On spinal apoplexy / [Alexander Peddie].

  • Peddie, Alexander, 1810-1907
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: On spinal apoplexy / [Alexander Peddie]. Source: Wellcome Collection.

    7/20 page 5
    “ might be observed, resembling vessels. These, on examination, were found “ to consist of pigmentary masses, varying in size, situated in the neurilemma, “ surrounding bundles of nervous tubes.” In the Thorax, the morbid appearances were, here and there, small patches of black carbonaceous deposit in the pleura pulmonalis, in the substance of the lungs, and bronchial glands ; very general emphysema of the anterior surface and margins of the lungs; and the heart considerably loaded with fat. In the Abdomen, the parietes presented a very great quantity of fat, as also did the omenta (and indeed the whole body); on the peritoneal lining were several small melanotic-like patches; and attached to the larger omentum were a few tumours, the largest the size of a walnut, and like little spleens. The liver was enormously enlarged, about double the ordinary size, and of a greenish colour throughout. Both kidneys were almost entirely disorganized, presenting abscesses of different sizes communicating with the pelvis of each, and containing besides pus, numerous phosphatic calculi of various forms and sizes from that of a pin head to a large pea or small bean. Several culculi, likewise, were sticking in the ureters, which were much dilated and thickened. A number were contained in the bladder, one being the size of a pigeon’s egg, and another about the size of a small bean, was impacted in the prostatic portion of the urethra. The bladder contained, besides the calculi, a quantity of thick dirty pink fluid; and its surface was generally thickened and roughened at parts, as if by chemical action. After a careful examination of all the cases of spinal apoplexy which I can find on record, none have been met with in which the morbid appearances resemble those of the instance above detailed. There are examples of extravasation of liquid blood alone or mixed with serum into the spinal canal, of blood infiltrated into the sub¬ stance of the cord, of ecchymosed patches from recent effusion, of coagula circumscribed and diffused, of coagula partially absorbed, of a coagulum surrounded by a distinct filamentous false membrane, and of a dense empty cystic cavity of long standing. Nevertheless, I am inclined to consider the remarkable, circumscribed, dark green coloured portion of the cord in this instance, as affording at once an evidence of the existence, and marking out the locality of a sanguineous extravasation or infiltration. A cyst is not invariably found in old cerebral apoplexies ; and the presence of such cannot be considered as an essential character of an apoplectic seizure at a distant date, since there are only two instances recorded, in which the subjects survived an extravasation more than a few weeks, the one of which is reported by Cruveilhier, and the other by Bright (vide table, case 6 (ls£ attach), and 15); and in both the effusion was external to the medulla. In the case now under consideration, although there might have been an adventitious membrane formed and absorbed during the long period of two years and seven months, without leaving any traces of its existence, yet it is more probable that the blood was at first infiltrated and imbibed into the substance of the cord—breaking up the white nervous tubes as the microscope demonstrated; and that subsequently, under the influence of the
    digitised image 1
    digitised image 2
    digitised image 3