

PHYSIOLOGY OP THE POSTERIOR PITUITARY. 517 



"It is difficult to determine whether the nerve-cell lesions 

 are secondary, perhaps directly dependent on the connective- 

 tissue hyperplasia about the cells and fibers, or are primarily 

 due to defective nutrition of the ganglion-cell bodies. Per- 

 haps these ganglionic changes are wholly, or in greater part, 

 responsible for the degenerations and atrophies which take 

 place in the muscles of the voluntary system. 



"Sympathetic Ganglia. The changes in the sympathetic 

 ganglia and trunks have been made the subject of special study 

 by several very prominent investigators, among whom are 

 Marie, Marinesco, and Arnold, and have been looked upon by 

 many as factors of an etiological nature. Finding, as we do, 

 such pronounced change in the blood-vessels, it does not seem 

 at all strange that lesions in the sympathetic ganglia should 

 be present; but a view intimating a dependence or relation 

 of the vascular changes to the lesions in the sympathetic sys- 

 tem is not in accordance with our own ideas expressed at the 

 close of this paragraph. In general, the changes in the sym- 

 pathetic ganglia are very similar to those already described in 

 the ganglia and trunks of the cerebro-spinal system. In some 

 cases the size of the ganglia is considerably increased (Arnold, 

 Marie, Marinesco), and, microscopically, the connective-tissue 

 web is thickened and proliferating. The ganglion-cells are 

 often reported as exhibiting evidences of degeneration." 

 . . . "Arnold has found vacuolization; not infrequently 

 considerable deposits of pigment are seen within the cytoplasm. 

 But, as in Case II, the ganglion-cells may be normal; the Nissl 

 bodies are present in normal arrangement, volume, and shape, 

 and show no deviations in their staining reactions; and the 

 pigmentary deposit is not abnormally abundant. The sym- 

 pathetic ganglia in the case reported by Gauthier were also 

 normal. It is advisable, at this point, to call attention to the 

 fact that the interstitial hyperplasia is by no means a lesion 

 characteristic of the sympathetic system, but is simply an ex- 

 tension of the general process so often alluded to. The growth 

 of connective tissue in the sympathetic may depend in part 

 on lesions in the walls of the vessels; or both may be referable 

 to the common factor of deranged nutrition. 



"Cord and Medulla. The pathological findings in both 



