156 we had dared to hope for. Whatever be the value of our ex-I periments on animals as regards the mode of action of these remedies, it is now certain that they have really a great power in diminishing the amount of blood in the spinal cord and its membranes. It is very well known that many French physicians, especially Bretonneau, Payan, Barbier, and Trousseau, have for many years employed with success belladonna and ergot of rye in cases of paraplegia. Of course we do not claim to have been

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... he first to make use of these remedies in paraplegia, any more than we claim priority as regards employing i , strychnine in various forms of paralysis. But we claim to have pointed out, as clearly as we could, in what cases of paraplegia strychnine or belladonna and ergot of rye are to be employed or avoided. To indicate this distinction is the principal object of these lectures. In the beginning of the treatment of chronic myelitis, we usually employ ergot of rye alone internally, and belladonna externally in a plaster applied to the spine, over the painful spot. The dose of ergot, when the powder is used, which is almost always the case, is at first two or three grains twice a day; gradually the dose is increased until it reaches five or six grains twice a day; and in a few cases we have given eight grains twice a day. We do not think it is necessary to make use of the very large doses employed by 1I. Payan. The belladonna plaster applied to the spine must be a very large one, four inches wide, and six or seven inches long. If there is no amelioration in a few weeks, we give the extract of belladonna internally in doses of a quarter of a grain twice a day. When we find that the patients, after six or eight weeks of treatment by ergot of rye and belladonna, do not get better, we give iodide of potassium in doses of five or six grains twice a day, in addition to the preceding remedies. When there is any reason to suspect that there is a degree of meningitis together with myelitis, we begin at once the treatment by the iodide of potassium with the ergot and belladonna. IL The second rule of treatment of myelitis is to prevent the formation of sloughs, or to cure them when formed, and to prevent other alterations of nutrition in the paralysed parts. 1st. Ulcerations and sloughs on the nates, the sacrum, or other parts, may be prevented or stopped in their development, if they have not acquired a great extent, by very simple means, which I have found perfectly successful in experiments upon animals. Led by the view that sloughs are chiefly due to an irritation of the vaso-motor nerves, producing alterations in the nutrition of certain parts of the skin, I have thought that alternate applications of cold and heat to the parts where there is a threatening of sloughing, by acting upon the bloodvessels, so as to produce in them considerable contractions and dilatations, might prevent the effects of the irritation of the vaso-motor nerves in the spinal cord; and the success I have obtained shows that this view is probably quite right. The means I propose is the alternate application of pounded ice in a bladder, and a warm poultice, the ice to be left ten minutes, or even less, and the poultice an hour. It is in cases of fracture of the spine, followed by myelitis, that I have employed these means; but hitherto only on animals. I hope surgeons will soon decide what is the real value of this means in man. 2nd. To prevent the alterations of nutrition (cedema, atrophy, &c.) in the paralysed limbs in myelitis, the best means are, shampooing, applications of galvanic currents, and the use of the flesh-brush. When there is no oedema, a warm foot bath every night is of service in those cases where the feet are very P.() 1 il -3rd. The morbid alterations in the kidney and bladder may be prevented or alleviated by the exhibition of liquor potassse, turpentine, copaiba, tolu balsam, &c. We need hardly say, that if nephritis or cystitis occur, it should be treated energetically. 4th. The bowels must be kept open, on account of the increase of the congestion of the spinal cord that results from constipation. The narcotics which produce constipation and congestion of the spinal cord, especially opium, should be avoided; and, in case of sleeplessness, hyoscyamus, conium, lactuca virosa, and cannabis indica, are amongst the remedies that should be resorted to. We usually prefer hyoscyamus. III. As regards other remedies, we sometimes give cod-liver oil in those cases where rheumatic pains seem to exist. As regards dietetic rules, nutritious food, and a little wine and ale (not containing strychnine), are to be prescribed. The patients should take moderate exercise in the open air. Prognosis and Treatine?2t of Paraplegia due to Ohronic .AfeHtHt&—The prognosis of this affection is nearly the same as that of chronic myelitis, with this difference, that the paralysis may be more completely cured after a meningitis than after a myelitis. I The treatment of chronic meningitis is almost the same as that of chronic myelitis, with the following exceptions :lst. Blisters ought to be the principal means employed in cases of meningitis : every fortnight a new one should be applied while the preceding one is drying up. 2ndly. Iodide of potassium, in doses of six grains twice a day, is to be preferred to ergot and belladonna in cases of chronic meningitis. If there are signs of considerable effusion, diuretics should be used in conjunction with the iodide. Prognosis and Treatment of Paraplegia due to a Congestion of the Spinal Cord and its l4Tembranes.-This affection is much less fatal, and much easier to cure completely, than myelitis or meningitis. However, when the paraplegia due to congestion is of long standing, it is almost as difficult to cure as paralysis due to meningitis. The same general rules are to be followed in the treatment of congestion as in that of inflammation of the spinal cord and its meninges. Internally, at the same time, ergot of rye, belladonna, iodide of potassium, and sometimes diuretics, should be used. Externally the cold shower-bath should be employed rather than the hot douche, or any other revulsive; and if the shower-bath cannot be borne, the alternate application of two sponges, one with very cold water, the other with hot water, should be made every morning all along the spine.