Nervous and mental diseases . It may be limitedto thoracic or abdominal hands. It maybe unilateral or symmetrical. In figure147 it is of unusual outline, but will benoticed to roughly conform to some spinalsegments. In some eases areas at firstdiscrete have been observed to coalesceinto anatomical cord-territories. The analgesia may be partial or com-plete, and usually conforms in outline tothe thermo-anesthetic area or may be moreextensive. It embraces all the tissues, so that felons, caries of bone, and disintegrating joints may be painlessand insensitive. As a general rule, tactile sensibil
Nervous and mental diseases . It may be limitedto thoracic or abdominal hands. It maybe unilateral or symmetrical. In figure147 it is of unusual outline, but will benoticed to roughly conform to some spinalsegments. In some eases areas at firstdiscrete have been observed to coalesceinto anatomical cord-territories. The analgesia may be partial or com-plete, and usually conforms in outline tothe thermo-anesthetic area or may be moreextensive. It embraces all the tissues, so that felons, caries of bone, and disintegrating joints may be painlessand insensitive. As a general rule, tactile sensibility is perfect. A slight diminutionof it is not inconsistent with the diagnosis, and its obliteration followsextreme invasion of the posterior columns, being then a part of theabsolute anesthesia that marks such a lesion. An anesthetic area maythus have a border of thermo-anesthesia and analgesia, or these condi-tions may be found in different parts of the body, in relation to theamount and distribution of the cord Fig. 149.—Thermo-anesthesia and anal-gesia (Brissaud). 390 DISEASES OF THE CORD PROPER. * Motor disturbances are dependent largely upon the invasion of theanterior horns and the pyramidal tracts. They are, therefore, usuallysecondary in point of time to the sensory symptoms with which they cometo be associated. As the anterior horn is invaded, the associated muscleslose power and their reflexes diminish and disappear. Some muscularatrophy is almost always present, and it may reach a high grade. Itsdistribution depends upon the part of the cord involved, and may con-form to many of the typical spinal atrophies, such as the form ofDuchenne-Aran, for which it has no doubt been frequently may be progressive or advance by spurts, and is most common in the upper extremities. Fibrillary twitch-ing and reaction of degeneration mark theatrophic muscles, as in other muscularatrophies of spinal origin, and theirstrength is reduced in proportion to them \
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