210 DISEASES OF THE NERVOUS SYSTEM. 



walk, and becoming complicated with tonic convulsions which 

 become finally epileptic, and, lastly, stupor, coma, and death. 

 Kenner treated two cases with calomel, opium, and purgatives. 

 The author did not have good results, although he treated a case 

 in tlie same way. 



Inflammation of the Spinal Cord and its Membranes. 

 {Myelitis and Spinal Meningitis.) 



Etiology. A common cause of myelitis and spinal meningitis 

 is traumatisms of some kind causing direct injuries to the spine. 

 It may also be caused by simple contusions, violent blows, shocks, 

 falling out of a window, etc., and further by concussions of the 

 spinal cord. Violent muscular exertions frequently bring it on. 

 In very rare instances the disease may follow the presence of an 

 abscess on the outside of the spinal canal (for instance, in one case 

 which was observed by the author, iu the long muscle of the back), 

 by extension of the suppurating process through the orifice of the 

 vertebra, and occasionally you see it originate in connection with 

 some infectious disease (distemper, rabies, pysemia). It may al.-o 

 1)6 caused by cold. 



Pathological Anatomy. The inflamed pia mater appears 

 thickened, infiltrated, and injected in some places, and, as a rule, 

 adherent by means of the exudation to the spine itself. It is 

 covered on its upper surface by a serous, fibrinous, or purulent 

 exudation. The arachnoid exudation is covered by a milky, false 

 membrane and greatly thickened. The dura mater is rarely 

 involved, but when such is the case it becomes thickened and 

 loo-iened, and covered with a thin serum. The spine itself shows 

 the inflammatory process either extended over large surfaces or 

 else confined to small centres. In the early part of the disease 

 the spine is slightly swollen; the gray substance is somewhat red- 

 dened, dark, and soft. Later the spine becomes a yellowish-red 

 breaks down and undergoes white, yellow, or red degeneration. 

 In the chronic course we see atrophy of the nerves as a conse- 

 quence of malformations of the connective tissue. 



Clinical Symptoms. The symptoms of alteration of the 

 spinal cord appear gradually, and become more intense as the dis- 



