! distressing sensations about the groin or bladder. He is in all respects well and comfortable.-May 25th, 1821. Ninth Case. Miss N. O. aged fourteen years last March, of a florid complexion and delicate habit, has for the last six years been afflicted with a lateral curve, which has been gradually increasing. The vertebræ can be distinctly felt passing under the right shoulder-blade, which stands a good deal above its fellow. She can strike the two scapula together with considerable force. Lower down, the vertebræ are irregular in height, in their direction, and in their distances from each other. All the Jumbar and lowest dorsal bones are too protuberant, and are considerably arched. The ribs on the right side are depressed. On the left, the back is unusually hollow. Forwards the chest is peaked. In front, the ribs are too much risen; those of the right side are sunk downwards. Owing to this disposition of the breast, the left mamma is much fuller than the other. The right shoulder-top is visibly higher than the opposite one; and the foot on that side requires a thicker-soled shoe to make her limbs of equal length. Menses and bowels are regular; her health is good. The back measures twenty-one inches.-An elder sister, affected with the same kind of deformity, having lately died of pulmonary consumption, and, as her family be lieve, in consequence of it, their solicitude is increased to get her delicate form restored, to preserve her from a similar fate. Nov. 10, 1820. The vertebræ are more regular in their height and direction. The lumbar bones are still raised, but the arch has wholly disappeared. The hollowness is become equal on both sides. The chest in front is quite open. The ribs are more forward on the left than towards the right. Mammæ are nearly alike; and there is little difference in the shoulder-tops. The back has sensibly increased, being now twenty-two inches long. Her health is in all respects very good.-Dec. 14. The vertebræ are quite regular; the lumbar bones have sunk into their natural places. On the right side the ribs are still too high, and the opposite spine is a little crooked.-Feb. 25. The ribs are nearly equal on both sides, and the spine is scarcely bent. She is in the best possible health.-April 10 The natural form of the spine and chest has been sometime restored. She is in a very good state of health, and in excellent spirits. Her constitution being peculiarly delicate, she is advised to continue the horizontal position for some time longer. May 24, 1821. No. 269. Tenth Case. Miss P. Q. a tall, well-formed, delicate lady of fifteen, complains of being soon fatigued with walking or dancing, in both of which recreations she used to take great delight, and to persevere in them with much pleasure for several successive hours. She is subject to hysterics from exercise, to frequent attacks of numbness, coldness, and spasmodic twitchings in her arms and legs. These symptoms having come on within the last three months, I was consulted this forenoon, under an idea that they originated in the spine. Ön examination, I found a large swelling of the right shoulder, and another in her left loin, with marked curves in the upper dorsal and lumbar vertebræ. There were corresponding depressions in the left side and right loin. Menses have lately been frequent and profuse.-Jan. 6, 1821. The health is in all respects good, and the deformity is entirely removed. She indulges in music, and enters with moderation into the various recreations of this gay capital.-Feb. 21. Eleventh Case. Master Burton, aged fifteen months, of a sanguine temperament, and scrofulous constitution, is of a small size for his age. He is backward in walking and talking. When the mother carries him, which is almost constantly, he reclines on her left arm and bosom, with his right side lying against her person. In this posture, his right arm being fixed, he necessarily employs his left hand on all occasions. On examination, I found his back-bone between the shoulders bent towards the left, and in the loins towards the right. His right side is forced inwards, by the weight of his body placed over it. His left bosom stands very protuberant, showing a marked difference between the two sides of the chest.-Jan. 2, 1821. I have been insensibly led, by a concurrence of accidental circumstances, to entertain some peculiar opinions on the subject of spinal distortions and their distressing consequences. These I propose to lay before the public, in a series of Essays, as my leisure and opportunities will permit, till I shall have fully explained my ideas of the causes and treatment of the disease. After having practised as a physician, and treated spinal complaints upwards of thirty years, according to the usual routine, I was consulted for a married lady, who roused my attention and interested my feelings in an extraordinary manner. She had already submitted to issues and the recumbent posture for more than twelve months, under the care of eminent metropolitan practitioners. As she had derived no benefit, I resolved upon the substitution of other expedients. A period of three months having been unavoidably suffered to elapse before any steady course could be adopted, I employed the time in a careful examination of the prevailing doctrines, and was brought to entertain doubts of their consistency and truth. Under this uncertainty, I suggested a trial of frictions and pressure to the curved vertebra, and had the satisfaction. ultimately to force them back again into their natural stations. In the following summer, I was of equal service to four other invalids. The succeeding spring afforded opportunities to prosecute my plan with several fresh cases. Hitherto, agreeably to professional etiquette, I had merely directed and superintended the new method, leaving its execution to the domestic attendants. I began at length to suspect that, from their total ignorance of anatomical knowledge, the progress was greatly impeded, and often unnecessarily interrupted. Impressed with this idea, I deemed it my duty, in order to ascertain the truth, to become an operator myself: the consequent success having fully justified the suspicions entertained, and satisfied my most sanguine anticipations in the more speedy and complete recovery of my patients, I have ever since continued to take, an active part in the treatment. In compliance with the sage maxim of the learned Celsus, that physicians are to cure cito, tuto, et jucunde, and fortified also with the most ample licence and authority contained in my doctor's diploma, obtained at the University of Edinburgh, I shall not hesitate in future to interpose my own personal exertions, so long as I am encouraged to believe they conduce towards the more speedy recovery of my patients; leaving it to the learned professors and senatus academicus of my Alma Mater to defend their own regulations, should they be assailed from any quarter. Whatever may be the result, I am fully convinced that ere long I shall be entitled, through this very mode, to the gratitude of my brethren for having introduced them to a new branch of practice, in the enjoyment of which they will have the unspeakable satisfaction of removing personal deformity, restoring the use of crippled Jimbs, and preventing the ravages of many fatal complaints which have hitherto baffled the most skilful and experienced. The presence of spinal maladies may be discovered, in most instances, by merely looking at the countenance, which appears anxious, distressed, aged, and care-worn. Several of these symptoms were observed in the face of Mary Rafter, and they grew fainter as the distortion abated. Professor RUST has detailed thirteen of these cases, where the atlas and second vertebra were carious. They are strikingly illustrated in an accompanying print. In it the features are made to exhibit the most lively agony and distress. Cephala is a common attendant. The pains may be internal or external, and are by no means confined to any particular spot; they invade sometimes one part of the head, sometimes another; the violence may continue many hours without intermission, or go off entirely in a few minutes. The invasion and abatement are equally sudden. These pains, like those of the tic douloureux, are distinguished from most others, by their leaving the patient cheerful and easy. During the intervals he expresses no apprehension or alarm about their return, and seldom mentions them. We shall have no difficulty in understanding the cause of this species of cephaloa, or of the distortion of countenance, when we consider the intimate association which takes place in the neck between the great sympathetic, the par vagum, recurrent nerves, spinal accessary, glosso pharyngæus and laryngæus, the portio dura of the seventh, the last of the cerebral, first and second spinal, nerves, &c. Some of these nerves are connected with branches distributed upon the different parts of the head, and form a medium of intercourse between them and the great sympathetic. These are chiefly the pes anserinus and other ramifications of the fifth pair, the portio dura of the seventh, and upper cervical nerves. Hence we can easily understand how a distorted state of the vertebral pillar produces cephalœa, and is displayed in the countenance. Deafness is another attendant upon spinal maladies, as I shall have occasion to notice in the series of cases which it is my intention to lay before the faculty. The explanation of this symptom will readily occur to the anatomical reader, when he reflects upon the communication which subsists between the great sympathetic and auditory nerve, the portio mollis of the seventh pair, through the portio dura of the same trunk. -7, Holles-street, Cavendish-square; May 1821. Dr. CHARLES H. PARRY, in Reply to Dr. WILSON PHILIP. To the Editor of the London Medical and Physical Journal. NIR,-I have this day, for the first time, seen a letter addressed to you, and inserted in your Journal so long ago as March 1820, in which Dr. Wilson Philip replies to Mr. Brodie, Dr. C. H. Parry, and others. My entire ignorance of the publication of such a reply, must be my apology for not having before noticed it. I am still ignorant what Mr. Brodie and others have done on this occasion; but, if the entire defence exhibits as weak an array of arguments as that portion of it which is devoted to my observations, they may, perhaps, have passed it over in silence. Thus far, indeed, my silence might also have been justified; but, as Dr. Wilson Philip imputes to me two errors, of which one is of an intellectual, and the other may be of a moral nature, I cannot feel satisfied without advancing the general plea-Not Guilty, as well to the charge of misapprehension as to that of misquotation. To meet these accusations, it is necessary for me to analyse very minutely the whole of Dr. Wilson Philip's defence. Of the zeal and merits of this gentleman in the cause of science, every one is sufficiently convinced; but, if Dr. Wilson Philip is in error, and will not admit it, a close examination of the subject becomes necessary, exactly in proportion as his deserved celebrity may have a tendency to mislead others. There is no real charity to the world in the respect and deference which Dr. Wilson Philip appears to claim for science, under the circumstances in which he is placed. Dr. Wilson Philip begins by saying, "It is with reluctance that I notice his answer, [Dr. C. H. P. in the Additional Experiments,] because I am wholly at a loss to account for his, I may almost say, uniform misconception of my meaning. In the 160th page he begins his answer, by observing, Dr. Wilson Philip, taking up the opinion of Bichât and others, has, indeed, attempted a direct proof from experiment in favour of the exclusive influence of the capillaries in carrying on the circulation.' If (continues Dr. Wilson Philip,) Dr. C. H. Parry can point out any passage in my treatise in which such an opinion is expressed, I shall be more surprised than he can possibly be that any one should maintain a position so extravagant." This is, perhaps, one of the least successful attempts at the right conception of an author's meaning that ever appeared in support of the charge of almost uniform misconception, It shows to what extent, by a skilful separation from the whole context, an independent sentence may be made to convey any meaning which is suitable to a commentator's purpose. Will it be believed, that Dr. Wilson Philip endeavours to convey to your readers the idea that the author of the Additional Experiments charges him, Bichât, and others, with supposing the rest of the sanguiferous system wholly inactive towards the purposes of circulation? The veriest tyro would scarcely believe that such an assertion could have been made; and yet, if this is not Dr. Wilson Philip's belief, the intended and involved object of this quotation, his remark has no meaning at all. The alternative will, of course, not be admitted by those who know what are the opinions of Bichât, Dr. Wilson Philip, and others, in regard to the capillary circulation. Dr. Wilson Philip is, then, honestly and fairly of opinion. that, by "the exclusive influence of the capillaries" in all its |