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diseased part of the cervical medulla, such circumstances may be thought by some, sufficient to explain most of the phenomena observed during the patient's life. Nevertheless, in these difficult and often disputed questions respecting the functions and diseases of the nervous system, other physiologists may conclude, and with considerable show of reason, that the loss of motion, so remarkable in this instance, was solely owing to the generally softened condition of the anterior part of the cord, which change in all probability arose from the previous inflammation already mentioned.

Besides these considerations, it is also deserving of notice, that the reddened state of the cord, above the softened portion of that organ, indicated such a degree of irritation in the spinal medulla, as would sufficiently account for the occurrence of those spasmodic actions of the lower extremities noticed in the case, and from which the patient latterly suffered so severely; whilst it is also probable, that had he lived for a longer period of time, the extent of disease in the cervical medulla would have been materially augmented.

As these, with some other interesting points, respecting the nature and seat of affections implicating the nerves, and exhibiting symptoms similar to the case above described, are still surrounded by considerable difficulty, more extensive experience, supported by dissections, is necessary to enable physicians to explain some of the discrepancies in

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opinion yet prevalent among physiologists on these important subjects; I therefore submit this case to the notice of the Society, as an instructive and somewhat rare example of disease of the nervous system, which in my opinion appears worthy of attentive consideration.

CASE OF

BRONCHIAL CALCULUS,

WITH OBSERVATIONS ON DISEASE OF THE
BRONCHIAL GLANDS.

BY JOHN CHARLES GRAHAM TICE, M.D.,
ASSISTANT SURGEON 8TH (KING's) REGT. OF FOOT.

COMMUNICATED BY SIR JAMES M'GRIGOR, BART.

READ JANUARY 10TH, 1843.

MR. JOB ALDRIDGE, quarter-master, 8th (King's) Regiment, quartered in the Royal Barracks, Dublin, ætat. 48, plethoric and of nervous temperament, began, about the 7th September 1842, to complain of pain in the right side, affecting, to a trifling extent, the freedom of respiration.

Pressure over the liver caused great uneasiness. The pulse was natural, tongue furred, bowels constipated, and heat of surface moderate.

He states, that for some time past he has been annoyed, particularly in the morning, with a most disagreeable taste, resembling fried onions.

Suspecting the biliary secretion to be in a vitiated state, and the organ somewhat gorged, calomel, with cathartic extract, was given, followed by infusion of senna and salts. Several dark, offensive stools succeeded; the pain and difficulty of breath

ing, however, were rather increased than otherwise. The pulse was fuller, and resisting-sixteen ounces of blood, taken from the arm, produced some relief. The breathing became more free. This treatment was directed, not only with the view of improving the secretions of the liver, but of relieving any congested state of that viscus.

The alteration for the better was of short duration. The pain of liver, the difficult and painful respiration, returned with increased violence, while paroxysms of cough followed each other in rapid succession. Pulse 98, of large volume, but readily yielding to pressure; a thick brown coating on the tongue; heat of surface moderate; bowels acting freely; motions foetid, of a dark colour; urine plentiful and light. He continued to refer the pain to the liver. Pressing that organ against the diaphragm, caused more acute pain than pressure exercised in any other direction.

The foetor of breath increased. This, though so distressing to him, is not perceptible by myself. The horizontal posture is now attended by a sense of suffocation.

Blood was again drawn from the arm, and as the difficulty of breathing was thereby but little relieved, 24 leeches were applied over the right hypochondrium. The quantity of blood lost by this mode was so trifling, that a further abstraction of blood by cupping was thought advisable. He could now bear much greater pressure, but the cough and dyspnoea remained unaltered.

Calomel, squills and the tartrate of antimony were given in small but repeated doses, and a blister was placed over the region of the liver.

The cough and dyspnoea continued increasing in severity, and the only position in which he could remain with anything like ease, was leaning forwards, holding both knees.

In consequence of the alarming state of the patient, I requested Dr. Peile, deputy inspectorgeneral, to see him, who, from the nature of the symptoms, suspected that effusion had taken place, causing, by the gravitation of the fluid, that distressing sense of suffocation which invariably occurred in lying down.

Percussion elicited no morbid sound, and auscultation proved the lungs on both sides to be in a healthy condition, as also the heart.

The patient on this occasion stated, that about three weeks prior to his illness he had partaken of a pear, and while part of it was passing down the œsophagus, he experienced a sense of soreness, and thought it remained in his chest.

He pointed to a spot, a short distance below the clavicle, and a little to the left of the sternum. He added, that from that day up to the present, whatever he has swallowed, liquid or solid, appears to him not to pass beyond that spot.

It was soon after the above event that he first noticed the fœtor of his breath, which he represents, at times, as most intolerable.

The active treatment which had been pursued

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