OF THE SPINAL CORD 143 



leg, as a double path, the one crossed and the other 

 uncrossed, is open to it. 



TABLE TO ILLUSTRATE THE EFFECTS OF A TUMOUR 

 OF THE LEFT LOWER CERVICAL REGION. 



Right Arm. 



Normal. 



Left Arm. 



Pain. Some anaesthesia. 

 Flaccid paralysis, loss of 

 reflexes, wasting. 



Right Leg. 



Loss of sense of heat, 

 cold, pain. 



Left Leg. 



Loss of muscular sense, 

 joint sense, tactile discri- 

 mination and recognition of 

 objects. Spastic paralysis ; 

 exaggerated reflexes. 



3. It may arise in the central grey matter, when it 

 becomes inoperable. In this case there will be loss 

 of the heat, cold, and pain senses on both sides, 

 but tactile and muscular sense will remain. There 

 may be some spastic paralysis of both legs. In the 

 early stages the diagnosis from syringomyelia may 

 be only a matter of opinion. 



4. In some cases it may produce bilateral spastic 

 paralysis with involvement of the sphincter func- 

 tions and with anaesthesia without any dissociation 

 phenomena. The diagnosis is then very difficult. 



Each of the thirty-one nerve-roots issuing from 

 the spinal cord has a definite distribution, which may 

 be motor, sensory, and visceral, and these have now 

 been ascertained with some accuracy by a combina- 

 tion of anatomical, physiological, and clinical 

 methods. As given in the various textbooks and 

 monographs, the information is a good deal more 



