ME. J. L. CLARKE ON THE INTIMATE STRUCTURE OE THE BRAIN. 
313 
cysts on their surface. The heart was exceedingly flabby, soft, and yellowish, with 
accumulation of fat outside the left ventricle, which was dilated, and broke down 
easily under the fingers. There was no disease of mitral valve. The wall of the right 
ventricle was exceedingly thin — nearly as thin as that of a healthy auricle. The 
tricuspid valve was healthy. 
At the base of the brain the arteries were atheromatous. The membranes at its upper 
surface were thick and opaque, with some sub-arachnoid fluid and numerous patches of 
white, flaky, and granular matter. They were adherent to the calvarium which was 
unusually thick. About four ounces of fluid flowed into the calvarium on removing 
the brain. The surface of the anterior lobes of the cerebrum was much depressed and 
atrophied. The grey substance of convolutions was about the usual colour. The 
under surface of the right crus cerebri was softened. On the outer part of the right 
corpus striatum were the remains of an old clot, about the size of a horse-bean. The 
substance beneath it was much softened. In the middle of the right optic thalamus 
were the remains of another and much larger clot. On the surface of the left optic 
thalamus was a softened and chocolate-coloured depression, and beneath this were the 
remains of a small clot. 
Cerebellum . — In the central white substance, on each side, was a cyst containing turbid 
fluid. That on the right was about as large as a moderate-sized hazel-nut, and destroyed 
only part of the convoluted lamina of the corpus dentatum ; that on the left was some- 
what larger, and destroyed nearly the whole of the lamina. The fluid in the cysts con- 
sisted of globular aggregations of oil-globules, some of which were tinted with brown 
and yellow, and accompanied with crystals and granules of heematoidin. 
The medulla oblongata was curiously misshapen, and tilted to the right side. This 
displacement appeared to be due chiefly to atrophy of the right corpus olivare. At the 
lower two-thirds of the olive the atrophy was considerable, but diminished along the 
‘upper third. Fig. 64, Plate XIV. is an exact representation of a transverse section of 
the medulla through the middle of the olivary bodies. Not only was the right olivary 
body exceedingly reduced in bulk, but the greater number of its nerve-cells were wasted 
to granular points or small granular masses tinted brown or yellow by pigment, as the 
accompanying preparations very distinctly show*. Between the olivary bodies the 
central part of the medulla was softened, so that its lateral halves readily separated 
along the median raphe. Neither the hypoglossal nor the vagal nuclei were reduced in 
bulk to any remarkable degree ; but the vagal nucleus, which in Man normally contains 
a certain number of dark pigmentary cells, contained these in much greater number than 
usual ; and many of the cells of the hypoglossal nucleus had lost some of their sharpness 
of outline, and contained more than their natural amount of pigment. 
* A case of extreme atrophy of the nerve-cells of the spinal cord, in muscular atrophy, has been published by 
me in the British and Foreign Medico-Chirurgical Review, July 1862, and two others in the Medico-Chirurgical 
Transactions, 1867 and 1868, with drawings. In No. XIII. of Beale's ‘Archives of Medicine,’ I recorded 
another case, in which I described the successive changes by which the cells undergo the process of degeneration. 
2x2 
