DISEASES OF THE SPINAL COED. 213 



MYELITIS, OR INFLAMMATION OF THE SUBSTANCE OF THE SPINAL CORD. 



This is a rare disease, except as a secondary result of spinal menin- 

 gitis or injuries to the spine. Poisoning by lead, arsenic, mercury, 

 phosphorus, carbonic-acid gas, etc., has been known to produce it. 

 Myelitis may be confined to a small spot in the cord or may involve 

 the whole for a variable distance. It may lead to softening, abscess, 

 or degeneration. 



Sy^nptoms. — The attack may begin with a chill or convulsions ; the 

 muscles twitch or become cramped very early in the disease, and the 

 bladder usually is affected at the outset, in which there may be either 

 retention or incontinence of urine. These conditions are followed by 

 complete or partial paralysis of the muscles posterior to the locality of 

 the inflamed cord, and the muscles begin to waste away rapidly. The 

 paralyzed limb becomes cold and dry, due to the suspension of proper 

 circulation; the joints may swell and become edematous; vesicular 

 eruptions appear on the skin; and frequently gangrenous sloughs 

 form on the paralyzed parts. It is exceedingly seldom that recovery 

 takes place. In a few instances it may assume a chronic type, when 

 all the symptoms become mitigated, and thus continue for some time, 

 until septicemia, pyemia, or exhaustion causes death. 



Pathology. — The inflammation may involve nearly the whole length 

 of the cord, but generally it is more intense in some places than others; 

 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 CONGESTION. 



This condition consists in an excess of blood. As the blood vessels 

 of the pia mater are the principal source of supply to the spinal cord, 

 peremia of the cord and of the meriinges usually go together. The 

 symptoms are, therefore, closely allied to those of spinal meningitis 

 and congestion. 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 posterior 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 



