File:Diseases of the nervous system (1910) (14773158235).jpg

Identifier: diseasesofnervou00chur (find matches)
Title: Diseases of the nervous system
Year: 1910 (1910s)
Authors: Church, Archibald, b. 1861, ed Salinger, Julius L. (Julius Lincoln), tr
Subjects: Nervous system
Publisher: New York and London : D. Appleton and company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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thecauda equina. In the last twenty years authors have directed special atten-tion to this differentiation. The following points must be borne in mind: First, affections of thecauda are produced much less rapidly than those of the conus, as may be in-ferred from the preceding statements as to the cause of these diseases. Inthe overwhelming majority of cases a lesion of the conus produces no pain,while in an affection of the cauda, particularly at the onset, there is acutepain, localized in the sacrum, the bladder, the rectum and the buttocks,and this often radiates. Furthermore, in caudal affections motor irritative PARALYSIS IN THE PUDEXDIC AXD COCCYGEAL PLEXUSES 737 phenomena are absent (fibrillary contractions) while they are common indiseases of the conns. Symptoms.—The most constant disturbances in lesions of the lower por-tions of the spinal cord, as well as of nerves originating in this region, arethose which affect the innervation of the bladder and the rectum, these organs
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being paralyzed and their normal functions suspended. This paralysis of thebladder and rectum is rarely found without a simultaneous disturbance ofsensation along the course of the nerves originating from the pudendic andcoccygeal plexuses. This disturbance in sensation affects the perineum, the posterior surface of 738 PARALYSES OF THE PERIPHERAL NERVES the scrotum, the penis, or the labia majora in the female. There is also anes-thesia in the region of the anus, the anal groove, in the buttocks, and uponthe posterior surface of the thigh to the upper border of the middle third.The mucous membrane of the genital organs and the rectum is also implicatedin the anesthesia. Before describing the motor symptoms in these cases, I must call attentionto the fact, most important in the differential diagnosis, that these disturb-ances of sensation may be distinguished by the time of their appearance andthe degree of completeness (an important guide). If the conus is injured,anomalies of sensat

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