AMAarchives of neurology & psychiatry . tion (twice repeated) wasnegative in both blood and spinal fluid. \ alente, a Portuguese investi-gator, reports three cases with positive spirochete findings but negativeWassermann reactions in the spinal fluid. In my experience I can recallno case of general paralysis, confirmed by the microscope, in whichthe fluid Wassermann test, if made, was consistently negative. Jahnelregards a positive Wassermann reaction as a probable index of thepresence of spirochetes in the body. I think we should look on the DUXLAP—GEXERAL PARALYSIS 599 negative Wassermann re
AMAarchives of neurology & psychiatry . tion (twice repeated) wasnegative in both blood and spinal fluid. \ alente, a Portuguese investi-gator, reports three cases with positive spirochete findings but negativeWassermann reactions in the spinal fluid. In my experience I can recallno case of general paralysis, confirmed by the microscope, in whichthe fluid Wassermann test, if made, was consistently negative. Jahnelregards a positive Wassermann reaction as a probable index of thepresence of spirochetes in the body. I think we should look on the DUXLAP—GEXERAL PARALYSIS 599 negative Wassermann reactions (not further described especially as totreatment) with some skepticism, as defects in technic or reagents arenot rare; the personal equation of the serologist has also to be con-sidered, and it is possible to mix up specimens. HOW DO SPIROCHETES REACH AND ENTER THE BRAININ GENERAL PARALYSIS? This is still an open cpestion. Some authors, such as \alente, thinkthat spirochetes may enter the central nervous system at the time of. Fig. 10.—General view showing the position of spirochetes in both nervousparenchyma and in blood vessels. The dark masses are due to aggregationsof spirochetes in large numbers. the early syphilitic meningitis, when the whole system is flooded withspirochetes; at this time, under unknown conditions, they break throughthe neuroglial boundary membrane. Such views do not seem toaccount satisfactorily for the long incubation period of ten to twentyyears in general paralysis. That spirochetes do enter originally bythe blood or meningeal route, however, seems most probable. LONG INCUBATION PERIOD AND EHRLICH S VIEWS OFRECIDIVE STRAINS The neurorecidive theory of Paul Ehrlich does take the incubationperiod into account, and while admittedly only a theory which is unten- 600 AKCIIiriLS OF XEUROLOGV AXD PSYCmATRY able at present on the basis of estal)lishe(l tacl>, it is extremely sucj-gestive, although it makes no attemj)t to show just how the spir
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