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January 1916


Author Affiliations

From the Otho S. A. Sprague Memorial Institute Laboratory of the Children's Memorial Hospital.

Am J Dis Child. 1916;XI(1):23-32. doi:10.1001/archpedi.1916.04110070034004

Since the first accurate description of pachymeningitis hemorrhagica interna by Virchow1 in 1856, observers have differed in their views regarding the exact nature of this condition. Virchow believed that the membrane formation on the inner surface of the dura precedes the hemorrhage. Huguenin2 maintained that the hemorrhage is primary, the organization of the clot causing the membrane formation. The work of Melnikow-Raswedenkow3 and others supported Virchow's view, which has gradually become the prevailing one.

It was thought that most of the cases seen in the adult4 resulted from sclerotic changes incident to chronic diseases of the brain, heart, kidneys and lungs. Similarly, regarding cases occurring in the infant, the prevailing opinion seemed to be that pachymeningitis is secondary to other diseases, the cerebral changes being usually discovered at necropsy in infants dying from various infectious diseases, or in chronic cachectic conditions.5

Kremiansky6 performed experiments