"I raise a cry of joy in honor of my King, man and God combined. I will sing of his mercies through ages to come and in the eternity beyond the ages.' But notwithstanding that he had made his peace with God, the savage inhabitants continued to perse cute him, and on the evening of the day that witnessed his conversion he was found dead on the bank of a river. Some shepherds of the Picts had stoned to death the noble bard whom they called the "fool.” "Thus," as M. Hersart de la Villemarqué-whose account I have hitherto almost literally followed-remarks, "appears to have perished a man whose history is scarcely better known than that of other celebrated poets who have passed from the earth. To cite but two famous names, have Homer and Lucretius been more highly favored than Merlin, and is not all that is asserted in regard to them simple conjecture?" But Merlin's influence did not end with his life. Like every other truly great man, his power continued long after death, and throughout Britain was felt, when the real events of his history were nearly all forgotten. Legends and romances were constructed upon the slender type of truth which the composers had at their command, and others in which he played a prominent part, were fabricated altogether. That these stories were beneficial to the national literature and character, cannot be doubted. They told of noble deeds performed by brave men, of sacrifices by holy and virtuous women, and almost invariably made frankness and goodness triumph over deceit and wicked ness. They have been the means of giving to English literature some of its most glorious themes, and have handed down from generation to generation the love of fair play, contempt of danger, and boundless hope, which distinguish the Anglo-Saxon race wherever it is found. The Pathology and Treatment of Organic 2 By WILLIAM A. HAMMOND, M.D., &c. The form of paralysis occurring in young children, and which I design considering in this memoir, is that which Rilliet and Barthez1 have described as the Paralysie essentielle de l'enfance, and to which Duchenne has given the name of Paralysie atrophique graisseuse de l'enfance. Previous to the writings of these authors, the affection in question was not distinctly recognized as a separate disease, but was confounded with a much less serious disorder. Thus Dr. West described it tolerably well in a paper on the paralysis of infants, but regarded it as a variety of a disease which appeared under two other forms, one of which was congenital, and the other of cerebral origin. Both the latter, were not, in his opinion, of any serious character. The other, which was much more severe, occurred generally in debilitated children, and without exhibiting symptoms of any disorder of the brain. Traité clinique et pratique des Maladies de l'Enfance. Paris, 1853, t. II, p. 335. De l' Electisation localisée, etc. Paris, 1861, p. 275. 3 Medical Gazette, Sept. 8th, 1843. Recovery was often only partial, and though the general health sometimes became robust, the affected limb remained powerless and wasted away. Dr. Kennedy1 wrote two very excellent memoirs on a form of temporary paralysis, to which he had observed children to be liable. This came on very suddenly and disappeared in a few days under appropriate treat ment. Dr. Handfield Jones has recently related the details of several cases of this temporary paralysis, and a number of similar ones have been under my own charge. All recovered under the use of strychnia and iron, combined with mild faradaic currents applied to the affected limbs. Duchenne, in the work to which reference has been made, describes the affection, now under notice, with much minuteness, both as regards its symptoms and pathology. As the name he gives it indicates, he considers it to consist essentially in atrophy of the muscles, attended with fatty degeneration. That this latter is almost always the condition of the muscles, I am very sure; at the same time, my experience leads me to the conclusion that the conversion of the muscular tissue into fat is not a necessary accompaniment. Not long since, I related the details of several cases of this dis ease, and stated that I was disposed to regard it as 1 "Dublin Medical Press," Sept. 29, 1841, and “Dublin Quarterly Journal of Medicine," February, 1850. 2 Clinical Observations on Functional Nervous Disorders. Am. edition, 1867, p. 92. 3 On the Treatment of a Certain Form of Paralysis Occurring in Children, NEW YORK MEDICAL JOURNAL, December, 1865, p. 168. an affection in which the muscles become atrophied and lose their irritability without necessarily undergoing fatty degeneration. Further experience has confirmed me in this opinion. As a rule, however, there is no doubt of the correctness of Duchenne's view in relation to the pathology of the disease. According to this author, the principal phenomena which characterize what I have designated organic infantile paralysis, are paralysis, atrophy, and in some muscles a more profound lesion-fatty degeneration, or substitution. The fact that Duchenne himself thus admits that this last condition is not invariable, is a serious objection, even if there were no others, to the term which he has applied to the disease. Its length and the difficulty of rendering it into ordinary English, have aided in inducing me to propose the name which stands at the head of this article. Organic infantile paralysis is generally preceded by febrile excitement and pain in the back. This pain marks the seat of the disease of the spinal cord, to which the paralysis of the muscles is due. What the exact character of this spinal affection may be, cannot generally be determined. In one instance, when I had the opportunity of making a post mortem examination and of inspecting the condition of the cord, I found a cicatrix partially filled with a very small clot. The paralysis in this case was situated in the left lower extremity, and had begun four years previously. The lesion existed in the lower part of the dorsal region, in the left anterior column. In some cases, doubtless, the membranes of the cord, only, are affected, and the condition may be one of simple congestion or of inflammation, which generally appears in a chronic form. In others the substance of the cord is diseased. When the disease of the cord or its membranes, wholly or in part disappears, so long a time has generally elapsed, that the contractile power of the muscles is lost, atrophy has begun, and fatty substitution is often going on. The affection is then entirely muscular. The nerves are not apparently impaired in the integrity of their functions; sensibility is not materially, if at all, lessened. There is simply mal-nutrition of the muscles, not due to any inability of the nerves to transmit impressions, but to the fact, that from central disease, the proper stimulus has not been sent through the nerves of the affected parts to the muscles, for so long a time, that the latter, having lost the power of being excited by their natural motor influence, are incapable of recovering their tone and healthy condition. Very early in the course of the disease, the electric contractility of the affected muscles is abolished. When the poles of an induction coil are applied to a healthy muscle, contractions are produced. But, very soon after the appearance of organic infantile paralysis, this faculty begins to fade, and in the course of a few months is altogether lost in some of the muscles—not in all, for it generally happens that some one or more can be excited to contractions by strong induced currents. The power of the will is always lost over those muscles in which the electric contractility has disappeared. |