The genctic origin of Dementia Praecox 83 



of the brain (suicide or accidentj, the organs of this case having been 

 sent to me when I was seeking normal material from cases that died of 

 injury. Six years later the present case carne under my notice; the ñame 

 of the patient was unusual and when I examined the sections of the tes- 

 tis I recalied the fact that it was the same ñame as the injury case. Here 

 then were two brothers having this very characteristic regressive atrophy 

 of the testes. Both highly intelligent and both successful in their pro- 

 fessional careers, one probably died under circumstances which pointed 

 to possible suicide, the other as we see, died of exhaustion and heart fai- 

 lure of acute restless melancholia with delusions and later symptoms like 

 a meningismus. Although in the numerous cases of which I have exa- 

 mined the nervous system, there were a few that died of acute illness 

 such as pneumonia and dysentery, in the majority pulmonary tubercu- 

 losis was the cause of the fatal termination, but the changes in the repro- 

 ductive organs of either sex and of the nervous system were practically 

 the same whether death, occurred from chronic or acute disease. 



This case is however of special interest because it appears to conform 

 to the description which Kraepelin gives when he refers to the investi- 

 gations of Reichardt in which he says "it has become probable that we 

 have to do with an acute 'cerebral oedema' with rapid changes of the brain 

 which cause an enlargement of volume and therewith the appearance of 

 fatal cerebral pressure". The notes of the symptoms during life and the 

 post mortem and naked eye and microscopio appearances of the nervous 

 system about to be described accord with this condition. It may be re- 

 marked that the congestive stasis and cellular changes in the brain are 

 out of all proportion to the appearances met with in other organs. The 

 morbid changes in the testes are of long standing and must have preced- 

 ed a long time the acute mental break down. 



The Morbid Changes in the Central Nervous System. — Sections of the 

 brain and spinal cord were cut by "the freezing microtome and stained 

 with Scharlach-haematoxylin. The ganglion cells in the cortex, the basal 

 ganglia, the pons, medulla, and spinal cord showed lipoid granules in the 

 cytoplasm. The cells of Purkinje of the cerebellum did not show any 

 obvious lipoid. The lipoid granules were most abundant in the cells of 

 the cortex and basal ganglia; especially were they abundant in the large 

 cells of the thalamus; they were seen however in the cells of the pons, 

 medulla, and spinal cord. 



