SYMPTOMATIC INVOLVEMENT OF THE NERVOUS SYSTEM IN DIFFERENT FORMS OF DYSENTERY

A number of different cases have been described in which nervousdiseases,nervous syndromes and single nervous symptoms appeared in causal connection with dysentery.The nervous symptoms may beindependent of anemia,with special reference to the cases of combinedsclerosis.Anemia may be absent or present in these cases.The ner-vous disorders,especially in combined sclerosis,may accompany anemiabut are not necessarily caused by it.On the other hand we know fromthe studies of Keefer and his collaborators,that many cases of dysenteryshow anemia without nervous disorders.The nature and probable etiology of the nervous disorders in dysen-tery are difficult to determine clinically.Some of the changes describedmight be considered to be inflammatory,as in the cases of encephalitisand acute myelitis.Others might be toxic,especially in the cases withsymptomatic psychotic behavior.But the term "toxic" should be sub-jected to analysis.In the studies of Spielmeyer and Bodechtel a num-ber of "toxic" brain changes were shown to be primarily circulatory orvascular in nature and further study may well resolve the concept of"toxic" still more into its radicals.Another set of factors in producing these nervous disorders seemsto be metabolic,due chiefly to undernutrition and avitaminosis,parti-cularly in the cases with subacute combined sclerosis and neuritis,asdescribed by Keefer with his collaborators,by Menzel and others.Thisgroup can probably be extended,The part played by these metabolicfactors and by dehydration and edema in some of the nervous disordersis also difficult to determine clinically.Here anatomical studies step in.We are making such studies atpresent and will be able to report our results in the near future.