The examination of the rest of the body developed nothing abnormal. April 12th.-Find patient worse; cannot stand with assistance; pain in the head; took cold; pain in breast; cough; too weak to expectorate; can't see so well; reads only for a few minutes, then all is a mist; pupils natural; pain in back. Speech somewhat impaired; when in bed cannot move; if legs are crossed cannot get them back. Good use of his hands; appetite very good; bowels costive; has to take purgative medicine continually. Gave him volatile liniment for chest; cups to back, only taking a drachm or two of blood; quinine, fer. sulph., nux vom., and rhoei. pills three times a day. R.-Quin. Sulph., grs., xv.; Ferri. Sulph., grs., xxx.; Nux Vom., grs., X.; Pulv. Rhoi., 3i. Mis. ft. pill, xxx. April 16th. Find patient better of chest troubles, the rest being the same. Sight somewhat improved. Prohibit reading; allow him to eat whatever agrees, but not too much. Continue pills and liniment. April 21st.-Find patient better; sight entirely restored; can read well, and as long as he likes without inconvenience; no longer necessary to give purgative medicine, except what was contained in the pills. Paralysis very much the same. Continue pills and liniment. May 6th.-Patient the same. Continue pills. May 16th.-Find patient much the same; suffering with some subsultus tendinum of neck and face; attributable to nux vom. in pills; discontinued pills until they had subsided, and ordered them to be stopped at any time it reöccurred, and wait a day or two before commencing them again. Was not to see him again until sent for. May 24th.-Called to see another member of his family. Found boy much better; could begin to use his lower limbs; put them on a chair, and sat on another, the gastrocnemii mus cles appearing to show the first signs of repair giving him a temporary talipes equinus. Continue pills. May 25th.-Boy much the same. May 27th.-Find him improving. June 1st.-Found him much better; could take a few steps with assistance. But now another trouble. As his lower limbs improved his upper limbs were growing worse; he cannot now hold to anything; has to be fed. Gave a stimulating liniment for his arms, and continued pills. June 4th. Find his lower limbs still improving; can walk tolerably well with assistance. Upper limbs still growing worse; seems to be entirely powerless, especially at the wrists. Continue liniment and pills. June 8th.-Find him about the same, except his appetite is not quite so good, and feels very weak when he gets up in the morning; weakness passes off about 10 o'clock. Ordered milk punch to be taken about an hour before rising. Continued pills and liniment. June 11th.-Find him much better; all weakness has passed off; arms somewhat better; can hold on to things tolerably well. For example, can hold to the railing and walk around the porch. Continue pills, liniment, and punch. June 19th.-Find him still improving; use electricity, with same treatment as before. June 24th.-Find him still improving; can walk across the room by himself, and use his arms comparatively well. Continue the same treatment, except electricity, which would not work. July 5th.—Find him much better; improving in his walking; arms slightly improved. Apply electricity and continue same treatment. The bladder in this case was so slightly affected as not to be worthy of notice. He has continued to take his pills, gradually decreasing the amount until September. At that time he appeared quite as well as he ever had been in his life, and has continued in good health ever since; increasing in weight from 90 pounds when I first saw him to 120 pounds on June 1st, 1871. The case of which I have given a synopsis is one of great interest, and instead of two or three pages, it affords material for many, in showing how an injury of the kind could take so long a time as three or four years to produce its effects, and in what way it could cause paralysis. But as I have not time to give more, I will simply state that in my opinion it could not arise from any other cause than the one given. Since the injury there had been a gradual loss of nervous power hardly perceptible, until at last Nature could no longer maintain her own, and disease necessarily triumphed. The treatment I adopted may seem to be a very simple one; much more so than might have been used, but I think it suited all the symptoms in the case, and would suit all similar cases of paralysis resulting from the same causes. ART. III.-FOREIGN BODY IN THE TRACHEA NOT PRODUCING THE USUAL SYMPTOMS. By J. UNDERWOOD HALL, M. D., Gold Hill, Nevada. On Wednesday, July 9, 1871, at 11 o'clock A. M., I was summoned to the residence of Mr. George W. D, a few rods distant from my office, whose daughter, aged four and one-half years, represented that she had just swallowed a bean, and judging from her livid countenance, embarrassed breathing, and impending suffocation, I was induced to believe that her assertion was correct. I at once introduced my index finger into the pharynx and fauces, which produced moderate retching, at the same time apparently relieving the obstruction and spasm of the glottis. I gave her some water, which she drank without difficulty, and expressed herself entirely relieved. I questioned her as to where she got the bean, she said “that she would show me," and went out a few paces in front of the house, and B Drs. C pointing to a spot where a number of oblong white beans had been spilled on the ground. At that time, from her apparent relief, I was induced to believe that the bean had not passed into the trachea, but had been lodged externally to the rima glottidis, and that by thrusting my finger into the pharynx I had dislodged it, and that she had swallowed it into the stomach. I left the patient under that conviction, but on the following day, (she having experienced no inconvinence in the meantime from the extraneous body, no cough nor dyspnoea), 28 or 29 hours after the accident there was a message left at my office to visit in haste the little girl, "that she was taken just as she was the day before." I was absent, returned in an hour, and immediately responded to the summons. On my arrival at the house I found in attendance, who had been summoned Dr. C arriving first, had diagnosed the case as laryngismus stridulus, and accordingly gave her 20 grs. pul. ipecac, prescribed brandy internally, and ordered mustard bath; no emesis from the ipecacuanha. The dyspnoea and impending suffocation very great. Dr. B arrived, concurred in the diagnosis, and suggested one scruple sulphate zine, which was given; producing no emesis. At this juncture I arrived, and received from the physicians in charge an account of the treatment the patient had received, and their diagnosis of the case. Up to that time she apparently had received no benefit from the treatment which she had been subjected to, the prostration and impending suffocation becoming greater with every respiration. In consultation with Drs. C and BI stated to them that I must disagree with them as to their diagnosis, being convinced that the symptoms were not croupal, but that they were produced by a foreign body in the wind-pipe. But they contended that no extraneous body could remain in the air passages 28 or 29 hours without producing symptoms to indicate its presence, she having rested, ate, drank, and slept as usual, until a few minutes before the second siezure of suffocation. I insisted that she must die from suffocation very soon if not relieved by an operation, and urged the neces sity of resorting to tracheotomy as the only probable method of relieving her. Her counsel insisted on administring one more scruple of zinc, and if that did not produce vomiting, and relieve the spasm of the glottis, that they would then consent to the operation. The zinc was given, waiting some twenty minutes for its operation, during which time a spasm intervened, from which she never rallied. I was so very sanguine that my diagnosis was correct, that I desired to verify it by an autopsy, to vindicate myself in the former conducting of the case, and insisted on making a post mortem examination, which was granted. Dr. B and myself proceeded to open the windpipe, and found the bean lodged transversely in the trachea at its bifurcation. The bean was greatly swollen, and doubtless had failed to produce much obstruction until the swelling occurred, remaining dormant from the time that I dislodged it from the glottis. My object in submitting this article is to show the length of time an extraneous body may remain in the air passages without producing such aggravated symptoms as to indicate its presence in the air passages, and from its entire passiveness, to lead two physicians, eminently qualified to diagnose, to make an incorrect diagnosis. ART. IV.-A MAN RUNS SIXTY YARDS AND LIVES ONE HOUR AFTER BEING SHOT THROUGH BOTH LUNGS AND THE RIGHT AURICLE OF THE HEART. By J. B. ROBERTS, M. D., Sandersville, Ga. On Saturday morning, about 9 o'clock, September 9, 1871, Dr. W. W. Carr shot his son-in-law, Mr. S. D. Grantland, with a Spencer rifle (seven-shooter), carrying a ball of one and a quarter ounces in weight. The coroner's inquest justified Dr. Carr in the killing, and the body of the deceased was carried to Milledgeville, Ga., (about twenty miles from Dr. Carr's, where Mr. Grantland was killed), and buried the next day. The father and relatives of the deceased became very much dissatisfied, |