Showing papers in "Journal of Nervous and Mental Disease in 1937"

A proposed mechanism of emotion

Abstract: The work of Cannon,1Bard,2Penfield,3Ranson4and others has greatly advanced knowledge of the functions of the hypothalamus. In the light of these researches the connections of the hypothalamus to the medial wall of the cerebral cortex gain a new significance. The following discussion presents some anatomic, clinical and experimental data dealing with the hypothalamus, the gyrus cinguli, the hippocampus and their interconnections. Taken as a whole, this ensemble of structures is proposed as representing theoretically the anatomic basis of the emotions. It is generally recognized that in the brain of lower vertebrates the medial wall of the cerebral hemisphere is connected anatomically and integrated physiologically with the hypothalamus and that the lateral wall is similarly related to the dorsal thalamus (Herrick5). These fundamental relations are not only retained but greatly elaborated in the mammalian brain by the further development of the hippocampal formation

Cerebral circulation: the reaction of the pial arteries to a fall in blood pressure

Abstract: Since the introduction of the use of the cranial window by Forbes,1study of the vasomotor reaction of the pial arteries has been productive of a number of important results. Not only the influence of chemical substances on these arteries has been revealed but also the effect of changes in the composition and osmotic concentration of the blood and the effect of the stimulation of various nerves. Simultaneously with the influence which these diverse forces exert on the cerebral arteries, however, there are frequently universal vasomotor reactions and consequent changes in both the arterial and the venous blood pressure; therefore, it is necessary to investigate what effect changes in the endovascular pressure itself have on the pial arteries. Both in this and in several subsequent articles, the question as to the relationship between the arterial blood pressure and the tonus of the pial arteries will be discussed. The reaction

Personality features and reactions of subjects with migraine

Abstract: The psychobiologic aspects of the many-sided problem of migraine have until recently received little attention. Ulrich's1subjects with migraine reported attacks after an exciting play at the theater, after card playing, after dancing and (many housewives) after a "large washday." Also mentioned were sick headaches that came with riding on trains and sustained noises and on hot summer days. The first day at school and the arithmetic hour were exciting factors among the young subjects. Headache associated with an unattractive variety of work and relieved by giving up such work also was noted by Ulrich. Hilda Weber2noted that attacks resulted from emotion of a distressing nature or followed anything which wounded the vanity. She also inferred that in some patients migraine was associated with strong feelings of repressed guilt arising from hostile sentiments entertained toward persons with whom they were in close affective relations. Weber's patient showed

Structure of the nerve root: i. nature of the junction between the central and the peripheral nervous system

Abstract: The principal terra incognita in the histology of the cerebrospinal nerve root has concerned its central glial segment and the nature of its junction with the peripheral segment. The inadequacy of staining technic has been largely the cause of the retardation in the study of these problems. Recent improvements in the metallic impregnation methods of the Spanish school, enabling a more complete portrayal of neuroglia, Schwann cells and reticulin, afford an opportunity to supply this deficiency. My purpose in this investigation has therefore been a study of the central glial segment of the nerve root and the nature of its junction with the peripheral nerve segment. HISTORICAL REVIEW That a nerve root contains a central glial segment and a peripheral nonglial segment was recognized soon after Virchow discovered neuroglia by Thomsen 1 and many others. Staderini, 2 as well as Weigert, 3 subsequently showed that the neuroglia is more dense

Phenylpyruvic oligophrenia: introductory study of fifty cases of mental deficiency associated with excretion of phenylpyruvic acid

Abstract: In the study of the so-called primary, or endogenous, mental deficiency, when one excludes well defined pathologic types, such as amaurotic idiocy, tuberous sclerosis and mongolism, a large number of cases may still be found that escape any but a psychometric classification. It can hardly be doubted that these cases constitute a heterogeneous group in which future investigation will individuate new nosologic types, differing essentially in etiology, symptomatology and pathologic character. An apparently new type of mental deficiency has recently been indicated by Folling, 1 with the term "imbecillitas phenylpyruvica." This author reported having found phenylpyruvic acid in the urine of 10 mentally defective patients, 4 of whom were males and 6 females, ranging from 2 to 20 years of age. In 6 instances the metabolic abnormality was present in two members of a sibship, but it was never found to occur in mentally normal relatives. The mental defect was

The cerebellum: a review and interpretation

Abstract: Detailed studies of the comparative anatomic relations and development, phylogenetic and ontogenetic, of the cerebellum in mammals and submammals have thrown new light on the functional connections and relations of its fundamental divisions. They have made necessary a modification of the morphologic interpretation of the organ and some revision of terminology. This reinterpretation has been made gradually in a series of papers, which have been chiefly descriptive. Changes in terminology have been made grudgingly, with a desire to avoid encumbering further an already troublesome nomenclature. As the studies have progressed, some new terms have seemed necessary, and modifications of old terms have also been introduced from time to time. These changes are scattered through a number of papers, for which reason it appears desirable to gather them together into one article, to point out briefly the reasons for their use and to discard some that have been used more or

Evidences of vascular occlusion in multiple sclerosis and encephalomyelitis

Abstract: Recent experimental work1has made it seem probable that the lesions of multiple sclerosis and also those of the forms of "disseminated encephalomyelitis" which seem to represent a more acute stage of the same process2are produced by a local circulatory disturbance, apparently of the nature of an obstruction on the venous side. According to this point of view, there must be a primary change in the contents of the vessels of the central nervous system, or possibly of the intimal lining, which leads to thrombosis of venules. This produces local passive congestion and a mild degenerative process which affects myelin sheaths more than other structures. The myelin degenerates and is phagocytosed. The "inflammatory" phenomena would then be regarded as secondary or symptomatic and the gliosis as reparative or reactive. This hypothesis obviously must remain largely a speculation as long as it rests on the results of experimentation

Structure of the nerve root: ii. differentiation of sensory from motor roots; observations on identification of function in roots of mixed cranial nerves

Abstract: In a previous study 1 the structure of a typical cerebrospinal nerve root was investigated. The present study is concerned with the difference in structure of the various cerebrospinal nerve roots. Such a study has enabled the formulation of criteria for differentiating sensory and motor nerve roots. As a result, it has been possible to establish some degree of correlation between the structure and the function of certain roots of the mixed cranial nerves. HISTORICAL REVIEW That nerve roots vary with respect to the length of their glial segments has been recognized since the discovery of neuroglia. Virchow 2 called attention to the occurrence of neuroglia along the acoustic nerve. Henneberg and Koch 3 demonstrated a neuroglial extension constituting the central part of all nerve roots except the olfactory and the optic. It will be seen later that, like subsequent investigators, Henneberg and Koch were in error in their conception

Neural mechanisms controlling the palmar galvanic skin reflex and palmar sweating: a consideration of available literature

Abstract: Evidence that the autonomic nervous system as well as the innervation of the skeletal musculature finds representation within the cerebral cortex demands a revision of certain conceptions regarding the significance of autonomic changes. Especially is this the case with respect to the control of the palmar galvanic skin reflex and palmar sweat secretion. 1 This peripheral autonomic activity, which available evidence indicates is related to manipulative activity, reactions of orientation and conative functions, may be linked neurologically as well as functionally through intermediate subcortical mechanisms, with activity at the higher cortical levels. The available evidence relating to the neural mechanisms is presented for consideration at this time, to the end that more attention may be given the phenomena in neurologic studies where applicable data are accessible, and that investigators having facilities may be led to help in the solution of the problems which are implied. Implications regarding the central mechanisms

Cerebral circulation: xliv. vasodilation in the pia following stimulation of the vagus, aortic and carotid sinus nerves

Abstract: Central stimulation of the vagus nerve in animals is followed, under certain conditions, by dilation of arteries in the pia-arachnoid. When first reported in 1928 this dilation was thought to be a simple vasomotor reaction1which would involve nerve fibers passing upward from the medulla to the arteries in question. Such an interpretation was supported by the work of Cobb and Finesinger2and of Chorobski and Penfield.3 Despite these observations, the exact conditions determining the arterial dilation were not fully understood. In some experiments the caliber of the arteries seemed to be affected by changes in the blood pressure, the respiration or the strength of the stimulus; in others, no such relationship could be made out. Furthermore, it was difficult to reconcile our observations with those of other workers, notably Schmidt.4 During the past two years we have studied the problem again with the hope of

The psychodynamics of chronic alcoholism.

Abstract: THE PSYCHODYNAMICS OF CHRONIC ALCOHOLISM ROBERT KNIGHT; The Journal of Nervous and Mental Disease

Functional determinants of cerebral localization

Abstract: Since the pioneer work of Broca and of Fritsch and Hitzig, there has been a steady accumulation of evidence for the anatomic and functional specialization of different cerebral areas. Diversities of cortical structure revealed by myelino-architectural and cyto-architectural studies have been correlated with differences in subcortical connections and with consistent and characteristic symptoms of defect following local injuries. The principal sensory and motor areas have been delimited, and the problem of cerebral localization has become one of the degree of specialization within cyto-architectural areas, of the nature of the functional disturbances following various types of injury and of the mechanisms of organization. Behind these questions of detail and interpretation there remains, however, the problem of the functional significance of all localization. The basis of localization of function within the nervous system is apparently the grouping of cells of similar function within more or less isolated nuclei or fields. The fundamental

Geniculate neuralgia (neuralgia of the nervus facialis): a further contribution to the sensory system of the facial nerve and its neuralgic conditions

Abstract: It is thirty years since I made my first report to the American Neurological Association on herpetic inflammation of the geniculate ganglion and geniculate neuralgia. 1 This subject I elaborated in some detail in a series of subsequent publications. 2 Up to that time the facial nerve in man had been regarded as essentially motor; its sensory system —the nerve of Wrisberg and the geniculate ganglion and its peripheral divisions—were accorded only secretory, vasomotor and gustatory functions. Spiller, 3 however, had already drawn attention to the preservation of deep sensibility of the face in the anesthetic area after removal of the gasserian ganglion, which supported the hypothesis of Henry Head that motor nerves convey sensory fibers of deep sensibility. Cushing 4 also had indicated in his studies of the trigeminal field after operation on the gasserian ganglion the preservation of a crude form of tactile sensibility on the anterior two

Colloid cyst of the third ventricle: report of a case; operative removal with section of posterior half of corpus callosum

Abstract: The following case is noteworthy because of the unusual nature of the tumor and because of the interesting symptoms which followed operation. Since it was necessary to section the posterior half of the corpus callosum to remove the tumor, the postoperative disorders have a direct bearing on the problem of the callosal syndrome. The patient was a highly intelligent woman who was not in any way neurotic or given to exaggeration. It was possible to follow her case over a number of years, both before and after the operation, and an unusual opportunity was presented to study under the most favorable circumstances the interesting problems presented. REPORT OF CASE Paroxysmal headaches precipitated by flexion of the head and by stooping, later accompanied with vomiting, bradycardia and syncope. Colloid cyst of anterior part of third ventricle localized and removed successfully five years after onset of symptoms. Posterior half of corpus callosum

Vascular architecture of the lesions of multiple sclerosis

Abstract: A relationship between the location of the lesions of multiple sclerosis and the veins of the nervous system was pointed out by Rindfleisch. 1 The majority of those who have dealt with the subject have agreed that small lesions usually surround small veins and that larger plaques probably arise by coalescence. A similar relationship between lesions and veins in cases of "post-infectious encephalomyelitis" has recently been pointed out by Finley. 2 In other papers of this series the probable cause for such a relationship has been traced. Veins in the neighborhood of sclerotic plaques are often found to be engorged, tortuous, surrounded by blood pigment, thrombosed or obstructed. Thrombosis of veins in the central nervous system invariably produces lesions of the same general type as those seen in "encephalomyelitis" and multiple sclerosis. Presumably, therefore, the vascular abnormality is primary to the parenchymal lesions. 3 It is the purpose of the

The catathymic crisis: a clinical entity

Abstract: In the field of the psychiatry of crime the psychiatrist is confronted with a phenomenon for which he is little prepared by general psychopathology. The person to be examined has committed one or several overt acts. Usually the nature of these acts is familiar. One knows a great deal about their content, their meaning and their motivation from experience with patients who express a similar content in their fantasies, dreams and various symptoms. But however much one may know about fantasies that are, for instance, cruel and sadistic, it is a long step from this knowledge to the understanding of such a case as that of a girl, not psychotic or mentally deficient, who because of jealousy deliberately pours lysol on the eyes of a sleeping girl who has been her friend and blinds her. Even if one grants that thought is just another form of activity, the problem remains

Experiments with quinine and prostigmin in treatment of myotonia and myasthenia

Abstract: There is acute clinical contrast between myotonia congenita and myasthenia gravis: that of the sthenic and the asthenic; great muscles and lean ones, progressive power and progressive weakness. By Walker's1discovery of the effectiveness of prostigmin (the dimethylcarbamic ester of 3-oxyphenyltrimethylammonium methylsulfate)2in the treatment of myasthenia and the recent observation by one of us (A. W.)3that quinine abolishes myotonus, pharmacologic tools have become available with which to show also a chemical contrast between these two disorders. The value of quinine in the treatment of myotonia is further established by the following brief report of four additional cases, bringing the total number in our series up to eight. REPORT OF CASES Case 1. —A. B., a middle-aged woman, had had myotonia atrophica for six years. Myotonus most evident in grasping movements and on percussion of the tongue, was eliminated by the administration of quinine hydrochloride, 5

Extirpation of a huge pinealoma from a patient with pubertas praecox: a new operative approach

Abstract: Since the early unsuccessful attempts to remove pineal tumors by Brunner (quoted by Rorschach 1 ) in 1913 and by Puussep 2 in 1914, operative approach to these deeply seated, yet often relatively benign, growths has been by two main routes. The first of these was described in great detail by Dandy. 3 By this method the pineal region is exposed from above by separating the posterior portion of one cerebral hemisphere from its venous attachments to the sagittal sinus, retracting the hemisphere outward and then incising the caudal end of the corpus callosum (fig. 1). The second method is that described by Van Wagenen. 4 This consists in a transventricular exposure of the area in question by an incision through the right occipital region down to the posterior part of the dilated right lateral ventricle, after which the medial wall of the ventricle is incised and the growth disclosed (fig.

Survival and revival of nerve centers following acute anemia

Abstract: It is generally accepted that the nerve centers, particularly the bulbar centers, are extremely sensitive to anoxemia, anemia and circulatory disturbances. It has been stated, moreover, that acute anemia or an arrest of circulation not only rapidly depresses but paralyzes the bulbar centers (especially the respiratory center) and that it is impossible to reestablish their functions after the heart has been stopped for more than a few minutes. Although the effects of acute anemia on the nerve centers have been studied by a number of observers,1it appears unlikely that arrest of the entire circulation to the nerve centers was achieved by their methods. It has therefore appeared worth while to study this problem again by methods which insure beyond question the cessation of circulation to the nerve centers. We have attempted to answer the following questions: 1. After what duration of arrest of the circulation do the principal

Effects of sodium amytal and other drugs on the reactivity of the hypothalamus of the cat

Abstract: It is my purpose in this communication to report the effects of faradic stimulation of certain areas of the anterior portion of the hypothalamus and the motor cortex in cats and the modifications of these reactions under the influence of the systemic or the intrahypothalamic injection of sodium amytal or other drugs. Sixty-four cats were prepared in several series of experiments, according to the following technics: METHODS Acute Experiments.— Series A 1. —Hypothalamic Preparations: The cat was lightly anesthetized in an ether jar and the anesthesia continued by the use of an intratracheal cannula connected to a valved ether bottle. Both carotid arteries were isolated and encircled with separate loops of catgut for later approach. The Horsley-Clarke stereotaxic apparatus was then mounted, the skull trephined and an insulated nichrome electrode inserted into the hypothlamus, usually at the coordinate settings of anterior plane 14, right or left sagittal plane 2.5 and

Relation of the hypothalamus to disorders of personality: report of a case

Abstract: The obvious approach to the study of personality seems to be psychologic, since most of the attributes of personality appear to be in this field and in the field of the emotions. This statement does not mean, however, that there may not be also a physical basis of the personality and emotions. Attempts to determine what this physical factor consists of have been made in the past with relatively scant success. More recently attention has been directed to changes in personality and mood associated with disease of the hypothalamus. There appears to be both clinical and experimental proof that this region is in some way associated with the regulation of personality and mood and that lesions in this region may cause changes in personality and mood. The case which is reported in this paper appears to throw further light on this problem. REPORT OF CASE Diabetes insipidus; marked personality changes;

Meningiomas: origin, divergence in structure and relationship to contiguous tissues in light of phylogenesis and ontogenesis of the meninges, with suggestion of a simplified classification of meningeal neoplasms

Abstract: The probable origin and true histologic character of the meningioma, a tumor best known as dural endothelioma, are fairly old problems A century ago, Cruveilhier 1 (1835) intimated the meningeal origin of such tumors by naming them "cancerous growths of the meninges" He substituted this name for the older term "fungus growth of the dura," used by earlier writers Since then, almost each decade has brought to the foreground important contributions on this subject, embodying observations and conclusions of some outstanding anatomist, pathologist or neurosurgeon At first sight it would seem that these studies have resulted in little more than the creation of a large assortment of names, which include such terms as cylindroma, of Billroth; 2 psammoma and dural sarcoma, of Virchow; 3 epithelial cancer, of Bennett; 4 fibroplastic tumor, of Lebert; 5 epithelioma, of Bouchard 6 and Robin; 7 endothelioma, of Golgi; 8 cancer of the arachnoid, of

Hypothalamic regulation of temperature in the monkey

Abstract: The location of the temperature-regulating center has formed the subject of many investigations. The work of Isenschmid and Schnitzler 1 has given what seems to us reliable information. They showed that small bilateral lesions in the region of the mammillary bodies and the posterior part of the tuber cause loss of the capacity to guard the body against abnormal drops in body temperature. More recent work has established beyond dispute the importance of the hypothalamus for regulation of temperature, but there is a great deal of difference of opinion as to the exact location of the center or centers involved (Alpers; 2 Bazett, Alpers and Erb; 3 Bazett and Penfield; 4 Davison and Selby; 5 Dworkin; 6 Frazier, Alpers and Lewy; 7 Glaubach and Pick 8 Keller: 9 Keller and Hare, 10 and Solari 11 ). Observations made on animals decerebrated at various levels are not altogether satisfactory because so much

Facial tic in relation to injury of the facial nerve: an experimental study

Abstract: Kuhne's much cited demonstration of bifurcating axons to the gracilis muscle of the frog has not been successfully repeated in mammals. In fact, it remains to be shown that a single axon can normally supply fibers to two distinct muscles or to spatially separate portions of the same muscle. On the other hand, there is abundant evidence that under pathologic conditions one axis-cylinder may arborize over a wide area. Langley and Anderson 1 and, almost contemporaneously, Kilvington 2 demonstrated the branching of axons by mechanical and electrical stimulation of motor nerves regenerated after being severed and reanastomosed in various combinations. The histologic studies of Ramon y Cajal 3 also exhibited regenerating axons greatly distorted and frequently branching in the neighborhood of the injury. However, these physiologic and anatomic observations have never been correlated in a single experiment in which both the axon reflex and its morphologic raison d'etre, the branched