in] Post-amputation ('/HHII/CS In flic ('crfhrttf Cortex 57 



degeneration, that is tn say, tin- globose swelling of the cell body was only moderate, Nissl bodies were 

 present, in tin- upper half instead of at the apex only, and the nucleus instead of being moved quite to 

 tln> periphery was only eiventrir : associated with these changes there was a great excess of pigment at the 

 lu-ie of the cell. The remaining 30 of rolls were healthy. The remnants of completely atrophied cells 

 were .ill-rut anil there was no evidence of a numerical reduction. Approximately speaking, the diseased area 

 had a vortical extent of 3 era., the affected cells were confined entirely to the frontal wall and lip of the 

 liolandic fissure, and more were seen in the lower than in the upper half of the field (text-figure 4, la). 



Following on this was a short stretch about a centimetre in length, in which no degeneration was found, 

 and then the Betz cells ceased. 



CASE No. -2. 



Male, aet. 16. Amputation of the right arm, 10 cm. below the head of the humerus. The date of the 

 operation was not ascertained but it was evidently old-standing as the shoulder muscles were greatly atrophied. 



The upper half of the Betz cell area, including the annectant buttress, was healthy. 



In a well-marked group of cells lying just below the buttress some excellent examples of "reaction ci 

 distance" were found. From this position down to a point about T5 cm. above the lower extremity of the 

 fissiu-e of Rolando (text-figure 4, 2) typical "reaction a distance" was not common, but numbers of cells 

 exhibited the following condition: the whole body of the cell possessed a curious pallid, finely granular or 

 reticulate appearance and the usual chromophilic elements absolutely defied definition; the nucleus was 

 distinctly swollen, frequently but not always eccentric, and its outline was occasionally indented ; the cell 

 body in general was increased in size, and its margins often irregular, but globosity was not a marked 

 feature; the cells had lost their lateral processes but one or more could generally be seen springing from 

 the base, these, however, were of extraordinary thickness and very palely stained. There was no increase 

 ill the amount of pigment, in fact, by far the majority of cells contained none at all. 



As in Case No. 1, the degenerated cells were equally distributed over the affected area, but I am 

 inclined to think that a larger proportion of elements suffered in this instance. 



Again the lower extremity of the Betz cell area contained normal elements, but it has to be noted 

 that these were of rather small size. 



CASE No. 3. 



Female, aet. 26, with an old-standing amputation of the right hand, one inch above the wrist joint. 



The central convolutions, from both hemispheres, were submitted to a thorough examination, and 

 numerous cell counts and drawings were made, to illustrate the condition of affairs in both the precentral 

 and postcentral gyri. The changes present in the postcentral gyms will be referred to in the section dealing 

 with the postcentral area, here I will confine my remarks to the state of the Betz cells. 



These cells showed unuiistakeablc alterations in the left hemisphere. Proceeding from above downwards, 

 signs of disease made their appearance at a point about 3 cm. below the superior annectant gyrus and 

 about 2 cm. above the level of the inferior frontal sulcus, and they continued to show themselves over a 

 stretch of cortex measuring 15 mm. in the vertical direction, ceasing at a point a few millimetres below the 

 level of the inferior frontal sulcus, and some distance above the lower extremity of the Rolandic fissure. 

 The changes affecting the Betz cells consisted of shrinkage, stunting of the apical and complete loss of the 

 basal processes, almost universal chromatolysis, and nuclear dislocation. In addition to this there was an 

 obvious reduction in the number of the cells, only two or three being visible per section, and there seemed 

 little doubt that a good many had disappeared. Furthermore, when the layer of external large pyramidal 

 cells was compared with the same layer in the normal hemisphere there was a manifest reduction in their 

 number. 



C. 8 



