Page:The American Cyclopædia (1879) Volume XV.djvu/280

 268 SPINAL CORD the flower stalks are 2 to 3 ft. high, hollow, furrowed, and branching; the apetalous flow- ers are dioecious, the mule in long spikes, the female in clusters at every joint of the stem ; the calyx in the pistillate flowers hardens and forms an involucre to the seeds, and in some Spinach. varieties has two or three horns on the sides. But few varieties are known, the principal being the prickly, the smooth-seeded, and the lettuce-leaved. SPINAL CORD. See NERVOTJS SYSTEM. SPINAL DISEASES, the common appellation of diseases affecting the bony spinal column and the spinal cord and its membranes. The prin- cipal diseases of the spinal column are lateral curvature and angular curvature or Pott's dis- ease, sometimes called scrofulous caries of the spine. Lateral curvature is the more common, and usually affects girls between 10 and 20 years of age and women of sedentary habits. Those who take much exercise are not often its subjects, as the symmetry of the spinal col- umn is preserved principally by the action of the muscles. In its early stages lateral curva- ture is apt to escape detection, the first notice taken of it being generally the prominence of one shoulder, more frequently the right, or some elevation of the hip. The curvature is always double ; that is, when a curve has taken place in the upper dorsal region, a complemen- tary curve in the opposite direction will be found in the lumbar region, giving the spine a sigmoid appearance. Lateral curvature is also usually accompanied with more or less rotation of the spinal column, due to the action of the ribs, which are carried down on one side more than on the other. The treatment in slight cases is good diet, pure air, and well regulated exercise, and sometimes the administration of ferruginous tonics. When the curvature is considerable, stays, braces, and bandages will be of service ; but they must not take the place of exercise, and should be regarded as expe- dients rather than curative agents. Posturing and great attention to the position of the body SPINAL DISEASES when lying in bed should be employed as the chief hygienic measures. Angular curvature, or Pott's disease, is caused by inflammation of the bodies of the vertebrae and of the interver- tebral substance, usually commencing in the latter. It is often accompanied with tubercle, and some hold that it is essentially a scrofu- lous disease. The immediate cause of the cur- vature is caries, and it most commonly shows itself during the period of bodily development, usually attacking the lower dorsal region. Recovery sometimes takes place without pus making its appearance, but "spinal abscess" is a common accompaniment, the pus point- ing in the groin, and finding its way from the dorsal region beneath the fascia of the psoas muscle, under Poupart's ligament, forming what is known as " psoas abscess." The pus sometimes burrows beneath the muscles and involves the whole thigh. The abscess some- times appears above Poupart's ligament, and sometimes in the loin, forming in the latter case "lumbar abscess." "When the cervical vertebrae are affected, the abscess appears in the pharynx. Angular curvature is not diffi- cult of diagnosis, as the ill health, suppuration, and deformity are highly indicative. The in- itiatory symptoms are also not obscure, the principal being the persistent local pain and difficulty in bending the back, accompanied by great general disturbance and hectic fever. After curvature has taken place recovery is always accompanied by anchylosis, from union of newly formed bony tissue. The treatment requires careful attention to the general health, including good diet and the employment of ton- ics and alteratives, such as iron, quinine, iodine, and cod-liver oil. The local applications of fo- mentations and leeches and of counter-irritants are also serviceable. Setons, moxas, and mer- cury, as tending to exhaust the strength, are to be avoided. On getting up, the patient's back should be supported by some kind of mechanical appliance. The abscess should not be opened too hastily, for it may be absorbed ; but when it progresses steadily a free opening should be made, under a piece of lint saturated with car- bolated oil, to prevent entrance of air. The principal diseases of the spinal cord, that is, the pathological conditions to which it is sub- ject, are spinal meningitis, myelitis, and spinal apoplexy. These conditions give rise to or aid in developing a variety of symptoms, which in turn are classed as diseases, such as paralysis (including paraplegia and spinal hemiplegia), general spinal paralysis, and locomotor ataxia. The diseases known as progressive muscular atrophy and infantile paralysis, although their causes are not clearly made out, are generally considered to be connected with affections of the spinal cord. Spinal Meningitis, or inflam- mation of the membranes of the spinal cord, corresponds to inflammation of the correspond- ing membranes of the brain, and rarely occurs in the arachnoid and pia mater independently of cerebral meningitis, except in cases pro-