Lectures of the diagnosis of diseases of the brain / by W. R. Gowers.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Lectures of the diagnosis of diseases of the brain / by W. R. Gowers. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    of disability whicli should natui-ally give rise to grave con- cern. The change never goes beyond this; but in this degree it is very common, and rarely fails to strike a medical observer as peculiar, although the friends regard it as merely the expression of an admirable resignation. The early symptoms of general paralysis vary much. They may be mental or physical. The mental change .that •is most characteristic is the familiar expansive delirium, as it is called, in which the patient revels in exaggerated personal delusions. Often, however, there is no more than a tendency to regard all things through rose-coloured spectacles, without any actually false idea. There may not even be this optimism; there may be merely mental weakness and failure of memory. The physical symptoms are as much spinal as cerebral. Tremor on movement is often conspicuous; it interferes vvith the more delicate actions, and is especially conspicuous in the muscles of the lips and face in articula- tion. Speech is hesitating and drawling, with a tendency to slur word-endings. Loss of the light-reflex of the iris, and inequality of the pupils, are common. With these there may be no spinal symptoms, or there may be indications of either lateral or posterior sclerosis. Cases of what may be termed pseudo-general paralysis, in which the characteristic physi- cal symptoms exist almost alone—merely loss of memory and slight optimism representing the mental disturbance—are not uncommon, both in syphilitic subjects and in those who have not had syphilis. These eases run a much more benign course than does the classical form of the disease, often re- maining stationary for years, and even improving. They do not get into asylums, and therefore are scarcely recognized in descriptions of the disease, although they are far from rare. In conclusion, we may glance briefly at some of the more salient points in the all-important distinction between the so-called functional and organic diseases of the brain. The diseases that most frequently give rise to difficulty are hysteria, neuralgia, and some forms of epilepsy, but the chief diagnostic indications of the inorganic head-pain and con-