38 PARALYSIS — PALSY. 



he continued feeding. During the insertion of a couple of setons 

 in the thighs he manifested great pain, plunging violently under 

 the operation with his fore parts, at the time that his hind were 

 without the power of moving. In the majority of cases of para- 

 plegia, the spinal marrow is so inj ured or compressed that both its 

 functions — mobility and sensibility — are simultaneously destsoyed 

 or impaired : there may and do, however, occur cases in which, 

 from partial injury or compression, but one of these faculties is lost. 

 The lesions sustainable by the medulla or its membranes, from 

 fracture and consequent displacement of the vertebrae, are resolv- 

 able into such as produce compression only, and those that occasion 

 laceration : from the latter, hemorrhage may ensue, to say nothing 

 about the harm that mere concussion or extension of the marrow may 

 occasion. What is called " a broken back," in general arises from 

 fracture of some one or two of the posterior dorsal or anterior lum- 

 bar vertebrae — mostly, I believe, of the 15th, 16th, or 17th dorsal*. 



Of the cases called general paralysis, originating in falls or blows, 

 the majority may be regarded as so many instances of "broken 

 neck." The force applied — to the occiput, commonly — fractures 

 the base of the skull, breaks most likely the condyloid processes, 

 the dislocation consequent on which occasions compression of the 

 anteriormost portion of the spinal marrow, paralysing the volun- 

 tary muscles of the body generally, and destroying their sensibility, 

 probably, as well. At the same time, the respiration being affected, 

 will shew that the medulla oblongata is implicated in the injury. 



There can be no doubt but that, on occasions, such spontaneous 

 morbid changes of the medulla spinalis and its membranes take place 

 as give rise to paralysis : the cases called idiopathic paraplegia, 

 rare though they be, are sufficient to prove this. It does not seem 

 likely that simple congestion would be followed by such conse- 

 quences; but congestion may end in extravasation or effusion, 

 either of which terminations might give rise to palsy. Not con- 

 gestion, however, merely, but inflammation must, every now and 

 then, from a variety of causes, arise in the medulla spinalis, or 

 rather in its membranes, particularly in the region of the loins, 

 where these parts are more liable to become strained, or stretched, 



* For further information on " Fracture of the Spine" consult vol. i, p. 261. 



