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Updated: May 24, 2025


The diminished supply of oxygen to the brain and to the muscles produces muscular twitchings, and sometimes convulsions. Finally the pupils dilate, the sphincters relax, and death ensues. Young children stand the loss of blood badly, but they quickly recover, as the regeneration of blood takes place rapidly.

Thus the motions of the sphincters of the bladder and anus were originally excited into action by irritation; for young children give no attention to these evacuations; but as soon as they become sensible of the inconvenience of obeying these irritations, they suffer the water or excrement to accumulate, till it disagreeably affects them; and the action of those sphincters is then in consequence of this disagreeable sensation.

But the reflex function exists as a continuous muscular action, as a power presiding over organs not actually in a state of motion, preserving in some, as the glottis, an open, in others, as the sphincters, a closed form, and in the limbs a due degree of equilibrium or balanced muscular action a function not, I think, hitherto recognized by physiologists.

Closely related to the apathy, and probably merely an expression of it, is the inactivity which is both muscular and mental. It exists in all gradations from that of flaccidity of voluntary muscles, with relaxation of the sphincters, and from states where there is complete absence of any evidence of mentation to conditions of mere physical and psychic slowness.

The fact that the lower animals are excited by the same emotions as ourselves is so well established, that it will not be necessary to weary the reader by many details. Terror acts in the same manner on them as on us, causing the muscles to tremble, the heart to palpitate, the sphincters to be relaxed, and the hair to stand on end.

The paralytic symptoms gradually go on increasing, the sphincters refuse to act, and death may occur from suffocation and choking. Sometimes, during the earlier stages especially, there may be maniacal paroxysms or epileptic fits.

All the fibres in the parietes and septum are circular, as in the sphincters; those, again, which are in the columns extend lengthwise, and are oblique longitudinally; and so it comes to pass that when all the fibres contract simultaneously, the apex of the cone is pulled towards its base by the columns, the walls are drawn circularly together into a globe the whole heart, in short, is contracted and the ventricles narrowed.

Exaggerated respiratory activity; air hunger; anxiety; congested appearance of face; ringing in ears. Loss of consciousness; convulsions; relaxation of sphincters. Respirations feeble and gasping, and soon cease; convulsions of stretching character; heart continues to beat for three to four minutes after breathing ceases. Post-Mortem Appearances External.

When the injury is in the dorsal region, there is paralysis of the legs and of the sphincters of the bladder and rectum, but power is retained in the arms and the upper intercostal muscles act, the extent of paralysis depending on the level of the lesion. In injuries to the lumbar region the legs may be partly paralysed, and the rectal and bladder sphincters may be involved.

During the three weeks that followed she remained in bed, recovering only the function of the arm. Her husband fed her by forcing open her mouth with a spoon. She did not lose control of the sphincters. As she manifested no other progress to recovery despite the administration of drugs, numerous-rubbings and liniments, the physician in charge called the writer into consultation.

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