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DR. H. I. BOWDITCH'S LETTER OF RESIGNATION FROM THE STATE BOARD OF

HEALTH.

BOSTON, January 20, 1880.

HIS EXCELLENCY, JOHN D. LONG, Governor OF MASSACHUSETTS:

SIR,I wish respectfully to resign my office of member of the Massachusetts State Board of Health, Lunacy, and Charity. I do this with regret, but I feel compelled to do it for the following reasons:

First. It is impossible for me to attend to the duties imposed upon me by the law establishing the board without neglecting my profession, upon which my family depends for its support. These duties have been more than trebled under the new régime, and I have been obliged to give up all thought of attending to the greater part of them. I have tried the experiment for six months, and I am unwilling, and it is not right towards the State for me, any longer to hold any office, the duties of which I am obliged thus systematically to ignore.

Second. I objected very strongly to the union of the board with any other. I knew that the proper education of our people in sanitary matters would require the full attention of all the seven members of the board. I felt persuaded that nothing but evil would happen to our board if it should have put upon it such

wide and multifarious duties as were performed by the Board of Charities, especially if, superadded to them, should be given the care of the lunatic hospitals and lunacy in Massachusetts. The experience of the past six months more than convinces me that I was right in making that protest. I believe if the present law remains upon the statute-book the public health will not be promoted as it would be were the board as untrammeled as it was up to July, 1879; and as I see no chance, at present, for any change in that law, I herewith resign my commission as an officer of the commonwealth. I remain, with sentiments of high respect, H. I. BOWDITCH.

LETTER FROM DR. POLK.

MR. EDITOR, I have just received a letter from Dr. C. G. Polk, of Philadelphia, in which, referring to my article published in the JOURNAL January 15th, he says: "Of course you know that the statement that I was professor in the Eclectic College was an unmitigated falsehood, although my name did appear in the announcement."

Will you be so kind as to publish this denial as a matter of justice, and oblige, Yours very truly, R. T. EDES.

REPORTED MORTALITY FOR THE WEEK ENDING JANUARY 24, 1880.

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Two thousand three hundred and twenty-two deaths were re- ing-cough, and diarrhoea having been more fatal, lung diseases ported; 914 under five years of age: principal "zymotic less so. diseases (small-pox, measles, diphtheria and croup, diarrhoeal diseases, whooping-cough, erysipelas, and fevers) 511, consumption 378, lung diseases 295, diphtheria and croup 211, scarlet fever 89, measles 45, typhoid fever 33, diarrhoeal diseases 40, whooping-cough 31, malarial fevers 20, erysipelas 18, cerebrospinal meningitis 11, small-pox 11.

From measles, New York 33, Brooklyn three, St. Louis two, Philadelphia, Chicago, Pittsburgh, Lowell, Lynn, Holyoke, and Northampton one. From whooping-cough, New York and Boston six, Philadelphia, Brooklyn, and New Orleans four, Pittsburgh two, Chicago, St Louis, Cleveland, Gloucester, and Brockton one. From malarial fevers, New York 10, Brooklyn and St. Louis three, District of Columbia two, Milwaukee and Charleston one. From erysipelas, New York six, Cleveland four, Philadelphia two, Brooklyn, Baltimore, New Orleans, District of Columbia, Milwaukee, and Providence one. From cerebro-spinal meningitis, New York, Chicago, and Cincinnati two, Philadelphia, Milwaukee, Haverhill, Fitchburg, and Quincy one. From small-pox, Worcester five, Philadelphia four, District of Columbia two. From typhus fever, Philadelphia and Chicago one. One death from typhus fever was reported in Philadelphia and in Chicago; one death from hydrophobia and one from tetanus were reported in New Orleans; scarlet fever was more prevalent and malignant in Cleveland, less so in Providence. Small-pox is reported as apparently "stamped out "in Baltimore. Influenza has become very prevalent in Wakefield, Mass. The death-rate of colored persons in the District of Columbia was nearly double that of whites.

The total number of deaths, and especially the deaths under five, show a considerable increase over the previous two weeks. There were fewer deaths from lung diseases, and many more from consumption. The mortality was increased from all the principal "zymotic" diseases except typhoid fever, which was without change; small-pox, measles, scarlet fever, and diphtheria were much more fatal. In 37 cities and towns of Massachusetts, with an estimated population of 1,018,610 (population of the State about 1,690,000), the death-rate was 20.58 against 20.89 and 20.65 of the previous two weeks, scarlet fever, whoop

For the week ending January 3d, in 143 German cities and towns, with an estimated population of 7,523,410, the deathrate was 27.2 against 27.5 and 26.5 of the previous two weeks. Three thousand nine hundred and thirty-five deaths were reported; 1753 under five: pulmonary consumption 542; acute diseases of the respiratory organs 510, diphtheria and croup 174, scarlet fever 95, measles and rötheln 63, whooping-cough 57, typhoid fever 56, puerperal fever 26, small-pox and typhus fever three. The death-rates ranged from 16.6 in Carlsruhe to 36.2 in Augsburg; Königsberg 30.2; Dantzic 24.3; Breslau 21.8; Munich 29.8; Nuremberg 29.3; Dresden 26.6; Berlin 26.0: Leipsic 26.1; Hamburg 29.3; Hanover 24.1; Bremen 23.5; Cologne 33.4; Frankfort 27.7. For the same week, Vienna 33.0; Prague 36.7; Paris 33.4.

For the week ending January 10th, in the 20 English cities with an estimated population of 7,499,468, the death-rate was 24.0 against 29.1 and 27.4 of the previous two weeks. Three thousand four hundred and forty-four deaths were reported: acute diseases of the respiratory organs 455, whooping-cough 182, measles 131, scarlet fever 126, fever 44, diarrhoea 30, diphtheria 19, small-pox (London eight, Bristol one) nine, showing a striking diminution of deaths from lung diseases, an increase in measles and small-pox, and a decrease in diarrhoea and diphtheria, scarlet fever remaining about the same. The death-rates ranged from 15.8 in Oldham to 35.5 in Plymouth; London 25.0; Bristol 26.4; Birmingham 23.3; Leicester 17.7; Liverpool 28.3; Manchester 25.0; Leeds 19.8. In Edinburgh 22, Glasgow 23, Dublin (small-pox five deaths) 41. In the 20 chief towns of Switzerland, with an estimated population of 462,576, 240 deaths were reported and 253 births: acute diseases of the respiratory organs caused 33 deaths, pulmonary consumption 16, diarrhoea of children seven, diphtheria and croup seven, whooping-cough five, puerperal fever five, fever two, erysipelas, measles, small-pox one, scarlet fever none. The death-rate was 27.5 against 26.3 of the previous week; Geneva 24.3; Zürich 23.2; Basle 24.5; Berne 36.8; Lausanne 25.8; Vevay 11.3. The meteorological record for the week in Boston was as follows:

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1 O., cloudy; C., clear; F., fair; G., fog; H., hazy; S., snow; R., rain; T., threatening.

OFFICIAL LIST OF CHANGES OF STATIONS AND
DUTIES OF OFFICERS OF THE MEDICAL DE-
PARTMENT U. S. ARMY, FROM JANUARY 24, 1880,
TO JANUARY 30, 1880.

HEGER, A., major and surgeon. So much of the order as directs him to proceed to San Antonio, Texas, on or before February 1, 1880, is amended to read on or before February 20, 1880. S. O. 19, A. G. O., January 26, 1880.

WHITE, C. B., major and surgeon. His leave of absence on surgeon's certificate of disability, granted him July 24, 1879, extended six months on surgeon's certificate of disability. S. O. 20, A. G. O., January 27, 1880.

TREMAINE, W. S., captain and assistant surgeon. His extension of leave of absence on surgeon's certificate of disability of November 11, 1879, farther extended twelve months on account of sickness, with permission to go beyond sea. S. O. 18, A. G. O., January 24, 1880.

34.00 1.64

LIST OF CHANGES IN THE MEDICAL CORPS OF
THE NAVY DURING THE WEEK ENDING JAN-
UARY 31, 1880.

PASSED ASSISTANT SURGEON P. FITZSIMMONS from the Naval Hospital, Yokohama, Japan, and to return home and wait orders.

Passed Assistant Surgeon J. R. WAGGENER detached from the receiving ship at Boston, and ordered to the U. S. S. Vandalia.

Assistant Surgeon GEORGE ARTHUR detached from the U. S. S. Vandalia, and ordered to Naval Hospital, Norfolk, Va. Assistant Surgeon S. H. DICKSON detached from the Naval Hospital, Norfolk, and waiting orders.

BOOKS AND PAMPHLETS RECEIVED. The Sanitation of Small Cities. By David Prince, M. D. (Reprint.)

Lectures.

CLINICAL LECTURES ON ORTHOPEDIC SURGERY.1

DELIVERED AT BELLEVUE HOSPITAL, NEW YORK. 3 BY LEWIS A. SAYRE, M. D.,

Professor of Orthopaedic Surgery and Clinical Surgery in Bellevue Hospital

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Medical College.

II. POTT'S DISEASE OF THE SPINE. (CONTINUED.) GENTLEMEN, — I have already lectured so much on the subject of Pott's disease that there would seem to be but little left for me to say in regard to it; but during the last few days several cases of the affection have come under my notice which have been receiving other forms of treatment than that which you have been accustomed to hear me advocate, and I have therefore thought it well to bring some of them before you, in order that you may be better able to appreciate the advantages of that by partial suspension and the use of the plaster-of-Paris jacket over every other that has as yet been devised. Other cases have also come into my hands of late in which the treatment by suspension and the plaster jacket has been improperly managed, and from these I desire to impress upon you in the most forcible manner that I am capable of a most useful lesson, namely, the importance of attention to all the details that have been prescribed in the method. In illustration of this point I will show you two cases which have been treated by means of the plaster jacket, and yet treated in the worst possible manner, the results being as unsatisfactory as if the patient had been treated by any of the methods formerly in vogue, and still practiced by some, though they now stand condemned in the light of modern surgical science. The plaster jacket can do just as much harm as these in the hands of the ignorant or careless; for it is not so much upon the dressing itself as on the proper manner of applying it that success depends in any instance. After an experience now embracing many hundreds of cases, I can confidently and positively as sert that if this plan of treatment is carried out just as it should be the patient suffers no pain whatever. Whenever in any case pain is complained of, you can rest assured that some mistake has been made in the application of the dressing, and it at once becomes the duty of the surgeon to remove it entirely and find out what was wrong about it.

CASE I. Our first patient to-day is a little fellow whom you will probably all remember as having been brought here a few weeks ago by Prof. Alfred C. Post. The child had had Pott's disease for two years, and for nine months before Dr. Post saw him had been under treatment at the Hospital for Ruptured and Crippled in this city. In consequence of the pressure of the iron cross-bar of the instrument which was ordered to be worn by the surgeon in attendance, an enormous lumbar abscess was formed, and this you will remember was operated upon by Dr. Post in the most brill. iantly successful manner by Callender's method of hyperdistention of the sac. When first shown before the application of the plaster jacket, the little patient could not stand, except by resting his hands his thighs, as seen in photograph. He had also the peculiar grunt which is so characteristic of these cases. Immediately after the lecture the plaster dressing was put on, and, on account of the high point at which 1 Reported for the JOURNAL.

you,

upon

the disease was situated in the vertebral column, it was found necessary to employ the head-rest in addition. The child has worn the apparatus ever since, and there has already been very marked improvement, so that now, as you perceive, he walks as erect as a drum major. Such a practical illustration renders it quite unnecessary, I think, to dilate much upon the advantages of this method of treatment. To be convinced of the benefit that has resulted from it here you have but to look at the rosy hue upon the cheek that has replaced the sickly pallor which you saw before and which belongs to all cases of Pott's disease, and to contrast the smile of contentment on the little one's face with the pinched and anxious expression which it habitually wore previously. [See photograph.] CASE II. I come next to the cases of which I spoke as showing the bad results of this same method of treatment when improperly applied. The child now before you was suffering from Pott's disease, and the physician in attendance concluded very properly that the best way of treating it was by means of the plaster jacket. Unfortunately, however, either through ignorance or carelessness, he neglected to attend to all the minute details of the application, which may at first sight seem of but little consequence, but which I have always insisted upon as of the greatest importance in order to secure the perfect success which is attainable by the method. So, instead of first putting on a knit shirt made exactly to fit the patient, he used no shirt at all, but applied the plaster bandage directly upon the skin itself. In order to prevent pressure upon the spinous processes of the affected vertebræ he placed several strips of green pasteboard on either side of them before putting on the dressing.

After the application the child became so comfortable that both the physician and the parents were delighted. In about three weeks, however, the child began to complain of pain; but the doctor, because the jacket had afforded relief at first, refused to remove it. Consequently, as the pain and discomfort continued to increase, the mother took the dressing off herself, when she found that the green poisonous pasteboard had been reduced to a pulp by the perspiration, and had fallen down over the hump, and that a large slough over the seat of disease had been caused by its pressure. So the mother and the doctor were now as much disgusted as they had at first been delighted with the plaster-of

Paris treatment.

The patient was then brought to New York, and after he had worn iron braces until he became paraThe child was lyzed the mother came to consult me. then in a terrible condition, as, in addition to the paralysis, there was an ulcer two inches in diameter over the diseased vertebræ sloughing down to the bone, and another one of rather less size over the sacrum. On account of these circumstances I had to put on two or three plaster jackets before I succeeded in getting one that was quite satisfactory and rendered him perfectly comfortable; but I persevered until this had been accomplished, and that was the end of the story. now so near complete recovery, that you can hardly form any idea of what a bad way he was in; but when I remove the dressing you can still see cicatrices of the enormous ulcers of which I have just spoken. The last jacket, which he is still wearing, was put on five months ago, while I was in Europe, by my son, a hole being cut in the plaster over the seat of disease. In a few weeks afterward the jacket was cut

He is

down in front, and its edges were provided with eyelets, so that it could be laced up like a corset. The child can now walk about with perfect freedom, and can jump, as you see, heavily upon the heels, without the slightest inconvenience, when the jacket is off, so that we can regard him at the present time as practically well. He can continue, however, to wear the jacket as a corset, as a means of protection against relapse. CASE III. I now have to show you a case in which the plaster treatment, and every other in fact, was abandoned as hopeless by those who previously treated him. There was a projecting point over the sternum as well as in the back, as is frequently the case in Pott's disease, and as pressure was not guarded against in the application of the dressing employed the most serious consequences have resulted. If cartilage once begins to slough, the process is an extremely tedious one, lasting much longer than caries in bone. In applying the plaster dressing in cases of this kind we should not only protect such projecting points by pads on either side of them, but also cut out holes of sufficiently large size over them in the jacket after it has been completed.

We are now ready to put on the plaster before you, and as this is being done I beg that you will once more notice carefully all the minutiae of the process, which I have in former lectures fully described to you, and which it will scarcely be necessary for me to mention in detail on this occasion. In order to have the tightfitting knit shirt entirely without wrinkles during the application of the plaster, the front and back of the garment should be pinned together between the legs, and a safety pin should always be used for this purpose. This may seem a trifling point; but if the pin should happen to prick the child while the dressing is being put on, it might kick and struggle in such a manner as to render it necessary to do the whole thing over again. Before suspending the child I take it across my lap (which puts it in a perfectly comfortable position, because it relieves all the pressure upon the diseased part), and place a pad upon each side of the affected vertebræ, parallel with the spinal column. We then put him in the suspensory apparatus, and having raised him until this position of perfect comfort is reached, two similar pads are placed on either side of the projection on the sternum, when the application of the plaster bandage is commenced. This child was brought to me two days ago from Maine, wearing a plaster jacket, it is true, but suffering the most intense agony, because little or no care had been taken to protect these exposed points from pressure. The casing was about an inch in thickness, and the mother stated that the physician who had put it on, instead of carrying the suspension just to the point of comfort, raised the child until its feet were two or three feet from the floor, where it was left dangling about, with no assistant to steady it, all the time that the dressing was being put on.

When the disease is as high up in the spinal column as in this case, it is necessary to resort to the "jury mast," or head-rest, in addition to the plaster jacket. After a few turns of the plaster bandage have been made around the trunk, this apparatus- the "jury mast" is placed in position, and then secured by applying the bandage over the iron frame behind and the strips of perforated tin passing around to the front of the thorax. The application is then continued, layer by layer, until the complete jacket is formed; and when this is done we must not forget to press the casing close into the iliac fossa, which flattens it out, and

thus prevents undue pressure upon the anterior superior spinous processes of the ilia. I think you will all now be struck with the difference in the color of the child's face since the jacket has been put on. Previ ously, as you must have noticed, it was excessively pale, but now already the cheeks have assumed a rosy hue. This is due to the more free oxygenation of the blood, which I believe to be one of the most important features of this treatment. On account of the conical shape of the trunk and the close manner in which all its interstices are filled by the dressing, the spine is rendered straight and immovable; while, on account of the pad which is placed on the anterior portion of the chest and the abdomen previous to the application of the plaster, as well as the flattening out of the casing over the projecting points of the ilia, there is not only no interference whatever with the organs of respiration and digestion, but they are enabled by means of it to perform their functions in a more perfect manner than would be otherwise possible.

At this point I wish to direct your attention for a few minutes to the contrast as regards respiration between the plaster jacket and the Knight apparatus, such as I hold in my hand, or any other which consists of iron bars applied to the back and held in position by means of a canvas webbing that laces tightly across the chest in front. It is altogether impossible to construct an apparatus of this character which will fit the thorax accurately, and while the organs of respiration are compressed by the tight lacing over them there are spaces left at the back and sides (just where it is most important) where no support at all is afforded. I have taken off numbers of these "cribs," as I sometimes call them, from patients who have been under treatment at the Hospital for Ruptured and Crippled, and I have yet to meet with the first case in which no galling or chafing was occasioned by the instrument.

CASE IV. The next case illustrates several of the points to which I have alluded in my remarks to-day, and as it is a very interesting one I will give you the history somewhat in detail, as it is recorded in my books. The patient, whose name is Louis E, first came under my notice six months ago, when he was six years old. The parents and one other child are healthy. He enjoyed good health up to September, 1877, when he fell down a flight of four stone steps and struck upon his back and head. About a month later it was noticed that when he walked his body inclined towards the right, and he was taken to the family physician, who told the parents that he thought there was something wrong about the spine (though there was no deformity), and recommended a spinal brace. This was applied by the instrument maker who manufactured it, and was worn by the child for three months. About three weeks after the apparatus was applied, a projection was discovered on the spine, about the upper and middle dorsal vertebræ, and after this he steadily grew worse. At the end of the three months he was taken to a hospital especially devoted to the correc tion of this class of deformities, where one of the usual braces used in that institution was applied on the 13th day of May, 1878. From that date to the time when he first came under observation the mother says he had worn no less than seven of these instruments. During this period, she further says, the deformity did not increase very much, but the child suffered a great deal of pain.

When the instrument which he was wearing at the time was removed at my office, it was found that the skin was chafed on each side of the spine from the pressure of the iron rods in this position, and also over the shoulders and ilia from the pressure of other portions of the brace. The patient was wholly unable to stand erect, even while wearing it, and he was constantly obliged to support the trunk by means of the hands placed on the thighs.

The child was suspended, and a thoroughly-fitting plaster jacket with head-rest was applied, when he immediately became perfectly comfortable, and as soon as the plaster had set was able to stand up straight without any other support whatever. Since then two more jackets have been applied, and the child has continued to do perfectly well until very recently, when he has complained of some pain over the seat of the disease. This was because the jacket had become too tight for him, on account of his rapid growth, and when he was brought to my office to-day I therefore cut it down the centre, as you see. The moment that we remove it now he feels the need of it, and caunot stand with comfort without supporting the trunk by resting his hands on his thighs. Yet there has been very marked improvement since he came under treatment six months ago. At that time there were excoriations not only over the anterior superior spinous processes, but also over the posterior crests, of the ilia, as well as all other prominent bony projections, which had been produced by the instrument that the child had been wearing. But this was not all. On either side of the spine at the seat of disease, extending for a distance of at least two inches, there were other excoriations, which were the result of the pressure of the two upright iron bars of the brace; and the cicatrices of all these sores are still plainly visible, as I now point Yet for months and months this little patient was compelled to wear this instrument of torture, and suffer untold agonies, and all in the name of science and humanity, forsooth! Such cruelty is so barbarous in its character, and so totally unnecessary, that it seems to me that it is time that it should be put a stop to by the strong arm of the law. If the lower animals are so zealously and vigilantly protected from injury by Mr. Bergh's society, certainly the association which has for its object the prevention of cruelty to children should not be any less efficient; and here, I think, is a fair field in which it may legitimately carry out its benevolent work. Such unscientific treatment, which inflicts so much unnecessary pain, in the very face of recent developments of methods that are far superior in their results and entirely painless in application, is not creditable to our profession.

out to you.

As it is desirable that the boy should have a clean knit shirt before the jacket is reapplied to remain, I will to-day simply make a few turns of the plaster bandage around the old one, to secure it in position temporarily, after having put in sufficient padding in front to separate the cut edges to such an extent that the dressing will no longer be too tight for him. At once, you see, he is able to stand perfectly erect and walk about with ease; and I want you to contrast his present appearance and carriage with what they were six months ago, as exhibited in this photograph which I now show you. When it was taken he was making his best effort to stand up straight; but in spite of this you see that his body was bent over at an angle of about forty-five degrees, and that even thus he was compelled to rest his hands upon his thighs.

[The next day a new knit shirt having been put on him, Dr. Sayre reapplied the old jacket, which had been cut down in front, as it was perfectly fitted to the surface of the trunk. Before doing so, however, he removed the outer layers of the dressing down to the head-rest apparatus, aud put in enough padding in front to separate the edges of the cuirass nearly an inch, so that there should be no undue compression. The "jury mast" was then secured in position again by a fresh plaster bandage, enough layers of which were put on to make the whole jacket perfectly compact and firm. When this was completed, the child felt entirely comfortable, and was able not only to walk but to run without support.]

CASE V. In order to remind you of a still further application of the plaster jacket in spinal troubles, I now again introduce to you with great pleasure my friend, Dr. C. W. Hackett, of Massachusetts, who you will no doubt remember first came before you six weeks ago to-day. Two years ago last October he was unfortunate enough to receive a fracture of the lumbar vertebræ from a railroad injury,' which resulted in paralysis of the bladder, rectum, and lower extremities, as well as the formation of numerous abscesses. Up to six weeks ago last Sunday he had not been able to walk a single step, or even to stand without powerful support. On that day his spine was extended by 1 [At the request of many professional and other friends, Dr. Hackett has sent us the following statement for publication. — ED.]

RAILROAD INJURY. CASE OF DR. C. W. HACKETT.

October 15, 1877, in switching from a main track to a branch, the train going round a curve at a rapid rate, while I was standing in stove, and instantly paralyzed below the waist, probably by a fractthe rear of the car, I was violently thrown upon the corner of a ure of one of the lumbar vertebræ, - presumably the third. While paralysis of motion was complete at the time, there was some sensation and pain in the outside of the left thigh for a few hours. There was loss of control of the bladder and rectum, with a feeling of constriction, as of a tight band, about the lower part of the ab domen, the line of demarcation between the active and paralyzed parts being clearly defined. Pain at the point of injury was incessant, and severe beyond description. The bowels were evacuated by cathartics and clysters, and the bladder by the catheter, with of sensation, with ability to evacuate the bladder voluntarily as a treatment expectant only. After ten weeks there was some return general thing, and in a little more than five months from the time of the injury there commenced a slight muscular action in the legs, which increased irregularly, so that in a year after the hurt the limbs could be drawn up and pushed down in the bed, and even be made to move as in walking, with the body supported on crutches and by an attendant; but only a trifling amount of weight could be sustained by them.

During all this time there were frequent periods of almost total dently, by the formation of numerous abscesses, which began about paralysis of both motion and sensation, greatly influenced, evisix months after the injury, discharging through the rectum, the outside of the right thigh, and the inside of the left, the latter more in length, and from one to two lines in thickness: one piece giving exit to two fragments of bone half an inch to an inch or from two to three lines in width at the base, tapering to a point, and partly necrosed; the other, from one to two lines wide, somewhat and clean, and showing its fracture very plainly. I am confident pointed and slightly curved or twisted in shape, but perfectly bright that another fragment of bone had previously escaped per rectum, while still another was distinctly felt in the abscess that formed in the outside of the right thigh, but afterwards disappeared. During the winter of 1878-79 abscesses formed with great frequency, causing much loss of strength through the large quantities of pus formed and the severe pain they created; the partial recovery of the action of the muscles was in a great measure lost, so that they responded to the test of electricity no more than would those of a man recently deceased, and I was unable to distinguish the difference between heat and cold when applied to the surface of the extremities, indeed, so imperfect was sensation that I had both legs badly burned on different occasions by too hot soap-stones without being aware of it at the time (it being necessary to use artificial heat to maintain proper warmth in the extremities).

The abscesses finally stopped forming under the use of iodide of the last potassium, so that after May, 1879, only two appeared, about the first of August. With the cessation of abscesses improvement took place in the general health and in the action of the legs, apparently aided by the daily use of electricity and frictions, and

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