S6i DISEASES OF THE SPINAL COED AND ITS MEMIiRAXES. 



by force, has any influence in determining the appearance or in- 

 tensification of the existing symptoms. We must not be misled 

 by tlie appearance of the eyes, seeing that similar changes may 

 follow spinal as pure cerebral disease. Careful manipulation 

 over the various regions of the spine Avill sometimes yield a 

 little information, or the history of the case may afford more. 



Treatment. — When it is evident, or when we are satisfied 

 that active congestion exists in connection with this portion of 

 the nervous centres, treatment should at once be directed to 

 dirdinish the congestion, and prevent, as far as possible, active 

 inflammatory action. With this object iff view, it is advisable 

 that particular attention should be directed to the condition of 

 the bowels. As they are usually confined, purgatives are 

 indicated. Should aloes — the best purge, in most cases, for 

 the horse^iave been exhibited, it had better be followed by 

 the daily administration of salines in the drinking-water. 

 Bleeding may in some, or in many, instances be indicated, but 

 must not be carried out where paralysis exists. 



Should local pain be an attractive feature, the repeated 

 application of hot-water cloths or poultices will usually be 

 productive of relief. These may be medicated with belladonna, 

 or, following their removal, may be succeeded by a large bella- 

 donna plaster. In addition to the purgative and repeated 

 administration of the salines, there is at this stage, Avhen the 

 hyperemia of the cord is more likely to exist, a probability 

 that benefit will result from the employment of such agents 

 as experiment proves have a controlling poAver over the 

 calibre of the vessels of the cord ; chief of these agents are 

 belladonna and ergot of rye ; the former as the extract, the 

 latter as the iethereal tincture, may be exhibited to the extent 

 of from one to four drachms daily. 



The employment of stimulants, ordinary or special, internal 

 or external, must not be had recourse to during the stage of 

 active congestion, or at least we may say they appear contra- 

 indicated, and practically they are Avorse than useless. When, 

 however, there is good reason to believe that this condition 

 has subsided, and indications of defective nervous power still 

 exist, stimulation both externally and internally is indicated. 

 As an external stimulant, there is nothing equal to the actuiil 

 cautery. This is to be employed fairly over a considerable 



