Nervous and mental diseases . CRANIAL NERVES. 107 cerebrospinal fluid is the sole cause, and support this contention withnumerous clinical observations and animal experiments. In toxic casesit may represent the local action of the poison. Deutschmann * insiststhat it is due to pathogenic organisms which enter from without. Thequestion is not settled. Atrophy of the optic nerve may (1) follow papillitis and reti-nitis or choroiditis; (2) it may result from injury or inflammationto the nerve-trunk; (3) it may be associated with sclerotic disease inthe brain and spinal cord; (4) it may be due to
Nervous and mental diseases . CRANIAL NERVES. 107 cerebrospinal fluid is the sole cause, and support this contention withnumerous clinical observations and animal experiments. In toxic casesit may represent the local action of the poison. Deutschmann * insiststhat it is due to pathogenic organisms which enter from without. Thequestion is not settled. Atrophy of the optic nerve may (1) follow papillitis and reti-nitis or choroiditis; (2) it may result from injury or inflammationto the nerve-trunk; (3) it may be associated with sclerotic disease inthe brain and spinal cord; (4) it may be due to diabetes, malaria,or syphilis ; and (5) it may be of unknown causation. The atrophy consecutive to papillitis is easily understood, and of thesame nature is the retinitic and choroiditic forms. Injury to the opticnerve naturally results in atrophic degeneration of the nerve-head. Thatform of optic atrophy found in about a tenth of the cases of locomotorataxia, often present in paretic dementia, and not infrequent in multiple. Fig. 34.—Optic neuritis Fig. 35.—Atrophy of the optic nerve. or disseminated sclerosis, has an importance quite its own. Atrophy isfound in amaurotic idiocy and in the cerebellar form of family ataxia. The symptoms and ophthalmoscopic pictures are tolerably uniformfor the various forms. In the variety associated with tabes the disc isoften grayish, translucent, and shows the stipling of the lamina the postpapillitic form the translucency and stipling are less amaurotic idiocy there is a peculiar bluish spot at the site of themacula about twice the size of the disc, presenting in its center abrownish-red spot strongly contrasting with its surrounding patch andresembling a central embolism or hemorrhage. At the same time the discis atrophic. In all forms of atrophy the disc is sharply outlined fromthe surrounding retina by its pallor and the vessels are diminished in size. Functional and Toxic Blindness.—The peculiarities of hyste
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