INFLAMMATION OF THE SPINAL CORD AND MEMBRANES 245 



the following description, which may be observed in affections of the 

 spinal cord: 



Motor symptoms of paralysis are, as a rule, the first symptoms pre- 

 sented. The patients have a dull heavy look, staggering gait, but not 

 irregular (in this the condition differs from disease of the cerebellum). 

 Finally, they begin to drag their hind legs after them (Fig. 94), the poste- 

 rior extremities are invariably the parts paralyzed. When they are placed 

 on their legs they stand with them spread apart, or they may simply drop 

 sideways on their hind cjuarters. In rarer cases, not only the posterior ex- 

 tremities but also the anterior are paralyzed, and it is evident that in 

 cases of paralysis of all the members the spinal substance of the cervical 

 region must be affected, while paralysis of the posterior extremities follows, 

 no matter what part of the cord is affected. In these cases we always 

 have the double-sided paralysis, and in very rare cases the paralysis may 

 be more intense on one side than the other; but in such a case we can 

 only suppose that in one-half of the spinal cord the disease is more ad- 

 vanced than in the other. 



In the early stages of the disease there are slight, irregular twitchings 

 of the extremities, rarely of any great consequence, and seldom leading 

 to convulsions. There may be marked hypersesthesia and the animal 

 gnawing continually at certain points of the body, muscular twitchings, 

 drawing in of the hind legs toward the abdomen. There may also be a 

 continual erection of the penis, and the evacuation of the urine and faeces 

 may be interfered with on account of the convulsive contraction of the 

 sphincter or paralysis of the detrusor urinae and muscles of the intestine. 

 We also observe disturbances of sensitiveness either in the form of hy- 

 persesthesia or of anaesthesia. The former is invariably observed in the 

 early stages of the disease; the patients show intense pain, especially when 

 touched, lifted, or pressed upon the spinal cord. (This they indicate by 

 biting, howling, etc.) In the latter case they do not show the slightest 

 reaction in the affected regions, even when subjected to serious irritations 

 of the skin. It must be remembered, however, that symptoms similar 

 to hyperaesthesia may also be present in rheumatism. 



In mild stages of this disease the sphincters, such as the bladder 

 and rectum, appear slightly affected. In the more serious stage we ob- 

 serve complete paralysis, loss of control of the sphincters, and frequently 

 complete paralysis of the sphincter vesicae. More details will be found on 

 this subject under Diseases of the Bladder. Such paralytic conditions of 

 the bladder may occur in all diseases of the spine. There is difficulty in 

 the passage of faecal matter, producing constipation, caused to a certain 

 extent by the loss of abdominal pressure. Paralysis of the sphincter is 

 evinced by a gaping rectum and the involuntary escape of faecal matter 

 which accumulates in the lower bowel. Through want of active exercise, 



