and ultimately ends in complete paraplegia.
The pain is not confined to the region supplied by any one nerve root,
but affects a diffuse area, and the patient complains also of a
sensation of tightness in the limbs. There is never absolute
anaesthesia, but there is relative anaesthesia for all forms of
sensation, which extends as a rule as far as the sixth or eighth
thoracic root.

There are no vaso-motor phenomena, and no tendency to the formation of
pressure sores. Sometimes the patient complains of pain in the spine,
but this is not aggravated by movement.

_Treatment._--The treatment recommended by Horsley consists in
performing laminectomy, opening the theca, and washing it out with 1
in 1000 mercurial lotion. After the wound has healed, mercurial
inunction over the spine is employed to hasten the absorption of
inflammatory products. The administration of anti-syphilitic drugs has
not proved beneficial.

#Acute Spinal Meningitis.#--The spinal membranes may become implicated
by direct spread in cases of acute intra-cranial lepto-meningitis, or
they may be infected from without--for example, in gun-shot injuries
or in cases of spina bifida.

When the infection spreads from the cranial cavity, the cerebral
symptoms dominate the clinical picture, but evidence of involvement of
the membranes of the cord may be present in the form of rigidity of
the cervical muscles with retraction of the neck; deep-seated pain in
the back, shooting round the body (girdle-pain) and down the limbs;
painful cramp-like spasms in the muscles of the back and limbs, with
increased reflex excitability, sometimes so marked as to simulate the
spasms of tetanus.

When the theca of the cord is directly infected the spinal symptoms
predominate at first, but as the condition progresses it involves the
cerebral membranes, and symptoms of acute general lepto-meningitis
ensue.

Once the condition has started little can be done to arrest its
progress, but the symptoms may be relieved by repeated lumbar
puncture.

#Spinal Myelitis.#--The term "myelitis" is applied to certain changes
which occur in the spinal cord as a result, for example, of haemorrhage
into its substance (_haemorrhagic myelitis_); or of pressure exerted on
it by fragments of bone, blood-clot, tuberculous material, or new
growths (_compression myelitis_).

In another group of cases myelitis is a result of the action of
organisms or their toxins. Syphilis is a common cause, bu