A REPORT PREPARED FOR THE CHICAGO MEDICAL SOCIETY, AT ITS REGULAR MEETING, DEC. 15, 1873. BY N. S. DAVIS, M.D. A LTHOUGH not a member of this Society, the late Dr. Milton Parker had been a practitioner in this city during the last seventeen years, and was so well known to most of us, that I have thought a brief history of the disease which terminated his life would not be without interest and value. the respect and esteem of a large circle of friends. About three years since he began to complain of a feeling of uneasiness and pressure, accompanied at times by sudden sharp pains in the region of the lower cervical and four upper dorsal vertebræ. There was also tenderness on pressure over the third, fourth and fifth dorsal vertebræ. These symptoms were very variable in the degree of their severity, but seldom were sufficient to interrupt his attention to professional business. After a few months, he found a considerable space over the anterior surface of his chest entirely anesthetic, or devoid of ordinary sensibility. Then followed, in succession, a great variety of morbid sensations Dr. Parker was born in 1810, in the State of New Hampshire, and died Dec. 7, 1873, at the age of sixty-three years. His education, both preliminary and medical, was obtained chiefly in Cambridge and Hanover. During the first few years after he entered the profession, he practiced with his father, who was a physician, residing in Acworth, New Hampshire. Desiring the advantages of a milder climate, however, he removed to Virginia in 1845, and continued the practice of sometimes like the trick his profession in that State until 1856. In the last-named year he became a resident of this city, and soon aca fair practice, and also won quired along the spine and in the lower ex tremeties. These sensati, as Suces water, sometimes a ri of the ་་ intere are dividual muscular fibres, more especially in the legs. These symptoms, with the frequent sharp neuralgic pains in the dorsal part of the spine, and sometimes in the legs and feet, were sufficient to cause a great amount of discomfort and loss of sleep, but were not accompanied by any general derangement of digestion, nutrition, and secretion, until within a few weeks before his death. But the steadiness and co-ordination of muscular action in the lower extremities began to fail visibly in the early part of the present year; and such failure steadily increased until, six months since, his gait became so unsteady that it greatly limited his attention to business. The sharp, twinging pains through the back, shoulders, and region of the pectoral muscles, also increased much in frequency and severity. During the slow progress of his suffering, he received, from time to time, the counsel and advice of several of his medical friends, and submitted to a variety of treatment. He used early and efficient counter-irritation over the affected portion of the spine, and, subsequently, anodyne plasters and liniments. He used, internally, both iodine and mercurial alteratives, the bromides, chloral, ergot, and various tonics, but with very little apparent control over the progress of the disease. About four or five weeks before the fatal result he rather suddenly lost all power of motion in his lower extremities, and, at ps RULES time, suffered a great inhe pains and muscular between the scapular and hest. To relieve the insuffering, he called for, from of his medical friends, daily, a subcutaneous injection of morphia, which afforded much temporary relief. But the paralysis. rapidly extended upward until it included the rectum, bladder, and whole lower half of the body. His appetite and digestion failed; hiccough became troublesome; the extremities cool; the pulse feeble; the mucous. membrane of the mouth and fauces tender; the mind incoherent; and at last he sank into a pulseless and lethargic condition, which ended in death on the morning of the third day. Although no post-mortem examination was made, there can be no reasonable doubt but that his disease was a slow organic or structural change in the upper half of the dorsal portion of the spinal cord. Concerning the exact nature of the morbid change in the cord, all might not agree. It differed from cases of ordinary spinal atrophy or progressive locomotor ataxy in these particulars : The pains and local tenderness were both much more severe and persistent; the impairment of muscular motion and co-ordination did not become manifest until a much later period in the progress of the disease than usual; and, in the end, paraplegia came on much more sudden and complete. My professional familiarity with the case was limited to the last six months of the patient's life, and I regarded it as one of true sclerosis; in other words, an inflammatory thickening or hypertrophy of the connective tissue, so interfering with the sensibility and nutrition of the true nerve-matter as to cause both irritation and atrophy, thus accounting for both the unusual pains and progressive failure of sensibility and motion. INVIRMINATION, ASSOCIATED WITH MEASLES. BUBONOCELE. CLINICAL NOTES, BY F. K. BAILEY, M.D., KNOXVILLE, TENN. F., 4 powders. Sig., one every three hours, followed with castor oil on taking the last. April 6th, 10 A. M. Was called, and learned that nine large round worms had been voided since Thurs day. Found the child much depressed; pulse soft, feeble, and about 120; face purplish; and inclined to sleep. Was told that her mother had, during the morning, given her a dessert spoonful of "vermifuge," which I found to be composed, principally, of wormseed oil. Has voided one since daylight. Gave milk-punch, and half grain doses of quinia every hour. 12 M. - Has aroused so as to talk; countenance now natural; now natural; tongue clearing off; occasional reddish spots upon the face; no cough; and has no pain. worm April 7th, 9 A. M.-Eruption of measles upon the face and forehead, but slight upon the body. Bowels moved twice during the night; one worm voided. Is wakeful; slept but little during the past night. To have warm drinks and to be kept from a current of air. April 11th.-Has been free from fever since last report; some cough, which was allayed by taking a simple expectorant of syr. ipecac and sang. canadensis. Bowels open. April 12th-Discharged. In this case the measles were very light; and were she not affected at the same time with worms, no disturbance would have resulted. As it was, the child nearly succumbed to the reflex condition induced by their pres ence. CASE II.-W., aged fifteen; pure African; came to my office, and showed a large swelling in the left groin. There is a warty excrescence upon the penis, posteriorly, and near the frænum, which is reddened and appears inflamed. No other lesion of structure. Touched the wart with strong solution of carbolic acid, and directed him to return. April 7th.-A small, soft chancrous abrasion upon the glans can be seen. This I touched with carbolic acid and I prescribed tinct. iosapplied to the inguinal swa aces April 26th.-This bo of the occasionally for a few da sore upon the glans healed readily. The inguinal swelling subsided slowly, without opening. Of the specific character of the affection above described, I am not sure. The boy admitted having connection with a girl, as likewise did two or three others, who had simple gonorrhoea, at the same time. It is not at all uncommon to meet with negro boys, of a more tender age than this fellow, laboring under syphilis and gonorrhoea. In ante bellum days, we read of a social status among the slaves which shocked our sensibilities. If such a condition obtained then, which was worse than what we know to be true now, if the admission of patients is relied on, the slave condition was truly deplorable. Emancipation certainly has not proved a reformation. I would not tempt incredulity on the part of the readers of THE EXAMINER in the relation of what is well known to be true; and the same is true, also, of a certain class of whites in our midst. In illustration of the latter remark, I will relate the following case: In March, 1871, a woman brought to me her little boy, three years old, who, as she said, another doctor had told her had "a bad disorder." I found phymois, and upon the left side of the glans, bulging out through the preputianal integuments, a hard swelling. This had been touched with some kind of caustic by my predecessor in the case, which caused inflammation, and the phymotic condition as above stated. I merely advised some soothing application for the present, and soon lost sight of the case. I learned subsequently that some one had him in charge who treated the affection as syphilis. A glance at the social surroundings of the family would suffice to render a diagnosis certain. I once met with the case of a white girl, not over nine years old, who had to exhibit as profuse a crop of condylomata upon the genitals, and extending well over the whole perinial region, as was ever seen in one of riper years. There appeared to be both gonorrhoea and syphilis in this DISLOCATION OF THE HUMERUS. CLINICAL LECTURE, SURGICAL WARDS COOK COUFTY HOSPITAL. SERVICE PROF. EDWIN POWELL, DEC. 5, 1873. Reported by D. A. K. Steele, M.D., Home Surgeon. ENTLEMEN: This patient, J. R, Jared red thirty-two, native of Ireinto the hospital Dec. 3d; wo days previous to his adas pitched out of a saloon, 'is hands and right shoul der; has had some pain in the hand and arm since; says fingers feel numb; cannot move the injured arm freely. Now let us proceed to examine him, and see if our diagnosis corresponds with that on the House-Sur |