l82 INANITION AND MALNUTRITION 



Human Infants. — The first detailed account of the changes in the brain of 

 infants during inanition was that of Parrot ('68), who described a "steatosis" 

 (fatty degeneration) as characteristic for various organs in athreptic infants. 

 In the brain and spinal cord, the arachnoid presents irregular, yellowish, opal- 

 escent spots, due to fatty degeneration of the connective tissue cells. In the 

 substance of the brain and cord, the neuroglia cells appear similarly infiltrated, 

 forming fatty granulations, either microscopic or visible to the naked eye. 

 The corpus callosum is most frequently affected. The cerebral vessels rarely 

 show changes. In his classic treatise, Parrot ('77) described three chief lesions 

 in the brain of athreptic infants — steatosis, hemorrhage and softening, none of 

 which has been found characteristic by most of the later observers. Thiercelin 

 ('04) concluded that the cerebral symptoms (coma, strabismus, convulsions) 

 are due to cerebral congestion and toxemia, rather than to softening or 

 hemorrhage. 



Tardieu ('80) mentioned cerebral and meningeal congestion among the 

 signs of death from inanition in the newborn. Talbot ('09) thought the arrested 

 development of the facial region and teeth in malnourished children may be 

 due to interference with the blood supply on account of malnutrition of the 

 brain, "since the brain presides over the development of the tissues." Moncke- 

 berg ('12) described the cell changes in "pedatrophy" as primarily an inanition- 

 atrophy affecting all the organs and tissues in various degrees. Nicolaeff ('23) 

 sometimes observed hyperemia and increase of ventricular and subarachnoid 

 fluid in the brains of famine-stricken children. 



Adult Animals. — Carville and Bochefontaine ('74, '75) noted that the 

 meninges, brain and spinal cord appear congested in starved dogs. Falck ('75), 

 on the other hand, found the meninges and brain anemic and firm, with a slight 

 amount of fluid at the base of the brain and in the ventricles. 



Mankowsky ('82), during inanition in rabbits and dogs, found the meninges 

 and brain pale and edematous, with loss of weight. The cerebral and spinal 

 ganglion cells show atrophic degeneration, with vacuolation, pigmentation, and 

 fatty degeneration; some appearing shrunken and granular. The white sub- 

 stance and neuroglia are unchanged. The changes are sometimes general, 

 sometimes in localized, softened areas. Two dogs were refed to normal weight 

 after a long fast. In one the nervous system appeared anemic; in the other, 

 hyperemic. The ganglion cells showed fatty degeneration, but not the atrophy 

 found in the starved animals. 



Rosenbach ('83, '84) described marked changes in the nerve cells of the 

 brain and spinal cord in starved dogs, although the white substance and stroma 

 are but slightly affected. The nerve cells react differently in different regions. 

 The spinal ganglion and anterior horn cells suffer most, with marked atrophy, 

 vacuolation and albuminous degeneration. The posterior horn cells show only 

 cloudy swelling. The cerebellar cells rank next, with shrinkage and vacuolation 

 of the Purkinje cells. The cells of the cerebral cortex show but slight traces of 

 cloudy swelling. The pyramidal cells rarely present coagulation necrosis and 

 vacuolation, but the round cortical cells are more strongly affected. The 

 nuclei in these cells appear less resistant, and show granules, but the nuclear 



