. Text-book of nervous diseases; being a compendium for the use of students and practitioners of medicine . anterior tibial and musculo-spinil nerves on the two sides areoftenest and most diseased. The process when mild in grade re-sembles a secondary degeneration following section of the severer cases there is evidence of interstitial inflammation as well 92 DISEASES OF THE NERVOUS SYSTEM. as degeneration (Fig. 51). This process, however, varies in degreeat different points of the nerves course. Hence it has been calledsegmental or disseminated neuritis. In some of these ca
. Text-book of nervous diseases; being a compendium for the use of students and practitioners of medicine . anterior tibial and musculo-spinil nerves on the two sides areoftenest and most diseased. The process when mild in grade re-sembles a secondary degeneration following section of the severer cases there is evidence of interstitial inflammation as well 92 DISEASES OF THE NERVOUS SYSTEM. as degeneration (Fig. 51). This process, however, varies in degreeat different points of the nerves course. Hence it has been calledsegmental or disseminated neuritis. In some of these cases and inall acute pernicious cases there is still more interstitial inflamma-tory change; small hemorrhages occur, exudation takes place, andcollections of leucocytes about the vessel walls and among thenerve fibres are seen (Fig. 52). The muscles supplied by the dis-eased nerves undergo atrophy. This is usually simple and non-in-flammatory. But sometimes there is an interstitial myositis withexudation compressing the fibres (Senator). If the disease progresses, the nerve fibres degenerate and their. Fig. 52.—Longitudinal Section of a Nerve in Multiple Neuritis, showing rich prolifer-ation of nuclei (Leyden). The process here is inflammatory as well as degenerative. place is taken by connective tissue, and the same process occurs inthe muscles. The spinal cord when examined by the help of JSTissl and Marchistains shows some involvement. The anterior-horn cells undergothe same degeneration as that which occurs when the nerve is cutacross, and slight areas of degeneration are found in the posteriorand lateral columns. The changes are very slight compared withthose in the nerves and in the writers opinion are secondary. It will be seen, therefore, that in multiple neuritis there maybe: (1) Simple degeneration; (2) degeneration with some evidencesof interstitial neuritis (degenerative neuritis) ; (3) decided intersti-tial neuritis with degeneration of nerve fibres. GENERAL DISE
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