On spinal apoplexy / [Alexander Peddie].

  • Peddie, Alexander, 1810-1907
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: On spinal apoplexy / [Alexander Peddie]. Source: Wellcome Collection.

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    speculation. To Dr Hall in particular belongs the merit of pointing out satisfactorily the Reflex functions of the spinal cord,1 and its capacity for dispensing motor power independently of volition. In the instance under consideration, while so large a portion of the cord, about eight inches, was to all appearance as disqualified for the reception and discharge of sensory and motor influence, as if it had been removed from its place, the most sudden and energetic contractions were produced by gentle tickling of the soles of the feet, without communicating any impression to the mind. This effect proves the independence of the spinal functions under such circum¬ stances; and supports the inference which Dr Budd in his “ Contri¬ butions to the Pathology of the Spinal Cord,”2 draws from some in¬ teresting cases of paraplegia, that such muscular movements vary in extent and force, inversely with the degree of voluntary power pos¬ sessed by the afflicted limbs. It may be interesting here to notice that the priapism, so readily excited by the stimulus of the catheter, is not merely an example of the reflex power exerted independently of an emotional impulse or sensation, but is also a proof of the influence which is thus exercised over a decidedly organic function, namely, that of vascular tur- gescence.3 But the chief interest of this case, as connected with the func¬ tions of the spinal cord, and the theory of reflex power, seems to consist in the following fact. When the patient wTas moved in bed, unless care and force were employed by his attendants, very powerful contractions were induced in the extremities, the legs flexing forcibly on the thighs, and the thighs on the abdomen, and then a little pain was felt in the upper part of the dorsal region corresponding to the lowest portion of healthy cord in con¬ nexion with the sensorium. Now, here appears to be an instance of what might be called a compound or double reflex action. First, the impression is made on the surface, and conveyed along the sensory or afferent nerves to the cord, which it affects without any sensa¬ tion appreciable by the mind, and from thence it is reflected through the motor or efferent nerves to the muscles, occasioning contractions. But nowT having arrived at this stage, how are wre to account for the rest of the process, namely, the return to the cord of the impression produced by the contractions, through the same class of nerves which conducted the first impression (the stimulus), and the trans¬ mission of it through a large segment of disorganised medullary 1 Transactions of Medico-Chirurgical Society of London, vol. xxii. xxiii. and xxiv. also, in treatise “On the Diseases and Derangements of the Nervous Sys¬ tem,” and more lately, “New Memoir onTrue Spinal Marrow, and its Anatomy,” &c. 2 Transac. Med.-Chir. Soc. of Lond., vol. xxii. p. 185. Ibid, p. 176 : also Muller’s Physiology, vol. i. p. 225, for proof that erection is caused solely by vascular turgescence, and vol. ii. p. 1483.