508 SURGICAL APPLIED ANATOMY. [Chap. xxiv. 



the medulla spinalis maybe reached if the wound have 

 a certain direction. Thus, a case is reported where a 

 pointed body entered the canal between the ninth and 

 tenth dorsal vertebrae, having been introduced from 

 below upwards. 



Several examples of damage to the cord by sword 

 or bayonet wounds have been put on record, but in 

 most of these instances the wound was associated with 

 some fracture of the protecting bone. 



Concussion of the cord. After certain in- 

 juries to the back a train of symptoms, usually of a 

 severe and complicated character, have been described, 

 which have been assigned to a concussion or shaking 

 of the spinal cord. 



In these injuries it is assumed that, as a result of 

 a sudden shock transmitted to it, the cord undergoes 

 certain molecular changes, which lead to a more or 

 less severe disturbance of its function. The condition 

 has been compared to concussion of the brain, al- 

 though it must be owned that the symptoms often 

 accredited to concussion of the cord have a character 

 more complex than that seen in like lesions of the 

 more complex organ, 



A great many surgeons are inclined to dispute the 

 existence of this lesion, or rather decline to recognise 

 the connection between a certain train of symptoms 

 and a simple molecular disturbance of the cord. It is 

 very probable that in many of the reputed instances of 

 cord-concussion the symptoms (if we except such as 

 are assumed and such as depend upon changes in the 

 brain) are due to a more distinct damage to the medulla 

 spinalis, to haemorrhages, to pressure, and to other 

 gross changes. Without entering into any discussion 

 upon the subject, it may be sufficient to point out some 

 of the anatomical objections that appear to oppose 

 themselves to the common conception of concussion of 

 the cord. The spinal cord is swung or suspended in 



