On Arsenical Paralysis. 15 



The experiments made bjf Kreyssig as well as J^schke^) were 

 therefore principally of negative significance as regards the settling of 

 the main question in dispute. 



J^SCHKE had also proved the occurrence of hemorrhage in the 

 medulla. But all these experiments were of course of no use in deciding 

 the question as to the localization of arsenic paralysis. 



Consequently the experiments vere resumed by Alexander^), who, 

 in his poisoning experiments, found the same clinical form of arsenic 

 paralysis as found in man ; namely paralysis followed by muscular atrophy 

 and disorders of sensibility also tenderness to pressure of the neural 

 trunks. Alexander could now prove that the ganglion cells in the me- 

 dulla really bad the peculiarities pointed out by Popow, but agrees wdth 

 Kreyssig in that respect that these had no pathological signification. Also 

 he found important changes in the peripheral nerves, namely a colossal 

 increase to the normal conditions of degenerated spinal nerve fibres as 

 well both motor as sensory. 



On the other hand the cranial nerves were unchanged. These 

 changes Alexander looked upon as secondary to the capillary throm- 

 boses discovered by Silbermann as caused by arsenical poisoning. 



Even the degenerations of the muscles Alexander regards as de- 

 pending upon nutritive disorders and not at all as secondary results of 

 neural degeneration. 



If now, by experiments, the question as to the pathological ana- 

 tomical changes of arsenic intoxication of animals can he regarded as 

 in great part solved, one cannot immediately apply the same to man. 



The first pubhshed case of postmortem examination after arsenic 

 paralysis in man which I know in detail appeared this year (1892) in 

 foreign literature by the Russain Doctors Erlicki and Rybalkin. 



In their case the first symptoms of the effects on the nerves of 

 arsenic occurred on the 8*" day after the poisoning; on the 9"" and 10*'' 

 weakness ensued in the lower extremities and a few days later in the 

 arms as well. After about 2 mouths the patient died and on the post mor- 

 tem examination the following changes in the nervous system were noted. 



No macroscopical changes in the medulla oblongata or spinal 

 cord. On the other hand the microscope showed a considerable dege- 

 neration of the nerve cells in the anterior cornua and central part of 

 the grey substance. 



1) Inang. Diss. Breslau 1882 (S. Alexajtdee). 



2) Inaug. Diss. Breslau 1889. 



