thh: histology of disseminated SCLEROSIS. 731 



Fig. 144. Medulla oblongata through the middle of the inferior olive. Note the symmetry in both this 

 and the previous figure. 



Fig. 145. Middle third of the pons and the cerebellum. Note the very slight peri-ventricular sclerosis. 



Fig. 146. Pons — at level of root zone of the trigeminal nerve. 



Fig 147. Upper limit of pons — at level of anterior corpora quadrigemina. 



Figs. 148-155. Various levels of the spinal cord. Kulschitsky-Pal with picro-fuchsin. x 2. Note 

 the symmetry of the involvement in fig. 148 (C4) and fig. 149 (C7) — a symmetry which was continued 

 between these segments and gave the impression of an ascending and descending degeneration. Note in 

 fig. 155 small, isolated areas in each anterior horn of grey matter. 



Plates LVI and LVII (Case VI) (pp. 708-711). 



Figs. 156-177. Sections of brain and spinal cord. Kulschitsky-Pal with picro-fuchsin. Figs. 178-184. 

 Sections to show the prevailing type of area present. Marchi method. 



Figs. 158-160, x 2. Medulla oblongata above decussation of the pyramids (fig. 158); at lower level 

 of the inferior olive (fig. 159); and through middle medulla (fig. 160). Note the symmetry in the two 

 lower levels. 



Fig. 156, x 2£. Lower pons with cerebellum. Note a = the marked involvement of the floor and 

 lateral walls of the IVth ventricle; 6 = the extensive distribution of early diffuse areas through the rest of 

 the tissue ; and c = the involvement of the intra-medullary portion of the VIHtli nerve roots. 



Fig. 157, x 2J. Pons at level of Vth nerve root. Note a = involvement of both inferior peduncles as 

 they pass to the dentate nuclei ; and b = of the intra-medullary portions of the Vth nerve roots. 



Fig. 161. Mid-brain, x 2£. Note (a) involvement of both red nuclei; (b) extension to the substantia 

 nigra and point of emergence of the Illrd nerve on both sides. 



Fig. 162, x 1\. Subthalamic region. x 2|. a = Peri-aqueductal sclerosis extending between the 

 red nuclei ; b = ventricular portion of both red nuclei also involved. 



Figs. 163-165, x 2. Optic tracts, chiasma, and optic nerves. 



Figs. 166-176. Various levels of the spinal cord. Figs. 166-169, x 3; figs. 170-176, x 2. The cord 

 at all levels was in a stage of early involvement (cf. figs. 178-180). 



Fig. 177, x 2. "Early" area involving the hilum of the dentate nucleus of the cerebellum. 



Figs. 178-184. Frozen and Marchi sections to show the prevailing "early" type of area present in 

 this case. 



Figs. 178-180. Spinal cord areas in cervical and dorsal segments : to show the extensive distribution of 

 the areas containing fat granule cells— involving frequently the whole transverse section of the cord. 

 Fig. 178, Scharlach R, x 6 ; figs. 179-180, Marchi, x 6. 



Figs. 181-184. Typical cerebral areas. Marchi method. Fig. 181, x 15, peri-ventricular area ; fig. 182, 

 x 20, showing cone-shaped mode of extension; fig. 183, x 20, triangular area at the extreme tip of a 

 medullary ray — extending to involve the radiations ; fig. 1 84, x 20, area involving a medullary ray along its 

 whole course, and passing into the radiations at the tip of the convolution. 



Plate LVIII (Case VII) (pp. 712-714). 



Figs. 185-199. Various levels of the spinal cord. Figs. 185-186, x 4; figs. 187-199, x 6. The 

 areas showed a more complete degree of sclerosis than in any of the other cases, and numerous small, 

 isolated areas were present — several of which picked out individual groups of anterior horn cells, e.g. 

 figs. 187 and 195 (C7 and L2). Note also the widening of the glia marginal zone (cf. figs. 194-199 (b) ) in 

 all of the sections, and in the lumbar cord a peri-central sclerosis which extends into the grey matter on 

 each side for a varying distance (cf. figs. 194-199 (a)). 



Fig. 200. Horizontal section through cerebral hemispheres at the level of the middle of the basal 

 ganglia — showing marked peri-ventricular sclerosis, especially around both the anterior (A) and posterior (a) 

 horns of the lateral ventricles. Mounted specimen, x \. 



Fig. 201. Outer wall of lateral ventricle showing zones of greyish-bine staining, which outlines the 

 suh-ependymal veins (a). Mounted specimen. 



