e cord is pressed upon, the motor paralysis and loss of
ordinary sensation are on the same side as the tumour, and the loss of
the sense of pain and of the temperature sense is on the opposite
side. Retention of urine accompanies the onset of paralysis, and later
gives place to incontinence. The rectum becomes paralysed, and
cystitis and pressure sores develop.

Anti-syphilitic treatment should be employed in the first instance to
exclude the possibility of the lesion being of the nature of a gumma.
Radical operative treatment is contra-indicated in intra-medullary
and in metastatic growths, but decompressive measures may be employed
for the relief of pain. In meningeal and extra-dural tumours, however,
in view of the hopeless prognosis if the condition is allowed to take
its course, an attempt may be made to remove the tumour by operation.
It is to be borne in mind that the lesion may be two or three segments
higher than the complete anaesthesia would appear to indicate; the
vertebral canal, therefore, should be opened about four inches above
the level of the anaesthesia.

When the tumour is not removable, the patient's suffering may
sometimes be alleviated by resecting the posterior roots of the nerves
emerging in the vicinity of the lesion.

#Chronic Spinal Meningitis.#--Victor Horsley (1909) described by this
name a condition which gives rise to symptoms closely simulating those
of a tumour of the cord. He believes it to consist in a
pachymeningitis combined with a certain degree of sclero-gliosis of
the periphery of the cord. The theca is greatly distended over a
variable extent of the cord; the cerebro-spinal fluid is increased in
quantity and is under considerable tension; and the cord itself
presents a shrunken appearance. Sometimes there is thickening of the
arachno-pia and matting of the nerve roots. The condition appears to
begin in the lower part of the cord, and to spread up, usually as far
as the mid-thoracic region. There is frequently a history of syphilis,
sometimes of recent gonorrhoea, but in some cases no cause can be
assigned for the lesion.

_Clinical Features._--This affection is almost always met with in
adults, and the earliest symptoms are pain and weakness in the legs,
and sometimes a slight kyphotic projection of the spinous processes.
The loss of power, which is sometimes attended with spasticity,
usually manifests itself in one leg first, and later affects the
other; it is progressive,