing more than the perception of repetitive mechanical stimuli delivered to the so-called deep receptors. Among these are included the pressure receptors of the skin and subcutaneous tissues, which are stimulated by mechanical forces that deform the surface of the skin, as well as those sense organs which respond to mechanical stimulation and lie in the fascia, muscles, tendons, joint capsules and periosteum of bones. Later, under the stimulus of work by von Frey,1 the opinion arose that vibration was perceived by means of repetitive mechanical stimulation to the tactile receptors located in the skin and not by any other sense organs. Von Frey expressed the belief that the bone to References 1. von Frey, M.: Die Vergleichung von Gewichten mit Hilfe des Kraftsinns , Ztschr. f. Biol. 65:203, 1915. 2. Katz, D.: The Vibratory Sense and Other Lectures , Bulletin 32, no. 10, Orono, Maine, University of Maine, 1930. 3. Allen, F., and Hollenberg, A.: On the Tactile Sensory Reflex , Quart. J. Exper. Physiol. 14:351, 1924. 4. Pollock, L. J.: Vibration Sense , Arch. Neurol. & Psychiat. 37:1383 ( (June) ) 1937. 5. Yacorzynski, G. K., and Brown, M.: Studies of the Sensation of Vibration: I. Variability of the Vibratory Threshold as a Function of Amplitude and Frequency of Mechanical Vibration , J. Exper. Psychol. 28:509, 1941.
ELECTROENCEPHALOGRAMS OF THIAMINE-DEFICIENT PIGEONSSWANK, ROY L.;JASPER, HERBERT H.
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050123011
Abstract In acutely thiamine-deficient pigeons marked impairment of function of the central nervous system develops, associated with a characteristic and progressive series of head and neck movements and degeneration of certain neurons (Swank1; Swank and Bessey2; Swank and Prados3). The first of these movements consists of rhythmic lateral rotation of the head alone or combined with extensor thrusts of the neck and has been designated preopisthotonos. This phase may last from a few to twenty-four hours and in progressive thiamine deficiency is followed by complete opisthotonos. If the deficiency is allowed to become more severe, and death does not intervene, opisthotonos is followed by slow relaxation; the pigeon can no longer elevate its head above the horizontal and is generally listless. This final stage, enopisthotonos, is followed by death within a few hours if thiamine is not administered. Histologic studies (Swank1; Swank and Prados3) have revealed References 1. Swank, R. L.: Avian Thiamin Deficiency: A Correlation of the Pathology and Clinical Behavior , J. Exper. Med. 71:683, 1940.Crossref 2. Swank, R. L., and Bessey, O. A.: Avian Thiamin Deficiency: III. Characteristic Symptoms and Their Pathogenesis , J. Nutrition 22:77, 1941. 3. Swank, R. L., and Prados, M.: Avian Thiamin Deficiency: II. Pathological Changes in the Brain and Cranial Nerves (Especially the Vestibular) and Their Relationship to the Clinical Behavior , Arch. Neurol. & Psychiat. 47:97 ( (Jan.) ) 1942. 4. Tokaji, E., and Gerard, R. W.: Avitaminosis B and Pigeon Brain Potentials , Proc. Soc. Exper. Biol. & Med. 41:653, 1939. 5. Attempts were made first to obtain the series of electroencephalograms from electrodes placed directly in contact with various areas of the brain. Histologic study showed that damage to cerebral tissue almost invariably resulted from such procedures. It was decided that the less efficient and less well localized records obtained without exposing the brain were probably more desirable than those entailing the complication of damage to cerebral tissue resulting from any attempt to keep electrodes directly in contact with the brain for repeated examination. Control studies with needle electrodes in the optic lobes or forebrain showed records similar in all essential respects to those taken from skin surface leads over burr holes in the skull. Simultaneous photographic and ink writer records compared favorably except for the high frequencies (about 200 per second) from the cerebellum, which did not show up in the ink writer records. Simultaneous records of the neck muscle potentials were taken throughout to control possible artefacts from this source. Artefacts due to eye movements were also ruled out by careful observation. 6. Sugar, O., and Gerard, R. W.: Anoxia and Brain Potentials , J. Neurophysiol. 1:558, 1938. 7. Jasper, H. H.; Swank, R. L., and Cipriani, A.: Local Cerebral Blood Flow, pH, and Electrical Activity During Hyperventilation, Anoxemia and Anemia, unpublished data.
PERIARTERITIS NODOSA: A CLINICOPATHOLOGIC REPORT, WITH SPECIAL REFERENCE TO THE CENTRAL NERVOUS SYSTEMMALAMUD, N.;FOSTER, D. BERNARD
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050130012
Abstract The manifestations produced by periarteritis nodosa in the muscles, skin, peripheral nerves and various internal organs have been described previously, but there is little information available on the involvement of the central nervous system. It is our purpose to report a case presenting multiple neurologic changes and to compare our observations with those in similar cases in the literature. REPORT OF A CASE G. A., a white married man aged 43, was admitted to the University Hospital on Sept. 3, 1939, with a history of progressive ease of fatigue, pain in the legs, evening edema of the ankles, blurring of vision, diplopia and nocturia of eight months' duration.On examination he appeared poorly nourished and chronically ill. The temperature was 99.6 F., the pulse rate 100, the respiratory rate 24 and the blood pressure 124 systolic and 80 diastolic. The right pupil was larger than the left, but both reacted References 1. Gruber, G. B.: Kasuistik und Kritik der Periarteriitis nodosa , Zentralbl. f. Herz- u. Gefässkr. 18:145, 1926. 2. Arkin, A.: A Clinical and Pathological Study of Periarteritis Nodosa , Am. J. Path. 6:401 ( (July) ) 1930. 3. Runge, W., and Melzer, R.: Ueber Periarteriitis nodosa mit starker Beteiligung des Zentralnervensystems , J. f. Psychol. u. Neurol. 40:298 ( (May) ) 1930. 4. Richardson, M.: Läsionen des Zentralnervensystems bei Periarteriitis nodosa , Ztschr. f. d. ges. Neurol. u. Psychiat. 115:626, 1928.Crossref 5. Urechia, C. I., and Elekes, N.: Les formes nerveuses de l'artérite noueuse de Kussmaul , Ann. de méd. 36:466 ( (Dec.) ) 1934. 6. Kernohan, J. W., and Woltman, H. W.: Periarteritis Nodosa: A Clinicopathologic Report with Special Reference to the Nervous System , Arch. Neurol. & Psychiat. 39:655 ( (April) ) 1938. 7. Gruber, G. B.: Zur Frage der Periarteriitis nodosa, mit besonderer Berücksichtigung der Gallenblasen- und Nieren-Beteiligung , Virchows Arch. f. path. Anat. 258:441, 1925. 8. Wohlwill, F.: Ueber die nur mikroskopisch erkennbare Forme der Periarteriitis nodosa , Virchows Arch. f. path. Anat. 246:377, 1923. 9. Baló, J.: Maladie de Kussmaul-Maier et sclérose diffuse , J. beige de neurol. et de psychiat. 40:160 ( (March) ) 1940. 10. Silbermann, J.: Zur Klinik und pathologischen Histologie der Periarteriitis nodosa , Monatschr. f. Psychiat. u. Neurol. 72:225 ( (June) ) 1929. 11. Harris, A. W.; Lynch, G. W., and O'Hare, J. P.: Periarteritis Nodosa , Arch. Int. Med. 63:1163 ( (June) ) 1939.
SOME PROBLEMS OF WARTIME NEUROLOGYPENFIELD, WILDER
1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050141013
Abstract The sound of marching feet across the Polish frontier in 1939 changed the world in which we lived, we who lived in the British empire. Exploding bombs in Pearl Harbor altered the outlook of the rest of the people in the world who use the English tongue. Although one may recognize that one's world has changed, it is not immediately evident to the individual what his own particular reorientation may be, where his own talents may be applied. Conscription and the training of troops who will march or sail away form only one aspect of war today. We, who have thought so little about war, are apt to have a rather hazy medieval conception that it signifies only a situation in which soldiers depart on a crusade which is carried through by an inevitably rising tide of patriotism. This point of view ignores the fact that today a civilian war
News and Comment1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050144014
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract A CALL TO QUALIFIED PSYCHIATRIC SOCIAL WORKERS BY THE AMERICAN RED CROSS The American Red Cross is responsible for social service in Navy and Army general and station hospitals, both here and abroad, and in psychiatric units in Navy and Marine Corps training stations. Psychiatric social workers are needed for the psychiatric services in these hospitals and units and may also be used as field directors in general hospitals and assistant field directors in station hospitals.This psychiatric service is largely concerned with diagnosis and military disposition. The psychiatric social worker, through Red Cross channels, provides the psychiatric social history and assists with the patient's readjustment after discharge through interpretative letters to the Red Cross chapter in his home community.Salaries range from $150 to $225 per month, depending on the qualifications of the worker and her responsibilities. For foreign assignments the salary is $225 plus $45 for flat maintenance,
Epilepsy and Cerebral Localization. A Study of the Mechanism, Treatment and Prevention of Epilepoic Seizures.1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050177018
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This book has its roots in an observation of Hippocrates on crossed convulsive movements, in the studies on stimulative epilepsy of Fritsch and Hitzig and in the keen clinical studies of Hughlings Jackson and Charles Sherrington. It is dedicated to the last two investigators. By studying the physiologic reactions of the brains of conscious patients exposed at operation, Penfield and his associates have answered questions which for centuries have been asked in vain. They have observed the appearance and the circulation of the brains of patients before and during convulsions; they have stimulated various areas of the cortex, recorded the responses and correlated these with the patient's spontaneous seizures. The reports teach a great deal about the anatomic significance of the constituent manifestations of seizures and about the physiology of the brain of epileptic, and perhaps of normal, persons. Equally valuable are the authors' painstaking histologic studies on brain injuries,
Science and Sanity: An Introduction to Non-Aristotelian Systems and General Semantics.1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050179019
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract No thoughtful scientist would quarrel with Korzybski's thesis that one must give up the outworn modes of expression in terms of either... or, in stultifying dichotomies such as "mental or physical," "functional or organic." These limited ways of thinking have done much harm to sciences, especially to psychiatry. Korzybski would have all learn to apply a multiordinal mechanism of evaluation. He says: "If we stop to reflect, however, it seems obvious that those who are trained in two-valued, macroscopic, 'objective,' aristotelian orientations only, are thoroughly unable to have modern, electrocolloidal, sub-microscopic, infinite-valued, process orientations in life, which can be acquired only by training in non-aristotelian methods." By this he means, it seems to me, that dualistic philosophies will not work in the twentieth century. Human bodies and what they do and experience cannot exist separately. Dividing objects into elements and analyzing them is no longer scientific in 1942, because it
Anoxia: Its Effect on the Body.1942 Archives of Neurology & Psychiatry
doi: 10.1001/archneurpsyc.1942.02290050180020
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This small volume constitutes a useful outline of the many aspects of anoxia as it affects various organs and activities of the body. The material is clearly presented, and the references are in general excellent. The chapter on the effect of anoxia on the nervous system, which is likely to be of particular interest to readers of this journal, is perhaps less authoritative than other chapters of the book. One has the impression that it was written from the literature, rather than from experience. It follows rather closely the compendiums of McFarland, Wolff and others but omits the important volume of the Association for Research in Nervous and Mental Disease on the circulation of the brain, and the recent work of the Gibbses, Lennox, Nims, Himwich and others on the utilization of oxygen by the brain under varying conditions. Carbon monoxide poisoning is presented as a condition due purely to