but neuralgia is the cause of it, which is certainly aggravated by such depletion."

Dr. Church has met with a number of cases of disordered digestion, attended with soreness of the upper cervical vertebræ, which, he thought, had a very considerable influence over the disease, and sometimes seemed to be the principal cause of it. He relates the following very striking case :

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"A gentleman about forty-five years of age consulted me about two years ago, on account of a disordered state of the stomach, attended with a great deal of palpitation of the heart. He was greatly troubled with water-brash, tongue furred, bowels irregular, occasionally some fever. He had been troubled with the most of these sysmptoms for seven years, more particularly the palpitation and water-brash. When I first saw him the palpitation was alarming, and I had little doubt that he had an organic affection of the heart. I examined the cervical vertebræ, and found them very tender, particularly the upper ones. I concluded to adopt the plan of blistering the spine, together with alterative doses of blue pill, and a tonic of pulv. columbo. On seeing the patient two or three days after, I had the satisfaction of learning that the palpitation and water-brash had nearly disappeared immediately after the blister had drawn. His health rapidly improved from this time without interruption, exept an attack of ague and fever a short time afterwards, which was cured by quinine."

There is, he thinks, good reason to believe that sick-headache, which so often baffles every effort to cure or even to relieve it, is often an affection of the same part of the nervous system; he does not recollect an instance of habitual sick-headache, that has fallen under his observation, in which there was not soreness in the upper cervical vertebræ, and he has treated the complaint with blisters and irritants to the nape of the neck, obtaining thereby not only temporary relief but a radical cure.

We can add our testimony to the relief derived from irri

tants, particularly sinapisms over the cervical vertebræ, in this distressing affection, although we have not pursued this method of treatment with a view to a raidical cure, and cannot therefore pronounce upon its efficacy from observation. Three cases are related by Dr. Church, in illustration of the treatment recommended; the following is one of them:

"A married lady of twenty-six years of age, had been for several years severely afflicted with what she called the blind headache. It came on once in a few months, commencing with sickness of the stomach, headache and giddiness to such a degree, that she was obliged to remain in bed constantly, and every attempt to raise herself in bed induced blindness for the moment. The remedies formerly used had done but little to alleviate the complaint, and she had come to the conclusion there was no remedy for it. I accidentally saw her while confined with one of these attacks, and inquired into her symptoms, particularly whether there was any soreness in the neck. I found there was a great degree, and on particular inquiry learned of her that she was habitually subject to a slight stiffness of the neck, not however to such a degree as to excite much attention. Under these circumstances I strenuously recommended a blister to the nape of the neck, and without any other remedy the disorder abated immediately, and she was well of her complaint by the time the blister had healed. I deemed it advisable to use stimulating liniment to the neck for some time as a precaution against a return of it. This occurred two years and a half ago, and the complaint has never returned." .

Dr. Church closes his Address with the rehearsal of three cases of rheumatism in which spinal irritation or inflammation existed, and in which cups, blisters and stimulating liniments appeared to afford considerable relief; but as these are not particularly striking and less satisfactory than some others that have been published, especially those of Dr. John K. Mitchell in the American Journal of Medical Sicences for August, 1833, we forbear to quote from them.

Dr. Davis' essay on diseases of the spinal column is a much

more elaborate production than that of Dr. Church; its scope, also, is more extensive, embracing not only irritation but inflammation of the spinal cord, and curvatures of the spinal column. It is in fact a monograph of the whole subject of spinal diseases, evidently prepared with care, and is a good digest of what has been written by the most esteemed authors, interspersed with some very interesting observations of his own. In the closing chapter of his essay, on spinal irritation, the only one which our limits will permit us to notice, the author very properly cautions against ascribing too wide a range to the morbid influences of this peculiar condition of the medulla spinalis,-which, according to some writers, is the first link, the grand starting point of every disease. To enforce this caution, he relates the following instructive case:

"Not long since I was called to visit a young lady who had been scarcely able to leave her room except in a carriage for four or five years. She was considerably emaciated, with a languid countenance, tongue rather red but moist, pulse languid and feeble, bowels generally slightly costive, sometimes relaxed, with frequent severe pain after indulging in too much food, appetite moderate, much pain along the course of the spine, and especially in the lumbar region, tenderness to pressure over the spinous processes of the inferior dorsal and upper lumbar vertebræ, great excitability, as well as debility of the whole system, with frequent palpitations of the heart, and a feeling of great languor and indisposition to exertion.

"This lady had been attended at different times, by a number of medical gentlemen, some of them of high standing in their profession. Her complaint had been considered one of general debility, nervous irritation, dyspepsia, or consump

tion.

"She had used accordingly and in succession tonics, chalybeates, dieting, very slight frictions with tartar emetic ointment over the spine, mercury to salivation, &c. She had once or twice resorted to the most celebrated watering places in our country, but all with no permanent benefit, and her health on the whole continued to fail, Not being satisfied

in regard to the nature of the pain in the back, I determined on making a more thorough examination. This was attended with some difficulty owing to the extreme delicacy of the patient. At length however, an old and experienced accoucheur, was permitted to make the desired examination.And to his surprise "the os uteri was found low down in the vagina, and the fundus of the uterus thrown back toward the sacrum;" constituting a considerable degree of prolapsus uteri with partial retroversion. No cause for this displacement could be ascertained except the pernicious habit of tight lacing, and perhaps a little too free exercise in ascending a flight of stairs to take care of a sick relative, a short time previous to the commencement of her illness. And yet to any one acquainted with the extensive influence which this displacement exerts over the other organs of the system, it will afford an ample explanation of the preceding symptoms. And I scarcely need to add that the application of a proper mode of treatment, designed principally for remedying the uterine affection, has already afforded much relief."

Nevertheless Dr. Davis is well convinced that morbid irritability or irritation of the spinal cord may give rise to a great variety of distressing functional disorders in other organs, which will yield to no other treatment than counterirritation over the spine.

H. M.

Selections from American and Foreign Journals.

PH. RICORD on the special treatment of Phimosis and Paraphimosis. Translated from the French for the Western Journal of Medicine and Surgery, by BENJAMIN Dennis, M. D., Cincinnati.

OF PHIMOSIS.

PHIMOSIS is complete or incomplete, permanent or tempo

rary.

The permanent may be congenital or accidental, it may exist with excess in the length of the prepuce, with a prepuce not covering the entire gland, or with excess in the length of the frænum; it may have adherences to the gland, ancient or recent, complete or incomplete.

The temporary may be inflammatory or cedematous, complicated with erysipelas, with considerable tension, with gangrene, with inflammation of the gland, with blennorhagia, with chancres, with vegetations, with herpes, with perforation of the prepuce, with dysuria or ischuria. Before its development there might have been a slight narrowness of the prepuce, or to use a vulgar expression, the patient could only unsheath the penis with difficulty, the opening of the prepuce being very narrow.

Temporary phimosis, as its name indicates, happens in persons who, hitherto, found no difficulty in uncovering the penis, and yields without the necessity of an operation.

Permanent phimosis with excess in the length of the prepuce, or with induration of the circumference of that cutaneous envelope, demands circumcision, unless it is desired to remedy one deformity by creating another. When there are recent adhesions, easy to destroy, it is necessary to