Diving Bells and Suits 409 



When the nature of this disease has been determined, we shall know 

 whether there are two different causes which produce these two kinds 

 of morbid manifestations, or whether they are different degrees of 

 one affection. 



I shall merely remark that if one tried to explain these symptoms 

 solely by the change in the atmospheric pressure, that would not be 

 enough; because very certainly the disturbance of health began at 

 the bottom of the sea. The fisherman felt ill and gave the signal to 

 be hauled up. M. Cotsonopoulos mentions a case in which the diver 

 was hauled up almost dead, and died after a few movements. The 

 patient whom I attended also told me of a similar accident. I am 

 not sure whether death came to my patient in the same way (obser- 

 vation I). These people say that they are sick when they work at a 

 great depth for four or five hours, when there are wind and waves 

 (and perhaps the pressure of the machine cannot be regulated then), 

 and finally when they are too tired. It must be noted that when the 

 diver gives the signal that he is ill, haste is made to draw him up 

 very quickly, and to the first disturbance perhaps that of sudden 

 decompression is added. When they go down to a depth greater than 

 30 meters, they cannot work there very long; the deeper they go, the 

 shorter a time do they remain. Moreover, sometimes the pressure of 

 the machine is not strong or regular enough, and the diver feels the 

 column of water beginning to press the suit around his hands and 

 feet; then he makes the signal agreed upon and air is sent him. It 

 seems that they were working in our country, at least at first, with 

 the English suit. 



As for the persistent paraplegia, we see that it is a remnant of 

 a disturbance which acted upon the whole organism (observations 2, 

 4), but which, not having caused death, leaves material disturbance 

 only in the spinal cord, because we cannot accept the idea that this 

 affection of the marrow alone caused death or that general state 

 observed at the beginning. But what is the nature of this affection? 

 M. Le Roy de Mericourt thinks that capillary hemorrhages occur in 

 the spinal cord during the deebmpression. In our patient, (observation 

 4), we saw at the beginning a paraplegia, a complete failure of the 

 functions of the spinal cord; a very great improvement occurred after 

 a few days, and later we had the syndrome of myelitis. The seat of 

 the affection must be in the thoracic portion, since the bladder and 

 the rectum were more or less paralyzed, for when the lumbar region 

 is affected, there is merely paralysis of the lower extremities. 



The autopsy of the other patient showed us diffused softening of 

 the spinal cord and a hemorrhage. But it is the softening of 

 the cord, which did indeed affect the thoracic portion, which can 

 explain the symptoms of paralysis of the bladder and the rectum, 

 and not the hemorrhage which affected the lumbar portion. As for us, 

 we think that the ecchymoses of the membranes are related to the 

 gangrene of the sacrum. Let us say in addition that our patient had 

 felt no pain, and pain would have been produced in case of hemorr- 

 hage of the membranes of the cord. 



But how is this inflammation of the cord produced? Is it by cap- 



