July 21, 1906


JAMA. 1906;XLVII(3):209. doi:10.1001/jama.1906.02520030051007

The nutrition of the tissues has been supposed to be dependent on the integrity and healthy action of special trophic nerves and centers, disorder of which has been invoked to explain certain forms of wasting and destruction. Such structures, however, have never been actually demonstrated and their existence must still be considered problematical. On the other hand, there are reasons for believing that the changes referred to are attributable to derangement of function or alteration of structure in the ordinary nerves of motion and sensation. Some phases of this subject are discussed by Sir William E. Gowers,1 in his customary illuminating manner, in the course of a lecture dealing with the dystrophies of tabes dorsalis. namely, arthropathy and perforating ulcer. In his opinion, the tissues possess an inherent vitality which is influenced by the state of nutrition of the nerves related to them. In cases of tabes dorsalis, as

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