On characteristic modes of fatal termination in multiple neuritis, with clinical and pathological investigation of an illustrative case / by G. A. Gibson and R. A. Fleming.

Date:
1895
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Licence: Public Domain Mark

Credit: On characteristic modes of fatal termination in multiple neuritis, with clinical and pathological investigation of an illustrative case / by G. A. Gibson and R. A. Fleming. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    can be readily differentiated from the lymphoid cells by their relationship to the nerve fibres, and by their spindle- shaped appearance on longitudinal section. From a very careful study of a large number of sections of all the nerves, we may confidently assert that where these changes in the segmental nuclei exist, the myelin of the fibre is inevitably degenerated. 3. Axis cylinders.—These are seen in certain nerves to be much distended, in others swollen up and vacuolated, and in many fibres of the most affected nerves they have dis- appeared altogether. The parenchymatous changes will he referred to at greater length where requisite. It should be stated that different portions of each nerve were examined so as to compare changes at different levels, so far as the specimens permitted ; and we can assert that in these nerves, though there were marked differences in detail, the chief characteristics remained the same; generally, how- ever, the nearer the termination the more marked the degener- ative changes were. Taking the nerves in order:— Eight sciatic.—The changes in the arterioles, etc., are well marked, though not to the same extent as in the right posterior tibial nerve. They are well seen in the connect- ive tissue between the funiculi, but specially within the funiculi themselves. The cells are most numerous in the intima, and there is less thickening of arteriole walls than in the right posterior tibial. The perineurium is little changed, only here and there aggregations of lymphoid cells. There are few lymphoid cells in the interior of the funi- culi, and only a small proportion of these show karyokinetic figures. Of the nerve fibres, many are normal, hut more are granular ; here and there, nearest the periphery of the funiculi, a few fibres have apparently run together, but these are not numerous. Some of the axis cylinders show swelling, and some have totally disappeared, especially in those fibres show- ing most advanced degenerative changes. Eight posterior tibial nerve.—In this nerve the most marked