, 1874-05-24
TINS INSANE.
hAcroscopica1 Detection Of L.
sions Of tho Brain.
Paper By Prof. Kempstcr Before the
State 3ieroscopical Society.
A New Field Of Discovery.

Sciences, tho President, H. ". Fuller, in the
chair The attendance WAS quite large and q
NUMBER OF Instruments, and many objects OF
Genera interest, were exhibited.
THE BRAINS OF THE INSANE.
Tho following paper from DR.. Walter Komp-
ster, Medical Superintendent of the Oshkosh
Insane Asylum, was read By DR.. 4. Reeves Jack
SOD. Before the reading Of the paper, Mr. Full
ler directed attention to the excellence OF the
photo-microErnphs Concerning them Or. Z.
writes: They are entirely the work Of my own
hands. From the post mortem until tho photos
we're pasted on the cards had no help, aud in
the meantime had also to learn the process Of
photography"
The paper, which WIS entitled " Notes On the
Microscopic Appearance Of the Brains Of the In-
sane. il as follows:
The pathological histology Of tho brain and nervous
sss'e!n bus. until comparatively recent date, re-
ceiyed but little attention. fcv earnest seekers have
carefully Investigated 1uiuts bearing upon tho phyeiol
og Of the central nervous system, and thay have d.
erly surrounded it. The profession must remain for
eyer indebted to Lockhart, Clarke, 1loanaky, VIZ
chow Aeyne1t Gerlucb Shuttle, and Deite1s for tho
impetus they have given to tho study Of the physiology
and pathology u the nervous system- Among these
accurate observers, however, Of them, fur
the ahnormalties found In the bruins of hosc who die
while insane. The student Of pathology who drecta
LIZ attention 10 t18 subject met At the OuEet with
the ktcreotyled phrase. that there disccrnha
LESSONS peculiar to EHGEity HIS attention called
the appearance Of tha duga-natcr, Arachnod, and p!a
mater tue quantity and color Of tho the size Of
tho Vessels the color and consstenco Of the convoiu-
tons, and tho number Of the runcta vasculusa. It
was with tho view Of Obtaining q correct idea OF
TIE ACTUAL APPEARANCE
OF the brains Of those who die iusaue that tho writer
ago began aeries Of aysteuatic microscopic
EXAMINATIONS which have been continued from time to
time closely other duties would permit until the
Present.
At this time cannot DO more than spcak in general
way Of some OF the LEMONS observed. The
atllued embrace I'll forms Of insanity, from acute
raia to denaenta, including puerpera and ep1leptic
insanity. In each and all forms,
MARKED LESION
has been found and from the number Of examinations
nad have able to group certain lc.ions, aud
will Ia apparent upon examining the photo-naicro-
graphs accompanying this paper.
In certain forms Of insanity, and notably in de-
nlentia,
THE TIMER caP1I1An1Es
Ehow marked indications Of d.easc tho rcrvascular
60 much that tho vessel itzo1 aprears to lay In
tunnel its ca1fbre being much less than the sheath
hs 1s s s saf he
vessel and the surrounding ttsae Of their elasticity
The shenth is often filed With clear fluid, somewhat
mstps n
cations Ct disease Il ia often irregular In abre, the
tons hut entirely distinct from the military anerlrisms
60 ably described by Charcot which are often ound
in other forms Of mental alienation.
Frequently there 1r:ay be seen between there cn-
arguments constrisonr reducing the size Of the
vesael below the normal conddon; it is often observed
that Of these pouch-nke en1a1gements bsgius at
b1urcaton, the pouch existing each branch Of the
capillary. There enargemeuts are due, believe, to
the loss Of support from tie surrounding tissue,
which, above stated has been deprived OF is elas
ticity by the repeated congestion.
Hence there Is stnsis OF blood in tho cerebral ssue
thus accounting In for the enlarged puncta
often mentioned Ii post-mort..pa notes.
THE sE1T STEP
In the abnormal PROCESS Is degeneration OF the wall
Of the CAPILLARY the vessel Presents dark red patches
at various points outside its wills these patches grad
ually tcken, until they sometimes become larger than
tho calbre Of tile vessel. At times they knocked
OF during the manipulation Of tho section, and then
en opening is made into the capillary.
This condition Q: the smaller cerebral VESSELS may he
studied best in thoeo case. ct de1acnta which have
syrlili,ic ori7n, although they not entirely
fined to tlat particular class.
TEE PRoCEss APPEans DE DUE
to fatty nc:a:nor1hosia CT ;:Eszon:. The smaller
capillary vols in all parts Of the brain affected
the nednia oblongata. Not tnfrequently, in making
a section Of tEe caplar5es Gre laid open long
to bo nled with c!ot have also IN my collection
specimen III which the section was made directly
through Of tho athc-o!natous engagements, dis
dtion tho capllarics has been observed by several
Of the German 1croscopists particularly Meynert,
seen. although iR account does not describe them
fully could bo desired.
While examining section, taken from tho gray and
eoluaou, Of case Of chronic mania in 1871, tzst
i
4 PECULIAR APPEARANCE TIE TISSUE
situated in the white substance, but closely ap-
proximating the gray matter Of tho convolution.
Thcre number Of snlall white spots clearly de-
hucd, having distinct margin, and In sharp contrast
with the surrounding nerve ttaaue. They varied in
from the $50 to the 1000 Of inch In diameter,
appeared to be Of granular and were much
moro IN structure than the surrounding brain
substance They were entirely disconnected, each
tpot being completely surrounded by the normal
,v}t ia ThayI mt nfaorh cArmina e0lu-
lon used to stain The section, even their edges pre-
sentins the pearv whfteness characteristic Of the spot
lariss. They arc grouped in soma places, whtla 1t
other points they are in pairs In 7hnpe some are
round tomo ovoid IN the specimen & exhibited no
Immediately surrounding the spot appears to be
crowded cr,-rollea as though the growth
OF tbs SPOT had been rapd and the normal tissue had
not time to become absorbed.
At place in the specimen. the Incta1norphoss Of
tbs branehes. Ths sa Of ths Vasss can be made out
but it s shrunken and partially destroyed On the
surface OF Of the spots ho hbres Of con-
ncctfye tissue Erd crystals Of nargarin. The entire
specimen indicates abundance Of connective tissue
answering 10 tho condition described by yirchow -
vessels nd1cate plainly discussed condition, ar<ar to
that above described, but not in an advanced stage.
The appearances have attempted to portray were en-.
tirely new to me. and could find no description OF
them in any treatise on pathology ut my command.
In order to dsterinine
rnEm True CHARACTER,
began series Of micro-chculical .,pulations. It
was notcod aboro stated, that thoy would not at
sorb tho car1nine solution, ma tor how long the
Icction remained in it, how strong tho solution
might be- On aubjocting them to solution Of gold,
Lhe margins becae slightly discoored permitted to
rcmnin it for sixty hours. and have observed IN
those specimens stained With gold, and mounted that
there is tendency to grow darker, although
some sections In my cabinet which have Eept !
hres yeara do not show much alteration In color.
Boiling alcohol and ether did not materially change
.hcir appearance.
The iodine tests did not Indicate starch Turpen-
tiDe made them trihe more translucent, but Ero.
auccd no marked change. Acctc ac:d had 70 effect
N the spot merely producing the ordinary change in
he connective tissue-lbrcs their surface. Hydro
,horc acid caused ef}ervcscencc, thus disp.f1rs
If tho dca that they might he cncareons 6u1rnuric
acid tinged the whole tissuo yollow.
STRONG NITRIC ACID
yas tho only re2gcnt which produced any marked
,hsaee in their appearance On tho addition Of the
cid the whole section rendered transparent.
including tho rnetamorphosed spot and, after come
moments eapsed, globulea OF auid, possessing IN oy
Constituency could us squeezed out Of tho spot; the
tuId wpy tenacious and required considerable pres
ure to force it away from the degenerated purtion-
After these globules had been removed by the acid
nd pressure nu1ocrous hne dGres could b, seen e1-
eudie ncross the spot but at POINTS In the spot whore
be fluid had not been re-ncFed the ores could not DO
4,-f1%rt 3N% WArF10