On Arsenical Paralysis. 17 



Even the left pyramidal track was in a certain part in the length 

 of a few cm changed where the hemorrhage lay at the limit of the grey 

 substance besides the named path. 



Also a ascending degeneration of the GoU's columns was found. I 

 have said above that in the spinal cord of animals poisoned by arsenic 

 microscopical or small macroecopical hemorrhages were discovered in 

 the grey «ubstance. 



Some inquirers appear to have taken no notice of these whilst 

 others have decidedly affirmed that they were constantly present. In 

 Erlicki's sand Rybalkin's case there was an injection found in the larger 

 vessels. It is under these circumstances interesting to find that in my 

 case this hyperaemia has developed to hemorrhage. Such spinal apo- 

 plexies or hematomyelia of [as one might term it in this case] primary 

 kind are extremely rarely met with, if we except traumatic cases. It 

 is true that Levier^) had collected 16 cases of hematomyelia and Hayem^) 

 34, but the latter cames on a critical examination of these to the con- 

 clusion that at that time (1872) no primary case was to be found pu- 

 blished in literature. However Eichhorst^) as well as Leyden*) prove 

 that real primary medullar hemorrhages were to be found and Leyden 

 has even grouped them with regard to the etiology into hemorrhages 

 namely due to 1) arteriosclerosis, 2) traumata, 3) diminished pressure of 

 air (divers etc.), 4) spontaneous, [which hemorrhages arise from physi- 

 cal exertion or suppressed menstruation]. My case cannot be classed 

 in any of these groups, therefore it clearly forms example of a fifth 

 variety where hemorrhage is caused by intoxication. In this way this 

 case is not unique as similar hemorrhages in arsenic poisoning of ani- 

 mals are often met with and in one case of arsenic poisoning in man 

 (Popow) ^). The hemorrhage in this case has, as in the arsenic experi- 

 ments, appeared in ,the grey substance and is so called column-formed 

 as in Levier's and Leyden's case, if also only of inconsiderable extension. 



According to Leyden the hemorrhage of the cord is characterised 

 by pain. This seems to have been absent in my case; probably owing 

 to the slight extension of the hemorrhage and its restriction to the an- 



1) Beitr. z. Pathol, der ßückenmarksblutungen. Inaug. Diss. Bern 1864. (S. 

 Eichhobst). 



2) Des hemorrhagies iatrarachidiennes. Thèse Paris 1872. (S. Leyden). 



3) Charitéannalen 1874 P. 192. 



4) Zeitschr. f. klin. medic. 1887 S. 225. 



5) Virchow's Arch. Bd. 113. 



Nova Acta Keg. Soc. Sc. Dps. Ser. III. • ^ 



