CASE OF PARAPLEGIA. 
27 
accompanying drawing, which he roughly took on the spot, and 
which will serve to give a general idea of the relative size and 
situation of the tumour. Mr. Y. was told that I expected to find 
an enlargement adhering to the spine, near the loins, but he was 
very vaguely made acquainted with the symptoms manifested. 
The drawing shews a large tumour closely adhering to the last 
lumbar and first sacral vertebrae. It was of a very dark (nearly 
black) colour, and somewhat like a gland in appearance, several 
pounds in weight, and occupying a space as large as two human 
hands. It had so pressed upon the posterior caya and iliac veins, 
that their external coats were altogether absorbed, the serous only 
being left. The vein had considerably dilated laterally, but its ver¬ 
tical diameter was very much diminished, so that the mean cali¬ 
ber of the vein was lessened, and partial obstruction must have 
taken place, which would account, in some measure, for the oede- 
matous legs. The arteries and nerves seemed altogether buried 
in this mass of substance, and the latter must have been injuriously 
pressed upon; and when we consider that the last lumbar and first 
sacral nerves mainly contribute to the formation of the sciatic nerve 
which principally supplies the muscles of the posterior extremity, 
we shall be at no loss to understand the impaired action of the 
hind quarters. It will be seen that the two iliac veins, together 
with part of the vena cava, are cut open, and exhibit the tumour 
as it were within them ; the only difference between the tumour 
