Selected essays and monographs : translations and reprints from various sources.

Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Selected essays and monographs : translations and reprints from various sources. Source: Wellcome Collection.

    103/476 (page 93)
    lie still thinks that hydromyelia is the predisposing cause of syringomyelia. In short, it ought to be considered a congenital disease, due to an anomaly in development of the cord ; this anomaly consisting of incomplete closure of the primitive groove on the posterior aspect of the cord. In the embryonic state a cavity of considerable size exists in the central region of the cord in place of a canal. Kahler and Pick* bring forward some new facts in support of Leyden’s theory. In reality, they say, several cavities may be present in the cord, and yet not give rise to any symptoms. They conclude that these cavities may be diverticula of the central canal, and that it may have several separate channels in a portion of its extent; lastly, that the condition may remain latent in adults, just as hydromyelia may remain latent in children. Kahlerf has again recently advocated the view that the cavity depends upon a hydromyelia. “ In typical cases of central cavities in the cord the aperture is due to dilatation of the central canal. The proof of this lies in the comparatively frequent presence of epithelial cells more or less completely lining the cavity, even when it occupies an abnormal situation or is multiple. If the disease gives rise to clinical signs, destructive changes of the nerve parenchyma around the dilated central canal are likewise present. These changes I attribute, provisionally at least, to chronic inflammatory processes, which I would place in the same category as the ordinary sclerosis of the central nervous system.” Harcken i also believes that the spinal cavities are either dilatations or diverticula of the central canal: that they may become the starting point of a cavity, and increase in size, owing to destructive changes in the tissues forming their walls. We prefer, however, to think with Charcot that hydromyelia is simply a malformation resulting from dilatation of the central canal—a sort of anatomical anomaly, the clinical history of which is little known. The name “hydromyelia” should be reserved for the dropsical distentions or other dilatations of the central canal, and the word “syringomyelia” for the cavities * Kaliler u. Pick, Prager Vierteljahrsch., T. CXLII.,, 1879. t Kahler, Prag. vied. Wochensch., 1888. X Harcken, These de Kiel, 1883.