File:Diseases of the nervous system - a text-book of neurology and psychiatry (1915) (14780352654).jpg

Identifier: diseasesofnervo00jell (find matches)
Title: Diseases of the nervous system : a text-book of neurology and psychiatry
Year: 1915 (1910s)
Authors: Jelliffe, Smith Ely, 1866-1945 White, William A. (William Alanson), 1870-1937
Subjects: Mental Disorders Nervous System Diseases
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Rectum.—The chief innervation here is through the hemorrhoidalplexus and the inferior mesenteric. Here both autonomic and cere-brospinal influences are active. Voluntary muscle activities play alarge role in defecation, the grade of tension in the rectum, however,is registered by the autonomic system, which is responsible for theoriginal impulses, after which voluntary and involuntary activities areoperative. The spinal autonomic center is located in the lumbo- 1 Consult Crile, Study of the Emotions, Philadelphia, 1915. RECTUM 93 sacral spinal segments. The cortical association connections arethought by Bechterew to be in the sigmoid gyrus. Frontal associationpathways are also present, interference with which causes involuntarydefecation, as with frontal tumor, general paresis, epileptiform con-vulsion, profound stupor, emotional loss of control, etc. Interruption of spinal pathways may cause obstipation or diarrhea(tabes, poliomyelitis, multiple sclerosis, tumor, syphilis of cord,
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Fig. .34.—Scheme of pelvic innervation: eg, spinal genital center; \n, first lumbar;s, sympathetic; ct, conus; iUi, ileohypogastric; gmi, inferior mesenteric ganglion; ghp,hypogastric ganglion; pZ/i, hypogastric plexus; g/im, hemorrhoidal ganglion; n/i (above),hypogastric nerve; ne, sacral nerve; s, erigens; npc, common pudendal; nh (below),hemorrhoidal nerve; ndp, dorsalis penis; njpp, deep perineal; vu, bladder; scr, scrotum.(Bechterew.) hematomyelia, syringomyelia, etc.). Here deep sensibility conductingfibers—autonomic and cerebrospinal—are interfered with and the auto-nomic reflexes fail to establish the psychical connections either forcompulsion (discharge) or control of sphincter (retention). The analreflex here is of great localizing value, its positive appearance rulingout disease of the lower sacral and coccygeal segments. Lesions of thecervical or dorsal cord interfere with the voluntary activities of theabdominal muscles in defecation, while lesions of the lower lumb

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