1777. He fometimes complained of a pain, but generally of á numbness, at the margin of the thorax, under the cartilages of the ninth and tenth ribs of the left-fide, with a cough, fpitting, and fhortened refpiration, when he lay on that fide; the fpinal process of the seventh or eighth dorfal vertebra was confiderably protuberant; his belly was prominent and flaccid, with a numbnefs extending itself over the whole abdomen, and great debility of the mufculi obliqui and tranfverfales, whenever he voluntarily attempted to contract them; a fenfation of chillness prevailed in his knees, with a want of feeling in the fore part of his legs, and an inability of drawing them up in bed.

To these symptoms were added twitchings in the flexors of his legs, and numbness of the feet, a jarring fenfation in the tendo Achillis of one foot, and tranfient pains in both, which, with the chillness, proceeded, as he conceived, and repeatedly declared, not from the protuberant part of the fpine, but the lumbar vertebra immediately above the os facrum.

The quickness of the pulfe, the florid ap

pearance

pearance of his countenance, and ftate of refpiration, ftrongly fuggefted the idea of hectic fever prevailing in the fyftem.

Thefe affections, with a numbness of the fphincter ani, coftiveness, and a want of confcioufnefs when his fæces were ejected, completed the catalogue of his complaints.

Upon repeated inquiries, he constantly declared, that he did not recollect any strain, or other accident, to which he could afcribe his prefent fufferings.

It appeared that it was nearly three years fince his disorder commenced. His first complaint was a rheumatic affection in the fide, which was cured by gum guaiacum. About this period he imagined he got cold, a pain and forenefs in the small of his back fucceeding to that complaint, and a sense of inward weakness in his breaft. These fymptoms were exafperated by a cough; numbnefs of the abdomen followed next in order, with a gradual acceffion of the other fymptoms, until he was confined to his bed.

Before the application of the cauflics he made trial of the cold-bath, mercurial frictions, tinctura facra, volatile liniment, a Dd frengthening

II.

ftrengthening plaifter to the loins, and the fcrew-chair, without any good effect what

ever.

The cold-bath and fcrew-chair were

evidently hurtful.

The cauftics being applied, according to Mr. Pott's directions, on each side of the protuberance, foon produced a fenfible effect; the twitchings in his thighs and legs were increased, and in fome degree sensation and voluntary motion were restored in his feet; but the advances to a perfect cure were not very rapid during the first fix months.

He next recovered the power of expelling flatus per anum: during this period the curvature appeared to diminish: the numbness in his infteps remained for many months ; but, at length, all his complaints wore off, his former ftate of health returned, and he intirely recovered his former vigour.

CASE II.

R. B. aged twenty-one, was admitted into St. Bartholomew's hofpital in June, 1778. A protuberance being obferved in the fpine, the cauftics were applied in the course

course of the following month. At that time, he lay totally deprived of the use of his lower extremities, which were rigid, and almost intirely infenfible, an imperfect feeling remaining only in the plantæ pedum and the knees. Tranfitory twitchings and tremblings prevailed at times, with general rigors, as in the cold fit of an ague; his fæces came away without his knowledge, his urine flowed without his confent, a violent pain in his bowels preceding its evacuation. He was also affected with numbnefs below the navel. He complained at times of a pain in his fide, with spitting, and a constant uneafinefs under the fternum.

His ftrength at this time was much wafted, in confequence of two large fores on his hips of more than eight inches diameter, accompanied with exfoliations of the great trochanters. A fymptom somewhat fingular was observed in his cafe. For about a month before the date of his admiffion, he was affected with a convulfive motion in the fecond finger of one of his hands.

From his account of the origin and progrefs of the diforder, I collected as follows: About

Dd2

1

1777. He fometimes complained of a pain, but generally of á numbness, at the margin of the thorax, under the cartilages of the ninth and tenth ribs of the left-fide, with a cough, fpitting, and fhortened refpiration, when he lay on that fide; the fpinal procefs of the seventh or eighth dorsal vertebra was confiderably protuberant; his belly was prominent and flaccid, with a numbnefs extending itself over the whole abdomen, and great debility of the mufculi obliqui and tranfverfales, whenever he voluntarily attempted to contract them; a sensation of chillness prevailed in his knees, with a want of feeling in the fore part of his legs, and an inability of drawing them up in bed.

To these symptoms were added twitchings in the flexors of his legs, and numbness of the feet, a jarring fenfation in the tendo Achillis of one foot, and tranfient pains in both, which, with the chillness, proceeded, as he conceived, and repeatedly declared, not from the protuberant part of the spine, but the lumbar vertebra immediately above the os facrum.

The quickness of the pulfe, the florid ap

pearance