Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

But in another case you may find nothing of the kind, and you are driven to assume a diseased condition of the lower portion of the cord, perhaps a simple atrophy. Now, let me convince you that you can have all these symptoms, that they may go on to complete paraplegia, and the patient may die, and that then you may find the cord perfectly healthy, so far as our examina- tion can teach us, while the kidneys and bladder, either or hotli, are found the seat of manifest disease. M. Rayer, in his great work on diseases of the kidneys, (vol. iii. p. 108,) says, " The development of paralysis after diseases of the urinary passages is even now a fact unknown to a great many physicians." As the condition of the urinary organs im- proves, so the recovery of power in the limbs is manifest; but in fatal cases there will grow all the appearances of severe inflam- mation of these organs, while the brain, cord, and vertebrae are perfectly healthy. So that while, on the one hand, disease of the urinary organs is constantly caused by paraplegia, so, on the other, paraplegia, through the sympathetic, is frequently con- secutive to diseases of the urinary organs. To enable us to distinguish this form of paraplegia from that depending on spinal disease, Dr. Wells says, we must first bear in mind the history of the case, and compare this with the his- tory of injury or disease of the vertebrae, or intervertebral car- tilages, or inflammation of the cord and its membranes, and bear in mind the following characteristics: — 1. There is found in " urinary paralysis " some impediment to the discharge of urine, as one of the earliest symptoms. 2. This is closely connected with some obstinate gastric de- rangement. 3. The weakness in the limbs is rather extreme debility than true paralysis. ■i. The tactile skin sensibility is but slightly, if at all, im- paired, while the muscular sense may be, and usually is, almost totally lost. 5. The limbs are tolerably well nourished; they may be thin, but there is no marked muscular atrophy, and their temperature is very little lowered.