. yet been demonstrated in the humancerebro-spinal fluid. Flexner. and Lewis, however have provedits presence in that of monkeys. It is possible that when paral-ysis, which alone renders the diagnosis of the disease certain,is present the virus has passed entirely out of the spinal fluidand into the cord. It may yet be found in the spinal fluid ofone of the so-called abortive cases. The pathological process in the cord itself is primarily de-pendent upon vascular changes and secondarily upon changesin the« cells, both ganglionic and interstitial. The vessels ofthe cord, medulla, p
. yet been demonstrated in the humancerebro-spinal fluid. Flexner. and Lewis, however have provedits presence in that of monkeys. It is possible that when paral-ysis, which alone renders the diagnosis of the disease certain,is present the virus has passed entirely out of the spinal fluidand into the cord. It may yet be found in the spinal fluid ofone of the so-called abortive cases. The pathological process in the cord itself is primarily de-pendent upon vascular changes and secondarily upon changesin the« cells, both ganglionic and interstitial. The vessels ofthe cord, medulla, pons, basal ganglia, and even the cerebralcortex are dilated and engorged and in the cord, medulla andpons the capillaries are distended to more than twice their nor-mal calibre. This hyperemia is found at all levels of the cordirrespective of the intensity of the other inflammatory and veins are both affected and contrary to the oldconception the anterior spinal vein is generally more markedly. Fig. 3.— First sacral segment showing the intense infiltration of mononuclear cells in the pia mater.
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