Recent Progress in Diseases of 
the Brain and Nervous 
System. 
B Y 
F. ROBERT ZEIT, M. D., 
OF MEDFORD, W1S. 
Reprint from the Transactions of the State Medical Society, 189a. 
MADISON, WIS.: 
TRACY, GIBBS <S CO., PRINTERS AND STEREOTYPERS. 
1892. Recent Progress in Diseases of 
the Brain and Nervous 
System. 
BY 
F. ROBERT ZEIT, M. D., 
OF MEDFORD, WIS. 
Reprint from the Transactions of the State Medical Society, 1892. 
MADISON, WIS.: 
TRACY, GIBBS <S CO., PRINTERS AND STEREOTYPERS. 
1892. RECENT PROGRESS IN DISEASES OF THE BRAIN 
AND NERVOUS SYSTEM. 
BY F. ROBERT ZEIT, M. D., OF MEDFORD, 
CHAIRMAN OF THE COMMITTEE ON NEUROLOGY. 
In this paper I have confined myself to a few phases, only, 
of my subject, such as have elicited a more general interest 
during the past few years, recognizing the impossibility of 
doing justice to the subject if taken as broadly as the title 
would indicate. 
The neurotic tendency of mankind has, perhaps, at no time 
been so pronounced and fully developed as at present. The 
modern achievements of civilization, the arts, sciences, and in- 
dustries, developed by the age of steam, followed closely by 
the age of electricity, their different applications towards rapid 
locomotion and transmission of thought, so that the North 
and South poles fairly kiss each other, all have their sway in 
increasing the tension of nervous tissue to its utmost; other 
factors are the outgrowth of a life of competition with its haste 
after the almighty dollar, the attendant mental exertion and 
exhaustion, relieved artificially, but temporarily, by sedatives, 
hypnotics, and narcotics; excesses in venere et baccho, and 
idleness; social and moral problems and influences. 
The fatalistic pessimism, preached by a modern school of 
literature, calling itself realistic, has disclosed to the general 
public eye the darkest side of human life, an aspect of human 
weakness, misery, and depravity which can be tolerated only 
and gazed at, when lit up by the purifying rays of medical 
science. It is not, as those authors would have us believe, 
the normal man they have portrayed; it is the degenerate by 4 
heredity, or through the violation of the laws of health. On 
the other hand, the belief in the fatalism of heredity, as car- 
ried into the extreme by the dramaturgist Ibsen and others, is 
becoming far too general. Education, healthy surroundings, 
mental and moral training, with one word, proper measures 
to prevent exciting causes, in a few generations will certainly 
remove the inherited predisposition to most psychoses and 
neuroses. 
But not enough;—during the past years a poison of special 
affinity for nervous tissue, influenza, has been ingrafted upon 
this highly strung nervous system to furnish another exciting 
cause for neuroses and psychoses. The poisonous and infect- 
ious matter of influenza is thought to affect the vis medicatrix 
of nerve centres primarily; disease of lungs, heart, and digest- 
ive tract being only caused by derangement of the nervous 
supply of these organs. 
The neurologist has repeatedly pointed out that the gener- 
al practitioner must be the one to recognize the premonitory 
symptoms of psychoses and neuroses arising from all the 
causes named, if prevention, or cure, is to be expected. 
LOCALIZATION OF CEREBRAL CENTRES. 
During the past two years no’new discoveries in regard to 
localization have been made, but current theories have been 
confirmed by the work of the pathologist and clinician. 
Primarily, the brain has been looked upon as a gland, at- 
tracting the mucus from the whole body and discharging it 
through the nose, until Galen taught that the soul was a sub- 
stance distilled from the blood by the brain, and endowed 
with three functions, locating these in the three cavities of 
the skull. This remained the current theory until Flourens 
proved the intimate relation existing between brain-function 
and manifestation of soul, by his classic experiments. He de- 
scribed how the psychic functions slowly decreased as he re- 
moved layer after layer from the brain, “cutting down the 
soul by slices” as it were. 5 
Ferrier and Munk maintain that certain circumscribed cen- 
tres may be located on the cerebral cortex, in which the act 
of conscious sense impressions takes place, and which represent 
the “storehouse of memories of the sense impressions.” Golz 
claims that no localized centres exist, that the brain can only 
act as a whole; that the function of any part, when destroyed, 
will be performed by other portions of the brain. Luciani 
and Exner, finally, advocate an aurea mediocritas by their 
view that the cortical centres overlap each other to some ex- 
tent and that they have no sharply defined boundary lines. 
CEREBRAL SURGERY. 
It seems only natural that the successful localization of les- 
ions by the neurologist, the experimental physiologist, and 
the joint observations of the clinician and pathologist have 
revolutionized the surgery of the central nervous system. By 
applying “modern principles of surgery,” the greatest danger 
of former operations has been abolished. 
During the last two or three years trephining has been suc- 
cessfully applied to many cases of cranial hemorrhages, extra 
as well as intra-dural, traumatic and non-traumatic, whenever 
pressure symptoms appeared. The white matter has been cut 
into to a considerable extent without pronounced harm. Brain 
tumors, invariably fatal if not removed, have been success- 
fully excised when they allowed of accurate localization, 
and, if not found, the trephine hole has given marked re- 
lief. Portions of the dura have been removed as large as 
two and one-half by three and one-half inches, without bad 
effects on cerebration. Early trephining has been frequently 
successful in cases of brain abscess, formerly fatal; in cases 
where pus was not found on opening the dura, the aspirating 
needle has been thrust into the brain in all directions until 
pus was found. Traumatic epilepsy has been palliated by 
trephining, and temporary relief was afforded in Jacksonian 
epilepsy. Cases of intense cephalalgia of long standing, in- 6 
curable by drugs, have nearly all perfectly recovered when 
trephined. Cases of acquired microcephalus, due to prema- 
ture closure of the skull, were markedly improved by linear 
craniotomy and trephining. Some cases of general paresis, 
even, have been temporarily benefited by trephining, and who 
knows but what future work in this direction may not be 
crowned by the revelation that many cases of insanity can be 
cured by surgical measures? 
A goodly number of operations upon the spine have been 
done lately for traumatism, neoplasms, and caries, relieving 
pressure upon the cord, curing inflammatory and suppurative 
processes by removal of dead bone and free drainage. 
NEUROSES. 
A vigorous contest has been going on during the past 
years to prove, and disprove, the claims of Stevens that er- 
rors of refraction are the cause of reflex neuroses, such as 
chorea and epilepsy. It is now more generally believed that, 
while peripheral irritation may produce reflex neuroses in 
exceptional cases, it would be going too far to subject all 
these cases to surgical measures for the relief of ocular strain, 
in believing this peripheral irritation to be the only cause. 
Otherwise the treatment of chorea and epilepsy remains the 
same, large doses of arsenic for the former and bromides for 
the latter. In cases of status epilepticus, hydrobromate of 
hyoscine or conine has been highly recommended. 
A good deal has been said and written about the care of 
epileptics. The insane asylum is certainly an unfit place for 
them, and so are their homes. An outburst may occur at 
any time, leading even to crime. A benevolent provision is 
sadly needed to furnish a retreat for these unfortunates. Ger- 
many has shown us the way to care for our epileptics. At 
Bielefeld a colony of more than one thousand epileptics has 
been established, with a large number of cottages, making 
quite a village, where the different trades and industries are 
carried on by the members. 7 
The dispute concerning traumatic neuroses still continues. 
Railway spine, or Erichsen’s disease (Clevenger), has been 
called litigation disease by the railroad surgeon (Judd). The 
neurologist insists on the first term, which implies a distinct 
group of symptoms, not to be regarded as simulated, and 
which may develop slowly and insidiously some time after the 
accident, leading on to serious spinal disease. The railroad 
surgeon wants these cases classed as hysteria and neuras- 
thenia, when no immediate symptoms arise pointing to in- 
flammatory and other morbid changes in the cord. Accord- 
ing to him, all symptoms arising later than about four days 
after receipt of injury are simulated. 
SUSPENSION IN SPINAL DISEASES. 
The enthusiasm with which the profession took up the new 
and promising means of treating spinal diseases by stretching 
of the cord, has had its day, and has subsided rapidly during 
the past two years, as experience in its use demonstrated 
that the promising claims of its first advocates were not 
being realized. Horsley, and others, maintain that no ma- 
nipulation during life is capable of stretching the cord, while 
others are just as firm in their belief to the contrary. The 
theory has been advanced that suspension causes a relaxa- 
tion, breaking down of adhesions, and that impediments to 
the circulation were removed thereby. Even if it does not 
cure, many nervous diseases have been benefited by it, such 
as tabes dorsalis, amyotrophic lateral sclerosis, and progres- 
sive muscular atrophy. About sixty per cent, of the ataxic 
cases reported were, more or less, benefited by suspension. 
Lately, Bonuzzi and Benedict proposed to apply forced 
extension to the spinal cord, by seizing the feet of the 
patient with a towel and carrying them forwards so that the 
knees touch the patient’s head. They claim that, with due 
care, an elongation of the cord may be thus obtained three 
times as great as that resulting from the use of any special 8 
apparatus, and that the results are consequently more bene- 
ficial. 
MENTAL DISEASES. 
Although this subject does not properly belong to Neurol- 
ogy, it is one which is so intimately connected and related to 
it, that the two can hardly be separated at this day. The 
subject of psychiatry is usually neglected by the general 
practitioner, as well as the majority of our colleges. It is, 
therefore, only natural that he who might see many oppor- 
tunities for prevention, by being somewhat familiar with its 
incipient manifestations, will allow these cases to go on until 
they populate our asylums as incurables. The alienist has 
repeatedly complained about this condition of affairs during 
the past years, and has recommended small wards for acute 
cases, which are to be accessible to students for clinical 
instruction. To the general practitioner, the subject of psychi- 
atry is of the greatest importance and, frequently, of far 
reaching consequence, aside from its intimate connection with 
jurisprudence. 
Of late years the question of private, or hospital treatment 
has been ventilated freely. It has been claimed that asylum 
physicians are given too many cases to treat; that they have 
no opportunity to do justice to curable cases, because 
asylums are overcrowded with incurables; that the practice 
of allowing mild, and curable, cases to mingle with severe, 
and incurable, types of insanity is detrimental to the 
former; that for many curable cases of insanity (such as sub- 
acute mania, melancholia without great agitation, precordial 
fear, or stupor, many cases of primary dementia, puerperal 
insanity, epileptic, hysterical, and periodical insanity, and 
the insanities of childhood), home treatment is very much to 
be preferred. 
Physical restraint, not only as a former punishment for 
bad conduct, but also in its application for purposes of treat- 
ment, prevention of injury, etc., is only being used in its 
mildest forms. 9 
The different classifications of insanity, the pathological- 
anatomical, the psychological-symptomatic, and those based 
on the etiology and course of the disease, are giving way to 
a modern clinical classification, which endeavors to collect 
such types into a class, which have a similarity of pathogene- 
sis, symptoms, and course, and the same pathological basis, 
perhaps. 
In regard to the psychoses following influenza, experience 
has demonstrated that, in the majority of these cases, a 
favorable prognosis may be given, the treatment consisting 
in sedative and tonic measures. 
ALCOHOL INEBRIETY. 
No subject, perhaps, has of late received more general 
attention from the profession, as well as the laity, as that of 
inebriety. It has become a specialty of men who have de- 
voted their lifetime to the study of this branch of neurology. 
As our forefathers in the medical profession made it their 
philanthropic duty to rescue the insane from the clutches of 
an ignorant and superstitious public, who supposed these un- 
fortunates possessed of the devil, it appears to be plainly our 
duty to protect and rescue the confirmed inebriate, unques- 
tionably insane, from the destroying and degrading influence 
of commitment by the courts. 
Neither the law, the church, nor other moral pledge to ab- 
stain, can cure inebriety. An appeal to the will power of 
the individual affected with this disease is on a par with the 
pledge of an insane patient not to commit a crime. The ap- 
peal is made to a power which is no longer present. It is 
distinctively the pathognomonic symptom of the disease in- 
ebriety, that the will power is lost and that an irresistible 
impulse to drink has supplanted it. While inebriety is a dis- 
ease with granular degeneration of nerve cells, miliary aneu- 
risms, exudations and indurations of the cerebrum, drunken- 
ness may be a habit. Crothers says that, in 1890, over half 10 
a million persons were arrested in this country for being 
drunk and disorderly, and that “the first legal punishment of 
inebriates is followed by a species of fatality, seen in a repe- 
tition of the same offence ever after. The courts call these 
cases repeaters.” 
The crime of the confirmed inebriate is motiveless, like 
that of the “criminal insane,” and no premeditation, prep- 
aration or reflection is used in committing it. He may com- 
mit any crime, from the stealing of Bibles to the most hein- 
ous murder. His acts and reasoning are not under control, 
and the courts should hold him irresponsible, instead of con- 
sidering his inebriety as an aggravating circumstance. 
To cure this disease, then, the nerve cells must be brought 
back to their normal condition, and that this can not be 
done by the lightning method of the “hypnotiseur of Dwight” 
has, by this time, been fully demonstrated. There are many 
retreats in our country where inebriety is treated, and cured, 
by rational and scientific methods. Thirty-five to thirty- 
eight per cent, of 5,000 cases, treated eight to twelve years 
before their discharge, were temperate and well. Keeley 
may, therefore, keep secret his so-called secret. We do not 
need, nor wish to know such “secrets” as he speaks of, from 
“on high.” There are physicians enough yet who know 
their duty toward mankind. 
OPIUM INEBRIETY. 
Opium inebriety also is looked upon as a disease. Of the 
opium imported into the United States only 50 per cent, is 
used in medicine and pharmacy, according to Crothers, and 
he estimates the number of persons affected with this neuro- 
sis in this country, as over a hundred thousand. A degener- 
ation of the brain is thought to be the cause of narcomania. 
A strong plea has been made during the past year to use 
codeine for pain and insomnia, and narceine as a simple sop- 
orific, in places where morphine would be indicated. These 
drugs establish no craving. 11 
Of the three methods in use for treatment of this neurosis, 
immediate withdrawal is generally stamped as inhuman and 
dangerous ; rapid reduction is used to some extent ; gradual 
withdrawal of the drug is the method which is most favor- 
ably spoken of. These cases can only be properly treated 
in a special institution. 
It. is a matter of the greatest consequence that the great 
number of patent medicine cures for opium inebriety, which 
nearly all contain opium in some form or other, should be 
wiped out of existence by legislative enactment. 
Stephen Lett, in speaking of opium inebriety, says: “The 
unfortunate opium habitue needs help. He needs care. He 
needs kindness. He has suffered long years of torture and 
deprivation ; been tossed hither and thither like a rudderless 
vessel, upon the turbulent waves of a cold and austere world ; 
looked upon as a vicious outcast, whose every action is 
treated with suspicion, his statements doubted, his case mis- 
managed. Let your full sympathy and aid go out toward 
him ; you will then brighten a dark spot in the deepest of 
despair.” 
SEXUAL PERVERSION AND ALLIED STATES. 
This subject is one which merits a more general attention 
and study by the profession. There is no village or hamlet 
without such cases, and every now and then the community 
is startled by some loathsome deed or crime, committed by a 
victim of these neuroses or psychoses. While no one will 
for a moment fail to see the far-reaching influence which the 
sexual life has over the thought and action of the individual 
and social life, its psychopathology should also receive due 
consideration, notwithstanding its being one of the darkest 
sides of human life. 
Krafft-Ebing divides sexual neuroses into : 
A. Mentally sound cases of peripheral and spinal origin 
teuropathological). 12 
B. Mentally unsound cases (psychopathological). 
In the latter (B) class he distinguishes between : 
1. Paradoxia sexualis, the sexual appetite of childhood and 
senility. 
2. Anesthesia sexualis, sexual appetite congenitally lacking 
or its abolition acquired. 
3. Hyperethesia sexualis, augmentation of sexual appetite. 
4. Paresthesia sexualis, perversion of sexual appetite. 
Sexual perversion (paresthesia sexualis) is subdivided by 
him into: 
(a) Sexual affinity to persons of other sex with perverse mani- 
festations, such as flagellation, fetichism, flaying of an- 
imals, mangling of women, cutting and stabbing of 
girls, necrophilia, and murder for mere gratification of 
lust. 
(b) Diminished or abolished affinity for other sex and affin- 
ity for their own sex (contrary — or homosexual affin- 
ity), either acquired or congenital, with which are 
classed cases of psychic hermaphroditism, urnings, 
androgynus and androgyna. 
As the neurotic tendency of the times, and the propagation 
of neuropathic constitutions from generation to generation is 
increasing, so are these sexual delicts increasing in number. 
Irritation of the sexual centres leads on to passion and ex- 
cesses, these to perversion. The Whitechapel murders, the 
Mitchell-Ward tragedy, and other similar cases, are still fresh 
in our memory. The psychopathological nature of most 
of these is beyond question. The female urning is as frequent 
as the male, and is generally not an inherited vice, but ac- 
quired by masturbation. Parent-Duchatelet and Taxil already 
reported cases of amor lesbicus, and bloody revenge through 
jealousy. 
Incest, rape, bestiality, pederasty, amor lesbicus, frequent- 
ly are of psychopathological nature, but not always. Necro- 
philia, and murder for mere gratification of lust, are always 
considered as psychopathological. 13 
PRESENT ASPECT OF HYPNOTISM. 
No greater contradiction can be offered to one who recog- 
nizes “de nihilo nihil” as the basis of all philosophic truth 
and reasoning, than that the less of a remedy is given, by in- 
finitesimal division, or dilution, the more powerful must be 
its effect in disease, and yet we see a number of cases, treated 
according to such principles, recover. He who knows ine- 
briety to be a disease with structural changes of nerve-cells, can 
hardly be made to believe that these cases, treated only for a 
few weeks, have been cured by some wonderful secret medi- 
cine, although they may have lost their irresistible craving for 
the time being. He who has seen some incurable case go the 
rounds of reputable physicians, unrelieved, cannot believe that 
the traveling mountebank, the clairvoyant, the animal mag- 
netizer, has effected a cure, albeit he observes, sometimes, an 
indubitable temporary improvement. What force is it, then, 
that performs these wonders? Can it be anything else than 
mind cure, pure and simple, by suggestive hypnotism? A 
saying, as old as Galen, gives credit to confidence in the phy- 
sician for half the cure in functional diseases. In this, the most 
skeptical concerning hypnotism insist fully as much as its most 
enthusiastic advocates. 
When Krafft-Ebing, Forel, Jendrassik, Focachon, Beaunis, 
and Delbceuf tell us that they have raised blisters by hypnotic 
suggestion, not to speak of the marvelous reports of Liebault 
and Bernheim, who vouch for the removal of nearly all the ills 
of mankind by this means alone — a veritable fairy story—we 
can no longer question the efficacy of hypnotism. What then 
is our duty but to study its effects, immediate and consequent, 
which would lead to a clear understanding of the conditions 
permitting its use. 
“Learn magic, but (!) do not use it” is old advice, and like- 
wise we are asked to do with hypnotism. Those practising 
hypnotism tell us that sleep and the hypnotic state are iden- 
tical; that nothing is observable to differentiate the induced 14 
from the natural sleep; that any remedy may prove dangerous 
when injudiciously used, but that many cures result by its ap- 
plication, no remedy giving as great promise for diseases of 
the nervous system; and that the danger incurred is far out- 
weighed by the advantages gained. The opponents of hyp- 
notism (Kerr and others) see, as its results, only a disordered 
cerebral state and abnormal psychic conditions; denying its 
therapeutic value, it being a pathological modification of the 
nervous system, indicating a neuropathic condition of the sub- 
ject; that it is frequently dangerous and rarely useful; that it can 
cure no disease which is not more easily curable by less danger- 
ous methods; that only a limited number of patients are suscept- 
ible to it, Charcot claiming only one in a hundred thousand; 
that it produces bad after-effects, such as disturbance of men- 
tal equilibrium, dissipation of energy, and nervous exhaustion; 
that if, by it, one disease has been cured, it was by substitut- 
ing another; that it lowers mental activity, causes moral per- 
version, mental unsoundness, and morbid nervous suscepti- 
bility; finally, it has been denominated artificial madness and 
experimental imbecility. 
A committee of the British Medical Association, appointed 
to inquire into hypnotism, drew the following conclusions last 
year: “I. Hypnosis is a subjective phenomenon, notin itself 
a disease. 2. Neurotic disposition predisposes to hypnosis, 
but the strongest minds have been enthralled. 3. Three states 
are recognized—lethargy, somnambulism, and catalepsy. 4. It 
has been serviceable in medicine and surgery as a therapeutic 
agent, and in some cases as a safe anesthetic.” 
A general protest has been made by the medical profession 
of the entire world, almost, during the last few years, against 
public exhibitions of hypnotism by wandering mountebanks, 
these being dangerous and destructive. France, Belgium and 
Russia, and many of our larger cities, have prohibited these 
hypnotic shows, restricting the use of hypnotism to the medi- 
cal profession. 15 
I will not pass from this subject without expressing my 
strong conviction that there is perhaps no more fitting appli- 
cation of hypnotic suggestion than in cases of sexual perver- 
sion— referred to above. These cases cannot be harmed very 
much by suggestive hypnotism, and are certainly benefited a 
great deal.