AMAarchives of neurology & psychiatry . ly with, the destruction of the myelin sheath. This viewis based on the fact that in many scars devoid of myelin coat and normalnerve fibers there were naked axis cylinders, fairly uniform in outline, unin-terrupted in their course and showing practically no pathologic changes 372 arciiues op xeurology and psychiatry i¥\^. 4). We arc not in accord with the observations of Shimozono orWohlwill, l)ut support tin- studies of Hassin. It is true that there existnumerous naked axis cylinders which show advanced pathologic changes, suchas vacuolization, fragmen
AMAarchives of neurology & psychiatry . ly with, the destruction of the myelin sheath. This viewis based on the fact that in many scars devoid of myelin coat and normalnerve fibers there were naked axis cylinders, fairly uniform in outline, unin-terrupted in their course and showing practically no pathologic changes 372 arciiues op xeurology and psychiatry i¥\^. 4). We arc not in accord with the observations of Shimozono orWohlwill, l)ut support tin- studies of Hassin. It is true that there existnumerous naked axis cylinders which show advanced pathologic changes, suchas vacuolization, fragmentation, swelling, cork-screw formation and ball-liketerminations. These changes, however, in our opinion, are secondary. Withthe swelling of the myelin sheath there commonly occurs a coincident changein the outline of the axis cylinder, and as the pathologic process in the myelinsheath advances, the change in the axis cylinder progresses. Complete destruc-tion of the myelin sheath leads eventually to dissolution of the axis Fig. 4.—Section through an area of softening showing a naked axis cylinderfairly uniform in outline, free of myelin sheath, and surrounded by numerousgranular cells; occasional Elzholz bodies. Elzholz Bodies: These were everywhere in large numbers, particularlyin areas of acute softening. They occurred along the course of naked axiscylinders between myelin sheaths and neurilemma, and independent of axiscylinders or myelin sheaths. The lack of uniformity in distriliution, the absenceof a definite relationship to axis cylinder or to myelin sheath, leads us to con-clude that they cannot be looked on as an indication of primary axis cylinderdisease. GLOBUS-STRAUSS—FVMCULAR MYELOPATHY 373 Glia : The most striking histologic changes were offered by the reactionsof the various types of glia elements in both acute and chronic areas ofdegeneration. Granular cells were found in extremely large numbers wherever the destruc-tive process was still in pro
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