Diseases of the nervous system : a text-book of neurology and psychiatry . he cervical sympathetics. Cortical centers have been placed in the frontal areas (Lewandowsky,Weber; denied by Miiller and Glaser, who claim the midbrain as thehighest center), from which the pathways pass through the internalcapsule, caudate nucleus, thalamus, hypothalamus, pons, central grayof fourth ventricle, oblongata, Helwegs triangular bundle, anterolateralbundle to lateral horns—the fibers crossing in the posterior commissure(Helweg). The autonomic and sympathetic fibers apparently followdifferent pathways from


Diseases of the nervous system : a text-book of neurology and psychiatry . he cervical sympathetics. Cortical centers have been placed in the frontal areas (Lewandowsky,Weber; denied by Miiller and Glaser, who claim the midbrain as thehighest center), from which the pathways pass through the internalcapsule, caudate nucleus, thalamus, hypothalamus, pons, central grayof fourth ventricle, oblongata, Helwegs triangular bundle, anterolateralbundle to lateral horns—the fibers crossing in the posterior commissure(Helweg). The autonomic and sympathetic fibers apparently followdifferent pathways from the cord, the vasodilator autonomic pathwaysfollowing the course of the sensory roots, the vasoconstrictor sym-pathetic by way of the anterior roots, the motor nerves, and thesympathetic ganglion. Thus irritation of the posterior roots causeshyperemia (vasodilatation) with pain; paralysis of the same causesanemia with anesthesia. Within the bloodvessels themselves ganglion cells are found, saveperhaps in those whose vasomotors run in the spinal nerves (Miiller < Oh. fl 0) ^ -^ S- sT 0 0 CA >. r h 0 g T3 ^ D5 r: Q p •i-H 0 f; CC w ^ C5 o f- a) i-j c cC +j 0 0 fc 03 03 CC 0) B 0 Sh c -^j >^ S- W VASOMOTOR NEUROSES 101 and Glaser), and reflexes occur here exactly as in all of the skin andtendon reflexes from terminal stimuli. Hence an analysis of vasculardisturbances must include a stud} of the sensory, motor and centralportions of the reflex arc—the last including both medullary andcorticospinal reflex pathways. VASOMOTOR NEUROSES. Disturbances of the peripheral mechanisms of the vasomotorpathways have been more completely analyzed than those occurringin the spinal, bulbar, thalamic, or cortical portions of the same. Ofthese, more detailed mention may be made of the: (1) tonic hyper-emias (erythromelalgia), (2) spastic anemias (pseudosclerosis, Ray-nauds disease, migraine, intermittent claudication), and (3) vaso-motor irritability, as in acute angioneurotic edema,


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