these cases is the reduction of the disease in the spine, and also of the stomach, liver, or lungs, almost constantly accompanying curvature of the spine.

I frequently find such patients harnessed with cushions and splints, but regarding them as worse than useless, I always remove them.

Note E.

TUBERCULA OF THE SPINE.

Caries of the Vertebra and Distortion of the Spine.

Master W. H. F., of the City of New York, of light complexion, aged 6 years. His parents brought him to me in Sept. 1837, with white swelling and distortion of the spine from tubercular disease of the eleventh and twelfth dorsal, and first lumbar vertebræ-the last dorsal projecting backwards, and it was with great difficulty he could maintain himself in an erect position. The disease (in which the common remedies had been used without benefit) commenced about two years before that time with pain in these vertebræ, which still continued with intervals of abatement, during a few weeks, when it would sometimes return with such violence as to produce spasmodic symptoms.

Prescribed, magnetic remedies.

His health soon began to improve, and in about six months it was entirely recovered. I examined his back a number of times during the summer and fall of 1838, and also on the 15th of June, 1839, and found it perfectly sound and strong, and he walked as erect, and appeared as well, as any boy of his age.

TUBERCULA OF THE SPINE AND NECK.

King's Evil, and White Swelling of the right side of the Spine.

Master J. M. S, of Union, Butler county, Ohio, aged seven years. I was called to see him, August 3d, 1833. He had a white swelling on the under jaw of the right side, and a number of large tubercles on the same side of his neck, and a white swelling on the right side of the lower dorsal vertebræ, (back bone,) and it was now about three weeks since the disease commenced. Prescribed, magnetic pills and plaster. In six weeks the white swellings disappeared, and his usual good health was re-established.

September 23d, 1833. Prescribed for Master W. C., the brother of Master J. M. S, aged 4 years. He had a white swelling of the neck, and lower jaw of the right side, over tubercles on the same side of

the neck. Prescribed, magnetic pills and plaster. In five weeks the swellings and tubercles had disappeared. His health continues good.

The case of J. M. S-, under the common treatment, like the following case of Master J. S- would have terminated in distortion of

the spine and lumbar abscess. This disease always commences with white swelling on the front or back side of the spine.

TUBERCULA OF THE SPINE.

Distortion of the Spine, Lumbar Abscess, White Swelling, &c

Master J. S, of Sycamore, Hamilton county, Ohio, aged twelve years. I was called to see him October 24th, 1832. He has tubercles of different sizes, on both sides of his neck, and it is now six years since they first appeared, and his health began to decline; and he had now a distortion of the spine (back bone) ninth dorsal vertebræ, which formed an obtuse angle backward; and the lumbar vertebra, (joints of the back bone belonging to the small of the back,) from this point to the os-coccyx, inclined to the right side, so far as to form nearly a half circle; which ⚫ with the whole left side of the back, was occupied with a large lumbar abscess. The distortion of the spine commenced three years before, with white swelling on the right side of the spine. He had also a white swelling on the left thigh, and a very great enlargement of the abdomen, produced by an enlargement of the mesenteric glands. The lumbar abscess had been discharging scrofulous matter about two years, which now amounted to more than half a pint in every twenty-four hours; and he was so much emaciated as to make his face, chest and limbs, except the left thigh, appear precisely like a skeleton covered with a thin skin. He had a severe cough, and was expectorating freely, and had hectic fever, night sweats, and diarrhea, with irregular vacillating pain in the chest and stomach, which was much increased by the little food he was able to swallow; and he was now, and had been for the last two months, so feeble as to be unable to move his head, body, or limbs, excepting only feeble motions of his arms. Three physicians had prescribed for him, at different times, without apparent benefit. Prescribed, magnetic pills and plaster. His health, in a few days, began slowly to improve, and the quantity of matter discharged from the abscess gradually became less, and his cough, expectoration, fever, night sweats, and diarrhoea gradually disappeared, and his strength improved. In May following, the discharge from the abscess was reduced to a teaspoon full in twenty-four hours, and the lumbar vertebræ had resumed their natural situation, in a line with the dorsal; and the enlargement of

the abdomen had disappeared; and on the first of August he was able to walk.

There was in this case a loss of bony substance in the dorsal vertebræ, by the ulceration, and the matter formed by it passed down along the facia of the psoas muscle, and through the groin into the upper part of the thigh and produced the swelling or abscess there. There was also a loss of bony substance by ulceration on the left side of all the lumbar vertebrææ, and the matter discharged from these produced the lumbar abscess, and these losses of bony substance was the cause of the distortion of the dorsal, and of the obliquity of all the lumbar vertebræ

EXPLANATION OF THE SUBJOINED CUTS.

Fig. 1 represents the case of Master J. S., as it was when I first saw it in October, 1832. A, lumbar abscess, with four openings, from which matter issued. B, psoas abscess, situated in the upper and inner part of the left thigh. CC, abdomen distended by tuberculated intestines and mesentery. DD, line of cervical glands, tuberculated on both sides of the neck. See the description of it, page 91.

Fig. 2 represents the same case as it was when published in June, 1834, and as it now is. The distortion of the ninth dorsal vertebræ backward, will be seen as in Fig. 1, and the tenth dorsal fallen down on its side, or nearly so; and it would be difficult to tell, according to Mr Sanson's views of such accidents, where that portion of the spinal marrow is, that once passed through its centre.

Caries of the vertebræ is the consequence of tubercula, or white swel ling of the vertebræ.

The disease it will be seen by an examination of the preceding cases, is easily distinguished by the new and natural symptoms in any of its stages, and easily cured by the natural remedies, and as a knowledge of these facts is of great importance to the community, I shall give copious extracts from a lecture on caries of the vertebræ, by M. Sanson, of the Hotel Dieu, who is one of the most distinguished surgeons in Europe, and was delivered before one of the most learned, and most numerous forums in the world, for the purpose of showing the great difficulty in distinguishing tubercula or scrofula, in this, as well as other parts of the body, by the common symptoms, and the common erroneous views of the disease, with the absolute uselessness of the common treatment for it.

M. Sanson was a candidate for the vacant medical chair in the university of Paris, occasioned by the death of Baron Boyer, and this lecture was a trial of his learning and skill, in an immense amphitheatre, before

the faculty of medicine, who were his judges, and more than 2500 students, and has been published and lauded in the medical journals of Europe and this country, and is consequently generally esteemed the very best authority on the subjects of which it treats

1. LECTURE OF M. SANSON AT THE CONCOURS OF PARIS, IN JUNE, 1834.The two patients who fell to the lot of M. Sanson, were placed at No. 19, Salle St. Martha, and No. 12, Salle St. Jeane, Hotel Dieu, and afforded subjects for the following lecture:

First Patient.-CARIES OF LUMBER VERTEBRÆ.

GENTLEMEN: The first is a child eight years of age, of a lymphatic temperament; his skin is fine and white, the abdomen much developed; the hair light coloured; in a word, he presents the characteristics of what may be called a scrofulous beauty. The family of this child is, according to all accounts, healthy, and he himself has enjoyed a good state of health until within eight months of the present time. At that period the patient first experienced some pain in the region of the loins, which remained for some time, I cannot tell exactly how long, as the answers of the child were not very precise on this point; the pains were not accompanied by any feebleness of the lower extremities, or symptoms of any organic affection. After a few months a tumor made its appearance at the upper part of the thigh, and was at first accompanied by pulsations, which have since disappeared. The swelling gradually increased in size, and is now as large as two fists. When examined by the hand, there is an evident feeling of fluctuation, and its volume is influenced by the position in which the patient may be placed. Thus, when the child lies down on his back, the tumor becomes less tense than in the upright posture, and if we press the hand flat on the thigh, the contents are displaced, and ascend into the illiac fossa; hence we may conclude the existence of a large cavity, filled with a liquid matter. I should remark that the skin is not adherent to the surface of the tumor, but is moveable on all points of it. The child, as was before remarked, seems to enjoy still a good state of health; he is not affected with diarrhoea or sweating; his appetite is good; sleeps sound; he walks without experiencing inconvenience, and the affection is as yet completely local. The sister of the ward says he has coughed for the last three months; this led me to examine carefully the state of the chest ; on auscultation we could not discover any symptoms of the presence of any tubercles in the lungs ; the respiration, on the contrary, was healthy; there was no matity upon percussion at any point of the thorax; the only abnormal sound was some mucous rale, indicating a chronic catarrh, but this was slight, and the expectoration was by no means abundant. What, we ask, is the nature of the disease under which our patient labours? It may be laid down, as a general rule, that when you have a tumor presenting itself at the upper part of the thigh, after a continuance of lumber or dorsal pains, the existence of caries of the vertebral column is very probable. The diagnosis is sometimes, however accompanied with difficulties; in the present case, indeed, we are assisted by a leading symptom, for we have a slight gibbosity of the lumber vertebræ, and hence we are justified in concluding that the vertebral column is affected; we should, however, in all cases, wait for the formation of an abscess, before we give a decided opinion, because in