INFLAMMATION OF SPINAL OOBD AND MEMBRANES. 211 



ease progresses, where the disease is due to violent traumatisms, 

 producing a direct destruction or laceration of the nervous centres, 

 or pressure, which is caused by the blood being discharged and 

 pressing upon the spine. In all diseases of the spinal cord it is 

 very important to recognize the fact that consciousness is present. 

 As a rule, the symptoms appear either slowly or quickly, accord- 

 ing to the amount of irritation present on the spine itself, and in 

 cases where the spinal cord is very much involved and compressed 

 by masses of exudated serum we find complete paralysis. We 

 will take up all these symptoms in the following description, which 

 may be observed in afEections of the spinal cord : 



1. Motor Symptoms of Paralysis. These are, as a rule, the first 

 symptoms presented. The patients have a heavy, dull look ; stag- 

 gering gait, but not irregular (in this it differs from disease of the 

 cerebellum). ■ Finally, they drag their hindlegs ; as a rule, these 

 extremities are 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-quarters. In rarer cases, not only 

 the posterior extremities but also the anterior are paralyzed, and 

 it is evident that in cases of paralysis of all the members the 

 spinal substance of the neck must be affected, while paralysis of 

 the posterior extremities must occur no matter what part of the 

 spine becomes affected; it may be in any part of the spinal column. 

 In these cases we always have the double-sided paralysis; and in 

 very rare cases paralysis is marked more intensely on one side than 

 the other; but, as a rule, it is very rarely present, and we can only 

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

 advanced than in the other. 



2. Motor Symptoms of Irritation. These appear in the shape 

 of slight, irregular twitchings, rarely of any great consequence, 

 and seldom leading to convulsions. They are generally noticed 

 in the early stages of the disease upon the extremities. 



3. Disturbances of Sensitiveness. We observe more rarely dis- 

 turbances of sensitiveness in the shape of hypersesthesia than in 

 t!ie form of anaesthesia. In the former it may invariably be 

 observed in the early stages of the disease that 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 



