Paralyses, cerebral, bulbar and spinal ; a manual of diagnosis for students and practitioners / by H. Charlton Bastian.

  • Bastian, H. Charlton.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Paralyses, cerebral, bulbar and spinal ; a manual of diagnosis for students and practitioners / by H. Charlton Bastian. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    tlie extremely varied forms of paralysis may often be distinguished from one another, as dependent upon defect in this or that part of the nervous system. Paralyses are almost, if not quite, invariably caused by definite morbid conditions appreciable either by the naked eye or by the micro- scope, or by both. Convulsions, on the other hand, are in all probability as invariably caused by mere molecular disturbances, inappreciable either by the naked eye or through the microscope. This view is not really contra- dicted by the fact that convulsions so often occur in association with, and as apparent consequences of, various organic diseases of the brain. The organic disease does not immediately give rise to the convulsion; it favours from time to time, through the intervention of other unnatural processes, disorderly molecular movements in certain of the nerve centres, which are the immediate forerunners of convul- sions. Neither of these positions would receive the assent of all patholo- gists and physicians. Some believe that paralyses not unfrequently exist without visible structural defects of any kind ; whilst probably many could be found who would say that' coarse' pathological lesions are often the actual causes of convulsions. The causes of the morbid states with which we are now concerned —that is the different forms of paralyses—are to be found, therefore, occupying the widest possible range from the point of view of their kind or nature. They extend from mere molecular or nutritional per- versions through the whole gamut of pathological conditions—the commonest of which are haemorrhage, thrombosis, embolism, and new- growth. Functional and structural morbid conditions of the cerebro-spinal nervous system have, therefore, alike to be considered in their relation to different kinds of paralysis. Instances of paralysis due to mere functional defects or perversions will, however, be found to be com- paratively rare; and when existent will be sometimes cerebral but perhaps more frequently spinal in their type. The diagnosis of diseases of the nervous system is now, by common admission, a two-fold problem. The locality as well as the nature of the lesion has as far as possible to be determined. In other words, a Eegional Diagnosis as well as Pathological Diagnosis has to be arrived at.