832 THE NEKVOUS SYSTEM. 



toms make their appearance within a few mouths after the chancre. The 

 lesion sometimes appears in the brain as the so-called gummy tumors. 

 These are most frequently found near the periphery of the brain, are usu- 

 ally connected with the meuinges, and may be sharply circumscribed. 

 The central portion of the tumor is apt to be in a condition of cheesy 

 degeneration, and at the periphery is seen fibrous tissue or a dense infil- 

 tration of small spheroidal cells. 



Syphilitic inflammation of the brain very frequently occurs in a dif- 

 fuse form, characterized by the formation of a gelatinous, grayish tissue, 

 consisting of a more or less homogeneous or granular basement substance, 

 with numerous small round cells. The neighboring nerve elements are 

 apt to be atrophied. A most common syphilitic lesion is a specific arte- 

 ritis with or without the formation of small guinmatous tumors in the 

 walls of the vessels. 



Syphilitic inflammation in the cord is usually secondary to a similar 

 process in the spinal meuinges. The size and shape of the gummata are 

 modified by the restriction of the vertebral canal. The tumors are 

 mainly significant from the more or less extensive secondary degenera- 

 tions which they induce. 



The relation of syphilis to multiple cerebral and spinal sclerosis is 

 still uncertain. Its relation to tabes and to dementia paralytica has been 

 noted under their respective titles. It is probable that most or all of 

 those rare cases of tabes occurring in children are the results of inherited 

 syphilis. 



Syphilitic inflammation of the peripheral nerves is, like tuberculous 

 inflammation of nerves, usually dependent upon an extension of the 

 process either from the meniuges or from some tissue through which the 

 nerves pass. 



ACTINOMYCOSIS. 



Actinomycosis of the brain has been described. It is a rare form of 

 brain infection, and is usually secondary to actinomycosis of the neck or 

 face. The condition is apt to lead to suppuration and abscess formation. 

 A case has been reported by Bellinger in which the disease was appar- 

 ently primary in the brain. 



LEPROUS INFLAMMATION. 



This occurs in the peripheral nerves and consists in the formation 

 within the nerves of masses of new-formed tissue somewhat resembling 

 granulation tissue. In the cells of this tissue multitudes of characteristic 

 bacilli are uniformly found (see Leprosy). It constitutes the variety of 

 leprosy known as lepra auaesthetica. 



