78 



Dr. S. Martin. 



[Mar. 17, 



due to the action of many muscles, but there is no safe ground for 

 believing that the combination is of a functional character; the 

 weight of evidence is against this. 



As to the question whether a muscle, when supplied by several 

 nerve-roots, is supplied by them in such a way that one piece of the 

 muscle is supplied by one root, another by another, although there is 

 certainly great interlapping of regions belonging to the individual 

 roots, I cannot agree with Forgue and Lannegrace when they say, 

 " Excitation of a spinal root determines in the muscles which it sup- 

 plies a total, not a partial, contraction." Simple inspection is enough 

 to convince one, that in the case of some of the larger muscles, e.g., 

 in the thigh and spinal regions, the nerve supply from the individual 

 roots is distinctly partial, that a district of the muscle belongs to this 

 root, another district to that, although always with a large mutual 

 overlap ; striking examples are given by the sartorius, 3rd and 4th 

 (Macacus) sacrococcygeus superior, 7th, 8th, 9th (cat), &c. On the 

 other hand, as the distal end of the limb is approached, the inter- 

 mingling of the root- districts in the several muscles becomes more 

 intimate, and in the muscles of the sole the intermingling of the 

 muscle-fibres belonging to individual nerve-roots is so complete 

 as to baffle analysis, except by the degeneration method. In the 

 sphincter muscle of the anus there is an overlap of the motor dis- 

 tributions of the right and left halves of the body. The sphincter 

 ani is supplied by four nerve-roots, two right-hand, two left-hand. 

 Any three of these may usually be cut through without the anus 

 becoming patulous, or exhibiting asymmetry. Conversely, excitation 

 of any one of the efferent roots supplying it causes contraction of 

 both right and left halves of it. The innervation of the bladder from 

 its right- and left-hand roots, is, on the other hand, neither in the 

 case of its sympathetic nor its direct spinal supply of a bilateral 

 character. 



IY. " On the Causation of Diphtheritic Paralysis." By Sidney 

 Martin, M.D., F.E.C.P., Assistant Physician to University 

 College Hospital. Communicated by George BUCHANAN, 

 M.D., F.R.S. Received March 2, 1892. 



The paralysis following diphtheria in man is so closely associated 

 with the acute disease that it is more correctly considered as a 

 symptom and not a sequela. Its mode of production in man has not 

 been demonstrated. 



A chemical examination of the blood and spleen of eight patients 

 who had died of diphtheria revealed the presence of two classes of 

 substances not normally present in the tissues of the body, viz. (1) of 



