Report of the Poliomyelitis Committee of the Medical Association of the District of Columbia : epidemic 1910.

  • Medical Society of the District of Columbia. Poliomyelitis Committee.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Report of the Poliomyelitis Committee of the Medical Association of the District of Columbia : epidemic 1910. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    20/34 (page 94)
    ever, a fact contradictory to this supix)sed origin. Tliis short polymorphonuclear period may be considered as the meningeal reaction to the penetration of the virus into the nervous system. From the distribution of the histopathological picture in polio- myelitis and also from the comparison with similar pathological lesions in other diseases of non-bacterial origin, e.g., trypanoso- miasis, echinococcus, blastomicosis, sporotrichosis of the nervous tissue and probably rabies, it seems not unlikely that the organism producing the disea.se is a parasite (probably a protozoan) and that the way of entrance is through the vascular system.* W e observed also small altered erythrocytes appearing variously stained, and degenerated lymphocytic nuclei which were found very often in the spinal fluid in this disease. The other elements found in the fluid do not merit s])ecial de- scription ; they are lymphocytes in their various forms; small and medium size plasma cells usually with a single nucleus, rarely in a karyokinetic process; occasionally mast cells of a very small size; mononuclear cells belonging to the large lymphocyte grou]) and to the transition forms of Ehrlich; Kornchenzellen with round, oval or compressed nuclei, the framework of which aj^pears splendidly stained hv the triacid method, and finally several endothelial cells (many of them having vacuolated protoplasm) indicating a pro- gressive or regressive character. .\ separate description of them will be found in the article by one of us previously referred to’). Conclusions. 1. The cerebrospinal fluid in acute anterior poliomyelitis is gen- erally clear; there is in the early stages of the disease an increase of pressure although this is not generally ])ronounced and there is usually an increase of the ])rotein content sullicient to give a positive Xonne-.^lpelt and Xoguchi butyric acid reaction. 2. In the earlier stages of the di.sease there is more or less pleocytosis in the spinal fluid. There are many polymorphonu- clear leucocytes which are jirobably dependent upon the reaction of the meninges to the penetration of the virus into the central nervous system. 3. The increase of polymorphonuclears disappears a few days after the acute onset of the disease and is substituted by a lympho- cytosis with some plasma cells and sometimes a few mast cells. 4. The disappearance of the polymorphonuclears is brought about through the rapid and vigorous phagocytic activity of the macrophages which sometimes contain twenty or more rests of the polynuclear elements. i). These degenerated polymorphonuclear leucocytes show in the framework of the macrophages very different degrees of histo- ' We lienr in iiiiml, however, the fnct thnt'sonie chronic Iwicterinl disea.wslof the nervous system, ns tutierculosis. present a somewhat similar pntholoincal picture. ’Op. Cit.