. A treatise on the nervous diseases of children, for physicians and students. glion cells are secondary. Many ofthe authors are also inclined to regard poliomyelitis as anacute infectious disease, in spite of the entire absence, upto the present day, of proof of the microbic origin of thedisease. They are of the opinion that the entire graysubstance is easily affected and infected by the poison, andthat that part of the spinal cord is most easily involvedwhich has the most abundant blood-supply. Goldscheiders investigations, which were most carefullymade, point to the important role played by
. A treatise on the nervous diseases of children, for physicians and students. glion cells are secondary. Many ofthe authors are also inclined to regard poliomyelitis as anacute infectious disease, in spite of the entire absence, upto the present day, of proof of the microbic origin of thedisease. They are of the opinion that the entire graysubstance is easily affected and infected by the poison, andthat that part of the spinal cord is most easily involvedwhich has the most abundant blood-supply. Goldscheiders investigations, which were most carefullymade, point to the important role played by the blood-ves- * Rissler and v. Kahlden upheld Charcots views for many years. 26o THE NERVOUS DISEASES OE CHILDREN. sels of the spinal cord. The author concludes that a condi-tion of irritation is present in the walls of the blood-vesselswhich leads to a dilatation of these vessels and to a prolif-eration of their endothelial elements. From this the morbidprocess extends to the neuroglia and produces a prolifera-tion of its cells. The changes in the ganglion cells are of a. Fig. 61.—Poliomyelitis Anterior ; Part of an Acute Myelitis. Death of child (age, twoand a half years) eight days after onset of complete palsy of legs and arms. (Sie-merling.) Section through lumbar segment, showing disruption of anterior graymatter from hemorrhage into it. B, marginal blood-vessel; A, branch of anteriorspinal artery. degenerative nature, and the changes in them, as well as inthe nerve-fibres, are secondary and due to disease of theblood-vessels. Goldscheider has also shown that these de-generative changes occur most distinctly in the vicinity of INFANTILE SPINAL PARALYSIS. 261 altered blood-vessels, and that the degenerated ganglioncells lie in vascular areas. The cases reported by Siemerling, while corroboratingthe views of Goldscheider and others, have a still deepersignificance. They show that in some instances a poliomy-elitis anterior is merely a part of a general myelitis of botht
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