INFLAMMATION. 433 



The highest powers of the microscope (1200 diameters) showed in many 

 capillaries of the cerebellum an enlargement of the endothelia, with a coarser 

 granulization therein, and a splitting of the original endothelia into coarsely 

 granular clusters. The peri vascular sheaths in some instances were consider- 

 ably dilated and sometimes filled with globular elements, slightly increased 

 in refractive power. From the above facts it would seem that the shining 

 globular bodies are products of the endothelia, which first become inflamed, 

 then proliferate, and the inflammatory elements thus formed become infil- 

 trated with lime-salts. Concerning the formation of the corpora amylacea, 

 we at present know nothing. The gray layers of the cerebellum with a high 

 power of the microscope showed a reticular structure. The white substance 

 of the cerebellum was composed almost exclusively of nerve-fibers with 

 numerous varicosities, and a reticular structure was seen in the nerve-fiber 

 as well as in the varicosities. On broken ends of nerves, I could trace several 

 sheath-like layers, composed of a row of spindles, bounding the swollen pear- 

 shaped ends of the nerve-fiber, while the center of the so formed body showed 

 a delicate reticular structure. Such formations, we know, never are seen so 

 long as myeline is present. It therefore follows that either the myeline has 

 oozed out after death, or has been absorbed during life, perhaps in the same 

 manner that adipose tissue disappears in wasting diseases. The boundary 

 layer of the nerve-fiber in all instances was shining and homogeneous, thus 

 representing a complete sheath. There is no reason, therefore, to my mind, 

 for denying the existence of a sheath in the nerves of the white substance of 

 the cerebellum, and I may also add cerebrum, for they were both similar in 

 this case. 



The gray substance of the cerebrum was similar in structure to that of the 

 cerebellum. The calcareous corpora amylacea were less frequently, and the 

 calcareous globules exceptionally, found. The blood-vessels were, as a rule, 

 distended with blood. The perivascular sheaths were, in some instances, 

 dilated. Several specimens showed a fatty degeneration of the blood-vessels 

 and of the ganglionic bodies, both demonstrated by their refraction and by 

 the action on them of osmic acid, which produced a black stain. The fat- 

 granules were arranged in the ganglionic bodies in a crescent shape, the con- 

 vexity being on one side of the ganglion, and the concavity toward the 

 nucleus. In the cerebrum I frequently found empty spaces, as they were 

 found also in the cerebellum so-called vacuoles. * Most of the vacuoles had 

 in their interior a pale nucleus, and their origin must be attributed to an 

 accumulation of fluid around the nucleus after death, or to a hydropic destruc- 

 tion of the ganglionic elements, due to serous exudation. The latter view is 

 corroborated by similar formations around the blood-vessels, where not only 

 lymph-sheaths were found dilated, containing bioplasson elements, but there 

 was also a large space around the lymph-sheath. Several ganglionic bodies 

 with partly fatty degeneration also showed closed empty spaces on the 

 periphery. 



The diagnosis, as obtained from the microscope, in this case is chronic 

 pachy-meningitis, meningitis, and encephalitis, terminating in atrophy. 



* Later observations in the gray substance of the brain and the spinal cord, which 

 were invaded by atrophy, due to chronic encephalitis and myelitis, demonstrated that the 

 bioplasson reticulum was more or less rarifled viz. : its meshes enlarged. There is a gradual 

 transition of enlarged mesh-spaces to still larger spaces, termed vacuoles. I am unable to say 

 what becomes of the bioplasson in such a wasting process. ED. 



28 



