688 Injuries to, and Concussion of, the Spinal Cord. 



Tn many cases the sjniiptonis differ from those described. Tn some the paraly- 

 sis ami in others the anesthesia is less pronounced, or the reflexes posterior to the 

 scat of injury are obliterated. Balint's investii^ations and the observations of 

 Hutyra & Marek on horses killed by pithing showed that the reflexes disappear 

 behind the seat of injury if the roots or cells of the nerves in question were in- 

 jured. In one horse that had fractures of the first and second lumbar vertebrae 

 there was in addition to -the symptoms due to the contusion great restlessness and 

 difficulty of respiration, the cause being the simultaneous existence of an incar- 

 cerated diaphragmatic hernia. 



Course. Even in those cases in wliicli the injury does not 

 cause the immediate death of the animal, death is the usual 

 sequel. The larger animals die, as a rule, within one or two 

 days, seldom more, hut death is generally delayed somewhat 

 in small animals, and results from l)edsores, hypostatic con- 

 gestion of the lungs or cystitis. Occasionally it happens that 

 animals, and especially small ones, survive for a longer time, 

 the s;ymiptoms persisting unaltered, or in cases where hemor- 

 rhage is the only lesion, gradually ahate. S^anptoms may dis- 

 appear rapidly. The possibility of recovery does not appear 

 to be excluded in cases in which the injury causes only hemor- 

 rhage or only slight lesions of the cord. 



In some cases, the animals show no disturbance or only 

 a slight paresis for some time, which may amount to weeks, 

 after the occurrence of the injury, but then by some compar- 

 atively slight influence there is caused displacement of the ends 

 of the bones and complete paralysis results. 



Diagnosis. As in most cases there is an obvious connec- 

 tion between the symptoms of paralysis and some wound or 

 injury, diagnosis usually resolves itself into determining 

 whether the s>anptoms are due to some injury to the cord itself, 

 or whether they are caused by hemorrhage. A point that is 

 of value in coming to a decision is that disturbances due to 

 hemorrhage only tend to improve with time, and also hemor- 

 rhage is indicated by a paralysis that is somewhat slow in de- 

 velopment. 



Dogs are often said to have been run over, when careful 

 enquiry elicits the fact that the animal's movements were not 

 quite perfect previously, and that there is either an ossifying 

 inflammation of the dura, or there is some compression of the 

 cord. In the differential diagnosis in horses the principal con- 

 dition that is likely to be met with is paralytic hemoglobinemia. 

 In this condition the paralyzed muscles are hard, the urine fre- 

 quently contains blood pigment, and the sensibility of the skin 

 is normal. In cases of pelvic fracture, there is no loss of sen- 

 sibility of the skin, defecation and urination are not disturbed 

 and there are symptoms indicating fracture of the bones. 



Treatment. Improvement is only to be expected when 

 there is simply contusion of the cord, owing to tearing of the 

 membranes or intermeningeal hemorrhage. If in the larger 



