Diseases of the nervous system .. . mentioned tracts,and in each of the individualcases now frequently observedthe seat of the disease varies, at one time this, at another time that, columnbeing implicated. The clinical symptoms vary exceedingly; they resemblethose of other spinal cord diseases, and may be as vague as the anatomicallocalization. Hence, the anatomical starting-point of the disease remainsobscure, and we are in doubt whether a diffuse leukomyelitis chronica, per-haps starting from the vessels, or a prinuiry diffuse disease of the gray sul)-stance is the cause. We cannot to-day p
Diseases of the nervous system .. . mentioned tracts,and in each of the individualcases now frequently observedthe seat of the disease varies, at one time this, at another time that, columnbeing implicated. The clinical symptoms vary exceedingly; they resemblethose of other spinal cord diseases, and may be as vague as the anatomicallocalization. Hence, the anatomical starting-point of the disease remainsobscure, and we are in doubt whether a diffuse leukomyelitis chronica, per-haps starting from the vessels, or a prinuiry diffuse disease of the gray sul)-stance is the cause. We cannot to-day positively assert that the affection isa neuron disease, as is maintained by some authorities. We may point byanalogy to similar degenerations of the white substance, not in columns but,on the contrary, occurring in foci, particularly in severe anemias and in cer-tain intoxications. Here the assumption of processes which start from thevessels and only secondarily lead to degeneration of the nervous substancesis much more Fig. 114.—Combined System Diseases.(After Oppenheim.) V. OTHER DISEASES OF THE CENTRAL NERVOUS SYSTEM I must now consider the pathological histology of those affections of thebrain and spinal cord which do not depend upon the primary disease ofone nerve tract or of one or more neurons, which, therefore, are not limitedin their extent but are found in any area regardless of the nature and func-tion of the nerve elements there situated. The cause of such diseases isacute or chronic inflammation which may occur diffusely or in foci withinthe central nervous system, or which may attack the membranes, and sec-ondarily implicate the nervous substance; at times we are dealing with degen-erative processes which may originate in the vessels, or from the interstitialtissue and may develop in various areas. Finally, tumors or injuries maysimultaneously implicate the various nervous elements. All the tracts which are damaged by diffuse or circumscribed (focal
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