Nov. 1. 1919 Pathology of Dourine 151 



fibers. The contrast was better seen in the ventral and lateral columns 

 and was less apparent in the dorsal column where the medullated fibers 

 appeared to be of a faded slate color approaching a yellowish tint, thus 

 bordering on a beginning stage of degeneration. The change was suffi- 

 cient to indicate a degeneration. 



The Marchi method and Robertson's modification of Heller's method, 

 both containing osmic acid, showed decided degeneration of the myelin 

 in the medullary sheath of the nerve fibers. The intermedullary fibers 

 within the gray substance contained a fair number of black clumps in 

 the dorsal portion of their course. The extramedullary sensory fibers 

 constituting the dorsal root showed more black clumps at the point of 

 their entrance, the dorso-lateral groove. The black clumps gradually 

 became fewer as the fibers entered the dorsal horns. The intramedullary 

 fibers of the ventral horns, as well as their extramedullary portion, the 

 motor-nerve roots, had only occasionally some black clumps. The dis- 

 tribution of these clumps in the medullated fibers of the white substance 

 deserves special attention on account of the columns that are involved 

 and the deduction of symptoms that could be made from a clinical 

 standpoint. 



The principal manifestations were found in the outer portion of the 

 dorsal column, which is known as "funiculus cuneatus" or "Burdach's 

 column." The black clumps were more numerous in the medullated 

 fibers forming the outer boundary of the column or the fibers close to the 

 dorsal-nerve roots and the dorsal horns. Fewer black clumps were 

 present in the fibers near the inner boundary. The inner portion of the 

 dorsal column is known as "funiculus Gracilis" or "Goll's column." 

 Fewer black clumps were present than in the outer Burdach's column. 

 Their number diminished as the fibers approached the dorsal medium 

 septum. The medullated fibers of lateral and ventral columns showed 

 no black clumps, except in the vicinity of the tips of the ventral horns. 

 The changes observed in sections from the lower lumbar region were 

 similar to the changes present in the sacral region. The degree of 

 degeneration was a little more marked in the sacral region than in the 

 lower lumbar region. The staining with the Marchi method and Robert- 

 son's modification of Heller's method showed the degeneration of the 

 myelin in the medullary sheaths more pronounced and especially in the 

 column of Burdach and to a less degree in the column of Goll, where the 

 black clumps decreased in number. The black clumps gradually became 

 fewer and disappeared entirely toward the distal end of the sacral region. 

 In man the subdivision of the white matter into various tracts with 

 defined conducting pathways by which nerve impulse is conveyed has 

 been worked out by research based on combined evidence of anatomical, 

 pathological, and embryological investigation; but our knowledge of 



