Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 3: Ins-Pla
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit29464/770/
721t 
PHYSIOLOGY OF THE NERVOUS SYSTEM. 
urine from the bladder by the catheter ; this he 
found to be acid, a sufficient proof that the 
urine was not alkaline when secreted, but un¬ 
derwent the change during its stay in the 
bladder. 
In those affections of the spine which are 
not attended by a paralysed state of the blad¬ 
der, the urine is not alkaline ; let, however, the 
power of the bladder be impaired, even to a 
slight degree, and the quality of the urine will 
soon suffer. And it is well known that in cases 
where impediment to the flow of urine from 
the bladder occurs independently of any para¬ 
lysis of the organ, as from stricture of the 
urethra, a similar derangement in the quality 
of the urine is apt to take place. 
It must not, however, be forgotten that 
chronic disease of the brain or spinal cord is 
frequently accompanied by phosphatic urine, 
even when the power of the bladder is unim¬ 
paired, and that in such urine the addition of a 
little liquor atnmoniæ or potassæ will cause a 
more or less copious precipitate of triple phos¬ 
phate. There can, therefore, be no doubt that 
the cerebral or spinal lesion affects in some way 
or other the renal secretion so as to favour the 
developement of alkaline phosphates in it, and 
thus to create a tendency to its becoming 
alkaline. This, however, may arise not from 
any special influence upon the kidney, but 
from an undue waste of nervous matter, which 
would furnish the material for the formation of 
the phosphatic salt. 
A very striking connection between the 
spinal cord and the kidneys, whereby a dis¬ 
eased state of the latter organs induces a func¬ 
tional derangement of the former, is shown by 
the history of those cases to which the attention 
of medical men was first called by Mr. Stanley. 
The patients are more or less completely para¬ 
plegic, and all the symptoms of disease of 
the spinal cord exist : but at the same time 
there exists irritation or actual organic lesion of 
the kidneys, which, however, may be over¬ 
looked or attributed to the spinal disease. 
When the renal disease has been completely 
removed and the kidneys restored to their normal 
condition, the paralysis gets well; but more 
frequently both the renal disease and the pa¬ 
raplegia resist all remedial means, and the 
patients die. On examination, both the brain 
and spinal cord are found perfectly free from 
any organic lesion ; but distinct evidence of in¬ 
flammatory or other irritant disease of the 
kidneys exists.* 
In a case of this kind which came under ray 
own observation, there was, along with com¬ 
plete paralysis of sensation and motion in the 
lower half of the body, excessive hæmaturia, 
which had all the characters indicative of renal 
hemorrhage. From theman’s habits and history 
I suspected that the affection of the kidney had 
something to do with suppressed gout, and 
accordingly I used every means to attract gout 
to the feet. These means were successful, for, 
no sooner was my patient attacked with an 
active paroxysm of gout in one great toe than 
* Med. Chir. Trans, vol. xviii. 
the renal disease began to subside, and the pa- i 
ralytic affection disappeared simultaneously. 
Rayer, in his valuable work on diseases of 
the kidneys, relates several cases, which, in j 
addition to those put on record by Mr. Stanley, j 
leave no room to doubt that renal irritation may j 
be propagated to the cord, and may occasion j 
such an amount of disturbance of the functions 
of that organ as to give rise to paralysis of the j 
lower extremities. 
There seems no other mode of explaining ; 
these cases than by ascribing them to irritation 
of the cord excited by irritation of the kidneys, 
the nerves of the latter organ being the medium 
through which the renal affection excites the 
spinal. Yet there is no special connection be¬ 
tween the nervous system of the kidney and 
the spinal cord, excepting probably through such 
tubular fibres as may be found in the renal 
plexus. These probably run a short course, 
and their origin in the cord is in close proximity 
to their distribution in the kidney; and on this 
account they may be more obnoxious to the 
influence of irritant disease of the latter 
organ. 
The power which irritation of the cord has 
to develope erection of the penis may be here 
noticed as a remarkable instance of the influ¬ 
ence of that organ over a local circulation. 
For it is only by assigning it to a temporary 
turgescence of the complex vascular system of 
the penis that we can explain this erect state. 
Even in ordinary erection, excited by a stimu¬ 
lus applied to the glans, as already pointed 
out, the influence of the cord is called into 
action, and the phenomenon is produced by a 
reflex, or what Dr. M. Hall would call an . 
excito-motor act. Yet, (and here we may no-: 
tice how ill-chosen has this term “ excito-l 
motor ” been,) there is in reality no excitation 
of muscular action, but the influence of the. 
stimulus propagated to the spinal cord is 
extended by a reflex act to the nerves which , 
are distributed to the vessels of the penis, and 
they, instead of being excited to any contrac¬ 
tion, become rather relaxed, and are thus pre¬ 
pared to receive a larger supply of blood ; or 
by the extension of this excited influence of I 
the cord, the attractive force (vis a fronte) of I 
the capillaries is increased, and thus a larger 
quantity of blood is attracted to the organ, and 
erection takes place. The influence of the j 
nervous system on this act is shown by the j 
most convincing evidence—by the highly sen-,* 
sitive state of the organ, especially of the glans 
by the large size of its nerves ; by the effects of 
injury or disease affecting the cord imme¬ 
diately, or by extension from some part of the;j 
encephalon ; and lastly, by the experiment of!) 
Giinther, who divided the nerves on the dor-*l 
sum of the penis in a stallion, and thereby, 
destroyed the power of erection, although thesj 
vessels were uninjured. 
On the mechanism of the functions of the;j 
cord.—Having shown that the spinal cord isi: 
concerned in voluntary motions and in sensar'l 
tion, (mental nervous actions,) and in certain ; 
reflex actions, as well as in certain organic:) 
functions, (physical nervous actions,) it is inttjfil 
1 
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