which Mr. G. had previously suffered for a long time so peculiarly, again became as marked and severe as before, until the ability of moving any of his limbs got at last so very feeble, that eventually he was entirely deprived of the use of both legs and arms. Ultimately, the muscles of the abdomen and chest were similarly affected, whereby respiration could then be only carried on by the diaphragm; when the patient likewise lost the power of coughing, and was scarcely able to expectorate. The bowels now became even more constipated than before, and in order to act upon them sufficiently, it was necessary to employ very active purgatives, assisted by strong enemata; whilst the bladder required to be frequently emptied by the catheter, during many months consecutively. Notwithstanding the total loss of power over all the muscles situated lower than the neck, the sense of touch still continued as acute as ever throughout the entire frame; indeed, the cuticular surface appeared occasionally to be even more sensible to external impressions than in the patient's previous good health; since he could, for instance, feel most acutely the slightest change in the temperature of the surrounding atmosphere, especially when a current of air passed over any part of his person.

Although the patient appeared, at a subsequent period of his disease, to have acquired a slight degree of control over some of the muscles connected with the shoulder, so as to be then able to move partially that part of his body, such temporary

power was again soon lost; and ultimately the privation of voluntary motion remained as marked as before, excepting in the head, the features, and the tongue; or in the muscles of deglutition, which were never affected. At the same time that these symptoms prevailed, all the senses continued perfectly normal, the memory appeared unimpaired, the patient had no headache, and his intellectual faculties were as perfect as they had ever been at any former period, although once or twice he seemed to be a little confused or slightly delirious; but this symptom was of such partial duration, that it scarcely deserves observation.

Besides the symptoms already detailed, Mr. G. frequently complained of feeling intense heat over all the body, whilst the surface actually felt cold to a bystander; and at other times he experienced alternations of heat and cold, although his skin appeared to others of the natural temperature. Again, if a foot or even a toe were touched, spasmodic twitchings of the limb, accompanied with pain, were always produced; the patient's sense of feeling being, at the same time, so accurate, that he could distinctly tell the particular point of his body to which the attendant's finger was applied. The circulation still continued languid, and sometimes the pulse was intermitting; whilst the cuticle remained devoid of perspiration, being perfectly dry, and exhibiting quite an opposite condition to that noticed during the patient's previous robust health.

In the latter months of his illness, Mr. G. often complained of excessive coldness in the epigastrium and stomach, along with considerable distension of the abdomen from flatus, although the trunk of the body and the extremities frequently felt burning hot to the patient at the same moment. At this stage of the disease, the spasmodic twitchings of the legs were not only more frequent than previously, but they sometimes even became so violent as almost to throw the patient off his couch, being also attended with great additional suffering.

Besides these symptoms, it ought to be mentioned that the urine, which at first was very little altered from its healthy condition, now deposited a considerable quantity of a thick ropy sediment, and although this secretion had long been drawn off by the catheter, it now passed involuntarily, and almost in drops; whilst the fæces likewise came away in a similar manner, the evacuations being of a watery consistence, and latterly very offensive.

The appetite and digestion, always much impaired, entirely failed towards the termination of this painful and protracted malady; when frequent nausea, vomiting, singultus and apthæ supervened. Finally, notwithstanding the efforts made to alleviate the afflicted patient's sufferings, all the symptoms continued, with unmitigated severity till the 22nd of July last, when Mr. G. died, quite exhausted; retaining however his intellectual faculties perfect to the last moment of existence.

Treatment. Respecting the means pursued in

the alleviation of Mr. G.'s lingering malady, it will suffice to state generally, that having the advantage of being frequently seen by Dr. Chambers, Dr. Seymour, Sir Benjamin Brodie, and Mr. Tatum, who repeatedly met me in consultation, every remedy likely to mitigate the symptoms, when even no hope existed of curing the disease, was had recourse to; but all proved either inefficient, or produced only temporary benefit. Among the remedies employed, purgatives with strong enemata were found to be most beneficial, especially when the latter contained confection of rue. The tincture of cantharides, given as a diuretic, seemed likewise of considerable efficacy, at the same time that leeches were applied near the spot on the nape of the neck, where pain was felt on moving the head backwards; their application being followed by blisters. Subsequently, a constant discharge was maintained from two issues, about four square inches in size, on each side of the spinal column, which were kept open for many months, by a mixture of mercurial and blistering ointments. The drain thus produced was considerable, and at one time it seemed to be rather advantageous; but the relief obtained from it, or indeed from any remedy, was only transitory, and never very decided.

Besides the above plan of treatment, mercury, sarsaparilla, hydriodate of potassa, strychnia, hydrocyanic acid, morphia, and various other medicines, which it would be superfluous to detail, were likewise tried, but without any beneficial or permanent

result. Respecting one of the remedies just named, it deserves to be noticed as a peculiar feature in the present case, that although mercury was administered internally in very large doses, and rubbed in to an unusual extent, for some months consecutively, whilst both the issues were constantly dressed with mercurial and blistering ointments, this powerful mineral scarcely produced any apparent effect, either upon the patient's mouth, or his system generally.

During the last months of Mr. G.'s existence, notwithstanding the treatment seemed to have very little power over the disease, and although an unfavourable prognosis was for a long time entertained, nevertheless to alleviate the almost tetanic symptoms, to procure sleep, and, if possible, to give temporary ease to the afflicted patient, morphia was frequently administered, and in large doses; indeed, towards the fatal termination of the case, this excellent anodyne was the chief remedy trusted to for relief and however hopeless of curing the patient, its use certainly diminished the severe sufferings, and tended to soothe the acute pain of his latter moments.

Autopsy. About eighteen hours after death, the examination was very carefully made by Mr. Hewett, in the presence of Dr. Nairne, Mr. Tatum, Mr. Charles Hawkins, Mr. Powell and myself. From notes made at the time, I have since drawn up the following Report of the pathological appearances met with:-

The body appeared considerably emaciated, but was not discoloured. Having removed the skull