

THE SPINAL CORD. 673 



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 suc- 

 ceed one another rapidly, the urine is discharged in interrupted jets, and the 

 passage of the feces 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." The 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, and 

 the extent and power of these, diminished. This case, then, exhibits an 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 im- 

 paired, as 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 325. 



708. In another case, the paralysis was more extensive, having been pro- 

 duced 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 inter- 

 costal muscles did not participate in the movements of respiration. The sensi- 

 bility of the hands and feet was greatly impaired. There were retention of 

 urine, and involuntary evacuation of the feces. Recovery took place very 

 gradually ; and during its progress, several remarkable phenomena of reflex 

 action were observed. At first, tickling one sole excited to movement that 

 limb only which was acted upon ; afterwards, tickling either sole excited 

 both legs, and, on the 26th day, not only the lower extremities, but the trunk 

 and other extremities also. Irritating the soles, by tickling or otherwise, was 

 at first the only method, and always the most efficient one, by which convulsions 

 could be excited. From the 26th to the 69th day, involuntary movements in 

 all the palsied parts continued powerful and extensive, and were excited by the 

 following causes : in the lower extremities only, by the passage of flatus from 

 the bowels, or by the contact of a cold urinal with the penis ; convulsions in the 

 upper extremities and trunk, attended with sighing, by plucking the hair of the 

 pubes. On the 41st day, a hot plate of metal was applied to the soles, and 

 found a more powerful excitor of movement than any before tried. The move- 

 ments continued as long as the hot plate was kept applied ; but the same plate, 

 at the common temperature, excited no movements after the first contact. The 

 contact was distinctly felt by the patient; but no sensation of heat was per- 

 ceived by him, although the plate was applied hot enough to cause vesication. 

 At three different intervals, the patient took one-eighth of a grain of strychnia 

 three times a day. Great increase of susceptibility to involuntary movements 

 immediately followed, and they were excited by the slightest causes. No con- 

 vulsions of the upper extremities could ever be produced, however, by irri- 

 tating their inteugment ; though, under the influence of strychnia, pulling the 

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