the important difference that in disseminated sclerosis the demyelination is a progressive process. It is therefore not improbable that a common factor may be responsible for this peculiar lesion in these various forms of nervous disorders. It is of interest to recall here that in the past many clinicians have put on record their belief that the cause of disseminated sclerosis is to be found in the acute infective diseases possibly as the result of a double or combined infection ", as P. Marie has suggested.

66

Experimental analogies.

A similar lesion (perivascular demyelination) has been recorded experimentally by certain observers. Thus Claude (1897) described a lesion of this type in the central nervous system of a dog which had received repeated inoculations of tetanus toxin. Ceni and Besta (1905) also described a similar perivascular lesion in the brain of a dog which had received intraperitoneal injections of material infected with aspergillus fumigatus. In the experimental animal, therefore, as much as in man, this particular form of nervous disorder appears to have followed after the entry into the body of viruses as different as those of measles and of vaccinia in the case of man, and of substances so widely separated as tetanus toxin and an aspergillus in the case of the dog.

Conclusion.

As the result of a fresh study of the histology of post-vaccinal encephalitis recently carried out, the claim of Professors Turnbull and McIntosh that post-vaccinal encephalitis can be certainly differentiated histologically from encephalitis lethargica and from poliomyelitis is confirmed. The problem of the etiology of post-vaccinal encephalitis is still being investigated experimentally, and no opinion can be expressed on this question at the present moment. But it seems most probable that the nervous accidents following vaccination against smallpox belong to the same category as those recorded in the course of the acute infective diseases and of Pasteur's treatment (antirabic inoculations). It is not unlikely, therefore, that these various conditions may have some etiological factor which is common to them all. The resemblance of the histological lesions of these various maladies to those found in early or acute cases of disseminated sclerosis is very striking and may possibly have some bearing on the etiology of the latter condition as well.

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