INFLAMMATION. 417 



These large bodies exhibited all stages of endogenous formations and prolif- 

 erations of living matter, sufficiently indicating their origin from the gang- 

 lionic elements of the gray substance of the brain. 



The literature on the subject of my studies is extremely sterile. No exact 

 observations, at least to my knowledge, have as yet been made on acute 

 encephalitis and suppuration of the brain substance. Only one point has so 

 far been called attention to, and this is the proliferation of the ganglionic 

 bodies of the gray substance. Th. Meynert * first noticed a proliferation of 

 the nucleoli and nuclei of ganglion elements. E. Fleischl t found a division of 

 ganglionic bodies, though not in a strictly inflammatory process, but in a brain 

 involved in the formation of a tumor. A. R. Robinson \ produced inflamma- 

 tion in the ganglia of the sympathetic nerve around the aorta of the frog, and 

 observed a division of the ganglionic elements from the formation of a furrow 

 on the surface to the complete division into small particles. The division 

 may involve only a part of a ganglionic body, the rest remaining normal, or it 

 may invade the whole. Analogous transformations were also observed in the 

 elongations of the ganglion cells. 



Andrea Cecchirelli produced traumatic lesions in the large hemispheres of 

 the brain of a chicken and of rabbits. He saw enlarged and granular " gang- 

 lion cells " within the inflammatory focus, and came to the conclusion that the 

 nuclei had increased in number and that the whole " ganglion cell," by divi- 

 sion, had been transformed into smaller elements. 



The results of my own observations can be summed up in the following 

 points : 



( 1 ) The gray substance of the brain, by the inflammatory process, is trans- 

 formed into inflammatory or medullary elements, in the production of which the 

 nuclei and ganglionic bodies also share. Non-medullated nerve-fibers, through 

 an increase of living matter in the axis-cylinders, are likewise transformed into 

 medullary elements. The same results are produced in inflammation of the 

 white substance of the brain, after the dissolution of the myeline. 



(2) The medullary elements, sprung from the gray or the white substance 

 of the brain, are transformed into connective tissue, either myxomatous or 

 fibrous, and thus the wall of an abscess in the brain is the result of the reduc- 

 tion of the brain tissue first into medullary corpuscles, next into myxoma- 

 tous, and lastly into fibrous connective tissue. 



(3) Medullary elements, irrespective of which particular nerve-element 

 they had originated, when broken apart, constitute pus-corpuscles, and, 

 therefore, the contents of an abscess of the brain. In the fluid of the abscess 

 clusters of bioplasson bodies are seen, proving a transformation of ganglionic 

 elements into pus-corpuscles by a process of endogenous new formation and 

 subsequent division of living matter. All the stages of this process are 

 observable within the ganglionic bodies of the inflamed gray substance itself. 



(4) The endothelia of the blood-vessels become enlarged, coarsely granu- 

 lar, and proliferating in the process of inflammation of the brain-tissue. New 

 blood-vessels are formed in the wall of the abscess. A consolidation of the 





* " Vierteljahrschrift fur Psychiatric," 1867. 



1 " Med. Jahrbiicher," 1872. 



t " Ueber die eutziiiidlichen Veranderungen der Ganglionzellen des Sympathicus," Med. 

 Jahrbiicher, 1873. 



"Ein Beitrag zur Kenntniss der entziindlichen Verauderungen des Gehirnes," Med. 

 Jahrbiicher, 1874. 



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