EXTRACT XXVIII. 



MYOPATHY. 1 



MUSCLE tissue, including the fibre or sarcous material 

 and its interstitial or non-sarcous elements, represents a 

 structure whose growth is due to nutritive materials 

 supplied from two different sources, the physiological 

 balancing of which represents the condition of proper 

 tone and health of the muscular substance, and the dis- 

 turbance of which produces such ailments as atrophy and 

 hypertrophy of its dual structural elements. The nutri- 

 tive materials are supplied from the nervine and haemal 

 circulations respectively, with both of which the affected 

 muscles are structurally connected or continuous. 



Muscle fibre, or the sarcous or fleshy part of muscle, 

 is isolated and insulated from its interstitial and surround- 

 ing non-sarcous structural or connective elements, and, 

 therefore, is cut off from direct haemal nutritional relation- 

 ship and cast upon nervine sources of supply, not only 

 for functional impulse and tonus, but for the material 

 renewal and structural nutrition of its fibro-sarcous ele- 

 ments, this being effected and the nutritive materials 

 conveyed to it by an unbroken circulation through the 

 motor nerve axons from their parent neurons or cells in 

 the central nervous system, brain, cord, or ganglia. The 

 medullary and axis cylinder substances respectively of 

 these motor axons at their distal terminations, where they 

 are exuded by the terminal nerve plates, represent the 

 nutritive sources of supply of the manifold muscular 



1 Vide Sir W. E. Gowers' Lecture, British Medical Journal, July 

 I2th, 1902. 



