Neurosyphilis

by Elmer Ernest Southard; Harry C. Solomon

The treatment for neurosyphilis according to the viewpoint of the authors is treatment for syphilis. It is necessary in order to cure a case of neurosyphilis to cure the syphilis in the patient. Accordingly, the methods of treatment best adapted for the cure of syphilis are indicated in the treatment of neurosyphilis. As experience shows that it is often more difficult to cure the neurosyphilitic cases, treatment will have to be pushed with greater intensity than in some non-nervous system syphilis. In general, then, the methods that have been applied by the syphilologist will be used in the treatment of cases of neurosyphilis. In addition, methods attempting to bring the drug into local contact with the central nervous system have been devised. The methods of treatment have been in part indicated in Chart 27.

The method chiefly used in treatment of the cases of this book is what we have called intensive systematic intravenous treatment. The treatment consists of intravenous injections of salvarsan (or a substitute for salvarsan, as arsenobenzol and diarsenol) given in a dose of about 0.6 gram and repeated twice a week over a period of a number of months. In addition, injections of mercury salicylate averaging 0.065 gram once a week are given and potassium iodid by mouth. As indicated, the important point is to keep up treatment for a long period of time. This method has produced practically no untoward results, certainly no more untoward results than are to be expected with salvarsan in smaller quantities and it has seemed to us that the therapeutic results have been as satisfactory as in any other form of treatment.

Specialized forms of treatment intended to place the drug in contact with the central nervous system may be described under the headings of spinal intradural treatment and cerebral subdural and intraventricular treatment.

Three main therapeutic agents have been largely used. These are (1) salvarsanized serum according to the method of Swift-Ellis (in vivo). The serum according to this method is prepared as follows: An intravenous injection of salvarsan is given to a patient and blood withdrawn at the end of one-half hour. This is allowed to clot. The serum is removed and after inactivation at 56° C. for one-half hour it is ready for use. The average dose is 15 to 30 cc. of serum. As a matter of fact, it is not necessary to use the blood serum from the same patient to whom the intraspinous injection is to be given. (2) The salvarsanized serum according to the method of Ogilvie (in vitro). Blood serum is prepared from any patient and to it is added salvarsan in such a strength that the amount to be injected, 10 to 30 cc. of serum, will contain 0.0001 to 0.001 gm. (3) Mercurialized serum according to the method of Byrnes. Mercury bichloride is added to blood serum in such proportion that the amount of serum to be injected will contain from 0.00065 gram to 0.0026 gram.

The method of intraspinous injection is to perform lumbar puncture, withdraw an amount of fluid approximately equivalent to the amount to be injected; then allow the serum to be injected to run in by gravity.

For the cerebral, subdural and intraventricular injections, the same sera may be used as for the intraspinous. Five or six times as much salvarsan may be given, but a smaller amount of serum may be advisable, that is, 10 to 15 cc. To perform injections a trephine opening is made in the calvarium about the size of a dime. The location of choice for the opening is slightly back of the longitudinal prominence just to the right of the median line, to avoid the frontal sinus. For subdural injections a curved needle is thrust between the dura and the brain and the serum allowed to flow in slowly by gravity. For the intraventricular injections a blunted spinal puncture needle is thrust through the brain substance into the 3rd ventricle. When the 3rd ventricle is reached the clear cerebral fluid will flow out; then after withdrawing a sufficient amount, the serum may be introduced by gravity. The trephining may be done under local anesthesia but as a rule it is better to induce general anesthesia. The subsequent injections can be made without recourse to any anesthesia whatsoever, as they are practically painless.

All procedures both in the injections and in the preparation of sera are naturally to be performed under aseptic conditions.

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].
  • epilepsy, [229].
  • hallucinosis, [225].
  • pseudoparesis, [222], [223], [451].
• Allergie, [129], [204].
• Alzheimer, [428].
  • method, [472].
• 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].
  • cerebral, [47], [134], [205].
  • parenchymal, [41].
  • pontine, [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].
  • of softening, [27], [36], [54].
• 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].
  • premonitory symptoms, [342].
  • prognosis, [80], [103], [124], [433], [443].
  • spinal fluid findings in, [348].
  • symptoms, [99].
  • treatment, [98], [103], [184], [302], [390].
  • treatment, results, [343].
• Diplopia, [50], [184], [253], [356].
  • causes, [140].
• 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].
  • tests, [473].
• 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].
  • age of onset, [158].
  • and Addison’s disease, [279].
  • and delinquency, [298].
  • prognosis, [156], [158], [162], [273], [275].
  • treatment, [154], [161], [278], [299].
• 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].
  • optic, [365].
  • root, [235].
  • syphilitic, [235].
• 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].
  • and Moore, [428], [429].
• 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].
  • alcoholic, [222], [229], [451].
  • diabetic, [238].
  • senile, [263].
  • shell-shock, [421].
  • syphilitic, [223], [371].
• 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].
  • and Koefod, [243].
  • Smith and, [479].
  • Southard and, [202], [303].
• 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].
  • strains, [76], [263], [276], [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].
  • method, [428], [487].
• 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].
  • pineal, [213].
• 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].

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