Neurological Therapeutics

Abstract

I T has occasionally been said of organic diseases of the nervous system that while constituting a most interesting field of study in applied physiology and pathology, they are therapeutically destitute. An ardent neurologist might have replied that treatment in organic neurology at all times compared favourably with that in organic medical diseases, such as chronic conditions of the heart, liver and kidneys. We utter a truism in adding that all advance in knowledge of the setiology, pathology and diagnosis of a disease inevitably leads to increased understanding of the possible means of treatment. It is to these aspects of organic disease of the nervous system that most neurological research has been directed, with many brilliant results. Nevertheless, in reviewing the progress of neurology during recent years, it is evident that increasing attention has been paid to treatment per se and that the advances have been considerable. Several diseases, formerly considered almost untreatable apart from general care and management, are now subjected to direct attack. Foremost among these is that form of progressive syphilitic meningoencephalitis, popularly though unfortunately known as ' general paralysis of the insane.' The application of malarial therapy undoubtedly inhibits the malady in the majority of early cases with the result that after a number of years, varying from two to six, the cerebrospinal fluid becomes normal, losing its increased protein content, positive Wassermann reaction and Lange curve. Patients are known among the first to be treated in this country-some 14 years ago-who still survive and in some instances remain useful members of society. An average of the available statistics indicates that approximately 35 per cent. of all cases treated-irrespective of the stage of the disease-show good and lasting remissions, while in a fair proportion of the remainder improvement or arrest of the disease occurs. Compare this with the prognosis invariably given prior to the introduction of malarial treatment