On spinal apoplexy / by Alexander Peddie.

Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: On spinal apoplexy / by Alexander Peddie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    affected, is, that the extravasation was not so great in extent as to excite irritation of the membranes from simple pressure; and that there was no serious laceration of parts; but that it occurred in the grey substance of the cord, separating rather than tearing the fibres, gradually infiltrating the tissue of a limited portion even to saturation—if I may use the term, and entirely and consentane- ously destroying the functions of both the anterior and posterior columns. Thus, while the symptoms did not indicate that the apoplectic seizure was either preceded or accompanied by inflammatory soften- ing of the medulla, the occurrence of contractions and tetanic spasms in the paralysed limbs afforded positive evidence that this change was subsequently in progress; for it seems well established that these symptoms are the characteristic and diagnostic marks of this action going on, either in cerebral or spinal medullary sub- stance.' It Avas remarkable, however, that this lesion did not take place sooner; for during two months there was complete paralytic suppleness of the extremities befoi'C convulsive twitchings of the muscles occurred, and before any degree of pain was felt in the upper part of the dorsal region ; and several months more elapsed before these symptoms reached their maximum of intensity. Having stated my reasons for considering the above case as an instance of spinal apoplexy, I would now make some remarks on the various symptoms and changes which occurred in its pro- gress, and discuss their interesting physiological and pathological relations, did not the space permitted for this communication debar me from attempting more than a brief notice of some of the most important of its phenomena. The case presents a very remarkable instance of the effect which stimuli applied to the surface of the body produce on muscles of paralysed parts when the integrity of the spinal cord is interrupted by disease. The phenomena occasioned under such circumstances, and the analogous results shown in the inferior animals on sections being made of the medulla, and even when decapitation is per- formed,^ have attracted the notice of Sir Charles Bell, Magendie, VanDeen, Stilling, Dr Marshall Hall, Miiller, Volkmann and other eminent physiologists, and led to much ingenious and interesting 1 Dr Hughes Bennett in an analysis of twenty-six cases of cerebral and spinal softening, satisfactorily shews— that the occurrence of contraction is a more frequent symptom of inflammatory softening than many suppose. —Inflammation of Nervous Centres, p. 29. 2 See experiments of Van Deen in Traiteset Decouvertes sur la Physiologie de la Moelle Epiniere, Leide 1841 ;—and of Stilling Untersuchungen iiher die Functionem des Ruckenmarks nnd der Nerven, Leipzig 1842. Also an interesting account of the effects produced hy decapitation of the land sala- mander,—Salamander Maculata, and of frogs. Miiller's Physiology, translated by Dr Baly, vol. i. p. SO.].