A treatise on the nervous diseases of children, for physicians and students . seased. During the process of degeneration the myelin becomes disintegrated andis divided into irregular masses ; the axis-cylinder is also broken up and theprocess may finally leave nothing but a granular dibris within the sheath of DISEASES OF THE PERIPHERAL NERVES. 219 Schwann. The nuclei of the sheath undergo proliferation, and Ranvier is ofthe opinion that this is the primary factor in the entire process of degenera-tion. Figs. 52-55. This degeneration may be continued into the finest ramifications, andeven into
A treatise on the nervous diseases of children, for physicians and students . seased. During the process of degeneration the myelin becomes disintegrated andis divided into irregular masses ; the axis-cylinder is also broken up and theprocess may finally leave nothing but a granular dibris within the sheath of DISEASES OF THE PERIPHERAL NERVES. 219 Schwann. The nuclei of the sheath undergo proliferation, and Ranvier is ofthe opinion that this is the primary factor in the entire process of degenera-tion. Figs. 52-55. This degeneration may be continued into the finest ramifications, andeven into the muscle-plates. The cells of the endo- and peri-neurium also un-dergo proliferation, and the entire nerve-fibre may ultimately be changed toa mass of connective tissue. If degeneration has not lasted too long, regen-eration may set in. If the fibres have been cut, regeneration may set in if thecut ends are not too widely apart; the new fibrils are offshoots from the cen-tral stump, and have a tendency to grow toward the peripheral stump, and Fig. -The Brachial Plexus : the Branches involved in the Upper Arm Type ofParalysis are indicated by Shading. can grow even if decalcified bone be inserted between the cut ends (Gluckand others). In perineuritis there is swelling of the connective tissue surrounding thenerve-fibres, the blood-vessels are engorged, and the lymph spaces connective-tissue cells are increased. If the perineuritis last any length oftime, an insterstitial neuritis will also be developed. This latter form is char-acterized by similar changes; if the morbid process is continued, the nerve-fibre invariably suffers. Gombault has described a periaxillary or segmentalneuritis in which normal segments of the nerve alternate with degeneratedsegments. In this form the myelin alone is altered and the axis-cylinder re-mains normal. This occurs particularly in those cases which are due to toxicinfection. In dise
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