A Demonstration of Treponema Pallidum in the Brain in Cases of General Paralysis

Noguchi, Hideyo; Moore, J. W.

doi:10.1084/jem.17.2.232

Cited by 143 publications

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“…Not until the early twentieth century did the 'syphilitic hypothesis' begin to achieve widespread acceptance, with the Japanese bacteriologist Hideyo Noguchi's demonstration of the presence of the organism, then called Spirochaete pallida, in the brain of a patient who had died of GPI. 5 However, even then, Scottish asylum physicians continued to ascribe GPI to factors as diverse as 'bereavement', 'kick from a horse', and 'unknown origin'. 6 There was, however, broad agreement on the disease's symptomatology and prognosis.…”

Section: Introductionmentioning

confidence: 99%

The most deadly disease of asylumdom: general paralysis of the insane and Scottish psychiatry, c.1840–1940

Davis¹

2012

J R Coll Physicians Edinb

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General paralysis of the insane (GPI) was one of the most devastating diseases observed in British psychiatry during the century after 1840, in terms of the high number and type of patients diagnosed, the severity of its symptoms and, above all, its utterly hopeless prognosis. With particular reference to the physicians and patients of the Royal Edinburgh Asylum, this article explores the diagnostic process and the social and medical significance of the 'death sentence' that accompanied the GPI diagnosis.KeywoRdS General paralysis of the insane, mortality, diagnosis, prognosis, postmortem, Royal Edinburgh Asylum deClARATionS of inTeReSTS No conflicts of interest declared. General paralysis of the insane (GPI) emerged as a new and devastating form of insanity during the early nineteenth century. Its identification as a distinct disease category has been credited as the achievement of a small group of French psychiatrists, or alienists, as this profession was commonly known during the nineteenth century. G Davis1 The disease was not recognised in Scotland until around 1839, 2 though clinicians on both sides of the English Channel questioned whether this was simply because British alienists had not yet 'learned to see' the disease. 3,4 There was also considerable confusion as to the causation of GPI. Although the possibility of syphilis had been suggested as early as 1857, this was not generally accepted in the nineteenth century, when the disease was thought to be multi-causal, relating largely to the destructive influences of the urban environment and in particular to the excesses of alcohol, tobacco and sex. Not until the early twentieth century did the 'syphilitic hypothesis' begin to achieve widespread acceptance, with the Japanese bacteriologist Hideyo Noguchi's demonstration of the presence of the organism, then called Spirochaete pallida, in the brain of a patient who had died of GPI.5 However, even then, Scottish asylum physicians continued to ascribe GPI to factors as diverse as 'bereavement', 'kick from a horse', and 'unknown origin '. 6 There was, however, broad agreement on the disease's symptomatology and prognosis. It was widely perceived as the most deadly disease of psychiatry. The course of GPI was one of steady and progressive mental and physical deterioration ending in death. The disease inflicted degenerative dementia upon its sufferers in tandem with the development of muscular incoordination and paralysis, hence the disease's pseudonym 'dementia paralytica'. Most of those diagnosed were middle-aged males in the prime of their working lives; the socioeconomic implications of the disease were therefore a source of significant concern. Worst of all, there appeared to be no cure, the diagnosis conferring an almost certain death sentence upon its sufferers. As a result of the type of patient diagnosed, the severity of the symptoms and the hopeless prognosis, the eminent Scottish alienist Thomas Clouston described GPI as the 'most terrible of all brain diseases '. 7 Nor was this ...

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Section: Introductionmentioning

confidence: 99%

The most deadly disease of asylumdom: general paralysis of the insane and Scottish psychiatry, c.1840–1940

Davis¹

2012

J R Coll Physicians Edinb

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“…Colpito da questa osservazione, decise di indagare in modo sistematico, utilizzando i dati clinici disponibili. Le conclusion} della sua ricerca, riportate nella sua tesi di dottorato, e delle quali egli poi riferi ad un Congresso internazionale (Steenberg, 1884), furono accolte con scetticismo dall'ambiente medico e accademico dell'epoca; esse in realta anticipavano di quasi trent'anni la scoperta del treponema nel cervello dei pazienti che erano stati affetti da paralisi progressiva (Nogouchi & Moore, 1913), scoperta che rese chiaro a tutti l'origine sifilitica della malattia.…”

Section: Dalla Pratica Psichiatrica All'epidemiologiaunclassified

Psychiatric epidemiology and Italian psychiatry. Looking at the past, looking at the future

Tansella¹

1995

Epidemiol Psichiatr Soc

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“…The appearance of small black dots is considered diagnostic of general paresis. Noguchi and Moore (1913) were the first to describe spirochaetes in the cerebral cortex of patients with general paresis. Demonstration of this organism is accomplished by fluorescent antibody staining or the meticulous use of one of the many silver impregnation techniques.…”

Section: British3'ournal Of Venereal Diseasesmentioning

confidence: 99%

Presence of spirochaetes in paresis despite penicillin therapy.

Gager¹,

Israel²,

Smith³

1968

Sexually Transmitted Infections

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A Demonstration of Treponema Pallidum in the Brain in Cases of General Paralysis

Cited by 143 publications

References 0 publications

The most deadly disease of asylumdom: general paralysis of the insane and Scottish psychiatry, c.1840–1940

The most deadly disease of asylumdom: general paralysis of the insane and Scottish psychiatry, c.1840–1940

Psychiatric epidemiology and Italian psychiatry. Looking at the past, looking at the future

Presence of spirochaetes in paresis despite penicillin therapy.

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