Organic and functional nervous diseases; a text-book of neurology . Mader, Wiener klin. Wochen.,1895, p. 537. Jolly, Arch. f. Psych., 1897, p. 650. ^Stiefel. New York Polyclinic, 1893, March. Stembo, Deutsche med. Wochen.,1895, p. 461. ^ ^ ^ » PLATE XVII .^Z -^ m :4Mi Cross-section of Sciatic Nerve in a Case of Leprous Neuritis.(Marchi stain.) The degenerated nerve fibres in the various bundles of nerves are stained black. TheInfiltration of the perineurium and epineurium with granulation cells, not shown by thisstain, has forced the bundles apart. (Flatau, Spec. Pathol, u. Therap., Nothnagel,
Organic and functional nervous diseases; a text-book of neurology . Mader, Wiener klin. Wochen.,1895, p. 537. Jolly, Arch. f. Psych., 1897, p. 650. ^Stiefel. New York Polyclinic, 1893, March. Stembo, Deutsche med. Wochen.,1895, p. 461. ^ ^ ^ » PLATE XVII .^Z -^ m :4Mi Cross-section of Sciatic Nerve in a Case of Leprous Neuritis.(Marchi stain.) The degenerated nerve fibres in the various bundles of nerves are stained black. TheInfiltration of the perineurium and epineurium with granulation cells, not shown by thisstain, has forced the bundles apart. (Flatau, Spec. Pathol, u. Therap., Nothnagel, Bd. xi., Taf. viii.) LEPROUS NEURITIS. 243 anaesthetic areas do not, as a rule, correspond to the distribution ofany one nerjte, nor are they symmetrical, as in ordinary cases of mul-tiple neuritis ; but are extremely irregular. They are attended bynumbness and tingling and burning sensations or a pain of slight de-gree. The loss of sensibility may affect touch, temperature, and pain-ful sensations equally, or any one of these may be affected alone. A Fig. Atrophy and trophic changes in hand and fingers in a case of leprous neuritis. loss of pain and temperature senses, while touch is preserved, is notuncommon, hence the disease has been mistaken for paralysis is usually found in the very small muscles of the handsand feet, but may extend to the longer muscles of the extremities, andnot uncommonly a few of the facial muscles are paralyzed. A pro-gressive atrophy occurs in the paralyzed muscles, with reaction of de-generation. There is a loss of mechanical excitability in the musclesaffected. The trophic disturbances present in the disease, viz., whitishcolored plaques on the skin, peculiar thickening or atrophy of the skin,the glossy surface, the ulcerations, and the gradual loss of substance —are to be regarded rather as a part of the disease leprosy than as evi-dence of the local affection of the nerves. illustrates the condition occasional
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