This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
The Spinal Cord is a conducting organ between the brain and the nerves; thus, if the Cord be cut across at any point, or so crushed as to be thoroughly disorganized at that point, there will be a complete loss of feeling and voluntary motion in all those parts of the body situated farther from the brain than the seat of injury.
The causes of inflammation of the Spinal Cord are not always to be discovered. It sometimes extends from within the skull. It may be excited by external violence to the spine, of which a good example has been recorded by Sir Charles Bell: a waggoner sitting on the shafts of his cart, was thrown off by a sudden jerk, and pitched upon the back of his neck and shoulders. He was taken to the Middesex Hospital, where he lay for a week, without complaining of anything except stiffness of the back part of the neck. He could move all his limbs with freedom. On the eighth day after his admission he was seized with general convulsions and locked jaw. He then became affected with a singular convulsive motion of the jaw, which continued in violent and convulsive movement for about five minutes. This was followed by maniacal delirium. He then sank into a state resembling Typhus Fever: and after four days was found to be palsied and insensible in his lower extremities. The day before his death he recovered sensation in his legs.
On dissection a large quantity of purulent matter was found within the spinal canal..
The symptoms which flow from inflammation of the nervous pulp of which the spinal marrow is composed, are by no means uniform, nor can we expect that they should be so. The symptoms will vary likewise, according as the inflammation is acute or chronic. Tracking inflammation downwards, from the upper portion of the spinal marrow, we shall find, according to the part of the Cord affected, the following symptoms: Convulsive affections of the head and face, inarticulate speech, loss of voice, tetanus, difficulty in swallowing, spasmodic breathing, irregular action of the heart, tightness of the chest, vomiting, pain in the belly, sensation as if a cord was tied round the belly, numbness and tingling of the limbs, difficulty in voiding urine, retention of urine, incontinence of urine, priapism, constipation, involuntary stools, and palsy, sometimes but not very commonly, preceded by convulsions. Inflammation of the Spinal Cord may be caused by over-fatigue, combined with exposure to cold. The following case was published by Dr. Gull:
A healthy brickmaker, twenty years old, walked twenty-eight miles on July 18th, 1855, in search of work, and slept in a brickfield. On the next day, which was close and wet, he walked thirty-two miles, and allowed his wet clothes to dry upon his body. On the 20th, his legs suddenly gave way under him, and he fell down; but he got up again, and walked from his garden into his house, and two hours afterwards upstairs to his bed, feeling all the time "pins and needles" from the thighs to the feet. Reten-tion of urine then came on, and his bowels ceased to act. On the 26th, there was complete loss of power, with involuntary twitching and spasms of the legs, and gradually increasing loss of sensation below the navel, but nowhere complete. The motions of the lower ribs were imperfect. He had no priapism, no sense of tightness round the waist, and scarcely any pain. Slight movements of the legs could be produced by tickling the soles of the feet, and these movements were more readily excited as the case advanced. The retained urine became ammoniacal; sloughs formed over the sacrum; and he died exhausted, without any delirium, on August 20th.
There is one common and distressing consequence of such disease of the spinal narrow as produces palsy or loss of power, which should always be looked for. The muscles by which the bladder empties itself, are liable to participate in the palsy, and then the bladder can empty itself no longer. The urine accumulates in it and distends it, and even the ureters become dilated; and in this way not only the present but the prospective danger is increased. For the foundation of future disease of the kidneys is thus laid, even when such distension of the bladder by its retained contents occurs independently of any disease of the spine; as it may do from stricture; from enlargement of the prostate; or even from the voluntary retention of the urine beyond a certain period, through feelings of delicacy. It is necessary in these cases to look out for this distension of the bladder, to relieve it or prevent it by the introduction of a catheter. It does not do to be deceived by being told that the patient passes plenty of water; that it even runs from Mm. Incontinence of urine is, in fact, in these cases, though it may sound paradoxical, a sign of retention of urine. The urine dribbles away because the bladder is full, and admits of no further distension; it overflows, and runs out at the natural orifice, but the bladder remains constantly full and stretched. It is therefore necessary to make an examination of the lower part of the belly with the hand: if it is found hard and resisting, you may be sure, in these cases (where there is paralysis of the lower limbs, and the water dribbles away) that the bladder is full, and has lost the power of expelling its contents. Of course, it is necessary to have the water drawn off. Under these circumstances of palsy the urine becomes altered in quality, and the bladder becomes diseased. The urine grows alkaline, turbid and ropy, and exhales a very offensive ammoniacal smell; and the inner surface of the bladder is found, after death, to be in a state of chronic inflammation.
Great care must be taken, when there is palsy of the bladder, not only that the urine be regularly drawn off, but also that the patient be kept dry and clean; for if great attention be not paid to this point sores will form where the urine remains in contact with the skin, to the great increase of his suffering, and of his danger.
Inflammation of the membranes of the spine is most apt to show itself by pain, increased on motion, of the spine and of the limbs; and by rigidity and spasm of the muscles of the neck and back. Inflammation of the cord itself, which readily passes into or rather produces, softening of its substance, is most commonly marked by palsy of some parts of the body, with or without loss of sensation; and sometimes, but rarely, preceded by convulsive movements.