Muscidar Atrophy Considered as a Symptom 247 



HofFman have recently published cases in which neuritic 

 symptoms were present, such as sensory disturbances, marked 

 electrical reactions, local distribution, appearance after in- 

 fectious diseases, etc. Hoffman believes that this neuritis is 

 secondary to changes in the ventral cornua. If this is really 

 the case I see no reason why this type of atrophy should not 

 be considered under the myelopathic forms. Sachs who has 

 studied this form of atrophy very thoroughly, is disinclined 

 to accept Hoffman's ideas as to its pathology and relegates it 

 to the spinal form of muscular atrophy. 



The primary lesion in these neuropathic forms is to be 

 sought for in the nerves supplying the affected muscles. The 

 neuritis may be either interstitial, parenchymatous or degen- 

 erative. In the interstitial form the medullary sheath is 

 broken into fine granules of fat and debris and absorbed. The 

 axis cylinder is swollen, degenerated, and may be likewise 

 ab.sorbed. The nuclei of the sheath of Schwann become 

 swollen and proliferate, leading to the formation of new con- 

 nective tissue, which, after the period of regeneration, consti- 



Fig- 3- 



