The diagnosis of diseases of the spinal cord.

  • William Richard Gowers
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis of diseases of the spinal cord. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    68/126 page 56
    disease remains limited to tlie posterior columns. It may, however, extend forwards into the anterior cornua, causing muscular atrophy and weakness to be conjoined with the ataxy. Or the lateral columns may be affected at the same time as the posterior: we then have weakness as well as ataxy, but no wasting. The disease of the lateral columns causes, as I have just stated, increase of the muscle-reflex action, and this increase may thus co-exist with inco-ordina- tion, the damage to the posterior roots being sHght, perhaps absent, in these cases (see p. 36). Thus we may have the anomaly of ataxy with actual loss of power, excess of the knee-jerk instead of its loss, and the front-tap contraction obtainable, and even the foot-clonus. Associated with primary degeneration of the posterior column are certain other symptoms due to simultaneous degeneration elsewhere. Of these the most important are loss of reflex action of the iris to light, which is extremely common, loss of accommodation, which is rare, and optic nerve atrophy, which is occasional. An important fact to remember, regarding the posterior columns, is their proneness to degenerate: they recover less readily, and degenerate more readily, than any other struc- ture in the cord. A lesion in one spot may set up a degene- ration which ultimately involves them in their whole extent. Damage affecting the whole thickness of the cord may pass away from the rest, and persist in the posterior columns, and even spread there. In such a case we have ataxy succeeding loss of power. Movement returns, but without co-ordination. 3. Anterior Cornua.—The anterior cornua contain the motor nerve-cells, which, as I have said—(1) influence the nutrition of the motor nerve-fibres proceeding fi-om them, and consequently that of the muscles; (2) constitute a link in the path of the vohmtary impulse fi'om the brain to the muscles; (3) form part of the reflex loop, probably also of the reflex centre, with which the muscles are connected. Hence we have, as the result of disease of the anterior cornua—(1) degeneration of the motor nerves and wasting of the muscles; (2) loss of voluntary power, i.e., paralysis
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image