Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

Spinal Exhaustion. — I refer now to a form of paraplegia which comes on so insidiously that the sad victim of it, although young, or more likely along the very prime of life, is almost lost hefore he is aware that his health is seriously endangered. This disease is unaccompanied with pain, and it generally occurs in those gentlemen whose attention is so drawn from themselves, by active business or mental exertion, that they often pay no attention to the earlier symptoms — do not want to heed them, but rather strive to regard them as trivial and unimportant. Other cases of partial paraplegia, we know, are mostly inflammatory in their origin. The cases to which I now call attention arc, I believe, anaemic from the first; they are, in fact and effect, cases of spinal exhaustion. You sec the im- portance, then, of a correct diagnosis here, and as frank and open declaration of it to the patient. The history of the person will assist you, if you start the right train of inquiry. Dr. Latham says, " Prior to diseases, to their diagnosis, their history, and their treatment, — prior to them, and back beyond them,— there lies a large field for med- ical observation. It is not enough to begin with the beginning of the symptoms. There arc tilings and conditions earlier than the beginning of the malady, which deserve to be known. The /mints, the necessities, the misfortunes, the very vices of men in society, contain materials for the inquiry, and for the systematic study of physicians, fuller, far fuller, of promise for the good of mankind than even pathology itself." The kind of inquiry here referred to and commended by Dr. Latham is, I believe, a part of, and an essential element of, true scientific pathology. With reference especially to diseases of the nervous system, its para- mount importance is not — cannot be — too deeply impressed. This class of nervous difficulty commences with slight numb- ness in one or both of the lower extremities. This is followed by some loss of power. There is no pain in the spinal region at all. When you examine the spine, you may thump or press upon the processes and about them, from the neck to the coccyx, without producing pain. Still in some cases there is marked tenderness over the cauda equina, below the second lumbar