212 



when due to mechanical injury the inflammation may remain con- 

 fined to a small section. The cord is swollen and congested, reddened, 

 often softened and infiltrated with pus cells, and the nerve elements 

 are degenerated. 



Treatment. — Similar to that of spinal meningitis. 



SPINAL SCLEROSIS. 



This is the sequence of myelitis, when some mild form of the disease 

 has been existing. Thickening and hardening of the interstitial tis- 

 sues of the cord, the result of inflammatory products, constitute scle- 

 rosis. The affected section has a gray appearance, is firmer than the 

 surrounding tissue, sometimes j)resents a depressed surface and at 

 other times may be elevated above the general level of the cord. 



Symptoms. — Paralysis of sensation or motion in local muscles, and 

 when located in the region of the neck may present the symptoms of 

 locomotor ataxia or inco-ordination of movement. Spinal sclerosis 

 may be suspected when these symptoms succeed an attack of myelitis. 



Treatment. — The iodide of iron may be given in dram doses twice 

 a day for a week, alternating with two-grain doses of sulphate of 

 strychnia twice a day for a Aveek. 



SPINAL CONGESTION AND SPINAL HYPERJEMIA. 



The distinction between congestion and hyperjemia is one of degree 

 rather than kind. In both we find an excess of blood. In hypersemia 

 the current is unusually rapid, in congestion it is unusually slow. 

 The distinction between hypersemia and inflammation is also difficult 

 to make; one is only the forerunner of the other. As the blood ves- 

 sels of the pia mater are the x)rincipal source of supply to the spinal 

 cord, hyperemia of the cord and of the meninges usually go together. 

 The symptoms are, therefore, closely allied to those of spinal menin- 

 gitis and mj^elitis. When the pia mater is diseased the spinal cord 

 is almost invariably affected also. 



Cause. — Sudden checking of the perspiration, violent exercise, 

 blows, and falls. 



Symptoms. — The symptoms may vary somewhat with each case, 

 and closely resemble the first symptoms of spinal meningitis, spinal 

 tumors, and myelitis. First, some disturbance in movement, lower- 

 ing of the temperature, and partial loss of sensibility i:)Osterior to the 

 seat of the congestion. If in the cervical region it may cause inter- 

 ference in breathing and the action of the heart. When in the region 

 of the loins there may be loss of control of the bladder. When the 

 congestion is sufficient to produce compression of the cord, paraplegia 

 may be complete. Usually fever, spasms, muscular twitching, or 

 muscular rigidity arc absent, which will serve to distinguish spinal 

 congestion from spinal meningitis. 



