SCLEROSIS OF THE NERVOUS SYSTE:SI. 3G7 



in serious want of power over the voluntary movements, but 

 steadily marked by the existence of aberration of the controlling 

 function. * 



Treatment. — Although it is probable that sclerosis of the cord, 

 or other parts of the nervous centres, is rarely recovered from 

 in the sense of perfect restoration to structural integrity, it is 

 nevertheless true that the condition is more capable of ameliora- 

 tion by judicious management than many other diseased states 

 of the system. I feel tolerably certain, judging from observa- 

 tions made during life and examinations after death, that 

 several instances of this change have, by attention to proper 

 apportioning of work, the occasional use of preparations 

 of bromine, iodine, iron, arsenic, or nux vomica, together 

 with good food, been enabled for considerable periods to be 

 generally useful. Under this management there was an arrest 

 of distressing symptoms which did not again show themselves 

 for more than twelve months. 



lY. Spinal Hemorrhage and Morbid Growths in 

 Connection with the Cord. 



The first of these conditions is chiefly a surgical lesion, 

 the result of injury. In rather rare instances, from disease 

 of the vessels, hemorrhage may take place, either into the 

 substance of the cord itself, between the membranes, or out- 

 side the investments. When the intimate cord-structure is the 

 seat of the effusion, or where the blood extra vasated is con- 

 siderable, paraplegia is likely to occur suddenly ; when slight, 

 the indications are more likely to be excitation of function 

 first, whether or not this is followed by depression or paralysis. 



Of adventitious growths the chief are exostoses or bone 

 tumours, and malignant growths, as melanosis and true cancer. 

 In some cases the existence of these may be determined by 

 manipulatory examination. 



The symptoms attending their presence vary according as 

 the morbid growth is directly connected with the cord-struc- 

 ture, or only affects this by its contiguity. Besides local pain 

 exhibited on manipulation, there is ordinarily muscular dis- 

 turbance succeeded by paralysis. The symptoms rarely reach 

 their height suddenly, and even when appearing are subject to 



