The subject of this Thesis is Compression Paraple -, gia, a term which I use in the generally accepted sense
of all those conditions in which there is pressure upon the cord, whether a true motor paraplegia in the
narrower sense of the word, that is paralysis of the
lower limbs, is present or not.
The subject therefor; includes such conditions as
spinal tumour, morbid conditions of the lepto- and pachymeninges, spinal caries, malignant disease of the spine
and so on. It should also have embraced injuries to
the spinal column, but I have excluded the consideration of traumatic paraplegia, my desire being to study
more especially the more chronic forms of the condition.
I have devoted particular attention to certain of
these conditions, dealing only briefly with others,
such as spina/ caries, since to have discussed these
exhaustively would have led me into details of medicine
and surgery outside the scope of neurology.
I have divided the essay into two main divisions.
In the first :I have endeavoured to correlate the signs
and symptoms of the condition with the anatomy and physiology of the structures involved. It has been necessary to deal only quite briefly with the general anatomy
of the spinal cord and the canal in which it lies and
with the tracts and nerves concerned with motor functions.
The sensory functions,however, demand somewhat fuller
consideration. During the last few years a large. -
mount of valuable work has been accomplished, notably
by Head, well nigh revolutionising our conceptions of
My own observations on compression paraplegia are
fundamentally in accord with the main lines of modern
research. I have therefore explained somewhat fully
the grouping of the various sensory impulses in so far
as they are concerned with the disorders under review,
more especially the remarkable change which occurs in
the cord as compared with the peripheral nervous system.
The principle symptoms and signs of compression
paraplegia are associated with the spinal roots,the
cord itself and the spine. These symptoms are next
discussed seriatim. In as much, however, as the involvement of these structures both in point of time and
distribution varies remarkably according to the particular nature and site of the lesion. a spinal tumour,
for instance, differing in its nature from that of a meningeal or vertebral affection - I have considered it
advisable to deal with the symptoms from this point of
view in a short section.
To complete the symptomatology of the condition
there remains yet to be described certain general symptoms such ae alterations iii the respiratory, cardiac
and vasomotor systems and the consideration of the effect of the level of the lesion upon the symptomatology
of any individual case. These are dealt with in a short
chapter in which I have included the motor and sensory
localisation of the spinal cord.
In the second part I have considered more in detail
the various extra -medullary disorders with which compression paraplegia may be associated.
For this purpose I have collected and analysed a
series of cases of compression paraplegia to Which
I have added cases w} :.ch clinically simulated. compression paraplegia but which operation or post mortem
examination proved to be due to other causes.