90 



The Postcentral Gyrus in Tabes Dorsalis 



[CHAP. 



EXAMINATION OF THE CEREBRAL CORTEX. 



Portions of the 1st, 2nd, and 3rd frontal, the precentral and postceutral, superior temporal, external 

 occipital and rnid-limbic convolutions were cut and stained by the fresh method of Bevan Lewis, and corre- 

 sponding portions were examined by the method of Nissl. 



In all these sections abundant evidence of the changes peculiar to general paralysis was found, namely, 

 thickening of the pia-arachnoid membrane, increased density of epicerebral fibrillation, the prevalence of 

 hypertrophied glia cells, particularly in the first layer and along the course of the blood vessels, thickening 

 and over-cellularity of blood vessels together with the presence in their neighbourhood of the cells which we 

 now associate with the name of Marschalko, various forms of nerve cell disintegration and a distortion of 

 their normal columnar arrangement. 



All these changes were general, but, with the exception of the ascending parietal gyrus, which I shall 

 describe separately, were more marked in the occipital and anterior frontal regions than elsewhere. 



Coming now to the ascending parietal gyrus, of which sections were obtained at three different levels, 

 close to the upper margin of the hemisphere, at the middle, and near the lower extremity, the alterations 

 were of a most profound description and entirely out of proportion to those in other parts. In the fresh 



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FIG. 8. Tabes Dorsalis, Case II. 



From a section of the posteentral gyrus taken from a point midway between the upper margin of the hemisphere and 

 the Sylvian fissure. The drawing has been made from the cortex on the Bolandic side and shows the condition of 

 affairs at the level of the external layer of large pyramidal cells. The disintegrated remains of three or more of 

 these large cells are seen as shapeless masses deprived of nucleus and processes. Only a few nerve cells, of a 

 smaller variety, persist. The neuroglia overgrowth is manifest; and no part could be found in which the blood 

 vessels did not stand out as they do here; one vessel, in particular, may be noted at the top of the field. Cf. 

 fig. 9. 



