Herrick, Pathology of General Paralysis. 153 



which are generally, though by no means universally, degener- 

 ate. The apical processes do not seem to be degenerate in any 

 case and the atrophy of the protoplasm and fatty pigmentary 

 degeneration at the base are Ihe most malign symptoms. The 

 smaller pyramidal cells of the ectal part of the cortex are gener- 

 ally intact. The usual alteration in the vessels occurs to a mod- 

 erate extent. We do not encounter the enormous development 

 of spider cells which Dr. Bevan Lewis considers characteristic 

 of the disease. 



In the region of Broca ( Plate E, Fig. i, No. 6 ) we are 

 dealing with a motor area and encounter chiefly fatty or pig- 

 mentary degeneration of the cells. This change involves not 

 only the deep pyramids but all the nerve cells to a greater or 

 less extent. Figs. 2, 3, 7 and 12, Plate B., illustrate the vary- 

 ing phases of this degeneration. In Fig. 12 the cells are 

 slightly altered while in Fig. 3. the degeneration appears in vari- 

 ous parts of the cell causing a certain amount of deformation. 

 Sometimes it is one of the basal processes while in others the 

 apical process is occupied by the yellowish granular material. The 

 nucleus is scarcely ever implicated. No changes of importance 

 can be detected in the neuroglia or nutritive elements. Rarely 

 we detect a degenerative fiber containing the serpentine bodies 

 described above. Usually where one of a "nest" of motor 

 pyramids is altered all of the cells are involved. 



There seems to be no increase in the number of leucocy- 

 tes about the injured pyramids — if anything, they are fewer 

 than about the normal elements. There can be no doubt that 

 these so-called "granules" are identical with those which 

 under pathological conditions ( congestion ) pass through the 

 vascular walls in such incredible numbers. It is a question of 

 some importance to decide whether the proliferation of leuco- 

 cytes take place within the vessels or at large within the brain 

 substance, or whether the multiplication goes on in the usual 

 sources and the accumulation in the perivascular spaces is due 

 to a kind of retardation incident to impaired vitality of the 

 brain. Our own observations thus far point to amitotic pro- 

 liferation in the adventitions sheaths. 



