A system of practical medicine . typhoid fever, smallpox, erysipelas, and diphtheria. Trau-matism claims its victims, the disease following the accident one ormore years after its occurrence, especially in cases in which the neuroseshave been prominent. While syphilis gives rise to lesions of the cordsimilar to those of multiple sclerosis, it is doubtful whether the diseasein its typical form is ever due to it. In nearly one half the cases noap])arcntly adequate cause can be traced. Pathoi>0(;i(;a i. Anatomy.—The macrosco]iic and microscopic changesin the central nervous system in multiple
A system of practical medicine . typhoid fever, smallpox, erysipelas, and diphtheria. Trau-matism claims its victims, the disease following the accident one ormore years after its occurrence, especially in cases in which the neuroseshave been prominent. While syphilis gives rise to lesions of the cordsimilar to those of multiple sclerosis, it is doubtful whether the diseasein its typical form is ever due to it. In nearly one half the cases noap])arcntly adequate cause can be traced. Pathoi>0(;i(;a i. Anatomy.—The macrosco]iic and microscopic changesin the central nervous system in multiple sclerosis are most and sharply defined reddish-gray patches of sclerotic tissuemay be found scattered throughout the central nervous tissue, and some- MULTIPLE SCLEROSIS. 411 times in the nerves, more commonly in the cranial. The islets vary in Fig. 53. The shaded areas in Figs. 53-56 represent the sclerotic patches seen in the brain and cord in dis-seminated sclerosis of the central nervous system. Fig. Same as Fig. 53. diameter from a few millimetres to two or three centimetres. They arefirmer than the surrounding brain tissue, but have less consistency 412 ENCEPHALITIS; MULTIPLE SCLEROSIS, ETC. than connective tissue, except in very old cases, when they may bePjg 55 almost cartilaginous. They do not appa- rently increase the volume of the part inwhich they are situated, and on cuttingthrough them in the centrum ovale theymay present a depressed appearance, whilein the crus, pons, and cord they may beslightly raised above the surroundinghealthy tissue.^ It has been taught thatthe cerebrum, the centrum ovale, central gan-glia, and corpus callosum are mainly invadedby the islets. In the cerebellum they areprincipally confined to the white claims, however, that—1. Whiteand gray matter are aifected indifferently ;2. There is no seat of predilection for thedevelopment of the sclerotic patches; 3. Thecortex of both cerebrum and cerebellu
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