744 DR ALEXANDER BRUCE AND DR JAMES W. DAWSON ON 
Il.—HISTOLOGICAL STUDY OF MULTIPLE NEUROMATA OF THE 
CENTRAL NERVOUS SYSTEM. 
INTRODUCTION. 
Clinical History. 
We are indebted to Dr R. A. Lunvim for the following clinical notes on the case :— 
The patient, H. S., died at the age of 30 on 11th November 1909. Her father, on 
that date, was alive and well, aged 46; her mother had died at 36 during childbirth ; 
and she has four brothers and two sisters all alive and well. 
At the age of seven she had ‘“‘ water in the head.” Three years later she began to 
lose power gradually in both legs, the left leg being first affected. This gradually pro- 
gressed, until at the age of 22 she became bedridden. Urinary troubles began with 
incontinence and continued throughout life; the bowels were very constipated, and she 
required aperient medicine regularly. She complained often of headache; her sight 
was very dim, and she could not see to read. No view of the fundus could be obtained 
on account of a diffuse opacity of the vitreous. She had often complained of pain in 
the left side, and had frequent attacks of gastritis and stomatitis. 
Post-mortem report (by Dr Harvey Preis, about 24 hours later):— 
Body much emaciated ; arms flexed at the elbow and wrist, but flexion could be 
overcome. Left leg fully flexed at the knee, flexed and markedly abducted at the hip 
(contracture). The right leg slightly abducted at the hip; fixed in fully extended 
position. Lumbar spine in position of marked lordosis. 
Spimal Cord.—Dura somewhat thickened, especially in the cervical region, the cord 
as a whole being very atrophied. On the surface no obviously sclerotic patches to be 
seen, but on section bluish gelatinous patches were seen to involve a large part of the 
sectional area of the cord throughout its whole length. 
Broin.—The medulla, and even more so the pons, show great general atrophy. On 
section this appeared to be diffuse, there being no appearance of any special sclerosed 
patches. The cerebellum also appears atrophied ; there is no apparent atrophy of the 
cerebrum, which appears pale on section. 
Abdomen.—Intestines chiefly in pelvis, as the lordosis has almost abolished the 
upper part of the abdomen in its antero-posterior diameter. The large intestine is so 
shrunken that it is smaller in diameter than the small intestine. The stomach is small 
and contained coffee-ground-looking material ; no ulceration. 
Kye.—Posterior half of left globe removed. 
Methods.—Portions of the cord, medulla oblongata, and pons were fixed in Zenker’s 
solution and in 10 per cent. formalin solution for the examination of cell and proto- 
plasmic structures, in 96 per cent. alcohol for Cajal’s reduced silver method for 
