70 THE AMERICAN MONTHLY [Mar 
sure. The vessels in the lower part of the central cord of 
a divided nerve show the nuclear proliferation, and, to a 
certain extent, the perivascular exudation to which I re- 
fer later. 
These changes become less marked as the nerve is fol- 
lowed upwards towards the cord, and therefore it seems 
probable that the effect of pressure on these fine fibers is 
to produce changes in the vessels which are very similar 
to those met with in peripheral neuritis. 
It should be added that unquestionably these fine fi- 
bers, if vaso-motor as I contend, supply vessels in mus- 
cles and other tissues as well asin the nerves themselves, 
and similar changes may be seen in the walls of the ves- 
sels supplying the muscles, etc., as in the vessels of the 
nerves. 
In peripheral neuritis, the first fibers to suffer degen- 
erative changes are these fine fibers, and where they suf- 
fer, exudations and vascular changes follow. There is 
hardly any question, in modern neurological opinion,that 
the toxin in alcoholic neuritis affects the cell, the centre 
of the neuron first, and probably chiefly, while the nerve 
tiber is secondarily affected. We know that the cells in 
the anterior cornua of the cord, the cells in the posterior 
nerve root ganglia, and even the cells in the brain under- 
go distinctive changes which are often selective as re- 
gards group or groups of cells affected in different cases. 
It is much more difficult to describe the changes which al- 
ways certainly occur in the vaso-motor cell centres. My 
efforts to elucidate these changes have so far been very 
contradictory. Itseems not improbable that the toxin has 
selective action on parts of vaso-motor neurons; andas I 
hope to be able to show, the pathological changes in peri- 
pheral neuritis strongly support this opinion. 
When the affected nerves from a case of peripheral 
neuritis are examined, the small fibres are seen to be 
specially degenerated, and, in common with the other nerve 
