Nervous and mental diseases . tized or stupefied with alcohol. At timeshe can be roused to answer in monosyllables, but promptly subsides intothe lethargic state and may become unconscious and comatose for a fewmoments, for an hour, or for several days. When he talks it is in anuncertain and unreliable way. Frequently there is a little headache alone seems to cause him trouble. Usually pupillarysluggishness and inequality are present, ptosis and squints are frequent,and diplopia sometimes admitted. There may be urinary incontinenceor retention. Fever is ordinarily, but not invaria
Nervous and mental diseases . tized or stupefied with alcohol. At timeshe can be roused to answer in monosyllables, but promptly subsides intothe lethargic state and may become unconscious and comatose for a fewmoments, for an hour, or for several days. When he talks it is in anuncertain and unreliable way. Frequently there is a little headache alone seems to cause him trouble. Usually pupillarysluggishness and inequality are present, ptosis and squints are frequent,and diplopia sometimes admitted. There may be urinary incontinenceor retention. Fever is ordinarily, but not invariably, absent and thephysical functions are well carried on. Death rarely results from thisform of cerebral syphilis, but, on the other hand, complete recovery isequally rare. Some trace in the way of mental apathy is likely to per-sist. In exceptional instances there is wild, maniacal delirium andmotor excitement, an elevated temperature, and quickened pulse. The Arterial Form.—Cerebral syphilitic arteritis is usually accom-. Fig. 209.—Brain showing basilar syphilitic meningitis, with generalized exudate and small cysts in thedeeper farrows (Dr. W. A. Jones). panied by basilar specific meningitis and the premonitory symptoms are also usually present. It gives rise tothrombus and cerebral softening, resulting in hemiplegia or monoplegia,or aphasia or other localized cortical disability. Usually this does notcome on at once, but by slight premonitory strokes and numerouswarnings. Transitory plegias and aphasias are always suggestiveof syphilis. When the motor cortex is involved, spasm or partialepilepsies are commonly induced. The rule applies here, as in gum-mata, that epileptic seizures after the age of thirty are generally due tosyphilis, and that paralytic seizures in adults, before the age of forty, in SYPHILIS OF THE NERVOUS SYSTEM, 487 the absence of cardiac and renal lesions, are almost invariably indication of syphilis is a mu
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