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Plate XII.
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Eichhorst's 1913 Observations on Spinal Cord Lesions Caused by a Blood-borne Agent (Smallpox-Virus):
The spinal cord cross-sections show, both at a weak (fig. 1) and stronger (fig. 2) magnification, that the "inflammatory foci's" points and stripes(densely dotted) are marked by heavy perivascular infiltrates of mostly mononuclear cells (fig. 3), red blood cells (fig. 2, B) or both sorts of cells (fig. 2, E,E).

Fig. 2: B, compact hemorrhage; E,E, "inflammatory foci".

Fig. 4: sld, "inflammatory infiltrate" seaming a blood vessel of the spinal cord's posterior median septum.

Characteristics of a Systemically Disseminated Spinal Cord Affection:
In the macroscopically inconspicuous spinal cord, microscopically a great number of strictly perivascular lesions, up to the size of a millet seed, appear spread through especially the spinal cord's central grey matter. In the lower spinal cord, the white matter is also involved. But of these white matter lesions, most connect with foci in the spinal cord's central grey matter -- only a minor part lying entirely within the white substance, and even fewer lesions reaching the spinal cord's circumference. Overall, the lesions appear so irregularly scattered that their pattern of spread is, even on closely adjacent spinal cord cross-sections, hardly ever comparable.


Relevance of the Documentation: Although this was not the first time that the picture of a "disseminated myelitis", i.e. multifocal spinal cord injury originating in a blood-borne agent's dispersion into the spinal cord was illustrated, Eichhorst's picture characterized this kind of injury particularly aptly. Regarding the septa-related injuries of multiple sclerosis, his image of a conformable "inflammatory septum affection" caused by a blood vessel's course within the latter (fig. 4, sld) deserves particular attention.

© Dr. F. Alfons Schelling, M.D.