The pathological prodromes of taboparesis : syphilis, meningitis, the genesis of the cranial nerve, implications / by Tom A. Williams.

  • Williams, Tom A. (Tom Alfred), 1870-
Date:
1910
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Licence: In copyright

Credit: The pathological prodromes of taboparesis : syphilis, meningitis, the genesis of the cranial nerve, implications / by Tom A. Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    filaments in a common fasciculus. It was shown by a thickening of the sheath around them, scarcely visible, and also by vascular filaments. The smaller fasciculi also showed this appearance along their nerve fibers. A little lower down (Fig. 3a) the arachnoid gut- ter was enormously thickened, but inflammation had not yet attained its height within the fasciculi, although the nerve itself was five times its normal thickness. This progressive swelling of the peri- fasicular sheath is one of the most instructive facts of the whole research in that it explains why a pathological diffusive-process is, symptomatically speaking, revealed by so few definite signs. The reason why the lesion has so long escaped notice now becomes clear; for it is confined to the first few tenths of a millimeter of the sheath of the nerve. The foregoing figures show how the intensity of the lesion progressively diminishes from this point; so that four millimetres lower, the meningitis prac- tically disappears, but its effect upon the nerve fibers is shown by their progressive disappearance, which constitutes an “atrophic” sclerosis. In fas- ciculus b, on the contrary, the atrophy was much less marked, although the meningeal lesion was as great as that of fasciculus a. This illustrates the rise and fall in intensity. The facts shown by the Van Gieson stain are, however, merely quantitative. Still more striking is the picture shown when the tissue is stained by hemateineosin-rose, which is not designed to show the collagen of adult connective tissue, but reveals the nuclei of active inflammatory cells. The nerve fiber bundles show a tremendous infiltration of small round cells and fibroblasts. The chronicity of the process is shown by the fewness of the poly-