Prognosis. Treatment. 685 



Formerly, the disease was very frequently confoi-incled with 

 muscular rheumatism, but the distinction between the diseases 

 is very striking in that in rheumatism there is no muscular atro- 

 phy, the reflexes are not affected, and the sensibility of the 

 skin is normal. The disease may be distinguished from tetanus 

 by the absence of trismus and spasms of the muscles supplied 

 by the facial nerve. In spinal meningitis there is an absence 

 of obvious objective pain, and owing to the more rapid develop- 

 ment of the disease, muscular contractions are not observed. 

 The course of transverse or diffuse myelitis is much more rapid. 



Prognosis. When symptoms are already clinically recog- 

 nizable, the condition ])ecomes aggravated either gradually or 

 suddenly until there is complete paralysis. In some cases, 

 temporary improvements are seen. 



Treatment. The anatomical alterations that are the cause 

 of the disease exclude the possibility of radical treatment. 

 Treatment can only be directed towards alleviating the pain, 

 and where possible delay, the appearance of fatal symptoms. 



Literature. Bonnet, Miineh. Jhb., 1880-81, 109.— Dexler, Ergebn. d. Path., 

 1896, III, 2, Abt., 516 (Lit.) ; Die Konipressionsmyelitis des Hundes, 1896.— Kitt 

 & Stoss, D. Z. f. Tm., 1883, IX, 142. 



3. Injuries to, and Concussion of, the Spinal Cord. Contusio 

 et commotio medullae spinalis. 



Etiology. The spinal cord may be injured by the penetra- 

 tion of pointed objects entering the vertebral canal through 

 interverteliral spaces, an accident which is especially likely to 

 happen in the cervical region. An accident that occurs far more 

 often is the crushing of the cord through dislocation of the 

 vertebrae, owing to some violence, such as falling, being run 

 over, collisions, etc. In many such cases, there is some frac- 

 ture of the bones, the cord being injured by dislocation of 

 the pieces or by splinters. In horses, and especially in well- 

 bred animals, fracture of vertebrae occurs without any external 

 violence, owing to severe muscular contraction, e. g., in jump- 

 ing, kicking and galloping, or in attempts to get free after 

 being cast. In many cases the resistance of the bones is de- 

 creased. Jacoulet and Vivien proved the existence of osteopo- 

 rosis in two cases of fractured vertebrae, and in many cases of 

 fracture of other bones. Decreased resistance of the bone tis- 

 sue must be assumed to be the immediate cause of fracture in 

 cases in which there is osteomalacia, or loosening of the inter- 

 vertebral joints owing to enchondrosis of the intervertebral 

 cartilages. According to the observations of Frohner, Flatten, 

 Nielsen, Pallain, and others, the injury causes only a splitting 

 of the bone, the complete fracture developing after some time, 

 generally some weeks. 



