Lectures on Clinical Psychiatry, by Dr. Emil Kraepelin

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated.1917 Excerpt: ... THE SERO-DIAGNOSIS OF GENERAL PARALYSIS During the last few years important investigations have been made in regard to the blood and cerebro-spinal fluid in general paralysis. The results obtained have been instrumental not only in confirming the syphilitic origin of general paralysis, but they have also afforded valuable methods for diagnosing the existence of the disease. The tests are especially useful in the earlier phases of the disease, when a correct diagnosis is sometimes a matter of considerable difficulty, since the clinical signs are anomalous and liable to be confused, not infrequently, with less serious disorders, such as neurasthenia. The existence of lymphocytosis in the cerebro-spinal fluid has long been recognised as an aid to diagnosis in general paralysis (" Lectures." p. 199). In addition to this, it has been found that in this disease there is a considerable increase in the proteid contents of the cerebro-spinal fluid. A minute amount of proteid is normally present in the cerebro-spinal fluid, but it is much increased in inflammatory conditions of the meninges and metasyphilitic affections, such as tabes and general paralysis, and can be recognised by much coarser tests. Thus, by Heller's test, as used in the examination of urine, a ring is formed which, by its density and thickness, can be recognised as deviating from the normal. There is a considerable difference of opinion as to the exact nature of the proteid present in the cerebro-spinal fluid of general paralysis, and the question cannot as yet be regarded as definitely settled. In all probability the proteid present in this disorder is a euglobulin, and is due to a process of leucolysis. These questions, however, are chiefly of theoretical interest, the more practical side being ...