995 made, no specimens of the bacillus could be discovered in the patient's blood two hours before death, though at the post-mortem examination large numbers were found. This is often the case-indeed, it seems that life cannot be carried on when the bacilli in considerable number are present in the blood. The bacilli cannot live without the presence of oxygen, and as soon as they are developed in the blood, they speedily deoxygenate that fluid, rendering life impossible. It is probable that the

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... spores of the bacillus circulate in the blood during the continuance of the disease, and it has been proved by experiment that they thrive without oxygen; as soon as the time comes for them to be developed into bacilli the patient dies. 2. The condition of Case 1 on the day of his death forcibly reminded me of a patient dying from cholera collapse. There was the same cold and clammy body and extremities, the same pulselessness, the same rapid breathing, and the same remarkable clearness of the mental faculties. 3. The satisfactory result which attends the early excision of malignant pustule is again exemplified. The success of this treatment has been proved at Guy's Hospital, where of fifteen cases in which excision was practised, thirteen made a good recovery. At Guy's it has been customary to apply chloride of zinc or some other strong caustic to the wound caused by the excision. Microscopic examination, however, proves that the bacillus is not found in the subcutaneous tissue, and this case shows that the application of a caustic is unnecessary. 4. As animals which die of splenic fever are in this district disposed of in the usual manner and sold for human food, it is interesting to know what is the effect of the bacillus when taken into the stomach. Koch made some experiments on sheep, with the object of elucidating the point. He found that sheep might be fed with unlimited quantities of the bacilli free from spores, and that no bad result occurred ; but if the virus contained spores in an active state of development, death invariably occurred within two days. Fortunately the meat that is eaten will all be cooked, and we may hope that the bacillus is thus destroyed, and that no harm results. But the risk that is run by the persons who have to prepare and dress the meat derived from diseased carcases is only too evident. While meat of this description is sold in the open market, we should remember that cases of charbon may come under our notice, in which it will perhaps be impossible to ascertain the mode of infection. CASE 1. Paralytic Glwrea. -This case, the first of which I have any record, occurred in 1850. It was that of a bank clerk aged eighteen years, of bilious habit and sluggish intellect. He was ill with paralytic chorea and what is now termed symptoms of incoördination and defective inhibition. His left hand had become unmanageable; he could not retain the hold of a pen, a teacup, or a book for a moment; and the loss of control extended to the left leg, which he dragged after him in walking. He was prone to involuntary laughter, and his features were seldom at rest. The senses I of sight, hearing, taste, and smell on the affected side were much impaired. After giving a trial to various local and constitutional remedies in vain, and finding that the fourth dorsal vertebra was exceptionally sensitive to percussion, I applied a small blister over the fourth and fifth vertebrae, and with the healing of the raw surface every choreic and paralytic symptom had departed. CASE 2. Facial paralysis. -About the same time a married lady, the mother of two children, consulted me for an attack of facial paralysis, accompanied with ptosis and derangement of vision in one eye, partial loss of taste, smell, and hearing on the same side, with loss of sensation in the integuments of the face and cheek on that side ; the third, fifth, and seventh cranial nerves were engaged. In her case the fourth and fifth dorsal vertebrse were painful on pressure, and these only. After fruitlessly trying a variety of remedies then in vogue, I ordered a blister to be applied over the tender vertebrse; this was done, and before the expiration of a week all the motor and sensory functions in abeyance were completely restored. CASE 3. Chorea.-In the summer of 1860 I was called to a case of well-marked chorea in an unmarried female, aged seventeen, her second attack. Her previous illness lasted for six weeks; she had then been under the care of a skilful practitioner, who prescribed cold shower-baths and drachm doses of carbonate of iron. I found her suffering from incessant jactitation of both upper and lower extremities, which seldom ceased even during sleep. Her head and tongue were in constant motion; there was no history of rheumatism or evidence of cardiac disease. Having found the fourth dorsal exceedingly sensitive to pressure, a blister was applied over it for eight hours; it rose well. I did not prescribe any other mode of treatment, and at the end of eight days the patient was restored to perfect health. CASE 4. Facial paralysis. -On June 14th, 1870, Miss P-called on me. She had contracted facial paralysis by sitting for some time at the open window of a railway carriage. Her mouth was drawn to one side, her left eye was permanently open, tears streamed unchecked from it over the cheek; common sensation and hearing were much impaired on the same side; she put out her tongue very awkwardly, and spoke with difficulty. On examining the vertebral column she shrank with a cry of pain when tapped over the fourth and fifth dorsal spines, over which a blister was applied. I saw her forty-eight hours afterwards, when she showed a marked improvement. Complete recovery resulted in the course of a few days. CASE 5. Chorea.-C. K-, a lad thirteen years of age, was brought to me on Sept. 9th, 1870. He had but recently recovered from a prolonged attack of rheumatic fever, fourteen days after which the present symptoms supervened. He had been treated, his mother informed me, for some time without any benefit as an out-patient at the General Hospital. The left arm and leg, which suffered most from the rheumatic attack, were now the most affected with choreic movements. His eyes, lips, and head were in almost perpetual motion; there was no perceptible cardiac complication. I did not prescribe any medicine, but over the fourth and fifth dorsal vertebrae, which responded as usual to pressure, I applied the ordinary counter-irritant. On the 12th he had acquired control of the left hand, could hold a cup steadily, and perform any manual office freely. On the 19th he was quite well, with the exception of nervous twitches in his face. I then applied a second blister over the same place, and when he visited me on the 26th every abnormal symptom had disappeared.-Second attack: On Jan. 23rd, 1871, the lad had a return of the disease, almost a counterpart of the first attack. I ordered a blister, as before, to the same region, but was disappointed in not discovering any improvement. On the healing of the raw surface, however, I applied dry cupping glasses over it and near it, with great relief ; a second application of the glasses completed the cure. I then took the lad into my service. Good fare and suitable occupation established his health, and he afterwards took to seafaring, and has been for some years an able bodied seaman in a coasting vessel. CASE 6. Facial paralysis.-On Feb. 2nd, 18&bgrO, a lady called with her daughter, Miss L——, aged nineteen years. The latter stated that when passing from an overheated room into the outer air, then below zero, she suddenly felt a burning sensation in her right cheek, followed by sorethroat. She was then menstruating. On reaching home it was observed that her mouth was drawn to the left side when she attempted to speak or laugh ; she was unable to corrugate her eyebrows, to wink with the right eye, or to close it, and when going to sleep had to bring down the right upper eyelid with her fingers. She could not distinguish even the largest type with that eye, and the sense of hearing on that side, and that of taste with the right half of the tongue, and of smell in her right nostril, were almost entirely obliterated. She suffered from epiphora, tears were constantly flowing over the affected cheek ; when attempting to masticate, her food remained in the right side of her mouth till relieved by the finger, and she could not clear her mouth of saliva by ordinary expectoration. Common sensation was almost absent on the affected side. Her speech was indistinct, and she could not pronounce any