THE HISTOGENESIS OF MULTIPLE SCLEROSIS

THEOPHIL KLINGMAN
1919 Archives of Neurology And Psychiatry  
Multiple sclerosis has steadily held the attention of the investigators for a number of decades, and the careful clinical study of the disease in conneetion with exhaustive histopathologic research has resulted in a number of theories on the basis of which the more recent histologic studies have given gratifying results. The newer methods of staining and modifications of the older ones made it possible to differentiate more definitely the tissue elements which enter into the pathologic process
more » ... pathologic process and in consequence of this, these have been minutely described. However, it is evident in the conclusions drawn from the results which have been revealed that the interpretation of the tissue changes and their correlation, not only from a histopathologic standpoint, but also in connection with the reaction of certain tissue elements under abnormal conditions and the reaction of a feeble biogenetic balance in the tissue as a whole, is incomplete and the conclusions indefinite. This fact warrants not only a recapitulation, but also establishes a basis for further attempts to correlate the pathologic changes which have caused the structural disorganization in the various parts of the nervous system with the physiologic changes. Further, the careful description of the elements and the changes occurring in them has made it possible to trace the origin of the disease to the embryonic stage. The basis of this investigation rests on four cases of multiple sclerosis; one of these the writer studied clinically as well; the other three and later the fourth were patients at the state hospitals for the insane where the clinical notes and necropsy protocols were made. All of the cases were under observation for considerable periods of time and presented sufficient clinical evidence for a positive diagnosis. For lack of space the case histories and clinical notes are omitted from the article, but these will appear in full in the reprints. Case 309.-Necropsy-Many of the bronchial glands were enlarged. The glands of the small intestines were found enlarged and, on section, showed cystic change with an abundance of yellow gelatinous substance exuding. The heart weighed 260 gm. The endocardium showed no marked localized change and there was no myocardial change. The kidneys showed only such changes
doi:10.1001/archneurpsyc.1919.02180010042004 fatcat:5mq2c7duuvac5odhey45xyt7ti