extensors of the back is often difficult to detect in young children.
Seeligmüller recommends that the child be laid across the mother's
knees and told to move the trunk from one side to the other while the
pelvis is held firm. If too young to obey the direction, the movement
can be excited by pricking or by electric irritation. It will be seen
that the trunk can be turned only to one side.
In these paralyses of the trunk it is clear that the deformity does
not develop under the influence of muscular antagonism alone, but only
when the non-paralyzed muscles attempt to sustain the superincumbent
weight of the body or a portion of it.
SUMMARY OF MECHANISMS OF THE DEFORMITIES.—We may indeed conclude, as
stated at the beginning, that this complex etiology exists in almost
all cases. When the limb is at rest in bed or the weight of the body
is transferred to crutches, then repeated contraction of the flexus
will suffice to bring the limb into a vicious position (contraction at
knee- and hip-joint). When the foot or hand hangs unsupported, its
weight is sufficient to cause deformity, even when all the muscles are
paralyzed, and sometimes in opposition to the direction of intact
muscles. Thus the weight which is passively borne by the limb, and the
efforts of intact muscles to effect the function of the limb in spite
of the paralysis, both concur in the production of the deformity.
ANATOMICAL LESIONS.—The theory of the anatomical basis of infantile
paralysis constitutes one of the most interesting portions of its
history. It is indeed one of the most instructive chapters of modern
pathology from the rapidity with which in a short time precise
knowledge has accumulated, and for the degree in which this has
revolutionized previous ideas.
Autopsies.—Until 1863 only five autopsies had been made upon persons
affected with infantile paralysis.[70] As the disease was never, of
itself, {1132} fatal, opportunity for pathological investigation did
not present itself, while attention was still vividly attracted to the
paralysis. When this had become a chronic infirmity, and patients had
succumbed to intercurrent disease, the opportunity must have occurred,
but was not then utilized.
[Footnote 70: I believe the first list of modern autopsies was made by
myself in a paper read before the New York County Medical Society,
Dec. 22, 1873. The paper was not published until May, 1874, and in the
mean time Seguin's lecture on “Infantile Paralysis” was published in
the _N. Y. Med. Record_, Jan. 15, 1874, with a tabulated list of 25
autopsies, necessarily almost identical with mv own—cases 9 and 10 are
really identical. A case by Roth is included; 4 negative autopsies are
omitted. In 1880, Seeligmüller, in his elaborate essay in _Gerhardt's
Handbuch_, published a list of 32 cases, including the above, and
adding to them the following: Case by Müller, 1871; 4 cases by Leyden,
1875 (_Arch. de Psych._); 1 case by Raymond, 1874 (_Gaz. méd. de
Paris_); 1 case by Demme, 1876 (_B. med. Bericht über das Jennerischt
Kinderspital zu Bern_); 1 case by Eisenlohr, 1876 (_Tageblatt des
Hamburger Naturforscher Versammlung_); 1 case by Schultze, 1877
(_Virch. Arch._, Bd. lviii.).
To this list we may now add 3 cases by Turner, Humphrey, Taylor, 1881
(_Path. Trans. London_); 2 cases by Dejerine, 1878 (_Progrès méd._),
giving a total of 37 cases with detailed histories and autopsies.]
The first cases affording autopsies in which the spinal cord was
thoroughly investigated, belonged, however, precisely to this class of
extremely chronic lesions, which should be regarded as showing rather
the results of the morbid process than that process itself. Omission
to observe this distinction has been the occasion of several
misinterpretations of the pathological appearances.
Premature Theories.—In the entire absence of evidence it is a little
remarkable that such high authorities as Rilliet and Barthez,[71]
West,[72] Vogel,[73] Eulenburg,[74] should have pronounced
dogmatically that the disease was essential—_i.e._ unaccompanied by
any structural lesion whatever; and that Bouchut,[75] on the strength
of most incomplete examination, should have built up a theory of
myogenic paralysis. It is still more remarkable, after the published
autopsies of Rinecker,[76] Laborde,[77] Cornil,[78] Prévost,[79]
Charcot and Joffroy,[80] Parrot and Joffroy,[81] Vulpian,[82] Roger
and Damaschino,[83] that Politzer in 1866,[84] Brown in 1871,[85]
Barwell in 1872,[86] Kétli,[87] Adams in 1873,[88] should still adhere
to this doctrine. They are, however, entirely in the minority, and all
recent monographs and works published with a view to presenting the
state of science assume the spinal nature of infantile paralysis to be
established beyond possibility of controversy.[89]
[Footnote 71: _Traité des Maladies des Enfants_.]
[Footnote 72: _Diseases of Children_, Am. ed., 1860.]
[Footnote 73: _Diseases of Children_, trans. from 4th ed., 1870.]
[Footnote 74: _Arch. Virchow_, Bd. xvii. 1859.]
[Footnote 75: _Deutsche Klinik_, 1863.]
[Footnote 76: _Gaz. méd._, 1864, Soc. de Biol., 1864.]
[Footnote 77: _De la Paralysie de l'Enfance_.]
[Footnote 78: _Gaz. méd._, 1866, Soc. de Biol., 1866.]
[Footnote 79: _Arch. de Phys._, 1870, p. 134.]
[Footnote 80: _Ibid._, p. 310.]
[Footnote 81: _Ibid._, p. 316.]
[Footnote 82: Bouchut is said by Simon (_loc. cit._) to be alone in
his theory; Kétli, however, agrees with him. Eulenburg, in 1872, in
his systematic treatise, assigns a central origin to infantile
paralysis, but offers no opinion in regard to its nature.]
[Footnote 83: _Gaz. méd._, 1871.]
[Footnote 84: _Jahrbuch für Kinderkrankheiten_, 1866.]
[Footnote 85: _Compend. für Kinderkrank._, p. 161.]
[Footnote 86: _Lancet_, 1872.]
[Footnote 87: _Jahrbuch für Kinderkrank._, 1873.]
[Footnote 88: _Treatise on Club-foot_.]
[Footnote 89: See Seguin, _loc. cit._, 1874; Erb, _Ziemssen's
Handbuch_, Bd. xi.; Seeligmüller, _Gerhardt's Handbuch der
Kinderkrankheiten_; Ross, _Treatise on Diseases of Nervous System_,
vol. ii.; Hammond, _Diseases of Nervous System_, 6th ed., 1881, etc.
etc.]
The following table contains a summary of the seven autopsies in which
the spinal cord is said to have been examined with negative results.
Of these, the only really important case is the third, in which a
microscopic examination, made by so competent an histologist as Robin,
was said to have discovered no lesion of the cord.
{1133} The foregoing autopsies may be tabulated as follows:
TABLE I.—NEGATIVE AUTOPSIES.
No.: 1
Year: 1850 or '51?
Name of Author and Patient: Rilliet and Barthez.
Age at time of Paralysis, of Autopsy: ?, ?
Nature of Symptoms: ?
Limbs Paralyzed: l. o.
Electric Reaction: ?
Appearances at Autopsy: Negative.
Reference in Literature: _Gaz. méd. de Paris_, 1850 (or '51?) p. 681.
No.: 2
Year: 1850 or '51?
Name of Author and Patient: Rilliet and Barthez.
Age at time of Paralysis, of Autopsy: ?, ?
Nature of Symptoms: ?
Limbs Paralyzed: b. u.
Electric Reaction: ?
Appearances at Autopsy: Negative.
Reference in Literature: _Ibid._
No.: 3
Year: 1867
Name of Author and Patient: Bouchut and Robin. (Angélique Lermain).
Age at time of Paralysis, of Autopsy: 1½, 3
Nature of Symptoms: Suddenly after 3 days' fever.
Limbs Paralyzed: both u.
Electric Reaction: —
Appearances at Autopsy: Negative microscopically.
Reference in Literature: _Union méd._, 1867, No. 130, p. 187.
No.: 4
Year: 1873
Name of Author and Patient: Adams.
Age at time of Paralysis, of Autopsy: —, —
Nature of Symptoms: —
Limbs Paralyzed: —
Electric Reaction: —
Appearances at Autopsy: Negative.
Reference in Literature: _Treatise on Club-foot_, p. —.
No.: 5
Year: 1873
Name of Author and Patient: Elischer and Kétli.
Age at time of Paralysis, of Autopsy: —, —
Nature of Symptoms: —
Limbs Paralyzed: —
Electric Reaction: —
Appearances at Autopsy: Negative.
Reference in Literature: _Jahrb. Kinderheilk._, 1873.
No.: 6
Year: 1873
Name of Author and Patient: Elischer and Kétli.
Age at time of Paralysis, of Autopsy: —, —
Nature of Symptoms: —
Limbs Paralyzed: —
Electric Reaction: —
Appearances at Autopsy: Negative.
Reference in Literature: _Ibid._
Heine, in the absence of autopsies, but arguing from clinical symptoms
alone, already inferred the existence of a spinal lesion as cause of
the paralysis, and believed that it consisted in congestion, or even
in hemorrhagic exudation, capillary or massive, which should compress
the cord and result in partial atrophy. The same opinion is advanced
in 1844 by Brunnière,[90] also by Vogt,[91] in 1868 by Salomon[92] and
Radcliffe.[93] The autopsies contained in the following table, in all
of which vascular lesions are prominent, might be invoked in support
of this view:
TABLE II.—AUTOPSIES SHOWING VASCULAR LESIONS OF CORD.
No.: 7
Year: 1829
Name of Author and Patient: Klein.
Age at time of Paralysis, of Autopsy: 5, 5
Nature of Symptoms: Persistent cerebral symptoms.
Limbs Paralyzed: l. o.
Electric Reaction: ?
Appearances at Autopsy: Congestion of pia around roots of left
brachial plexus.
Reference in Literature: Quoted by Heine.
No.: 8
Year: 1855
Name of Author and Patient: Brund.
Age at time of Paralysis, of Autopsy: 1, 5
Nature of Symptoms: Meningitis?
Limbs Paralyzed: r. u.
Electric Reaction: ?
Appearances at Autopsy: Chronic spinal klepto-meningitis.
Reference in Literature: —
No.: 9
Year: —
Name of Author and Patient: Hammond.
Age at time of Paralysis, of Autopsy: 4 yrs. stand.
Nature of Symptoms: —
Limbs Paralyzed: l. u.
Electric Reaction: ?
Appearances at Autopsy: Encysted clot in left ant. column, lower
dorsal cord.
Reference in Literature: _Journ. Psych. Medicine_, 1867.
[Footnote 90: _Krankheiten des Gehirns und Ruckenmarkes_.]
[Footnote 91: _Lahmung der Kinder_, p. —.]
[Footnote 92: _Jahrb. f. Kinderheilk._, 1865.]
[Footnote 93: _Reynolds's Syst. of Medicine_.]
The first really modern autopsy, that made by Cornil in 1863, agrees
with the two earliest on record in disclosing only an atrophy of the
cord. Some of the other cases, contained in Table III., note in
addition sclerosis of the lateral columns.
In all the remaining autopsies on record are noted atrophy of the
anterior gray cornua and more or less extensive destruction of the
ganglionic cells.
In a certain number of cases the atrophy seemed to be the unique
lesion. But it never was confined to the ganglionic cells, but
included the reticulum of gray fibres in which these were imbedded,
and which {1134} was replaced by a reticulum of connective tissue.
These cases were all examined many years after the occurrence of the
paralysis.
TABLE III.—AUTOPSIES SHOWING ATROPHY OR SCLEROSIS OF WHITE COLUMNS OR
ROOTS.
No.: 10
Year: 1825
Name of Author and Patient: Hutin.
Age at time of Paralysis, of Autopsy: 7, 49
Nature of Symptoms: Convulsions.
Limbs Paralyzed: b. u.
Electric Reaction: ?
Appearance at Autopsy: Atrophy of cord from below 8th dorsal nerve to
thickness pencil, and of nerves.
Reference in Literature: Quoted by Heine, p. 151.
No.: 11
Year: 1842
Name of Author and Patient: Lunget.
Age at time of Paralysis, of Autopsy: ?, 8
Nature of Symptoms: ?
Limbs Paralyzed: r. u.
Electric Reaction: ?
Appearance at Autopsy: Atrophy and brown discol. of ant. roots of
lumbar and sacral nerves going to sciatic.
Reference in Literature: _Anat. et Phys. du Syst. nerveux_, i. p. 358.
No.: 12
Year: 1863
Name of Author and Patient: Recklinghausen.
Age at time of Paralysis, of Autopsy: ?, ?
Nature of Symptoms: ?
Limbs Paralyzed: b. u.
Electric Reaction: ?
Appearance at Autopsy: Atrophy of ant.-lateral columns.
Reference in Literature: _Deutsche Klinik_, 1863, Jan. 3.
Seel. says also atrophy of cells; Seguin and J., tubercles.
No.: 13
Year: 1863
Name of Author and Patient: Cornil.
Age at time of Paralysis, of Autopsy: 2, 49
Nature of Symptoms: ?
Limbs Paralyzed: b. u.
Electric Reaction: ?
Appearance at Autopsy: Atrophy antero-lateral columns.
Seeligmüller says also atrophy of ganglion-cells, as if quoting
Charcot.
Reference in Literature: _Soc. de Biol., Comptes Rendus_, 1863.
Infiltration of gray and white corpuscles, with abundant amyloid
corpuscles, especially in anterior gray cornua. These through entire
extent of cord—cells—intact. Paraplegia, but walks by muscles of thigh
and pelvis; leg and foot atrophied.
No.: 14
Year: 1864
Name of Author and Patient: Laborde and Bouvier.
Age at time of Paralysis, of Autopsy: 1, 2
Nature of Symptoms: ?
Limbs Paralyzed: all four.
Electric Reaction: noted.
Appearance at Autopsy: Atrophy antero-lateral columns; nerve-fibres
atrophied and varicose.
Reference in Literature: Laborde, _De la Paralysie de l'Enfance_, pp.
109-119.
No.: 15
Year: 1864
Name of Author and Patient: Laborde and Cornil.
Age at time of Paralysis, of Autopsy: ⅔, 2
Nature of Symptoms: ?
Limbs Paralyzed: b. u.
Electric Reaction: ?
Appearance at Autopsy: Sclerosis of ant.-lateral columns.
Ganglion-cells normal; sciatic neuritis.
Reference in Literature: Laborde, _loc. cit._, p. 104.
The first group is contained in the following table:
TABLE IV.—AUTOPSIES SHOWING ATROPHY OF THE ANTERIOR CORNUA AND
GANGLION-CELLS.
No.: 16
Year: 1866
Name of Author and Patient: Prévost.
Age at time of Paralysis, of Autopsy: ?, 78
Nature of Symptoms: ?
Limbs Paralyzed: L. u.
Result of Autopsy: Atrophy of left anterior cornu, especially of
ganglion-cells.
Reference in Literature: _Comptes Rendus, Soc. Biol., Gaz. méd._,
1866.
No.: 17
Year: 1870
Name of Author and Patient: Charcot and Joffroy.
Age at time of Paralysis, of Autopsy: 7, 32
Nature of Symptoms: Sudden.
Limbs Paralyzed: All esp. l. u.
Result of Autopsy: Atrophy of cells ant. horns and ant. lateral
columns.
Reference in Literature: _Archives de Phys._, 1870.
No.: 18
Year: 1870
Name of Author and Patient: Parrot and Joffroy.
Age at time of Paralysis, of Autopsy: —, 3
Nature of Symptoms: Unknown.
Limbs Paralyzed: B. l.
Result of Autopsy: Atrophy and partial sclerosis of anterior cornua
and ant. lat. columns.
Reference in Literature: — {1135}
No.: 19
Year: 1870
Name of Author and Patient: Vulpian.
Age at time of Paralysis, of Autopsy: ?, 66
Nature of Symptoms: ?
Limbs Paralyzed: L. l.
Result of Autopsy: Atrophy of ganglion-cells, sclerosis of
antero-lateral columns.
Reference in Literature: _Archives Physiol._, 1870.
No.: 20
Year: 1871
Name of Author and Patient: Müller.
Age at time of Paralysis, of Autopsy: 4, 34
Nature of Symptoms: Fall from bed.
Limbs Paralyzed: L. lower.
Result of Autopsy: Atrophy of ganglion-cells ant. cornua; sclerosis of
anterior roots.
Reference in Literature: Quoted by Seeligmüller, _Gerhardt's
Handbuch_, Tabeln.
No.: 21
Year: 1873
Name of Author and Patient: Lancereaux and Pierret.
Age at time of Paralysis, of Autopsy: 2, 18
Nature of Symptoms: ?
Limbs Paralyzed: L. upper.
Result of Autopsy: Atrophy of external group cells in ant. cornua;
general atrophy of left half of lumbar cord.
Reference in Literature: Petitfils, _Thesis on Atrophie aigue des
Cellules motrices_, 1873, p. 33.
No.: 22
Year: 1875
Name of Author and Patient: Raymond.
Age at time of Paralysis, of Autopsy: ?, 75
Nature of Symptoms: ?
Limbs Paralyzed: R. arm.
Result of Autopsy: Atrophy of ganglion-cells in right ant. horn cerv.
region.
Reference in Literature: _Gaz. méd de Paris_, No. 19, 1875.
No.: 23
Year: 1879
Name of Author and Patient: Taylor.
Age at time of Paralysis, of Autopsy: 1½, 3
Nature of Symptoms: 3 days' fever.
Limbs Paralyzed: L. leg.
Result of Autopsy: Atrophy of left ant. cornua; disappearance of
ganglion-cells; no lesion in white column.
Reference in Literature: _Trans. Path. Soc. London_, 1879.
No.: 24
Year: 1875
Name of Author and Patient: Dejerine.
Age at time of Paralysis, of Autopsy: —, —
Nature of Symptoms: —
Limbs Paralyzed: R. foot (congenital equinus).
Result of Autopsy: Atrophy of ant. horn right side; atrophy external
group of motor-cells.
Reference in Literature: _Arch. Phys._, 1874.
No.: 25
Year: 1879
Name of Author and Patient: Humphreys.
Age at time of Paralysis, of Autopsy: 1½, 3½
Nature of Symptoms: ?
Limbs Paralyzed: L. leg.
Result of Autopsy: Atrophy of left half lumbar cord; disappearance of
medial group cells both sides; antero-lateral on left side.
Reference in Literature: _Trans. Path. Soc. London_, 1879.
In the remaining cases the ganglion-cells of the anterior cornua had
also disappeared; but in addition to this atrophy excited distinct
evidence of more or less extensive inflammation. This table includes
one case of autopsy at two months (Roger's); one at six weeks after
paralysis (Turner's).
TABLE V.—AUTOPSIES SHOWING EVIDENCE OF MYELITIS, TO WHICH THE ATROPHY
OF THE GANGLION-CELLS WAS CONSECUTIVE.
No.: 26
Year: 1866
Name of Author and Patient: Echeverria.
Age at time of Paralysis, of Autopsy: 3, 10
Nature of Symptoms: Fever.
Limbs Paralyzed: R. arm, R. leg.
Appearance at Autopsy: Granular pigmentation anterior cornua, diffuse
myelitis.
Reference in Literature: Quoted by Seguin, _loc. cit._
No.: 27
Year: 1866
Name of Author and Patient: Echeverria.
Age at time of Paralysis, of Autopsy: 2, 2½
Nature of Symptoms: Febrile diarrhœa.
Limbs Paralyzed: Both legs.
Appearance at Autopsy: Ibid.
Reference in Literature: _Ibid._
No.: 28
Year: 1871
Name of Author and Patient: Roger and Damaschino.
Age at time of Paralysis, of Autopsy: 1-5/6, 2
Nature of Symptoms: Scarlatina with second attack.
Limbs Paralyzed: L. arm, then both legs.
Appearance at Autopsy: Foci of softening throughout cord. Atrophy
ganglion-cells and nerve-fibres. Dilatation, fatty degen. vessels.
Sclerosis ant. columns. Atrophy ant. roots.
Reference in Literature: _Gaz. méd. de Paris_, 1871.
No.: 29
Year: 1871
Name of Author and Patient: Roger and Damaschino.
Age at time of Paralysis, of Autopsy: 2, 2½
Nature of Symptoms: Variola.
Limbs Paralyzed: Both legs.
Appearance at Autopsy: Foci of softening in ant. cornua. Fatty degen.
blood-vessels, circumscribed myelitis.
Reference in Literature: _Ibid._
No.: 30
Year: 1871
Name of Author and Patient: Roger and Damaschino.
Age at time of Paralysis, of Autopsy: 2, 3
Nature of Symptoms: Fever.
Limbs Paralyzed: Ibid.
Appearance at Autopsy: Foci of softening, as above.
Reference in Literature: _Ibid._
No.: 31
Year: 1873
Name of Author and Patient: Roth.
Age at time of Paralysis, of Autopsy: 1, 2
Nature of Symptoms: Ibid.
Limbs Paralyzed: Ibid.
Appearance at Autopsy: Focus myelitis on both sides. Disappearance
ganglion-cells, abundant exudation corpuscles.
Reference in Literature: _Virch. Arch._, 1873, Bd. lviii. {1136}
No.: 32
Year: 1868
Name of Author and Patient: L. Clarke.
Age at time of Paralysis, of Autopsy: 1, 32
Nature of Symptoms: After inoculation.
Limbs Paralyzed: Both arms.
Appearance at Autopsy: Extensive myelitis ant. and central part gray
matter. Disappearance ganglion-cells.
Reference in Literature: _Med.-Chir. Trans._, li. p. 219.
No.: 33
Year: 1876
Name of Author and Patient: Schultze.
Age at time of Paralysis, of Autopsy: 3, 22
Nature of Symptoms: Acute disease.
Limbs Paralyzed: Both legs.
Appearance at Autopsy: Atrophy lumbar cord ant. lat. columns. Atrophy
ganglion-cells. Abundant exud. corpuscles. Proliferation neuroglia.
Reference in Literature: _Virch. Archiv_, Bd. lxviii., 1876.
No.: 34
Year: 1876
Name of Author and Patient: Leyden.
Age at time of Paralysis, of Autopsy: 2, 60
Nature of Symptoms: Fall from table.
Limbs Paralyzed: L. leg.
Appearance at Autopsy: Circumscribed cicatrix with complete
destruction gray substance. Amyloid degeneration. Atrophy ant. roots.
Reference in Literature: _Archiv f. Psych._, 1876, Bd. vi.
No.: 35
Year: 1876
Name of Author and Patient: Leyden.
Age at time of Paralysis, of Autopsy: ¾, 1¾
Nature of Symptoms: Suddenly.
Limbs Paralyzed: L. leg.
Appearance at Autopsy: Atrophy ganglion-cells. Cellular diffused
infilt. (myelitis) gray subst'ce.
Reference in Literature: _Ibid._
No.: 36
Year: 1876
Name of Author and Patient: Leyden.
Age at time of Paralysis, of Autopsy: 4, 58
Nature of Symptoms: Sudden over night.
Limbs Paralyzed: L. leg.
Appearance at Autopsy: Amyloid infiltration ant. horns, atrophy
ganglion-cells left lumbar horn. Diffuse atrophy gray substance.
Reference in Literature: _Ibid._
No.: 37
Year: 1876
Name of Author and Patient: Leyden.
Age at time of Paralysis, of Autopsy: 3, 20
Nature of Symptoms: Ibid.
Limbs Paralyzed: R. leg, L. arm.
Appearance at Autopsy: Sclerotic focus in right lumbar and in left
cerv. region. Diffuse meningo-myelitis. Atrophy ant. lat. columns.
Encapsulated myelitis.
Reference in Literature: _Ibid._
No.: 38
Year: 1876
Name of Author and Patient: Demme.
Age at time of Paralysis, of Autopsy: ?, 3½
Nature of Symptoms: ?
Limbs Paralyzed: —
Appearance at Autopsy: Purulent focus in ant. cornua lumbar region.
Atrophy ganglion-cells.
Reference in Literature: Quoted by Seeligmüller, _loc. cit._, p. 18.
No.: 39
Year: 1876
Name of Author and Patient: Eisenlohr.
Age at time of Paralysis, of Autopsy: ?, ¾
Nature of Symptoms: ?
Limbs Paralyzed: B. legs.
Appearance at Autopsy: Diffuse inflammation anterior horns and ant.
lat. columns.
Reference in Literature: _Ibid._
No.: 40
Year: 1879
Name of Author and Patient: Turner.
Age at time of Paralysis, of Autopsy: 2½, 2¾
Nature of Symptoms: ?
Limbs Paralyzed: —
Appearance at Autopsy: Myelitic disorganization gray substance ant.
cornua lumbar cord.
Reference in Literature: _Trans. Path. Soc. Lond._, 1879.
No.: 41
Year: 1883
Name of Author and Patient: Archambault et Damaschino.
Age at time of Paralysis, of Autopsy: 30 m's, 31 m's, or 26 d'ys fr.
début.
Nature of Symptoms: Malaise and prostration one day.
Limbs Paralyzed: Left leg and right arm.
Appearance at Autopsy: Focus red softening ant. horns left lumbar;
right cervical region. Enormous enlargement vascular network, and
distension blood-vessels; granular corpuscles in lymphatic sheaths;
marked atrophy cells and of myeline sheaths of fibres in ant. roots;
myeline balls in sheath; axis-cylinders disappeared. Lesions more or
less marked throughout cord. Nerves not examined.
Reference in Literature: _Le Union médicale_, 1883.
No.: 42
Year: 1884
Name of Author and Patient: Money.
Age at time of Paralysis, of Autopsy: 2 yrs., 28 m's.
Nature of Symptoms: Fever and vomiting for a week.
Limbs Paralyzed: Paraplegia.
Appearance at Autopsy: Red area both anterior cornua lumbar region.
Here distension and thrombosis vessels; infiltration leucocytes;
absence multipolar cells.
Reference in Literature: _Trans. Path. Soc. Lond._, 1884.
No.: —
Year: 1884
Name of Author and Patient: Money.
Age at time of Paralysis, of Autopsy: Unknown, 7 yrs.
Nature of Symptoms: Unknown.
Limbs Paralyzed: Right leg.
Appearance at Autopsy: Wasting anterior horn almost throughout lumbar
region. Atrophy cells chiefly in ant., ant.-lat., post.-lateral, and
central groups, replaced by dense nucleated tissue.
Reference in Literature: —
It will be useful to add another table, which will group together the
cases in which the autopsies were made within two years after the
occurrence of the paralysis. Of these, all but the two made by
Laborde, in which the cornua are declared to be healthy and the lesion
limited to the {1137} white columns, show traces of destructive morbid
processes in the gray substance of the cord, greatly predominating in
the anterior cornua, but not absolutely limited to them, nor even to
the part of the cord which corresponds to the paralyzed limb:
TABLE VI.