82 



Scientific Proceedings (64). 



not account for the cell picture seen in this case. There are very 

 few type a cells. The number of pyknomorphous cells is very 

 large, as is also the number of type e cells. Very pronounced 

 vacuolization is frequently found. Comparing the sections of 

 this animal with those of others, normal and abnormal, there 

 are noticeably fewer Purkinje cells in P. 4. Of course this can 

 not be explained on the hypothesis of "shock," lowered blood- 

 pressure, damaging action of centripetal stimulation, etc. I do 

 not think anyone would advance the theory that in two hours a 

 large number of Purkinje cells could be absolutely removed. But 

 the question arises, was the animal normal before the experiment? 

 This can not be answered. The blood-pressure of P. 4 was 40 

 mm. to 60 mm. 



In series 3 the following report can be made: — 

 P. 2 is the only material which need claim our attention. The 

 Purkinje cells are in perfect condition. At the commencement of 

 the experiment the blood-pressure was 150 mm.; at the end of the 

 work it had fallen to 60 mm. 



In series 4 and 5 a factor is introduced which we do not find in 

 the other series. I refer to gross traumatizing of cerebral tissue. 

 In each case there is noted: "Poor transfusion." Had we found 

 extensive changes in the Purkinje cells it would have been hard 

 to draw any conclusion. From the ten cases in series I and the 

 one case in series 3 I would argue that any marked change in the 

 Purkinje cells was more likely to be due to trauma practically in 

 the immediate neighborhood. As a matter of fact there is little 

 if any more change than is found in S. 155, S. 158 and P. 3. 



Conclusions. 



In drawing conclusions from this work we must bear in mind 

 two points. The first is that the baneful effect of serious hemor- 

 rhage on the central nervous system has been well recognized for 

 years. Hoche has shown 1 how rapidly the central nervous system 

 is affected by hemorrhage and in the experimental work incident 

 to a paper on "Hemorrhage into the Ventricles" 2 I found how 



1 Neurol. Centralbl., 1895, No. 14, p. 754, and 1900, p. 994; also Berliner klin. 

 Wchnschr., 1900, No. 22, p. 479. 



2 Journal of A. M. A., July 18, 1908. 



