be bathed in cold water. To get in bed and cover all parts of the body comfortably, is doubtless the quickest means of disposing of any cold. There are few colds that cannot be cured in this way within thirty-six hours; for the covering is the same from head to foot. When dressed, some parts of a person are much more barely clad than others.

I will give one instance out of many: Recently a good minister of the Gospel said to me that his little daughter coughed every night enough to keep her and the whole family awake till a late hour. I suggested to him that if she were properly covered, in the bed was the place to cure a cold or prevent coughing; that if he would see that she was just comfortably covered with her hands and arms under the cover, and it well tucked around her shoulders and up to her ears so as to prevent currents of air from passing up and down her neck and body as she would breathe, that I did not think she would cough at all. He tried it the following night, and was much surprised to find that she did not cough at all that night, nor afterward at night, and in a few days was well of her cough.

I have so thoroughly tested the thoughts and conclusions here presented, during the past six years, that I now have them published with no doubt of their correctness.

FUNCTIONAL DISTURBANCES OF THE SPINAL CORD.

Read at the April Meeting of the Shelby County Medical Society,

BY B. F. TURNER, M.D.

Before entering upon the consideration of the signs of the pathological conditions of the spinal cord, I beg to occupy a moment in recalling to mind the physiology of that organ.

The spinal cord serves, 1, as a conductor of motor impulses from the brain to the peripheral nerves, and of sensory impulses from the peripheral nerves to the brain; 2, as a series of centers of reflex action; 3, as the seat of centers which govern the nervous action of structures immediately under control of the sympathetic system, e. g., the bladder and rectum; 4, it controls nutrition of the tissues of the body.

Furthermore, if we consider a transverse section of the

spinal cord, we know that its anterior half is made up mainly of motor fibers, and its posterior half mainly of sensory fibers.

If, now, we bear in mind these physiological and anatomical features of the cord, it will not be difficult to locate a lesion. anywhere in its substance.

Lesions of the cord may be traumatic, sclerotic, or degenerative; may involve the whole of the cord, or its entire diameter throughout a larger or smaller segment, or the entire length of the cord in only a small portion of its diameter. The possibility of two or more of these conditions obtaining at the same time, is the most frequent cause for confusion in diagnosis.

Any lesion involving the anterior half of the cord will produce paraplegia-paralysis of the lower extremities—more or less complete without disturbance of sensibility of the affected part; and according as it be situated, high up or low down in the cord, will be attended by exaggeration of, or diminution of, the tendon reflexes; in by far the majority of cases the former. Such will be the case in anterior myelitis, for instance, or the growth of a syphilitic gumma affecting the anterior portion.

Any lesion affecting the posterior half of the cord will produce disturbances or abolishment of sensation of the lower extremities with loss of the power of co-ordination of muscular action; also disturbance of function of the rectum and bladder. These two latter symptoms need careful consideration. It is not unusual for the victim of locomotor ataxia to describe himself as being paralyzed when, upon careful investigation, he is found to be afflicted not with loss of muscular power, but rather loss of co-ordination of muscular action, which may, of course, render his legs, or his arms, useless. Or, again, inability to micturate freely may be assigned to "bladder trouble" when, in truth, it is due to a lesion of the spinal cord in the lumbar region affecting the center which presides over the action of the bladder. So also may the source of a persistent constipation, or an unmanageable diarrhea, be a defective spot in the tissue of the spinal cord rather than in "the liver."

Many and various are the functions of the spinal cord. But

with a fair knowledge of its structure and functions to start with, it need not be difficult to separate those disorders which are due to derangement of it from those others which are easily confused with them.

SURGICAL NOTES.

BY E. A. NEELY, M.D., MEMPHIS, TENN.,

Division Surgeon Kansas City, Fort Scott and Memphis Railroad. Amputation of arm. Louis J., colored laborer, while assisting to couple together some oil-tank cars at the Southern Oil Mill near the city May 23, 1892, had his arm caught between two patent iron drawheads and so badly crushed as to necessitate amputation. This was done about two hours after injury on the office table at the mill. The seat of operation was about an inch above elbow, the circular method being employed and every antiseptic precaution being observed. He rallied nicely from the antiseptic, and was at once removed to his home near by. On the fifth day the stump was redressed, and drainage tubes removed. Wound was again dressed on the eleventh day, and stitches removed. On the fourteenth day dressings were removed, and the patient discharged. Union by primary adhesion was obtained.

Tuberculosis of knee-a typical resection. Geo. McK., white, male, age 30, an engineer with a good family history, there being no history of tuberculosis obtainable. Four years ago he jumped from his engine on the K. C. M. & B. R. R. to avoid participation in a rear end collision. The distance jumped was not great, but almost immediately after his right knee began to swell and was very painful. He was under treatment about four weeks, but was not able to return to work for four months. He then returned to work, but suffered occasionally with slight pain in the joint. About the first of March, this year, he received a direct blow on the knee and has been totally disabled since. I first saw the limb about May 1st, when I found it filled with fluid, 24 inches greater in circumference than opposite knee, and painful on pressure and when called upon to sustain weight of body. At this time I aspirated the joint, withdrawing about four ounces of fluid,

and without destroying the vacuum washed the joint cavity out with a solution of bichloride, 1-10,000, and put the entire limb in a plaster jacket. At the end of two weeks this was removed. The fluid had reaccumulated to some extent, and the pain was still so great as to totally disable.

On June 6th, there being no improvement in the condition of the knee, I decided to do an arthrectomy, as recommended by Senn. The patient was anesthetized, the knee shaved, and rendered thoroughly aseptic; a horseshoe-shaped incision with its convexity above was made, the flaps dissected up, the lateral ligaments divided, and the patella drawn through. The leg was now flexed and the crucial ligaments divided, the flexion continued, exposing the entire joint to view. The synovial sac was now carefully dissected out, and two points on the articular surface of the femur which had become involved in the tubercular process were chiseled out. When all the diseased tissue had been removed the patella was sewed with strong chromatized catgut, and the external wound closed with silk sutures. At either angle of the wound a few strands of catgut were left in for capillary drainage. The leg was now put in a plaster cast from the toes to thigh. Owing to an unusual amount of oozing, this had to be changed on the third day; afterward, the dressings were only changed at intervals of one week, and the sutures removed on the twentyeighth day. The wound healed perfectly by first intention, and at this date the patient is about on his crutches; all pain gone, and with returning motion.

Strangulated hernia of labia majus. Annie G., mulattress, age 25, married, no children. Had history of having had reducible hernia for several years. On June 6th the hernia came down, and in spite of all the means which she had hitherto employed with success to reduce it she failed to return it. On the evening of the 7th Dr. Elcan was called and found her with slight fever, pain over abdomen, diarrhea, and great pain in an oval-shaped tumor occupying the left labia majus. He diagnosed strangulated hernia, and tried to reduce it under the influence of chloroform without success. I saw her on the 8th, with about the same group of symptoms, when an operation was determined upon.

Mr. R. B. McKinney gave the anesthetic, and Dr. A. L. Elcan assisted me. An incision 2 inches long was made over the tumor, and the tissues carefully dissected until the sac was reached. This was opened, exposing the loop of intestines, which was greatly congested but in good condition considering the length of time it had been strangulated. The constriction was nicked, and the gut slipped back into abdomen without difficulty. The sac was then dissected up, tied and cut off, and the stump stitched to external ring. The wound was then closed with catgut sutures, a few strands of this being left at lower angle for drainage. On sixth day stitches were removed, and on the tenth day she was back at her work. On the morning after operation all of her symptoms prior to it were gone, and she got well without a marring incident.

Exsection of head of femur-tuberculosis. Will Allen, black, age 23, no family history obtainable. Four years ago he received a direct blow on left hip from a falling limb. Four or five months ago he began to suffer pain from about the hip, and an abscess soon formed and was opened on external surface about three inches below and posterior to trochanter major. This had continued to discharge a creamy-looking pus; his general condition was very fair, although very much. wasted; no cough. On June 14, assisted by Drs. Helms and Henderson and Drs. Ellis and Hicks, N.G.S.T., I removed head of femur, which I found in a carious condition, partially closed the wound, and filled it with iodoform gauze. The fistulous tract I opened up and scraped with a Volkman's sharp spoon, and packed with gauze. When the patient was taken to his home one week later both wounds were still discharging, but not so abundantly. I put him on tonics, and suggested to Dr. Rowland of Coffeeville, who was to continue his treatment, to throw into the wound a 10 per cent. emulsion of iodoform in glycerine after washing out with a hot solution of bichloride. The Doctor has written me since, saying that Allen's condition was not improved. On account of this patient's grave condition, I gave his friends very little encouragement.