. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. is of the shoulders, armsand hands, spastic paraly-sis of the legs, with thedissociation sensory symp-toms as seen in syringo-myelia. In such casesthere is usually deformityof the cervical spine fromthe old injury, and subse-quent ankylosis. Injury to the dorsalregion causes spastic para-plegia and all the othersymptoms as describedabove except those in theupper extremities. Theanaesthesia when presentgives a valuable clue tothe uppermost limit of theinjury. There may be a zone of h
. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. is of the shoulders, armsand hands, spastic paraly-sis of the legs, with thedissociation sensory symp-toms as seen in syringo-myelia. In such casesthere is usually deformityof the cervical spine fromthe old injury, and subse-quent ankylosis. Injury to the dorsalregion causes spastic para-plegia and all the othersymptoms as describedabove except those in theupper extremities. Theanaesthesia when presentgives a valuable clue tothe uppermost limit of theinjury. There may be a zone of hypera^sthesia at the extreme upper limit,due to irritation of the nerve-roots; and pain may radiate through the trunkat this level for the same reason. Injury to the lumbar region also causes paralysis of the legs, bladder,and rectum, but if the lumbar enlargement is involved the paralysis of thelegs is flaccid, with abolished .knee-jerks, wasting of the muscles, and elec-trical changes. Anaesthesia may be present on the buttocks, genitalia, peri-neum, thighs, and legs. Pain in the legs may also be Fig. 395.—Trauma of the cervical region of the spinal cord, simulating syringomyelia.—Lloyd. HEMORRlIACiK IN SIIXAL CORD AND MEMBRANES. 773 A unilateral lesion of tiie cord may cause the so-called lirown-St-tjuardsyndrome: there is paralysis of motion on the side of the lesion and lossof sensation on the opposite side, but this sensory loss is in the tempera-ture ami pain sense rather than in the tactile sense. If, however, the column of one side is affected there is tactile anajsthesia also, but itis on the side of the lesion. Diagnosis.—To determine the exact seat of the lesion the practitionershould study the uppermost limits of the amesthesia, and the muscle-groupsinvolved, and compare them with a chart and table of the spinal this way an exact local diagnosis may be reached (pp. 327, 328, Vol. I). The history of the case is usually suffici
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