CASE 2. -In May, 1880, I saw with Dr. Julius of Hastings an unmaried lady, aged thirty-one. Her history was that she had been in fairly good health until five years ago, when, during her mother's illness, she overtaxed her strength in nursing, since which time she had been a constant invalid, suffering from backache, bearing-down, inability to walk, disordered menstruation, and the usual train of uterine symptoms. She used to get a little better on going to the seaside, but soon became ill

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... , and in October, 1879, she was completely laid up. The least standing or walking brought on severe pain in her back and side, and she gave up the attempt, and had since remained entirely confined to her bed or sofa, suffering from constant nausea, complete loss of appetite, and depending on chloral and morphia for relief. Many efforts had been made to break her of this habit, but in vain. Her medical attendant had recognised the existence of a retroflexion, but no pessary remained in situ for more than a day or so, and he suspected that she herself pulled them out. I was unable to do more than confirm the diagnosis that had been made as to her local condition, but the pessary I introduced shared the fate of its predecessors, and she remained in the same condition-in no way benefited by my visit. Things going on from bad to worse, Dr. Julius sent her to London for treatment-in the early part of December. I now determined tc try the effect of the method I am discussing, of which I knew nothing when I first saw her. It was commenced on Dec. llth, and everything went on most favourably. A week after it was begun, when her attention was fully occupied with the diet, massage, &c., I introduced a sten pessary, being tempted to try this instrument, which rarely use, by the knowledge that she was at perfect rest. and that no form of Hodge had previously been retained. I do not think she ever knew she had it, and it remainec in situ for a month, when I removed it and inserted a Hodge. which was thenceforth kept in without any trouble. I ma say that I do not think the retroilexion had much to do witl her symptoms, except, doubtless, at the commencement o her illness, and she probably would have done quite as wel without any local treatment. She rapidly gained flesh an( strength, and very soon I entirely stopped both chloral an( morphia, and she never seemed to miss them. On Dec. llth when the treatment was commenced, she weighed 5 st. 9 lb On Jan. 20th she weighed 7 st. On Jan. 25th she walke( downstairs, and went out for a drive, and from that time sh went out twice daily. She complained of no pain of an; kind, and, although she wore a Hode, she did not seem t have any uterine symptoms. On Feb. 1st she went to th seaside, looking rosy, fat, and healthy, and has sine returned to her home in the country, where she remain perfectly strong and well. A few days ago she came t town, a long railway journey, on purpose to announce to m her approaching marriage. CASE 3.-illy third case differed in many respects from th first two, since the patient was not in the state of extrem nervous prostration from which the others suffered. Sh was not, like them, excessively emaciated, and she was abl to consume a fair amount of nourishment. It was, indeec a case of pure hysteria of an aggravated form, and its CUI was, I believe, chiefly due to isolation, and to moral pressm brought to bear on the patient. I commenced its treatmer with considerable hesitation, and relate it chiefly with th view of showing how much such cases are influenced by morbid craving for sympathy, and benefited when this not within their reach. Mrs. -, aged twenty-six, was sent to me from one our colonies with the following history. She had had b2 labours, followed by bearing-down, backache, and oth, uterine symptoms, and had been subjected by various medical men to much local treatment, including the use of pessaries, constant cauterisation, and the like, most of which had, I believe, a very prejudicial effect on her. I may say that I was unable to detect any uterine disease requiring topical treatment, although such may no uht 1 ave previouslyexisted. I extract from the full report sent to me hy her last medical attendant the following curious account of the nervous phenomena she exhibited. "Her lower limbs are partially paralysed, or, at all events, not under the propercontrol of her will. She is able to walk a short distance with a very uncertain gait, but the knees, after a few paces, suddenly give way, alJd she falls to the ground. When sitting quietly her hands are frequently affected with slight spasms, and her lips and eyelids are subject to occasional nervous twitches. Each menstrual period is preceded by violent hysterical attacks. In these seizures the body is violently convulsed, and the exhaustion which has followed has been so marked that I have occasionally failed to detect the puise. These attacks are also brought on at other than the menstrual periods by any slight unusual exertion." When the patient presented herself in my consulting-room, although supported by her husband, she fell down (,n the floor six times, in the manner above described, in walking the length ot the room, and this was the only way, I was informed, that she had been able to walk for some two years. She was very pale and anaemic, but fairly well nourished. I soon satisfied myself of the hysterical character of these symptoms, but had great dfticulty in inducing the patient to submit to my proposed treatment, especially as to separation from her husband, who had got into the way of constantly nursing and tending her, with a result most injurious to her health. Within twenty-four hours of the treatment being commenced she had a violent outburst of hysterical excitement, which, bowever, soon subsided on my proposing to dismiss the nurse and give up charge of the case. For ten days everything went on well, food was taken freely, and there was a perceptible increase in size and weight. When, however, faradisation was commenced, it led to a second paroxysm I of excitement, the patient writing piteous letters to her husband declaring that she was going mad, and that the agony produced by the electricity was perfectly unbearable. , Under my advice he had the good sense to write and tell , her that I was perfectly prepared to stop the treatment the instant she expressed a desire that it should be so, but that, as it had been b;.gun, he would not take on himself , the responsibility of doing so, and that the decision must be made by her. I then informed the patient that as the object of the electricity was to give strength to her weakened , limbs, the moment I was satisfied, by her walking downrstairs without falling, that the desired result had been gained, it would, as a matter of course, be stopped. This f lady was lodging rather more than a mile from my house, 1 and, to my very great surprise, the next morning after the 1 scene I have narrated, she was shown into my consulting-1 room, having of her own free will got up and dressed, , sent for her husband, and walked without assistance the . whole way without once falling. She has since left town 1 apparently quite cured, and I beard from her a few days e ago that she was about to start for a prolonged continental tour. o It will be obvious that in this case the massage, diet, and e electricity had only a secondary effect as part of a whole that e was intensely disagreeable to the patient. Clearly the main s factor was the removal of injudicious sympathy, but the o case seems to me worthy of record as showing the extreme e value of a determined effort to break through habits of a morbid character, and the importance of trying to make a e weakened will exert itself. e CASE 4.—This case is a typical instance of the kind of e nerve debility and exhaustion that may be associated with e old-standing uterine disease. It was placed under my care L, by Dr. George Kidd of Dublin, whose account of the case I e prefer giving to my own, having his permission to do so. e She had long been under his care and that of Dr. McClintock, and the fact that she had been treated by obstetricians so e eminent is of itself sufficient proof that all had been done a for her that the most advanced science could suggest. I may is premise that the patient was asinglelady forty-five years of age, that she had never been strong, but had not been completely laid up until 1872, since which time she had been confined to .d herbedorcouch. Dr.Kiddwrote to me as follows:—"Miss—— r has been a complete invalid for many years. r She suffers