INFLAMMATION. 413 



cylinders were transformed into a chain of pale "bioplasson bodies, the so- 

 called medullary or inflammatory elements. 



Within the inflamed portion of the white substance were observed numer- 

 ous varicosities, each of which was in direct connection with an axis-cylinder. 

 In many instances, the interior of these varicosities could be made out to be 

 of a delicate reticular structure ; they were invariably bounded by a dense 

 and homogeneous layer, continuous with the axis-cylinder. All the forma- 

 tions of the above description were uninterruptedly connected with each other 

 by extremely delicate threads. 



In some places small abscesses had formed outside the wall of the main 

 abscess ; these abscesses were detected only with the microscope. In such 

 localities the medullary elements had assumed a more uniform size, a some- 

 what coarser granulation, and, having also lost their mutual connections, they 

 were transformed into pus-corpuscles. As a matter of course, that portion of 

 the white substance which had undergone such a change into pus-corpuscles 

 was devoid of blood-vessels. The manner in which blood-vessels are lost, 

 shortly before the tissues break down and are transformed into pus, was 

 easily traceable in the neighborhood of such small abscesses. The endothelia 

 of both the blood-vessel and the perivascular sheath became considerably 

 enlarged, coarsely granular, or were supplied with at least several large 

 shining granules, which might justifiably be considered as newly formed 

 nuclei. By a process of splitting of the enlarged endothelia into medullary 

 elements, the caliber of the blood-vessel, as well as of the ,perivascular 

 sheath, became obstructed, and thus, what formerly had been a capillary, 

 now was seen to have become transformed into a row of medullary elements. 

 These at first remained in connection with each other by means of delicate 

 processes, traversing the newly formed cement-substance, afterward broke 

 apart and became pus-corpuscles, in shape and size fully identical with those 

 sprung from other portions of the inflamed tissue. 



The above-mentioned varicosities of the nerve-fibers, by different authors 

 are considered as post-mortem changes, and due to an irregular coagulation 

 of the myeline. The varicosities which I have described here have nothing 

 to do with myeline, but are formations of the axis-cylinders themselves, and 

 due to structural changes in the substance of these axis-cylinders proper 

 viz., enlargement of the thread, exhibiting the ordinary structure of bio- 

 plasson, and in close connection with the inflammatory changes of the nerve- 

 fibers in general. 



These changes in the axis-cylinders can be understood only if we look 

 upon the latter as formations of living matter. In the inflammatory process, 

 the granules of living matter in bioplasson bodies increase in size, some- 

 times to such an extent that the body is transformed into a shining, homo- 

 geneous lump, which readily divides into smaller particles, each of which in 

 turn may become a medullary element. The axis-cylinders, being formations 

 of living matter, also become coarsely granular, beaded, or rosary-like, and 

 each one of these granular enlargements may give rise to a new medullary 

 element, eventually a pus-corpuscle. In this manner we understand the 

 formation of rows of medullary elements and of pus in the middle of the 

 white substance of the brain. 



Ever since J. Cohnheim asserted that the main, if not the only, source of 

 inflammatory elements and pus-corpuscles are the emigrated colorless blood- 

 corpuscles, some authors had entirely overlooked the changes taking place 



