THE NERVOUS SYSTEM. 



825 



cular and nerve-cell spaces, and proliferation of the ueuroglia. Degen- 

 eration of the nerve cells occurs, probably secondary to the inflammatory 

 lesion. The inflammation is similar to that of an ordinary acute mye- 

 litis, but seems to be confined 

 mainly to the area of distribu- 

 tion of the anterior spinal artery. 



In about one-third of the 

 cases which are clinically in- 

 cluded under acute anterior po- 

 liomyelitis, the onset is without 

 fever, and there is at no time 

 any evidence of the existence of 

 an inflammatory process. While 

 thrombosis of a branch of the 

 anterior spinal artery or haemor- 

 rhages into the anterior horns 

 have been suggested in explana- 

 tion of these cases, their patholo- 

 gy remains as yet undetermined. 



Acute Ascending Paralysis 

 Landry's Paralysis. This is a 

 rare disease characterized clini- 

 cally by a rapidly ascending 

 paralysis, beginning in the lower 

 extremities and progressing up- 

 ward to involve the body, arms, 

 and head. Until recently no 

 pathological changes were 

 known to explain the symptoms. 



Within the last few years a number of cases have been reported in which 

 the lesion was an acute myelitis with or without an accompanying poly- 

 neuritis (Fig. 539). 



FIG. 539. LANDRY'S PARALYSIS. 



Section of spinal cord showing acute inflammatory proc- 

 ess about the blood-vessels. 



FIG. 540. LANDRY'S PARALYSIS. 

 Showing blood-vessels from Fig. 539, more highly 

 magnified. There are congestion and infiltration of 

 the walls with leucocytes. 



FIG. 541. LANDRY'S PARALYSIS. 



Showing blood-vessels from Fip. 539, more highly 



magnified ; leucocytes iin the walls. 



Bailey and Ewing ' reported a case in which the cord showed congestion with capil- 

 lary hemorrhages and circumvascular small round-cell infiltration (Fig. 540 and 541). 

 The ganglion cells were in various stages of degeneration. Similar lesions have been 

 reported by Marie and Marinesco, by Hertz and Leslie, and by others. Mills and Spiller 

 report in some cases a polyneuritis in addition to myelitis. Krewer finds an acute 

 myelitis and neuritis, and considers the lesion due to a non-specific infection. Brault 

 1 Consult Bailey and Ewing, New York Medical Journal, July, 1896. 



