822 THE NERVOUS SYSTEM. 



one of the more minute inflammatory foci complete resolution may 

 occur with absorption of the exudate. In the larger abscesses there may 

 be absorption of the exudate and of the products of degeneration, and 

 a replacement neuroglia hyperplasia, ultimately resulting in a sclerotic 

 patch. 



Suppurative encephalitis may occur as a result of traumatism or from 

 extension of suppurative meningitis. 



A form of encephalitis which has been designated acute noii-suppu- 

 rative hsemorrhagic encephalitis, has been described by Striimpell, Leich- 

 tensteiu, Oppeuheim, Putnam, 1 and others. The lesion consists in the 

 occurrence of multiple hsemorrhagic, inflammatory foci, which are non- 

 suppurative, and which are accompanied by leucocytic infiltration. These 

 foci may occur in any part of the brain, but are most numerous in the 

 white matter of the brain and basal ganglia. Some of these haemorrhages 

 may be quite large. 



ACUTE INFLAMMATION or THE SPINAL CORD. (Acute Myelitis.') 



Inflammation in the spinal cord is quite analogous to inflammation 

 in the brain. 



Acute Disseminated Myelitis 2 runs a rapid course and proves fatal in a 

 short time. The inflammation may involve nearly the whole length of 

 the cord, but is usually more intense in some places than in others. The 

 cord is swollen and congested, it is infiltrated with pus cells, the connec- 

 tive tissue is swollen, and there is degeneration of the nerve elements 

 proper. 



More frequently an acute myelitis is more localized. It involves but 

 a small portion of the length of the cord, while laterally it may com- 

 pletely cross it, and is hence spoken of as a transverse myelitis. When 

 the cord is removed and laid upon the table, if the lesion is marked, a 

 flattening of the cord at its seat may be observed; or on passing the 

 finger gently along the organ, the affected segment will be found softer 

 than the rest of the cord, sometimes almost diffluent. On making a sec- 

 tion through the affected portion the nerve tissue may appear white or 

 red or yellowish or grayish. 3 



Microscopial examination shows different appearances, depending 

 upon the stage of the degenerative or inflammatory process. There may 

 be much blood, or, if the lesion has existed for some time, blood pig- 

 ments ; also fragments of more or less degenerated nerve fibres and gan- 

 glion cells (Fig. 536), my elm droplets, free fat granules, and larger and 



'Putnam, Jour, of Nerv. and Ment. Dis., vol. xxiv., 1897, bibliography. 



2 Acute parenchymatous myelitis, like its analogue in the brain, is a lesion of the 

 ganglion cells, and is more properly classed as a degeneration. Embolic and throm- 

 botic softenings are more rare in the cord than in the brain, and are necessarily mxich 

 more restricted in extent. When of an inflammatory character they resemble the simi- 

 lar brain lesion and are red or yellow according to the amount of extravasation. 



3 It should be remembered that the mechanical injury to the cord in removal, such as 

 r.rushing or bruising, may reduce the injured portion to a pulpy consistence and thus 

 produce appearances somewhat similar to those of some forms of inflammatory soften- 

 ing. See reference to Van Oieson, on Artefacts of the Nervous System, p. 717. 



