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treatment, are philosophically resorted to. Having been in the
first instance exclusively instrumental in removing the treatment
of deformities, as a rule, from the hands of instrument makers
to those of the members of the medical profession at large, and
that with great advantage to the public, it will not be imagined,
by restricting the performance of surgical operations to fewer
cases than it has of late years been applied to, that I propose
again to delegate the treatment of deformities to the instrument
maker. On the contrary, I am more and more fully persuaded
that the proper contrivance, selection, and even the application
of a mechanical instrument can only be judiciously effected by
the medical man, who is properly versed in anatomy and pa-
thology, or at least under Ids immediate supervision.
In early life, from certain but not very clearly defined forms
of disease, involving parts of the cerebro-spinal system, one set
of muscles in a member may lose the power of contracting, and
become relaxed, or even paralyzed, whilst the antagonist muscles
more or less speedily manifest a disposition to contract; or else
that the muscles on both sides of a member, (flexors and exten-
sors,) without any distinct paralysis in this case, lose something
of their power of acting under the will. A state still more often
occurs of half paralysis and half spasm, to which the late Dr.
Marshall Hall, first, I believe, applied the term " spasmo-paraly-
sis," the consequence of which is, that the stronger set of mus-
cles, commonly the flexors, acquires a preponderance, contract-
ing the limb in the direction of their action, and that more usu-
ally occurring in the leg.
To such causes, partial paralysis and spasmo-paralysis —
the majority of the contractions of infancy and childhood — owe
their origin. If the tendency to contraction be borne in mind
by the medical attendant, its prevention may be effected. If the
contraction be discovered when nascent, its further progress may
be interrupted by suitable treatment, viz., attention to nutrition,
and the general health, especially to the condition of the alimen-
tary and nervous system. This is aided by local remedies, such
as adequate covering of the part, in order to maintain, if possi-
ble, a proper temperature — (I say, this must be done') — also,