That traumatic lesions of the spinal cord caused, for instance, by a fall, blow or gunshot wounds, may produce not only local but also remote changes, is proved by numerous clinical, pathologic and experimental studies. The local lesions are due to the direct effect of the injury, that is to say, to the contusion; the remote phenomena are the result of concussion. The former, manifesting themselves in laceration of the cord substance, hemorrhages, rupture of the meninges, etc., are, as a rule, so gross that a diagnosis is not difficult. In contrast, the phenomena of concussion may be so minute and microscopic that their demonstration is possible only after most careful study.
Discussed by me at some length elsewhere,1 they will be taken up here in conjunction with changes obtaining in spinal contusion.
—A Spaniard, age unknown, was admitted to my service at Cook County Hospital