TREATMENT.—The treatment of spinal tumors can be compressed into very small compass. In cases with syphilitic history, or when such history is suspected, although not admitted, antisyphilitic remedies should be applied with great vigor. It should be borne in mind, however, that even in syphilitic cases after destruction of the cord by compression or softening specific remedies will be of no avail. In tubercular cases and in those in which the system is much run down tonics and nutritives are indicated. Bramwell11 advises an operation in any case in which the symptoms are urgent, in which the diagnosis clearly indicates the presence of a tumor, when there is no evidence of malignant disease, when the exact position of the growth can be determined, and when a vigorous antisyphilitic treatment has failed to produce beneficial results. As some meningitis, meningo-myelitis, or myelitis is usually present in cases of spinal tumor, treatment for the complication will assist in relieving the torments of the patient. Anodynes, particularly opium and its preparations, should be used freely in the later stages of the affection. Bromides and chloral are of little value except in association with opiates. Operation offers even less hope than in brain tumor, but in very rare cases should be taken into consideration.
TABLE OF FIFTY CASES OF SPINAL TUMOR.
| No. | Sex and Age. | Clinical History. | Path. Anat. and Location. | Remarks. |
| 1 | M. 33. | Paresis of forearms, left worse. Paraplegia, then
paralysis of all limbs; paralysis of intercostals. Contractures of
hands, then of feet. Pain and stiffness of neck on motion. Wasting of
interossei. Diplegic contractions of legs. Only partial paralysis of
sphincters. Sensation perfect. Bed-sores. Duration, thirteen months. | Glioma; syringo-myelus. Dilated lymphatics.
Entire length of cord, and involving medulla oblongata. Upper four
inches of cord greatly enlarged. | T. Whipham, Trans. Path. Soc. London, 1881, xxxii. 8-12. |
| 2 | F. —. | Constricting pains about abdomen. Paresis of legs.
Persistent subsultus. Temporary improvement after labor. General
paralysis. Scoliosis. | Glio-myxoma.
In gray columns from medulla oblongata to cauda equina. | Schueppel, Arch. d. Heilk., viii. Bd., 1867 (quoted by
Rosenthal). |
| 3 | M. 15. | Paresis of left arm. Pain back of neck. Later,
paralysis of left arm, and wasting of arm, shoulder, and neck muscles.
Slight paresis of right arm. Prolonged vomiting. Constriction of neck;
dysphagia; paralysis of chest. | Gelatinous tumor left side of cord, and
involving in some parts the gray matter.
From medulla to sixth cervical vertebra. | S. Wilks, Lectures on Dis. of Nervous System, p. 266. |
| 4 | M. 18. | Paresis of left leg, increasing; some atrophy.
Weakness in left arm. Later, numbness in both legs. Contracture of
fingers. Some mental confusion. Left hand and leg livid and cold.
Hyperæsthesia of left leg; anæsthesia of right leg, perineum, penis,
scrotum, rectum, and inguinal region, and of left arm. Right arm
normal. Islands of heat and cold in leg, and of cold in arms. Left
ankle clonus. Left pupil contracted. Vomiting. Dysphagia.
Occipito-cervical pain and contracture of cervical muscles. Leg
contractures and tremor. Later, hyperæsthesia disappeared.
Incontinence of urine. Patellar and skin reflexes increased. Facial
spasm. Amblyopia, optic neuritis, diplopia, deafness, paralysis of
left abducens; pupils contracted. Sacral bed-sores. Thick speech. | Round-celled sarcoma or glio-sarcoma,
growing from ependyma of central canal, causing hydromyelia,
softening, and secondary degeneration. Dura mater thickened. Brown
exudate in cord and base of brain.
From medulla oblongata to dorsal cord. | Schultze (F.), Arch. f. Psychiat., Berlin, 1878, viii.
367-393, 1 pl. |
| 5 | F. 48. | Pain in abdomen and down legs, worse on left side.
Tonic spasm in flexors and adductors of thighs. No anæsthesia. Two
months before death paralysis of sphincters. Great emaciation. | Tumor (psammoma), growing from dura mater on
right side in cervical region.
Upper part of cervical region. | J. Hutchinson, Jr., Tr. Path. Soc. Lond., 1881-82, xxxiii.
23, 24. |
| 6 | —— | Pain in arms. Contracture of fingers of right, then
left side. Numbness in right foot, then upward, then left foot. Girdle
feeling. Priapism and dysuria. Complete anæsthesia, later, up to third
rib, with paralysis of legs and paresis of fingers. Respiration
diaphragmatic. Legs very jerky. Later, arms paralyzed. | Sarcoma of left post. aspect of cord;
adjacent cord compressed and soft. Belt of yellow substance enveloped
cord to cauda equina.
Between cervical bulb and second cervical vertebra. | E. Long Fox, Bris. Med.-Chir. Journ., 1883, i. 100-106, 2
pl. |
| 7 | F. 31. | Pain, stiffness in neck; pain radiating, aggravated
by jarring. Sudden paralysis of both arms; next day paralysis of legs,
incomplete. Partial anæsthesia. Marked skin reflexes in legs. Patellar
reflexes retained, weaker on right than left. Dyspnœa. Profuse
perspiration. Cardiac irregularity. Day before death temperature in
right axilla 100°; left, 102.2°. | Gumma of dura mater two inches long, with
intercurrent hemorrhage; flattening and softening of cord, with
secondary sclerosis.
From first to fifth cervical vertebra. | Charles K. Mills, Philada. Med. Times, Nov. 8, 1879, p. 58. |
| 8 | M. 34. | Pain in back of neck, with stiffness and
torticollis. Paresis of arms; later, of legs. Anæsthesia of arms, then
of legs; also paræsthesia of legs. Late symptoms: shortening and great
rigidity of neck, with choking sensation (girdle sensation at neck).
Dimness of vision. Atrophy of arms and less of legs. Complete
paralysis of arms, almost complete of legs. Electro-contractility
preserved. Violent skin reflexes in legs. Involuntary evacuations and
incomplete priapism. Severe pains in knees and ankles. No acute
bed-sores.
Paroxysms of dyspnœa. Average temp. for two weeks
before death, M. 97.9°, E. 98.3°. | Gumma of dura mater; caries, probably
syphilitic, of vertebræ. Abscess. Total (almost) transverse sclerosis
of cord. Secondary degeneration. Some softening above and below tumor.
Cervical nerves compressed and atrophied.
From second to fifth cervical vertebra; most in front. | Charles K. Mills, Philada. Med. Times, Nov. 8, 1879, p. 58. |
| 9 | M. 43. | Pain between shoulders. Numbness in right hand and
arm, with weakness and swelling. Numbness in left arm, which spread
over chest and abdomen. Unable at first to lie down. Felt as though
encased in armor. Pain in back of neck. Tongue protruded to right.
Exaggerated reflexes in legs. Right arm and leg weaker than left.
Vertigo. Dysphagia. Sense of constriction about neck. Breathing
impaired. | At third cervical vertebra, to right of
front of cord. Destruction of opposite vertebra. | E. H. Clark, Bost. Med. and Surg. Journal, 1859-60, lxi.
209-212. |
| 10 | —— | No record of symptoms especially referable to the
cysticercus. Symptoms of tabes dorsalis. | Cysticercus in substance of cord. Lesions of
tabes dorsalis.
On level with third cervical nerve. | Geo. L. Walton, ibid., vol. cv. p. 511. |
| 11 | M. 25. | Pain in back of neck; stiffness. Numbness of left
hand. Gradual loss of power of left arm. Jerking of arm. Paresis of
left leg. Constriction of upper chest. Right limbs involved, and
eventual complete paralysis of trunk and extremities. Severe headache.
Last three days absolute anæsthesia of arms and legs. No
ophthalmoscopic changes. Constipation and dysuria. | Fibro-sarcoma at level of fourth cervical
nerves. Cord compressed. | H. A. Lediard, Tr. Path. Soc. Lond., 1881-82, xxxiii.
25-27. |
| 12 | F. 25. | Œdema of ankles; pain in legs; afterward numbness,
formication, and stiffness of legs. Painful contractures in upper
extremities. Slight left scoliosis. Abdominal pains. Paresis of arms.
Fingers flexed. Fever. Respiration became involved, and bowels and
bladder paralyzed. Mind clear. Died in attack of suffocation.
Duration, two years and three months. | Fibroma, size hazelnut, under pia mater.
Between fourth and fifth cervical vertebræ. | Bernhuber, Deutsch. Klin., Berlin, 1853, v. 406. |
| 13 | M. 16. | Restlessness. Cramps in pharynx on swallowing.
Excitability. Delirium. Hallucination. Pain in the neck. On touching
neck general cramps. Grimaces. Salivation. In three days complete
paraplegia. No fever. Sudden change. Pulse 120. Pupils alternating.
Blepharospasm. Irregular respiration. Pulmonary œdema. Suspicion of
hydrophobia, because patient had been with hydrophobic dog; when
offered coffee had symptoms simulating rabies. | Sarcoma.
Extending from fifth to seventh cervical nerve on antero-lateral face
of cord, compressing left half and penetrating into right half, so
that anterior longitudinal fissure described arc of circle around it. | Adamkiewicz, Arch. de Neurol., Paris, 1882, iv. 323-336, 1
pl. |
| 14 | F. | Paresis and partial anæsthesia in all limbs for many
months, most marked on left side. Brain and special senses unaffected.
Had a tumor at bottom of right side of neck. Extensive bed-sore. | Carcinoma.
Tumor caused partial absorption of sixth cervical vertebra. Cord
compressed and twisted. Right lateral aspect especially affected. Cord
atrophied.
At level of sixth cervical vertebra. | J. W. Ogle, Tr. Path. Soc. Lond., 1885, 6, vii. 40, 41. |
| 15 | F. 34. | Pain in right foot, and paresis increasing to
paraplegia. Paresis of arms. Contractures of legs. Hyperæsthesia in
both legs up to crest of ilia. Later, great pain; paralysis of
sphincters. Bed-sores. | Sarcoma, growing from dura mater; nerves
passing through and over tumor. Cord congested and pushed to one side.
Thin, but not softened. Growth resembled psammoma.
Between sixth and seventh cervical nerves of left side. | T. Whipham, Tr. Path. Soc. Lond., 1873, xxiv. 15-19. |
| 16 | M. 57. | Pain in right arm. Numbness in hand, and paresis.
Paresis and coldness of left leg. Some anæsthesia and wasting of right
leg. Later, paraplegia. Diminished reflexes. Contractures.
Constriction sense about legs and abdomen. Triceps, deltoid, and
serratus magnus of right side paralyzed. Incontinence of urine,
difficult defecation, decubitus, fever. Abdominal muscles paralyzed.
Later, other muscles of arms paralyzed. Complete anæsthesia of legs.
Dyspnœa, œdema of lungs. | Myxoma from arachnoid. Cord compressed and
softened on right postero-lateral side. Secondary degeneration. Some
œdema of brain.
At sixth and seventh cervical vertebra on postero-lateral surface of
cord. | Pel (P. K.), Berlin. Klin. Wochensch., 1876, xiii. 461-463. |
| 17 | F. 35. | First, pain in right arm, weakness in right hand.
Then paralysis almost complete in arms, and impaired sensation. In
legs paralysis complete, sensation impaired. Alternate incontinence
and dysuria. Ankle clonus and increased knee-jerks and plantar reflex.
Tapping biceps causes reflex in little and ring fingers. No atrophy or
bed-sores. Cold on one side, hot on other. Pain and little swelling
over sixth cervical vertebra. No eye symptoms. Brain clear. Inability
to turn head. Before death respiratory paralysis and bed-sores.
Duration, fifteen months. | Spindle-cell sarcoma, springing from
arachnoid and destroying cord by pressure, except posterior columns.
Cord below tumor soft.
At sixth cervical vertebra. | E. Long Fox, Bris. Med.-Chir. Journ., 1883, i. 100-106, 2
pl. |
| 18 | M. 50. | Paresis in right arm. Stiffness in neck and back.
Paralysis of all extremities gradually developed. | Glioma in right half of cord. Old
hemorrhages in adjacent parts and in medulla oblongata. A more recent
hemorrhage in dorsal cord.
In lower cervical region. | Schueppel, Arch. d. Heilk., viii. Bd., 1867 (quoted by
Rosenthal). |
| 19 | —— | Coldness, numbness, violent pains, first in left
arm, later in both legs. Paralysis of all limbs and muscles of trunk.
Atrophy. Reactions of degeneration. Violent leg reflexes. | Tubercle, large as hazelnut. Consecutive
myelitis of adjacent parts and left anterior horn.
In lower cervical region. | Chvostek, Med. Press, 33-39, 1873 (quoted by Rosenthal). |
| 20 | M. 45. | Interscapular pain. Chest-pressure and dyspnœa.
Paræsthesia and pain in legs. Spastic paralysis. Difficulty in stools;
bloody urine and dysuria. Œdema of legs. Bed-sores. Kypho-scoliosis.
Pain on pressure over spine. Paralysis of left leg, paresis of right,
some anæsthesia of both. Broncho-pneumonia, fever. | Phlegmon of dura mater, compressing cord.
Some infiltration of tissues of throat and mediastinal space.
From seventh cervical to second dorsal vertebra. | Mankopff (E.), Berl. Klin. Wochensch., 1864, i. 33-46, 58,
65, 78. |
| 21 | M. 22. | Pain in back and side of neck and in limbs. Marked
pain in sternal region on coughing. Pressure and jarring cause pain.
Rapid loss of power in both arms. Feeble and slow movements of thighs,
legs, and feet. Right deltoid and flexors of fingers much wasted. No
paralysis of face. Knee-jerks exaggerated. Later, complete paralysis,
including bladder and rectum. | Tumor of membrane. Cord beneath compressed
and degenerated.
Lower cervical and upper dorsal region. | H. C. Wood, “Proceedings of Philadelphia Neurological
Society,” Medical News, vol. xlviii. No. 9, Feb. 27, 1886. |
| 22 | F. 50. | Pain in neck, shoulders, and chest. Stiffness of
neck, back, and arms. Chest fixed; breathing diaphragmatic. No
paralysis or altered sensation. | Secondary cancer of vertebræ.
Cervical region. | Gull, by Wilks, in Lect. on Dis. of Nerv. System. |
| 23 | F. 40. | Severe pain in back. At height complete paralysis in
legs, some paresis in arms. Variable anæsthesia. Girdle sensation and
mammary pain. Lively and distressing reflexes. Contractures in legs.
Bed-sores and paralysis of sphincter of bladder. Toward close rigors
(pyæmia?). | Fibro-cyst on right side, between cord and
dura, and between anterior and posterior nerves.
Top of dorsal region. | Risdon Bennett, Tr. Path. Soc. Lond., 1855-56, vii. 41-45. |
| 24 | M. 30. | Cough, dyspnœa, wasting, simulating phthisis. Pain
in back of neck and shoulders. Pain in joints; paresis of legs and
bladder. Pain in chest. Paresis of arms. Later, increased paralysis,
bed-sores, sweating. | Tumor, size of hazelnut, inner anterior
surface of dura mater. Flattening and softening of cord.
Top of dorsal region. | Gull, in Guy's Hosp. Rep., (quoted by Wilks in Lectures on
Dis. Nerv. Syst., p. 264). |
| 25 | F. 43. | Pain in shoulders, chest, and sides. Contractures of
legs; heels to nates. No anæsthesia. Later, retention of urine and
bed-sores. Incessant pain in back and abdomen. | Fibro-nucleated tumor from inner surface of
dura mater.
Opposite third dorsal vertebra. | Gull, by Wilks, ibid. |
| 26 | F. 43. | Pain in chest and shoulder, then in legs. Paresis of
legs. Contractures and jerking of legs. Spasm of abdominal muscles. No
anæsthesia. Paresis of bladder and rectum. Wasting and bed-sores.
Finally, paresis increased, but never complete paralysis. Duration,
nine months. | Fibro-nucleated tumor, size of a bean, from
dura mater. Cord compressed backward, and softened.
Opposite third dorsal vertebra. | Wilks, Trans. Path. Soc. Lond., 1855-56, vii. 37-40. |
| 27 | M. 24. | Paraplegia. Depressed reflexes; girdle symptom.
Partial anæsthesia. Dysuria. Vomiting. Pulse weak and intermittent.
Partial recovery from paralysis, and anæsthesia in left leg, and
reflexes in right foot regained. Later, complete paraplegia,
anæsthesia, and bed-sores. Duration, five months. | Probable gumma.
Middle dorsal region. | B. G. McDowell, M.D., Dubl. Q. J. Med. Sci., 1861, xxxii.
299-303. |
| 28 | F. 44. | Paresis in legs. Spine hypersensitive and
inflexible; least attempt at bending causes great cervico-brachial
pain. Paræsthesia; sense of falling out of abdominal viscera through
abdominal walls. Pains in extremities increasing, and involving right
shoulder, intercostals on both sides, and lumbar region. Paralysis of
right arm (first); complete paralysis of leg. Excessive spinal
tenderness. Loss of sensation (partial) in legs, body, and right arm.
Later, dyspnœa, then dysuria, then complete inability to empty bowels
or bladder. Great tympanites. Girdle sense above umbilicus, and
finally complete paralysis and anæsthesia below this band. Sense of
twisting of legs and feet, so that latter seemed close to face.
Œdema. Later, paresis of left arm. One small bed-sore. | Alveolar sarcoma.
Eighth and ninth dorsal vertebræ. | G. W. H. Kemper, Journ. Nerv. and Ment. Dis., xii. No. 1,
Jan., 1885. |
| 29 | F. 42. | Projection of seventh, eighth, ninth, tenth, and
eleventh dorsal vertebræ. Numbness below ankles, and early girdle
sensation. Peronei and anterior tibial muscles first involved; then
all leg-muscles, then sphincters, then arms. Died in a fit. | Round-celled sarcoma. The anterior columns
soft opposite tumor. Bodies of seventh, eighth, ninth, and tenth
vertebræ soft.
Opposite seventh, eighth, ninth, and tenth dorsal vertebræ. | E. Long Fox, Brit. Med. Journ., 1871, p. 566. |
| 30 | F. —. | Ill-defined hemiplegia; later, paraplegia, with
contractures and rigidity. | Gumma and syringo-myelus. Small cavities in
anterior cornua.
At ninth dorsal vertebra anterior aspect. | Taylor, Lancet, 1883, p. 685. |
| 31 | M. 7. | Paraplegia, except adductors and rotators of thigh.
Reflex contractures; most intense from irritation of penis and
scrotum. Rigidity of legs. Complete anæsthesia of lower half of body.
Later, anuria, incontinence of feces. Anal sphincter reflex; figured
stools. Cystitis. Pain on percussion in dorsal region. Pain in back.
Complete paraplegia. Very late, brain symptoms. Duration, nine months. | Tubercle (?).
Cord soft for two inches.
Tenth dorsal vertebra. | Geoghegan, Dublin Med. Press, 1848, xix. 148-151. |
| 32 | F. 46. | Fixed pain in left iliac region. Paresis in left
leg, increasing to paraplegia. Formication. Girdle sensation.
Incomplete, increasing to complete, anæsthesia of legs. Spontaneous
twitchings. Bladder and sphincter ani paralyzed. Bed-sores. Duration,
one year. | Fibroma (?) from inner surface of dura. Cord
hollowed out and softened.
Interval between tenth and eleventh dorsal vertebræ. | William Cayley, Tr. Path. Soc. Lond., 1864-65, vol. xvi.
21-23. |
| 33 | M. 30. | Hyperæsthesia; later, anæsthesia in legs; then
complete paraplegia. | Tubercle size of pea. Adjacent myelitis. In
lower dorsal region. | Chvostek, Med. Presse, 33-39, 1873 (quoted by Rosenthal). |
| 34 | M. 31. | Ataxia; stiffness of legs and cramps in abdomen and
legs. Slight nystagmus. Difficulty in forming words. Ataxia of arms.
Slight wasting of legs, especially of left. Lumbar pains; abdominal
cramps. Dysuria. Impotence. Later, increased spastic state of legs.
Mind depressed and emotional; attempts at suicide. Anuria. Bed-sores.
Urine albuminous. Duration, one year. | Myxoma of dura mater 3 inches long. Dura
mater of brain contained fluid and lymph.
Dorsal region, left side. | Shearman, Lond. Lancet, vol. ii. 1877, p. 161. |
| 35 | F. 50. | Pains in limbs (thought to be rheumatic). Paresis in
legs. Hyperæsthesia in right leg; burning pains alternating with sense
or coldness. | Cancer of vertebræ (sarcoma?).
Dorsal region. | Gull, by Wilks, Dis. Nerv. Syst. |
| 36 | F. 35. | Paresis of left leg; soon of right leg. Pain in back
and left side. Tonic spasms of legs. Darting pains in knees. Partial
anæsthesia. Exalted plantar reflexes. Dysuria. Later, complete
paraplegia and anæsthesia; violent reflexes; severe pain in back.
Bed-sores. Duration, seven and a half years. | Tumor, osseous or fibrous, three-fourths of
an inch long, growing from dura mater. Cord flattened, and softened
below tumor.
Lower part of dorsal cord. | H. Ewen, Tr. Path. Soc. Lond., 1848-50, i. 179. |
| 37 | F. 28. | Weakness in legs. Aching and shooting pains in legs.
Numbness and formication. Slight spasm in legs. “Felt as if ground was
some distance below feet.” Œdema of ankles. Later, numbness extended
to abdomen. Paralysis of bladder. Hyperæsthesia in right leg.
Obstinate constipation. Bed-sores. Some paralysis of respiratory
muscles. Duration, fourteen months. | Tubercle the size of cherry, which had
almost obliterated cord. Tubercles in lungs, bowels, and uterus.
Bed-sore had opened spinal canal.
Lower part of dorsal cord. | S. O. Habershon, M.D., Guy's Hosp. Rep., London, 1872, 3d
S., xvii. 428-436. |
| 38 | M. 63. | Progressive paresis of left leg for five years.
Right leg then paretic. Paralysis then in left leg. Rigidity on
extension of right leg. Paroxysms of clonic spasms in right leg. Joint
pains, sciatic pains. In left leg, hyperæsthesia, in right leg,
anæsthesia. Plantar reflex retained; other reflexes exaggerated.
Diplegic contractions in right leg from irritation in left. Late
symptoms: purulent urine, with retention; chest and lumbar pains like
bone pain; extension changed to flexion; swelling of legs and
ecchymosis; sacral and other eschars. | Psammoma adherent to dura mater. Cord
softened. Ascending degeneration in posterior columns, and descending
degeneration of lateral columns.
In dorsal region just above lumbar enlargement, anterior left side. | Charcot, Arch. de Physiol., Paris, 1869, ii. 291-296. |
| 39 | M. 20. | Paralysis of lower extremities; tremor; exaggerated
reflexes, hyperæsthesia of trunk; bed-sores. Œdema of feet. Fever.
Pus in urine. | Organized blood-clot exterior to dura mater.
Cord compressed and softened.
Opposite lower dorsal and upper lumbar. | C. B. Nancrede, Am. Journ. Med. Sci., O. S., lxi. 156. |
| 40 | F. 38. | Pain around abdomen, in back, and legs. Paraplegia.
Anæsthesia and tingling of feet and legs. Paralysis of bladder. | Hydatid cysts of vertebræ (?) and spin.
canal.
Lower part of spinal canal (probably lumbar region). | S. Wilks, Dis. Nerv. Syst., p. 265. |
| 41 | F. 23. | Bronzing of skin for two years; then headache,
giddiness, fever. Choreic movements in left arm, then in leg, then
general. Bronzing increased. Vomiting after meals. Duration, two years
and two months. | Tumor, consisting of granular matter, with a
few nerve-fibres and cells, springing from centre of cord backward to
posterior fissure. Cord slightly widened. Suprarenal capsules large
and nodulated.
Lumbar enlargement. | W. H. Broadbent, Trans. Path. Soc. Lond., 1861-62, viii.
246. |
| 42 | 10 ms. | Twitching and convulsive movements of right leg.
After removal of exterior tumor the movements ceased. Child died of
peritonitis. | Tumor outside of sacrum, and also protruding
through sacral opening. Reported to have been behind and pressing upon
cord (?). Fatty growth within membranes. | Arthur Johnson, ibid., 1856-57, viii. 28, 29. |
| 43 | F. 54. | Paresis, first of left arm and leg; then paralysis
of these and of right arm and leg. Pain in back and hips early; then,
suddenly, darting pains and incontinence of urine. Paræsthesia of left
arm and leg; no anæsthesia. Coma. | Hydatid cyst. Cyst also in liver. Fluid
beneath membranes of cord and brain.
At first and second left sacral foramen, opposite last lumbar and
upper three sacral vertebræ. | H. S. Wood, Australian Med. Journ., 1879, N. S. i. 222. |
| 44 | M. 46. | Fibrillary twitching. Increased patellar reflexes.
Paræsthesia and hyperæsthesia in legs, disappearing. Constriction of
chest (?). Headache. Dysuria for two years. Straining at stool.
Indigestion. Bloody vomiting. Cardiac palpitation; intracardial
murmurs; slow pulse. Swollen inguinal glands. Variations in
temperature. Bed-sores. | Glioma.
At filum terminale, upper part. | Lachman, Arch. f. Psychiat., Berl., 1882, xiii. 50-62, 1
pl. |
| 45 | M. 38. | Pain in legs. Œdema. After two years could not lie
down: rested on hands and knees. Paralyzed in legs; pain in seat.
Anæsthesia in legs, not complete in right. Paræsthesia in left.
Dysuria and constipation. Before death had incontinence with
hæmaturia, and was able to lie down. | A lobulated tumor from pia mater at lower
end of spinal canal, surrounded by nerves of cauda equina. Structure
not made out.
At cauda equina. | W. W. Fisher, Tr. Prov. M. and S. Ass., 1882, x. 203-208. |
| 46 | —— | This case had symptoms of posterior spinal
sclerosis, which possibly had no relation to growth, according to
reporter. | Myo-lipoma attached to conus medullaris.
Crescentic, clasping cord from anterior to posterior fissure.
Nerve-roots of cauda equina imbedded in it. Contained striated
muscular fibres. | W. R. Gowers, Tr. Path. Soc. Lond., 1875-76, xxvii. 19-22. |
| 47 | Und.
1 yr. | Spina bifida (?); hydrocephalus; convulsions, bloody
stools; partial paraplegia. (Above symptoms came on after closing of
sacral opening by surgical operation.) | Congenital sacral neuroma amyilinicum. | W. F. Jenks, M.D., Trans. Path. Soc. Philada. (1871-73),
1874, iv. 190-192. |
| 48 | M. 30. | Pain in back; abdominal girdle sensation. Pain in
legs; paraplegia; nearly complete anæsthesia; paralysis of bladder;
bed-sores. | Aneurism, eroding vert. and compressing
cord. Location not given. | Wilks, Dis. Nerv. Syst. |
| 49 | M. 54. | Paralysis of both legs, of sphincter ani, and of
bladder; urine alkaline, with pus and blood. Partial anæsthesia.
Pyonephritis. | Gumma from inner layer of dura mater and
involving pia mater. Location not given. | Delafield, N. Y. Med. Rec., 1875, x. 131. |
| 50 | Still-
born. | —— | Tumor, size of head of child two years old,
projected between legs from spinal column. Nerves of cauda equina over
anterior part. Some bone in tumor (dermoid cyst?). | Virchow, Monatschr. f. Geburtsk., Berl., 1857, ix. 259-262. |
BY MARY P. JACOBI, M.D.