Page:Acute Poliomyelitis.djvu/21



To understand the various clinical forms of the disease, an exact knowledge of its pathological anatomy is indispensable. As research in recent years has enabled us definitely to ascertain the nature of the morbid changes, I shall in this chapter somewhat fully discuss them, particularly those peculiar to the acute stage.

A. Acute Stage.—As far as I know, the following are the observers who have published reports upon the acute stage.

Rissler (1888) Dauber (1893) Goldscheider (1893) Siemerling (1894) Redlich (1894) Bickel and Roeder (1898) Bulow-Hansen and Harbitz (1899) Matthes (1899) Monckeberg (1903) Batten (1904) Schmaus (1905) Neurath (1905) Wickman (1905 and 1910) Forssner and Sjovall (1907) Harbitz and Scheel (1907) Barnes and Miller (1907) Cadwalader (1908) Marburg (1909) Hoffmann (1909) Hochhaus (1909) Strauss (1910) Benecke (1910) Pirie (1910) Marchand (1910) 3 cases (5-8 days). 1 case (5 days). 1 case (12 days). 1 case (8 days). 1 case (10 days). 1 case (12 days). 2 cases (resp. 5 and 7 days). 1 case (8 days). 1 case (12 days). 1 case (13 days). 1 case (3 days). 1 case (2 days). 14 cases (2-9 days). 2 cases (resp. 1 and 2 dsys). 13 cases (2 and 10 days). 13 case (8 days). 3 cases (3-6 days). 6 cases. 1 case (7 days). 2 cases (each 2 days). 8 cases (2-13 days). 3 cases. 1 case (5 days). 1 case.

Macroscopic Changes. — As Heine-Medin's disease is an infec- tious malady, symptoms of a general infection are to be expected. Enlargement of the spleen has been present in some cases; and sometimes, cloudy swelling, even distinct inflammation, appears