A system of practical medicine. By American authors. Vol. 5

by Unknown

⁵ “The Localization of Functions of the Spinal Cord,” American Journal Neurology and Psychiatry, iii., 1884.

The above table should be studied in connection with Gowers's diagram of the vertebral column and spinal cord ([Fig. 2, p. 53]), for the thorough study of cases of neural and spinal localization. Additional details of much value with respect to the peripheral nerve distribution are accessible in the works of Ranney⁶ and Ross⁷.

⁶ The Applied Anatomy of the Nervous System, N. Y., 1881, p. 355 et seq.

⁷ Handbook of Diseases of the Nervous System, Am. ed., Philada., 1885, p. 356 et seq.

III. The Localization of Lesions in the Medulla Oblongata.

In general terms, lesions of the oblongata are characterized by the early appearance and prominence of motor symptoms in the mouth, throat, and larynx, and by bilaterality of the symptoms. Remote symptoms consist of disturbances in the cardiac action and in the functions of some intra-abdominal organs. There may also be more or less paralysis of all the extremities. These lesions may conveniently be classified, like those of the cord, into systematic and focal.

A. SYSTEMATIC LESIONS OF THE OBLONGATA.—1. Systematic lesions of the æsthesodic system of the oblongata are, for purposes of practical diagnosis, unknown at the present time.

2. Systematic lesions of the kinesodic system of the oblongata, on the other hand, are often positively recognizable during the patient's life.