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Neurosyphilis

Chapter 13: INDEX
By Elmer Ernest Southard
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About This Book

The authors assemble 137 clinical case histories drawn from psychopathic and state hospitals and private practice to illustrate the varied manifestations, diagnostic challenges, laboratory methods (including Wassermann testing), pathological correlations and treatment responses of neurosyphilis. Early, ambiguous, and advanced presentations are grouped to show differential diagnosis between paretic and diffuse forms, with autopsy findings used to clarify outcomes. Sections discuss treatment regimens, practical guidance for general practitioners, medicolegal and social-service implications, and wartime case digests. A Summary and Key cross-reference propositions to cases, and the work emphasizes systematic diagnosis, correlation of clinical and pathological data, and cautious optimism about modern therapeutic approaches.

INDEX

  • Abscess, tonsillar, associated with neurosyphilis, 250.
  • Addison’s disease in juvenile paretic, 279.
  • Agraphia, 101.
  • Albumin test, 474.
  • Allbutt, Clifford, 257.
  • Alcoholism, chronic, 227.
  • Alcoholic dementia, 237.
  • Allergie, 129, 204.
  • Alzheimer, 428.
  • Amboceptor, 477.
  • Amnesia, 195.
  • Anaphylaxis, 129.
  • Anatomical formulae, 25.
  • Antigens, 476.
  • Aortic aneurysm, 35, 439.
  • —— sclerosis, 41, 46, 135.
  • Aphasia, 31, 43, 101, 262, 445.
  • Apoplexy, 197.
  • Argyll-Robertson pupil, 209, 212, 217, 291, 450.
    • as isolated symptom, 217.
    • in alcoholism, 214, 229.
  • Arndt, Junius and, 249.
  • Arsenobenzol, 375, 377, 389, 486.
  • Arteriosclerosis, cerebral, 101.
    • not a contraindication to intensive salvarsan therapy, 359.
    • radial, 68.
  • Ascending lesion, 23.
  • Asymmetrical lesions, 19.
  • Ataxia, 31, 223.
  • Atheromatous degeneration, 35.
  • Atrophy, cerebellar, 39.
  • Atypical case congenital neurosyphilis, 270.
  • Ayer, J. B., 472.
  • Ballet, 72.
  • Barrett, A. M., 54, 175, 187, 212, 218, 219.
  • Bechterew, 219.
  • Binet and Simon, 304.
  • Binet scale, 277.
  • Birnbaum, 403.
  • Blood pressure, high, 70, 262, 124.
  • Bly, 252.
  • Bonhoeffer, 404, 415, 417.
  • Bordet, 427.
  • Bratz, 278.
  • Bruck test, 479.
  • Bruck, C., 479.
  • Bumke, 214.
  • Canavan, 256.
    • and Southard, 70.
  • Cell count, 471.
  • Cerebral syphilis, see diffuse neurosyphilis.
  • Cerebrospinal syphilis, see diffuse neurosyphilis.
  • Cervical hypertrophic meningitis of Charcot, 56, 441.
  • Chancre, extragenital, 75, 342.
  • Character change, neurosyphilis, 314.
  • Charcot, 60, 186.
  • Choroiditis, 242.
  • Christian, 407.
  • Cimbal, 403.
  • Civilization and syphilis, 76.
  • Clinical evidences of syphilis, 131.
  • Clouston, 158.
  • Collins, Joseph, 145.
  • Compensation in neurosyphilis, 309, 402, 456.
  • Complement, 477.
  • Conduct disorder, 38.
  • Congenital syphilis, absence of stigmata, 318.
    • as cause of feeblemindedness, 159, 447.
    • involvement of nervous system in, 274.
  • Congenital neurosyphilis, 270, 395.
    • resembling feeblemindedness, 272.
  • Conjugal neurosyphilis, 263.
  • Convulsions, 43, 101, 248, 362.
    • cause of in paretic neurosyphilis, 232.
    • in psychopathic subject with syphilis, 417.
  • Corneal opacity, syphilitic, 234.
  • Cotard, 73.
  • Cotton, H. A., 472.
  • Craig, C. B., 152, 196.
  • Cramer, 125.
  • Cranial neurosyphilis, 140.
    • tenderness, 139.
  • Crises, gastric, 367.
  • Cysts, ependymal, 59.
  • Cytorrhyctes luis, 381.
  • Dana, Charles L., 65, 77, 78.
  • Dazed states, 264.
  • Deafness, 63.
  • Decompression, 138.
  • Defective delinquent—diffuse neurosyphilis, 300, 455.
  • Dejerine-Tinel, 61.
  • Delinquency and juvenile neurosyphilis, 298.
  • Delirium tremens, 332.
  • Dementia, 137.
  • Dementia paralytica, see paretic neurosyphilis.
  • Dementia praecox, 74, 185, 247.
  • Depression, 95, 126.
  • Depressive drugs, 189.
  • Diabetes, and neurosyphilis, 240.
    • insipidus, 190.
  • Diabetic pseudoparesis, 238.
  • Diarsenol, 377, 389, 391, 486.
  • Differential diagnosis, alcoholism and neurosyphilis, 227, 231, 234, 236.
    • brain tumor, diabetic pseudoparesis and neurosyphilis, 238.
    • diffuse and paretic neurosyphilis, 165, 193, 247.
    • manic-depressive psychosis and neurosyphilis, 69.
    • multiple sclerosis and neurosyphilis, 253, 255.
    • neurasthenia and neurosyphilis, 65, 183.
    • senile arteriosclerotic psychosis and neurosyphilis, 262.
  • Diffuse neurosyphilis, cerebrospinal syphilis, cerebral syphilis, spinal syphilis, 17, 80, 85, 97, 103, 122, 140, 183, 193, 300, 331, 342, 359, 433, 439, 443.
  • Diplopia, 50, 184, 253, 356.
  • Donath, 401, 403.
  • Drastich, 407.
  • Duco and Blum, 403.
  • Dupré, 407.
  • Dysdiadochokinesis, 231.
  • Ehrlich, 184, 428, 429.
  • Encephalitis, 27, 248.
    • disseminated, 218.
  • Endarteritis, 220.
  • Ependymal cysts, 59.
  • Ependymitis, 40, 47, 49, 134.
  • Epilepsy, 192.
    • alcoholic, 229.
    • brought out by syphilis, 415.
    • Jacksonian, 103.
    • parasyphilitic, 194.
    • relation to juvenile neurosyphilis, 277.
    • syphilitic, 103, 194.
    • syphilogenic, 415.
  • Epileptic neurosis, 195.
  • Erb’s syphilitic spastic paraplegia, 147.
    • treatment of, 148.
  • Euphoria, 73.
  • Excited states, 95.
  • Exner, M. J., 416.
  • Exophthalmic goitre, syphilitic (?), 205.
  • Extraocular palsy, 140, 441.
  • Eye changes in neurosyphilis, 257.
  • Eye muscles, paresis of, 17, 50.
  • Facial paralysis, 53.
  • Families of neurosyphilitics, 275, 316, 318, 320, 373, 431, 457.
  • Family of neurosyphilitic, normal-looking, but syphilitic, 318.
  • Familial syphilis, 299, 306.
  • Farrar, C. B., 411.
  • Fearnsides, Head and, 21, 140, 150, 193, 217, 374, 378.
  • Feeblemindedness, 395.
    • and congenital syphilis, 159.
  • Fernald, W. E., 159, 273, 396.
  • Fildes, McIntosh and, 129, 329.
  • Focal changes, 221.
    • meningitis, 50.
    • softenings, pontine, 54.
  • Fournier, 142, 222, 186, 194, 381.
  • Franz, 357.
  • Froissart, 413.
  • Fugue, hysterical, 264.
  • Garnier, 407.
  • General paresis, see paretic neurosyphilis.
  • Glands, 270.
  • Gliosis, 39, 47, 49, 136, 180.
  • Globulin, 229.
  • Glycosuria, 238, 241.
  • Goddard, 397.
  • Gold sol reaction, 247, 474.
    • in brain tumor, 100.
    • paretic, 85, 98.
    • paretic, other tests negative, 383, 385.
    • in purulent meningitis, 100.
    • syphilitic, 85, 98, 345.
  • Graham, Thomas, 429.
  • Grandiosity, 72, 295, 455.
  • Graves, W. W., 157.
  • Grilli, 407.
  • Gross, 257.
  • Gumma, see gummatous neurosyphilis.
  • Gumma of tonsil, 250.
  • Gummatous neurosyphilis, 53, 56, 137, 138, 140, 221, 362, 438.
  • Hallucinations, 53.
    • in paretic neurosyphilis, 249.
  • Hauptmann, 348.
  • Head and Fearnsides, 21, 140, 150, 193, 210, 217, 374, 387.
  • Headache, 53, 63, 122, 247, 352.
    • causes of, 209.
  • Hecht, 399.
  • Hemianopsia in neurosyphilis, 242.
  • Hemiplegia, 31, 45, 80, 122, 262, 360.
    • causes of, 389.
  • Hemitremor, 197.
  • Heredity, neuropathic, 84.
  • Herxheimer reaction, 152.
  • Heubner, 427, 428.
  • Hinton, W. A., 471.
  • Huntington’s chorea, 258.
  • Hutchinsonian teeth, 45.
  • Hydrocephalus, 134, 306.
  • Hyperreflexia, explanation of, 233.
  • Hypochondriacal ideas, 133.
  • Hysteria, 185, 301.
  • Hysterical symptoms, 18.
  • Incontinence, vesical in tabetic neurosyphilis, 144.
    • rectal, 56.
  • Incubation period of neurosyphilis, 152.
  • Infectiousness of neurosyphilis, 95.
  • Insight, 95.
  • Insomnia, 63.
  • Intracranial pressure, 139, 362.
  • Intraspinal lesions, 95.
  • Intraspinous therapy, 122, 366, 486.
    • unpleasant results of, 366.
  • Intraventricular injections, 389, 487.
  • Involution-melancholia, 187.
  • Iodine, untoward results, of, 363.
  • Iritis, 17.
  • Järisch-Herxheimer reaction, 72.
  • Joffroy, 214.
    • and Mignot, 64.
  • Junius and Arndt, 249.
  • Juvenile neurosyphilis, 438, 447.
    • relation to epilepsy, 277.
  • Juvenile paresis, see juvenile paretic neurosyphilis.
  • Juvenile paretic neurosyphilis, juvenile paresis, 45, 154, 157, 272, 275, 298, 306, 440.
  • Juvenile paretic neurosyphilis, with initial trauma, 306.
    • congenital amputation of toes in, 158.
  • Juvenile tabetic neurosyphilis, 161, 447.
  • Kaplan, 255, 471.
  • Kéraval, 257.
  • Key, 427.
  • Knee-jerks, absence of, 223.
    • lively, 75.
    • return of, 24.
  • Koefod, Solomon and, 243.
  • Kolmer, 471.
  • Kraepelin, 65, 66, 69, 88, 91, 95, 187, 225, 249.
  • Krafft-Ebing, 84.
  • Laignel-Lavastine, 413.
  • Lange, C., 428, 429, 474.
  • Lancinating pains, 92, 141.
  • Lépine, 408, 413.
  • Leptomeningitis, 47, 54, 135.
  • Lewandowski, 210.
  • Liability of paretic, 295.
  • Lissauer’s paralysis, 38.
  • Locomotor ataxia, see tabetic neurosyphilis.
  • Long, 418.
  • Lucke, Baldwin, 93, 144.
  • Lues maligna, 250, 452.
  • Lumbar puncture, untoward effects, 352.
    • treatment of, 354.
  • Lüth, 278.
  • Lymphocytosis, 23, 30, 40, 49.
  • McDonagh, 381.
  • McIntosh, Fildes and, 129, 329.
  • Malaria, cerebral, simulation of paretic neurosyphilis, 245.
  • Mallory and Wright, 472.
  • Manic-depressive psychosis, 68, 71, 77, 187, 202, 291, 384, 442.
  • Marie, Chatelin and Patrikios, 412.
  • Marie, 408, 414.
  • Martin, E. G., 313.
  • Massary, de, 414.
  • Mattauschek and Pilcz, 347.
  • Medicolegal and Social, 454.
    • period of paretic neurosyphilis, 414.
  • Meilhon, 407.
  • Memory, failing, 63.
  • Meningitis hypertrophica cervicalis of Charcot, 56.
    • sympathica, 19.
    • syphilitic, 103.
  • Mercurialization, 98.
  • Mercury, 58, 83, 85, 98, 148, 193, 235, 376, 377, 389, 391, 395, 486.
    • untoward results of, 363.
  • Metasyphilis, 89.
  • Metchnikoff and Roux, 427, 428.
  • Microgyria, occipital, 47.
  • Mignot, Joffroy and, 64, 66.
  • Migraine, 19.
  • Mitchell, H. W., 218.
  • Mœbius, 429.
  • Mott, F. W., 158, 257, 308, 396, 437.
  • Multiple sclerosis, 253, 256.
    • relation of syphilis to, 254.
    • spinal fluid findings in, 254.
  • Muscular atrophy, 149, 446.
    • syphilitic relation to amyotrophic lateral sclerosis, 150.
  • Muscular weakness, 279.
  • Myerson, A., 196.
  • Nageotti, 428.
  • Nausea, 63.
  • Neisser, 399.
  • Nerve trunk tenderness, 148, 234.
  • Nervousness, 63.
  • Nervous indigestion, 63.
  • Neurasthenia, 63, 183.
  • Neuritis, cranial, 51.
  • Neurorecidive, 152, 153, 184, 196, 235.
  • Neuroses, relation of syphilis to, 186.
  • Neurosyphilis, 187, 238, 240, 242.
    • aggravated on military service, 404.
    • atypical, 258, 346.
    • atypical case resembling hysterical fugue, 264.
    • dates, 428.
    • forms of, 20, 21, 28, 29, 95.
    • galloping, 328.
    • history of, 427.
    • incubation period, 152.
    • infectiousness of, 95.
    • laboratory findings in, 82.
    • latent, 142, 203.
    • lesions, 303.
    • lighted up by stress of military service, 412.
    • and marriage, 319.
    • prevention, 320.
    • onset, 64.
    • in primary stage, 186.
    • in secondary stage, 185, 283, 390.
    • in secondary stage, prognosis, 390.
    • in secondary stage, treatment, 153.
    • spinal, 23.
    • and the war, 399, 466.
  • Nissl-Alzheimer method, 427.
  • Noguchi, 381.
  • Nonne, 82, 125, 152, 186, 195, 196, 214, 216, 235, 254, 265.
    • -Apelt test, 473.
  • Numbness, 56.
  • Nystagmus, 45, 253, 256, 279.
  • Obersteiner, 249.
  • Occupation-neurosis, 312.
  • Ogilvie method, 487.
  • Operation for gumma, 139.
  • Optic atrophy, 256.
    • in juvenile paretic neurosyphilis, 154.
  • Optic thalamus, syphilitic lesion of, 205.
  • Osteitis, syphilitic, 311.
  • Ozena, 350.
  • Pains, 31.
  • Pandy test, 474.
  • Paralysis, 123.
    • recovery from, 342.
    • of respiration, 248.
  • Paranoia, syphilitic, 225.
  • Paraphasia, 19, 43.
  • Paraplegia, 26, 30.
  • Parasyphilis, 89.
  • Paresis sine paresi, 126, 186, 204, 303, 445.
  • Paresis, see paretic neurosyphilis.
  • Paretic neurosyphilis, dementia paralytica, general paresis, softening of the brain, 37, 63, 68, 74, 78, 80, 85, 97, 131, 188, 192, 197, 199, 202, 227, 241, 262, 289, 295, 309, 314, 323, 338, 372, 375, 377, 382, 384, 386, 388, 392, 435, 440, 442.
    • adjuvant causes of, 414.
    • causing social complications, 289.
    • causes of death in, 197.
    • course, 85.
    • duration, 88.
    • forms, 95.
    • improvement, 377.
    • incidence among officers, 407.
    • incidence among soldiers, 402.
    • lesions of, 131.
    • “lighted up” by domestic stress in civil life, 420.
    • “lighted up” by “gassing,” 414.
    • mortality from, 89.
    • nomenclature, 88.
    • onset, 192.
    • pathology of, 436.
    • prognosis, 435, 444.
    • symptoms, 90, 131.
    • symptoms, mental, 87.
    • symptoms, physical, 86.
    • versus diffuse neurosyphilis, 165.
    • versus vascular neurosyphilis, 169, 172.
    • with very marked meningitis, 332.
    • with very marked brain atrophy, 335.
    • without mental symptoms, 315.
    • traumatic exacerbation, 310.
    • traumatic form, 308, 413.
    • traumatic, shell-shock, 401.
    • treatment of, 85, 370, 372, 377, 382, 384, 386, 388, 392.
    • treatment, results of, 351.
  • Pensions for disabilities resulting from venereal disease, 409.
  • Pensions for neurosyphilis, 411.
  • Peripheral neurosyphilis, 19.
  • Perivascular infiltration, 41.
  • Pernicious anemia with spinal symptoms, 267.
  • Petit mal attacks, 195.
  • Pförringer, 61.
  • Phobia, 67.
  • Pilcz, Mattauschek and, 347.
  • Pitres and Marchand, 421, 424.
  • Plaut, 249, 348, 428.
  • Plaut, Rehm and Schottmüller, 471.
  • Plasmocytosis, 40, 49, 55.
  • Pleocytosis, 23, 220, 247, 344.
    • effect of antisyphilitic treatment on, 244, 376.
    • in remissions, 243.
    • significance of, 243.
    • spinal fluid otherwise negative, 270.
  • Polydipsia, 190.
  • Polyuria, 190.
  • Pontine hemorrhage, 219.
    • softening, 54.
  • Posey and Spiller, 257.
  • Potassium iodid, 58, 85, 98, 193, 222, 376, 377, 389, 486.
  • Preparesis, 65, 77, 78.
  • Prince, Morton, 195.
  • Psammoma, 213.
  • Pseudoneurasthenia, 66.
  • Pseudoparesis, 449.
  • Pseudoparetic neurosyphilis, 222.
  • Pseudotabes, shell-shock, 424.
  • Psychogenic neurosyphilis, 189.
  • Psychographic disturbance, 228.
  • Psychopathic personality, 302.
  • Ptosis, 350.
  • Pupillary reaction, changes in, 261.
    • signs, 69.
  • Pupils, Argyll-Robertson, see Argyll-Robertson pupils.
    • irregular, 79, 201.
    • normally reacting in paretic neurosyphilis, 199.
    • sluggish reaction to light, 188.
    • stiff as isolated symptom, 265.
  • Purkinje cells, binucleate, 48.
  • Putnam, James J., 19, 56.
  • Pyramidal tract lesion, bilateral, 326.
    • sclerosis, 44.
  • Quadriplegia in juvenile paretic neurosyphilis, 275.
  • Quincke, 427, 428.
  • Randsklerose, 24.
  • Ravaut, 428.
  • Ravaut, Sicard, Nageotti, Widal, 428.
  • Rayneau, 407, 413, 414.
  • Recovery, 77.
  • Recurrences, 70.
  • Redlich, 403.
  • Régis, 73.
  • Remissions, 122, 435, 445.
  • Retardation, 187.
  • Retention of urine, 56.
  • Retinitis, hemorrhages, 365.
  • Richards, R. L., 402, 404, 406, 409.
  • Robertson, A. R., 59.
  • Rod cells, 226, 297.
  • Romberg sign, 141, 216, 279.
  • Root-sciatica, syphilitic, 418.
  • Rosenau, 471.
  • Ross-Jones test, 473.
  • “Rum fit,” 229.
  • Ryder, Charles T., 42.
  • Saddle-shaped nose, 210.
  • Salivation, 98.
  • Salmon, Thomas W., 89.
  • Salvarsan, 75, 83, 85, 193, 222, 377, 389, 486.
    • provocative, 78, 79.
    • untoward results of, 363.
  • Salvarsanized serum, 75.
  • Schaudinn, 427, 429.
  • Sciatic pain in neurosyphilis, 149.
  • Seizures, 31, 64, 83, 103, 444.
    • causes of in paretic neurosyphilis, 194.
    • Jacksonian, 392.
    • minor, 392.
  • Senile arteriosclerotic psychosis, 262.
  • Sensitized cells, 478.
  • Sérieux and Ducaste, 96.
  • Shaikewicz, 404.
  • Shanahan, 278.
  • Sheep’s corpuscles, 477.
  • Shock, 42, 81.
  • Sicard, 428.
  • Six tests, 80, 85.
    • in tabetic neurosyphilis, 141.
  • Smith and Solomon, 479.
  • Social cases, 454.
    • service, 232.
  • Solomon, 142, 255.
  • Somnolence, 45.
  • Southard, E. E., 48, 134, 212.
    • and Canavan, 70.
    • and Solomon, 202, 303.
    • and Taft, 397.
  • Spasms, clonic, 326.
  • Spastic hemiplegia in paretic neurosyphilis, 323.
  • Spastic paraplegia, Erb’s, 147, 306.
  • Spasticity, 18, 256.
  • Speech defect, 69, 133.
  • Spiller, 150.
    • Posey and, 257.
  • Spinal fluid findings in secondary stage of syphilis, 151, 185, 283.
    • in juvenile paretic neurosyphilis, 275.
    • negative in diffuse neurosyphilis, 140.
    • negative in gummatous neurosyphilis, 138.
    • negative in neurosyphilis, 216.
    • negative in tabetic neurosyphilis, 269.
    • in tabetic neurosyphilis, 141.
  • Spinal fluid, withdrawal for therapeutic purposes, 377, 379.
  • Spinal syphilis, see diffuse neurosyphilis.
  • Spirochetes, “drug fastness,” 381, 394.
  • Steida, 405.
  • Sterility in tabetic neurosyphilis, 144.
  • Stier, 407.
  • Stokes, Wile and, 186.
  • Suicide, 92, 126, 240, 296, 301.
  • Summary, 427.
  • Syphilis aggravated by service, 406, 411.
    • on service, 409.
  • Syphilis as cause of diabetes, 241.
    • as cause of feeblemindedness, 396.
    • hereditaria tarda, 160, 318.
    • history of, 427.
    • lesions in, 329.
    • of lung, 211.
    • from Mongolian, 76.
    • primary, 65.
    • secondary, 65.
    • tertiary, lesions in, 329.
  • Syphilitic feeblemindedness, pathology of, 160.
    • neuritis, 312.
    • psychosis, 91.
  • Syphilophobia, 67, 361.
  • Syphilotoxins, 72.
  • Swift, 129, 212.
  • Swift and Ellis, 428, 429.
  • Tabes dorsalis, see tabetic neurosyphilis.
  • Tabetic neurosyphilis, tabes dorsalis, locomotor ataxia, 30, 31, 141, 146, 366, 367, 434, 446.
    • associated with cerebral symptoms, 177.
    • atypical, 143.
    • cervical, 146.
    • course, 141.
    • with negative spinal fluid findings, 269.
    • prognosis, 94.
    • shell-shock, 403.
    • “shell-shocked” into paretic neurosyphilis, 401.
    • symptoms, 93.
    • symptoms in order of frequency, 145.
    • treatment, 145, 366, 367.
    • plus vascular neurosyphilis, 175.
    • with vascular insult, 30, 439.
    • versus pernicious anemia, 267.
  • Taboparesis, see Taboparetic neurosyphilis.
  • Taboparetic neurosyphilis, taboparesis, 92, 135, 195, 284, 443.
    • course, 92.
    • nomenclature, 94.
    • prognosis, 92, 443.
    • and typhoid meningitis, 284.
  • Taft, A. E., Southard, E. E., and,
  • Talon, 407.
  • Taylor, E. W., 50.
  • Temperature, paretic, 376.
  • Tests, changes under treatment, 102.
    • changed to negative in paretic neurosyphilis without clinical improvement, 385.
    • changed to less strongly positive in paretic neurosyphilis without clinical improvement, 386.
  • Therapeutic conception, 324.
  • Thibierge, 399.
  • Thierry, 158.
  • Throbbing in head, 63.
  • Thrombosis, cerebral, 36, 42, 342, 357, 360, 124.
  • Thymus, persistent, 282.
  • Tibial exostoses, 100.
  • Tigges’ formula, 248.
  • Todd, J. L., 406, 409.
  • Transient deafness, 18.
    • blindness, 18.
    • paralysis, 124.
    • paralysis, condition in which occurs, 123.
  • Trauma and juvenile neurosyphilis, 278, 306.
    • neurosyphilis, 456.
    • paretic neurosyphilis, 199, 308, 310.
    • syphilitic osteitis, 311.
  • Treatment of neurosyphilis, 67, 75, 83, 124, 148, 184, 222, 235, 299, 328, 332, 335, 342, 346, 350, 351, 355, 384, 390, 392, 395, 419, 439, 457.
    • case in which theoretically of no avail, 323.
    • methods, 356, 486.
  • Treatment of syphilis, effect on development of neurosyphilis, 142, 347.
  • Tremor, 197.
    • intention, 256
  • Tubercle, 80.
  • Tuberous sclerosis of Bourneville, 47.
  • Tumor, cerebral, 53, 191, 238, 253.
  • Unconsciousness, 53.
    • causes of, 389.
  • Vascular changes, 220.
  • Vascular neurosyphilis, 31, 42, 72, 296, 359, 433, 440.
    • plus tabetic neurosyphilis, 175.
    • prognosis, 433.
    • versus paretic neurosyphilis, 169, 172.
  • Veeder, B. S., 274.
  • Vertigo, 122.
  • Viet, 278.
  • Virchow, 427, 428.
  • Vomiting, 53, 63.
  • Warthin, 241.
  • Wassermann reaction, 191.
    • and alcoholism, 230.
    • in congenital syphilis, 160, 271.
    • meaning of “doubtful,” 360.
    • negative in diffuse neurosyphilis, 184.
    • negative in juvenile paretic neurosyphilis, 298.
    • negative in spinal fluid in spinal syphilis, 148.
    • negative in spinal fluid in neurosyphilis, 101.
    • negative in neurosyphilis, 252.
    • negative in paretic neurosyphilis, 77.
    • technique, 476.
    • titrations in spinal fluid, 348.
  • Wassermann, Neisser and Bruck, 428.
  • Weiler, 214.
  • Weygandt, 403, 404.
  • Widal, Sicard, Ravaut, 428.
  • Wiles and Stokes, 186.
  • Word-deafness, 35, 43.
  • X-ray diagnosis of bone conditions, 136.
  • Yerkes-Bridges, 304.
  • Ziehen, 409.
  • Zsigmondi, 429, 474.