FUNCTIONS OF THE SPINAL CORD. 637 



light on this interesting question from the phenomena of disease. A most 

 valuable collection of such cases, occurring within his own experience, has 

 been published by Dr. W. Budd; 1 and the leading facts observed by him 

 \vill be now enumerated. 



504. In the first case, Paraplegia was the result of angular distortion of 

 the spine in the dorsal region. The sensibility of the lower extremities was 

 extremely feeble, and the power of voluntary motion was almost entirely 

 lost. " When, however, any part of the skin is pinched or pricked, the limb 

 that is thus acted on jumps with great vivacity ; the toes are retracted to- 

 wards the instep, the foot is raised on the heel, and the knee so flexed as to 

 raise it off the bed ; the limb is maintained in this state of tension for several 

 seconds after the withdrawal of the stimulus, and then becomes suddenly 

 relaxed." "In general, while one leg was convulsed, its fellow remained 

 quiet, unless stimulus was applied to both at once." "In these instances, the 

 pricking and pinching were perceived by the patient ; but much more violent 

 contractions are excited by a stimulus, of whose presence he is unconscious. 

 When a feather is passed lightly over the skin, in the hollow of the instep, as 

 if to tickle, convulsions occur in the corresponding limb, much more vigor- 

 ous than those induced by pinching or pricking ; they succeed one another 

 in a rapid series of jerks, which are repeated as long as the stimulus is 

 maintained." "When any other part of the limb is irritated in the same 

 way, the convulsions which ensue are very feeble, and much less powerful 

 than those induced by pricking or pinching." "Convulsions, identical with 

 those already described, are at all times excited by the acts of defecation 

 and micturition. At these times, the convulsions are much more vigorous 

 than under any other circumstances, insomuch that the patient has been 

 obliged to resort to mechanical means to secure his person while engaged in 

 these acts. During the act of expulsion, the convulsions succeed one an- 

 other rapidly, the urine is discharged in interrupted jets, and the passage of 

 the faeces suffers a like interruption." The convulsions are more vigorous, 

 the greater the accumulation of urine ; and involuntary contractions occur 

 whenever the bladder is distended, and also when the desire to relieve the 

 rectum is manifested. "In all these circumstances, the convulsions are per- 

 fectly involuntary ; and he is unable, by any effort of the will, to control or 

 moderate them." This patient subsequently regained, in a gradual manner, 

 both the sensibility of the lower extremities, and voluntary power over them ; 

 and as voluntary power increased, the susceptibility to involuntary movements 

 diminished, as did also their extent and power. This case, then, exhibits au 

 increased tendency to perform reflex actions, when the control of the Brain 

 was removed ; and it also shows that a slight impression upon the surface, of 

 which the patient was not conscious, was more efficacious in exciting reflex 

 movements, than were others that more powerfully affected the sensory 

 organs. It should be added that, in the foregoing case, the nutrition of the 

 lower extremities was not impaired, as it is in most cases of paraplegia; the 

 rationale of this phenomenon, which is to be constantly observed when the 

 reflex actions of the part remain entire, will be understood by reference to 

 360, 512. In another case, the paralysis was more extensive, having been 

 produced by an injury (resulting from a fall into the hold of a vessel) at the 

 lower part of the neck. There was at first a total loss of voluntary power 

 over the lower extremities, trunk, and hands; slight remaining voluntary 

 power in the wrists, rather more in the elbows, and still more in the shoulders. 

 The intercostal muscles did not participate in the movements of respiration. 

 The sensibility of the hands and feet was greatly impaired. There were no 



1 Medieo-Chirurgical Transactions, vol. xxii. 



