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1. There are two different common crystalline forms of carbondiamond and graphite. A less common
form called fullerene, C60, also exists. Different forms of the same element in the same physical state
are called:
a. isotopes.
b. isomers.
c. alloforms.
d. allotropes.
e. structural formulas.
ANS: D
OBJ: Define allotrope.
TOP: Chemical Formulas
3. If a sample of butane, C4H10, contains a total of 8.0 103 atoms of carbon, how many molecules of
butane are in the sample?
a. 6.0 103
b. 3.0 103
c. 8.0 103
d. 1.1 104
e. 2.0 103
ANS: E
OBJ: Understand the relationship between molecular formula and the number of atoms of a specific
type contained in a single compound. | Convert the number of atoms in a substance to the number of
molecules in a substance.
TOP: Chemical Formulas
2
e. methane
ANS: B
OBJ: Know the names and chemical formulae of common acids.
TOP: Chemical Formulas
3
5. Name the molecular compound, SO3.
a. sulfur oxide
b. sulfurous acid
c. sulfur trioxide
d. sulfuric acid
e. none of these
ANS: C
OBJ: Translate the chemical formula of a binary molecule into a name.
TOP: Chemical Formulas
9. Butane, a highly combustible hydrocarbon found in disposable lighters, has the chemical formula:
a. CO2
b. C4H8
c. C4H10
d. C3H8
e. CH3OCH3
4
ANS: C
OBJ: Know the names and chemical formulae of common organic compounds. | Translate the
chemical formula of a binary molecule into a name.
TOP: Chemical Formulas
11. A compound contains only calcium and fluorine. A sample of the compound is determined to contain
2.00 g of calcium and 1.90 g of fluorine. According to the Law of Definite Proportions, how much
calcium should another sample of this compound contain if it contains 2.85 g of fluorine?
a. 2.71 g
b. 4.00 g
c. 3.00 g
d. 4.50 g
e. 6.00 g
ANS: C
OBJ: Apply the Law of Definite Proportions.
TOP: Chemical Formulas
12. A compound contains only magnesium and oxygen. A sample of the compound is determined to
contain 3.50 g of magnesium and 2.30 g of oxygen. According to the Law of Definite Proportions,
how much magnesium should another sample of this compound contain if it contains 6.91 g of
oxygen?
a. 1.16 g
b. 10.5 g
c. 4.54 g
d. 55.5 g
e. 0.858 g
ANS: B
OBJ: Apply the Law of Definite Proportions.
TOP: Chemical Formulas
5
14. Which of the following statements is incorrect?
a. Potassium chloride forms molecules that consist of one K+ ion and one Cl ion.
b. Ions that possess a positive charge are called cations.
c. Polyatomic ions are groups of atoms that have an electric charge.
d. It is acceptable to use formula unit to refer to either an ionic compound or a molecular
compound.
e. Ions that possess a negative charge are called anions.
ANS: A
OBJ: Distinguish between properties that define a substance as ionic or molecular.
TOP: Ions and Ionic Compounds
17. Each response below lists an ion by name and by chemical symbol or formula. Also each ion is
classified as monatomic or polyatomic and as a cation or anion. Which response contains an error?
a. hydroxide / OH / monatomic / anion
b. carbonate / CO 32 / polyatomic / anion
c. ammonium / NH4+ / polyatomic / cation
d. magnesium / Mg2+ / monatomic / cation
e. sulfite / SO 23 / polyatomic / anion
ANS: A
OBJ: Know the names, chemical formulae, and charges of monatomic ions and common polyatomic
ions.
TOP: Ions and Ionic Compounds
18. Each response below lists an ion by name and by chemical symbol or formula. Also each ion is
classified as monatomic or polyatomic and as a cation or anion. Which response contains an error?
a. phosphate / PO 43 / polyatomic / anion
b. sulfite / SO32 / polyatomic / anion
c. nitrite / NO3 / polyatomic / anion
d. iron(II) / Fe2+ / monatomic / cation
e. bromide / Br / monatomic / anion
6
ANS: C
OBJ: Know the names, chemical formulae, and charges of monatomic ions and common polyatomic
ions.
TOP: Ions and Ionic Compounds
7
ANS: A
OBJ: Translate the name of an ionic compound into a chemical formula.
TOP: Names and Formulas of Some Ionic Compounds
24. Choose the name / formula pair that does not correctly match.
a. aluminum phosphate / AlPO4
b. calcium acetate / CaCH3COO
c. ammonium sulfide / (NH4)2S
d. magnesium hydroxide / Mg(OH)2
e. zinc carbonate / ZnCO3
ANS: B
OBJ: Translate the chemical formula of an ionic compound into a name. | Translate the name of an
ionic compound into a chemical formula.
TOP: Names and Formulas of Some Ionic Compounds
25. From the following ionic compounds, choose the name / formula pair that is not correctly matched.
a. sodium sulfide / Na2S
b. ammonium nitrate / NH4NO3
c. zinc hydroxide / Zn(OH)2
d. sodium sulfate / Na2SO3
e. calcium oxide / CaO
ANS: D
OBJ: Translate the chemical formula of an ionic compound into a name. | Translate the name of an
ionic compound into a chemical formula.
TOP: Names and Formulas of Some Ionic Compounds
26. From the following compounds choose the name / formula pair that is incorrectly matched.
a. sodium sulfite / Na2SO3
b. ammonium fluoride / NH4F
c. copper(II) carbonate / CuCO3
d. ferric chloride / FeCl3
e. cuprous sulfide / Co2S
ANS: E
OBJ: Translate the chemical formula of an ionic compound into a name. | Translate the name of an
ionic compound into a chemical formula.
TOP: Names and Formulas of Some Ionic Compounds
27. Which element has a mass that is 7.30 times that of carbon-12?
a. Mg
b. Sr
c. Ca
d. Br
e. Rb
ANS: B
OBJ: Apply the modern definition of relative atomic mass.
TOP: Atomic Weights
8
28. Which element has a mass approximately 4 times that of an H atom?
a. Be
b. He
c. Li
d. Ti
e. K
ANS: B
OBJ: Apply the concept of relative atomic mass.
TOP: Atomic Weights
29. The molecular formula for a compound is CX4. If 2.819 g of this compound contains 0.102 g of
carbon, what is the atomic weight of X?
a. 320
b. 160
c. 35.5
d. 79.9
e. 39.9
ANS: D
DIF: Harder Question
OBJ: Calculate the atomic weight of an unknown element based on the chemical formula and mass of
each component in a sample.
TOP: Atomic Weights
31. Calculate the number of moles of oxygen atoms in 35.2 grams of oxygen.
a. 2.20 moles
b. 4.42 moles
c. 0.54 moles
d. 2.57 moles
e. 1.13 moles
ANS: A
OBJ: Translate the name of a diatomic element into a chemical formula. | Use the formula weight or
molecular weight of a substance to convert grams of a substance to moles.
TOP: The Mole
9
ANS: B
OBJ: Translate the name of a diatomic element into a chemical formula. | Use the formula weight or
molecular weight of a substance to convert moles of a substance to grams.
TOP: The Mole
34. Determine the number of sulfur atoms in 27.1 g of molecular sulfur (S8).
a. 0.845
b. 5.27 1023
c. 5.09 1023
d. 2.07 1023
e. 0.106
ANS: C
OBJ: Determine the molecular weight of a substance using atomic weights and the chemical formula.
| Use Avogadro's number, molecular formula, and molecular weight to convert grams to number of
atoms.
TOP: The Mole
10
37. What is the mass of 2.2 109 CO2 molecules?
a. 9.7 1010 g
b. 1.0 1012 g
c. 1.2 106 g
d. 4.4 1014 g
e. 1.6 1013 g
ANS: E
OBJ: Determine the molecular weight of a substance using atomic weights and the chemical formula.
| Use Avogadro's number and molecular weight to convert molecules to grams.
TOP: Formula Weights, Molecular Weights, and Moles
40. How many moles of POCl3 are there in 10.0 grams of POCl3?
a. 6.51 102 mol
b. 3.68 101 mol
c. 4.09 102 mol
d. 1.21 101 mol
e. 1.17 103 mol
ANS: A
OBJ: Determine the molecular weight of a substance using atomic weights and the chemical formula.
| Use the formula weight or molecular weight of a substance to convert grams to moles.
TOP: Formula Weights, Molecular Weights, and Moles
41. How many moles of CCl4 are present in 118. g of carbon tetrachloride?
a. 0.839
b. 1.19
c. 0.538
d. 1.30
e. 0.767
11
ANS: E
OBJ: Determine the molecular weight of a substance using atomic weights and the chemical formula.
| Use the formula weight or molecular weight of a substance to convert grams to moles.
TOP: Formula Weights, Molecular Weights, and Moles
44. How many atoms of carbon are present in 34.5 g of caffeine, C8H10N4O2?
a. 8.57 1023
b. 2.68 1025
c. 1.08 1024
d. 2.09 1023
e. 4.83 1023
ANS: A
OBJ: Determine the molecular weight of a substance using atomic weights and the chemical formula.
| Use Avogadro's number, molecular formula, and molecular weight to convert grams to atoms.
TOP: Formula Weights, Molecular Weights, and Moles
12
46. Which of the following is not a correct description of 16.0 grams of methane, CH4?
a. It is one mole of methane.
b. It is the amount of methane that contains 12.0 g of carbon.
c. It is 16.0 6.02 1023 molecules of methane.
d. It is the amount of methane that contains 4.0 grams of hydrogen.
e. It is the amount of methane that contains 4 6.02 1023 hydrogen atoms.
ANS: C
OBJ: Determine the molecular weight of a substance using atomic weights and the chemical
formula.| Convert grams of a substance to moles, grams of a component, molecules, or atoms.
TOP: Formula Weights, Molecular Weights, and Moles
47. A sample of ethane, C2H6, contains a total of 16N atoms, where N = 6.02 1023. How much C2H6 is in
the sample?
a. 2.0 g
b. 30 g
c. 60 g
d. 16 mol
e. 4 mol
ANS: C DIF: Harder Question
OBJ: Determine the molecular weight of a substance using atomic weights and the formula of the
substance.| Use Avogadro's number, molecular formula, and molecular weight to convert total atoms in
a sample to grams or moles.
TOP: Formula Weights, Molecular Weights, and Moles
48. Suppose you have a 100-gram sample of each of the following compounds. Which sample contains the
smallest number of moles of compound?
a. NH3
b. MgCl2
c. H3PO4
d. CrCl3
e. NaCl
ANS: D
OBJ: Understand and apply the relationship between mass, molar mass, and moles of a sample.
TOP: Formula Weights, Molecular Weights, and Moles
49. A mole of a compound composed of nitrogen and oxygen (NxOy) has a molecular weight of 92.0
g/mol. What is its formula?
a. NO
b. N2O4
c. NO3
d. N2O
e. NO2
ANS: B
OBJ: Translate molecular weight into a molecular formula.
TOP: Formula Weights, Molecular Weights, and Moles
13
50. What is the percent by mass of sulfur in Al2(SO4)3?
a. 9.38%
b. 18.8%
c. 24.6%
d. 28.1%
e. 35.4%
ANS: D
OBJ: Calculate percent mass of a component given the chemical formula of the substance.
TOP: Percent Composition and Formulas of Compounds
54. Analysis of a sample of a covalent compound showed that it contained 14.4% hydrogen and 85.6%
carbon by mass. What is the empirical formula for this compound?
a. CH
b. CH2
c. CH3
d. C2H4
e. C2H5
ANS: B
OBJ: Convert percent mass to the simplest formula (empirical formula).
TOP: Derivation of Formulas from Elemental Composition
14
55. What is the empirical formula for a compound containing 68.3% lead, 10.6% sulfur and the remainder
oxygen?
a. PbSO2
b. PbSO3
c. PbS2O3
d. PbSO4
e. Pb2SO4
ANS: D
OBJ: Calculate the percent mass of a third component from the data provided. | Convert percent mass
to the simplest formula (empirical formula).
TOP: Derivation of Formulas from Elemental Composition
56. A compound contains sulfur, oxygen, and chlorine. Analysis shows that it contains by mass 26.95%
sulfur and 59.61% chlorine. What is the simplest formula for this compound?
a. SOCl
b. SOCl2
c. SO2Cl2
d. SO2Cl
e. S2OCl2
ANS: B
OBJ: Calculate the percent mass of a third component from the data provided. | Convert percent mass
to the simplest formula (empirical formula).
TOP: Derivation of Formulas from Elemental Composition
57. A compound contains carbon, oxygen, and hydrogen. Analysis of a sample showed that it contained by
mass 68.9% carbon and 4.92% hydrogen. What is the simplest formula for this compound?
a. C6H6O2
b. C7H6O2
c. C8H6O2
d. C6H4O3
e. C7H8O
ANS: B
OBJ: Calculate the percent mass of a third component from the data provided. | Convert percent mass
to the simplest formula (empirical formula).
TOP: Derivation of Formulas from Elemental Composition
58. A sample of a compound containing nitrogen, hydrogen, and oxygen is found to contain 22.2%
nitrogen and 1.59% hydrogen. What is the simplest formula for this compound?
a. HNO
b. H2N2O3
c. H2NO3
d. HNO2
e. HNO3
ANS: E
OBJ: Calculate the percent mass of a third component from the data provided. | Convert percent mass
to the simplest formula (empirical formula).
TOP: Derivation of Formulas from Elemental Composition
15
Another random document with
no related content on Scribd:
fatty degen.
vessels. Sclerosis
ant. columns.
Atrophy ant. roots.
Foci of softening
in ant. cornua.
Roger and Fatty degen.
29 1871 2 2½ Variola. Both legs. Ibid.
Damaschino. blood-vessels,
circumscribed
myelitis.
Roger and Foci of softening,
30 1871 2 3 Fever. Ibid. Ibid.
Damaschino. as above.
Focus myelitis on
both sides.
Disappearance Virch. Arch.,
31 1873 Roth. 1 2 Ibid. Ibid. ganglion-cells, 1873, Bd.
abundant lviii.
exudation
corpuscles.
Extensive myelitis
ant. and central Med.-Chir.
After
32 1868 L. Clarke. 1 32 Both arms. part gray matter. Trans., li. p.
inoculation.
Disappearance 219.
ganglion-cells.
Atrophy lumbar
cord ant. lat.
columns. Atrophy
Virch.
Acute ganglion-cells.
33 1876 Schultze. 3 22 Both legs. Archiv, Bd.
disease. Abundant exud.
lxviii., 1876.
corpuscles.
Proliferation
neuroglia.
34 1876 Leyden. 2 60 Fall from L. leg. Circumscribed Archiv f.
table. cicatrix with Psych.,
complete 1876, Bd. vi.
destruction gray
substance.
Amyloid
degeneration.
Atrophy ant. roots.
Atrophy ganglion-
cells. Cellular
35 1876 Leyden. ¾ 1¾ Suddenly. L. leg. diffused infilt. Ibid.
(myelitis) gray
subst'ce.
Amyloid infiltration
ant. horns,
atrophy ganglion-
Sudden
36 1876 Leyden. 4 58 L. leg. cells left lumbar Ibid.
over night.
horn. Diffuse
atrophy gray
substance.
Sclerotic focus in
right lumbar and
in left cerv. region.
R. leg, L. Diffuse meningo-
37 1876 Leyden. 3 20 Ibid. Ibid.
arm. myelitis. Atrophy
ant. lat. columns.
Encapsulated
myelitis.
Purulent focus in
Quoted by
ant. cornua
Seeligmüller,
38 1876 Demme. ? 3½ ? — lumbar region.
loc. cit., p.
Atrophy ganglion-
18.
cells.
Diffuse
inflammation
39 1876 Eisenlohr. ? ¾ ? B. legs. Ibid.
anterior horns and
ant. lat. columns.
Myelitic
disorganization Trans. Path.
40 1879 Turner. 2½ 2¾ ? gray substance Soc. Lond.,
ant. cornua 1879.
lumbar cord.
41 1883 Archambault 30 m's 31 m's, Malaise Left leg Focus red Le Union
et or 26 and and right softening ant. médicale,
Damaschino. arm. horns left lumbar; 1883.
d'ys fr. prostration right cervical
début. one day. region. Enormous
enlargement
vascular network,
and distension
blood-vessels;
granular
corpuscles in
lymphatic
sheaths; marked
atrophy cells and
of myeline
sheaths of fibres
in ant. roots;
myeline balls in
sheath; axis-
cylinders
disappeared.
Lesions more or
less marked
throughout cord.
Nerves not
examined.
Red area both
anterior cornua
lumbar region.
Fever and Here distension Trans. Path.
42 1884 Money. 2 yrs. 28 m's. vomiting Paraplegia. and thrombosis Soc. Lond.,
for a week. vessels; infiltration 1884.
leucocytes;
absence
multipolar cells.
1884 Money. Unknown 7 yrs. Unknown. Right leg. Wasting anterior
horn almost
throughout lumbar
region. Atrophy
cells chiefly in
ant., ant.-lat.,
post.-lateral, and
central groups,
replaced by dense
nucleated tissue.
It will be useful to add another table, which will group together the cases
in which the autopsies were made within two years after the occurrence
of the paralysis. Of these, all but the two made by Laborde, in which the
cornua are declared to be healthy and the lesion limited to the white
columns, show traces of destructive morbid processes in the gray
substance of the cord, greatly predominating in the anterior cornua, but
not absolutely limited to them, nor even to the part of the cord which
corresponds to the paralyzed limb:
TABLE VI.
Date of Autopsy Year of
Case No. Name of Author. after Paralysis. Publication.
41 Damaschino. 6 weeks. 1883
40 Turner. 26 days. 1879
28 Roger and Damaschino. 2 mos. 1871
42 Money. 4 mos. 1884
27 Echeverria. 6 mos.
39 Eisenlohr. 6 mos.
29 Roger. 6 mos. 1871
31 Roth. 9 mos. 1873
35 Leyden. 11 mos. 1876
14 Bouvier and Laborde. 12 mos. 1864
30 Roger. 13 mos. 1871
15 Cornil and Laborde. 16 mos. 1864
12 Recklinghausen. 24 mos. 1863
38 Demme. 24 mos. 1876
23 Taylor. 18 mos. 1879
25 Humphrey. 24 mos. 1879
Leucocytes are often disseminated through the diseased area, and in one
case (Demme) were accumulated into a focus of pus. Besides the
leucocytes, the foci are often infiltrated with large round granular cells that
seem to be transformed neuroglia-cells (Leyden). In one case neuroglia
nuclei were accumulated in a ring around the focus, seeming to indicate
the beginning of encapsulation.
The most striking lesion, however, and the one which is common to the
most recent as well as to old cases, is the deformation, atrophy, and final
disappearance of the large ganglionic cells of the anterior cornua. The
first change consists in granular pigmentation;98 then the prolongations
disappear, leaving the body of the cell shrunken and deformed; at last the
whole cell disappears. Sometimes all the cells of an anterior horn have
disappeared throughout the entire depth of the focus; quite as often, in
certain sections at least, the atrophy is limited to certain groups, as the
external,99 or the external in one focus, the antero-lateral in another,
situated on the opposite side of the cord.100
98 Case of Echeverria, Tab. V.
99 Case by Schultze (this is a case of ancient lesion), Tab. V. (Virch. Arch., Bd. lviii.).
These focal lesions of the cord explain admirably, as will be seen, the
permanent symptoms of the disease. But of great importance for
understanding its initial period is the fact that structural changes—similar
to, but less severe than, those just described—have beer found diffused
throughout the cord. In several cases hyperæmia, partial atrophy of
ganglionic cells and nerve-fibres, infiltration with exudation corpuscles, in
the anterior cornua and even central gray canal from the lumbar to the
cervical region.101 In Damaschino's case, besides the focal lesions which
corresponded to the paralyses of the right arm and left leg, were others
corresponding to the left arm and right leg where no paralysis existed.
101 See cases by Leyden, Roth, Schultze, Clarke, Damaschino.
This case (1883) is also interesting in bringing out another lesion not
usually noticed. This is the breaking up into balls of the myeline in the
medullated tubes, both of the anterior intraspinal nerve-roots and of such
fibres as traversed the anterior nerves. In balsam preparations these
myeline drops are dissolved; but in osmic acid and glycerin preparations
they appear as black balls all over the field. The lesion is identical with
that already described by Dejerine (1875) in both nerves, roots, and white
columns. The columns of Clarke have always been found intact.
In the recent cases no lesions of the white columns have been observed
—a fact upon which reposes the doctrine that such lesions, when
existing, are secondary to those of the cornua.
The date of these lesions varies from seven to seventy-six years. In two
or three cases, where the autopsy was made on very old people, the
early history of the disease was unknown, but the probable date of the
paralysis was calculated.
In this group of cases patches of atrophy, semi-transparent and grayish in
color, focal or diffused, are clearly perceptible to the naked eye. As a rule,
the atrophy is unilateral, and sensibly affects the entire half of the cord. In
some cases of paraplegia, however, there is a bilateral, symmetrical
shrinkage of the entire lumbar cord, which has been reduced to the size
of a quill.
The atrophy involves, first and most markedly, one or both anterior
cornua; second, the anterior nerve-roots arising from them; third, the
antero-lateral columns.
In both the latter localities the microscope will often find individual nerve-
tubes wasted and deprived of their myeline. The atrophied patches are
generally sclerosed as the seat of a proliferated neuroglia, coloring deeply
with carmine. In Laborde's cases, published at the very beginning of what
may be called the anatomical period, the atrophy and sclerosis were said
to be limited to the antero-lateral columns and the nerve-roots, while the
cornua remained intact. In all more recent observations, however, the
lesion of the white columns and roots has been found strictly proportioned
to that of the gray horns. The sclerosis extended into the latter,
constituted by a reticulum of connective-tissue fibres, sometimes fine,
sometimes so matted together as to form a dense felt-like substance,
sometimes offering the ordinary aspect of sclerosis.
103 Seguin (loc. cit.) observes that the opinion is gaining ground which ascribes these to a
transformation of the neuroglia corpuscles.
As in the relatively fresh cases, the circumstance which has attracted the
most attention is the atrophy of the ganglionic cells from the sclerosed
patches of the anterior cornua. The completeness with which these have
disappeared in any focus seems to be proportioned to the completeness
of the paralysis in the corresponding limb. Partial atrophy or
disappearance of spinal groups of cells from the cornua may sometimes
be correlated with paralysis of special muscles.105
105 Thus in Schultze's case, already quoted, the external group of cells had disappeared
from the focus in one gray horn, and the extensors of the foot were alone paralyzed. This
seems to confirm the opinion advanced by Spitzka, that this external group of motor-cells
corresponds to the extensor, the internal groups to the flexor muscles.
107 Charcot, Leçons sur les Maladies du Syst. nerveux; Prévost, Soc. Biol., 1864; Joffroy,
Arch. de Physiol., 1870; Petitfils, “De l'Atrophie aigue des Cellules matrices,” Thèse de
Paris, 1873.
108 Schultze, Virch. Arch., Bd. lxviii.; Roth, Ibid., Bd. lviii.; Henoch, loc. cit., p. 208; Ross, loc.
cit., p. 125; Seguin, loc. cit., 1877; Erb, Ziemssen's Handbuch; Seeligmüller, Gerhardt's
Handbuch; Roger and Damaschino, Gaz. méd., 1871; Turner, Path. Trans. Lond., 1879;
Hammond, loc. cit.
111 When this objection is accepted, Barlow's remark falls to the ground, that “the similarity
of lesion found in two such different diseases as infantile paralysis and progressive muscular
atrophy proves the failure of anatomical characters, taken alone, to serve as a basis of
nosology” (Brain, April, 1879, p. 74).
113 It might be said that the fall of the fever as soon as the paralysis is declared and the
motor cells presumably melted down should contradict the idea that their dying substance
acts as an irritant upon surrounding tissues.
A third objection has been brought forward by Leyden, and is really an
enlargement on the second. It is, that various lesions or morbid processes
may underlie the same clinical history. In four autopsies of cases
presenting all the clinical history of acute anterior poliomyelitis this author
has found three different lesions. In one an extensive lepto-meningitis,
together with irregular focal sclerosis of the white columns, evidently
depended upon the latter, and in turn caused sclerosis of the anterior
cornua with consequent destruction of their cells.114 In two other cases an
anterior poliomyelitis was accompanied by diffused lesions of the central
canal. Finally, in a fourth case the lesions were limited to the anterior
cornua, as is most usual.
114 This case of Leyden's throws light on the two autopsies by Laborde with sclerosis of the
white columns and intact cornua. It seems probable that a process originating in the cornua
had then been arrested or had receded, while continuing its evolution in the white columns.
1. Inflammation of motor and trophic nerve-cells: (a) Infantile spinal paralysis; (b) Spinal
paralysis of adults; (c) Pseudo-hypertrophic spinal paralysis.
3. Inflammation of trophic cells: (a) Progressive muscular atrophy; (b) Progressive facial
atrophy (Dis. Nerv. Syst., 6th ed., p. 464).
“There cannot be the slightest doubt,” observes Erb, “that the lesions
described constitute a degenerative atrophy similar to what may be
caused by section or sense traumatism of a peripheric nerve.”
The peripheric nerves have been much less thoroughly studied than the
spinal cord. Leyden first directed special attention to the nerves. He found
the sciatic altered in two cases,118 in the first by an interstitial neuritis; in
the second by partial atrophy. In 1880 the same writer, in an extensive
article on poliomyelitis and neuritis,119 greatly extends his views as earlier
expressed. Not only does he claim the coexistence of neuritis with spinal-
cord disease in atrophic paralysis, but thinks that many cases of this, and
also of other forms of paralysis, “lately supposed to originate in the spinal
cord, may really begin in any part of the motor apparatus,” thence
sometimes generalize throughout the whole apparatus, sometimes
remain limited to the original portion affected. Thus, progressive muscular
atrophy may sometimes begin in the nerves, sometimes in the muscles,
and sometimes in the ganglionic cells of the cord; and this variety of origin
explains the discrepancies of opinion which have been held upon the
nature of this disease. Similarly, all forms of acute or chronic atrophic
paralysis in either children or adults may begin in either the nerves or
cord, thence become generalized to both, or remain limited to one part of
the spinal motor system. Cases of atrophic paralysis which recover are
probably not cases of poliomyelitis at all, but of multiple neuritis,
rheumatic, traumatic, or infectious in nature. The regeneration of
peripheric nerves is a well-demonstrated possibility, but not that of the
cells of the cord. Lead-paralysis is usually confined to the nerves, but
sometimes extends to the cord. In diphtheritic paralysis Buhl has found
injection, thickening, and granular infiltration of nerves at the union of their
anterior and posterior roots;120 and as long ago as 1876, Dejerine, in a
case of atrophic paralysis in a syphilitic woman, found varicose swelling
of the medullary sheath in the nerves of the paralyzed lower extremities,
together with heaping up of the myeline into large drops, colored black in
glycerin and osmic-acid preparations. Coincidently, in the cord, at the
origin of the same nerves, the number of motor-cells was diminished, and
of those that remained the prolongations, and even the body, of the cell
were atrophied.121
118 Cases 34 and 35 of Table V., quoted from Arch. de Psychiatrie, Bd. vi., 1876.
The brain is usually normal, unless indeed the paralysis has affected
children previously rendered idiotic by congenital atrophia cerebri.
Sandie, however, examined one brain with an interesting positive
result.124 The brain was taken from a boy of fifteen paralyzed since the
age of three in almost all his muscles, with even paresis of the muscles of
the trunk and neck. The paralysis was more marked upon the right than
on the left side. At the autopsy, in addition to atrophy of the muscles and
of the motor nerves, with exquisite atrophy of the anterior columns and
anterior cornua, was found a decided atrophy of the left central
convolution, and, less marked, of the paracentral lobule. This was shown
by comparative measurements with the opposite side of the same brain,
and also with the corresponding convolution and lobule in two other
brains. The child's intelligence had not been affected.
124 Centralblatt f. d. Med. Wissensch., No. 15, 1875.
FIG. 55.
c, trophic cell for nerve; a, cerebral fibre; b, trophic cell for muscle; d,
ganglionic cell; s, sensory fibre; f, trophic path to muscle; m, muscle. (From
Ziemssen's Handbuch der Speciellen Pathol., Bd. xi. Zweite H., Zweite Abtheil,
p. 313.)
Duchenne and Joffroy128 also argue the existence of special trophic
nerve-cells. The absence129 of the nutritive lesions of the skin and cellular
tissue which are so conspicuous when the gray matter around the central
canal or posterior to it is involved,130 the dependence of the nutrition of the
motor apparatus, nerves, muscles, bones on the integrity of the anterior
horns, are facts which, taken together, seem to indicate that the
maintenance of nutrition depends on the unbroken continuity of the motor
or sensory apparatus from the periphery to the ultimate central element,
rather than on any special central cells endowed with trophic functions.131
Erb's hypothesis, as his own scheme moreover denotes, demands not
only trophic cells distinct from motor cells, but separate trophic cells for
the muscles, for the motor, and for the sensory nerves.
128 “De l'Atrophie aigue et chronique des Cellules nerveuses,” Arch. de Phys., No. 4, 1870.
129 Money, and also Gowers, have signalized a condition of the skin resembling myxœdema
(Tr. Path. Soc. London, 1884, and Brit. Med. Journ., 1879).
130 Mayer (Herman's Handbuch Physiol.) sums up the great mass of evidence now
accumulated, which demonstrates the trophic influence of the central gray mass of the cord
upon the tissue.
131 Nepveu (La France médicale, 1879) mentions some cases of infantile paralysis
complicated with trophic lesions of the skin. The facts, if accepted, could only indicate an
extension of the myelitis to the central and posterior regions of the gray columns. The
relations between non-atrophic paralysis caused by interruptions of the motor tracts and
muscular atrophy dependent on lesion of the anterior cornua are exquisitely shown in a case
reported by Sander. An adult suffered from chronic motor paralysis, gradually increasing, in
the right arm, with paresis of the lower extremities. In the hand, arm, and shoulder the
paralysis was followed by gradual atrophy and diminution of the faradic contractility; in the
lower extremities no atrophy occurred. At the autopsy was found a gliomatous tumor seated
in the anterior cornua predominating on the right side, extending from the level of the sixth
dorsal to that of the eighth cervical vertebra. The ganglion-cells were pigmented and
compressed, not altogether destroyed. The lumbar cord was intact, and the non-atrophic
paresis of the lower extremities evidently resulted from the interruption of the motor tract
above.
Money133 points out that for the gray matter of the cord, as of the brain,
the centre or maximum force of the circulation is on the periphery, and the
nutritive supply of the centre is thus easily cut off. Moreover, while the
blood-vessels of the cervical and dorsal regions of the cord pass to it