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January 22, 1898


Author Affiliations

Professor of Mental Diseases and Therapeutics, Rush Medical College; Professor of Nervous Diseases Woman's Medical College (Northwestern University); Professor of Mental and Nervous Diseases, Post-Graduate Medical School. CHICAGO, ILL.

JAMA. 1898;XXX(4):180-181. doi:10.1001/jama.1898.72440560008001b

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The treatment of any disease, as a matter of course, is largely based upon its pathogenesis; and while we may safely assume that at least 90 per cent, of the cases of tabes dorsalis have an antecedent syphilitic history, yet it is not a true syphilitic disease, for in the remaining percentage of cases other etiologic factors are at work, among which are trauma, the acute infections, alcoholism, and the auto-intoxications, so that we may call the disease rather a degenerative sequela of these various processes, and we know not whether the disease begins in the neurons, in the connective tissue, or in the blood vessels. But let it begin where it may, the resultant is a sclerosis terminating in hypertrophy of the connective tissue and a destruction of the sensory neurons of the spinal cord. I am of the opinion that with many a too gloomy prognosis is made.

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