DISEASES OF THE SPINAL CORD. 307 



loss of muscular power is often followed by complete 

 paralysis of the posterior extremities. 



In those instances of chronic inflammation of the spinal 

 cord specially, as distinguished from that of the meninges, 

 loss of motor power is mostly followed by more or less 

 complete paraplegia. 



Morbid Anatomy. — After death from acute spinal in- 

 flammation, the cord and its membranes are more or less 

 congested, sometimes, indeed, very highly. The sub-arach- 

 noid space is filled with serous exudation, and the cord, 

 when cut into, is much redder than normal. The post- 

 mortem changes, however, are sometimes very slight in 

 comparison with the severity of the symptoms manifested 

 during life, and they vary greatly in extent and in 

 character. 



In some instances the cord becomes soft and pulpy, the 

 nerve-fibrils and cells undergo marked alterations, which 

 are more especially, however, concentrated in the grey 

 matter. 



In chronic inflammation, the cord is red, injected, and 

 softened ; the meninges are thickened, and the arachnoid is 

 covered with inflammatory exudation, by which the two 

 surfaces may become united, or the cavity is filled with 

 reddish serum. 



Diagnosis. — The history will in many cases help to clear 

 up any doubts as to the diagnosis of the case. Acute 

 spinal inflammation may be confused with azoturia. The 

 dark colour of the urine in the latter aff'ection, however, is 

 not a feature of spinal inflammation, and the spasms are 

 mostly limited to the gluteal region. In acute spinal in- 

 flammation a greater number and variety of muscles are 

 usually aff'ected, and the spasmodic contractions are of a 

 more clonic nature. 



Broken back is generally directly traceable to an injury, 



20—2 



