146 Journal of Comparative Neurology. 



with predisposing cause and the sequence of symptoms as shall 

 most nearly correspond with the requirements of treatment. 

 The prevailing unwillingness to recognize the great influence of 

 alcoholism may account for the failure adequately to construe 

 the influence of slight vascular disturbances if sufficiently long 

 continued. 



It will be gathered from our own observations that the 

 facts seem hardly to bear out the statements of Hirt: "This 

 view, according to which the atrophy is the primary process, is 

 in all probability correct, though it is still combatted by many 

 authorities (Mendel), who look upon the death of the nerve 

 fibres as the secondary, upon the increase of the connective tis- 

 sue, the thickening of the vessel walls and the appearance of 

 spider cells as the primary process ('encephalitis interstitialis')." 

 In the present case, however, the development of the spider 

 cells, upon which Bevan Lewis, Mendel and others lay so much 

 weight, is a very insignificant factor. The most important one 

 seeming to be the involvement of the blood-vascular system and 

 the greatest cellular modifications are seen in the motor co-ordi- 

 nating centres of the axial lobe. Our case supports the view 

 of Zeigler^ that the phemomena of general paralysis are not 

 uniformly inflamatory "but not rarely simply degenerative 

 processes in the meninges and the cortex." He says: "Es ers- 

 cheint danach die gestorte Ernahrung und die Degeneration der 

 Ganglienzellen und Nervenfasern als die wesentliche, und die 

 entziindliche Infiltration und die Zunahme der fibrillaren Stiitz- 

 substanz sind zwar fiir die anatomische Beurtheilung des Pro- 

 cesses, nicht aber fiir die Krankheitssymptome von wesentlicher 

 Bedeutung. " 



Mierzejewski and Voisin regard these spider cells and 

 fibrous aggregates, which are not noticeable in some cases, as 

 coagula of fibrin derived from homogeneous masses which may 

 contain nuclei. It may be that diverse structures have been 

 combined under this name. The "spider cells" which were 



^Lehrbuch der Allgemeinen Pathologische Anatomic und Pathogenese, 

 4th Edit. 1885, p. 591. 



