movements from the hip-joint, were developed to colossal proportions, contrasting strongly with the emaciated legs. Their walk was, therefore, very peculiar. As the

degeneration is going on, the disease may be arrested by the proper use of the direct current.

Figure 24 shows the appearance of a portion of muscle as examined by the microscope, October 21st, 1866.

Figure 25 represents a piece of the same muscle from the same part on December 3d, six weeks after treatment. In the first, oil-globules are seen to have displaced the muscular tissue to a great extent; the transverse striæ have disappeared entirely from some parts, and are faintly seen even where they are present. In the second, the quantity of fat is perceived to be very much les

sened, and the striæ are very much more numerous and distinct. This case, which was one of paralysis of the left leg and foot, entirely recovered.

After the power of the will is to some extent restored over the muscles, the induced current may be used with more advantage than the direct.

legs could only be used as stilts, at every step of the right or left foot there occurred a rotary movement, from behind forward, of the right or left thigh, which communicated itself to the whole body, causing it to turn at every step toward the one or the other side. The extensor power of the leg was very limited; the dorsal flexion of the foot and the extension of the toes were not in the power of the patients, and but a slight adduction of the toes possible; the patients trod upon the outer borders of the feet, and in the Mm. tibiales, consequently, contorted forms were exhibited. The adductors of the thigh, as well as the muscles of the foot, were normally developed; on the other hand, the extensors of the knee-joint, and all the muscles of the leg, had suffered greatly in respect of assimilative power. The sensibility of the skin and muscles was perfectly preserved. The electromuscular contractility was reduced in the quadriceps femoris, and altogether wanting in the Mm. peronæi, the extensores digit. comm., the gastrocnemii, etc., but the adductors of the knee-joint and the toes showed a weak reaction. The rare occurrence of an affection of this kind as the result of measles, together with the simultaneousness of its appearance in the twins, who had, up to that time, enjoyed perfect health, gives good ground for the presumption of a fundamental anatomical predisposition to the disease. An electric and tonic gymnastic treatment, continued for a year, had no perceptible effect. At the present time, both the twins are incapacitated for any forward movement.

The intensity of the current generated by the instruments I have described, is very great. They should not, therefore, be applied to any part of the body to which the fifth pair of nerves is distributed, as the retina may be injuriously excited and even blindness be produced. The induced current has no such effect.

Along with the galvanism, passive motions of the joints should be made, and the child should be encouraged to direct the will to the affected muscles as often and as powerfully as possible.-W. A. H.]

B. Paralysis caused by Interruption in the Conducting Power of the Spinal Cord.

If the spinal cord is subject to a considerable pressure, produced by exostoses or periostoses, or by a gradually-forming curvature of the spine (as in Pott's disease), or by an affection of the fibrous and serous tissues, the electro-muscular contractility remains intact, notwithstanding the paralysis, and the affected muscles suffer but little in assimilative power. Of these paraplegias, there is a second and highly important diagnostic criterion—namely, the reflex movements, which occur in the paralyzed extremities whenever the lower part of the spinal cord is subjected to pressure or the skin is irritated, and sometimes through the influence of cold, etc.

Duchenne' gives the following case, falling under this head, with an accompanying dissection and report:

Pierre Bros, twenty-one years old, a robust, brawny water-carrier, experienced pains which centred in the lower part of the back, and radiated up to and embraced the lower ribs, preventing him from stooping. In the beginning of January, 1860, these were followed by weakness in the legs, and a staggering gait. On the 16th of February he was admitted into the Hospital Lariboisière. Both legs, and the trunk below the tenth rib, as well as the rectum and bladder, were deprived of all motor power and sensibility. The prick of a needle and cold were alike unfelt; both, however, as well as lying on the back, excited reflex movements, which the patient distinctly felt. He experienced also a sensation like that produced by the crawling of an insect. The proc. spin. of the sixth vertebra was evidently sprung outward, and was painful to the touch. Appetite, digestion, respiration, normal; both arms retaining their muscular power; the patient in good spirits. The only occasion of the attack was, as far as Bros was aware, the unusual exertions required

1 L. c., p. 253.

for the accomplishment of his regular work during the short winter days. On the sound leg and on both trochanters gangrenous spots appeared, which rapidly increased in size. The patient failed visibly; a nocturnal fever set in, followed by necrosis of the femur, and the swelling of the lower extremities; the paralysis extended up to the seventh rib, and on the 12th of April death ensued. Duchenne had satisfied himself that the muscles of the paralyzed extremities retained their electric irritability, and inferred from this the integrity of the spinal cord.

The dissection gave the following results: The vertebræ, when laid bare, presented to the touch a soft, fluctuating surface; in cutting through the ligt. vertebrale ant., an accumulation of purulent matter was found; the organization of the sixth and seventh dorsal vertebræ was for the most part destroyed; the adjacent ones, from the third to the tenth dorsal vertebra, were superficially disorganized; the proc. spin. of the sixth dorsal vertebra formed a sudden projection from the line. After removal of the posterior arches of the vertebræ, the dura mater and the cellular tissue were found red, flocky, and swollen. The spinal cord presented to the naked eye no perceptible alteration; its consistency was unmodified.

CASE 22. Ch. K., a woman of twenty-eight years, who had been for the last ten years the mistress of an old, impotent soldier, had experienced at times, in the course of several years, shooting pains in the legs, which frequently changed their place. For a year past reflex movements now and then occurred, which, when the patient lay on her back, shook her entire body, and, if she happened to be on her feet, jerked up the one or the other leg, and thus rendered walking unsafe. In September, 1866, a remarkable degree of weakness was felt in both legs; the pains became more persistent and rending. In November the weakness increased; the patient staggered in her walk, was apt to turn her ankle, most frequently the right one, and often fell.

After an injudicious application of cold bandages to the body, which excited no transpirations, there ensued a complete paralysis of both the lower extremities, as well as a paralysis of the bladder and the rectum, and a cutaneous and muscular anæsthesia of so intense a degree, that the patient did not feel the prick of a needle, and could give no account of the position of her legs. Upon the internal use of strychnine, the patient was, by the end of December, so far improved as to be able to extend the muscles of the thighs a little, and sometimes to feel the passage of urine. The menses were regular, and remained thus during the period of the disease.

When, at the request of Dr. O. Steinrück, I visited the patient, February 5, 1867, the evidences of paralysis were still all present; the patient could not move either the thighs, the legs, or the feet; the anesthesia reached even to the navel, and was more intense on the right side than on the left. When the patient, held up on both sides, attempted to stand, her legs were so utterly incapable of giving support that they sank from under her, her feet slipping to the right and left; when lying on her back, her feet fell outward. The electromuscular contractility of the paralyzed muscles, when directly or indirectly irritated, was found but little modified; on the right side, in consequence, probably, of the greater reflex irritability of this leg, it was even a little raised, so that the contractions, especially upon irritation of the right plexus cruralis, were somewhat convulsive, causing the leg to be thrown up. Tearing pains also were felt in the legs, accompanied in the left N. ulnaris with a dull sensation. The case thus presented was undoubtedly that of a slowly-progressing gray degeneration of the posterior roots of the spinal nerves, which had gone on for several years, united with an active exudation of serum, which, by inducing a pressure on the spinal cord, brought on the paralytic effects.

I employed the secondary induction - current and wet sponges to excite the nerves and the muscles, and the