On Pigmentary Deposits in the Brain resulting from Malarial Poisoning
By William A. Hammond, M.D., Professor of Diseases of the Mind and IServous System in the University of the City of New York, etc.
The object of the author is to call attention to a condition of the brain resulting from malarial fevers. This is stated to be a deposition of pigment in the organ, either in the form of emboli or thrombi, but as a contradistinction to the form usually denominated under the name of ” embolism.” After an elaborate discussion upon what was known of the occurrence of pigment-cells in the blood, and their deposition in the various organs, as the spleen, liver, and brain, until within the last fifteen years, and in which the names of such distinguished pathologists as.
Yirchow, Bright, Frerichs, and Stietel conspicuously figure, our atten- tion is called to a number of the most interesting cases taking place within the author’s own experience. Dr Hammond states that many years ago he noticed that several persons residing in malarious districts,, who had been the subjects of repeated attacks of endemic fever, and were at the same time suffering from enlargement of the spleen, ex- hibited evidences of cerebral disease?such as epileptic convulsions, frequent attacks of vertigo, impairment of sight, and loss of mobility in one or other side of the body; and, in many cases, upon ophthal- moscopic examination, the existence of double optic neuritis with pigmentary deposits was clearly established.
This highly instructive pamphlet, which is well worthy of a careful perusal, terminates with the following conclusions:? 1st. That as a consequence of malarial poisoning, the pigment of the blood undergoes a change in appearance and form, and that the alteration is effected in the spleen, leading to hypertrophy of this organ.
2nd. That this pigment may enter the general circulation from the spleen, either in a free condition, or in picrment-holding cells, and that it may be deposited in the cerebral bloodvessels, or pass through their coats.
3rd. That these deposits may give rise to various symptoms, indica- ting derangement of the nervous system.
4th. That arsenic appears to have the power of, in a way at present unknown, so altering the character of the pigmentary deposits as to facilitate their removal, and to cause the disappearance of the symptoms to which they give rise.
5th. That we may have, during the life of the individual, ocular demonstration of these facts by the presence of pigments in the fundus of the eye, as revealed by the ophthalmoscope.
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