the discovery that he could not feel any heat. He said that he "felt all the time as cold as ice"-that when he came to the fire he could not tell by his sense of feeling when he was warm, or whether he was burning. At a time when he said his feet and legs felt " as cold as ice," I put my hand on them and they felt to me as warm as the flesh of ordinary persons.

To-day, July 27, 1840, Mr. Howell called on me, when I read him the foregoing paragraph, and he said it was strictly true. He moreover stated, that from the back part of his head down the whole length of his spine, he feels all the time cold, and from the calf of his legs down he feels no heat. I felt his skin again, and it was to my hand as warm as that of any other person. He farther stated, that from 1835 to the present time, he has had great weakness of his hands and arms, and frequently can scarcely use his knife and fork in eating, and that he is subject to frequent cramps in his legs.

This case is the opposite of that of Judge Vanderburg, of Vincennes, who retained the power of distinguishing heat after that of muscular motion and of touch or feeling was lost. Mr. Howell retains to a considerable extent the power of muscular motion and feeling, while the ability to distinguish or perceive heat is lost.

I think that physiological facts like these, as suitable cases may present themselves, ought to be recorded for the purpose of leading to farther observations.

The truth of Mr. Howell's case depends on his own veracity, and, so far as I know, there is no one in Wheeling who will doubt it. But I have had no opportunity to make any experiment on him during sleep for the purpose of testing it. August, 1840.

ART. IV.-Intermittent Fever, Hepatitis, Pneumonitis, Laryngitis and Intestinal Mucous Irritation. By DANIEL DRAKE, M. D., Professor of Clinical Medicine and Pathological Anatomy in the Medical Institute of Louisville.

We have written down these words to draw the reader's attention to a case which this day fell under our observation. We do not claim for it any very remarkable character, but as it is perhaps equal in interest to much that is published in medical journals we venture to send it forth.

Edward Dykes, a laboring man, living in the valley of Salt Creek, Chillicothe, Ohio, aged 32, of a sanguine temperament, and free from tubercular or other hereditary taint, was attacked about sixteen years ago, in autumn, with ague and fever, which lasted two months. For the next fourteen years it returned almost every atumn. During that long period, he continued most of the year to labor, and was free from cough, but sometimes had irritable bowels with slight diarrhoea.

In August, 1838, he was seized with the malady which had so often attacked him before. The type was at first tertian, and the cold stage amounted to a shake; at length became quotidian, with a chill only, about six o'clock, P. M. He continued to go about. Living with a "steam-doctor," he took two profuse sweats, and after the second "caught cold," and began to cough; at first without pain, but at length that symptom set in-being "located" in the right hypochondrium. His expectoration was sparing. He took two vomits of ipecac. but was neither bled nor blistered. Throughout the whole of the following winter, 1838, '39 he continued to have an evening chill, followed by fever in the early, and sweats in the latter part of the night, and frequent attacks

of diarrhoea. His cough still continued with little expectoration. His larynx became somewhat sore and his voice and cough hoarse and flat, which sounds have continued ever since. Much eating brought on fits of coughing, and these brought up, by exciting a retrograde œsophageal action, the food which oppressed his stomach. Throughout the whole of the year 1839, these symptoms, including the evening chill, continued to return upon him, but he still kept on his feet, and did not become very much emaciated. In the month of January last, 1840, he awoke in the morning with severe pain extending from the clavicle to the short ribs on the right side, with sense of suffocation, and a new reduction of the powers of his voice. He was bled, cupped, blistered and took expectorants; under which the symptoms rapidly abated. Since that time he has not had evening chills, nor morning sweats; though he thinks his feet and hands hot at night; but his diarrhoea has continued. He has from five to eight evacuations daily. The discharges in the forenoon, often appearing to have received a tinge from the food he had taken the day before, but frequently of a light hue. In the afternoon they are small in quantity and attended with tenesmus, and very commonly have the appearance of "matter from a sore," which has been the case for eighteen months. His urine is often saffron colored. His cough is slight and his expectoration extremely limited. Twice or thrice lately the mucus has been tinged with blood.

At this time he has a moderately furred tongue, natural in size and color. His eyes although a little turbid, are not jaundiced. His skin generally is reduced in whiteness, but that of his face is dark and sallow, nearly up to his hair. The ends or balls of his fingers are a little enlarged. His pulse is 76, quiet and regular-not hard.

Examination of the Neck and Chest.-LARYNX with a tender spot on the right side, within the thyroid cartilage. Os hyoides exceedingly moveable. A grating sound when the larynx is moved by the hand. CHEST, when examined, naked and in quiet respiration, well formed, except a little bulg. ing out of the most convex part of the false ribs, of the right side; which side, however, has the same circuit with the left both there and above. Breathing chiefly diaphragmatic. When directed to make a deep inspiration, his left shoulder ascends and the ribs rise and bulge out; but the right remains unmoved. When a cord was passed round the body, with its middle pressed upon one of the spinous processes, and the ends were brought to the sternum, a deep breath rendered the last extremity too short, but there was no recession of the right end. Under percussion no hollowness was discovered over any part of the right lung or of the sternum, either in the erect or recumbent position-the hollow sound of the left side was rather greater than common. Auscultation could detect no respiratory murmur, anywhere over the right side; but disclosed a considerable degree of broncophony with an occasional sibilant ronchus. His respiration throughout the left lung was puerile.

The position and movements of his heart were natural. Percussion, pressure and deep inspirations excited very little cough.

Examination of the Abdomen.-No enlargement of the spleen or liver; no tenderness in the region of the former, but decided soreness in the latter, extending into the epigastrium. General soreness on pressure over the abdomen, but especially across it, in a zone passing a little below the umbilicus. Soreness in both iliac regions, extending upwards and backwards, towards the hypocondriac and lumbar regions.

Slight general fulness of the abdomen-more or less painand considerable flatulence.

Examination of the Spine.-No tenderness except near the junction of the vertebra with the sternum. No tendency to cough from pressure.

For some time preferred to lie on his left side-now lies easier on his right; walks and rides about, and thinks himself much better than he was last winter.

The recurrence of ague and fever upon this patient, through such a long term of years, is not unprecedented, as such things have happened before in the alluvial valleys of the West; but the transition which occurred in the autumn of 1838, from misamatic, to pseudo-hectic fever is a phenomenon not often seen. The tertian character and the shake of the annual attack of that autumn, seem clearly to characterize it as of malarious origin; and, moreover, he had at that time no cough nor other pulmonary difficulty, as far as we could gather from him. But at length he became affected with a double tertian or quotidian, and while this was still returning upon him, pneumonitis of a mild kind set in, and soon afterwards night sweats began, and with the chill and nocturnal fever continued for twelve or fourteen months; when in January, 1840, he seems to have had a re-inforcement of the pneumonic inflammation. Thus we have before us a series of little interruption, for eighteen months, commencing as an endemic ague and fever and ending as well marked hectic, with a transition from one to the other, in the most imperceptible manner. Still further, the fever assumed a hectic character, while the pulmonary affection was yet too recent, according to common experience, to have produced it. It appears from this case, that a miasmatic fever has not the