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=On the development of the nuclei pontis during the second and third months of embryonic life=
 
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Talk:Paper - On the development of the nuclei pontis during the second and third months of embryonic life (1901)
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=On the Development of the Nuclei Pontis during the Second and Third months of Embryonic Life=
ON THE DEVELOPMENT OF THE NUCLEI PONTIS DURING THE SECOND AND THIRD MONTHS OF EMBRYONIC LIFE[edit]
 
Long M. On the development of the nuclei pontis during the second and third months of embryonic life. (1901) Johns Hopkins Hospital Bulletin 12:
 
  
 
By Margaret Long.
 
By Margaret Long.
  
[From the Aiiatojitii'iil Laboralori/ of Johna Ih'pkiita Vnu'erxitij.)
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[From the Anatomical Laboratory of Johna Hopkins Vnu'erxitij.)
 
 
  
 +
This work was undertaken in the fall of 1899 at the suggestion of Doctor Barker, and has been carried out with his assistance. The specimens used are human embryos and were very kindly lent by Doctor Mall from his collection.
  
This work was undertaken in the fall of 1899 at the suggestion of Doctor Barker, and has been carried out with his assistance. The specimens used are human embryos and were very kindly lent by Doctor Mall from bis collection.'
+
* The numbers of the embryos correspond with their numbers in the embryological cabinet of the Anatomical Laboratory of the Johns Hopkins University.
  
' The numbers of the embryos correspond with their numbers in the embryological cabinet of the Anatomical Laboratory of tlie .lohns Hopliins University.
 
  
 +
The following embryos are described in the order of their probable age, as estimated by their length and by the develojiment in the rhombencepbalon. The arrangement of the cerebral nerves and the general appearance of the {{medulla oblongata}} agree with the His models and with the description given by His in "''Die Entwicklung des menscblicben Kautenhirns''"; a description of these is accordingly unnecessary. Each embryo has been studied in serial sections and from tliese sections a few, at different stages of development,. have been selected as characteristic of the structure of the pons, its nuclei and fibres. To make the work complete it will be necessary to study more embryos at intermediate stages between the five given here, and others from the third montli up to the adult pons.
  
  
The following emljryos are described in the order of their probable age, as estimated by their length and by the develojiment in the rliombencepbalon. The arrangement of the cerebral nerves and the general appearance of the medulla oblongata agree with the His models and with the description given l)y His in "Die Entwicklung des menscblicben Kautenhirns"; a description of these is accordingly unnecessary. Each embryo has been studied in serial sections and from tliese sections a few, at different stages of development,. have been selected as characteristic of the structure of the pons, its nuclei and fibres. To make the work complete it will be necessary to study more embryos at intermediate stages between the five given here, and others from the third montli up to the adult ))ons.
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Embryo No. LXXV {{{CE75}}} is 30 mm. long and has been cut into serial sagittal sections. The nuclei, whiuli I have designated as " B," " C," " D," " E " and " H " in the various sections, are masses of cells distributed through the ventral part of the mantle layer (Mantelsehicht of His) at or near the level of the pontal flexure. The most medial of these nuclei extend to within 0.7 mm. of the middle line. An unstained fibre bundle can he .seen on the surface of the rhombencephalon ventral to the mantle layer throughout its entire length.
  
Embryo No. LXXV is 30 mm. long and has been cut into serial sagittal sections. The nuclei, whiuli I have designated as " B," " C," " D," " E " and " H " in the various sections, are masses of cells distributed through the ventral part of the mantle layer (Mantelsehicht of His) at or near the level of the pontal flexure. The most medial of these nuclei extend to within 0.7 mm. of the middle line. An unstained fibre bundle can he .seen on the surface of the rhombencephalon ventral to the mantle layer throughout its entire lengtli.
 
  
 
Section No. 73 is 2.1 mm. to the left of the middle line (Fig. 1). Near the ventral surface on the cerebral side o.f the nervus trigeminus is a well defined cell-mass, '" B.' On the ventral surface opposite the nervus acusticus is a deeply stained cell-mass, " IT," which (wlien followed in the series) is seen to extend lateralward and spinalward to the floor of the fourth ventricle at the Junction of the latter with the telachorioidea. The section of the mantle layer presents longitudinal striations which have a slight ventral convexity. A few of these strands are more deeply stained than th.e rest between the level of the N. trigeminus and that of the N. acusticus. The dark ependymal epithelium and the unstained ventral fibre bundle are evident.
 
Section No. 73 is 2.1 mm. to the left of the middle line (Fig. 1). Near the ventral surface on the cerebral side o.f the nervus trigeminus is a well defined cell-mass, '" B.' On the ventral surface opposite the nervus acusticus is a deeply stained cell-mass, " IT," which (wlien followed in the series) is seen to extend lateralward and spinalward to the floor of the fourth ventricle at the Junction of the latter with the telachorioidea. The section of the mantle layer presents longitudinal striations which have a slight ventral convexity. A few of these strands are more deeply stained than th.e rest between the level of the N. trigeminus and that of the N. acusticus. The dark ependymal epithelium and the unstained ventral fibre bundle are evident.
Line 39: Line 27:
  
 
Section No. 96 is 1.05 mm. to the left of the middle line. "H" and "C" are still present. The ventral fibre bimdle passes partly along the dorsal surface of "H" and partly between " C " and " E." Just cerebralward from the pontal flexure, close to the floor of the ventricle, is " M, an oval mass of cells witli a clear unstained area behind at its spinal end, and measuring 0.8 mm. in transverse diameter. The appearance of the mantle layer is the same as before. In its dorsal and cerebral part is seen an unstained dorsal fibre bundle.
 
Section No. 96 is 1.05 mm. to the left of the middle line. "H" and "C" are still present. The ventral fibre bimdle passes partly along the dorsal surface of "H" and partly between " C " and " E." Just cerebralward from the pontal flexure, close to the floor of the ventricle, is " M, an oval mass of cells witli a clear unstained area behind at its spinal end, and measuring 0.8 mm. in transverse diameter. The appearance of the mantle layer is the same as before. In its dorsal and cerebral part is seen an unstained dorsal fibre bundle.
 
Embryo No. LXXXVI is 30 mm. long and has been cut into serial coronal sections. There is ventralward a definite mass which I have designated as the nucleus pontis ventralis; it is about 1 mm. long by 3 mm. wide. The raphe enters
 
  
  
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Embryo No. LXXXVI ({{CE86}}) is 30 mm. long and has been cut into serial coronal sections. There is ventralward a definite mass which I have designated as the nucleus pontis ventralis; it is about 1 mm. long by 3 mm. wide. The raphe enters this nucleus in the middle line. Dorsal from its lateral part are several scattered masses which 1 have designated, tentatively, the nuclei pontis dorsales. The unstained ventral fibre bundle is dorsal from the nucleus pontis ventralis.
  
this nucleus in the middle line. Dorsal from its lateral part are several scattered masses which 1 have designated, tentatively, the nuclei pontis dorsales. The unstained ventral fibre bundle is dorsal from the nucleus pontis ventralis.
 
  
Section No. 175 is spinalward from the masses mentioned. On the ventral surface medialward from the nervus acusticus (-A^.l ) is the cell-mass " H." Followed through the series this cell-mass extends spinalward, dorsalward and lateralward to the ependymal epitlu^lium of the fourth ventricle; cerebralward, it is medial to the nervus trigeminus and continuous with the nucleus pontis. Taken in order from the raphe lateralward in the mantle layer are the nucleus olivaris superior (8) and the superior olivary complex {S}, the ascending and descending parts of the root of the nervus facialis, the nucleus nervi facialis {NNP), and the corpus restiforme {OR). On the floor of the fourth ventricle are the nucleus nervi abducentis (NNA) and the nucleus N. vestibuli (radicis deseendentis), {III? I'D); further lateralward are the nuclei N. cochleae, namely the nucleus N. eochleffi dorsnlis (NRCD) and the nucleus N. cochlea; ventralis (NNCV). The unstained area is the ventral fibre bundle (I'-P') Section No. 184 is 0.45 mm. cerebralward from the preceding section. In the mantle layer are seen in order the nucleus olivaris superior, (S), the nucleus nervi facialis (NNF). and parts of the ascending and descending limbs of the nervus facialis. "H" is on the ventral surface lateral from tlie nervus facialis. On the floor of the fourth ventricle is the nucleus N. vestibuli medialis et radicis descendentis (NNV).
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Section No. 175 is spinalward from the masses mentioned. On the ventral surface medialward from the nervus acusticus (-A^.l ) is the cell-mass " H." Followed through the series this cell-mass extends spinalward, dorsalward and lateralward to the ependymal epithelium of the fourth ventricle; cerebralward, it is medial to the nervus trigeminus and continuous with the nucleus pontis. Taken in order from the raphe lateralward in the mantle layer are the nucleus olivaris superior (8) and the superior olivary complex {S}, the ascending and descending parts of the root of the nervus facialis, the nucleus nervi facialis {NNP), and the corpus restiforme {OR). On the floor of the fourth ventricle are the nucleus nervi abducentis (NNA) and the nucleus N. vestibuli (radicis deseendentis), {III? I'D); further lateralward are the nuclei N. cochleae, namely the nucleus N. eochleffi dorsnlis (NRCD) and the nucleus N. cochlea; ventralis (NNCV). The unstained area is the ventral fibre bundle (I'-P') Section No. 184 is 0.45 mm. cerebralward from the preceding section. In the mantle layer are seen in order the nucleus olivaris superior, (S), the nucleus nervi facialis (NNF). and parts of the ascending and descending limbs of the nervus facialis. "H" is on the ventral surface lateral from tlie nervus facialis. On the floor of the fourth ventricle is the nucleus N. vestibuli medialis et radicis descendentis (NNV).
  
 
Section No. 202 is 0.9 mm. cereliralward from section 184. The nucleus pontis ventralis reaches lateralward as far as the nervus trigeminus. In the middle line the raphe extends from the nucleus pontis to the ependymal epithelium. The nuclei pontis dorsales consist of several irregular masses, " A," " B," " C," and " E," and a more ventral and lateral mass. " D." These nuclei extend through the pons for a distance of 0.5 mm. in the cerebrospinal diameter. Between these ventral and dorsal nuclei is the unstained ventral fibre bundle. Lateral from the nervus trigeminus are the nucleus nervus trigeminus ascendcns and an unstained area.
 
Section No. 202 is 0.9 mm. cereliralward from section 184. The nucleus pontis ventralis reaches lateralward as far as the nervus trigeminus. In the middle line the raphe extends from the nucleus pontis to the ependymal epithelium. The nuclei pontis dorsales consist of several irregular masses, " A," " B," " C," and " E," and a more ventral and lateral mass. " D." These nuclei extend through the pons for a distance of 0.5 mm. in the cerebrospinal diameter. Between these ventral and dorsal nuclei is the unstained ventral fibre bundle. Lateral from the nervus trigeminus are the nucleus nervus trigeminus ascendcns and an unstained area.
  
Embryo No. XLV is 28 mm. long, and has been cut in serial sections, which divide the pons in an oblique direction in the following way: Instead of corresponding to the transverse diameter of the pons the left side of each section is further spinalward than the right side of the same section. The ventrodor.sal plane of the section is also oblique, so that in each section the left half of the dorsal surface is the more lateral, but in the right half of the pons the dorsal surface is more medial than the ventral. In other words, the first section removes a small portion of the pons about the cerebral ventral corner on the left side, and at the dorsal-spinnl angle on the right side.
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Embryo No. XLV ({{CE45}}) is 28 mm. long, and has been cut in serial sections, which divide the pons in an oblique direction in the following way: Instead of corresponding to the transverse diameter of the pons the left side of each section is further spinalward than the right side of the same section. The ventrodor.sal plane of the section is also oblique, so that in each section the left half of the dorsal surface is the more lateral, but in the right half of the pons the dorsal surface is more medial than the ventral. In other words, the first section removes a small portion of the pons about the cerebral ventral corner on the left side, and at the dorsal-spinnl angle on the right side.
 
 
The nucleus pontis, as seen in this series, is on the surface of the rhombencephalon and follows the curve of the pontal flexure so that it is crescentic in shape, with a ventral convex surface and cerebral and spinal ends or horns. Consequently.
 
 
 
 
 
  
THE JOHNS HOPKINS HOSPITAL BULLETIN, APRIL-MAY-JUNE, 1901.
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The nucleus pontis, as seen in this series, is on the surface of the rhombencephalon and follows the curve of the pontal flexure so that it is crescentic in shape, with a ventral convex surface and cerebral and spinal ends or horns. Consequently the following sections may have a ventrocerebral, a ventral, a veutrospinal and a dorsal edge.
  
  
Line 62: Line 44:
 
PLATE XXI.
 
PLATE XXI.
  
 
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Fig. 1. — Section through the {{pons}} of embryo LXXV, oO mm. lous; X 1.5 diameters.
 
 
G.V.
 
 
 
 
 
 
 
 
 
B
 
 
 
 
 
 
 
VF - H.
 
 
 
 
 
 
 
NT.
 
 
 
 
 
 
 
 
 
Fig. 1. — Section through the pous of erabrj'o LXXV, oO mm. lous; X 1.5 diameters.
 
  
  
  
 
Fig. 3. — Section No. 91 of embryo LXXV, x 1.5 diameters.
 
Fig. 3. — Section No. 91 of embryo LXXV, x 1.5 diameters.
 
 
 
 
N.N.K. N.N.V
 
 
 
 
 
NRC.D
 
 
 
 
■M.R.C V CR.
 
 
  
  
Line 107: Line 54:
  
  
 
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Fig. 4. — Section No. 17.5 through the brain of embryo LXXXVI, oO mm. long, x 15 diameters.
v.r. 5 s.
 
 
 
 
 
 
 
Fig. 4. — Section No. 17.5 tlirougli tlic brain of embryo LXXXVI, oO mm. long, x 15 diameters.
 
 
 
 
 
 
 
THE JOHNS HOPKINS HOSPITAL BULLETIN, APRIL-MAY-JUNE, 1901.
 
  
  
Line 123: Line 61:
  
  
 
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Fig. 5. — Sectiou No. 1.S4 through embryo LXXXVI.
N.NV.
 
 
 
 
 
 
 
 
 
-.c R.
 
  
  
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Fig. (i,— Sectiou No. 302 through embryo LXXXVI
  
"N.N.F
 
  
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Fig. 7. — Section No. KIO through embryo XLV, x lo duimeters.
  
  
s s.
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Fig. 8.— Section 142 through embryo XLV.
  
  
  
N,F.
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Fig. 9. — Sectiou 14.5 through embryo XLV.
 
 
 
 
 
 
 
 
R— V
 
 
 
 
 
 
 
Fig. 5. — Sectiou No. 1.S4 throuirb embryo LXXXVI.
 
 
 
 
 
 
 
^f- N.PV,
 
 
 
Fig. (i,— Sectiou No. 302 througb embryo LXXXVI
 
 
 
 
 
 
 
N.P.D
 
 
 
 
 
 
 
 
 
N.PD. S
 
 
 
 
 
 
 
Fig. 7. — Section No. KIO tbrounb embryo XLV, x lo duimeters.
 
 
 
 
 
 
 
N.PD N.RYV. F: - N.PD
 
 
 
 
 
 
 
 
 
-C
 
 
 
-C.R.
 
 
 
 
 
 
 
.H.
 
 
 
 
 
 
 
N.A.
 
 
 
 
 
 
 
Fig. S.— Section 142 tbrougb embryo XLV.
 
 
 
 
 
 
 
Fig. i). — Sectiou 14.5 tbrouffb embryo XLV.
 
 
 
 
 
 
 
THE JOHNS HOPKINS HOSPITAL BULLETIN, APRIL-MAY-JUNE, 1901.
 
 
 
  
  
Line 207: Line 80:
  
  
 
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Fig. 10. — Section No. 92 through embryo XCV ({{CE95}}).
 
 
'\
 
 
 
 
 
 
 
Fig. 10. — Section No. 92 tUrougb embryo XCV.
 
 
 
 
 
 
 
 
 
-^^^^
 
 
 
 
 
 
 
Fig. 11.— Section No. lUO tlirough embryo XCV.
 
  
  
  
THE JOHNS HOPKINS HOSPITAL BULLETIN, APRIL-MAY-JUNE, 1901.
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Fig. 11.— Section No. lUO through embryo XCV ({{CE95}}).
  
  
Line 233: Line 91:
  
  
 
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Fig. 13.— .Section No. UIC. through eniliryo XCV ({{CE95}}).
y? ./"^
 
 
 
 
 
 
 
jaSo?^y?^
 
 
 
  
  
  
 +
Fig. 13.— Section No. lOS through embryo XCV ({{CE95}}).
  
  
Line 248: Line 101:
  
  
 
^S
 
 
 
 
 
/
 
 
 
 
5.
 
 
 
 
"i
 
 
 
 
./-"'"
 
 
 
 
y
 
 
 
 
 
 
 
ill
 
 
 
 
^m^
 
 
 
 
//
 
 
 
 
Fig. 13.— .Section No. UIC. tUronsli eniliryo XCV.
 
 
 
 
TC-
 
 
 
 
HM-—-i
 
 
 
 
Fig. 13.— Section No. lOS through embryo XCV.
 
 
 
 
Apetl-Mat-June, 1901.]
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
125
 
 
 
 
the following sections may have a ventrocerebral, a ventral, a veutrospinal and a dorsal edge.
 
  
 
The nucleus pontis ventralis is a solid mass of cells continuous with the raphe. The nucleus pontis dorsalis ia divided into right and left halves not continuous in the middle line. The ventral fibre bundle passes between the ventral and dorsal nuclei except at their extreme lateral parts, where the cerebral ends of the two nuclei are united.
 
The nucleus pontis ventralis is a solid mass of cells continuous with the raphe. The nucleus pontis dorsalis ia divided into right and left halves not continuous in the middle line. The ventral fibre bundle passes between the ventral and dorsal nuclei except at their extreme lateral parts, where the cerebral ends of the two nuclei are united.
  
Section No. 13G is 0.05 mm. to the right of the middle line. On the right side the nucleus pontis ventralis is separated from the raphe by the ventral liljre bundle and nucleus extends across the middle line. On the left side the two ends of the nucleus pontis dorsalis are separated from the rajiho by the ventral fibre bundle and mantle layer. On the veutrospinal surface at the level of the nervus facialis is a deeply stained mass of cells, " H." This mass is continuous opposite the nervus trigeminus with the nucleus pontis; spinalward, dorsalward and lateralward it extends to the ventricular epithelium of the medulla oblongata. In the medulla is a cell-mass, " T," on the medial side of the corpus restiforme. and reaching from the fourth ventricle to the ventrospinal surface. Between " T " and the nucleus pontis dorsalis is a small round mass, " S," a little more deeply stained than the rest of the mantle layer.
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Section No. 13G is 0.05 mm. to the right of the middle line. On the right side the nucleus pontis ventralis is separated from the raphe by the ventral liljre bundle and nucleus extends across the middle line. On the left side the two ends of the nucleus pontis dorsalis are separated from the raphe by the ventral fibre bundle and mantle layer. On the veutrospinal surface at the level of the nervus facialis is a deeply stained mass of cells, " H." This mass is continuous opposite the nervus trigeminus with the nucleus pontis; spinalward, dorsalward and lateralward it extends to the ventricular epithelium of the medulla oblongata. In the medulla is a cell-mass, " T," on the medial side of the corpus restiforme. and reaching from the fourth ventricle to the ventrospinal surface. Between " T " and the nucleus pontis dorsalis is a small round mass, " S," a little more deeply stained than the rest of the mantle layer.
  
 
Section No. 143 is 3.5 mm. to the left of the middle line and shows only the left side of the pons. Between the nuclei pontis is the ventral fibre bundle. The nucleus pontis dorsalis is in the mantle layer; in its spinal end is a small unstained space. On the ventrospinal surface is the uuiss " H." Medial from the corpus restiforme is a round, deeply stained area " S." Near the fourth ventricle are several dark masses just like those in section 136.
 
Section No. 143 is 3.5 mm. to the left of the middle line and shows only the left side of the pons. Between the nuclei pontis is the ventral fibre bundle. The nucleus pontis dorsalis is in the mantle layer; in its spinal end is a small unstained space. On the ventrospinal surface is the uuiss " H." Medial from the corpus restiforme is a round, deeply stained area " S." Near the fourth ventricle are several dark masses just like those in section 136.
Line 327: Line 110:
 
Section No. 145 is 0.4 mm. to the left of the middle line. The nuclei pontis ventralis and dorsalis are continuous at their cerebral ends. Between them is the ventral fibre bundle. Opposite the radi.x N. cochleae is " H," and median from it a cylindrical-shaped area. Between the cerebellum and the pons is an unstained area, the corpus restiforme.
 
Section No. 145 is 0.4 mm. to the left of the middle line. The nuclei pontis ventralis and dorsalis are continuous at their cerebral ends. Between them is the ventral fibre bundle. Opposite the radi.x N. cochleae is " H," and median from it a cylindrical-shaped area. Between the cerebellum and the pons is an unstained area, the corpus restiforme.
  
Embryo No. XCV is 46 mm. long and cut into serial sagittal sections. The nucleus pontis is a solid mass of cells on the ventral surface of the pons, which has increased in size and measures 3 mm. in cerebrospinal, 4.6 mm. in transverse, and 0.5 mm. in ventrodorsal diameter. The ventral fibre bundle divides into two masses, the larger passes dorsal to the nucleus, the smaller through it.
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Embryo No. XCV ({{CE95}}) is 46 mm. long and cut into serial sagittal sections. The nucleus pontis is a solid mass of cells on the ventral surface of the pons, which has increased in size and measures 3 mm. in cerebrospinal, 4.6 mm. in transverse, and 0.5 mm. in ventrodorsal diameter. The ventral fibre bundle divides into two masses, the larger passes dorsal to the nucleus, the smaller through it.
 
 
Section No. 93 is 0.3 mm. to the left of the middle line. The nucleus pontis is a solid nuiss of cells. Dorsal from it is a dark wedge-sluiped area; its ventral surface reaches as far as the nucleus pontis and extends 0.4 mm. beyond the middle line on each side, the dorsal surface is continuous with tlie ependymal epithelium in the middle line and for a distance ol 0.3 mm. to the right. This area contains ventrodorsal markings, and small masses of cells staining more deeply than the rest of the tissue of the wedge between them. On the floor of the fourth ventricle just cerebral from the pontal flexure are two dark round cell-masses, " M," which extend through
 
 
 
  
 +
Section No. 93 is 0.3 mm. to the left of the middle line. The nucleus pontis is a solid nuiss of cells. Dorsal from it is a dark wedge-sluiped area; its ventral surface reaches as far as the nucleus pontis and extends 0.4 mm. beyond the middle line on each side, the dorsal surface is continuous with tlie ependymal epithelium in the middle line and for a distance ol 0.3 mm. to the right. This area contains ventrodorsal markings, and small masses of cells staining more deeply than the rest of the tissue of the wedge between them. On the floor of the fourth ventricle just cerebral from the pontal flexure are two dark round cell-masses, " M," which extend through a few sectjons on either side of the middle line, but in the middle line are overlapped by the greatly thickened ependymal ejiitlielium. On the ventral surface of the medulla oblongata is the ventral fibre bundle. Near the dorsal surface cerebral from the pontal flexure is the dorsal fibre liundle. The mantle layer contains the curved longitudinal striatiou, and in the isthmus is more deeply stained than in the medulla, and also contains blood-spaces. Next the epen(lynuil cpitlielium the mantle layer of the medulla [iresents a unit'onn appearance, and in the isthmus it contains several darker masses ol' cells.
  
a few sectjons on either side of the middle line, but in the middle line are overlapped by the greatly thickened ependymal ejiitlielium. On the ventral surface of the medulla oblongata is the ventral fibre bundle. Near the dorsal surface cerebral from the pontal flexure is the dorsal fibre liundle. The mantle layer contains the curved longitudinal striatiou, and in the isthmus is more deei)ly stained than in the medulla, and also contains blood-spaces. Next the epen(lynuil cpitlielium the mantle layer of the medulla [iresents a unit'onn appearance, and in the isthnuis it contains several darker masses ol' cells.
+
Section No. lOO is 0.6 mm. to the right of the middle line. The s]>iiwl portion of the nucleus pontis is divided into ventral and dorsal parts by a clear area, containing a few dark strands composed of cells. " M is still present; between it and the nucleus pontis are several small cell-masses. The ventral fibre bundle is on the surface of the medulla and next the dorsal side of the nucleus pontis. The mantle layer contains the curved longitudinal striatiou and blood-spaces. Between the dorsal fibie bundle and the ependymal epithelium arc numerous dark cell-masses.
  
Section No. lOO is 0.6 mm. to the right of the middle line. The s]>iiwl portion of the nucleus pontis is divided into ventral and dor.^al parts by a clear area, containing a few dark strands com}iosed of cells. " M is still present; between it and the nucleus pontis are several small cell-masses. The ventral fibre bundle is on the surface of the medulla and next the dorsal side of the nucleus pontis. The mantle layer contains the curved longitudinal striatiou and blood-spaces. Between the dorsal fibie bundle and the ependymal epithelium arc numerous dark cell-masses.
 
  
 
Section No. 106 is 1 mm. right of the middle line. The nucleus pontis is more unevenly stained. Its cerebral end is divided into ventral and dorsal parts by an unstained area, which is continuous with the ventral fibre bundle. The fibre bundle extends the entire length of this section. It is now seen that this fibre bundle has an oblique direction through the cerebrolateral and spinomedial portion of the rhombencephalon. The appearance of the mantle layer is the same as in the preceding section; between the nucleus pontis and the nucleus olivaris a foAV of tlie curved striations are more deeply stained than the rest, S."
 
Section No. 106 is 1 mm. right of the middle line. The nucleus pontis is more unevenly stained. Its cerebral end is divided into ventral and dorsal parts by an unstained area, which is continuous with the ventral fibre bundle. The fibre bundle extends the entire length of this section. It is now seen that this fibre bundle has an oblique direction through the cerebrolateral and spinomedial portion of the rhombencephalon. The appearance of the mantle layer is the same as in the preceding section; between the nucleus pontis and the nucleus olivaris a foAV of tlie curved striations are more deeply stained than the rest, S."
Line 341: Line 121:
 
Section No. 108 is 1.4 mm. to the left of the middle line. The nucleus pontis is a smaller mass, unevenly stained owing to the presence of large numbers of white spots (nerve-fibres). Dorsal from it is the ventral fibre himdle. The mantle layer appeal's as before but the mass " M " is not present. Between the nucleus pontis and the nucleus olivaris are a few small cell-masses, and several more are scattered throughout the mantle layer of the isthmus.
 
Section No. 108 is 1.4 mm. to the left of the middle line. The nucleus pontis is a smaller mass, unevenly stained owing to the presence of large numbers of white spots (nerve-fibres). Dorsal from it is the ventral fibre himdle. The mantle layer appeal's as before but the mass " M " is not present. Between the nucleus pontis and the nucleus olivaris are a few small cell-masses, and several more are scattered throughout the mantle layer of the isthmus.
  
Embryo No. XCYI is 48 mm. long and cut into serial sagittal sections. The nucleus pontis has increased in the ventrodorsal diameter. The appearance of this specimen is almost identical with that of No. XCV, and is only of interest because it corroborates what was found there. So I have not thought it necessary to add illustrations. Just spinal from the nervus trigeminus the nucleus pontis is continuous with a mass of cells which reaches to the ependymal epithelium of the fourth ventricle. The ventral fibre bundle passes partly along the dorsal surface of the nucleus pontis and partly through it. Among the latter fibres are a few scattered strands of cells resembling more the appearance of the pons at later stage. The wedged-shaped area and the cell-mass appear as before.
 
 
The histological structure of these specimens is as follows: The ependymal epithelium contains large, dark, densely
 
 
 
 
126
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
  
 +
Embryo No. XCVI ({{CE95}}) is 48 mm. long and cut into serial sagittal sections. The nucleus pontis has increased in the ventrodorsal diameter. The appearance of this specimen is almost identical with that of No. XCV, and is only of interest because it corroborates what was found there. So I have not thought it necessary to add illustrations. Just spinal from the nervus trigeminus the nucleus pontis is continuous with a mass of cells which reaches to the ependymal epithelium of the fourth ventricle. The ventral fibre bundle passes partly along the dorsal surface of the nucleus pontis and partly through it. Among the latter fibres are a few scattered strands of cells resembling more the appearance of the pons at later stage. The wedged-shaped area and the cell-mass appear as before.
  
  
[Nos. 121-122-123.
+
The histological structure of these specimens is as follows: The ependymal epithelium contains large, dark, densely packed, round and oval cells. The mantle layer in the earlier stages consists of round cells and a few oval cells. In embryo No. LXXV an unstained fibrous network is seen and the round cells are scattered through it, which in No. LXXXVI and No. XLV are more closely packed together. In the older specimens neuroblasts of the mantle layer point in various directions, a good many of them direct their axones ventralward, and many roimd cells are still seen. Most of the neurolilasts are now arranged in definite groups; between them is an unstained fibrous network which contains spongioblasts. Both the nucleus pontis and the mass " M " are composed of round cells in all the sections. The mass " H " consists of round cells, resembling in size and staining reaction those of the ependynial epithelium. The raphe appears in two specimens; it consists of filjres which interlace across the middle line, round cells, ami in the frontal sections a few oval cells with their long axis transversely directed. In sagittal sections the raphe is not seen; its fibres, if present, would be cut in cross-sections.
  
 +
==Summary==
  
 +
The main nucleus pontis is situated on the ventral surface of the rhombencephalon at the level of the pontal flexure. In the specimens the nuclei pontis are first seen on the surface and in the ventral part of the mantle layer of the lateral part of the pons Varolii. Ventral to all, in this early stage, except the mass of cells " H," is the ventral fibre bundle. In the second embryo the nucleus pontis ventralis extends across the middle line of the rhombencephalon and the nuclei pontis dorsales are separated from its lateral part by the ventral fibre bundle. The nuclei pontis dorsales next form two solid masses, reaching almost to the middle line. They are still separated by the ventral fibre bundle from the nucleus pontis ventralis, except at the extreme lateral ends, where they are continuous with each other. Next the nucleus pontis becomes a solid shell on the ventral surface cut by a .small branch from the ventral fibre bundle. After the sixth month the pons consists mainly of fibres and scattered groiips of cells which increase at the expense of the dorsal part of the nucleus, while a narrow ventral nucleus or eell-nuiss is left on the surface.
  
packed, round and oval cells. The mantle layer in the earlier stages consists of round cells and a few oval cells. In embryo No. LXXV an unstained fibrous network is seen and the round cells are scattered through it, which in No. LXXXVI and No. XLV are more closely packed together. In the older specimens neuroblasts of the mantle layer point in various directions, a good many of them direct their axones ventralward, and many roimd cells are still seen. Most of the neurolilasts are now arranged in definite groups; between them is an unstained fibrous network which contains spongioblasts. Both the nucleus pontis and the mass " M " are composed of round cells in all the sections. The mass " H " consists of round cells, resembling in size and staining reaction those of the ependynial epithelium. The raphe appears in two specimens; it consists of filjres which interlace across the middle line, round cells, ami in the frontal sections a few oval cells with their long axis transversely directed. In sagittal sections the raphe is not seen; its fibres, if present, would be cut in cross-sections.
 
 
Summary.
 
 
The main nucleus pontis is situated on the ventral surface of the rhombencephalon at the level of the pontal flexure. In the specimens the nuclei pontis are first seen on the surface
 
 
 
 
and in the ventral part of the mantle layer of the lateral part of the pons Varolii. Ventral to all, in this early stage, except the mass of cells " H," is the ventral fibre bundle. In the second embryo the nucleus pontis ventralis extends across the middle line of the rhombencephalon and the nuclei pontis dorsales are separated from its lateral part by the ventral fibre bundle. The nuclei pontis dorsales next form two solid masses, reaching almost to the middle line. They are still separated by the ventral fibre bundle from the niicleus pontis ventralis, except at the extreme lateral ends, where they are continuous with each other. Next the nucleus pontis becomes a solid shell on the ventral surface cut by a .small branch from the ventral fibre bundle. After the sixth month the pons consists mainly of fibres and scattered groiips of cells which increase at the expense of the dorsal part of the nucleus, while a narrow ventral nucleus or eell-nuiss is left on the surface.
 
  
 
The neuroblasts of the pons are continuous with the epithelium of the floor of the fourth ventricle:
 
The neuroblasts of the pons are continuous with the epithelium of the floor of the fourth ventricle:
  
(1) By the cell-mass " H " at the lateral end of the nucleus pontis.
+
# By the cell-mass " H " at the lateral end of the nucleus pontis.
 
+
# By the round cells in the rajjhe.
(2) By the round cells in the rajjhe.
+
# In the middle line by the neuroblast in tlie wedge, which connects both the ependymal epithelium and the cellmass " M " w ith the nucleus pontis.
 
 
(3) In the middle line by the neuroblast in tlie wedge, which connects both the ependymal epithelium and the cellmass " M " w ith tlie nucleus pontis.
 
 
 
 
 
 
 
THE ARCHITECTURE OF THE GALL-BLADDER.
 
 
 
By Mervin T. Sudler, Pn. D., M. D.,
 
 
 
Iiislruclor in Anaioniy, Johns Tloplins University.
 
 
 
 
 
 
 
During the past few years the development of the surgery of the gall-bladder and ducts has increased the interest in their finer anatomy, and various investigations have been undertaken in order to add to our knowledge in regard to their structure. The lymphatics and finer blood-supply, however, do not seem to have had the same attention as the musculature and nerve supply; and so this paper deals more with this part of its structure and its histology than those which have been carefully considered in other papers.
 
 
 
The results mentioned here were obtained for the most part by the use of the gall-bladders of dogs and pigs. They were used because of their suitability and the ease with which they could be obtained. A limited number from cats and beeves were used also. The results thus obtained from fresh material were verified or refuted upon human gallbladders as far as the limited supply and general bad condition of them allowed. Within a few hours after death the bile stains and macerates the tissues so that they are quite changed. The mucous membrane disappears entirely in from five to six hours after death; the nuclei and tissues under it refuse to stain, and it is impossiljle to obtain satisfactory results from any but the fresliest material. For the histology small pieces hardened, distended and contracted in saturated
 
 
 
 
 
 
 
corrosive sublimate solution yielded material that stained well and gave good pictures. For the connective-tissue elements the most striking picture was obtained by the use of Van Gieson's acid fuchsin and picric acid, but Weigert's elastic fibre stain furnished the most accurate and delicate picture. For the blood-vessels ordinary carmine gelatin mans and lamp-black or cinnabar gelatin mass were all that were necessary. For the lymphatics a saturated aqueous solution of Prussian-l)lue proved to Ije the best, notwithstanding a careful trial of a number of more complicated and presumably better masses.
 
 
 
The thickness of the wall of the gall-bladder varies according to its state of distention. In an adult human sul)ject it is from 5 lum. thick in a state of distention to 2 mm. in a state of contraction. The distended gall-bladder of a newborn infant is nearly J mm. thick. In the pig it may be from 5 to 3 mm. thick, and in a dog of medium size from \ mm. to 1^ mm. thick. The wall of the gall-bladder is made up of the following coats: 1. mucous; 2. fibro-muscular; 3. subserous and on the free part covered by peritoneum; 4. serous. The relative thickness of these coats can be seen in Fig. 0, wliieli sliows tlie gall-bladder of the dog contracted. The relations are essentially tlu' same in man as in the dog.
 
 
 
 
 
 
 
Apeil-Mat-June, 11)01.]
 
 
 
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
 
 
 
127
 
 
 
 
 
 
 
The mucows layer is thrown into a series of folds from ^ to I mm. high in man. These folds of mucous membrane cover corresponding ridges of connective tissue of the fibromuscular layer and contain an exceptionally rich capillary network. The irregular spaces surrounded by these folds are much larger at the fundus than at the duodenal end of the gall-bladder. In man the measurements in the distended gall-bladder are 3 mm. X 5 mm. in the fundus and 1 mm. X i nim. or smaller near the beginning of the cystic duct. In the crypts formed by the folds solitary lymph follicles are found. These are more numerous in the dog than in the pig, and in this regard there seems to be a great deal of individual vaiiation. The mucous layer is composed of simple colunmar eiiitlielium, which rests upon an iucomjilete muscnlaris mucosa. In the dog these cells are from 25-43 />• thick. These cells seem to secrete a thick mucous material but no goblet cells are present. R. Virchow (1), in an article published in 1857, finds tine fat-drops in the ends of these cells of the gall-bladder and ducts during or just after the absorption of chyle. These droplets gradually became larger and worked toward the base of the cell. He thought this fat had been lost from the liver in the secretion of the bile and was again picked up by these cells. Nothing was seen in my preparations to suggest this. Granules were often seen in the outer end or near the base of the cells, but these gave no reactions for fat. Belonging also to the mucous layer were the tubular glands. These were beautifully shown in specimens stained in gold chloride. There are few of them in the dbg, but in the pig, and especially in the ox, they are quite numerous.
 
 
 
The fibro-muscnlar coat is composed of smooth muscle fibres and interlacing bands of connective tissue. The direction and arrangement of these fibres has been very carefully studied by Hendrickson (2). He concluded that in the gallbladder there are no definite layers and that the bundles of fibres interlace in all directions with the greatest number tending toward a transverse direction. According to Doyon (3), the muscle fibres arrange themselves in two methods in different animals: 1. A network with rather rounded meshes. This arrangement is found in the guinea-pig. This fact has been corroborated by Ranvier. 2. The muscle fil)res are arranged into bundles which form a number of principal directions more or less plainly marked out. This is found in the dog and cat, and means about the same as the description of Hendrickson. My preparations and sections lead me to agree with Hendrickson, with the possible exception that near the fundus in the dog there is an outer and rather definite longitudinal layer. See Fig. 0. The part of this layer near the mucous membrane is composed almost entirely of connective tissue with only a few muscle fibres scattered through it, the part directly under the epithelium forming a mucosa which, however, shades ofi: gradually and is not sharply separated from the underlying tissue. It is in this region that the thickest plexus of capillaries and intrinsic lymph channels exists. The solitary lymph follicles, to which reference has already been made, are found also here just
 
 
 
 
 
 
 
inider the mucous membrane. Toward the subserous layer, on the contrary, the muscle fibres are collected into well developed bundles (especially so in the pig and ox) and theconnective tissue is corresponding-ly less. Elastic tissue occurs even here, however, varying in form from fine threads to coarse bands. It is especially abundant in the neighborhood of the blood-vessels. See Fig. 6. Unstriped muscle also exists in the larger gall-ducts, and at the point where the ductus communis joins the ductus pancreaticus it becomes modified into a sphincter. This has been found by Hendrickson in man, the dog and the rabbit, and also by Helly (4) in man, and Oddi (5) in man. The fibro-mnscular layer contains the larger blood-vessels, which divide into branches and thus supply the other layers. See Figs. 2 and 6.
 
 
 
The subserous layer is composed of dense interwoven elastic tissue bands which contain comparatively few nuclei, and therefore few connective-tissue elements. These bands form an irregular mesh-work which is denser on the side toward the serous layer. This layer is poorly supplied with bloodvessels, although there is a well developed set of lymph channels which communicate with the large superficial vessels coming from the liver. By ])nlling the gall-bladder apart it is possible to divide it into two la3'ers; the separation occurring at the junction of the subserous and fibro-muscnlar layers. By separating injected tissues in this manner a very pretty picture of the circulation in each part can Ije obtained distinct from the other.
 
 
 
The serous layer is present only on the part covered by peritoneum, i. e. the fundus, the inferior surface of the gallbladder and the outer surface of the gall-ducts. If is composed of simple flat endothelial cells from 4-6 ," thick and adds but little strength to the organ. The larger lymphatic vessels from the liver and deeper layers of the gall-bladder nui between it and the subserous layer.
 
 
 
Brewer (G) has described in a very careful manner the way the cystic artery reaches the gall-bladder in man and the variations one would find ordinarily. He found that in 50 subjects only 3 corresponded to the type described in textbooks of anatomy. It is possible to judge from this of the great amount of variation existing in its blood-supply. The largest artery after it has reached the gall-liladder is usually found, however, on its inferior surface and on the side toward the middle line of the body. There also may be a smaller branch on the side away from the middle line. This is covered at first by peritoneum and then penetrates the outer part (if tlie fibro-muscnlar layer and gives off the branches which suj)ply the viscus. ]\Iost of tlie larger vessels are in the fibro-muscnlar layer near the dividing line between it and the subserous layer. See Fig. C. If the needle of a hypodermic syringe be introduced into one of the smaller arteries and llie mucous surface be watched while the fluid is slowly iujecti'd tlie arterioles and capillaries can be seen to be filled in areas about 2i mm. in diameter at a time from a single centrally placed artery. The capillaries under the mucous niemlirane are very niuuercnis and in the folds tlie capillary nclwdrk is especially lliick. See Fig. 2. The blood from
 
 
 
 
 
 
 
128
 
 
 
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
 
 
 
[Nos. 121-122-133.
 
 
 
 
 
 
 
these is collected into the veins and returned to the larger and deeper lying ones accompanying the arteries.
 
 
 
The subserous layer has a comparatively poor blood-supply. The arteries are small and the capillaries widely separated. Some of the capillaries run out between this layer and the serous layer, and thus provide for the nourishment of the peritoneal covering. Some veins of considerable size are also found in this layer. On the surface of the gall-bladder in contact with the liver the veins communicate with the branches of the portal vein and the arteries in part come from the hepatic artery.
 
 
 
The large lymphatic vessels running over the gall-bladder bring lymph from the liver and the coats of the gall-bladder. They follow the inner side of the cystic duct and end in mesenteric lymph glands in the dog. In the pig and in man we have either one or two systems of the large lymph vessels. In almost all cases both are represented but the territory may not be equally large and there is wide variation in their method of distribution. In cross-section these vessels are always flattened although the degree of flattening varies with the completeness of the injection. Sappcy (7) figures a mass of them running over the gall-bladder in a manner somewhat resembling Fig. 4, but he only mentions the fact that they bring in the lymph from the liver and deeper layers of the gall-bladder. In my preparations they run down eventually on the inner side of the gall-bladder but there is usually a large vessel coming from the same side, but with the exception of one specimen figured in Plate 2, .Fig. 4, which was believed to be pathological, are not as numerous as shown by Sappey.
 
 
 
In the subserous layer there is a network of lymph channels which empty into these larger vessels. See Fig. 7. This network is very irregular and the lymph channels vary markedly in size and shape. The picture of these lymphatics which seemed most normal was obtained by injecting carmine gelatin into the portal vein at a pressure of 80 mm. of mercury for fifteen minutes. This injects the lymphatics of the liver and in turn the larger ones over the gall-bladder, and finally these in the subserous coat in a more or less complete manner, but without any tearing or stretching of the vessels. In Fig. 2 they are represented as though the greater part lie simply on top of the subserous layer, while, as a matter of fact, they are scattered through it rather evenly.
 
 
 
The submucous sets of lymphatics are in the connective tissue just under the mucous membrane. However, they rarely run u]) into the connective-tissue folds but are at their lowest part or more frequently just at their base. The network is almost entirely absent in the denser muscular part. These were best seen by injecting aqueous Prussian-blue slowly under the mucous membrane and the injected portion was afterwards fixed and studied. In some cleared specimens the lymphatic vessels could be seen running up and joining the more superficial lymphatics of the subserous layer or directly one of the large superficial vessels as shown in Fig. 1. The lymphatic tissue belonging to this layer has already been described.
 
 
 
 
 
 
 
The nerve supply of the gall-bladder has been studied by Dogiel (8) and Ilubor {'.)) within recent years. The nerve supply is derived from two sources, viz., 1. tiie sympathetic system of ganglia and fibres connecting them, and 2. raedullated fibres accompanying the large arteries. In regard to the distribution of the sympathetic fibres Huber suggests from the condition prevailing in other viscera that they supply the blood-vessels and smooth muscle of the coat. Doyon thinks these are unable to act without receiving stimuli indirectly from the great splanchnic nerve. Dogiel has figured in a beautiful manner the kinds of cells found in the sympathetic ganglia and concludes that all the varieties found in the walls of the intestines occur here also. Quite a number of medullated fibres are also found near the large arteries. Both Huber and Dogiel have noted them. The former suggests that they are sensory fibres and are distributed to the mucous membrane. Their termination, however, has not yet been settled by direct observation.
 
 
 
Eefehences.
 
 
 
(1) Rud. Virchow: " Ueber das Epithet dcr Gallenblase imd tiber einen intermediaren Stoffwechsel des Fettes." Virchow's Archiv, Bd. 11, H. 6, 1857.
 
 
 
(2) Wm. F. Hendrickson: "A study of the musculature of the entire extrahepatic biliary system, including that of the duodenal portion of the common bile-duct and of the sphincter." The Johns Hopkins Hospital Bulletin, vol. ix, 1898.
 
 
 
(3) Maurice Doyon: "Etude analytique des organs moteurs des voies biliares chez les vertebretes," These sc. nat. Paris, 1894. An abstract of this article in Lehrbuch der Vergleich. Mikros. Anat. der AVirbeltiere, Albert Oppol, Jena, 1900.
 
 
 
(4) K. K. Helly: " Die Schliessmuskulatur an den Miindungen des Gallon und dcr Pankreasgiinge." Arch. f. Mikros. Anat. Bd. 54, 1899.
 
 
 
(5) E. Oddi: " D'une disposition a sphincter speciale de I'ouverture du canal choledoque." Arch. Ital. de biol. T. 8, Fasc. 3.
 
 
 
(6) George Emerson Brewer: " Some observations upon the surgical anatomy of the gall-bladder and ducts." Contributions to the Science of Medicine by the Pupils of Wm. II. Welch, 1900.
 
 
 
(7) C. Sappey: Description des vaisseaux ]yui]ihatiques. Paris, 1885.
 
 
 
(8) A. S. Dogiel: Ueber den Ban der Ganglion in den Geflecthen des Darmes und der Gallenblase des Menschen und der Saiigethiere. Archiv f. Anat. u. Phys., 1899.
 
 
 
(9) G. Carl Huber: Observations on sensory nerve-fibres in visceral nerves, and on their modes of terminating. Journal of Comparative Neurology, vol. x, No. 2, 1900.
 
 
 
DESCRIPTION OF PLATES XXV-X.XVI.
 
 
 
Fro. 1. — Tlio <!;[in-bUi(lder of a pig; natural size. Tlie lymphatics were injected by placing the needle just under the peritoneal covering of the liver near the edge of the gall-bladder at (.V). The blurred mass in the centre represents the injection mass showing through and the
 
 
 
 
 
 
 
THE JOHNS HOPKINS HOSPITAL BULLETIN, APRIL-MAY-JUNE, 1901.
 
 
 
 
 
 
 
PLATE XXV.
 
 
 
 
 
 
 
 
 
THE JOHNS HOPKINS HOSPITAL BULLETIN, APRIL-MAY-JUNE, 1901.
 
 
 
 
 
 
 
PLATE XXVI.
 
 
 
 
 
 
 
 
 
 
 
 
 
Fig. 4.
 
 
 
 
 
 
 
Fk:. h.
 
 
 
 
 
 
 
 
 
Fig. 6.
 
 
 
 
 
 
 
 
 
 
 
Fi(i.
 
 
 
 
 
 
 
Fig. S.
 
 
 
 
 
 
 
M. T. Suiller del.
 
 
 
 
 
 
 
Aphil-May-June, 1901.]
 
 
 
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
 
 
 
129
 
 
 
 
 
 
 
lymphatic vessel coming up from the deeper layer to join tlie large superficial one. X:= Needle of syringe.
 
 
 
Fig. 2. — Reconstruction of the wall of the partially contracted gallbladder of a dog, magniBed 60 times, showing the blood-vessels on the right and the lymphatic vessels on the left. Lymph follicles are shown on the right as two rounded eminences just under the epithelium. The vena comites shown is quite characteristic for the larger arteries. The large lymphatic vessel is shown partially collapsed.
 
 
 
Fio. 3. — Gall-bladder of adult man, showing superficial lymphatics. }4 natural size.
 
 
 
F[G. 4. — Gall-bladder of man 19 years old, dead of chronic nephritis, showing the large superficial lymphatics. This gall-bladder gave
 
 
 
 
 
 
 
evidence of having been through an inflammatory process, and so the lymphatics are probably abnormally numerous.
 
 
 
Fig. 5. — Gall-bladder of dog, showing the superficial lympliutic vessels. Natural size.
 
 
 
Fig. 6. — Section through the contracted gall-bladder of a dog, magnified 80 times, showing the arrangement into coats and the relations of the blood-vessels.
 
 
 
Fig. 7. — The lymphatics of the subserous layer of a dog. (Camera drawing.)
 
 
 
Fig. 8. — The lymphatics of the fibro-mnscnlar layer of a dog, showing their relation to the folds on its surface. These folds are represented narrower and less complicated than in the specimen in order not to hide the lymphatics. (Outlines made with the aid of a camera.)
 
 
 
 
 
 
 
REMARKABLE CASES OF HEREDITARY ANCHYLOSES, OR ABSENCE OF VARIOUS PHALANGEAL JOINTS, WITH DEFECTS OF THE LITTLE AND RING FINGERS.
 
 
 
 
 
 
 
By George Walker, M. D., Instructor in Surgery, Johns Hopkins Unircrsily.
 
 
 
 
 
 
 
Account.? of diverse abnormalities of the arms, forearms, hands, and feet, are to be found in literattire from the remotest medical history, and not a few books and monographs on these Yarious defects have appeared from time to time. Most of these reports comprise instances of polydactylism of various degrees; abnormal shapes of the metacarpal and phalangeal bones; absence of the jihalanges and carpal bones; increase in the number of the phalanges; absence of fingers; absence of the bones in the arm and forearm; abnormal sha]ies and lengths of the radius and ulna; lateral tminn of the jihalanges; union of the fingers by the soft parts, etc.
 
 
 
Two cases have recently come to my knowledge which have sufficient Ijearing on the ones herein reported to warrant a short synopsis of them in this paper.
 
 
 
The first was that of a child in which there was a lateral fusion of the first and second metacarpal bones of both feet. This was not supposed to be hereditary until the grandmother, upon examining her own foot, to show where the defect had occurred in the child, found her own bones in exactly the same condition. Although she was seventy years old, she had never previously noticed it.
 
 
 
The second case was that of a young girl whom I examined. There was a partial stiffening in tlie metacarpo-phalangeal articulation of the thumb; this was ligamentous, and not bony, and permitted a certain amount of motion, probably about one-half that of normal. This defect had occurred in one of her brothers, one uncle, her father and her grandfather. All of them were afl^icted in the same joint, and had about the same amount of motion.
 
 
 
The cases which I herewith report show either a complete bony ancliylosis or an absence of various Joints between the l>halanges, together with an absence of one or more bones of the little and ring fingers. As will be seen in the family tree, it has occurred in five generations. I have examined the cases so far as possible, and have made Koentgen photogra]ihs from four of them, thus representing two generations.
 
 
 
Thomas B. applied to the dispensary of the Johns Hopkins
 
 
 
 
 
 
 
Hospital for the treatment of leg ulcer. He was fifty-two years of age, well nourished and apparently well developed and healthy. On examination of his hands I found the thumb and index finger normal; in the ring and middle fingers nothing could be seen on inspection in the extended hand, contrary to the usual type, but on jialpation there was found an entire bony anchylosis of the second metacarpal joints of above fingers; the bony enlargements corresponding to the heads of the bones were present, and in the middle finger a distinct sulcus could be felt on the thumb side; other than this the enlargement was regular and smooth.- The terminal joints were negative. The little finger presented only two phalanges, there being, however, near the end of the first phalanx, a slight enlargement which possibly corresponded to a joint. The thumb was 7 cm. in length; first phalanx, 4 cm.; and second phalanx, 3 cm. The index finger, 8^ cm.; first phalanx, 3^ cm.; second, 3 cm.; third, 2^ cm. Middle finger, 9:^ cm.; first and second together, 7^ cm.; third, 1| cm. The first from basal joint to middle of enlargement, 4 cm.; the second, from middle of enlargement to distal joint, 3i cm. Ring finger, 9 cm.; first and second phalanges, 6-^ cm.; third, 2^ cm. Little finger, 6 cm.; first phalanx, 3} cm.; second, 2^ cm. The left hand presented nearly the same appearance, and on cai'cful palpation and measurement the only difference found was that in the little finger, first phalanx, there was a slight bowing, making a palmar concavity toward the end. This was due, according to the statement of the patient, to an old fracture. Tlu^ enlargement at this site, as is shown in Eoeutgen Photograph No. 1, is very much greater than ift the other hand, and suggests that it had probably i)een caused by trauma; in the other finger the enlargement can be seen, but to a much less degree, thu?? making it doubtful whether there is an obliterated joint, or the absence of the middle phalanx. The metacarpals were of normal length and their articulations were negative. The carpus was negative. The feet presented nothing abnormal, except a slight giving way of the arch. The other parts of
 
 
 
 
 
 
 
130
 
 
 
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
 
 
 
[Nos. 131-133-123.
 
 
 
 
 
 
 
the osseous s_ystem were well developed and did not differ from the usual types. The patient stated that the deformity gave him very little inconvenience, and did not interfere with his work. Both the above hands are shown in Eoentgen Photograph No. 1.
 
 
 
On being questioned in regard to his family history, he said that his father, grandfather and great-grandfather were similarly affected. The middle joints of all his father's fingers were stiff; the defect in the grandfather and great-grandfather was known to have existed, but the e.xact nature could not he determined. He had three uncles and one aunt; two of the uncles he thought were affected, but was not certain; the other uncle and aunt were free. In his immediate family there were four brothers and one sister. One brother and the sister had negative hands; the otber three brothers ])resented the family trait. He had four children, all of whom were free. His younger brother had had three cliildren, two dead and one living, none of whom were affected. His elder brother had eleven children; four of them, two boys and two girls, had the defect. I have visited and examined the two brothers and their families, and I give in the following a report of said examination.
 
 
 
Henry B., the younger brother of the above described, is a gardener, 48 years old; a strong, well built, healthy man; five feet eight inches in height and weighs 148 pounds. Both hands are affected. Right thumb, negative; length, 7 cm.; first phalanx, 4 cm.; second phalanx, 3 cm. Index linger, length, G| cm.; first and second, 5 cm.; third. If cm.; the first Joint is normal, second is stiff, distinct bony enlargement at site of joint, slight sulcns on thumb side. Middle finger, 2^ cm.; first and second phalanges, 7^ cm.; third, 2 cm.; first from basal joint to middle of enlargement, 4^ cm.; first joint is negative, the second is stiff with rounded, smooth, bony enlargement; no sulci. Ring finger, 8| cm.; first and second, 6| cm.; third, 3 cm.; first joint is negative, second anehylosed, bony enlargement not so marked. Little finger, 5^ cm.; first and second, 3f cm.; third, 1^ cm.; the first joint completely stiff, second negative, metacarpal bones and carpus negative. Other hand presented same appearance and nearly the same measurement. Feet and remainder of bones in the body did not differ from normal.
 
 
 
William B., elder brother, very strong, hale, robust man, 58 years of age, 5 feet 11 inches in height, weighed 172 pounds. Both hands affected, as shown in Eoentgen Photograph No. 2. Middle joint, ring and middle finger and both joints in little finger stiff. Thumb and index finger normal, remainder show absence of middle joints. Length of thumb,
 
 
 
7 cm.; first phalanx, 4i cm.; second phalanx, 2^ cm. Index.
 
 
 
8 cm.; first phalanx, 3| cm.; second, 3 cm.; and third, H cm. Joints all negative. Middle finger, 9^- cm.; first and second phalanges, 7i cm.; third, 2 cm. The first joint completely anehylosed, distinct thickening at joint site, with small depression. Ring finger, 9 cm.; first and second, 7 cm.; third, 2 cm.; first joint site presents nsual bony enlargement, but no joint was present; second joint negative. Little finger, 5i cm.; slight palmar concavity, comjilcte anchylosis of lintli
 
 
 
 
 
 
 
joints; 1^ cm. from the end there is a slight enlargement with furrow in middle at joint site, but no motion; the first joint is also completely immobile. The metacarpals are normal in length, size and articulation; the carpus is negative. The left hand does not differ in essential characteristics from the one described. The feet presented no abnormality.
 
 
 
The patient stated that he had worked at the same bench with two men for fifteen years, and they had never noticed the defect. He had eleven children in his family, four of whom were affected; the others had perfect hands.
 
 
 
I have seen most of the children of the above described, and the following is the condition of the four wlio are affected.
 
 
 
Sallie B., aged seventeen, rather poorly developed, tall ami slim, height five feet six inches, weight 115 pounds, both hands affected, as shown in Roentgen Photograph No. 3. Thumb and index, free; right hand, thumb, 6 cm.; first phalanx, 3|- cm.; second phalanx, 2^ cm.; joint normal. Index finger, 7 cm.; first phalanx, 3 cm.; second, 2| cm.'; third. If cm.; both joints negative. Middle finger, 8^ cm.; first and second, 6| cm.; third, 2 cm.; complete anchylosis fir.st joint, second joint is negative. Ring finger is represented only by the first plialanx, which is 4 cm. in lengtli. The distal end is slightly enlarged, and tapers towards middle finger. The little finger is represented also by only first phalanx, 3| cm. in length. It presents same shape of enlargement at distal end as ring finger. The left hand is the same as right, except that- the middle joint of the index finger is anehylosed. In these hands, notably in the left one, there is a distinct crowding together of the metacarpals, being most marked in the fifth, which, as shown in the photograph, decidedly overlaps the fourth. The carpi are negative; the remainder of bones apparently normal. The feet were not examined, but according to the statement of the patient they presented no abnormalities.
 
 
 
Carrie B., aged fifteen, rather strong and robust, weight one hundred and seventeen, five feet four inches in height. I was unable to procure a photograph of this hand on account of the unwillingness of the patient. Both hands are affected, and very similar to those of her sister, as above described. Right hand, thumb and index finger, normal. Ring and little fingers of both hands, as in the case of her sister, present only one phalanx, that of the ring finger is 4 cm. in length, and that of the little, 3 cm.; the distal ends are slightly enlarged, and according to palpation are like her sister's. In the other hand the index finger is anehylosed at the middle joint, and the middle finger presents a striking peculiarity in that the anchylosis is in the second joint, the first being free.
 
 
 
Henry B., a picture of whose hand I was unable to obtain, but upon examination found the following conditions:
 
 
 
Not very robiTst, tall and slim, age fifteen; height five feet six inches, weight one hundred and twenty pounds, both hands affected. Index and thumb in both negative, remainder affected. Thumb, right, 5| cm.; first phalanx, 3 cm.; second phalanx, 2| cm.; joint negative. Inde.x, 7| em.; first phalan.x, 3 em.; second, 2^ cm.; third, 2 cm.; phalanges normal in size, and ioints negative. T\Tiddle finger, 8.', cm.; first and second
 
 
 
 
 
 
 
April-May-Junk, 1901.]
 
 
 
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
 
 
 
131
 
 
 
 
 
 
 
]ihalanges, 6^ cm.; third, 2^ cm.; first joint is stiff with distinct bony enlargement, and slight depression between heads of bones; second joint is negative. Ring finger, 8 cm.; first and second, 6 cm.; third, 2 cm.; first joint is anchylosed, second is negative. Little finger, 5^ cm.; first phalanx, 4 cm.-, middle is absent; the third, 1| cm. There seems to lie an entire absence of the second phalanx; the first is normal and presents no enlargement which might correspond to a joint. The left hand differs in one particular from the above described, in that the terminal phalanx of the little finger is turned inward toward the ring finger, and forms an angle of 135 degrees with the second phalanx. The metacarpals and carpi are negative. The remainder of the bones present no defects.
 
 
 
George B., aged seventeen, height five feet six inches, weight one hundred and fifteen jiounds, rather poorly developed, slightly anemic. J'>oth hands shown in Roentgen Photograph No. 4. Right hand, thumb, G cm.; first phalanx. '■Vj cm.; second, 2} cm., joint, normal. Index finger, 7 cm.; first and second, 4^ cm.; third, 2^- cm.; first joint site shows normal enlargement, but is stiff; second is negative. Middle finger, 8 cm.; first and second, G cm.; third, 2 cm.; first joint completely anchylosed; second, negative. Ring finger, TJ cm.; first and second, 5-i cm.; third, 2 cm.; first joint stiff; second, negative. Very slight enlargement at first joint site. Little finger, 5 cm.; first, S^ cm.; second, absent; third, l-J- cm. .Iiiint is negative; first phalanx is normal in length and shajK'. (liei'e Ijeing no enlargement nor anything to suggest an anchylosed joint. Jletacarpals and carpi negative. The other lianil [iresented the same apiiearance. The remainder of the liiidy negative.
 
 
 
In ]ienising the literature bearing on these subjects, I have round only a few similar cases reiioi'ted, none of them being so marked as mine, and only one was hereditary.
 
 
 
Klausner, in a rather exhaustive monograph on various deformities of the arm and band, reports a case in which the anchylosis was present in the second phalangeal joint of the index finger; the hand was very much deformed otherwise, aiul the fingers partly webbed. There was no hereditary history, nor were any other members of the family so affected.
 
 
 
Wolf, very recently, has put on record an anchylosis of the second phalangeal joint of the little finger. In this case the middle phalanx was very much shortened and was joined to the first by a bony union at an angle of about 14.'J degrees. The terminal phalanx was apparently normal. This anchylosis had occurred in four generations, and was in-esent in eight instances. Some of them were inherited from the father and others from the mother. The same joint of the same finger was affected in every case; the remainder of the hand was normal; there is no record of any other defects in the body; the condition of the pectoral muscles is not mentioned. The fingers in the cases of both Klausner and Wolf are shown by Roentgen photographs.
 
 
 
E. Stintzing reports a case of a very much deformed hand in which there was an almost complete anchylosis in the second joint and partial in the first. In this case the fingers
 
 
 
 
 
 
 
were webbed; a diminution in the leUgth of several of the nuddle phalanges and a defect in the right pectoralis major muscle.
 
 
 
J. Sklovowski relates an instance of a defect of the sternum, pectoralis major and minor muscles, and a portion of the back muscles, together with an absence of the second, phalanx in the second and third fingers; a shortening of the other ])halanges, and a limitation of movement in nearly all of the phalangeal joints, with a complete anchylosis of both joints in the fourth finger.
 
 
 
Hoffman describes a deformity occurring in a man 48 years of age, in which there was a stiffening in one or more lihalangcal joints, and a shortening of the middle phalanx of the middle finger. In the index finger the middle phalanx was small and completely fused with the third [ibalanx. There was also webbing of the finger?, associated with muscular defects in the chest and back muscles.
 
 
 
Fuerst gives an accurate account of a hand whieli was examined after death by a very careful dissection. In this hand there was great shortening and malformation of the middle phalanx of the middle and ring fingers. There was no anchylosis in any. In all of the above cases, with the exception of the last, the observations have been made on the living subject, and usimlly by palpation alone.
 
 
 
With the exception of the two girls in the ])resent generation of the cases which I herewith report, none of the females have heretofore been affected, and in them appeared the only instances in which the terminal phalanges were absent. There is another striking difference in one of them, as is shown in the Roentgen Photograph No. 2, in the partial overlapping of the fifth metacarpal bone, which suggests the )iossibility that continued transmission might produce a fusion, or an absence of one of these bones.
 
 
 
From the above it will be seen that the defects have existi'd in five generations, and have been confined entirely to the hands, the i-eniaining osseous system pi-esenting no peculiarities. Except in the )u-esent generation the hands have been otherwise nornuil. The first dejiarture from this was in the case of the boy. Roentgen Photograph No. 4, where there isau absence of the middle phalanx of the little finger; while in both of the girls, as is shown in one by the Roentgen Photograph No. 3, the end and the middle phalanges of the middle and ring fingers are absent. There is also a partial obliteration of the distal enlargement of the remaining phalanges.
 
 
 
By a study of the photographs, one can see that there is undoubtedly a bony union and not a filn-ous anchylosis in the joint sites. The enlargements corresponding to the heads of the bones are plainly to be seen and felt, but the joints arc absolutely unformed. In a number, small sulci could be palpated, corresponding to the normal depression between the heads of the bones. The jihotographs also show that there is a certain porosity at the joint sites, which seems to be more than normal.
 
 
 
The question arises whether these are cases of entire absence of the joints, or of early anchylosis. The two phalanges are about the normal length, and there is a distinct enlarge
 
 
 
 
 
132
 
 
 
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
 
 
 
[Nos. 121-122-123.
 
 
 
 
 
 
 
uioiit coiTospoiuling to the metacarpiil lioads, with small sulci between some of them, but other than this there is no evidence whatever of an attempted Joint formation. In view of the fact of a complete bony union, it appears best to consider them as cases of an absence of the joint rather than of an anchylosis. It has been suggested that probably the ancliylosis may have occurred after birth as the result of some disease; but according to the statements of the motliers of these various children, it was a congenital defect. A careful examination of the other bones failed to show any abnormal conditions or diseases, and the history of lues was not present.
 
 
 
The examination of the arm shows a fairly good muscular development, and so far as could be made out there was no atrophy of the flexor sublimis digitorum. The muscles of the hand were also well developed and the thenar and the hypothenar eminences were apparently normal. There was an exception to this in the hand of the girls, where there was found a rather poor development of the hand muscles, which was most notably marked at the hypothenar eminence.
 
 
 
The palmar folds in the hand were normal, but in the skin over the anehylosed joints they had become nearly smoothed out; the two normal croasings being scarcely discernible.
 
 
 
The epiphyses were all joined; which was unfortunate as otherwise some light might have been thrown on .the bony development.
 
 
 
In nearly all of the reported cases there have been defects in the back and breast muscles; the most striking examples of which were found in the pectoral region. The cases which I herewith report presented no such abnormality, and showed upon examination a completely developed condition of the muscles of the arm, shoulder and back. In all the instances the feet were negative.
 
 
 
These cases are in striking contrast to the generally accepted opinion that deformities of the hands and feet arc transmitted by the mother, for in each of those in this series it came through the father, the mothers having all been normal. It is most interesting to note that in each generation only one male member has transmitted the deformity to his offspring.
 
 
 
The occupations of tlic individuals were very little interfered with; the only inability complained of was that of being unable to grasp small articles with the whole hand. The deformity, except in the cases of the two girls, was not at all striking, and unless one carefully inspected the hands it would be overlooked, and even in shaking hands it was not noticeable.
 
 
 
Shortening of the Phalanges.
 
 
 
In my cases, as well as in most of the above-reported ones. there has been a decided shortening of one or more of tlic phalanges. It has been in nearly every instance most stiikingly observed in the middle phalanx with a certain predilection for the little finger.
 
 
 
In discussing such cases, Fuerst states that in nearly all of these defects the shortening is seen in the middle phalanx. and he ascriljes it to the fact that in embryologic development the middle phalanx is the last to become bony. This
 
 
 
 
 
 
 
occurs when the embryo is about 8 centimeters in lengtli. and he thinks that at this period the deformity commences. From observations of his case, and a study of certain others, he concludes tluit the shortening and anchylosis are stages in fusion of the first ajid second bones. The shortening represents the first stage; the anchylosis the second stage, and the whole phalanx the third stage.
 
 
 
Tliis theory does not seem to be based upon sufficient observation, nor is there enough evidence in the studied cases to justify any such assumption.
 
 
 
In my cases, as is shown in tbc photograjihs, there is no shortening at all in the ]ihalanges of the second and third fingers, although a com])lete anchylosis exists; this would stand directly against the theory which Fuerst has advanced. In the little finger, however, there is some evidence for the liypothcsis, for in the second generation there is present a diminution in the phalanx, then an anchylosis, and finally, in the case of the boy, the joint has entirely disappeared, and there remain only two normal phalanges.
 
 
 
A very distinct and decidedly unique type, so far as the above-mentioned cases are concerned, is to be seen in the hand of the girl; for in this case the end and middle phalanges have entirely disappeared, and have left the first phalanx only partially developed. The diminution and absence of the end phalanx were not noted in the other reported cases, and can not be explained on the ground of the late bony development.
 
 
 
The little finger first shows a beginning defect, and in the case of Thomas B., Eocntgen Photogi'aph No. 1, left hand, the first phalanx is long, somewhat curved, and presents a slight enlargement which probably corresponds to a joint site. The middle phalanx then will be represented by a small bone about H cm. in length. In the case of the nephew there are certainly only two phalanges; and in each of the girls only one is present, and the defect has extended to the ring finger.
 
 
 
Thanks are due to Dr. Finney for ]iermi.ssion to re])iirt these cases. I am also indebted to Professor W. A. S. HamUK^l for the care which he gave to the preparation of the photographs.
 
 
 
Literature.
 
 
 
Wolf: Ifucnchener niedicinische Wochenschrift, Mai '21), 1900, No. 22.
 
 
 
R. Stintzing: Dcr angeborene und crworbene Defect dcr Rrustmuskeln, zugleich ein klinischcr Beitrag zur progrcssivcn Muskelatrophie. Deutsches Archiv fiir klinische Mcdicin, 15 Bd., 1889.
 
 
 
J. Sklodowski: ITebcr cineu Fall vtm angeborencin I'echtsseitigem Mangel der M. pectoralis major et minor uiit gleichzeitigen Missbildungcn der rechtcn Hand. Archiv fttipath. Anat., etc., von E. Virchow, Bd. 121, 1890, 1.
 
 
 
Hoffman: Ein Fall von angeborenem Brustmuskeldefect niit Atrophic des Amies und Schwimmhautbildung. Virchow's Archiv, Bd. IIH, 189fi, S. 163.
 
 
 
Fuerst: Zeitschrift fiir Morphologic und Anthropologic. Band II, Heft 1, 1900.
 
 
 
 
 
 
 
THE JOHNS HOPKINS HOSPITAL BULLETIN. APRIL-MAY-JUNE, 1901.
 
 
 
 
 
 
 
PLATE XXVII.
 
 
 
 
 
 
 
 
 
Fig. 1.
 
 
 
 
 
 
 
 
 
Fig. 2.
 
 
 
 
 
 
 
THE JOHNS HOPKINS HOSPITAL BULLETIN, APRIL-MAY-JUNE, 1901.
 
 
 
 
 
 
 
PLATE XXVIII.
 
 
 
 
 
 
 
 
 
Fig. :!.
 
 
 
 
 
 
 
 
 
Fio. i.
 
 
 
 
 
 
 
April-May-June, 1901.]
 
 
 
 
 
 
 
JOHNS HOPKINS HOSPITAL BULLETIN.
 
 
 
 
 
 
 
133
 
 
 
 
 
 
 
Thomas B., Known to be aflectt-d.
 
 
 
Charles B., son.
 
 
 
Known to be utt'ected.
 
 
 
Exact condition unknown.
 
 
 
 
 
 
 
Charles B., (iraudsuu. Unknown.
 
 
 
 
 
 
 
John B., Grandson.
 
 
 
Both hands, middle joint,
 
 
 
all tinners.
 
 
 
 
 
 
 
Susan B.,
 
 
 
Granddaughter.
 
 
 
UnalTected.
 
 
 
 
 
 
 
C'HAiiLES B., Grandson. Unknown.
 
 
 
 
 
 
 
William B.,
 
 
 
Great-trrandson : Both hands, rintt, middle and little lingers. First joint.
 
 
 
Sallie B., I
 
 
 
Great-jrreat-granddaui; liter. Both hands, inde.x and middle linger. King and little linger, one i)halan.\ only.
 
 
 
Carkie B.,
 
 
 
(i reat-great-granddaughter. Both hands; middle linger, tirst and second joint, right hand. Iude.\ and middle, Urst joint, left hand. Ring and little linger, one phalanx.
 
 
 
George B.,
 
 
 
Great-great-grandson. Botli hands, inde.x, ring and middle fingei, first joint;
 
 
 
ihsenee phalanx middle linger. Henry B,, Great-great-grandsou. lioth hands, ring, middle and little linger, tirst joint.
 
 
 
Joseph B., UnalTected.
 
 
 
Caleb B., Unallected.
 
 
 
Edith B., Unatl'ected.
 
 
 
George B., Unaffected.
 
 
 
JOSEI'II B.,
 
 
 
Unaffected.
 
 
 
Susan B., Unaffected.
 
 
 
Charles B., Unaffected.
 
 
 
 
 
 
 
Thomas B,,
 
 
 
Great-grandson.
 
 
 
Both hands, ring,
 
 
 
middle and little linger.
 
 
 
Middle joint.
 
 
 
Jennie B., Unaffected.
 
 
 
Marv B., Unaffected.
 
 
 
John B., Unaffected.
 
 
 
William B.,
 
 
 
Unaffected.
 
 
 
 
 
 
 
Henry B., Great-grandson. Both hands, middle and ring linger. Middle joint.
 
 
 
Charles B., Unaffected.
 
  
Joseph B., Unaffected.
 
  
Margaret B., Unaffected.
 
  
 
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Long M. On the development of the nuclei pontis during the second and third months of embryonic life. (1901) Johns Hopkins Hospital Bulletin 12: 123-126.

Carnegie Collection: 45, 75, 86, 95

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On the Development of the Nuclei Pontis during the Second and Third months of Embryonic Life

By Margaret Long.

[From the Anatomical Laboratory of Johna Hopkins Vnu'erxitij.)

This work was undertaken in the fall of 1899 at the suggestion of Doctor Barker, and has been carried out with his assistance. The specimens used are human embryos and were very kindly lent by Doctor Mall from his collection.

  • The numbers of the embryos correspond with their numbers in the embryological cabinet of the Anatomical Laboratory of the Johns Hopkins University.


The following embryos are described in the order of their probable age, as estimated by their length and by the develojiment in the rhombencepbalon. The arrangement of the cerebral nerves and the general appearance of the medulla oblongata agree with the His models and with the description given by His in "Die Entwicklung des menscblicben Kautenhirns"; a description of these is accordingly unnecessary. Each embryo has been studied in serial sections and from tliese sections a few, at different stages of development,. have been selected as characteristic of the structure of the pons, its nuclei and fibres. To make the work complete it will be necessary to study more embryos at intermediate stages between the five given here, and others from the third montli up to the adult pons.


Embryo No. LXXV {{{CE75}}} is 30 mm. long and has been cut into serial sagittal sections. The nuclei, whiuli I have designated as " B," " C," " D," " E " and " H " in the various sections, are masses of cells distributed through the ventral part of the mantle layer (Mantelsehicht of His) at or near the level of the pontal flexure. The most medial of these nuclei extend to within 0.7 mm. of the middle line. An unstained fibre bundle can he .seen on the surface of the rhombencephalon ventral to the mantle layer throughout its entire length.


Section No. 73 is 2.1 mm. to the left of the middle line (Fig. 1). Near the ventral surface on the cerebral side o.f the nervus trigeminus is a well defined cell-mass, '" B.' On the ventral surface opposite the nervus acusticus is a deeply stained cell-mass, " IT," which (wlien followed in the series) is seen to extend lateralward and spinalward to the floor of the fourth ventricle at the Junction of the latter with the telachorioidea. The section of the mantle layer presents longitudinal striations which have a slight ventral convexity. A few of these strands are more deeply stained than th.e rest between the level of the N. trigeminus and that of the N. acusticus. The dark ependymal epithelium and the unstained ventral fibre bundle are evident.

Section No. 91 is 1.2 mm. to the left of the middle line. On the ventral surface of the pons is a delicate shell or mass of cells, " H," continuous lateralward with " H " of the previous section. Between it and the mantle layer is the ventral fibre bundle. Dorsal from " A " is a cell-mass, " C," partially subdivided by a few colorless dorsoventral stripes; ventralward and cerebralward from " C " is another mass, " D," and still more cerebralward and dorsalward are two small deeply stained cellular masses, " E." The mantle layer of the medulla oblongata is deeply stained. It contains a diamond-shaped mass, " S," spinalward from " C," the longitudinal striations mentioned in the previous section, and an unstained dorsal filire bundle (DF).

Section No. 96 is 1.05 mm. to the left of the middle line. "H" and "C" are still present. The ventral fibre bimdle passes partly along the dorsal surface of "H" and partly between " C " and " E." Just cerebralward from the pontal flexure, close to the floor of the ventricle, is " M, an oval mass of cells witli a clear unstained area behind at its spinal end, and measuring 0.8 mm. in transverse diameter. The appearance of the mantle layer is the same as before. In its dorsal and cerebral part is seen an unstained dorsal fibre bundle.


Embryo No. LXXXVI (86) is 30 mm. long and has been cut into serial coronal sections. There is ventralward a definite mass which I have designated as the nucleus pontis ventralis; it is about 1 mm. long by 3 mm. wide. The raphe enters this nucleus in the middle line. Dorsal from its lateral part are several scattered masses which 1 have designated, tentatively, the nuclei pontis dorsales. The unstained ventral fibre bundle is dorsal from the nucleus pontis ventralis.


Section No. 175 is spinalward from the masses mentioned. On the ventral surface medialward from the nervus acusticus (-A^.l ) is the cell-mass " H." Followed through the series this cell-mass extends spinalward, dorsalward and lateralward to the ependymal epithelium of the fourth ventricle; cerebralward, it is medial to the nervus trigeminus and continuous with the nucleus pontis. Taken in order from the raphe lateralward in the mantle layer are the nucleus olivaris superior (8) and the superior olivary complex {S}, the ascending and descending parts of the root of the nervus facialis, the nucleus nervi facialis {NNP), and the corpus restiforme {OR). On the floor of the fourth ventricle are the nucleus nervi abducentis (NNA) and the nucleus N. vestibuli (radicis deseendentis), {III? I'D); further lateralward are the nuclei N. cochleae, namely the nucleus N. eochleffi dorsnlis (NRCD) and the nucleus N. cochlea; ventralis (NNCV). The unstained area is the ventral fibre bundle (I'-P') Section No. 184 is 0.45 mm. cerebralward from the preceding section. In the mantle layer are seen in order the nucleus olivaris superior, (S), the nucleus nervi facialis (NNF). and parts of the ascending and descending limbs of the nervus facialis. "H" is on the ventral surface lateral from tlie nervus facialis. On the floor of the fourth ventricle is the nucleus N. vestibuli medialis et radicis descendentis (NNV).

Section No. 202 is 0.9 mm. cereliralward from section 184. The nucleus pontis ventralis reaches lateralward as far as the nervus trigeminus. In the middle line the raphe extends from the nucleus pontis to the ependymal epithelium. The nuclei pontis dorsales consist of several irregular masses, " A," " B," " C," and " E," and a more ventral and lateral mass. " D." These nuclei extend through the pons for a distance of 0.5 mm. in the cerebrospinal diameter. Between these ventral and dorsal nuclei is the unstained ventral fibre bundle. Lateral from the nervus trigeminus are the nucleus nervus trigeminus ascendcns and an unstained area.

Embryo No. XLV (45) is 28 mm. long, and has been cut in serial sections, which divide the pons in an oblique direction in the following way: Instead of corresponding to the transverse diameter of the pons the left side of each section is further spinalward than the right side of the same section. The ventrodor.sal plane of the section is also oblique, so that in each section the left half of the dorsal surface is the more lateral, but in the right half of the pons the dorsal surface is more medial than the ventral. In other words, the first section removes a small portion of the pons about the cerebral ventral corner on the left side, and at the dorsal-spinnl angle on the right side.

The nucleus pontis, as seen in this series, is on the surface of the rhombencephalon and follows the curve of the pontal flexure so that it is crescentic in shape, with a ventral convex surface and cerebral and spinal ends or horns. Consequently the following sections may have a ventrocerebral, a ventral, a veutrospinal and a dorsal edge.


PLATE XXI.

Fig. 1. — Section through the pons of embryo LXXV, oO mm. lous; X 1.5 diameters.


Fig. 3. — Section No. 91 of embryo LXXV, x 1.5 diameters.


Fig. 3.— Section No. 90 of embryo LXXV.


Fig. 4. — Section No. 17.5 through the brain of embryo LXXXVI, oO mm. long, x 15 diameters.


PLATE XXII.


Fig. 5. — Sectiou No. 1.S4 through embryo LXXXVI.


Fig. (i,— Sectiou No. 302 through embryo LXXXVI


Fig. 7. — Section No. KIO through embryo XLV, x lo duimeters.


Fig. 8.— Section 142 through embryo XLV.


Fig. 9. — Sectiou 14.5 through embryo XLV.


PLATE XXIII.


Fig. 10. — Section No. 92 through embryo XCV (95).


Fig. 11.— Section No. lUO through embryo XCV (95).


PLATE XXIV.


Fig. 13.— .Section No. UIC. through eniliryo XCV (95).


Fig. 13.— Section No. lOS through embryo XCV (95).




The nucleus pontis ventralis is a solid mass of cells continuous with the raphe. The nucleus pontis dorsalis ia divided into right and left halves not continuous in the middle line. The ventral fibre bundle passes between the ventral and dorsal nuclei except at their extreme lateral parts, where the cerebral ends of the two nuclei are united.

Section No. 13G is 0.05 mm. to the right of the middle line. On the right side the nucleus pontis ventralis is separated from the raphe by the ventral liljre bundle and nucleus extends across the middle line. On the left side the two ends of the nucleus pontis dorsalis are separated from the raphe by the ventral fibre bundle and mantle layer. On the veutrospinal surface at the level of the nervus facialis is a deeply stained mass of cells, " H." This mass is continuous opposite the nervus trigeminus with the nucleus pontis; spinalward, dorsalward and lateralward it extends to the ventricular epithelium of the medulla oblongata. In the medulla is a cell-mass, " T," on the medial side of the corpus restiforme. and reaching from the fourth ventricle to the ventrospinal surface. Between " T " and the nucleus pontis dorsalis is a small round mass, " S," a little more deeply stained than the rest of the mantle layer.

Section No. 143 is 3.5 mm. to the left of the middle line and shows only the left side of the pons. Between the nuclei pontis is the ventral fibre bundle. The nucleus pontis dorsalis is in the mantle layer; in its spinal end is a small unstained space. On the ventrospinal surface is the uuiss " H." Medial from the corpus restiforme is a round, deeply stained area " S." Near the fourth ventricle are several dark masses just like those in section 136.

Section No. 145 is 0.4 mm. to the left of the middle line. The nuclei pontis ventralis and dorsalis are continuous at their cerebral ends. Between them is the ventral fibre bundle. Opposite the radi.x N. cochleae is " H," and median from it a cylindrical-shaped area. Between the cerebellum and the pons is an unstained area, the corpus restiforme.

Embryo No. XCV (95) is 46 mm. long and cut into serial sagittal sections. The nucleus pontis is a solid mass of cells on the ventral surface of the pons, which has increased in size and measures 3 mm. in cerebrospinal, 4.6 mm. in transverse, and 0.5 mm. in ventrodorsal diameter. The ventral fibre bundle divides into two masses, the larger passes dorsal to the nucleus, the smaller through it.

Section No. 93 is 0.3 mm. to the left of the middle line. The nucleus pontis is a solid nuiss of cells. Dorsal from it is a dark wedge-sluiped area; its ventral surface reaches as far as the nucleus pontis and extends 0.4 mm. beyond the middle line on each side, the dorsal surface is continuous with tlie ependymal epithelium in the middle line and for a distance ol 0.3 mm. to the right. This area contains ventrodorsal markings, and small masses of cells staining more deeply than the rest of the tissue of the wedge between them. On the floor of the fourth ventricle just cerebral from the pontal flexure are two dark round cell-masses, " M," which extend through a few sectjons on either side of the middle line, but in the middle line are overlapped by the greatly thickened ependymal ejiitlielium. On the ventral surface of the medulla oblongata is the ventral fibre bundle. Near the dorsal surface cerebral from the pontal flexure is the dorsal fibre liundle. The mantle layer contains the curved longitudinal striatiou, and in the isthmus is more deeply stained than in the medulla, and also contains blood-spaces. Next the epen(lynuil cpitlielium the mantle layer of the medulla [iresents a unit'onn appearance, and in the isthmus it contains several darker masses ol' cells.

Section No. lOO is 0.6 mm. to the right of the middle line. The s]>iiwl portion of the nucleus pontis is divided into ventral and dorsal parts by a clear area, containing a few dark strands composed of cells. " M is still present; between it and the nucleus pontis are several small cell-masses. The ventral fibre bundle is on the surface of the medulla and next the dorsal side of the nucleus pontis. The mantle layer contains the curved longitudinal striatiou and blood-spaces. Between the dorsal fibie bundle and the ependymal epithelium arc numerous dark cell-masses.


Section No. 106 is 1 mm. right of the middle line. The nucleus pontis is more unevenly stained. Its cerebral end is divided into ventral and dorsal parts by an unstained area, which is continuous with the ventral fibre bundle. The fibre bundle extends the entire length of this section. It is now seen that this fibre bundle has an oblique direction through the cerebrolateral and spinomedial portion of the rhombencephalon. The appearance of the mantle layer is the same as in the preceding section; between the nucleus pontis and the nucleus olivaris a foAV of tlie curved striations are more deeply stained than the rest, S."

Section No. 108 is 1.4 mm. to the left of the middle line. The nucleus pontis is a smaller mass, unevenly stained owing to the presence of large numbers of white spots (nerve-fibres). Dorsal from it is the ventral fibre himdle. The mantle layer appeal's as before but the mass " M " is not present. Between the nucleus pontis and the nucleus olivaris are a few small cell-masses, and several more are scattered throughout the mantle layer of the isthmus.


Embryo No. XCVI (95) is 48 mm. long and cut into serial sagittal sections. The nucleus pontis has increased in the ventrodorsal diameter. The appearance of this specimen is almost identical with that of No. XCV, and is only of interest because it corroborates what was found there. So I have not thought it necessary to add illustrations. Just spinal from the nervus trigeminus the nucleus pontis is continuous with a mass of cells which reaches to the ependymal epithelium of the fourth ventricle. The ventral fibre bundle passes partly along the dorsal surface of the nucleus pontis and partly through it. Among the latter fibres are a few scattered strands of cells resembling more the appearance of the pons at later stage. The wedged-shaped area and the cell-mass appear as before.


The histological structure of these specimens is as follows: The ependymal epithelium contains large, dark, densely packed, round and oval cells. The mantle layer in the earlier stages consists of round cells and a few oval cells. In embryo No. LXXV an unstained fibrous network is seen and the round cells are scattered through it, which in No. LXXXVI and No. XLV are more closely packed together. In the older specimens neuroblasts of the mantle layer point in various directions, a good many of them direct their axones ventralward, and many roimd cells are still seen. Most of the neurolilasts are now arranged in definite groups; between them is an unstained fibrous network which contains spongioblasts. Both the nucleus pontis and the mass " M " are composed of round cells in all the sections. The mass " H " consists of round cells, resembling in size and staining reaction those of the ependynial epithelium. The raphe appears in two specimens; it consists of filjres which interlace across the middle line, round cells, ami in the frontal sections a few oval cells with their long axis transversely directed. In sagittal sections the raphe is not seen; its fibres, if present, would be cut in cross-sections.

Summary

The main nucleus pontis is situated on the ventral surface of the rhombencephalon at the level of the pontal flexure. In the specimens the nuclei pontis are first seen on the surface and in the ventral part of the mantle layer of the lateral part of the pons Varolii. Ventral to all, in this early stage, except the mass of cells " H," is the ventral fibre bundle. In the second embryo the nucleus pontis ventralis extends across the middle line of the rhombencephalon and the nuclei pontis dorsales are separated from its lateral part by the ventral fibre bundle. The nuclei pontis dorsales next form two solid masses, reaching almost to the middle line. They are still separated by the ventral fibre bundle from the nucleus pontis ventralis, except at the extreme lateral ends, where they are continuous with each other. Next the nucleus pontis becomes a solid shell on the ventral surface cut by a .small branch from the ventral fibre bundle. After the sixth month the pons consists mainly of fibres and scattered groiips of cells which increase at the expense of the dorsal part of the nucleus, while a narrow ventral nucleus or eell-nuiss is left on the surface.


The neuroblasts of the pons are continuous with the epithelium of the floor of the fourth ventricle:

  1. By the cell-mass " H " at the lateral end of the nucleus pontis.
  2. By the round cells in the rajjhe.
  3. In the middle line by the neuroblast in tlie wedge, which connects both the ependymal epithelium and the cellmass " M " w ith the nucleus pontis.



Cite this page: Hill, M.A. (2020, April 8) Embryology Paper - On the development of the nuclei pontis during the second and third months of embryonic life (1901). Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Paper_-_On_the_development_of_the_nuclei_pontis_during_the_second_and_third_months_of_embryonic_life_(1901)

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