Page:Manual of pathological anatomy (IA manualofpatholog00jone).pdf/300

284 CONDITION OF THE BRAIN IN INSANITY, Cysticercus cellulose is either confined to the brain or else there is a simultaneous development in the muscles. It may occur in very large numbers ; according to Cobbold, at least 100 fatal cases have come to light.

Serous cysts, neither originating in heemorrhage nor duc to parasites, are of very rare occurrence; but true Dermoid cysts haye been recorded, In a case referred to by Vérster a compound cyst, containing hair, cartilage, and bone, was found in tho left cerebral hemispheve of a boy ten weeks old. Another containing fat, with short stiff hairs, was scen by Sir J. Paget, under the cerebellum of an elderly man.*

Although there are no specific morbid conditions always asso- ciated with insanity some tacts have been ascertaincd which are worth considerution. They must necessarily be given in a some- what fragmentary form. In acute mania we tind evidences of great hyperemia, or incipient inflammation, especially in the cortex of the brain.t The grey matter (and especially its inner two-thirds) assumes a distinct pink tint, which is not removed by washing the cut surface. The samo is seen in a less degree in some parts of the white medullary substance. This intense hype- reemia is probably always accompanied by some degree of capillary hwmorrhage; and on microscopical oxamination red blood cor- puscles may be seen scattered among the nervous elements. To this condition especially belong the so-called dissecting anourisms; though we must repeat that they are not peculiar fo cases of in- sanity. A more chronic change consists in an increase of connective tissue, by which the nervous elements are compressed and impaired. This connectiye tissne growth appears to start from the walls of the capillary vessels themselves, and not from the neuroglia, The vessels suffer also move obvious changes; they become varicose, tor- tuous, knotted, or ancurismal; their walls show great thickening and fatty or calcareous degeneration. ‘These changes in the yessels are especially charactoristic of insanity, accompanied by general paralysis. Degeneration of other structures is shown by the presence of amyloid corpuscles, pigmented, fatty, and atrophied nerve cells. Actual calcification of the ganglionic cells has also been observed. Peculiar changes in the nerve cells have further been observed by Meynert, who describes yesicular enlargement or


 * “Surgical Pathology,” second edition, p. 435.

+ We believe this fori of hypersemia to be essentially different from that caused by meningitis. It is distivoguished by the stratified appearance of the eortex, and by the red tint being chiefly scen in the mner part, while the outer layer is pale. Tn smoningitis, or siuple congestion, on the other hund, the whole of the grey cortical substance has a uniform pinkish tint,.

£ Described by Rokitansky, Wedl, Sankey, and others. See dexeription and figures by Sankey in “Trans. Path. Soc.,” 1866, vol. xvii. pl. i. p. 8. �