Literary Notices. 



xem 



*r-' 



Fig. 2. Intra-rnuscular nerve, bundle-teased. Osmic acid. 

 a,healthy nerve fibre; b, small nerve fibre; c, nerve fibre un- 

 dergoing acute parenchymatous degeneration; d, advanced 

 degeneration. 



ence in that portion of the nerve trunk from which healthy nerve 

 fibres have disappeared of a number of very small nerve tubes with 

 extremely thin medullated sheaths, unstained by Weigert's hema- 

 toxylin or the modifica- 

 tions of Weigert's meth- 

 ods is very remarkable. 

 The change appears to 

 be a textural reversion 

 to an embryonic or 

 lower type, comparable 

 with the pial adhesions, 

 the subpial felt-work, 

 and the enormous nu- 

 clear proliferation occurring in the cortex cerebri. The more per- 

 ipheral the site examined in the mixed trunk, the more extensive will 

 the degeneration be found to be. 



Spinal nerve roots. Degeneration always considerable, but never 

 extensive. In the posterior root ganglia no obvious degeneration of 

 nerve cells beyond some hyperpigmentation was noticed, and the post- 

 erior roots beyond the ganglia were but little diseased. 



Changes in the muscles. In brief the changes noted are fatty de- 

 generation, atrophy, and complete or partial disappearance of a num- 

 ber of muscle fibres, with proliferation and increase of the nuclei of 

 the sarcolemma and connective tissue. The number of motor end- 

 plates is reduced. 



Cra?nal nerves and their nuclei of origin. The existence of more 

 or less constant interstitial degenerative changes in many of these 

 nerves is confirmed. The changes are most marked at the periphery. 

 The ascending root of the fifth in the medulla in many cases markedly 

 sclerosed. The vagus nucleus most strongly affected, in many others 

 traces of degeneration. 



The author classifies general paralysis as a primary intrinsic tox- 

 cemic multiple neuritis. The changes occurring in general paralysis 

 are certainly compatible with those seen in those toxcemic neurites in 

 which the virus, so far as is known, is primarily and intrinsically pro- 

 duced within the body independently of any definite or known dis- 

 ease, and, further, such a morbid blood state provides us with a far 

 more reaching and sufficient explanation of the general widespread 

 disposition of the disease and many of its other characteristics. The 

 peripheral neuro-muscular alterations are not looked upon as of sec- 

 ondary origin. The fact that the more peripherally situated portions 



